Seroprevalence survey of rubella infection in pregnancy at the University of Benin Teaching Hospital, Benin City, Nigeria

Objective: To determine the serosusceptibility of rubella infection in pregnancy and the feasibility of establishing an organized prevention program in a tertiary hospital in Nigeria.Materials and Methods: This prospective, cross-sectional, laboratory-based study involved 300 consecutive pregnant women who gave informed consent and were screened for rubella immunoglobulins G (IgG) and M (IgM), using the ELISA-based quantitative assay at the University of Benin Teaching Hospital, Nigeria. Of the cohort, 30 women later withdrew. IgG seropositive samples were screened for IgM antibodies.Results: The mean age and parity of the women were 30.0 ± 4.8 years, 95% CI 29.727-30.873 and 2.0 ± 1.4; 95% CI 1.317-1.661, respectively. IgG seroprevalence was 53%, while 10.0% of all IgG seropositive women were IgM seropositive. Most infections were acquired before the age of 35. None of the women ever had previous rubella vaccination. Rubella vaccine is scarce in Nigeria.Conclusions: Prevalence of rubella seromarkers for previous and current infection is high. Facilities for routine diagnosis and vaccination are lacking. Initiation of organized screening and vaccination programs is limited by lack of vaccine. We recommend immunization of children and women of child-bearing age as a cost-effective public health intervention strategy for managing the sequelae of the congenital rubella syndrome

Neonatal jaundice and its management: Knowledge, attitude, and practice among expectant mothers attending antenatal clinic at University of Benin Teaching Hospital, Benin City, Nigeria

Introduction: Neonatal Jaundice (NNJ) is a common disorder worldwide and one of the important contributors to the high neonatal morbidity and mortality in Sub-Saharan Africa. Severe neonatal jaundice leads to brain damage or even death in otherwise healthy newborns. The objective of the study was to assess the knowledge, attitude and practice of expectant mothers about neonatal jaundice and its management.Materials and Methods: The study was descriptive cross-sectional, carried out among 389 expectant mothers who were attending the antenatal clinic at the University of Benin Teaching Hospital. A structured, Pre-tested, researcher administered questionnaire was used to interview the respondents. Data was analysed using SPSS version 15.Results: The mean age of the expectant mothers was 30.5 (SD 4.9) years. Fifty-five (14.1%) of respondents had previous experience with NNJ, 8 (2.1%) lost babies due to NNJ. 334 (85.9%) were aware of the condition, 381 (77.4%) knew how to recognize the symptoms of NNJ, 279 (71.7%) knew a correct method of treatment of NNJ. A large proportion ofthe expectant mothers 261 (67%) knew some complications of NNJ. Two hundred and five (52.7%) did not know any danger sign of complications of NNJ. Three hundred and fifty five (91.3%) had good attitude towards its management. Majority of expectant mothers whose previous babies had NNJ took the babies to the hospital for treatment. A large proportion also expressed their willingness to seek medical attention if their babies were to develop the condition. Their knowledge of neonatal jaundice was significantly influenced by their level of education and the number of theirprevious babies who had NNJ.Conclusion: This study revealed that expectant mothers attending antenatal clinic at UBTH had good knowledge of the treatment and complications of NNJ but inadequate knowledge of the causes and danger signs of the condition. Their attitude and practice towards the management of NNJ was good. It is therefore recommended that Health care providers should give more health education on NNJ to the expectant mothers during antenatal visits.Key words: Neonatal jaundice, expectant mothers, antenatal clinic, Benin Cit

Carcinoma Of The Uterine Cervix In Nigerian Women: The Need to Adopt a National Prevention Strategy.

Background: Cervical cancer is the second most common type of cancer affecting women, and was responsible for over 250,000 deaths in 2005, approximately 80% of which occurred in developing countries. Without urgent action, deaths due to cervical cancer are projected to rise by almost 25% over the next 10 years. Prevention of these deaths will contribute to the achievement of the Millennium Development Goals. In Nigeria, carcinoma of the cervix is the commonest malignancy of the female genital tract, with an estimated incidence of 32 per 100,000 females. As a result of extremely poor knowledge and attitude towards cervical screening, and limitations posed by lack of facilities and human resources for its control, many women are presenting with, and dying from, complications of advanced stages of this preventable disease. Unfortunately, there are only five major functional radiotherapy facilities in Nigeria at present culminating in very long waiting queues for treatment. Consequently, many women never benefit from treatment before they die in despair. The subject of this review is to explore how this situation can be reversed. Objective: To determine the magnitude of, and social factors associated with, cervical cancer in Nigeria and the efforts being made to reduce the disease burden in Nigerian women. To proffer cost-effective strategies for intervention. Method: The review of previous strategies employed in targeted, hospital-based cervical screening programs in Nigeria and literature search in Medline, PubMed and Google. Results: There is poor public awareness of cervical cancer and strategies for its prevention. The utilization of hospital-based prevention programs (cervical screening) is extremely poor leading to a minute percentage of the population at-risk being reached. Many women present with advanced stages of the disease that require radiotherapy, which many can neither access nor afford. Conclusion: The number of Nigerian women with unmet need for cervical cancer screening is large. We recommend the augmentation of current prevention strategies with three pragmatic models viz the “Hub and Spoke Model”, the “Mobile Van Cervical Cytology Clinic (MV3C) Model” and the “Screen and Treat Model” to reach the larger rural population who are the predominant victims of this disease. Keywords: Cervical cancer, Prevention, ‘Hub and Spoke', Mobile Clinic, Screen and Treat, Model, NigeriaSahel Medical Journal Vol. 11 (1) 2008: pp. 1-1

HIV-AIDS Related Maternal Mortality in Benin City, Nigeria

Objective: To determine the causes and characteristics of maternal deaths in HIV-infected women.Design: A retrospective study of maternal deaths in a cohort of HIV-infected women.Setting: A facility-based maternal death review using case records and mortality summaries.Methods: Thirty seven maternal deaths which occurred in HIV-infected women were reviewed in a university teaching hospital in southern Nigeria over a 4- year period. Causes and circumstances surrounding each maternal death were identified. Result: One in every four maternal deaths occur in women with HIV infection. Majority (64.9%) of the  women presented in advanced stage (WHO stage III/IV) of HIV syndrome while 86.5% had missed opportunities for antiretroviral programme. Pregnancyrelated sepsis was the commonest cause of maternal death. Other common causes were death from tuberculosis and pneumonia.Conclusion: HIV-related maternal death is emerging as a leading cause of pregnancy related death in Nigeria. There is need to scale-up preconception care and ensure comprehensive and sustainable prevention of mother -to-child transmission service for all pregnant women throughout Nigeria to reduce the burden of HIV/AIDS infection and minimize avoidable deaths from opportunistic infections