Perinatal outcome in anaemic pregnant women in South-Western Nigeria

Background: Anaemia in pregnancy is a global public health problem in most developing and developed countries with major consequences for human health as well as social and economic development. Fetuses of anaemic mothers are at risk of preterm deliveries, low birth weights, morbidity and perinatal mortality due to the impairment of oxygen delivery to placenta and foetus.Methods: This study was conducted at the antenatal clinic and labour ward complex of a teaching hospital in south-western Nigeria to determine the effect of anaemia in pregnancy on perinatal outcome. Eligible participants were enrolled for the study by consecutive sampling method. Relevant data were extracted from the case records of these eligible women and a structured interviewer administered questionnaire was used for the data collection.Results: There were statistically significant differences between anaemia and reduced gestational age at birth (P = 0.000), low one-minute (P = 0.000) and five-minute (P = 0.003) Apgar scores, reduced birth weight (P=0.005) and foetal death (P = 0.013). No significant difference was noted in the rate of neonatal admission in the two groups (P = 0.085).Conclusion: This study has thus highlighted the importance of considering maternal anaemia as an indicator of adverse perinatal outcomes. There is therefore, a need to counsel intending mothers and their partners about early antenatal booking, compliance with routine antenatal medications and prompt identification and treatment of anaemia in pregnancy, all as means of curtailing the overwhelming perinatal morbidity and mortality associated with the condition.

Preterm delivery and low maternal serum cholesterol level: any correlation?

Background: Preterm birth is a major challenge in perinatal health care with prematurity accounting for 40-60% of all perinatal deaths in Nigeria. The physiologic hypercholesterolaemia of later pregnancy suggests an adaptive function for pregnancy maintenance or fetal growth. Decreased levels of maternal total cholesterol and low-density lipoprotein cholesterol have been reported in association with preterm delivery.Methods: This was a prospective observational cohort study designed to assess whether low maternal serum cholesterol during early pregnancy is associated with preterm delivery in these women. Eligible participants were enrolled for the study at gestational age of 14 to 20 weeks over a period of 12 months. Blood samples were obtained to measure total serum cholesterol concentrations and the sera were then analyzed enzymatically by the Cholesterol Oxidase: p-Aminophenazone (CHOD PAP) method.Results: The study showed an incidence of 5.0% for preterm delivery in the low risk study patients. Preterm birth was 4.83-times more common with low total maternal cholesterol than with midrange total cholesterol (11.8% versus 2.2%, P = 0.024).Conclusions: We can infer from the study that the low maternal serum cholesterol (hypocholesterolaemia) is associated with preterm delivery. We can therefore recommend on this basis that the concept of an optimal range for maternal serum cholesterol during pregnancy may have merit and pregnant women should be encouraged to follow a healthy, balanced diet and ensure regular antenatal visit to their healthcare provider

Mobility of the Poor in Akure Metropolis: Income and Land Use Approach

Nigeria being a developing economy still has a high percentage of low income earners. Mobility and modal choice affect us all in our daily life whether we are commuting to work or for recreational purpose. Catering for the effective and efficient mobility of this unique set of low income earners is a task for transport planners. This research assessed the mobility of the poor using land use and level of income. The study area was divided into six zones based on the land use configuration.Income level, frequency of trip and the predominant modal choice for both work and business trip were evaluated. The result showed that the use of taxi and motor cycle in the study area is high. The low income group has the highest frequency of trip base on the level of income and land use. The result of this research will aid the government at all levels and policy makers in formulating a good transportation scheme for the low income earners now and in the foreseeable future. It will also provide policy makers with an improved understanding of the travel behavior of the poor and their preferred modal choic

Knowledge and Acceptability of Human Papillomavirus Vaccination among Women Attending the Gynaecological Outpatient Clinics of a University Teaching Hospital in Lagos, Nigeria

Objectives. This study was aimed at determining the knowledge and acceptability of HPV vaccine among women attending the gynaecology clinics of the Lagos University Teaching Hospital (LUTH). Methods. This was a descriptive cross-sectional study involving 148 consecutively selected women attending the gynaecology clinic of LUTH. Relevant information was obtained from these women using an interviewer-administered questionnaire. The data was analysed and then presented by simple descriptive statistics using tables and charts. Chi-square statistics were used to test the association between the sociodemographical variables and acceptance of HPV vaccination. All significance values were reported at P<0.05. Results. The mean age of the respondents was 35.7±9.7 years. The study showed that 36.5% of the respondents had heard about HPV infection while only 18.9% had knowledge about the existence of HPV vaccines. Overall, 81.8% of the respondents accepted that the vaccines could be administered to their teenage girls with the level of education of the mothers being the major determinant of their acceptability (P=0.013). Conclusions. Awareness of HPV infections and existence of HPV vaccines is low. However, the acceptance of HPV vaccines is generally high. Efforts should be made to increase the awareness about cervical cancer, its aetiologies, and prevention via HPV vaccination

