Postpartum contraception: determinants of intention and methods of use among an obstetric cohort in a tertiary hospital in Jos, North Central Nigeria

Background: Postpartum contraception reduces the risk of unintended and rapid repeat pregnancies. A comprehensive postpartum family planning (PPFP) service can enable women make adequate and informed choices on a preferred contraceptive method, initiating a method as well as encouraging them to use that method for a period depending on their reproductive intentions.Methods: This study aimed to determine women’s intention regarding uptake of postpartum family planning, the preferred methods and the factors associated with uptake. We conducted a cross-sectional study among women attending antenatal and postnatal clinics at the Jos University Teaching Hospital, Jos, Nigeria using structured questionnaires. Data was analyzed using descriptive statistics and chi square test of comparison.Results: Four hundred and five women participated in the study. The mean age of the respondents was 28.4+5.3 years. The previous contraceptive usage was 39.8%. A total of 262 (64%) women intend to use a method of postpartum contraception. The most preferred intended postpartum contraceptive was subdermal implant (19.2%) followed by injectables (18.4%) and intrauterine contraceptive device (14.7%). Reasons cited for nonuse of postpartum contraception include spousal refusal, effect on fertility, desire for further child bearing, religious beliefs.Conclusions: Counselling on postpartum contraception during the antenatal and postnatal period can help women make informed choices among the wide range of available contraception

Activity-Based Costing and Firm’s Value of Manufacturing Companies in Nigeria

This study focuses on Activity-Based Costing (ABC) and firm’s value. An ex-post facto research design was employed. Data were collected and statistically analysis using multiple regression. The results show that ABC effectiveness is significantly and positively related to firm’s value. The results show that ABC effectiveness is significantly and positively related to firm’s value. The result indicates that firms with greater degree of cost accountant competency, corporate resource facilitation, and price competitive force appear to have a higher effect on cost driver fitness, cost calculation accuracy, cost information creditability and cost reporting usefulness. The cost accountant competency, whose knowledge, skill, coordinate, knowledge sharing and competence, is very necessary in organization to ensure that cost accountants can do task in their responsibility completely and to achieve goals. Managers and executives of firms should apply the relationship among ABC effectiveness and firm’s value to the actual business situation. Managers should effectively utilize the resource and capability of the firm in order to ABC effectiveness. Clearly understanding of ABC effectiveness can help gain competitive advantages and achieve higher level of firm’s value. Importantly, to maximize the benefits of ABC effectiveness, they should provide resources such as cost accountant competency, resource facilitation to support in order to ABC effectiveness and to increase firms' competitive advantage and crucially to gain firm’s value. Keywords: Activity-Based Costing Effectiveness, Cost Calculation Accuracy, Cost Driver Fitness ,Cost Information Creditability, Cost Reporting Usefulness, Firm’s value

