Cord blood full blood count parameters in Lagos, Nigeria

Introduction: Full blood count (FBC), one of the most frequently requested for laboratory investigations, is a simple, fast and cheap test and is a reliable indicator of health. Due to its usefulness in the  assessment of health status of individuals, its parameters in cord blood, a major source of haemopoietic stem cell transplantation and an ideal source for laboratory investigations for newborns were determined to provide a useful guide to local neonatologists and stem cell transplant physicians. Methods: Three millilitres of umbilical cord blood was collected from 130 normal birth weight newborns (69 males and 61 females) whose cord were clamped immediately after delivery, at a teaching hospital in Lagos, Nigeria and full blood count parameters were determined using Sysmex autoanalyzer, model  KX-21N. Consented mothers of the newborns were selected based on, age between 18 and 45 years;  uneventful pregnancy and delivery and haemoglobin (Hb) concentration ≥ 10 g/dL. Results: There were no statistical gender differences in the mean values of Hb concentrations (M=13.27  ±1.60 g/dL; F=13.32±1.61g/dL; p=0.93), total white cell count (M=3.16±5.43 × 109/L; F=13.07±4.98  × 109/L; p= 0.92), platelet count (M= 223.64± 64.21 × 109/L; F=226.69±80.83 × 109/L; p=0.81) and other parameters. Conclusion: Mean values of full blood count parameters obtained in this study are  comparable to reports from other studies in developing countries and could be a useful guide for neonatologists and stem cell transplant physicians in our geographical location.Key words: Haemoglobin, cord blood, stem cell, umbilical cord, neonatologis

Chlamydia trachomatis among women with normal and abnormal cervical smears in Lagos, Nigeria

Background: Chlamydia trachomatis is one of the most common sexually transmitted disease agents. Cervical intraepithelial neoplasia (CIN) has been independently associated with serological evidence of chlamydial infection. This study therefore was aimed to determine the prevalence of C. trachomatis and the association between Chlamydia trachomatis infection and cervical intra-epithelial lesion.Methods: It is a cross-sectional case control study carried out at the Lagos University Teaching Hospital (LUTH) with the study participants selected into 2 groups: the case group (women with abnormal smears) and the control group (women with normal Pap smear). Relevant information was obtained using a structured interviewer-administered questionnaire. Endocervical swab sample was collected and analysed by Polymerase Chain Reaction (PCR) test. Data analysis was done using Epi-Info statistical package (version 3.4.3).Results: The overall prevalence of C. trachomatis was 27.7% with a decreasing trend noted with age (P <0.05). The majority of women with C. trachomatis were in the reproductive age group of 25-45 years. 50% of women with abnormal smears were positive for C. trachomatis, compared to only 16.7% of the controls (X2 = 10.95; P = 0.001). There was no statistically significant association between prevalence of C. trachomatis and cervical cytological types (X2 = 1.892; P = 0.595)Conclusions: The study revealed an association between Chlamydia trachomatis and precancerous lesions of the cervix. Routine screening and treatment of sexually active adolescents and women in the reproductive age group is recommended as an indirect measure to reducing the incidence of cervical cancer in Nigeria

Sources of Contraceptive Commodities for Users in Nigeria

BACKGROUND: Understanding the sources of contraceptive commodities is an important aspect of the delivery of family planning services and is required by planning programme managers for strategic planning purposes. Findings from the 2003 Nigeria Demographic and Health Survey have previously showed that the private sector was the most frequently reported source of contraceptive supply, providing contraception to two and a half times as many women as the public sector. We conducted a community-based study to examine further the sources of contraceptive commodity for users in Nigeria with a view to identifying their preferences for distribution centres. This information would be useful to improve commodity distribution and to build the necessary capacity for satisfactory delivery of contraceptives. METHODS AND FINDINGS: A multi-stage random sampling technique was used. A state was randomly selected to represent each of the four health zones in Nigeria. Two local government areas (LGAs) were then selected representing both urban and rural areas. Ten enumeration areas were subsequently selected from each LGA. Of the 2,001 respondents aged 15–49 years, 1,647 (82.3%) were sexually active, out of which 244 were found to be using contraceptive methods at the time of the study, giving a contraceptive prevalence of 14.8%. The commonest source of information on contraceptives was through friends (34%), followed by the radio (11.5%) and husbands (10.2%). Most respondents procured their contraceptives from chemist/patent medicine shops (19.7%), while only 0.8% obtained them from designated family planning clinics. The younger groups in this study (15–24 years), single people, Catholics, and Muslims, showed a greater preference for chemist/patent medicine shops for their sources of contraceptives. The older groups and married respondents, however, made use of government and private hospitals to obtain their contraceptives. CONCLUSION: Strategies to increase contraceptive use must take into consideration these identified sources of contraceptives with a view to enhancing the quality, quantity, and variety of methods available, and to building capacity for effective service delivery. There is also a need to encourage the establishment of adolescent-friendly clinics where young people can go for counselling and obtain contraceptives of their choice, including emergency contraceptive pills