UNIVERSITY COMMUNITY COMMUTING TRIP PATTERNS: TEMPORAL ASSESSMENT

The trip pattern of the university community is a vital component of the overall transportation demand of a province, but it is not well epitomized in travel demand models. This descriptive research assessed the temporal commuting pattern in the university environment, with special focus on universities in southwestern Nigeria. This study was achieved by using detailed questionnaires and oral interviews for data collection from both staff and students in the universities considered. Information on socioeconomics, demographics, the frequency of trips, trip time, and transportation mode choice were analyzed. We adopted statistical software SPSS version 21 and Microsoft Excel for the data analysis. The results of our research showed that the use of the shuttle as a transportation mode declined as the trip time increased, among university staff, with an R2 of 0.9308. Conversely, bicycle use increased irrespective of the trip time for both student and staff, with a R2 value of 0.928. Universities’ commuting patterns are important, because the commuting habits of students and staff have consequences on the motivation for both study and work. Ultimately, this data will help transportation policy makers work on the effective strategy required for efficient transportation planning in the university environment in similar cities in Nigeria and developing nations

Health insurance status affects hypertension control in a hospital based internal medicine clinic

Hypertension is a worldwide disorder that contributes significantly to morbidity, mortality, and healthcare costs in both developed and developing communities. A retrospective cohort study of hypertensive patients attending the Internal Medicine continuity clinic at Nashville General Hospital (NGH) between January and December 2007 was conducted. Given the easy access to health care at NGH and affordable Blood pressure (BP) medications, we explored the ability to achieve optimal BP control <140/90 ​mmHg and evaluated which factors are associated. Of the 199 subjects, 59% achieved BP goal <140/90 ​mmHg. The mean BP was 139/80 ​mmHg. Health insurance status was associated with SBP and DBP (All P ​< ​0.046). Patients with health insurance had a 2.2 fold increased odds of achieving BP control compared to patients without health insurance (P ​= ​0.025). Furthermore, the number of BP medications used was significantly associated with SBP and DBP (All P ​< ​0.003). Patients taking more than three BP medications had a 58% reduced odds of achieving optimal BP control compared to patients taking one medication (P ​= ​0.039). Ethnicity was not associated with achieving BP control. Our study revealed the number of BP medications used and health insurance status, are factors associated with achieving BP control

A Study on the Association between Low Maternal Serum Magnesium Level and Preterm Labour

Objectives. The study was aimed to assess the association between low maternal serum magnesium levels and preterm labour. Methods. It is a cross-sectional case-control study in which eligible participants were pregnant women admitted in labour within the labour ward complex of a Lagos tertiary hospital. Relevant data were extracted from the case records of these women and blood samples were obtained from all participants and serum magnesium levels measured. Results. The study showed that 36% of the study patients had varying degrees of hypomagnesaemia. The relative risk indicates that preterm labour is 1.83 times higher among the patients with low serum magnesium (less than 1.6 mg/dL). The mean difference in serum magnesium levels in both groups was statistically significant (P<0.05). Conclusion. We can infer that low serum magnesium (hypomagnesaemia) is associated with preterm onset of labour. We can, also from this finding, formulate a proposition that would help in preventing preterm labour and birth with the use of prophylactic oral magnesium supplementation among patients with higher risk for development of preterm labour

Participation in innovation platform and asset acquisitions among farmers in Southern Africa

Asset development is a crucial tactic for advancing social and economic development in Southern Africa. But until now, there has not been any solid evidence of how asset-building strategies affect Southern African households. This study investigates the relationship between participation in innovation platforms and the acquisition of assets among farmers. Data for the study were collected using a multistage sampling approach. The data were analyzed using the Endogenous Treatment Linear Regression model. According to the findings of the first regression (Probit regression), gender, marital status, years of education, number of male working-class members, number of female working-class members, number of aged dependents in the household, access to extension service and locational effect of farmers in Mozambique have a significant relationship with the participation of farmers in Innovation Platforms. The results of the endogenous treatment linear model for asset acquisition among farmers reveal gender, age, marital status, number of male-working class members, access to extension service, the locational effect of farmers in Mozambique, and participation in the activities of the Innovation Platform are all statistically significant. After controlling for observed and unobserved covariates, the study concluded that participation in the activities of Innovation Platforms has a positive relationship with the acquisition of assets among the farmers than they would have in the absence of participation in Innovation Platforms. Therefore, farmers need to enhance their asset base by participating in Innovation Platforms. This has a significant implication for the attainment of most of the targets of the SDG

