Insights from birthing experiences of fistula survivors in North-central Nigeria: Interplay of structural violence

Obstetric Fistula is an abnormal opening between the vagina and rectum resulting from prolonged and obstructed labour. Studies indicate that delays in accessing maternal care and home birth contribute to the development of fistula. Survivors are usually women of low socioeconomic status residing in rural locations. This study explores the birthing experiences of 15 fistula survivors through a narrative inquiry approach at a repair centre in North-central Nigeria. Using structural violence as a lens, it describes the role of social, political and health systems in the inequitable access to care for women. For women opting for home births, preference for home delivery was mainly due to lack of finances, poor health systems and cultural practices. Rural location inhibited access as, women seeking facility delivery faced transfer delays to referral centres when complications developed. Inequitable maternal health services in rural locations in Nigeria are inherently linked to access to health care; and these contribute to the increased incidences of fistulae. Structural intervention is a health policy priority to address poor health systems and achieve universal health coverage to address maternal health issues in Nigeria

Effect of use of insecticide treated nets on birth outcomes among primips in a peri-urban slum settlement in south- east, Nigeria

Introduction Each year in sub-Saharan Africa, where 80 to 90% of the world's malaria cases occur, approximately 19 to 24 million women are at risk for malaria and its adverse consequences during pregnancy. The major impact of malaria during pregnancy in these regions is caused by persistent or recurrent, predominantly low-grade, sometimes sub-patent, parasitaemia. In Nigeria, malaria has severe negative effects on maternal health and birth outcomes, resulting in maternal anaemia, a high incidence of miscarriages and low birth weight. Primigravidae and secundigravidae are most at risk. Resistance to first-line antimalarials has increased in sub-Saharan Africa, and the available arsenal of alternative tools for malaria control in pregnancy is very limited. One of the most promising of these tools is insecticide-treated bed nets (ITNs), which have been shown to reduce the number of infective mosquito bites by 70 to 90% in a variety of ecologic settings. In Nigeria, the current use of ITNs by the at-risk groups, pregnant women and children under five years, is just 1%, according to the latest report of the Nigeria Demographic and Health Survey (NDHS). Aim This study aimed at examining the effects of the use of ITNs on pregnancy outcomes among 208 primigravidae. Methodology The study design was an analytical case control. One hundred and four subjects, the intervention group, received ITNs between August 2003 and January 2004. The other 104 subjects were the control. Data were obtained using the new World Health Organization antenatal care classifying form and the basic component checklist, and a self-structured, 30-item pre-tested questionnaire. The Apgar scores of the babies and their birth weights were observed and recorded for both the intervention and the control groups. Results The results showed that 83% of babies of mothers in the intervention group had a good condition at birth, while 87% of babies of mothers in the control group had a good condition at birth (p larger than 0.07; X2=1.69). A small increase in mean birth weight (0.001kg) of the babies of mothers in the intervention group was observed over those of mothers in the control group (p larger than 0.90). This showed that there were no significant beneficial impacts of the use of ITNs on foetal condition at birth, mean birth weight and low birth weight. Conclusion The use of ITNs by primigravidae in Okpoko, a peri-urban slum in south-eastern Nigeria, showed no significant impact on pregnancy outcome. South African Family Practice Vol. 49 (6) 2007: pp. 1

Nasopharyngeal pneumococcal carriage in Nigeria: A two-site, population-based survey

Changes in nasopharyngeal (NP) carriage of vaccine-type (VT) Streptococcus pneumoniae can be used to assess the effectiveness of a pneumococcal conjugate vaccine (PCV10). We conducted a baseline carriage survey in rural (Kumbotso, Kano) and urban (Pakoto, Ogun) Nigeria. In this cross-sectional study, we obtained data on demography, clinical history, risk factors, and took NP swabs for pneumococcal culture. We calculated crude and age-standardised carriage prevalence and used log-binomial regression to assess risk factors for carriage. Among children aged <5 years, 92% (95% CI: 88-95%) and 78% (73-82%), respectively, carried any pneumococcus and 48% and 50%, respectively, carried PCV10 serotypes. In Kumbotso, carriage prevalence was >40% across all ages. The age-standardized prevalence of pneumococcal carriage was 66% in Kumbotso and 40% in Pakoto. The most commonly identified serotypes were 19 F, 6 A and 23 F. Risk factors for carriage were young age, recent rhinorrhoea, cohabitation with ≥2 children aged <5 years, and sharing a bed with ≥2 persons. Pneumococcal carriage prevalence is high in this Nigerian population. Persisting prevalence of VT-carriage in older children and adults suggests that PCV10 introduction in children will not eliminate transmission of vaccine serotypes rapidly. High vaccine coverage will therefore be required to ensure full protection of children

Effect of extrusion ratio on microstructure and mechanical properties of microwave-sintered magnesium and Mg/Y2O3 nanocomposite

10.1007/s10853-008-2649-3Journal of Materials Science43134503-4511JMTS