Induced Abortion in Nigeria: Findings from Focus Group Discussion

Abortion is carried out daily in Nigeria despite the restrictive abortion law. This study was carried out to obtain information on societal attitude to the issues of family planning, unwanted pregnancy, abortion, adoption of children and laws relating to them. Focus group discussions were held in south-western Nigeria among 11 sub-groups. Participants felt that there was high prevalence of unwanted pregnancy and abortion particularly among youths. They had high level awareness of contraceptives and ascribed its low use to negative side effects, high cost and provider bias. Christians favoured planning of pregnancies while the Muslims did not. Majority of the respondents had negative perception of induced abortion. Some of them supported abortion if the education of the young girl would be disrupted, if paternity of pregnancy is in dispute, or if it would save the family from shame. Participants supported the enactment of laws that would make adoption of unwanted children easier. (Afr J Reprod Health 2005; 9[1]: 133-141

The knowledge and use of misoprostol among women in a Nigerian population

Background: Increasing the availability and accessibility of misoprostol in low resource settings has been advocated to reduce maternal deaths from primary postpartum haemorrhage (PPH). WHO recommends a strategy of antenatal distribution of misoprostol to pregnant women, for self-administration for the prevention of PPH, in settings where women are likely to give birth outside of a health facility or in the absence of skilled health personnel. The success of such strategies depends on the current knowledge and acceptability of misoprostol among women in such population. The aim of this study was that we assessed the knowledge and use of misoprostol among Nigerian women.Methods: It was a prospective cross-sectional population based survey in which 16445 consenting women, from randomly selected households and communities across the 20 local government areas (LGA) of Lagos state, had in-depth interview with the aid of an interviewer administered structured questionnaire to assess their knowledge and use of misoprostol. Data obtained were presented in frequency and proportions.Results: Thirteen per cent and 6.5% of the respondents were aware of drugs that could be used to terminate pregnancy and stop bleeding following childbirth, respectively. Only 5.2% of the women were aware of misoprostol, two-third (67%) of which knew it could be used to terminate pregnancy and 5% of women aware of misoprostol knew it could be used to reduce or stop bleeding following childbirth. Only 2.3% of the entire study population admitted to personal use of misoprostol.Conclusions: Knowledge about the safe, life-saving and effective use of misoprostol among Nigerian women is low. There is need to disseminate information about misoprostol especially in settings where women are likely to give birth outside of a health facility or in the absence of skilled health personnel.

Maternal serum vitamin D levels and pregnancy outcomes: from Lagos, Nigeria

In an attempt to investigate the effect of vitamin D deficiency on pregnancy complications including caesarean section and foetal outcome in our population, blood samples of 461 pregnant women who attended antenatal booking clinic between 10 and 28 weeks of pregnancy were taken for vitamin D estimation and followed up. Details concerning pregnancy complications, labour and foetal outcome were obtained after delivery. They were divided into three groups according to the serum vitamin D level: group 1 (0–20)ng/ml (deficiency), group 2 (21–30)ng/ml (insufficiency), and group 3 (more than 30 mg/ml) normal. The prevalence of vitamin D deficiency was 29%. There were no differences between the groups regarding complications during pregnancy, including preeclampsia and rate of caesarean section. A multicenter study was advocated to elucidate further the role of vitamin D during pregnancy in our population

Cord blood haemoglobin and ferritin concentrations in newborns of anaemic and non-anaemic mothers in Lagos, Nigeria

