Knowledge and practice of cervical cancer screening using pap smear among women attending antenatal clinic at Aba, south-eastern Nigeria

No Abstrac

How do we improve male partner involvement in prevention of mother to-child transmission of HIV (PMTCT) in Nigeria?

Background: Recently, male partner involvement (MPI) has been advocated as a priority intervention in prevention of mother-to-child HIV transmission (PMTCT) programs. This is pertinent if we must attain the World Health Organization (WHO) global goals to achieve “zero new HIV infections, zero discrimination and zero AIDS-related deaths” by 2020.AIM: This study is aimed at evaluating the outcome of male partner involvement in counseling and testing in a single comprehensive HIV treatment and PMTCT site in southeastern Nigeria.Method: Pregnant women (n = 2707) participating in PMTCT program at a health facility in Aba, Nigeria were encouraged by way of a written invitation and phone calls to inform and invite their partners for couple HIV counseling and testing (cHCT).Results: A total of 1164 male partners (43%) presented for cHCT and 8 (0.7%) knew they were living with HIV, whilst 11(0.9%) learned of their HIV-seropositve status for the first time. Seven HIV seropositive men were serodiscordant with their female partners and and 10 HIV seronegative men had female partners who were HIV seropositive. Couple HIV counseling and testing resulted in significant decrease in unprotected sex and increase in partner disclosure (p <0.05).Conclusion: Within PMTCT programs, counseling should emphasize the advantages of partner involvement to encourage women to inform and convince male partners to come for HCT.Keywords: male partner, HIV, counseling, testing, PMTCT

Knowledge of genital herpes infection among antenatal clinic attendees in South-Eastern Nigeria

Background: Herpes simplex virus (HSV) is a major cause of genital ulcer disease worldwide and a significant factor for increased risk of acquisition and transmission of the Human Immune Deficiency Virus (HIV). The determination of the level of knowledge of genital herpes is necessary for the design and implementation of its specific preventive strategies as well as the reduction of the contribution of genital herpes to HIV transmission.Objective: To determine antenatal women’s knowledge on genital herpes infection. Design: A cross sectional descriptive study.Setting: Antenatal clinic of Abia State University Teaching, Hospital, Aba, Nigeria. Subjects: Three hundred and fifty consecutive and consenting antenatal clinic attendees of Abia State University Teaching Hospital (ABSUTH), Aba, South Eastern, Nigeria. Results: Seventy nine respondents (22.6%) had ever heard of genital herpes whilst sixty two (17.7%) had ever had recurrent blisters around their genitals. Two hundred and sixteen respondents (61.7%) reported having had cold sores or blisters around thelips or mouth following an episode of fever. Seventy four (21.1 %) of the respondents knew that the virus that causes cold sores or blisters can be sexually transmitted. Higher educational levels attained and occupations other than being a housewife or farmer were associated with a greater awareness of genital herpes (

Risk Factors for Hepatitis B Virus Infection during Pregnancy in South Eastern Nigeria

Objective: To determine the seroprevalence of hepatitis B surface antigen (HBsAg) and possible risk factors in pregnant women.Design: A cross –sectional serological survey of women attending antenatal clinics.Setting: Five antenatal clinics in Aba, South Eastern Nigeria.Subjects: Eight hundred and ten consecutive and consenting antenatal clinic attendees over the period 15 June- 15 November 2010.Main Outcome measures: For each pregnant woman, the medical and sociodemographic data were documented. Hepatitis B surface antigen seropositivity determined.Results: Twenty two (2.7%) of the 810 subjects were found to be HBsAg seropositive and asymptomatic. Maternal age, parity, educational level attained, marital status, history of blood transfusion, intravenous drug use, tattooing, jaundice in the past and Human Immunodeficiency Virus seropositivity did not show any association with HBsAg sseropositivity.Conclusion: HBsAg seropositive women in the study were asymptomatic and showed no association with the medical and sociodemographic characteristics examined. These findings affirm the recommendation for universal HBsAg screening in pregnancy and imply that screening on the basis of the presence of risk factors alone may be insufficient

Experience with Jadelle Contraceptive Implant in obese and overweight women in south-eastern Nigeria

