Seroprevalence survey of rubella infection in pregnancy at the University of Benin Teaching Hospital, Benin City, Nigeria

Objective: To determine the serosusceptibility of rubella infection in pregnancy and the feasibility of establishing an organized prevention program in a tertiary hospital in Nigeria.Materials and Methods: This prospective, cross-sectional, laboratory-based study involved 300 consecutive pregnant women who gave informed consent and were screened for rubella immunoglobulins G (IgG) and M (IgM), using the ELISA-based quantitative assay at the University of Benin Teaching Hospital, Nigeria. Of the cohort, 30 women later withdrew. IgG seropositive samples were screened for IgM antibodies.Results: The mean age and parity of the women were 30.0 ± 4.8 years, 95% CI 29.727-30.873 and 2.0 ± 1.4; 95% CI 1.317-1.661, respectively. IgG seroprevalence was 53%, while 10.0% of all IgG seropositive women were IgM seropositive. Most infections were acquired before the age of 35. None of the women ever had previous rubella vaccination. Rubella vaccine is scarce in Nigeria.Conclusions: Prevalence of rubella seromarkers for previous and current infection is high. Facilities for routine diagnosis and vaccination are lacking. Initiation of organized screening and vaccination programs is limited by lack of vaccine. We recommend immunization of children and women of child-bearing age as a cost-effective public health intervention strategy for managing the sequelae of the congenital rubella syndrome

The Prevalence of Dual Human Immunodeficiency Virus/Hepatitis C Virus (HIV/HCV) Infection in Asymptomatic Pregnant Women in Benin City, Nigeria

Concerted efforts have been made to combat HIV infection in Nigerian. By contrast, much less attention has been paid to hepatitis C viral (HCV) infection. These viruses have similar immuno-epidemiology.The objective of this study was to determine the prevalence of HCV/HIV dual infection among 269 antenatal attendees at the University of Benin Teaching Hospital in southern Nigeria. The study was prospective and cross-sectional and consisted of the analysis of the sera of the participants for anti-HCV and HIV antibodies using ELISA. The result showed that 1.86% samples were HCV antibodies positive while 8.30% were seropositive for HIV-1 antibodies. There were no cases of dual infections. The HIV positive women and their babies had antiretroviral therapy. We conclude that dual HCV/HIV infection in pregnancy in Nigeria may be uncommon but suggest multicenter studies to determine the national prevalence while initiating strategies for their prevention (Afr J Reprod Health 2009; 13[2]:97-108)

Health Workers' Knowledge of Preventing Mother-To-Child Transmission of HIV in Benin City, Edo State, Nigeria

Introduction: Health workers have important roles to play in reducing mother-to-childtransmission of HIV. This study assessed health workers' knowledge of the nationalguidelines on preventing mother-to-child transmission of HIV in Benin City, Edo State,NigeriaMethodology: The study design was a descriptive cross-sectional survey. The studypopulation comprised health workers providing services for preventing mother-to-childtransmission of HIV in Benin City, Edo State, Nigeria. Data was collected through selfadministeredquestionnaires.Results: Two hundred and seventy health workers participated in the study comprisingdoctors, nurses, pharmacists, laboratory scientists and counsellors. All the respondentshad heard of preventing mother-to-child transmission of HIV. Ninety-two (34.1%) hadreceived training on the national guidelines on preventing mother-to-child transmissionof HIV. The proportion of health workers with poor, fair, and good knowledge of thenational guidelines on PMTCT was 8.5%, 30.4% and 61.1% respectively. Knowledge ofthe national guidelines was significantly associated with the health workers' occupation,previous training on PMTCT and having a copy of the national guidelines.Conclusion: This study highlighted important gaps in health workers knowledge ofPMTCT. Training and retraining of health workers remains crucial to achieving the goalof reducing mother-to-child transmission of HIV. The study findings may guide thecontent of future training of health workers on PMTCT to ensure relevance andadequacy