Postmaturity and Fetal Macrosomia in Jos, Nigeria

Background: One of the risk factors of post term pregnancy is fetal macrosomia. The excessively large infant presents a recurring and potentially serious obstetric problem. Methods:This was a retrospective study of all consecutive births in the maternity unit, Jos University Teaching Hospital, Jos, Nigeria, between January 1998 and December 2001. The case records of all mothers of babies born with weight of 4000g and above were retrieved and data collated and analyzed for total deliveries, maternal and fetal characteristics, complications and outcome of pregnancy. Results:Macrosomic infants (4000g and above) were 286 cases representing 2.9% of all deliveries. Ten (3.5%) of the infants with macrosomia were preterm, 90.9% were term, and 5.6% were post-term. The mean age and parity of the mothers with pregnancies at term was 29.2 years, and 3.2 respectively. The post term mothers had a mean age and parity of 32.7 years and 3.8 respectively. Maternal morbidity included increased caesarean delivery, and vaginal trauma (episiotomies, tears and bruises) in both groups. Caesarean section was the mode of delivery in 31.3% of post term and 27.6% term infants, while the indication for caesarean section was cephalopelvic disproportion in 80% and 87.3% for post term and term infants respectively. Fetal complications were birth asphyxia and stillbirth. There were no gross fetal abnormalities recorded in the series. Still birth rate was 8.1% and 12.5% in term and post term infants respectively. Conclusion: Post term pregnancies account for macrosomic babies in our facility, posing an increased risk to the mother and fetus. Early diagnosis, intrapartum fetal monitoring and recourse to operative delivery may improve the fetal outcome of these infants. A correction to this article has been issued in Annals of African Medicine, Vol. 4, No. 3, 2005, pp. 141. Please see the full text HTML document for further details.Introduction :- L'un des facteurs de risque de la postmaturit\ue9 de la grossesse est la macrosomie foetale. Un enfant qui est excessivement grand provoque un probl\ue8me obst\ue9trique qui est r\ue9current et potentiellement grave. M\ue9thodes : Il s'agit d'une \ue9tude r\ue9trospective de toutes des naissances cons\ue9cutives dans le service d'obst\ue9trique, centre hospitalier universitaire de Jos, Jos, Nig\ue9ria, entre janvier 1998 et d\ue9cembre 2001. Les dossiers m\ue9dicaux de toutes les m\ue8res des enfants n\ue9s avec 4000g poids et de plus ont \ue9t\ue9 tir\ue9s et les donn\ue9es rassembl\ue9es et analys\ue9es pour accouchement total, des caract\ue9ristiques materneles et foetales, complications et le r\ue9sultat de la grossesse. R\ue9sultats : Enfants macrosomiques (4000g et lus) \ue9taient 286 soit 2,9% de tous accouchements. Dix soit 3,5% des enfants avec macrosomie \ue9taient pr\ue9terme, 90,9% \ue9taient terme. Et 5,6% \ue9taient post terme. L'\ue2ge moyen et la parit\ue9 des m\ue8res avec des grossesses \ue0 terme \ue9taient 29,2 ans, et 3,2 respectivement. Des m\ue8res post termes avaient un \ue2ge moyen et une parit\ue9 de 32,7 ans et 3,8 respectivement. Morbidit\ue9 maternelle comprend augmentation d'accouchement c\ue9sarien, et traumatisme vaginal. (\uc9pisiotomies, d\ue9chirures et des blessures l\ue9g\ue8res) dans les deux groupes. La c\ue9sarienne \ue9tait la m\ue9thode d'accouchement en 31.3% des post termes et 27,6% des enfants \ue0 terme, tandis que l'indication pour la c\ue9sarienne \ue9tait c\ue9phatopelvien dispropotionel en 80% et 87,3% pour des enfants post termes et \ue0 terme respectivement. Complications foetales \ue9taient la naissance asphyxie et mort \ue0 la naissance. Il n'y avait aucune abnormalit\ue9 foetale grave not\ue9e dans la s\ue9rie. Taux de mort \ue0 terme et enfants n\ue9s \ue0 post terme respectivement. Conclusion : Grossesses post termes constituent des b\ue9b\ue9es macrosomique dans notre centre. Ceci provoque une augmentation de risque pour des m\ue8res et foetus. Un diagnostique pr\ue9coce, surveillance d'intrapatum foetal et recours au accouchement \ue0 travers l'intervention chirurgicale pourrait am\ue9liorer le r\ue9sultat foetal chez ces enfants

Introducing Misoprostol for the Treatment of Incomplete Abortion in Nigeria

Despite legal restriction, induced abortions and resulting complications are common in Nigeria. Misoprostol administration for incomplete abortion was introduced in 3 Nigerian hospitals. The feasibility of the hospitals, patient and provider acceptability were assessed using questionnaire and interview guides administered to 205 women and 17 providers respectively. Amongst the women, 194 (95%) were satisfied and very satisfied with misoprostol, 176 (86%) would choose misoprostol again if another incomplete abortion occurred and 191 (93%) would recommend it to another woman in a similar situation. Providers were highly satisfied with misoprostol. The ease of use and ability to redirect surgical resources to more complicated issues were positive features cited by them. The providers agreed that integration of misoprostol was straightforward and required few resources. Therefore, misoprostol for incomplete abortion is safe, efficacious and acceptable to providers and patients. In remote areas of Nigeria with limited post-abortion care (PAC), misoprostol administration is an important potential PAC treatment modality. Features of misoprostol-low cost, room temperature stability, and ease of introduction-render it an important treatment option, particularly in low resource and rural settings

Incidence of and socio-biologic risk factors for spontaneous preterm birth in HIV positive Nigerian women

BACKGROUND: Recent studies have identified HIV as a leading contributor to preterm delivery and its associated morbidity and mortality. However little or no information exists in our sub-region on this subject. Identifying the factors associated with preterm delivery in HIV positive women in our country and sub-region will not only prevent mother to child transmission of HIV virus but will also reduce the morbidity and mortality associated with prematurity and low birth weight. This study was designed to determine the incidence and risk factors for preterm delivery in HIV positive Nigerians. METHOD: The required data for this retrospective study was extracted from the data base of a cohort study of the outcome of prevention of mother to child transmission at the Nigerian Institute of Medical Research, Lagos. Only data of women that met the eligibility of spontaneous delivery after 20 weeks of gestation were included. Ethical approval was obtained from the Institution’s Ethical Review Board. RESULTS: 181 women out of the 1626 eligible for inclusion into the study had spontaneous preterm delivery (11.1%). The mean birth weight was 3.1 ± 0.4 kg, with 10.3% having LBW. Spontaneous preterm delivery was found to be significantly associated with unmarried status (cOR: 1.7;1.52-2.57), baseline CD4 count <200 cells/mm(3)(cOR: 1.8; 1.16-2.99), presence of opportunistic infection at delivery (cOR: 2.2;1.23-3.57), multiple pregnancy (cOR 10.4; 4.24 – 26.17), use of PI based triple ARV therapy (eOR 10.2; 5.52 – 18.8) in the first trimester (cOR 2.5; 1.77 – 3.52) on univariate analysis. However after multivariate analysis controlling for potential confounding variables including low birth weight, only multiple pregnancy (aOR: 8.6; CI: 6.73 – 12.9), presence of opportunistic infection at delivery (aOR: 1.9; CI: 1.1 – 5.7), and 1st trimester exposure to PI based triple therapy (aOR: 5.4; CI: 3.4 – 7.8) retained their significant association with preterm delivery. CONCLUSION: The spontaneous preterm delivery rate among our cohort was 11.1%. HIV positive women with multiple pregnancies, symptomatic HIV infection at delivery and first trimester fetal exposure to PI based triple therapy were found to be at risk of spontaneous preterm delivery. Early booking and non-use of PI based triple therapy in the first trimester will significantly reduce the risk of preterm delivery

