Diagnosis and Management of Ureterovaginal Fistula in a Resource-Constrained Setting: Experience at a District Hospital in Northern Nigeria

During 2007 we were invited at different times to review and manage four women with ureterovaginal fistula following caesarean section performed in different rural hospitals. We describe our experience of a simple technique of diagnosis and management of these indigent patients in a resourceconstrained hospital. The condition was diagnosed by the three-swab test in all four patients, and abdominopelvic ultrasound was employed to help find the ureter involved. Transvesical ureteral implantation with a stent was carried out. Stent was removed after 2 weeks. All four patients were dry. Amidst the complexity of and sophistication of modern health care, it is important to remind ourselves of the common occurrence of this distressing condition following caesarean section and the use of a well known simple diagnostic technique and subsequent management in resource-poor communities Keywords: Ureterovaginal fistula, Caesarean section, Resource constrained Libyan Medical Journal Vol. 4 (1) 2009: pp. 45-4

Spontaneous rupture of the middle colic artery resulting in delayed postpartum collapse: a case report

No Abstract

Ectopic (tubal) Molar Gestation: Report Of Two Cases

Ectopicmolar gestation is a rare event. Itsmalignant potential is similar to that of an intrauterine molar pregnancy. To document two cases of tubalmolar gestations seen over a 10-year period. Case series. Two young Nigerian undergraduates presented with features of ruptured tubal pregnancy. They had total salpingectomy and histopathological analysis of the tubal specimens revealed complete hydatidiform mole.HCGlevel normalized in both caseswithin threeweeks of treatment. Ectopic molar gestation does occur occasional in our setting. It is pertinent that clinicians in this part of the world be aware of this and to take routine histological examination of tubal specimens in ectopic pregnancy very seriously in order to diagnosed cases of ectopic molar gestations early and mount appropriate post treatment surveillance. Keywords: ectopic,Tubal,MolarGestation. Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 392-39

Molecular Epidemiology of Hepatitis C Virus (HCV) in Kadun State

Objective: To determine the distribution of hepatitis C virus (HCV)  genotypes and subtypes among blood donors and outpatients attendees positive for antibody to HCV (anti-HCV).Justification: Hepatitis C virus (HCV) continues to be a major disease burden on the world and Man is the only known natural host of Hepatitis C virus (Chivaliez and Pawlotsky, 2007). There is no published data on the prevalence of the genotypes and subtypes of HCV in Kaduna State.Setting: Three hospitals one in each of the 3 senatorial zones in Kaduna State.Patients: Blood donors who reported for blood donation and outpatient department attendees.Method: Antibody detection by a third generation HCV ELISA (Biotech Laboratories, UK); HCV RNA and genotyping by Reverse Transcriptase polymerase chain reaction with genotype-specific primers. (Sacace Biotechnologies, UK).Results: of the 259 plasma specimens screened for Hepatitis C virus in this study, 20(7.7%) were positive for anti-HCV antibodies by ELISA and 16(6.2%) of the antibodies positive specimen were positive for HCV RNA. Of the 139 blood donors tested, 8 (5.8%) were HCV RNA positive. Similarly, 120 were tested from the outpatient Department attendees and 8 (6.7%) were HCV RNA positive. Hepatitis C virus genotype 1b was found in the entire HCV RNA positive sample.Conclusions: The findings of 6.2% prevalence of HCV infection based on HCV RNA test confirmed that there is Hepatitis C virus in Kaduna State with genotype 1b as the predominant genotype found in all the three senatorial zones

Pattern of childhood gynaecological presentations in a Nigerian tertiary health facility

