Late Antenatal Care Booking And Its Predictors Among Pregnant Women In South Western Nigeria

Introduction: Antenatal care is concerned mainly with prevention, early diagnosis and treatment of general medical and pregnancy associated disorders. For it to be meaningful, early booking is recommended, however, late booking is still a major problem.\ud Objective: To determine the prevalence of late booking in our environment and factors related to it.\ud Methodology: A descriptive cross-sectional study using structured interviewer assisted questionnaires.\ud Results: Mean gestational age at booking was 20.3±6.2 weeks. Prevalence of late entry to antenatal care was 82.6%. Maternal education and age remained significant factors influencing late booking.\ud Conclusion: Late booking is still a major problem in this part of the world. Public enlightenment, health education coupled with women empowerment would be helpful in reducing the proble

Eclampsia and Pregnancy Outcome at Lautech Teaching Hospital, Osogbo, SouthWest, Nigeria

Eclampsia is one of the leading causes of maternal and perinatal morbidity and mortality in sub-Saharan Africa. This problem has continued unabated due to lack of policies supporting financial protection in times of ill health,non-implementation of proven interventions as well as gaps in capacity building by stakeholders in health care delivery in this region. The aim of this retrospective study is to assess the impact of eclampsia on maternal and perinatal survival and suggest ways of reducing maternal death. A 6-year retrospective study was conducted with eighty-three cases ofeclampsia. The cases were mainly antepartum patients with poor blood pressure control and resultant eclampsia. The case fatality rate was 8.3% and perinatal death was 24.1%. Magnesiun sulphate may have contributed to improvements in pregnancy outcome as mortality was higher amongwomen with no access to magnesium sulphate. Most of the eclamptic patients were referred late from private health facilities hence the need for public-private collaboration in strengthening the referral system and making magnesium sulphate widely available in maternal care centers

Utilization of the partograph in primary health care facilities in Southwestern Nigeria

No Abstract

Knowledge and Utilization of the Partograph among obstetric care givers in South West Nigeria

This cross-sectional study assessed knowledge and utilization of the partograph among health care workers in southwestern Nigeria. Respondents were selected by multi-stage sampling method from primary, secondary and tertiary levels of care. 719 respondents comprising of CHEWS - 110 (15.3%), Auxiliary Nurses - 148 (20.6%), Nurse/Midwives - 365 (50.6%), Physicians – 96 (13.4%) were selected from primary (38.2%), secondary (39.1%) and tertiary levels (22.7%). Only 32.3% used the partograph to monitor women in labour. Partograph use was reported significantly more frequently by respondents in tertiary level compared with respondents from primary/secondary levels of care (82.4% vs. 19.3%; X2 = 214.6, p < 0.0001). Only 37.3% of respondents who were predominantly from the tertiary level of care could correctly mention at least one component of the partograph (X2 = 139.1, p < 0.0001). The partograph is utilized mainly in tertiary health facilities; knowledge about the partograph is poor. Though affordable, the partograph is commonly not used to monitor the Nigerian woman in labour. (Afr Reprod Health 2008; 12[1]:22-29).Cette étude transvasale a évalué la connaissance et l\'utilisation du partographe parmi les membres du personnel soignant au sud-ouest du Nigéria. Les personnes interrogées ont été sélectionnées à l\'aide d\'une méthode d\'échantillon à plusieurs étapes à partir des niveaux de soin primaire, secondaire et tertiaire. Au total 719 personnes ont été interrogées, y compris les travailleurs communautaires pour l\'extension des services de santé 110 (15,3%), des infirmières auxillaires – 148 (20,6%), les infirmières / sages–femmes – 365 (50,6%), les médecins – 96 (13,4%) ont été sélectionnées à partir des niveaux primaire (38,2%), secondaire (39,1%) et tertiaire (22,7%). Seuls 32,3% se sont servis du partographe pour surveiller les femmes au travail. L\'utilisation du partographe a été plus fréquent chez les interrogés qui appartiennent au niveau tertiaire par rapport aux intérrogés des niveaux primaire et secondaire de soin (82,4% vs 19,3% ; X2 = 214,6 p < 0,0001). Seules 37,3% des intérrogés qui appartenaient en majorité au niveau tertiaire de soin pouvaient mentionner au juste au moins un constituent du partographe (X2 = 139, p < 0,0001). Le partographe est utilisé surtout dans les établissement de santé tertiaire ; la connaissance du partographe est faible. Bien qu\'il soit abordable, le partographe n\'est pas communément utilisé pour surveiller la femme nigériane au travail.Keywords: partograph, healthcare providers, knowledge, utilization Knowledge and Utilization of the Partograph among obstetric care givers in South West NigeriaAfrican Journal of Reproductive Health Vol. 12 (1) 2008: pp. 22-2

Pattern of gynaecological consultations at Ladoke Akintola University of Technology Teaching Hospital

No Abstract

Surgical Patients\' Knowledge and Acceptance of Autologous Blood Transfusion.

