Unearthing the Hidden Tragedy: Stillbirths in Abakaliki, Nigeria – Prevalence and Causes

Background: Stillbirths are very traumatic events to the parents, family, and obstetricians. Although a global public health crises, it has remained relatively hidden while their devastations continue unabated in different parts of the world. We have not evaluated this tragedy in our practice environment hence the need for this paper. Methods: This is a retrospective study involving all cases of stillbirths that occurred at the Alex Ekwueme  Federal University Teaching Hospital, Abakaliki, over a 3‑year period, 2017–2019. The case notes were gotten and relevant information was retrieved and analyzed. Results: The prevalence of stillbirths in our centre was 16.1 per 1000 deliveries or one stillbirth in 62 deliveries. Majority of our parturients who had stillbirths 89 (81.7%) were unbooked, 43 (39.5%) had only primary  education, 16 (14.7%) had no education at all, and only 10 (9.2%) had tertiary education. The leading cause of stillbirths was abruptio placenta 27 (24.8%) followed by prolonged obstructed labor 22 (21.1%), intrauterine fetal death of unknown cause 18 (16.5%), and ruptured uterus 10 (9%). Seventy‑three (67%) women were delivered by spontaneous vaginal delivery while 18 (16.5%) had a caesarean section. Thirty (27.5%) women had postpartum hemorrhage. None of the dead babies had an autopsy performed on them. Conclusion: The prevalence of stillbirth in our centre is unacceptably high and majority of the causes are  preventable. There is an urgent need for public enlightenment to highlight this silent tragedy and mobilize  efforts toward its prevention. Carrying out autopsies on stillbirths especially those with unexplained causes will help elucidate some of the causes

Knowledge, attitude and practice of Nigerian specialist doctors in training of cervical cancer and its screening

Introduction: Cancer of the cervix is the second commonest cancer among women worldwide, the commonest female genital‑tract malignancy in Nigeria, and one of the leading causes of morbidity and mortality among women in Nigeria. Health workers are the trusted source of medical information and their attitude and practice toward diseases of public health importance like cervical cancer are very critical if the country must make progress toward the prevention of such diseases. This work assesses the knowledge, attitude, and practice of Nigeria’s specialist doctors in training toward cervical cancer and its methods of screening because this is critical to its prevention in the country.Materials and Methods: This is a cross‑sectional study involving the administration of pretested structured questionnaire to fifty specialist Nigerian doctors in training in various disciplines from different parts of the country.Results: The knowledge of the participants regarding cervical cancer and its screening is very good, with an average of 98%, but their attitude toward cervical cancer screening is poor as only 7 (14%) had ever recommended a woman for cervical cancer screening. The practice of cervical cancer screening among the participants is poor as only 5 (22.7%) of the 22 female doctors in training had ever screened for cervical cancer and only one male specialist doctor in training out of the 28 of them had the partner screened for cervical cancer before this study. Only 4 (9%) of the 28 males had ever recommended cervical cancer screening to their female partner and 44 (88%) of the specialist doctors in training had never spoken to any organization about cervical cancer screening.Conclusion: Though the knowledge of Nigerian specialist doctors in training on cancer of the cervix and its screening is very good, their attitude to it and practice are very poor.Keywords: Attitude; cervical cancer screening; knowledge; Nigerian specialist doctors; practic

Knowledge, attitude and practice of Nigerian specialist doctors in training of cervical cancer and its screening

Introduction: Cancer of the cervix is the second commonest cancer among women worldwide, the commonest female genital-tract malignancy in Nigeria, and one of the leading causes of morbidity and mortality among women in Nigeria. Health workers are the trusted source of medical information and their attitude and practice toward diseases of public health importance like cervical cancer are very critical if the country must make progress toward the prevention of such diseases. This work assesses the knowledge, attitude, and practice of Nigeria's specialist doctors in training toward cervical cancer and its methods of screening because this is critical to its prevention in the country. Materials and Methods: This is a cross-sectional study involving the administration of pretested structured questionnaire to fifty specialist Nigerian doctors in training in various disciplines from different parts of the country. Results: The knowledge of the participants regarding cervical cancer and its screening is very good, with an average of 98%, but their attitude toward cervical cancer screening is poor as only 7 (14%) had ever recommended a woman for cervical cancer screening. The practice of cervical cancer screening among the participants is poor as only 5 (22.7%) of the 22 female doctors in training had ever screened for cervical cancer and only one male specialist doctor in training out of the 28 of them had the partner screened for cervical cancer before this study. Only 4 (9%) of the 28 males had ever recommended cervical cancer screening to their female partner and 44 (88%) of the specialist doctors in training had never spoken to any organization about cervical cancer screening. Conclusion: Though the knowledge of Nigerian specialist doctors in training on cancer of the cervix and its screening is very good, their attitude to it and practice are very poor