Background: Gynaecological problems in children and adolescents are often both medically and psychologically unique and require a highly skilled approach differing from those utilized for an adult female population. There is paucity of data on childhood gynaecological problems in our environment. The purpose of this study was to document the prevalence and pattern of common gynaecological problems in the prepubertal child at Ahmadu Bello University Teaching Hospital Zaria, Northern Nigeria. Materials and Methods: This was a retrospective study involving case file-based data analysis over a 10-year period (1995–2004) of 62 children aged 1 month–12 years at the Gynaecology unit of Ahmadu Bello University Teaching Hospital Zaria, Northern Nigeria. Results: Sixty-two children were seen, 17 infants, 14 under 5 years of age, and the rest (31) were aged 6–12 years. The commonest condition was labial fusion (33.9%), urethral prolapse (14.5%), and suspected sexual assault (12%). Ambiguous genitalia (9.7%), vaginitis (6.5 %), and ovarian tumour (4.8%) were also encountered. Conclusion: Labial fusion, urethral prolapse, and suspected sexual assault are the commonest childhood gynaecological morbidities in Zaria. Provision of gynaecological services at every level of health care system to cater for young females is advocated. Keywords: Childhood, gynaecological morbiditiesAfrican Journal of Paediatric Surgery Vol. 5 (2) 2008: pp. 73-7

Cerebral malaria in pregnancy, a report of 3 cases

No Abstract. Annals of Nigerian Medicine Vol. 1(1) 2005: 30-3

Sero-prevalence of IgM antibody to Rubella Virus in pregnant women in Zaria, Nigeria

Rubella is a contagious viral infection, which in pregnant women leads to infection of a developing fetus causing fetal death or Congenital Rubella Syndrome. A cross-sectional study involving 180 women was carried out between June and August 2012 to determine the seroprevalence of IgM antibody to rubella in their serum using ELISA. The women comprised 160 pregnant women attending the antenatal clinic of Ahmadu Bello University Teaching Hospital, Zaria and 20 no pregnant women of childbearing age studying at Ahmadu Bello University, Zaria. Prior to sample collection, structured questionnaires were administered to gather relevant medical information, obstetrical and socio-demographic characteristics from the women. IgM antibody was detected in 62 (38.8%) of the pregnant women and 8 (40%) of the nonpregnant women. The majority (33: 53.2%) of the pregnant women who were positive were in their second trimester while 11 (17.7%) were in their first trimester. Infection with Rubella virus was not significantly associated with age, clinical symptoms and the possible risk factors studied (p>0.05). The level of awareness and knowledge of rubella and its transmission was extremely low for both population and uneducated pregnant women had the highest prevalence (54.5%: 6/11). The study showed seroprevalence higher than any previous reports in Nigeria with almost equal rate amongst the two populations. The high prevalence suggests that an outbreak might have occurred during the time of the study and emphasizes the need for the initiation of a national rubella vaccination program in Nigeria. 

Seroprevalence of rubella-specific IgM and IgG antibodies among pregnant women seen in a tertiary hospital in Nigeria

Okikiola M Olajide,1 Maryam Aminu,1 Abdullahi J Randawa,2 Daniel S Adejo2 1Department of Microbiology, Faculty of Science, Ahmadu Bello University, 2Department of Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria Background: Rubella is a contagious viral infection that in pregnant women leads to the infection of a developing fetus, causing fetal death or congenital rubella syndrome. Objective: Pregnant women are not routinely screened for rubella in Nigeria. Epidemiological data on rubella is therefore necessary to create awareness and sensitize health care administrators and providers. Materials and methods: A cross-sectional study was carried out at Ahmadu Bello University Teaching Hospital between June and August 2012 to determine the prevalence of immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies to rubella virus in pregnant women using enzyme-linked immunosorbent assay kits. Seroprevalence was compared among 160 pregnant women attending the antenatal clinic of Ahmadu Bello University Teaching Hospital and 20 nonpregnant women of childbearing age studying at Ahmadu Bello University. Prior to sample collection, questionnaires were administered to the women to obtain data on sociodemographics, awareness and knowledge of rubella, possible risk factors, and clinical symptoms associated with the viral infection. Results: Of the 160 pregnant women, 149 (93.1%) and 62 (38.8%) were positive for anti-rubella IgM and IgG antibodies, respectively. Similarly, of the 20 nonpregnant women, 18 (90%) and eight (40%) were positive for rubella IgG and IgM antibodies, respectively. None of the possible risk factors studied were significantly associated with infection. Age and other sociodemographic factors were of little significance, and awareness of rubella was low. Conclusion: The prevalence of rubella was high in both pregnant (93.1%) and nonpregnant women (90%), suggesting sustained transmission, which further suggests endemicity. The presence of rubella IgM and IgG antibodies in pregnant women predisposes babies to congenital rubella syndrome and emphasizes the need for the initiation of a national rubella vaccination program in Nigeria. Keywords: seroprevalence, rubella, antibodies, pregnant women, Nigeri

