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Despite the ability of sweetpotato to grow in marginal areas, large differential genotypic responses have been reported under varying environmental conditions. Differences in pest and disease pressure contribute significantly to inconsistencies in performance of genotypes in various environments. Using a randomized complete block design, eight sweetpotato genotypes were evaluated in one location successively for five years (seasons) (2010-2015). Additive main effects and multiplicative interaction (AMMI) stability value (ASV) was used to identify best genotypes that combine stability with high resistance to sweetpotato weevil Cylas puncticolis and root yield across the five seasons (years). Stability of genotypes for weevil infestation and damage thereof, and fresh storage root yield were determined for each season. The data on each of these parameters were correlated with rainfall and temperature data for each and across five seasons. Results show variability in the ranking of genotypes’ stability for resistance to weevil infestation and associated damage. Significant negative correlation was recorded between total rainfall and sweetpotato weevil damage. However, AMMI analysis of variance indicates genotype main effects, environmental main effects and the interaction thereof were all significant for root yield and weevil damage. Genotype selection index assisted to identify at least three genotypes namely Kokota, Lunga, and Kalungwishi which combined stability for high root yield and tolerance to weevil damage.

Background: Medline search revealed paucity of data with respect to the leucocyte changes in normal pregnancy in Maiduguri. Objectives: to determine the normal range of leucocyte count in pregnancy and the effect of parity on leucocyte counts. Method a cross sectional study carried out at the University of Maiduguri Teaching Hospital (UMTH) Maiduguri between April - October 2005. The subjects were pregnant women at different gestational age recruited from the antenatal clinic at booking. The control groups were women from the family planning clinic who had weaned their babies and not on hormonal contraceptives. Blood samples were collected from the 200 normal pregnant women (cases) and 150 non-pregnant controls for blood cell count and differential. Result: the mean count for the white blood cell (WBC) was higher in prignancy. The values for total leucocyte count (TLC) were 7.9 +/- 2.05, 8.33 +/- 1.74, and 8.74 +/- 1.87 in the 1, 2 and 3 trimesters respectively. The mean differential leucocyte counts in the 1, 2 and 3 trimesters were neutrophils 2.98, 2.98 and 3.9; lymphocytes 2.95, 3.66 and 3.86 eosinophils 0.72, 0.84 and 0.92 and monocytes 0.72, 0.84 and 0.88 respectively. The values for the non-pregnant controls were TLC 7.82 +/- 1.11, neutrophils 1.95, lymphyhocyytes 4.2, eosinophils 0.78 and monocytes 0.78. There were no statistically significant differences between parity and TLC. Conclusion: There is a significant rise in total leucocyte count with increasing gestation age, but parity has no effect on leucocyte count.

Abstract Background Attractive targeted sugar bait (ATSB) stations containing bait (to attract) and ingestion toxicant (to kill) sugar-foraging mosquitoes are hypothesized to reduce malaria transmission by shortening the lifespan of Anopheles vectors. Methods A two-arm cluster-randomized controlled trial (cRCT) was conducted in Western Province Zambia. Seventy clusters of 250–350 households were assigned (1:1) by restricted randomization to an intervention arm (ATSB) or control arm (no ATSB) in the context of standard of care vector control (insecticide-treated nets and/or indoor residual spraying). Two ATSB stations (Westham Sarabi, 0.11% dinotefuran w/w) were maintained on exterior walls of eligible household structures for a 7-month deployment period (December-June) during the high malaria transmission season. The primary outcome was clinical malaria incidence among two consecutive seasonal cohorts of children aged 1–14 years, followed-up monthly from January-June in 2022 and 2023. Secondary outcome was Plasmodium falciparum prevalence among individuals aged over six months. Analysis compared clinical malaria incidence and prevalence between arms among the intention-to-treat population. Results ATSB coverage, assessed by cross-sectional survey, was 98.3% in March–April 2022 and 89.5% in March–April 2023. 4494 children contributed any follow-up time to the cohort, with 2313 incident malaria cases in the intervention arm (1.28 per child per six-month transmission season), and 2449 in the control arm (1.38 per child-season). The incidence rate ratio between the two arms was 0.91 (95% CI 0.72–1.15, p = 0.42). 2536 individuals participated in cross-sectional surveys, with prevalence of P. falciparum 50.7% in the intervention arm and 53.5% in the control arm. The odds ratio between the two arms was 0.89 (95% CI 0.66–1.18, p = 0.42). Secondary covariable-adjusted and subgroup analyses did not substantially alter the findings. No serious adverse events associated with the intervention were reported. Conclusions Two ATSB stations deployed per eligible structure for two consecutive transmission seasons did not result in a statistically significant reduction in clinical malaria incidence among children aged 1–14 years or in P. falciparum prevalence in rural western Zambia. Further studies are needed to assess the efficacy of ATSB stations in different settings and with different deployment strategies. Trial registration The trial is registered with Clinicaltrials.gov (NCT04800055).

