海運に於ける競爭と獨占(二)

BackgroundAnaemia in pregnancy is associated with adverse maternal and fetal outcome. Unfortunately, in developing countries its prevalence has continued to rise. To improve the situation, iron supplement is routinely prescribed during pregnancy. We therefore examine the impact of the intervention as being currently practised in our clinical setting.MethodsIn total, 255 prenatal clinic attendees who had more than 8 weeks of prescribed iron supplements were sampled. Data was obtained on their socio-demographic features, haemoglobin concentration at booking, compliance with iron supplements and third trimester haemoglobin value.ResultsObserved iron supplementation compliance rate was 184(72.2%). There was a significant drop in mean haemoglobin (Hb) concentration between the two time points (booking Hb: 32.56±2.99; third trimester Hb: 31.67±3.01; mean diff: 0.89±3.04; t = 4.673; 95% CI= 0.52–1.27; p= <0.001). Anaemia increased from 132(51.8%) to 150(58.8%) by the third trimester. Increase in anaemia occurred in both iron-compliant and non-compliant groups. Non-compliance however had higher odds of predicting anaemia by the third trimester (OR: 1.83; 95% CI: 1.03–3.26; p: 0.04).ConclusionAlthough iron supplementation is still a good intervention in developing countries, it is not sufficient to reduce overall prevalence of anaemia by the third trimester. There is a need to look beyond the approach and reinforce the importance of better feeding practices, food fortification and reduced frequency of pregnancies

Gestational age at initiation of antenatal care in a tertiary hospital, Southwestern Nigeria

Context: Antenatal care utilization has been shown to be associated with reduction in maternal and perinatal morbidity and mortality while early initiation provides an opportunity for optimum utilization of this care with improved maternal and fetal outcomes.Aim: This study seeks to determine the time of initiation of antenatal care among pregnant women and possible factors influencing such timing.Setting: A cross‑sectional study involving 530 pregnant women was carried out at the booking clinic of the Ekiti State University Teaching Hospital, Ado‑Ekiti, between September 03, 2013, and March 04, 2014.Subjects and Methods: A pretested questionnaire was administered to them to obtain information on their sociodemographic characteristics and factors influencing their timing of antenatal care initiation.Results: The prevalence of early booking in this study was 22.7%, and the mean gestational age at booking was 21.09 ± 6.98 weeks. The age, parity, and occupation of the women and counseling on early booking were significantly associated with early booking among the respondents with P value of 0.010, 0.006, 0.011, and 0.009, respectively while on logistic regression, the occupation of women was the only significant association with early antenatal care initiation (adjusted odd ratio 0.388; confidence interval 0.212–0.710; P = 0.002). Complications experienced in previous pregnancies did not predict early initiation of care. More than half of the respondents (50.9%) gave early monitoring of their pregnancy as the reason for initiating the care.Conclusion: Late initiation of antenatal care is still prevalent in our environment. Therefore, pregnant women should be adequately informed about the concept of early antenatal registration.Keywords: Antenatal care, gestational age, initiation, Nigeria, Southwester

Predictors of insomnia among adults presenting at the general outpatient department of a Nigerian Tertiary Hospital

Background: Sleeplessness has contributed negatively in no small measure to the quality of life of individuals who suffer from it. Itbecomes imperative to study if there are sociodemographic predictors of insomnia so as to educate and counsel those presenting withsimilar parameters. Aim: To determine the sociodemographic predictors of insomnia among adult patients. Method: The data for this descriptive, cross-sectional facility-based study was obtained through systematic random sampling  technique involving three hundred and seventeen adults selected using an interviewer administered questionnaire. Result: The total prevalence of insomnia in the study was 28.4%. Poor sleepers were significantly older (χ2= 42.532; p < 0.001), married (χ2 = 18.894; p < 0.001), had a family history of insomnia (χ2 = 31.643; p < 0.001) and in polygamous family setting (χ2= 10.514; p = 0.002). Multivariate logistic regression analysis revealed that younger age and monogamous family setting were less likely to suffer from insomnia. Conclusion: It is important for clinician to pay particular attention to family history of insomnia in their patient whatever their age.This will help to educate and counsel those with family history of insomnia to pay particular attention to their sleep hygiene while theyare still young. This will ultimately reduce man power loss and increase productivity. Key words: Insomnia, Adults, Sociodemographic, Predictor

Predictors of asymptomatic bacteriuria among pregnant women in a low-resource setting

This study aims at identifying predictors of asymptomatic bacteriuria (AB) among pregnant women in a low-resource setting, with the intent of recommending a guideline for screening during antenatal care. A total of 266 healthy pregnant women were antenatally recruited after informed consent. They had routine antenatal investigations, a 1 h 50-g oral glucose tolerance test and quantitative urine culture and sensitivity. The data collected were analysed using statistical software package SPSS v. 17. Prevalence of AB was 23 (8.6%). Escherichia coli was the commonest isolate (6, 26.1%), closely followed by Staphylococcus aureus (5, 21.7%). AB was commoner among patients aged 25-34 years, of low parity and higher education. Blood group B- rhesus-positive significantly predicts the likelihood of developing AB in pregnancy (adjusted OR: 0.36; 95% CI: 0.14-0.96). We conclude that blood group B-rhesus-positive in association with other patients' characteristics, such as age 25-34 years, low parity and higher education could form guidelines for a screening algorithm in our environment