Background: Homologous blood transfusion carries a well-documented array of risks especially in an HIV endemic environment like Nigeria. It is therefore imperative to consider other forms of restoring blood volume in surgical patients. Autologous blood transfusion (ABT) is one of the ways the problem of HIV transmission can be reduced among surgical patients. The knowledge and acceptability of ABT among surgical patients about ABT, especially pre-donated ABT were assessed. It also assessed whether or not surgeons inform elective surgical patients about this alternative Materials And Methods Questionnaires were distributed among elective surgical patients that presented during the study period. The knowledge, willingness and the factors influencing the willingness of the patients to participate in ABT were investigated. The data were analyzed with SPSS Version10. Results Of the 116 patients [71 males; 45 females] interviewed, 29 (25.0 %) had heard about ABT, 80 (69.0 %) patients had never heard about ABT while 7 (6.1 %) were not sure. Of the 29 respondents who had heard about ABT, only 2 had had ABT. Of the 48 patients who needed blood for current surgical problems, only 4 (9.3 %) would have ABT. There was a significant difference in the number of respondents who believed that ABT is better than homologous transfusion (x2 = 69.11, p < 0.001). Conclusion The knowledge of ABT is low among our surgical patients and surgeons should present this alternative to their patients. The acceptance of ABT may also help in reducing or eliminating HIV transmission via blood transfusion. Keywords: homologous, hepatitis, surgical procedures, blood volume.Sudan Journal of Medical Sciences Vol. 3 (2) 2008: pp. 109-11

The contribution of alcohol to chronic liver disease in patients from South-West Nigeria

Objective: This study aimed at determining the level and type of alcohol consumed by patients diagnosed with chronic liver disease (CLD) and, hence, the extent to which alcohol may have contributed to the development of the condition.Study Design: Patients with diagnosis ofCLDwere consecutively recruited and a structured questionnaire was administered on each of them. Diagnosis of CLD was made based on liver histology and/or typical clinical and laboratory features.Alcohol consumption was considered significant if a patient took 50g/day for 10 years.Results: A total of 145 patients were studied consisting of 102 males and 43 females. Their ages ranged from 20- 80 years with a mean of 46.8 ± 15.7 years. Fifty-one (35.2%) patients, all males, drank significant alcoholwhile consumption was not significant in 43 (29.6%) patients. Alcohol was not consumed at all by 51 (35.2%) patients made up of 18 males (35.3%) and 33 females (64.7%). Beer was the commonest form of alcohol consumed (70.2%) followed by palm wine (50%) and locally-brewed gin (20.2%).The diagnoses made were liver cirrhosis [LC] (60, 41.38%), chronic hepatitis [CH] (54, 37.20%), hepatocellular carcinoma [HCC] (23, 15.86%), alcoholic liver disease [ALD] (6, 4.14%) and non-alcoholicfatty liver disease [NAFLD] (2, 1.38%). The liver disease spectrum did not differ between the patients who drank significant alcohol and those who did not. However, the proportion of LC/HCC cases increased relativetoCHwith increasing age and consumption of alcohol.Conclusions: The proportion of CLD directly attributable to alcohol (i.e. ALD) is low among the patients studied. However, the burden of LC andHCCis directly related to age and the amount of alcohol consumed andthe determinants of alcohol abuse are gender and affluence

The management of tetanus in adults in an intensive care unit in Southern Vietnam