Abstract Background Some settings continue to experience a high malaria burden despite scale-up of malaria vector control to high levels of coverage. Characterisation of persistent malaria transmission in the presence of standard control measures, also termed residual malaria transmission, to understand where and when individuals are exposed to vector biting is critical to inform refinement of prevention and control strategies. Methods Secondary analysis was performed using data collected during a phase III cluster randomized trial of attractive targeted sugar bait stations in Western Province, Zambia. Two seasonal cohorts of children aged 1–14 years were recruited and monitored monthly during the malaria transmission season, concurrent with entomological surveillance using a combination of human landing catch (HLC) and Centres for Disease Control (CDC) light traps at randomly selected households in study clusters. Behavioural data from cohort participants were combined with measured Anopheles funestus landing rates and sporozoite positivity to estimate the human behaviour-adjusted entomological inoculation rate (EIR). Results Behavioural data from 1237 children over 5456 child-visits in 20 entomology surveillance clusters were linked with hourly landing rates from 8131 female An. funestus trapped by HLC. Among all An. funestus tested by enzyme-linked immunosorbent assay (ELISA), 3.3% were sporozoite-positive. Mean EIR directly measured from HLC was 0.07 infectious bites per person per night (ib/p/n). When accounting for child locations over the evening and night, the mean behaviour-adjusted EIR was 0.02 ib/p/n. Children not sleeping under insecticide-treated nets (ITNs) experienced 13.6 infectious bites per person per 6 month season, 8% of which occurred outdoors, while ITN users received 1.3 infectious bites per person per 6 month season, 86% of which were received outdoors. Sleeping under an ITN can prevent approximately 90% of potential An. funestus bites among children. Conclusions In this setting ITNs have a high personal protective efficacy owing to peak An. funestus biting occurring indoors while most individuals are asleep. However, despite high household possession of ITNs (>90%) and high individual use (>70%), children in this setting experience more than one infectious bite per person per 6 month transmission season, sufficient to maintain high malaria transmission and burden. New tools and strategies are required to reduce the malaria burden in such settings. Graphical Abstract

Abstract Background Community acceptance is an important criterion to assess in community trials, particularly for new tools that require high coverage and use by a target population. Installed on exterior walls of household structures, the attractive targeted sugar bait (ATSB) is a new vector control tool designed to attract and kill mosquitoes. ATSBs were evaluated in Western Zambia during a two-year cluster randomized controlled trial to assess the efficacy of ATSBs in reducing malaria transmission. Community acceptance of ATSBs was critical for successful trial implementation. Methods A community engagement strategy outlined activities and key messages to promote acceptance. Annual cross-sectional surveys, conducted during the peak transmission period, assessed households for presence of ATSBs as well as perceived benefits, concerns, and willingness to use ATSBs. Sixteen focus group discussions and 16 in-depth interviews, conducted at the end of each ATSB station deployment period, obtained a range of perceptions and household experiences with ATSB stations, as well as ITN use in the context of ATSB deployment. Results Methods used during the study to promote acceptance and continued use of ATSBs were effective in achieving greater than 90% coverage, a high (greater than 70%) level of perceived benefits, and fewer than 10% of households reporting safety concerns. Common facilitators of acceptance included the desire for protection against malaria and reduction of mosquitoes, trust in health initiatives, and understanding of the product. Common barriers to acceptance included misconceptions of product impact on mosquitoes, continued cases of malaria, association with satanism, and damage to household structures. Discussion Future use of the ATSB intervention will likely require activities that foster community acceptance before, during, and after the intervention is introduced. Additional research may be needed to understand the impact of different levels of community engagement on ATSB station coverage, ATSB station perception, and ITN use. Conclusion There was high acceptance of ATSB stations during the trial in Western Zambia. Continuous and intense community engagement efforts contributed to sustained ATSB coverage and trust in the product. Acceptance of ATSBs during programmatic delivery requires further research.

