Assessment of age at menarche and menstrual pattern among secondary school girls in Awka, Southeast Nigeria

Background: Menarche is an important physiological milestone in girls and this usually occurs during their secondary school years. The menstrual pattern may vary in these adolescents. This knowledge may assist in counselling the young girls on reproductive health issues.Methods: A cross-sectional study of female secondary school students from Kenneth Dike secondary school, Awka; Amaenyi girls’ secondary school and community secondary school, Okpuno, all in Awka, Anambra state of Nigeria. All together 545 students were selected following informed consent. The study instrument was a pre-tested, semi-structured and self-administered questionnaire. Data analysis was done with IBM SPSS 20 software. Tests of association between variables were done with Fisher’s exact test and the level of significance set at p≤0.05. Results: The mean age of the 545 respondents was 16.79±1.736 years and majority of them are of the Igbo ethnic group (90.5%). The average age at menarche was 12.77±1.159 years. There is a significant difference between the age at menarche and the father’s occupation. The modal duration of flow was 4 days (48.7%) while 95.2% had a normal cycle length of 21-35 days.Conclusions: The average age of menarche of secondary school girls in Awka was 12.77±1.159 years. Most of the students had normal menstrual flow duration of 2-7 days with a cycle length of 21-35 days

Desire to practice postpartum contraception among antenatal women at Awka, Southeast Nigeria

Background: Postpartum contraception enables the nursing woman recover from the effects of pregnancy and childbirth before embarking on another pregnancy. It also promotes child welfare. The assessment of the desire by pregnant women to take up postpartum contraceptive service will help the planning of good delivery of this service.Methods: A cross-sectional study of antenatal clinic attendees at Chukwuemeka Odumegwu Ojukwu Teaching Hospital, Awka was done using a pretested interviewer-administered questionnaire. Data was analyzed with IBM SPSS version 20 software and associations between variables were tested with Chi square. Level of significance was set at P ≤0.05.Results: A total of 262 antenatal women were interviewed. The mean age of the respondents was 29.1±6.1 years while the mean parity was 2.5±1.5. Two hundred and one of the study women (76.7%) had the desire to practice postpartum contraception after the index pregnancy while only 9 (3.4%) were unsure whether they had the desire or not. Multiparous women are more likely to desire postpartum contraception (P <0.01). Also, previous use of contraception (P<0.01), desired index pregnancy (P=0.01) and being married or single (P=0.02) are all significantly associated with the desire to practice postpartum contraception.Conclusions: There was a high level of desire to practice postpartum contraception among antenatal clinic attendees at Awka. Parity, marital status, desired index pregnancy and previous practice of contraception all influence this desire

Perception of labour pain and desire for pain relief in labour among parturients in a tertiary health facility in south-eastern Nigeria

Background: There are varied perceptions about pain and its relief in labour among pregnant women in Africa.Objectives: This study aims to assess the perception of labour pain among parturients in a tertiary health institution in Nigeria. It also assessed the women’s awareness of and desire for labour analgesia.Methodology: One thousand, one hundred (1100) consecutive women who delivered at a University Teaching Hospital were studied using pretested researcher administered questionnaires. Data were entered into and analysed with SPSS 21. Statistical tests were done with Chi- square and T- test as appropriate. P-value of less than 0.05 was considered significant.Result: The mean age of the respondents was 29.2 + 5.89 while the mean parity was 2.43 + 1.59. One thousand and ninety respondents (99.1%) reported that labour was painful and majority (91.3%) of them graded pain as severe. The mean pain score was 85.1 + 16.2. Having antenatal care, partner support, attendance to antenatal classes, delivery by emergency C-section and induced labour were significantly associated with identifying labour as painful. Awareness of labour analgesia was poor as only 39.5% of the respondents reported so and only 1.4% of the parturients requested pain relief.Conclusion: The women generally reported labour as being very painful, yet they had poor knowledge of, and demand for labour analgesia. This poor knowledge exists despite the fact that majority of these women had antenatal care, suggesting that health information given to them may be deficient. Misconceptions were the main reasons for not requesting pain relief in labour.Keywords: Labour analgesia, Labour pain, Knowledge, Acceptanc

Desire to practice postpartum contraception among antenatal women at Awka, Southeast Nigeria

