Pattern of Eclampsia in a Tertiary Health Facility Situated in a Semi-Rural Town in Northern Nigeria

Background/Objective: To determine the pattern of eclampsia and its contribution to maternal mortality at the Federal Medical Centre, Birnin Kudu, Jigawa State in Northern Nigeria.Method: A 4-year retrospective review of the case records of all women who presented with eclampsia at the center. All the case records were retrieved from the medical record department and analyzed.Results: There were 207 cases of eclampsia out of 2197 deliveries during the period giving an incidence of 9.42%. 171(82.6%) of the patients were unbooked. Majority (58.5%) of the patients were aged lessthan 20 years. The highest frequency (78.3%) was recorded in the primigravida. Delay before reaching the hospital was established in 116(56%) of patients. The condition was antepartum in 68(32.9%),intrapartum in 112(54.1%) and postpartum in 27(13%). 107(51.7%) of the patients were delivered by cesarean section. Twenty two (10.6%) of the mothers died. Eclampsia was the commonest cause ofmaternal mortality and contributed 43.1% of all maternal deaths. 180(87%) of the babies were delivered alive while 27(13%) died.Conclusion: Eclampsia is a major cause of maternal mortality. There is need for health education on the need for patients to avail themselves of antenatal care

Prevalence and Risk Factors of High Risk Human Papillomavirus Infections among Women Attending Gynaecology Clinics in Kano, Northern Nigeria

Cervical cancer is the most common female cancer in northern Nigeria, yet the pattern of infection with human papillomavirus, the principal aetiologic agent is unknown. This was a preliminary study conducted in two referral hospitals in order to establish base-line data on the prevalence and risk factors for the infection in Kano state, Nigeria. Fifty (50) randomly selected women aged 18 years and above were recruited from gynaecology clinics in Murtala Muhammad Specialist Hospital and Aminu Kano teaching Hospital. Relevant sexual and socio-demographic information were obtained from each subject using a questionnaire. Exfoliated cervical cells were harvested and processed using Polymerase Chain Reaction to identify the DNAs of high-risk HPV types 16 and 18. The prevalence rate of HPV infection was 76% [(38/50) at 95% CI=61.8-86.9] with 60.5% (23/38) having co-infections with both HPV type 16 and 18. Risk factors of the infection include low literacy level; living in rural settlements; low parity; early menarche (<15 years of age); early onset of first sexual intercourse (≤16 years of age) and multiple sexual partners. There was however, no statistically significant association between oral contraceptive usage and acquisition of the infections. Findings of this study suggest a high prevalence of HPV types 16 and 18 among women attending gynaecology clinic in Kano and thus called for more elaborate community based study in order to establish the magnitude of the problem from wider perspective.Keywords: Human Papillomavirus; Prevalence; Risk Factors, Northern Nigeri

Time Budget on Major Activities of Livestock Grazing Heterogeneous Natural Range and Crop Fields in Semi-Arid Nigeria

Semi-arid rangelands of West Africa provide herbs, trees and shrubs, which together with crop residues form the main sources of feed for the livestock population. Feed supply in this region is characterised by a progressive decline in quantity and quality with advancing dry season. It was reported that walking ability as well as watering frequencies affect the productivity of grazing livestock (Dicko and Sangare, 1984). This study tests the hypothesis that advancing season increases both time spent walking as well as feeding, with a switch from grazing to browsing

Pattern of Eclampsia in a Tertiary Health Facility Situated in a Semi-Rural Town in Northern Nigeria

Background/Objective: To determine the pattern of eclampsia and its contribution to maternal mortality at the Federal Medical Centre, Birnin Kudu, Jigawa State in Northern Nigeria. Method: A 4-year retrospective review of the case records of all women who presented with eclampsia at the center. All the case records were retrieved from the medical record department and analyzed. Results: There were 207 cases of eclampsia out of 2197 deliveries during the period giving an incidence of 9.42%. 171(82.6%) of the patients were unbooked. Majority (58.5%) of the patients were aged less than 20 years. The highest frequency (78.3%) was recorded in the primigravida. Delay before reaching the hospital was established in 116(56%) of patients. The condition was antepartum in 68(32.9%), intrapartum in 112(54.1%) and postpartum in 27(13%). 107(51.7%) of the patients were delivered by cesarean section. Twenty two (10.6%) of the mothers died. Eclampsia was the commonest cause of maternal mortality and contributed 43.1% of all maternal deaths. 180(87%) of the babies were delivered alive while 27(13%) died. Conclusion: Eclampsia is a major cause of maternal mortality. There is need for health education on the need for patients to avail themselves of antenatal care.Fond/Objectif: Pour d\ue9termine la distribution de l'\ue9clampsie et sa contribution a la mortalit\ue9 maternelle au centre de sant\ue9 m\ue9dical f\ue9d\ue9ral de Birnin Kudu, \ue9tat de Jigawa au Nord du Nigeria. M\ue9thodologie: Ceci est une revue r\ue9trospective pendant quatre ans des cas reportes de toutes les femmes qui se sont pr\ue9sent\ue9es avec l'\ue9clampsie a ce centre. Tous ces rapports ont \ue9t\ue9 obtenu au d\ue9partement des rapports m\ue9dicaux et ont \ue9t\ue9 analyses. R\ue9sultats: Il y a eu 207 cas d'\ue9clampsie permis 2197 naissances. Ceci donne une incidence de 9.42%. 171 (82.6%) de tous ces patients n'ont pas fait de visite pr\ue9natale. La majorit\ue9 des patients (58.5%) \ue9taient ages de moins de 20 ans. La fr\ue9quence la plus \ue9lev\ue9e (78.3%) a \ue9t\ue9 obtenu parmi les primigravid. Le retard avant de se pr\ue9senter au centre de sant\ue9 a \ue9t\ue9 \ue9table chez 116 (56%) des patients. La condition \ue9tait pr\ue9natale chez 68 (32.9%), intra natale chez 112 (54.1%) et postnatale chez 27 (13%). Chez 107 (51.7%) patients, l'accouchement s'est fait par caesarienne. 22 (10.6%) de maman \ue9taient decedees. L'\ue9clampsie \ue9tait la cause de la mortalit\ue9 maternelle la plus \ue9lev\ue9e et a contribue a 43.1% de tous les d\ue9c\ue8s maternels. 180(87%) b\ue9b\ue9s sont n\ue9s vivant alois que 27(13%) \ue9taient mort nes. Conclusion: L'\ue9clampsie est la cause majeure de la mortalit\ue9 maternelle. Les patients ont besoin d'\ueatre \ue9duques et aussi d'aller aux visites pr\ue9natales