Predictors of Discontinuation of Subdermal Levonorgestrel Implants (Jadelle) at the Lagos University Teaching Hospital, Lagos, Nigeria: An Analytic Cohort Study

Uptake and continuation of long acting reversible contraceptives (LARC) such as subdermal levonorgestrel implants are pivotal to the achievement of some sustainable development goals (SDG). We evaluated Jadelle uptake and factors affecting its discontinuation in the first three years of&nbsp; initiation at the Family Planning Clinic of the College of Medicine, University of Lagos (CMUL), Nigeria. A retrospective cohort study was conducted among 517 consecutive new Jadelle acceptors, at the family planning clinic of CMUL, between 1 October 2007 and 30 September 2010, who were followed up till 30 September 2011. Survival life table analysis, Kaplan-Meier plots and multivariable Cox proportional hazard regression were conducted to evaluate factors affecting time to Jadelle discontinuation. Stata version 13 statistical software (StataCorp USA) was used for analysis. The mean age of Jadelle acceptors was 32.9 (S.D: ±5.4) years and uptake rate of Jadelle was 61.8%. The overall discontinuation rate was 19 per 100 women-years while the 1-year, 2-year and 3-year Jadelle discontinuation rates were 7.1%; 27.0% and 58.1% respectively. Increased age, (P=0.047) and previous contraceptive use (P &lt;0.001) were independent predictors of Jadelle discontinuation. Menstrual irregularity (51.4%) and intention to get pregnant (40.3%) were the commonest reasons for discontinuation. The failure rate was low at 0.27 per 100 women-years. This study showed that Jadelle had a high uptake rate complimented by a low failure rate; and is quite suitable for postpartum childbirth spacing as well as ongoing long term contraception. Keywords: Clinical experience, Jadelle, Lagos, long acting reversible contraceptives (LARC), progestogen only implant, survival analysis, Nigeria &nbsp; L'adoption et la poursuite de contraceptifs réversibles à longue durée d'action (LARC) tels que les implants sous-cutanés de lévonorgestrel sont essentiels à la réalisation de certains objectifs de développement durable (ODD). Nous avons évalué l'adoption de Jadelle et les facteurs affectant son arrêt au cours des trois premières années d'initiation à la Clinique de planification familiale du Collège de médecine de l'Université de Lagos (CMUL), au Nigéria. Entre le 1er octobre 2007 et le 30 septembre 2010, une étude de cohorte rétrospective a été menée auprès de 517 nouveaux accepteurs Jadelle consécutifs, à la clinique de planning familial du CMUL, suivis jusqu'au 30 septembre 2011. Une analyse de la table de survie, des parcelles de Kaplan-Meier et une régression proportionnelle multivariable du risque de Cox ont été réalisées pour évaluer les facteurs affectant le délai avant l'arrêt de Jadelle. Le logiciel statistique Stata version 13 (StataCorp USA) a été utilisé pour l'analyse. L'âge moyen des accepteurs de Jadelle était de 32,9 ans (ET: ± 5,4) et le taux d'absorption de Jadelle était de 61,8%. Le taux global d'abandon était de 19 pour 100 femmes-années tandis que les taux d'abandon Jadelle 1 an, 2 ans et 3 ans étaient de 7,1%; 27,0% et 58,1% respectivement. L'augmentation de l'âge (P = 0,047) et l'utilisation antérieure de contraceptifs (P &lt;0,001) étaient des prédicteurs indépendants de l'arrêt de Jadelle. L'irrégularité menstruelle (51,4%) et l'intention de tomber enceinte (40,3%) étaient les raisons les plus courantes de l'arrêt. Le taux d'échec était faible à 0,27 pour 100 femmes-années. Cette étude a montré Ohazurike et al. Jadelle Discontinuation in Lagos, Nigeria 49 African Journal of Reproductive Health June 2020; 24 (2): que Jadelle avait un taux d'absorption élevé complété par un faible taux d'échec; et est tout à fait adapté à l'espacement des naissances post-partum ainsi qu'à la contraception à long terme en cours. Mots-clés: Expérience clinique, Jadelle, Lagos, contraceptifs réversibles à longue durée d'action (LARC), implant progestatif seul, analyse de survie, Nigéri