Asymptomatic Bacteriuria in pregnant women attending antenatal clinic in a tertiary hospital in Abuja, Nigeria

Context: Asymptomatic bacteriuria (ASB) predisposes to cystitis and pyelonephritis. In pregnancy it is associated with maternal morbidity and adverse perinatal outcomes. A wide range of prevalence has been reported in the literature. Efforts to improve maternal and perinatal outcomes have led to the recommendation of routine antenatal screening and treatment of clients with ASB.Objective: To determine the prevalence of ASB, the microbial isolates and antibiotic sensitivity among antenatal clients in the National Hospital Abuja.Patients and Methods: It was a cross sectional study of pregnant women presenting for the first antenatal clinic visit at the National Hospital Abuja. One hundred and forty six pregnant women who met the inclusion criteria and gave consent were interviewed, relevant demographic and clinical characteristics were obtained and clean catch, mid stream urine samples were collected and processed using standard bacteriological methods.Results: Significant bacteriuria (colony-forming unit ≥ 105/ml) was found in 67 (45.9%) of the 146 pregnant women tested. There was no significant difference in prevalence of ASB with respect to age (p=0.245), parity (p=0.607), occupation (p=0.172) and pregnancy trimesters (p=0.459). Staphylococcus aureus was the most common causative organism found in 24(35.8%) cases followed by Escherichia coli in 19 (28.36%) and Klebsiella species in 14 (20.9%) cases. The susceptibility rate of bacterial isolate was highest for levofloxacin (83.6%), followed by nalidixic acid (64.2%) and nitrofurantoin (62.7%). The pathogens were least susceptible to co-trimoxazole (8.3%), ampilcillin (8.8%) and amoxicillin (10.4%)Conclusion: The prevalence of asymptomatic bacteria among the pregnant women was high. The isolated organisms were resistant to many antibiotics commonly used in the management of urinary tract infection. The practice of routine urine culture for antenatal screening for asymptomatic bacteriuria will be beneficial in our setting.Keywords: Asymptomatic bacteriuria, antibiotic sensitivity, microbial isolates, pregnant women, urinary tract infectio

HIV prevalence and trends among pregnant women in Abuja, Nigeria: a 5-year analysis

Background: In the last decade there had been efforts to halt and reverse the high and increasing trends in HIV infection in sub-Saharan Africa. There is need to analyze trends in HIV prevalence to ascertain the current course of the HIV epidemic in our society. HIV prevalence among pregnant women attending Antenatal Clinics remains the principal data source to inform trends in generalized epidemics in developing countries.Objective: The aim of this study was to determine the prevalence of HIV and its trends among pregnant women attending antenatal clinic at a public tertiary hospital in the Federal Capital Territory, Abuja, Nigeria.Methods: Data of pregnant women who had HIV test as part of antenatal care between January 2005 and December 2009 were prospectively recorded and analyzed to determine the period HIV prevalence and trends.Results: For the five year period, there was 95% uptake of HIV testing, and out of 8,443 pregnant women tested, 973 were sero-positive, giving a period prevalence of 11.5% (CI;10.9%-12.2%). In 2005 HIV prevalence was 4.5%, rose to 11.2% in 2006 and peaked at 15.4% in 2009. This trend was statistically significant (χ2-trend=94.1; p<0.001). There was an inverse trend with maternal age with a higher prevalence among younger mothers (15-24 years) compared to older cohorts (30-49 years). This decreasing trend with maternal age was also statistically significant (χ2- trend=5.28; p=0.022). Although HIV prevalence was slightly higher among women with higher parity, this trend was not statistically significant (χ2-trend=0.73; p=0.39). HIV prevalence was significantly higher in women in lower social class 1-4, compared with those in higher social class 5 and 6 (χ2- trend=148.7; p<0.0001).Conclusion: The HIV prevalence among pregnant women is high and showed an increasing trend over the five year period. It is an indication of ineffectiveness of measures taken to arrest the scourge over time. This has implication for obstetrics practice and may translate to increase in pediatrics HIV/AIDS if adequate measures are not taken to prevent mother-to-child transmission.Key Words: HIV, Prevalence, Pregnant women, Prevention of mother-to-child transmission of HIV, Nigeria

Contraception in the Context of HIV/AIDS: A Review

Over 50% of the 33.3 million HIV-positive persons are women within the reproductive age group. With increasing availability and use of highly active antiretroviral therapy (HAART), the prognosis, life expectancy and quality of life of infected persons has improved. HIV-positive women, like their uninfected counterparts, may desire to plan pregnancies, limit their families, or avoid pregnancy. The effective use of contraception by HIV-positive clients can contribute significantly to reduction in both sexual and vertical transmission of the virus. HIV-positive clients can use most of the available contraception methods including barrier, hormonal, intrauterine devices and sterilization. However, some antiretroviral drugs interact with hormonal contraceptives with potentials for reduction in efficacy. Dual protection with concomitant use of a more effective contraceptive method and male or female condom to prevent HIV and Sexually transmitted infections (STIs) is the standard. It is necessary to make provision for contraceptive service as part of comprehensive care for the HIV-positive client.Plus de 5o% des 33.5 millions des gens séropositives sont des femmes qui sont encore en âge de procréer. Grace à la disponibilité croissante et de l'emploi de la thérapie antirétrovirale active élevée(TAAE), la pronostic, l'espérance de vie et la qualité de vie des gens atteints s'est améliorée. Les femmes séropositives, comme leurs homologues non atteints, peuvent désirer planifier des grossesses, limiter le nombre d'enfants ou éviter la grossesse. L'emploi efficace de la contraception par les clientes séropositives peut contribuer de manière significative à la réduction dans la transmission verticale du virus. Les clientes peuvent se profiter des méthodes de la contraception disponible y compris la barrière, l'hormonal, les dispositifs utérins et la stérilisation. Néanmoins, certains médicaments antirétroviraux réagissent avec des hormono-contraceptifs qui ont la capacité de réduire l'efficacité. La double protection avec l'usage concomitant d'une méthode contraceptive plus efficace ainsi que le préservatif pour homme ou pour femme pour prévenir le VIH et les maladies sexuellement transmissibles(MST) demeure la norme. Il faut prévoir un service contraceptif comme faisant partie des soins compréhensif pour les clientes séropositives.Key words: AIDS, HIV, contraception, family planning, highly active antiretroviral therapy (HAART), condo

