Maternal Health Care Services Access Index and Infant Survival in Nigeria

Background: Infant mortality rate in Nigeria is among the highest world-wide. Utilization of modern health care facilities during pregnancy and at delivery reduces infant mortality rate. We examined the relationship between Infant Mortality (IM) and Maternal Health Care Services Access Index (MHCI) in Nigeria.Methods: This cross-sectional study utilized 2013 NDHS data and included women aged 15-49 years (n=12511). MHCI was obtained from information on antenatal visit, antenatal attendance, tetanus toxoid injection during pregnancy, place of delivery and birth attendance. Cox-proportional hazard and Brass models were used for the analysis (α=0.05).Results: Mean MHCI was higher among women with lower prevalence of IM. About 5.1% and 3.4% of the women with none and complete MHCI had experienced infant deaths respectively. The hazard of experienced infant deaths was 1.497(1.068-2.098) and 1.466(1.170-1.836) significantly higher among women with no and low MHCI respectively than those with complete MHCI. This pattern was observed when other factors were used as control. The refined IM probability (range=0.0482-0.1102) and IM rates (range=50-119) increased with reduction in the level of MHCI. The IM rate reduces from 119 per 1,000 live births among women whose MHCI score was zero to 50 per 1,000 live births among those with complete MHCI score.Conclusion: Infant death was least experienced among women who had complete MHCI. If women optimize utilization of health facility during pregnancy and delivery, infant deaths will reduce in Nigeria.Keywords: Infant mortality, Maternal health care, Pregnancy care, Delivery care, Nigeri

Influence of gender preference and sex composition of surviving children on childbearing intention among high fertility married women in stable union in Malawi

Background: Child’s gender preference (GP) frequently leads to high fertility which has adverse effect on family health. The link between women’s fertility intention, GP and Living Children’s Sex Composition (LCSC) as found in this study is less explored in Malawi.Objectives: We examined the relationship between GP, LCSC and fertility intention.Methods: This study utilized 2010 MDHS dataset and focused on married women aged 15-49 years (n=1739) in stable unions who currently have at least 5 living children. Data was analyzed at bivariate and multivariate levels (α=0.05).Results: About 39.7% of the women have GP and higher proportion (23.3%) has preference for females. Age, region, wealth-quintile, religion, residence and family planning programmes were significantly associated with fertility intention. Women who have GP and same LCSC were 1.35 and 2.4 times significantly more likely to have intention to bear more children than those who have no GP and different sexes composition respectively. These odd ratios changed to 1.38 for GP and 2.44 for LCSC after adjusting for other socio-demographic variables.Conclusions: We find that GP and LCSC significantly influence women’s intention to bear more children. Women should stop childbearing after attaining their desired number irrespective of the LCSC.Keywords: Fertility intention, Gender preference, Children sex composition, High fertility married wome

Contraceptive Use: Implication for Completed Fertility, Parity Progression and Maternal Nutritional Status in Nigeria

The study identified socio-demographic factors influencing contraceptive use while using nutritional status, completed fertility and parity progression as key variables. NDHS, 2008 dataset on married women aged 45-49 was used. Chi-square, ordinary linear and logistic regression models were used for the analysis. The mean age of the women and CEB were 46.8±1.5 years and 6.9±3.1 respectively. About 26.0% of the women ever used contraception, while 9.0% of the women were underweight. Parity progression from parity 0 to 4 was consistently higher among never-users than women who ever used contraception. The tempo changes for all parities above four as ever-users now progress at lower rate during these periods. The completed fertility and the risk of undernourishment were significantly higher among never users of contraception than ever users. The level of risk persists even when the potential confounding variables were used as control

Nitrate concentration in drinking water supplies in selected communities of Ibadan Southeast local government, Ibadan, Nigeria

Elevated levels of nitrate in drinking water have been associated with adverse health effects. Most susceptible to nitrate toxicity are infants under six months of age and pregnant women. This study assesses the nitrate concentration of 48 randomly selected wells in an urban-slum setting in Ibadan South East Local Government Area (IBSELGA), Nigeria. The coordinates of the wells were mapped with a hand-held Global Positioning System (GPS). The nitrate concentration ranged between 0.00 and 42.80 mgL-1 with a mean of log10 of 0.735 and a geometric mean of 5.43 mgL-1; and 0.00 and 93.30 mgL-1 with a mean of log10 of 0.696 and a geometric mean of 4.97 mg L-1 for the wet and dry seasons, respectively. During the wet season, the levels of nitrate in all the wells were within the WHO permissible limit of 45 mg L-1 NO3. However, during the dry season, few of the wells; six (12.5%) dried up completely. Out of the remaining 42 wells, six (14.3%) had nitrate concentration which exceeded the permissible limit. This same set of wells lacked sanitary features such as lining and cover. Out of the 48 wells, 30 (62.5%) and 24 (50%) were located at ≤10 m from the septic tank/pit latrine and refuse  dumps, respectively. Nitrate maps were developed using Georeferenced data for the water points. The nitrate exceedence map produced showed water sources within the study area with nitrate concentration exceeding the recommended limit and therefore requiring urgent intervention. The results of this study will serve as indicator for determining risk areas with respect to nitrate concentration in drinking water and therefore help in decision making activities.Key words: Global positioning system, Ibadan, nitrate, nitrate exceedence, wells, urban slum