Background: Postpartum contraception enables the nursing woman recover from the effects of pregnancy and childbirth before embarking on another pregnancy. It also promotes child welfare. The assessment of the desire by pregnant women to take up postpartum contraceptive service will help the planning of good delivery of this service.Methods: A cross-sectional study of antenatal clinic attendees at Chukwuemeka Odumegwu Ojukwu Teaching Hospital, Awka was done using a pretested interviewer-administered questionnaire. Data was analyzed with IBM SPSS version 20 software and associations between variables were tested with Chi square. Level of significance was set at P ≤0.05.Results: A total of 262 antenatal women were interviewed. The mean age of the respondents was 29.1±6.1 years while the mean parity was 2.5±1.5. Two hundred and one of the study women (76.7%) had the desire to practice postpartum contraception after the index pregnancy while only 9 (3.4%) were unsure whether they had the desire or not. Multiparous women are more likely to desire postpartum contraception (P &lt;0.01). Also, previous use of contraception (P&lt;0.01), desired index pregnancy (P=0.01) and being married or single (P=0.02) are all significantly associated with the desire to practice postpartum contraception.Conclusions: There was a high level of desire to practice postpartum contraception among antenatal clinic attendees at Awka. Parity, marital status, desired index pregnancy and previous practice of contraception all influence this desire

Prevalence and correlates of postpartum depression among women visiting postnatal clinic in a tertiary health institution in southeast Nigeria

Background: Postnatal depression (PND), a major health problem, can have deleterious effects on new mothers, their infants and their family. Unfortunately, little attention has been paid to this phenomenon in terms of identification, diagnosis and treatment in our environment.Objectives: This study was undertaken to determine the prevalence and correlates of PND among postnatal attendees in a tertiary health institution in South-East Nigeria.Methodology: This was a cross sectional study in which women visiting Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Amaku, postnatal clinic from 1st. March- 31st May, 2017 were recruited. Data were collected using Socio-demographic Questionnaire and Edinburgh Postnatal Depression Scale (EPDS). A score of 10 and above was considered a likely case of PND. One hundred and thirty two (132) self-administered questionnaires were completely filled and analyzed. Descriptive and inferential statistics including means, frequencies, X2 –test at the 95% confidence level (CL) were used in analysis. Logistic regression was applied to identify the independent predictors of PND risk.Results: The prevalence of PND among the women was 33.3%. PND showed significant association with maternal age (p=0.027), low socio-economic status (p=0.037), parity (p=0.031), mode of delivery (p=0.023), type of delivery (p=0.025) and lack of emotional support (p=0.001).Preterm delivery (OR=2.9), caesarean delivery (OR=3.7), low socio-economic status (OR= 4.1) and lack of emotional support (OR=5.8) from husband were independent risks factors for PND.Conclusion: The prevalence of PND, 33.3% among postnatal women is high. Screening and management of PND should be an important part of postnatal services so as to improve maternal and infant wellbeing.Keywords: Screening, risk factors, 4-6 weeks, post-delivery, maternal, infant, wellbein

Carbapenem-Resistant Enterobacteriaceae Posing a Dilemma in Effective Healthcare Delivery

The emergence and spread of Carbapenem-resistant Enterobacteriaceae (CRE) is seriously posing threats in effective healthcare delivery. The aim of this study was to ascertain the emergence of CRE at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Awka. Biological samples were collected from 153 consenting patient from 5 clinics in the hospital. The isolates were identified using standard microbiological protocols. Susceptibility to meropenem was done using Kirby-Bauer disc diffusion method on Mueller Hinton Agar. A total of 153 patients were recruited in this study. About one half of those from rural, 63.64% from Sub-urban and 42.27% from urban areas had significant E. coli and Klebsiella spp infections. The male: female ratio of the Enterobacteriaceae infection was 1:1. Almost as much inpatient as outpatient study participants had the infections. The infections were observed mostly on participants with lower educational status. The unmarried individuals were most infected compared to their married counterparts. Enterobacteriaceae infection rate was 50.98%. Of this, 28.21% had CRE infection while the overall prevalence of the CRE in the studied population was 14.38% (22/153). This study shows that CRE is quickly emerging in both community and hospital environments. Klebsiella spp was the most common CRE in this hospital especially Klebsiella oxytoca. Hospitalization was a strong risk factor in the CRE infections. Rapid and accurate detection is critical for their effective management and control