The prevalence and risk factors for gestational diabetes and pregnancy outcome in a tertiary hospital in Ahuja, Nigeria

Objectives: To determine the common diabetes risk factors (or OGTT; the prevalence of GDM; and the maternal and perinatal outcomes of GDM pregnancies in a Nigerian urban antenatal populationPatients and Methods: A retrospective study of pregnant women, who attended antenatal clinic, screened for diabetes mellitus, had OGTT when indicated and delivered in the hospital over a three year period at a tertiary hospital in Abuja, Nigeria. The main outcome measures were diabetes risk factors (or OGTT referral, prevalence of GDM, maternal complications, mode of delivery, birth weight, fetal and neonatal complications. GDM diagnosis was based on the 1999 WHO criteria of glucose lenl at fasting (0-hour) ≥7.0mmol/L(126mg/dl) or2-hour ≥ 7.8mmol/L(140mg/dl).Results: During the period under study 4,755 women had antenatal care and delivered in the hospital. Five hundred and six patients with various risk factors for diabetes had OGTT. The mean age of the women was 31.6±4.1 years, mean height 1.64 ± 0.1 m; and mean weight 85.1 ± 15.5kg. The three commonest GDM risk factors for referral for OGTT were family history of diabetes mellitus, history of previous delivery of macrosomic baby (≥.4.0 kilogram) and maternal weight greater than 90kg. The risk factors associated with GDM in this study are maternal weight greater than 90kg (OR= 2.39; 95% CI 0.74-6.59) and suspected big baby in index pregnancy (OR= 2.51; 95% CI 0.45-9.22). Twenty four patients met the criteria for GDM giving a prevalence of 0.5% among the antenatal population. The majority, 19(79.2%)of the GDM mothers were delivered by caesarean sections compared with 170(35.3%) women with normal OGTT. Hypertensive complication was present in 7 (29.2%) GDM clients compared with 58 (12.1%) women with normal OGTT. Six (25%) babies born to GDM mothers suffered from jaundice compared with 37 (7.7%) for normal OGTI mothers. The birth of macrosomic babies was however, more common in normal OGTT mothers, 107 (22.2%) compared with 4 (16.3%) in GDM mothers, though this difference did not reach significance level.Conclusion: OGTT remain a reliable tool forthe diagnosis of GDM. The risk factors for OGTT in our setting need to be reviewed. The detection and management of GDM is essential for prevention of diabetes associated adverse pregnancy outcomes.Keywords: Gestational diabetes mellitus; Risk factors for OGTT, pregnancy outcom

Emergency Contraception: A Wareness And Knowledge Among Hospital Workers In Abuja, Nigeria

A cross sectional descriptive survey of awareness and knowledge of emergency contraception among medical/paramedical and non-medical workers was carried out in the National Hospital Abuja, Nigeria. Most of the hospital workers were not aware of emergency contraceptive methods. 59.9% were not aware of emergency contraceptive pills, while 81.4% were not aware of the use of intrauterine contraceptive device. Medical and Paramedical workers show more awareness about emergency contraception than non-medical workers (

A Kap Study Of Hepatitis B Virus (HBV) Infection Among Medical Students In University Of Benin

Background: Hepatitis B virus infection which is the world’s most common blood borne viral infection is highly endemic in Nigeria. Health care workers including medical students are at risk of acquiring the infection while at work. Objective: To assess the knowledge, attitude and practice of HBV infection among medical students in the University of Benin.Method: A cross-sectional, descriptive study carried out among 300 pre-clinical and clinical medical students. Stratified sampling method was used in selecting participants. Data was collected by pre-tested, self-administered questionnaire. Results: Mean age of respondents was 23.8 + 3.8 years. Overall knowledge of Hepatitis B infection was high (65.7%) and this was significantly higher among the clinical (99.3%)than the pre-clinical students (31.1%), p < 0.0001. The males (96.7%) had more positive attitude to the infection than the females (87.4%). Less than 10% of the respondents knew their HBV status and less than a quarter had been vaccinated against the infection. Poor awareness, non-availability and high cost of vaccine were identified as factorsdiscouraging the uptake of vaccine. Conclusion: Though, overall knowledge and attitude to HBV infection was good, there is need to develop guidelines to ensure that medical students are not only fully vaccinatedagainst HBV but adequate practice of standard precaution is adhered to.Keywords: Knowledge, Attitude, Practice, Hepatitis B Virus, Medical students