Prevalence and risk factors for maternal mortality in referral hospitals in Nigeria: a multicenter study

Lorretta F Ntoimo,1,2 Friday E Okonofua,1,3,4 Rosemary N Ogu,1,3,5 Hadiza S Galadanci,6 Mohammed Gana,7 Ola N Okike,8 Kingsley N Agholor,9 Rukiyat A Abdus-Salam,10 Adetoye Durodola,11 Eghe Abe,12 Abdullahi J Randawa13 On behalf of the WHARC WHO FMOH MNCH Implementation Research Study Team 1WHO Implementation Research Group, The Women’s Health and Action Research Centre, Benin City, Edo State, 2Department of Demography and Social Statistics, Federal University Oye-Ekiti, Ekiti State, 3Centre of Excellence in Reproductive Health Innovation, University of Benin, Benin City, Edo State, 4Vice Chancellors Office, University of Medical Sciences, Ondo City, Ondo State, 5Department of Obstetrics and Gynaecology, University of Port Harcourt, Port Harcourt, Rivers State, 6Aminu Kano Teaching Hospital, Kano, Kano State, 7General Hospital, Minna, Niger State, 8Karshi General Hospital, Federal Capital Territory, Abuja, 9Central Hospital, Warri, Delta State, 10Adeoyo Maternity Hospital, Ibadan, Oyo State, 11General Hospital, Ijaye, Abeokuta, Ogun State, 12Central Hospital, Benin City, Edo State, 13Department of Obstetrics and Gynaecology, Ahmadu Bello University, Zaria, Kaduna State, Nigeria Introduction: While reports from individual hospitals have helped to provide insights into the causes of maternal mortality in low-income countries, they are often limited for policymaking at national and subnational levels. This multisite study was designed to determine maternal mortality ratios (MMRs) and identify the risk factors for maternal deaths in referral health facilities in Nigeria.Methods: A pretested study protocol was used over a 6-month period (January 1–June 30, 2014) to obtain clinical data on pregnancies, births, and maternal deaths in eight referral hospitals across eight states and four geopolitical zones of Nigeria. Data were analyzed centrally using univariate, bivariate, and multivariate statistics.Results: The results show an MMR of 2,085 per 100,000 live births in the hospitals (range: 877–4,210 per 100,000 births). Several covariates were identified as increasing the odds for maternal mortality; however, after adjustment for confounding, five factors remained significant in the logistic regression model. These include delivery in a secondary health facility as opposed to delivery in a tertiary hospital, non-booking for antenatal and delivery care, referral as obstetric emergency from nonhospital sources of care, previous experience by women of early pregnancy complications, and grandmultiparity.Conclusion: MMR remains high in referral health facilities in Nigeria due to institutional and patient-related factors. Efforts to reduce MMR in these health facilities should include the improvement of emergency obstetric care, public health education so that women can seek appropriate and immediate evidence-based pregnancy care, the socioeconomic empowerment of women, and the strengthening of the health care system. Keywords: maternal death, maternal mortality ratio, emergency obstetric care, pregnancy care, tertiary hospita