Blood transfusion requirement during caesarean delivery: Risk factors

Background: Group specific blood is often cross-matched ready for all patients scheduled for caesarean section in anticipation of haemorrhage during the surgery. This study was conducted to determine the risk factors for blood transfusion during anaesthesia for caesarean section.Methods: This was a prospective cross-sectional study. A total of 706 pregnant patients scheduled for emergency or elective Caesarean section at the University College Hospital, Ibadan, Nigeria between March and August 2011 were recruited. Participants were followed-up from the date of delivery till the end point of the study which could fall into either of the following conditions: satisfactory postoperative clinical status up to 48 hours post-delivery or death. Transfusion rate was determined and Chi-square test was used to determine if there exist an association between blood transfusion status and preoperative haematocrit level, years of experience of obstetrician, indication for Caesarean Section(CS), CS type (primary or repeat) and HIV status.Results: Transfusion rate was 9.1 %; variables found to be significantly associated with blood transfusion were; preoperative haematocrit less than 26%, increasing parity, years of experience of resident obstetrician, indication for CS (bleeding or not bleeding) and estimated blood loss. Being HIV positive does not increase the need for blood transfusion.Conclusion: Preoperative anaemia, increasing parity and severe blood loss at surgery significantly contribute to the requirement for blood transfusion in patients undergoing caesarean section.Keywords: Blood transfusion, Caesarean delivery, Risk factors, Anaemi

Assessment of the living conditions of rural based people living with HIV/AIDS with clinical presentations in Nigeria

Objective: To describe the living conditions of rural based people living with HIV/ AIDS (PLWHA) and their clinical presentationsDesign: Descriptive cross-sectional studySetting: University College Hospital, IbadanSubjects: PLWHA on anti-retroviral therapyResults: One hundred and fifty PLWHA participated. The mean age of the respondents was 28.7±8.9 years. Majority of the respondents visited had advanced disease (97%), were poor (75%) and presented with opportunistic infections such as oral candidiasis (92%), chronic diarrhoea (70%) and pulmonary tuberculosis (46%). Majority were treated for malaria (72%) and anaemia (61%). All respondents lived in homes predisposed to these opportunistic infections. They drink unsafe water and had poor disposal of their domestic wastes.Conclusion: PLWHA visited lived in homes that predispose them to various opportunistic infections. Improved living conditions and economic empowerment will improve the health conditions of PLWHA

An international comparative study of blood pressure in populations of European vs. African descent

Background: The consistent finding of higher prevalence of hypertension in US blacks compared to whites has led to speculation that African-origin populations are particularly susceptible to this condition. Large surveys now provide new information on this issue. Methods: Using a standardized analysis strategy we examined prevalence estimates for 8 white and 3 black populations (N = 85,000 participants). Results: The range in hypertension prevalence was from 27 to 55% for whites and 14 to 44% for blacks. Conclusions: These data demonstrate that not only is there a wide variation in hypertension prevalence among both racial groups, the rates among blacks are not unusually high when viewed internationally. These data suggest that the impact of environmental factors among both populations may have been under-appreciated

Toxicity, Tunneling and Feeding Behavior of the Termite, Coptotermes vastator, in Sand Treated with Oil of the Physic Nut, Jatropha curcas

Oil of the physic nut, Jatropha curcas L. (Malpighiales: Euphorbiaceae), was evaluated in the laboratory for its barrier and repellent activity against the Philippine milk termite Coptotermes vastator Light (Isoptera: Rhinotermitidae). The study showed that J. curcas oil had anti-feeding effect, induced reduction in tunneling activity and increased mortality in C. vastator. Behavior of termites exposed to sand treated with J. curcas oil indicated that it is toxic or repellent to C. vastator. Toxicity and repellent thresholds, were higher than those reported for other naturally occurring compounds tested against the Formosan subterranean termite

Complete Chloroplast Genome Sequences of Important Oilseed Crop Sesamum indicum L

Sesamum indicum is an important crop plant species for yielding oil. The complete chloroplast (cp) genome of S. indicum (GenBank acc no. JN637766) is 153,324 bp in length, and has a pair of inverted repeat (IR) regions consisting of 25,141 bp each. The lengths of the large single copy (LSC) and the small single copy (SSC) regions are 85,170 bp and 17,872 bp, respectively. Comparative cp DNA sequence analyses of S. indicum with other cp genomes reveal that the genome structure, gene order, gene and intron contents, AT contents, codon usage, and transcription units are similar to the typical angiosperm cp genomes. Nucleotide diversity of the IR region between Sesamum and three other cp genomes is much lower than that of the LSC and SSC regions in both the coding region and noncoding region. As a summary, the regional constraints strongly affect the sequence evolution of the cp genomes, while the functional constraints weakly affect the sequence evolution of cp genomes. Five short inversions associated with short palindromic sequences that form step-loop structures were observed in the chloroplast genome of S. indicum. Twenty-eight different simple sequence repeat loci have been detected in the chloroplast genome of S. indicum. Almost all of the SSR loci were composed of A or T, so this may also contribute to the A-T richness of the cp genome of S. indicum. Seven large repeated loci in the chloroplast genome of S. indicum were also identified and these loci are useful to developing S. indicum-specific cp genome vectors. The complete cp DNA sequences of S. indicum reported in this paper are prerequisite to modifying this important oilseed crop by cp genetic engineering techniques