Background: Pre-delivery haemoglobin and serum ferritin concentrations of anaemic and non-anaemic mothers were determined, and cord blood haemoglobin and serum ferritin concentrations of their newborns were compared. This is to establish the mean values for pre-delivery haemoglobin and serum ferritin concentrations of anaemic and non-anaemic mothers and the cord blood haemoglobin and serum ferritin concentrations of their newborns at term. Materials and Methods: A case-control study was done involving 142 pregnant women and their newborns. They were divided into two groups - the anaemic group ( n = 65) and the non-anaemic ( n = 77) group. Five millilitres of blood was collected from each woman and 2 ml was collected from the cord of their newborns into ethylenediaminetetraacetic acid (EDTA) bottle and plain bottle for full blood count analysis and ferritin assay, respectively. Results: The mean pre-delivery haemoglobin concentrations of the women in anaemic group and non-anaemic group were 9.5 ± 1.01 g/dl and 12.15 ± 1.07 g/dl, respectively, and their mean serum ferritin concentrations were 64.45 ± 138.76 μg/l and 32.83 ± 35.36 μg/l, respectively. The mean cord blood haemoglobin concentrations for anaemic and for non-anaemic groups were 12.54 ± 2.54 g/dl and 13.44 ± 2.23 g/dl ( P = 0.02), respectively, and the mean cord blood serum ferritin concentrations (non-anaemic, 69.38 ± 78.88 μg/l; anaemic, 7.26 ± 115.60 μg/l) ( P = 0.00) were higher in the newborns of non-anaemic than of anaemic mothers. Significant association was found between maternal anaemia and cord blood ferritin concentrations ( P = 0.025). Conclusion: Maternal anaemia has significant effects on cord blood haemoglobin and serum ferritin concentrations

Do Women in Rural South-West Nigeria Become Pregnant with Sub-optimal Haemoglobin Concentrations?

Background: Anaemia is a major public health concern worldwide, particularly in developing countries like Nigeria. In a previous study on determinants of prenatal anaemia, we found out that the majority of our respondents had dietary iron intake below the recommended value of 27mg∕day and all of them belonged to low socio-economic class. We opined that many of our respondents could have become pregnant with sub-optimal haemoglobin concentrations. Aim: This study was carried out to evaluate the prevalence of anaemia and the socio-economic determinants of anaemia in non-pregnant women of reproductive age in our community. Materials and Methods: The study which was descriptive and cross-sectional, involved two hundred consenting non-pregnant women of reproductive age in Ikenne Local Government Area of Ogun State, Nigeria. Interviewer-administered questionnaires were used to collect socio-demographic information and 24-hr dietary recall data which was used to determine the dietary diversity score (DDS) and daily dietary iron intake (DDI). Using a finger prick, the haemoglobin (Hb) concentration of each respondent was determined with a Haemoglobinometer DG-300HB. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 23. Results: The mean age of respondents was 32.04±8.99 years while the age range was 18-43years. The mean and range of Hb concentrations were 11.77±1.02 g∕dL and 8-16.67 g∕dL respectively. The prevalence of anaemia obtained from this study was 54% (mean 11.77 SD1.02). The prevalence of anaemia was highest amongst respondents who were farmers. There was a statistically significant association between Hb concentration and body mass index (BMI) p=0.009. Of the 200 respondents, 193 (96.5%) had inadequate dietary iron intake (&lt;18mg/day). There was statistically significant association between Hb groupings and daily dietary iron (DDI) intake. P=0.003. With a mean of 2.96±0.95 food groups and range of 1.0-5.0 food groups, 95 % of respondents had low DDS (&lt; 5 food groups). Hb concentration was also significantly associated with DDS as only 1(20%) of 5 respondents that had adequate DDS had Hb concentration below cut-off value. Conclusion: The prevalence of anaemia in non-pregnant women of reproductive age was high in the community studied making it possible for majority of them to enter pregnancy with sub-optimal Hb concentration. The prevalence was highest amongst respondents who were farmers. The majority of the respondents had inadequate DDS and daily DDI

Community-Based Survey of Unwanted Pregnancy in Southwestern Nigeria

Unwanted pregnancy, and consequently unsafe abortion, remains major reproductive health problems in Nigeria that needs to be tackled. Unfortunately, there is a dearth of information on this problem at the community level. This study therefore examined the prevalence of unwanted pregnancy in the community as well as associated factors including the views, perceptions and attitudes of community members towards unwanted pregnancy and the pattern of help-seeking behaviour on unwanted pregnancy. Information was obtained from 3,743 women in urban and rural communities in two Nigerian states of Lagos and Edo. At some point in life, 26.6% of the respondents had had unwanted Pregnancy while abortion prevalence was 21.7%. Short birth intervals (21.1%), high cost of raising children (20.1%), interruption of education (20.1%) and being unmarried (17.3%) were the most common reasons for not wanting pregnancies. Most of the respondents (91.3%) were aware of some form of contraception but ever-use rate was only 36.6% while current use rate was 23.4%. Both abortion and contraceptive use were significantly associated with increasing levels of education. Unwanted pregnancy constitutes a problem even at the community level and more research is needed to understand the persistent disparity between contraceptive knowledge and usage, as increased usage will reduce unwanted pregnancy and induced abortion. (Afr J Reprod Health 2004; 8[3]:103-115