Abstract Background Attractive Targeted Sugar Baits (ATSBs) offer a complementary vector control strategy to interventions targeting blood feeding or larval control by attacking the sugar feeding behaviour of adult mosquitoes using an attract-and-kill approach. Western Zambia was the first location to receive and deploy ATSB Sarabi version 1.2 stations in a Phase III cluster randomized controlled trial. This paper describes ATSB station installation, monitoring, removal, and disposal, quantifies ATSB station coverage, and reports major reasons for ATSB station replacement. Methods ATSB stations were deployed during two annual transmission seasons, through scheduled installation and removal campaigns. During deployment, monitoring was conducted per protocol to maintain high coverage of the ATSB stations in good condition. Routine monitoring visits during the trial captured details on ATSB station damage necessitating replacement following pre-defined replacement criteria. Annual cross-sectional household surveys measured ATSB station coverage during peak malaria transmission. Results A total of 67,945 ATSB stations were installed in Year 1 (41,695 initially installed+ 26,250 installed during monitoring) and 69,494 ATSB stations were installed in Year 2 (41,982 initially installed+ 27,512 installed during monitoring) across 35 intervention clusters to maintain high coverage of two ATSB stations in good condition per eligible household structure. The primary reasons for ATSB station replacement due to damage were holes/tears and presence of mold. Cross-sectional household surveys documented high coverage of ATSB stations across Year 1 and Year 2 with 93.1% of eligible structures having ≥ 2 ATSB stations in any condition. Discussion ATSB station deployment and monitoring efforts were conducted in the context of a controlled cRCT to assess potential product efficacy. Damage to ATSB stations during deployment required replacement of a subset of stations. High coverage of eligible structures was maintained over the two-year study despite replacement requirements. Additional research is needed to better understand the impact of damage on ATSB station effectiveness under programmatic conditions, including thresholds of threats to physical integrity and biological deterioration on product efficacy. Conclusions Optimizing ATSB stations to address causes of damage and conducting implementation research to inform optimal delivery and cost-effective deployment will be important to facilitate scale-up of ATSB interventions.

Abstract Background The attractive targeted sugar bait (ATSB) is a novel malaria vector control tool designed to attract and kill mosquitoes using a sugar-based bait, laced with oral toxicant. Western Province, Zambia, was one of three countries selected for a series of phase III cluster randomized controlled trials of the Westham ATSB Sarabi version 1.2. The trial sites in Kenya, Mali, and Zambia were selected to represent a range of different ecologies and malaria transmission settings across sub-Saharan Africa. This case study describes the key characteristics of the ATSB Zambia trial site to allow for interpretation of the results relative to the Kenya and Mali sites. Methods This study site characterization incorporates data from the trial baseline epidemiological and mosquito sugar feeding surveys conducted in 2021, as well as relevant literature on the study area. Results: Characterization of the trial site The trial site in Zambia was comprised of 70 trial-designed clusters in Kaoma, Nkeyema, and Luampa districts. Population settlements in the trial site were dispersed across a large geographic area with sparsely populated villages. The overall population density in the 70 study clusters was 65.7 people per square kilometre with a total site population of 122,023 people living in a geographic area that covered 1858 square kilometres. However, the study clusters were distributed over a total area of approximately 11,728 square kilometres. The region was tropical with intense and seasonal malaria transmission. An abundance of trees and other plants in the trial site were potential sources of sugar meals for malaria vectors. Fourteen Anopheles species were endemic in the site and Anopheles funestus was the dominant vector, likely accounting for around 95% of all Plasmodium falciparum malaria infections. Despite high coverage of indoor residual spraying and insecticide-treated nets, the baseline malaria prevalence during the peak malaria transmission season was 50% among people ages six months and older. Conclusion Malaria transmission remains high in Western Province, Zambia, despite coverage with vector control tools. New strategies are needed to address the drivers of malaria transmission in this region and other malaria-endemic areas in sub-Saharan Africa.