Uterine Prolapse Following Fundal Pressure in the First Stage of Labour: A Case Report

The use of fundal pressure to assist a woman in labor is a controversial procedure. Its benefits are yet to be scientifically confirmed and it is associated with complications such as perineal lacerations, uterine rupture and uterine inversion. A case is reported of a 28year old Gravida 5 Para 4\u2009+\u20090 (3 Alive) who presented to Aminu Kano Teaching Hospital, (AKTH) Kano, Nigeria with uterine prolapse following fundal pressure done in the first stage of labor in a peripheral hospital. She was delivered by Cesarean section and the prolapse successfully reduced under general anesthesia. Health workers need education on the risks associated with fundal pressure. Alternative methods of aiding women in labor should be promoted.L'utilisation de la pression fundale pour assister une femme en travail est une proc\ue9dure controversiale. Ses b\ue9n\ue9fices m'ont pas encore \ue9t\ue9 scientifiquement confirmes et il est associe aux les complications tels que: lac\ue9ration perinale, rupture de l'ut\ue9rus et inversion de l'ut\ue9rus. Il y a eu un reportage d'une femme de 28 ans, G5P4+0 (3 envie) qui s'est pr\ue9sent\ue9e au centre universitaire hospitalier de Kano, Nigeria avec une prolapse ut\ue9rine sur venue apr\ue8s une pression fundale faite pendant la premi\ue8re \ue9tape de l'accouchement dans un autre h\uf4pital. L'accouchement s'est fait par caesarienne et la prolapse a \ue9t\ue9 r\ue9duite sous anaesthesie g\ue9n\ue9rale. Les personnels de sant\ue9 ont besoin d'\ueatre \ue9duquer sur les risques associes a la pression fundale. D'autres m\ue9thodes pour aider les femmes en travail doivent \ueatre encourag\ue9es. Les personnels de sant\ue9 doivent \ueatre \ue9duquer sur les dangers associes a la pression fundale et sa pratique doit \ueatre d\ue9courager

What Are the Contextual Enablers and Impacts of Using Digital Technology to Extend Maternal and Child Health Services to Rural Areas? Findings of a Qualitative Study From Nigeria

Background: Strengthening health systems to improve access to maternity services remains challenging for Nigeria due partly to weak and irregular in-service training and deficient data management. This paper reports the implementation of digital health tools for video training (VTR) of health workers and digitization of health data at scale, supported by satellite communications (SatCom) technology and existing 3G mobile networks. Objective: To understand whether, and under what circumstances using digital interventions to extend maternal, newborn and child health (MNCH) services to remote areas of Nigeria improved standards of healthcare delivery. Methods: From March 2017 to March 2019, VTR and data digitization interventions were delivered in 126 facilities across three states of Nigeria. Data collection combined documents review with 294 semi-structured interviews of stakeholders across four phases (baseline, midline, endline, and 12-months post-project closedown) to assess acceptability and impacts of digital interventions. Data was analyzed using a framework approach, drawing on a modified Technology Acceptance Model to identify factors that shaped technology adoption and use. Results: Analysis of documents and interview transcripts revealed that a supportive policy environment, and track record of private-public partnerships facilitated adoption of technology. The determinants of technology acceptance among health workers included ease of use, perceived usefulness, and prior familiarity with technology. Perceptions of impact suggested that at the micro (individual) level, repeated engagement with clinical videos increased staff knowledge, motivation and confidence to perform healthcare roles. At meso (organizational) level, better-trained staff felt supported and empowered to provide respectful healthcare and improved management of obstetric complications, triggering increased use of MNCH services. The macro level saw greater use of reliable and accurate data for policymaking. Conclusions: Simultaneous and sustained implementation of VTR and data digitization at scale enabled through SatCom and 3G mobile networks are feasible approaches for supporting improvements in staff confidence and motivation and reported MNCH practices. By identifying mechanisms of impact of digital interventions on micro, meso, and macro levels of the health system, the study extends the evidence base for effectiveness of digital health and theoretical underpinnings to guide further technology use for improving MNCH services in low resource settings. Trial Registration: ISRCTN32105372