Search

Objective: To assess the practice of provider-initiated counseling and testing (PICT) for HIV infection by Nigerian Obstetricians and estimate missed opportunities at the gynecological and family planning clinics. Methods: Online cross-sectional survey of members of the Society of Gynaecology and Obstetrics of Nigeria (SOGON) over a 4-week period using SurveyMonkey®. Frequencies were used to present responses of participants. Results: There were 201 (29%) respondents. Participants' mean age was 46 ± 7.2 (SD) years and majority (93.3%) held consultant positions. Most respondents (92.2%) cared for HIV-infected pregnant women with dedicated HIV counselors (77.4%), and in dedicated counseling rooms (71%). Majority (75.7%) had been trained on HIV management in pregnancy and 95.3% routinely counseled and tested women attending the booking antenatal clinic. Fourteen per cent (14%) and 16% of respondents conducted routine counseling and testing for women attending the gynecological and family planning clinics, respectively, for the first time. For every 100 women tested at the antenatal clinic, 317 women were missed at each of the two clinics. Conclusions: PICT of HIV infection in Nigeria has focused on pregnancy. To eliminate new HIV infections in children, PICT should be routine at the gynecological and family planning clinics. [ABSTRACT FROM AUTHOR]

Violence against women is embedded in most cultures with pregnancy associated with higher rates. This study assessed the pattern of violence in pregnancy in two maternity centres in Ibadan, Nigeria. This was a cross-sectional study of antenatal clinic attendees, between 1 and 31 March, 2007 at the University College Hospital (UCH) and the Adeoyo Maternity (AMH). By systematic random sampling, 404 women were interviewed. Analysis was done by means, χχ2-test (at 5%% level of significance) and logistic regression. At UCH and AMH, 156 (38.7%%) and 248 (61.3%%) were studied, respectively. The prevalence of abuse was 17.1%% (69 women). The perpetrator was most often an intimate partner (48, 66.1%%). The commonest act of violence was a threat of abuse (23, 33.3%%). The most frequent reason for the abuse was demand for money. Women in polygamous unions ( p == 0.035), attending Adeoyo hospital ( p == 0.00) or with secondary school or less education ( p == 0.004) had higher levels of abuse. Regression analysis revealed women attending AMH were 3.6 times more likely to be abused (95%% CI for OR == 1.69--7.81). Violence is not uncommon in this population. Education and employment may reduce these acts. [ABSTRACT FROM AUTHOR]

The objective of this study is to document the anaesthetic preference of pregnant women in two tertiary institutions in North-eastern Nigeria. This was a cross-sectional study of pregnant women seen at the antenatal clinics of the university of Maiduguri teaching hospital and Federal Medical Centre, Yola, from August to October 2009. A total of 254 women were interviewed. They were aged 18-43 with a mean of 28.56 ± 5.602 years. The parity ranged from 1-9 with a mean of 2.71 ± 1.956. Most (178, 70.1%) respondents preferred general anaesthesia and the commonest reason for the preference was various forms of fear 128 (71.9 %). The commonest reason for preference for regional anaesthesia was to watch the procedure live 50 (65.8%). Age (χ2 = 52.364, p = 0.000), education (χ2 = 8.780, p = 0.032), occupation (χ2 = 18.555, p = 0.002) and religion (χ2 = 4.936, p = 0.026) were significantly associated with preference for general anaesthesia. Only age ( p = 0.000, OR 8.17, CI = 0.000-1.00) retained significance after multivariate analysis. Considering the fact that the global trend is towards regional anaesthesia due to lower morbidity and mortality, the high preference for general anaesthesia in our survey is worrisome. Health education during antenatal clinics should highlight the superiority of regional over general anaesthesia for caesarean delivery. [ABSTRACT FROM AUTHOR]

