Pelvic abscess complicating transvaginal oocyte retrieval: A case report from a public in vitro fertilization centre in Southern Nigeria

Pelvic abscess complicating transvaginal oocyte retrieval for in vitro fertilization is uncommon. Difficulties and/or delays in diagnosis,  attributable to the rarity of the pathology, are associated with  complications that lead to severe maternal and perinatality morbidity and mortality. In this report, we present a 37 year old nulliparous woman who underwent in vitro fertilization and embryo transfer for infertility treatment. She presented with non-specific symptoms of pelvic pain nine weeks after transvaginal oocyte retrieval for in vitro fertilization and embryo transfer. Despite antibiotic therapy, she developed acute abdomen that resulted in pregnancy loss and necessitated two laparotomies to save her life.There is need for high index of suspicion and early diagnoses of this rare complication of transvaginal oocyte retrieval particularly now that uptake of assisted reproduction technique in the treatment of infertility is likelyto increase in sub-Saharan Africa with the advent of public hospital involvement.Keywords: Pelvic abscess, transvaginal oocyte retrieval, in vitro fertilization

Socio-demographic Context of Resilience for Adaptation to Climate Change and Implication for Agricultural Extension in Buffelspruit, South Africa

The study examined the socio-demographic characteristics of smallholder farmers’ and resilience strategies for adaptation to climate change in Buffelspruit, South Africa. The objectives of the study were to determine local resilience strategies used by farmers and examine adoption behaviour in the use of local resilience strategies for mitigating climate change. The study was conducted in Buffelspruit community. A total number of 306 participants were selected randomly for this study. Structured and semi-structured questionnaires were used for data collection. The adoption behaviour of the farmers in the use of local resilience strategies was analysed using the logit model. Crop rotation, crop diversification and the adjustment of planting dates were the resilience strategies used by farmers. The result from the logit analysis reveals that gender (p = 0.047), level of education (p = 0.16), employment (p = 0.043), farm skills (p = 0.058), extension services (p = 0.011) and farm size (p = 0.022) influenced the adoption of climate resilient strategies in the study area. Extension education must move beyond technical training to enhance farmers’ abilities for planning, problem solving, critical thinking and leadership skills to work with multiple stakeholders. Extension must be proactive with capacity development in climate change education.

Association of anti-Chlamydia antibodies with ectopic pregnancy in Benin city, Nigeria: A case-control study

BACKGROUND: Ectopic pregnancy remains a major public health problem especially in many developing countries where it is a significant contributor to pregnancy related morbidity and mortality OBJECTIVE: To determine the association between prior Chlamydia trachomatis infection and the risk of ectopic pregnancy. METHODS: A case-control study from two tertiary health care facilities in Benin City, Nigeria. Ninety eight women with ectopic pregnancy (cases) and another 98 women with uncomplicated intrauterine pregnancy (controls) matched for age, were interviewed using a semi-structured questionnaire and evaluated for serological evidence of prior Chlamydia trachomatis infection. RESULTS: The antibody titres in cases (48%) were significantly higher than in controls (16.3%) (p<0.001). However, the association between Chlamydia antibodies and ectopic pregnancy was attenuated when the effects of indicators of previous pelvic infections, socio-demographic characteristics, contraceptive and sexual history were controlled for. Primary level of education (OR = 6.32; CI, 2.31 – 17.3), three or more lifetime sexual partners (OR = 5.71; CI, 2.39 – 13.65) and prior history of vaginal discharge (OR = 5.00; CI, 2.03 – 12.3) were more likely to be associated with ectopic pregnancy than with the presence of antibodies to Chlamydia trachomatis (OR = 2.82; 95% CI, 1.33 – 5.95). The Population Attributable Risk was 30.9%. CONCLUSION: Chlamydial infections play only a limited role in the pathogenesis of ectopic pregnancy

Association of anti-Chlamydia antibodies with ectopic pregnancy in Benin city, Nigeria: a case-control study

Background: Ectopic pregnancy remains a major public health problem especially in many developing countries where it is a significant contributor to pregnancy related morbidity and mortality Objective: To determine the association between prior Chlamydia trachomatis infection and the risk of ectopic pregnancy. Methods: A case-control study from two tertiary health care facilities in Benin City, Nigeria. Ninety eight women with ectopic pregnancy (cases) and another 98 women with uncomplicated intrauterine pregnancy (controls) matched for age, were interviewed using a semi-structured questionnaire and evaluated for serological evidence of prior Chlamydia trachomatis infection. Results: The antibody titres in cases (48%) were significantly higher than in controls (16.3%) (p<0.001). However, the association between Chlamydia antibodies and ectopic pregnancy was attenuated when the effects of indicators of previous pelvic infections, socio-demographic characteristics, contraceptive and sexual history were controlled for. Primary level of education (OR = 6.32; CI, 2.31 – 17.3), three or more lifetime sexual partners (OR = 5.71; CI, 2.39 – 13.65) and prior history of vaginal discharge (OR = 5.00; CI, 2.03 – 12.3) were more likely to be associated with ectopic pregnancy than with the presence of antibodies to Chlamydia trachomatis (OR = 2.82; 95% CI, 1.33 – 5.95). The Population Attributable Risk was 30.9%. Conclusion: Chlamydial infections play only a limited role in the pathogenesis of ectopic pregnancy