Complications of Breast Milk Application to the Infected Eye

Objective: To report complications resulting from the applicationof breast milk to the infected and injured eye seen at the University of Benin Teaching Hospital (UBTH) between June 1st 2006 and July 31st 2007.Methodology: This is a prospective study of five consecutivepatients who had breast milk applied to their eyes. They wereseen at the eye clinic of the University of Benin Teaching Hospital between June 1st 2006 and July 31st 2007. The sex, age, symptoms and signs, visual acuity, treatment and ocular complications were noted.Results: Four (80%) of the patients developed complications following instillation of breast milk in the eyes. Two patients developed endophthalmitis, 1 for bacterial conjunctivitis and 1 for trauma; 1 patient developed panophthalmitis, and the fourth developed endophthalmitis. One child with bacterial conjunctivitis did not develop any complication.Conclusion: Four out of the five patients studied lost vision in theaffected eye after developing endophthalmitis and panophthalmitis following breast milk instillation in the infected and injured eyes

Neonatal jaundice and its management: Knowledge, attitude, and practice among expectant mothers attending antenatal clinic at University of Benin Teaching Hospital, Benin City, Nigeria

Introduction: Neonatal Jaundice (NNJ) is a common disorder worldwide and one of the important contributors to the high neonatal morbidity and mortality in Sub-Saharan Africa. Severe neonatal jaundice leads to brain damage or even death in otherwise healthy newborns. The objective of the study was to assess the knowledge, attitude and practice of expectant mothers about neonatal jaundice and its management.Materials and Methods: The study was descriptive cross-sectional, carried out among 389 expectant mothers who were attending the antenatal clinic at the University of Benin Teaching Hospital. A structured, Pre-tested, researcher administered questionnaire was used to interview the respondents. Data was analysed using SPSS version 15.Results: The mean age of the expectant mothers was 30.5 (SD 4.9) years. Fifty-five (14.1%) of respondents had previous experience with NNJ, 8 (2.1%) lost babies due to NNJ. 334 (85.9%) were aware of the condition, 381 (77.4%) knew how to recognize the symptoms of NNJ, 279 (71.7%) knew a correct method of treatment of NNJ. A large proportion ofthe expectant mothers 261 (67%) knew some complications of NNJ. Two hundred and five (52.7%) did not know any danger sign of complications of NNJ. Three hundred and fifty five (91.3%) had good attitude towards its management. Majority of expectant mothers whose previous babies had NNJ took the babies to the hospital for treatment. A large proportion also expressed their willingness to seek medical attention if their babies were to develop the condition. Their knowledge of neonatal jaundice was significantly influenced by their level of education and the number of theirprevious babies who had NNJ.Conclusion: This study revealed that expectant mothers attending antenatal clinic at UBTH had good knowledge of the treatment and complications of NNJ but inadequate knowledge of the causes and danger signs of the condition. Their attitude and practice towards the management of NNJ was good. It is therefore recommended that Health care providers should give more health education on NNJ to the expectant mothers during antenatal visits.Key words: Neonatal jaundice, expectant mothers, antenatal clinic, Benin Cit

Seroprevalence and risk factors for cytomegalovirus infection among pregnant women in southern Nigeria

Objective: Vertically transmitted cytomegalovirus (CMV) is the most common cause of preventable congenital infection,including deafness and intellectual impairment worldwide. Till date, there is no consensus on routine antenatalscreening worldwide. The objective of this study was to determine the prevalence of previous and primary CMV infectionamong antenatal women at the University of Benin Teaching Hospital (UBTH) and the effect of age, socioeconomicclass, parity and gestational age on prevalence.Methods: In this descriptive cross-sectional study, blood samples were collected from each of 200 consecutive pregnantwomen attending the antenatal clinic of the university. Samples were analyzed for CMV specific IgG and IgM usingELISA test kits. A semi-structured researcher administered questionnaire was used to obtain socio-demographic informationwhich included; age, socioeconomic class, parity and gestational age.Results: Seroprevalence of CMV- specific IgG and IgM were 92% and 4% respectively, while 4% were seronegative.There was no significant association between seroprevalence and any of the risk factors (p>0.05).Conclusion: There is need for voluntary screening of pregnant women as part of antenatal care to detect primary andseronegative susceptible women. J Microbiol Infect Dis 2013; 3(3): 123-127Key words: Cytomegalovirus, seroprevalence, pregnancy, Nigeri

