Incidence and Determinants of Stillbirth amongst Parturients in Two Hospitals in Southern Nigeria

Background: Fetal death is a major but often overlooked public health issue. Aim: Knowledge of the causes and risk factors will help in designing measures to reduce the burden of fetal death in Nigeria. Materials and Methods: A 5 year descriptive study of all fetal mortality of >28 weeks in Southern Nigeria. Relevant details were extracted from the case notes and the registers in the labor ward, maternity ward, the labor ward theater and the main theater. Statistical Analysis Used: The data was analyzed using Statistical Package for Social Scientist (SPSS PC+) and this consisted of univariate analysis and comparisons of identified relationships. Results: The total number of deliveries from 28 weeks was 25,780 and the number of parturients with fetal mortality after 28 weeks was 157 and therefore the incidence of stillbirth was 0.6% giving a mortality rate of 6.1/1000 total births. However, 148 (85%) case notes of the total fetal deaths were retrieved and formed the study sample. Socio-demographic variables such as extremes of age and parity, unbooked status, unemployment, unmarried, Isoko, Itsekiri and Ijaw ethnic groups and primary level or no formal education were determinants of stillbirth. Others were maternal diabetes mellitus, malaria, hypertension, labor duration >4 h, instrumental or assisted vaginal delivery, gestational age at booking >12 weeks, low birth weight and preterm births. Conclusion: The fetal mortality (stillbirth) rate was low and the determinants were identified. Public health education, female education and socio-economic empowerment are suggested preventive measures.Keywords: Amongst parturients, determinants, fetal mortality, incidence, Southern Nigeria, stillbirt

Bacterial isolates from blood cultures of children with suspected septicaemia in Calabar, Nigeria

BACKGROUND: Septicaemia is a common cause of morbidity and mortality among children in the developing world. This pattern has changed little in the past decade. Physical signs and symptoms, though useful in identifying possible cases have limited specificity. Definitive diagnosis is by bacteriologic culture of blood samples to identify organisms and establish antibiotic susceptibility. These results are usually not available promptly. Therefore a knowledge of epidemiologic and antimicribial susceptibility pattern of common pathogens is useful for prompt treatment of patients. This report highlights the pattern of bacterial isolates in our environment from a retrospective study of our patients' records. METHODS: One thousand, two hundred and one blood samples were analysed from children aged 0–15 years, admitted into the children's wards of the University of Calabar Teaching Hospital, Calabar, Nigeria with features suggesting septicaemia. Samples were collected under aseptic conditions and cultured for aerobic and anaerobic organisms. Isolates were identified using bacteriologic and biochemical methods and antibiotic sensitivity determined by agar diffusion method using standard antibiotic discs. RESULTS: Bacteria was isolated in 552 (48.9%) of samples with highest rates among newborns (271 : 50.8). The most frequent isolates were Staphylococcal aureus (48.7%) and Coliforms (23.4%). Results showed high susceptibilities to the Cephalosporins (Ceftriazone- 100%:83.2%, Cefuroxime-100%:76.5%) and Macrolides (Azithromycin-100%:92.9%) for S. aureus and coliforms respectively. This study underscores the importance of septicaemia as a common cause of febrile illness in children and provides information on common prevalent aetiologic agents and drug susceptibilities of the commonest pathogens. CONCLUSION: Staphylococcus aureus and coliforms were the leading causes of septicaemia in children in this locality, and the third generation cephalosporins and azithromycin were shown to be effective against these pathogens