Background: Tetanus remains common in many low- and middle-income countries (LMICs) yet the evidence base guiding management of this disease is extremely limited, particularly with respect to contemporary management options. Sharing knowledge about practice may facilitate improvement in outcomes elsewhere. Methods: We describe clinical interventions and outcomes of 180 adult patients ≥16 years-old with tetanus enrolled in prospective observational studies at a specialist infectious diseases hospital in Southern Vietnam. Patients were treated according to a holistic management protocol encompassing wound-care, antitoxin, antibiotics, symptom control, airway management, nutrition and de-escalation criteria. Results: Mortality rate in our cohort was 2.8%, with 90 (50%) patients requiring mechanical ventilation for a median 16 [IQR 12-24] days. Median [IQR] duration of ICU stay was 15 [8-23] days. Autonomic nervous system dysfunction occurred in 45 (25%) patients. Hospital acquired infections occurred in 77 (43%) of patients. Conclusion: We report favourable outcomes for patients with tetanus in a single centre LMIC ICU, treated according to a holistic protocol. Nevertheless, many patients required prolonged intensive care support and hospital acquired infections were common

Clients' reasons for prenatal ultrasonography in Ibadan, South West of Nigeria

<p>Abstract</p> <p>Background</p> <p>Prenatal ultrasonography has remained a universal tool but little is known especially from developing countries on clients' reasons for desiring it. Then aim was to determine the reasons why pregnant women will desire a prenatal ultrasound.</p> <p>Methods</p> <p>It was a cross-sectional survey of consecutive 222 women at 2 different ultrasonography facilities in Ibadan, South-west Nigeria.</p> <p>Results</p> <p>The mean age of the respondents was 30.1 ± 4.5 years. The commonest reason for requesting for prenatal ultrasound scans was to check for fetal viability in 144 women (64.7%) of the respondents, followed by fetal gender determination in 50 women (22.6%. Other reasons were to check for number of fetuses, fetal age and placental location. Factors such as younger age, artisans profession and low level of education significantly influenced the decision to check for fetal viability on bivariate analysis but all were not significant on multivariate analysis. Concerning fetal gender determination, older age, Christianity, occupation and gravidity were significant on bivariate analysis, however, only gravidity and occupation remained significant independent predictor on logistic regression model. Women with less than 3 previous pregnancies were about 4 times more likely to request for fetal sex determination than women with more than 3 previous pregnancies, (OR 3.8 95%CI 1.52 – 9.44). The professionals were 7 times more likely than the artisans to request to find out about their fetal sex, (OR 7.0 95%CI 1.47 – 333.20).</p> <p>Conclusion</p> <p>This study shows that Nigerian pregnant women desired prenatal ultrasonography mostly for fetal viability, followed by fetal gender determination. These preferences were influenced by their biosocial variables.</p

The use of antenatal and postnatal care: perspectives and experiences of women and health care providers in rural southern Tanzania

BACKGROUND\ud \ud Although antenatal care coverage in Tanzania is high, worrying gaps exist in terms of its quality and ability to prevent, diagnose or treat complications. Moreover, much less is known about the utilisation of postnatal care, by which we mean the care of mother and baby that begins one hour after the delivery until six weeks after childbirth. We describe the perspectives and experiences of women and health care providers on the use of antenatal and postnatal services.\ud \ud METHODS\ud \ud From March 2007 to January 2008, we conducted in-depth interviews with health care providers and village based informants in 8 villages of Lindi Rural and Tandahimba districts in southern Tanzania. Eight focus group discussions were also conducted with women who had babies younger than one year and pregnant women. The discussion guide included information about timing of antenatal and postnatal services, perceptions of the rationale and importance of antenatal and postnatal care, barriers to utilisation and suggestions for improvement.\ud \ud RESULTS\ud \ud Women were generally positive about both antenatal and postnatal care. Among common reasons mentioned for late initiation of antenatal care was to avoid having to make several visits to the clinic. Other concerns included fear of encountering wild animals on the way to the clinic as well as lack of money. Fear of caesarean section was reported as a factor hindering intrapartum care-seeking from hospitals. Despite the perceived benefits of postnatal care for children, there was a total lack of postnatal care for the mothers. Shortages of staff, equipment and supplies were common complaints in the community.\ud \ud CONCLUSION\ud \ud Efforts to improve antenatal and postnatal care should focus on addressing geographical and economic access while striving to make services more culturally sensitive. Antenatal and postnatal care can offer important opportunities for linking the health system and the community by encouraging women to deliver with a skilled attendant. Addressing staff shortages through expanding training opportunities and incentives to health care providers and developing postnatal care guidelines are key steps to improve maternal and newborn health