Some pregnant women do book concurrently with multiple antenatal care providers. Structured questionnaires were administered to women attending antenatal clinics in 12 facilities in Enugu, Nigeria. A total of 535 women responded: 372 (69.5%) were booked into more than one facility and 163 (30.5%) were booked into a single facility; 280 (52.3%) booked into the two Teaching Hospitals and 91 (12.5%) booked with a traditional birth attendant. Reasons for multiple bookings included selecting a facility with affordable prices (43.9%); selecting a facility promising vaginal delivery (35.3%); avoiding HIV testing (17.9%); avoiding caesarean section (10.8%); avoiding being regarded as unbooked (10.1%) and booking into a facility where they were not known. Possible disadvantages were confusion in deciding where to deliver (53.1%); default on expert advice (27.5%); mismanagement (18.7%); delays, complications and death (12.5%). Multiple bookings were common in this study. Disadvantages of this practice, including risk of death, were identified by the women. [ABSTRACT FROM AUTHOR]

This study assessed voluntary counselling and testing (VCT) uptake, nevirapine use and infant feeding options among the pregnant women seen in a tertiary care centre in Enugu, South-east Nigeria, with the aim of identifying gaps (if any) in the prevention of mother-to-child transmission (PMTCT) implementation in the hospital. It was a prospective study of all antenatal clinic attendees and those who delivered at the University of Nigeria Teaching Hospital, Enugu, within a 7-month period (1 March to 30 September 2005). During the 7-month period, 635 pregnant women accessed the PMTCT services in the hospital. With respect to VCT, 25 (3.9%) of the antenatal clinic attendees had only group counselling, while 610 (96.1%) others had both group and individual pre-test counselling. A total of 87 (13.7%) of the 635 women tested were HIV positive. Some 426 (67.1%) women had post-test counselling carried out. Twenty (23.0%) of the 87 HIV-positive women had their infection diagnosed prior to the current pregnancy, while 67 (77.0%) had the disease diagnosed during the index pregnancy. Eight (9.2%) of them had previously had anti-retroviral therapy with nevirapine. Twelve (13.8%) of the women were on antiretroviral therapy in the index pregnancy - two on highly active antiretroviral therapy (HAART) and 10 on nevirapine. A total of 41 (47.1%) of the 87 HIV-positive women had delivered as at 30 September 2005. Ten of them had antiretrovirals administered to them during the antenatal period. The remaining 31 had antiretrovirals administered to them on arrival at the labour ward for delivery. Of the 41 women who delivered, 39 had intra-partum nevirapine, while the 2 women on HAART took their usual daily dosage. Regarding mode of delivery, one-third of the women had a caesarean section and two-thirds had vaginal delivery. Ten (24.4%) of the 41 women had episiotomy, while seven of the remaining 31 women who did not receive episiotomy sustained varying degrees of perineal tear. There was no maternal death. All the 41 live born babies received nevirapine syrup at birth. A total of 86 (98.9%) out of the 87 HIV-positive women had infant feeding counselling. All chose exclusive breast-milk substitutes for their babies. There was one twin delivery, giving a total of 42 babies delivered. One of the babies was a stillbirth. The rest survived the neonatal period. It was concluded that the VCT uptake at the University of Nigeria Teaching Hospital, Enugu, is high. The majority of the women and their babies received peripartum nevirapine and at delivery all the women chose to do exclusive formula-feeding. The main gaps identified by the study were that most of the women delivered vaginally and there were delays in obtaining HIV test results. It remains to be seen how these variables will affect the vertical transmission rate. [ABSTRACT FROM AUTHOR]

