Neonatal Sepsis in Rural Ghana: A Case Control Study of Risk Factors in a Birth Cohort

Neonatal sepsis poses a major challenge to achieving the MDG-4 due to lack of facilities to implement proposed management guidelines. Identifying risk factors of neonatal sepsis will help put strategies in place to prevent sepsis. This prospective case control study investigated risk factors of neonatal sepsis in the Asutifi District a typical rural setting of the Brong Ahafo Region of Ghana. A semi-structured check list was used to collect clinical and demographic data from 196 neonates (96 with sepsis as case and 100 without sepsis as control) and respective mothers. Maternal factors that were significantly associated with neonatal sepsis were foul smelling liquor (p=0.001), meconium stained amniotic fluid (p= 0.000), parity (p=0.000), history of UTI/STI (p=0.002) and maternal age (0.017). Neonatal factors that were significantly associated with sepsis include male sex (p=0.040), preterm (p=0.000), not crying immediately after birth (p=0.001), low birth weight \u3c2500g \u3e(p=0.000), APGAR score less than 7 (p=0.000) and resuscitation at birth (p=0.004). Priority attention must be given to neonates and mothers with the aforementioned characteristics during antenatal and postnatal care to prevent sepsis

Chlamydia trachomatis infection and maternal outcomes in Southern Ghana

Background: Despite the fact that Chlamydia trachomatis (CT) infection in pregnancy is known to have grave impact on maternal and neonatal health, routine CT screening in pregnancy is not available in Ghana The main aim of this study was to determine the prevalence and adverse maternal outcomes of CT infection among pregnant women attending antennal clinic at the Cape Coast Teaching Hospital.Methods: Two hundred and thirty two (232) pregnant women screened for CT infection by PCR were purposively selected and enrolled into the study after informed consent had been obtained. They included one hundred and twelve (112) participants with positive CT (cases) and 120 participants without CT infections (control). A structured questionnaire was used to collect their socio demographic, obstetric and medical history. They were monitored thereafter and data on maternal outcomes were collected.Results: The prevalence of CT infection was 5.6% (112/2014). A history of STI/UTI (p<0.001) spontaneous abortion (p=0.02), preterm labour (p<0.001) and intrapartum or postpartum fever (p<0.001) were found to be associated with CT infection. However a history of Stillbirth, PID and having been treated for infertility were not associated with CT infection. Participants with CT infection were more likely to have PROM (p<0.001) and FSL (p<0.001) than those who were not infected. Parity and mode of delivery on the other hand were not associated with CT infection.Conclusions: To alleviate the adverse maternal outcomes, screening for CT infection in pregnancy should be offered routinely to pregnant women to promote early detection and treatment.  

Effects of Chronic Hepatitis B Infection on Pregnancy and Birth Outcomes in Ghana

Ghana is a known endemic area for hepatitis B virus (HBV) infections, yet the consequences of HBV infection on pregnancy outcomes are unknown. This prospective cohort study was thus conducted among 512 pregnant women attending antenatal clinic in the Cape Coast Teaching Hospital, Ghana, between January, 2011 and December, 2013 to determine the effects of hepatitis B during pregnancy on birth outcomes in Ghana. The HBsAg status of all pregnant women was determined by the latex agglutination test while a researcher administered semi-structured checklist was used to collect demographic/obstetric/medical data of respondents. We obtained 262 HBsAg positive and 250 HBsAg negative women most of whom were aged 20-29 (40%), classified themselves as low income earners (50%), and had attained primary education (42%). Logistic regression analysis showed that pregnant women who had chronic hepatitis B were more likely to develop PROM (p=0.008) and foul smelling liquor (p=0.024) at delivery. Moreover, neonatal consequences for chronic hepatitis B were; preterm babies (p=0.002), underweight (p\u3c0.001), Apgar score lower than 7 (p\u3c0.001), asphyxia at birth (p=0.006) and still birth (p=0.04). We conclude that babies born to mothers with positive HBsAg status have a higher risk for vertical transmission as well as adverse neonatal consequences

Chlamydia trachomatis infection and maternal outcomes in Southern Ghana

Background: Despite the fact that Chlamydia trachomatis (CT) infection in pregnancy is known to have grave impact on maternal and neonatal health, routine CT screening in pregnancy is not available in Ghana The main aim of this study was to determine the prevalence and adverse maternal outcomes of CT infection among pregnant women attending antennal clinic at the Cape Coast Teaching Hospital.Methods: Two hundred and thirty two (232) pregnant women screened for CT infection by PCR were purposively selected and enrolled into the study after informed consent had been obtained. They included one hundred and twelve (112) participants with positive CT (cases) and 120 participants without CT infections (control). A structured questionnaire was used to collect their socio demographic, obstetric and medical history. They were monitored thereafter and data on maternal outcomes were collected.Results: The prevalence of CT infection was 5.6% (112/2014). A history of STI/UTI (p&lt;0.001) spontaneous abortion (p=0.02), preterm labour (p&lt;0.001) and intrapartum or postpartum fever (p&lt;0.001) were found to be associated with CT infection. However a history of Stillbirth, PID and having been treated for infertility were not associated with CT infection. Participants with CT infection were more likely to have PROM (p&lt;0.001) and FSL (p&lt;0.001) than those who were not infected. Parity and mode of delivery on the other hand were not associated with CT infection.Conclusions: To alleviate the adverse maternal outcomes, screening for CT infection in pregnancy should be offered routinely to pregnant women to promote early detection and treatment.