Perception and experience of menopause among primary school teachers in Jos North, north central Nigeria

Background: As life expectancy increases,most women spent a larger part of their lives in the post-menopausal state,with part of this during the peak of their career for working class women. Perception, attitude and experience of the menopause and its transitional period may differ from one female population to the other.Objective: The objective of this study was to determine the perception and experience of menopause among a group of educated Nigerian career women, and how menopausal symptoms affect their family relationship and work performance.Method: This was a cross sectional study.Two hundred and twenty five post menopausal primary school teachers in Jos North were administered structured questionnaires.The information obtained were analysed using Epi info 2002 statistical software.Results: Most of the women (99.1%) felt that menopause was a natural process of aging.The most frequently reported symptoms were low backache or muscle pains (72.9%),poor memory or forgetfulness (63.6%),hot flushes (51.1%) and tiredness (49.8%). Over half (55.6%) of the women were sexually active with 84.8% of them reporting reduced libido.Over half (56%) of the women studied felt that menopause negatively affected their work performance.Only 8% of the women had heard of hormone replacement therapy.Conclusion: Post-menopausal primary school teachers in Jos North have a positive perception of menopause. Menopausal symptoms are also common and this negatively affects work performance in quite a number of them.Keywords: Perception,Experience,Menopause,Primary school teacher

Pregnancy outcome among patients with sickle cell disease in Jos, north central Nigeria

Background: With advances in management, education, awareness and improved nutrition, men and women with sickle cell disease are enjoying an improved quality of life well into adulthood, when they elect to plan a family. As a result, sickle cell disease is a common haemoglobinopathy encountered during pregnancy in Nigeria. Reports from other parts of the country have documented increased maternal andperinatal morbidity and mortality, but none has been reported from Jos.Materials and Methods: A retrospective review of pregnancy outcome in patients with sicle cell disease managed at the Jos University Teaching Hospital, Jos over a 5year period was carried out. Data extracted from patients' case files were analysed using simple statistical methods with Epi info 2002 statistical software.Results: Case files of patients with sickle cell disease in pregnancy during the period under review were retrieved. The mean maternal age was 25.1±3.9 years. The mean gestational age at booking or first presentation was 19.3±7.7 weeks. The antenatal complications included anaemia (62.9%), vaso-oclusive (bone pain) crisis (58.1%), intra uterine growth restriction (45.7%), pregnancy induced hypertension and malaria 25.7% each. The maternal and perinatal mortality rates were 53 and 384 per 1000 live births respectively.Conclusion: Pregnancy in sickle cell disease patients is associated with high maternal and perinatal morbidity and mortality as reported in other parts of the country. The importance of early presentation for antenatal care and a call for preconception care is made.Keywords: Pregnancy, outcome, sickle cell, disease, Jo

Factors associated with use and discontinuation of Implanon contraceptive in Jos, Nigeria

Background: the contraceptive prevalence (CPR) in sub-Saharan Africa is low at 8-10% for over a decade. There is also the dominance of the less effective short-acting methods such as pills and injectables. The low CPR is the direct cause of the high total fertility of 5.7 in Nigeria. The use of contraception is the single most dominant contributory factor in fertility declines world-wide. This is especially more true with the use of long acting reversible contraceptive methods like implanon which has the potential to reduce the global burden of disease and mortality associated with a high total fertility rate.Objective: our aim was to analyse and determine the socio-demographic profiles of implanon acceptors and the factors associated with continuation or discontinuation of its use in the family planning programme of the Jos University Teaching Hospital, Jos Nigeria.Materials and Methods: This was a retrospective review carried out between March 2007 and March 2014 at the Jos University Teaching Hospital, Jos NigeriaResults: during the study period, 1482 women accepted implanon with about 85.8% having regular menstrual cycles. Sixty-one percent of these women were breastfeeding at insertion. Their mean age was 31 years with a range of 16 to 53. Christianity was the religion of 87.8% with 12.2% being Muslims. Just under half had tertiary education with over a third having attended secondary school. About 26.7% had no future fertility desires. Over 75% had previously used a contraceptive method. The mean parity in this study was 3.2 with a range of 0 to 12. The mean number of children alive was 2.9. Both the systolic and diastolic blood pressures were little affected by the use of implanon. However there was a mean weight gain among 900 of the women who came for follow up of 2.4 kg. However the weight change was highly variable with about a third of women losing between 1 to 30 kg, 10% not having any net changes and over 61% having a net weight gain of between 1 to 26 kg. About 3.8% had their implanon removed because of weight gain. The percentage loss to follow up was 28.2%. The 900 women who had follow up were exposed to the implanon for 2006.6 woman-years or 24,079 cycles. The mean number of months of exposure to the implant was 27.0 ± 14.7 months. The commonest reason for discontinuation was desire for pregnancy (36.1%) followed by those who changed to other methods (27.6%). Menstrual irregularity was the commonest side effect of implanon that led to removal. Seven in-treatment pregnancies occurred giving a pearl index of 0.35 although only one pregnancy was ultrasonographically-proven to be a method failure of the device.Conclusion: Accepting implanon was influenced by the educational attainment and religion of the women in our unit. The desire for another pregnancy was the commonest reason for discontinuation. However, menstrual irregularity was the commonest side effect of the implant that led to its removal especially in the first six months after insertion.Keywords: Implanon (etonogestrel) contraceptive, continuation rates, discontinuation, reason for discontinuation