Missed Opportunities in Comprehensive Response to Sexual Assaults in Ekiti State, Nigeria

Sexual assault referral centres were designed to provide comprehensive services to survivors to mitigate the physical and psychological consequences of rape. However, some of the survivors who reported at these centres did not benefit fully from these, thereby presenting as missed opportunities. We assessed the missed opportunities among the survivors who reported at Ekiti Sexual Assault Referral Centre, Ado-Ekiti, Nigeria from June 2020 to June 2022. Data were extracted from the records of the Ekiti Sexual Assault Referral Centre, Ado-Ekiti and the Department of Public Prosecution of Ekiti State Ministry of Justice, Ado-Ekiti. The missed opportunities for post-exposure prophylaxis for HIV, emergency contraception, economic empowerment and relocation/shelter services were 62.2%, 35.9%, 42.3% and 4.3% respectively. There were 18 convictions out of the 21 concluded cases. Delayed reporting and poor compliance with follow-up schedules appear to be common denominators in these missed opportunities. To improve on the effectiveness of these services, there is a need to understand the cascade of events leading to delayed reporting and poor compliance with follow-up schedules by the survivors. Mobilisation of adequate financial resources is also expedient for the effective delivery of these services

Pain perception among parturients at a University Teaching Hospital, South-Western Nigeria

Introduction: Labour pain is a universal experience. Relief of labour pains and companionship in labour are important aspects of quality of care in labour. Objectives: To evaluate perception of labour pains among parturients, their knowledge and awareness of pain relief during labour, the types of obstetric analgesia available and the outcome of their labour at the Ekiti State University Teaching Hospital, Ado-Ekiti. Materials and Methods: A cross-sectional study using questionnaire administered to pregnant women between 37 and 42 weeks gestational age in labour ward of the hospital. Results: The study revealed that 75.2% of the parturients experienced severe labour pains and 35.3% of them received analgesia in labour with Pentazocine injection being the only analgesic used. Only 18.3% had maximum relief of their pains. Parturients with increasing parity, higher social class and educational attainment and who had antenatal education on labour pains were associated with severe perception of labour pains with P values of 0.03, 0.03, 0.02 and 0.01, respectively. Parturients who were given Pentazocine injection for pains and had relief in labour had more spontaneous vaginal deliveries, P = 0.030 and better outcome for their babies, P = 0.028. Majority of the women reported that the practice of companionship and back rubbing in labour helped them to cope better with the labour process. Conclusion: Most women desire relief of pains of labour but the practice is still suboptimal in this centre. Efforts should be made towards developing the practice of obstetric analgesia and companionship in labour in this environment

Effect of intermittent preventive treatment of malaria on the outcome of pregnancy among women attending antenatal clinic of a new Nigerian teaching hospital, Ado-Ekiti

Background: Malaria is a public health problem globally especially in the Sub-Saharan Africa and among the under five children and pregnant women and is associated with a lot of maternal and foetal complications. Objective: The study was on the effect of intermittent preventive treatment of malaria in pregnancy on the prevalence of malaria in pregnancy and the outcome of pregnancy. Materials and Methods: In a descriptive cross-sectional study, a semi-structured questionnaire was administered to women admitted in Ekiti State University Teaching Hospital labour ward, Ado-Ekiti. About 4,200 women participated in the study and the inclusion criteria were women who were booked in the hospital, attended at least four antenatal clinic visits, and consented to the study while the exclusion criteria were those who didn′t book in the hospital and failed to give their consent. Results: The study revealed that about 75% of the pregnant women studied had access to intermittent preventive treatment of malaria. Among the women attending the antenatal clinic that received sulphadoxine-pyrimethamine (SP), about 78% of them took two doses of SP. The prevalence of clinical malaria was statistically higher in women who did not receive intermittent preventive treatment with SP during pregnancy (44.7% vs. 31.3%, P = 0.0001) and among women who had one dose of the drug instead of two doses (40.0% vs. 28.7%, P = 0.0001). There was no statistical significant difference in the mean age in years (31.53 ± 5.238 vs. 31.07 ± 4.751, P = 0.09 and the gestational age at delivery (38.76 ± 1.784 vs. 38.85 ± 1.459, P = 0.122) between the women who did not receive SP and those who had it. There was a statistical significant difference in the outcome of pregnancy among women who had Intermittent Preventive Treatment in pregnancy (IPTp) and those who did not viz.-a-viz. in the duration of labor (8.6 ± 1.491 vs. 8.7 ± 1.634, P = 0.011) and the birth weight of the babies (3.138 ± 0.402 vs. 3.263 ± 0.398, P = 0.0001). Conclusion: SP is an effective malarial prophylaxis in pregnancy