Mother-to-child transmission of HIV (MTCT) is responsible for more than 90% of the cases of HIV infection in infants and children In sub-Saharan Africa. Accurate data on the knowledge and perceptions of HIV/AIDS among women attending antenatal clinics in Nigeria are scarce. A cross-sectional survey of 804 women attending antenatal clinics in Ogun State, South-West Nigeria was done using interviewer-administered questionnaires. Approximately 90% of the women respondents had heard of HIV/AIDS, but only about 27% knew HIV could be transmitted from mother to child; of those, almost 94% believed in the reality of HIV disease; in contrast, the majority (64%) believed they were not at risk of HIV infection, and a slightly greater proportion (70%) did not understand the benefits of voluntary HIM counselling and testing (VCT). Nonetheless, almost 90% of respondents were willing to know their status following health education about VCT. Those that were older, attending public hospitals, and with a higher level of education had more knowledge and better perceptions about HIV. The results suggest an urgent need for public health education on HIV/AIDS and the benefits of VCT to control MTCT, particularly targeting young women and those with little or no education. [ABSTRACT FROM AUTHOR]

The adolescent maternal mortality ratio is high in Jos, north-central Nigeria. The main causes of maternal deaths among the adolescents were unsafe abortion, eclampsia and sepsis. The Hausa/Fulani ethnic group constituted the largest ethnic group of adolescent maternal deaths in our study. The risk factors for adolescent maternal mortality found in our study were illiteracy, non-utilisation of antenatal services and Hausa/Fulani ethnic group. [ABSTRACT FROM AUTHOR]

This study aimed to determine goitre prevalence in pregnant women. Seven hundred pregnant women attending the antenatal clinic at Wesley Guild Hospital, Ilesa, were interviewed and examined. The mean age of the subjects was 27.8% years, with mean parity of 2.65%. Mean gestation was 28.5% weeks. A total of 97.4% were resident in main water supply for nearly all the subjects. Only 7.3% of the subjects showed no thyroid enlargement. Early enlargement (1[SUPa] and 1[SUPb]) occurred in 441 (63%) patients. Grade 2 enlargement in 166 (23.2%) and a grossly enlarged in 40 (5.7%). The goitre rate was correlated with the age and parity of the patients. [ABSTRACT FROM AUTHOR]

Limited information exists on maternal perspectives of prenatal sonogram in north-eastern Nigeria. This study was aimed at documenting the views and expectations of pregnant women concerning prenatal sonogram as well as their level of awareness of its purpose, limitations and safety in a predominantly Moslem society. A survey was carried out on a convenience sample of 150 patients referred from ante-natal clinics for prenatal sonogram, by administering semi structured questionnaires. The results show that 61.3% of the women had prenatal sonogram, with little or no information about the purpose, capabilities and limitations of the procedure. 24.7% had neither formal western nor Islamic educational background that may have influenced their perceptions. Most of the women (81.3%) were sponsored by either government or their husbands, 72.7% perceived sonogram to be affordable and 63.4% viewed sonographic results as reliable. The perceived main reasons for having a prenatal sonogram were to determine the expected date of delivery and foetal well being, and to obtain reassurance of maternal health. Sex determination and number of foetuses were the least considered reasons. The study indicates that providing pregnant women with adequate information and sensitising them to the purpose and limitations of sonograms is necessary to guarantee its rational utilisation. Improving patient care, enhancing the skill of sonographers and providing more facilities would improve the services and patients' perspectives of prenatal sonography. [ABSTRACT FROM AUTHOR]

Today, caesarean section is one of the most commonly performed surgical procedures the world over. Despite the well-documented record of safety, the strong aversion of women in sub-Saharan Africa to the procedure, especially in the presence of life-threatening indications, is of great concern to many obstetricians. This cross-sectional study, aimed at assessing the knowledge of the patients about caesarean section and its acceptability as mode of delivery, was conducted among antenatal patients at a University Teaching Hospital in south-west Nigeria. A pre-tested structured questionnaire was used. Among the 201 patients surveyed, a high level of acceptability of caesarean section (85%) was found. However, 96.5% of those who would accept would give consent only after seeking the opinion of other people, especially their husbands. Previous major surgery and caesarean section were found to favour its acceptability, while age, tribe, marital status and the woman or her husband's educational status did not have any influence. With proper health education, especially during antenatal care, many more women would find caesarean section acceptable. [ABSTRACT FROM AUTHOR]

