Pediatric Endocrinology Practice in Nigeria: Challenges and Way Forward

The prevalence of endocrine disorders in children in Nigeria is not well known. Therefore the burden of these diseases is often overlooked as most cases are undiagnosed or diagnosed too late; and yet they constitute a significant cause of morbidity and mortality in children. There has been a paucity of Paediatric Endocrinologists, absence of laboratory equipments and even drugs for the treatment of these diseases are often not in stock. The desired attention these endocrine diseases should receive from both health care institutions and the government is lacking. Therefore, the aim of this review article was to highlight the challenges facing the practice of Paediatric endocrinology in Nigeria and to proffer a way forward to building a robust endocrine care services in health institutions in Nigeria. Keywords: Challenges, endocrinology, paediatrics, way forwar

Fertility Profile Following Induced Abortion in Calabar, Nigeria

Context: The incidence of induced abortion in Nigeria is high. Pelvic infection as a complication of this abortion is also common and with the rising prevalence of infertility in the population, there is a need to assess the impact of induced abortions on fertility in our women. Objective: To establish the impact of induced abortion on the fertility rate of women in Calabar. Design and Setting: Cross sectional descriptive study in Calabar, an urban community on the eastern flank of Nigeria's Atlantic coast. Subjects and Methods: Women seeking gynaecological, antenatal and family planning services who gave their informed consent were recruited. Those of them who gave a history of induced abortion were interviewed in-depth. Their demographic characteristics and detailed information about their abortion history such as number of abortions, sites where the abortions were performed, the personnel providing the abortion services and complications arising from the abortions were obtained. Results: Some 242 (40.3%) of the study subjects had undergone at least one induced abortion. The commonest late complications of induced abortion were secondary infertility (42.1%) and chronic pelvic infection (36.0%). Only 48.3% of the women who had induced abortions maintained their fertility while the remainder suffered secondary infertility ranging from three to eighteen years in duration. The fertility rate decreased with increasing number of abortions. Conclusion: Induced abortion is a major factor in the high prevalence of secondary infertility in Calabar. Training of medical practitioners on post-abortion care may help to ameliorate the burden of secondary infertility in Nigeria. Key Words: Abortion, Pregnancy Termination, Fertility, Infertility [Trop J Obstet Gynaecol, 2003, 20: 89-92