Quality of life in women of reproductive age: a comparative study of infertile and fertile women in a Nigerian tertiary centre

The study examined the quality of life in women of reproductive age and the aim was to evaluate and compare the quality of life (QoL) scores among fertile and infertile women. A cross-sectional study was carried out among women attending the Gynaecology and Postnatal Clinics of Ekiti State University Teaching Hospital comparing their QoL using the World Health Organisation Quality of Life-BREF (WHOQOL-BREF) questionnaire. The age of fertile women was significantly higher than the age of infertile women (p < .05), while a significantly higher proportion of the infertile and fertile women and their spouses were civil servants (p < .05). Infertile women obtained significantly higher scores than fertile women in the physical domain (QoL) and significantly lower scores than fertile women in the social domain (QoL), (p < .05). Among the infertile women, those with secondary infertility had significantly better overall QoL scores, (p < .05). Logistic regression showed that infertility and unemployment in women were associated with significantly lower QoL scores in psychological and social domains (p < .05). The quality of life is significantly lower among infertile women compared to fertile ones and this should be borne in mind when attending to these women.Impact statement What is already known on this subject: Infertility has been shown to be associated with poor quality of life. Most of these studies were conducted in developed countries. What the results of this study add: The findings of this study revealed that women who were infertile had low quality of life scores compared to the fertile ones in physical, social and psychological domains. What the implications are of these findings for clinical practice and/or further research: A community-based and multicultural study involving more participants may shed more light on this topic in future research. Counselling sessions should be incorporated as part of the holistic approach in the day-to-day management of the infertile women

Perceptions and Practice of Early Diagnosis of Sickle Cell Disease by Parents and Physicians in a Southwestern State of Nigeria

Background. Early sickle cell disease (SCD) diagnosis has shown promise in combating SCD in many countries. The aim of this study was to assess the practice and perception of early SCD diagnosis among a group of parents and physicians in Nigeria. Patients and Methods. This was a cross-sectional descriptive study conducted to assess the opinions and practice of early diagnosis of SCD among 135 physicians caring for SCD patients and 164 mothers of children with SCD in a southwestern state of Nigeria. Results. Most physicians 132 (97.8%) were aware of prenatal SCD diagnosis, but only 51 (37.8%) would recommend it. Most physicians 129 (95.6%) routinely recommend premarital SCD genetic counseling and testing, and 89 (65.1%) were aware of the national government newborn screening program but lesser proportion 75 (55.6%) were willing to recommend it. Amongst the mothers, 154 (94%) and 158 (96%) had encountered genetic counseling for SCD and were willing to offer newborn screening to their children, respectively. On the contrary, fewer mothers 42 (25%) were aware of prenatal SCD diagnosis, 28 (17%) were willing to partake in it, and 44 (26%) were undecided. There were discrepancies in the willingness by physicians to practice early SCD diagnosis and its uptake by mothers (p<0.0001). The commonest reason given by both the physicians and mothers for not practicing SCD prenatal diagnosis was the high cost of the procedure. Conclusion. The perceptions and practice of early SCD diagnosis was suboptimal in the study locality. Scaling up awareness and universal coverage are required