Molecular Characterization of the Circulating Strains of Vibrio cholerae during 2010 Cholera Outbreak in Nigeria

This study aimed at characterizing the phenotypic and toxigenic status of circulating strains of cholera during outbreaks in Nigeria, employing molecular typing techniques. Two hundred and one samples of rectal swabs, stool, vomitus, water (from the well, borehole, sachet, stream, and tap) and disinfectants (sodium hypochlorite) were collected from three states in the country. The samples were inoculated on thiosulphate-citrate bile salt-sucrose (TCBS), Cary-Blair transport medium and smeared on glass slides for direct examination. The Vibrio cholerae isolates were serotyped, biotyped, and characterized using PCR of the cytotoxin gene A (ctxA), wbeO1, and wbfO139 gene primer. Of the 201 samples screened, 96 were positive for V. cholerae O1 (48%), with 69 (72%) positive for ctxA gene. The results from this study showed that the circulating strains of cholera in Nigeria were of Ogawa serotype, also observed in other outbreaks in Nigeria (1991, 1992, and 1996). However, the strains were of the Classical biotype and were mainly (72%) ctxA gene-positive. This current investigation has confirmed the production of cholera toxin by the circulating strains, and this could be harnessed for possible cholera vaccine production in Nigeria

Monitoring the SNS basement neutron background with the MARS detector

We present the analysis and results of the first dataset collected with the MARS neutron detector deployed at the Oak Ridge National Laboratory Spallation Neutron Source (SNS) for the purpose of monitoring and characterizing the beam-related neutron (BRN) background for the COHERENT collaboration. MARS was positioned next to the COH-CsI coherent elastic neutrino-nucleus scattering detector in the SNS basement corridor. This is the basement location of closest proximity to the SNS target and thus, of highest neutrino flux, but it is also well shielded from the BRN flux by infill concrete and gravel. These data show the detector registered roughly one BRN per day. Using MARS' measured detection efficiency, the incoming BRN flux is estimated to be $1.20~\pm~0.56~\text{neutrons}/\text{m}^2/\text{MWh}$ for neutron energies above $\sim3.5$~MeV and up to a few tens of MeV. We compare our results with previous BRN measurements in the SNS basement corridor reported by other neutron detectors.Comment: Submitted to JINS

COHERENT Collaboration data release from the measurements of CsI[Na] response to nuclear recoils

Description of the data release 10.13139/OLCF/1969085 (https://doi.ccs.ornl.gov/ui/doi/426) from the measurements of the CsI[Na] response to low energy nuclear recoils by the COHERENT collaboration. The release corresponds to the results published in "D. Akimov et al 2022 JINST 17 P10034". We share the data in the form of raw ADC waveforms, provide benchmark values, and share plots to enhance the transparency and reproducibility of our results. This document describes the contents of the data release as well as guidance on the use of the data

First Probe of Sub-GeV Dark Matter Beyond the Cosmological Expectation with the COHERENT CsI Detector at the SNS

The COHERENT collaboration searched for scalar dark matter particles produced at the Spallation Neutron Source with masses between 1 and 220~MeV/c$^2$ using a CsI[Na] scintillation detector sensitive to nuclear recoils above 9~keV$_\text{nr}$. No evidence for dark matter is found and we thus place limits on allowed parameter space. With this low-threshold detector, we are sensitive to coherent elastic scattering between dark matter and nuclei. The cross section for this process is orders of magnitude higher than for other processes historically used for accelerator-based direct-detection searches so that our small, 14.6~kg detector significantly improves on past constraints. At peak sensitivity, we reject the flux consistent with the cosmologically observed dark-matter concentration for all coupling constants $\alpha_D<0.64$, assuming a scalar dark-matter particle. We also calculate the sensitivity of future COHERENT detectors to dark-matter signals which will ambitiously test multiple dark-matter spin scenarios