Background: As the worldwide obesity epidemic continues, the Obstetrician Gynaecologist must discuss contraception with obese women who want to postpone pregnancy. Obesity may affect the efficacy of hormonal contraceptives by altering how they are absorbed, distributed, metabolized or eliminated. There is a paucity of data about the suitability and efficacy of Jadelle and other hormonal contraceptives in overweight and obese women in our locale. Objective: This study describes the discontinuation, complication and pregnancy rates of Jadelle contraceptive implant in overweight and obese women compared to women of normal BMI. Design: An observational study. Setting: The family planning unit of a private hospital in Osisioma Ngwa Local Government Area, Abia State, Nigeria, under the Womens’ Health Project of Society for Family Health. Subject: One hundred and two women of high BMI (64 overweight and 38 obese women) and 153 women of normal BMI who accepted Jadelle contraceptive implant. Results: There was no statistically significant difference in the continuation (p = 0.78) and discontinuation rates (p = 0.71) between the high and normal BMI groups. The reasons for discontinuation of Jadelle before the expiration period of 5 years were similar for all BMI groups and they included prolonged and irregular vaginal bleeding and desire for another pregnancy. Side effects were similar and minimal for all BMI groups and mainly prolonged or irregular vaginal bleeding. Pregnancy was confirmed on two women of normal weight and this occurred within the first 2 months of use. Apparently, the women were pregnant at the time of insertion. Conclusion: Jadelle contraceptive implants are well tolerated and effective in obese and overweight women in South-Eastern Nigeria who desire effective pregnancy prevention for 5 years

Factors Influencing The Use Of Episiotomy During Vaginal Delivery In South Eastern Nigeria

Background: Given considerable evidence that routine episiotomy increases maternal morbidity and without evidence to support maternal or neonatal benefit, has episiotomy use changed among health care providers? To date, very limited information exists relating to the past and current practice of episiotomy in many developing countries. Objective: To determine the prevalence of episiotomy at Aba in South Eastern Nigeria, examine factors influencing the performance of episiotomy and document complications associated with the procedure. Design: A hospital based retrospective study. Setting: The Abia State University Teaching Hospital (ABSUTH), Aba in South Eastern Nigeria, from January 2001 to December 2005. Subjects: Four thousand, one hundred and seventy two mothers who delivered vaginally within the study period. Results: There were 1877 episiotomies, for an episiotomy rate of 45%. Ninety per cent of the primigravid parturients had episiotomy. Women undergoing episiotomy were younger (mean age 24.7 years; range 16-37) than women without episiotomy (mean age 28.5 years, range 20-43). When controlled for parity and maternal age, other risk factors were occipito-posterior position, vacuum extraction, forceps delivery, vaginal breech delivery, and a history of Caesarean section. Episiotomy use was also associated with major perineal lacerations and increased length of hospital stay. Conclusion: The episiotomy rate of 45 per 100 vaginal deliveries in this study is obviously higher than evidence-based recommendations for optimal patient care. A policy of systematic reduction in the incidence of episiotomy can be pursued in this hospital. Greater attention needs to be paid to selection of women to undergo episiotomy. East African Medical Journla Vol. 85 (5) 2008: pp. 240-24

Pregnancy outcome in booked and unbooked mothers in Southeastern Nigeria

Background: In order for individual health institutions in Nigeria to contribute towards the achievement of the Millennium Development Goals (MDG) with regards to maternal health, there is need for research on the local causes of and factors influencing adverse maternal outcomes. This would enable care providers and policy makers appreciate the burden of the problem and know where to focus as they distribute resources.Objectives: To compare the socio-demographical characteristics, obstetrical complications and foetal outcome in booked verses unbooked mothers who delivered at this hospital.Design: A hospital based retrospective study.Setting: The Abia State University Teaching Hospital (ABSUTH), Aba in South Eastern Nigeria.Subjects: Three thousand, seven hundred and thirty four mothers who delivered in the hospital between 1st January 2005 and 31st December 2007.Results: Unbooked mothers constituted 17.0% of the 3734 deliveries in the studied period. Compared to booked mothers, unbooked mothers were younger in age (28.2 ± 5.80 vs. 29.3 ± 6.04; p < 0.001) and had a lower educational status (

Contraceptive choices of women in rural southeastern Nigeria

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Rupture of the uterus in a primigravida: A case report

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Delayed interval delivery in twin pregnancy without cerclage: Case Report

This report describes a patient-counselling approach and non-surgical management of a dichorionic, diamniotic twin pregnancy where the delivery of the second twin followed the delivery of the first by 59 days. An initial ultrasound scan at twenty and a half weeks gestational age suggested cervical dilatation with protruding amniotic membrane of a dead first twin, and a viable second twin. She aborted the dead fetus at 21 weeks’ gestation and delivered a healthy female infant weighing 1300g at twenty nine and a half weeks gestation. After the loss of the first foetus, delayed delivery in multiple pregnancies can be successful in selected cases as exemplified by the case presentation. In well prepared perinatal centers, with physically and psychologically balanced patients who are well informed about the risks and benefits of the procedure, delayed interval delivery in twin pregnancy without cerclage may be a reasonable strategy