Harm elimination project for unsafe abortion in Nigeria: An operations research

Context: The harm elimination model is designed to improve access to pre‑ and postabortion care including free contraception and address the challenges posed by unsafe abortion to the sexual and reproductive health of the women recruited for the study. Aims: To determine the impact of the “Harm Elimination Project For Unsafe Abortion in Nigeria” (HELPUSAN) model on the rate of decision to keep the pregnancy by women seeking termination of pregnancy and the determinants of this decision. Subjects and Methods: Over the 6‑month period of this pilot survey, all women presenting for abortion were offered preabortion and postabortion counseling and services according to the study protocol. The study did not offer abortion services based on the abortion law in Nigeria. The clients were followed up for 6 weeks and assessed on decision to continue the pregnancy or not. Results: Of 105 attendees, 12.4% declined enrolment, 59.8%had induced abortion, and 45.8% had spontaneous abortion. Among those who presented for postabortion care following induced abortion, the main method used for inducing the abortion process was drugs (80.5%). A total of 90 (97.8%) of the participants were confirmed to be pregnant of which 52 (57.8%) were viable. Also, of the 52 participants with viable pregnancies, 19 (36.5%) decided to retain their pregnancies, while 33 (63.5%) decided not to retain their pregnancies.Conclusion: Almost 40% of clients presenting as pre abortion clients decided to retain the pregnancy. This work also once again highlights the high unmet need for contraception in Nigeria.Key words: HELPUSAN; pre‑ and postabortion counseling; preventing unsafe abortion in Nigeria; unsafe abortion

Estimating the burden of rubella virus infection and congenital rubella syndrome through a rubella immunity assessment among pregnant women in the Democratic Republic of the Congo: Potential impact on vaccination policy.

BACKGROUND: Rubella-containing vaccines (RCV) are not yet part of the Democratic Republic of the Congo's (DRC) vaccination program; however RCV introduction is planned before 2020. Because documentation of DRC's historical burden of rubella virus infection and congenital rubella syndrome (CRS) has been minimal, estimates of the burden of rubella virus infection and of CRS would help inform the country's strategy for RCV introduction. METHODS: A rubella antibody seroprevalence assessment was conducted using serum collected during 2008-2009 from 1605 pregnant women aged 15-46years attending 7 antenatal care sites in 3 of DRC's provinces. Estimates of age- and site-specific rubella antibody seroprevalence, population, and fertility rates were used in catalytic models to estimate the incidence of CRS per 100,000 live births and the number of CRS cases born in 2013 in DRC. RESULTS: Overall 84% (95% CI 82, 86) of the women tested were estimated to be rubella antibody seropositive. The association between age and estimated antibody seroprevalence, adjusting for study site, was not significant (p=0.10). Differences in overall estimated seroprevalence by study site were observed indicating variation by geographical area (p⩽0.03 for all). Estimated seroprevalence was similar for women declaring residence in urban (84%) versus rural (83%) settings (p=0.67). In 2013 for DRC nationally, the estimated incidence of CRS was 69/100,000 live births (95% CI 0, 186), corresponding to 2886 infants (95% CI 342, 6395) born with CRS. CONCLUSIONS: In the 3 provinces, rubella virus transmission is endemic, and most viral exposure and seroconversion occurs before age 15years. However, approximately 10-20% of the women were susceptible to rubella virus infection and thus at risk for having an infant with CRS. This analysis can guide plans for introduction of RCV in DRC. Per World Health Organization recommendations, introduction of RCV should be accompanied by a campaign targeting all children 9months to 14years of age as well as vaccination of women of child bearing age through routine services