A questionnaire survey was conducted among 1000 pregnant Nigerian women to identify their knowledge and perception of prenatal sex determination using ultrasonography. Eighty-one per cent of the respondents were aware of the technology. Knowledge of it was associated with high parity and education. However, only 64% of respondents desired to know the sex of their fetus. Younger age, low parity and less number of existing male children influenced this desire. There was no indication of considering possible abortion of the fetus if the identified sex was not the desired one. It is suggested that as there seem no grave sequelae of revealing the sex of the fetus, sonologists should not withhold this information from mothers if they so desire. [ABSTRACT FROM AUTHOR]

In a cross-sectional study, 230 pregnant women attending the antenatal clinic of the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria from January 2000 to December 2000 were screened randomly to determine the prevalence of common STDs among them, using conventional methods. One hundred and fourteen (49.4%) of the subjects harboured various agents including Candida spp. (37.8%), Trichomonas vaginalis (4.7%), Gardnerella vaginalis (3.9%), syphilis (1.7%) and Neisseria gonorrhea (1.3%). Risk factors associated with significant infection were young age and level of education. The importance of routine STD screening in pregnancy especially among the young and illiterate is advocated. It is recommended that routine screening for STDs should be incorporated into antenatal care. [ABSTRACT FROM AUTHOR]

This study investigates STD knowledge, awareness and perception among antenatal patients at a Nigerian teaching hospital. There was general awareness of the common STDs, such as gonorrhoea, 95·5% (n=127) and syphilis 66·92% (n=89), while the least awareness was recorded in chlamydial diseases, 6% (n=8). HIV/AIDS recorded the highest awareness, 96·2% (n=128). There knowledge of causes and treatment was remarkably poor. Only 58·6% (n=78) could recognise bacteria as causing STD. Surprisingly more than half, 72·2% (n=96) still believed that remedy could be obtained from prayer houses, herbs and other non-scientific means. The most common source of information was through media houses: radio 72·9% (n=97), television 64·7% (n=86). Preventive awareness was high, more than half believing that STD is preventable either by abstinence, barrier contraception or by mutual fidelity. Superstitious beliefs, greater influence of traditional medical practices and poverty are some of the numerous problems the few existing STD clinics face in the developing countries. Efforts should be geared towards establishing standard STD clinics and appropriate information disseminating organs. A situation where the herbalists and traditional medical personnel capture the mostly ignorant populace through unrestricted access to the media houses, as currently practiced in Nigeria, should be checked. [ABSTRACT FROM AUTHOR]

This study was carried out at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria with the aim of assessing pregnant clients' opinions on the issue of antenatal HIV screening which is at present very controversial in Nigeria. Five hundred and eighty-six clients were interviewed at the antenatal clinic using a close-ended questionnaire. Three hundred and eighty-five (67·8%) of the clients were found to have a good knowledge of HIV infection and were therefore included in the study sample. Of the clients, 75·1% and 61·5% accepted voluntary and mandatory screening, respectively. Respondent's reasons for accepting screening include prevention of transmission of infection to baby, husband and hospital staff, while reasons for objection to antenatal screening included financial implications, stigmatisation, fear of the outcome of the test and the right to choose. Four hundred and seventy-two (80·6%) and 389 (66·4%) patients will continue the pregnancy and not disclose the result if found positive at screening, respectively, while 11 (1·9%) expressed the view that they might contemplate suicide. Based on these findings, obstetricians in this locality are encouraged to modify the scope of antenatal care by gradually incorporating HIV screening as part of standard and screening procedure at booking or at the first visit. [ABSTRACT FROM AUTHOR]

The article discusses the survey on the attitude of Nigerian women to the prenatal screening services for congenital abnormalities. The delivery of the baby without congenital malfunction is the major goal of good antenatal care service and in order to achieve this, the most favorable condition for screening is in the early pregnancy. About 740 women were selected from different health institutions, 75% of them are aware of the prenatal screening and 50% had screened in their previous pregnancy.