The purpose of the current study is to assess the impact of working time on non-agricultural labour productivity in the South African economy. To achieve this objective, the study utilised the Autoregressive Distributed Lag Model (ARDL) and correlation analysis to analyse the effects of different working time arrangements on labour productivity. The results of the study indicated that weekly working hours have a significant influence on worker productivity. Working between 30 and 39 hours per week was found to greatly enhance productivity both in the short and long term. Additionally, working between 15 and 29 hours per week showed a slight positive effect on productivity. Conversely, working more than 39 hours per week (between 40 and 45 hours) only increased productivity in the short term, while working less than 29 hours and exceeding 45 hours per week had a negative impact on labour productivity. These findings suggest that an optimal working schedule to maximise labour productivity is between 30 and 40 hours per week, with overtime not exceeding 5 hours per week. Establishing a proper schedule of weekly working hours is crucial for maximising labour productivity and reducing work-related stress, which can impede productivity.

Although pallets have traditionally been constructed from wood, there has been a shift towards making them from plastic and other composite materials. Subsequently, the storage and transportation industry has been inundated with questions about 'the best' pallet material type in relation to a supply chain. In addition, in a rapidly changing global manufacturing and storage environment, industry players have difficulty justifying the high capital cost of adopting new state-of-the-art pallets. This paper seeks to build a model to identify the best pallet material-of-construction (MOC) as perceived by the end consumer. The approach used for this was based on different stages of building an assistive multi-criteria decision model. This included modelling the decision framework using the analytic hierarchy process and undertaking an independent case study as the baseline for the modelling. [ABSTRACT FROM AUTHOR]

BackgroundThe World Health Organization estimates that 56 million women and girls live with female genital schistosomiasis (FGS) in sub-Saharan Africa. FGS is often confused with symptoms of other genital abnormalities, and gold standard diagnosis with colposcopy is infeasible in most health facilities. Schistosomiasis haematobium is endemic in Zambia, yet routine screening or diagnostic efforts for FGS remain unavailable. Our study aimed to develop and pilot test a feasible FGS screening algorithm to implement in Zambian government clinics.Methodology/Principal FindingsWe recruited 499 women from a longitudinal cohort of HIV-negative adult women in Lusaka and Ndola, Zambia. We used demographic, risk factor, and symptom data collected from standardized surveys, gynecological exams, and laboratory tests to develop a screening algorithm for FGS among a derivation cohort (n=349). After cross-validation using 5-fold iterative resampling, the algorithm was applied in a holdout sample of the cohort (n=150). The prevalence of FGS (ascertained by expert review) was 23.4% in the study population. The screening algorithm included childhood and travel exposure to rivers and streams; testing positive for visual inspection of the cervix with acetic acid; hematuria; reporting less than the median average age at sexual debut (

Introduction: Childhood vaccination is an effective intervention for lowering the burden of infectious disease. Vaccine coverage has increased globally, but vaccine hesitancy and refusal threatens these gains. The 5C psychological antecedents of vaccination (“5C”) provides a validated measure of “vaccine hesitancy or confidence” to assess individual thoughts and behaviors behind vaccination. We investigated population-level factors that contributed to high and sustained vaccination coverage in Zambia, Nepal, and Senegal, and alignment with the 5Cs. Methods: Data was collected in the larger Exemplars in Vaccine Delivery study, from focus group discussions (FDGs) and key informant interviews (KIIs) at the national, regional, district, health facility, and community levels of health systems in Zambia, Nepal, and Senegal. We assessed the demand environment, as relayed by participants, and identified interventions reported as successful for demand generation, then retroactively aligned the interventions with the 5C constructs. Results: Demand was positively correlated with high confidence and collective responsibility. Psychological constraints sometimes impacted demand. Physical constraints created barriers in some communities, particularly difficult to access (i.e., mountainous). Occasionally, physical constraints did not affect vaccination behavior - parents believed the benefits of vaccination worth pursuing. Factors negatively correlated with demand and intent, complacency and calculation, had limited impact. Critical interventions were: targeted and tailored health education activities (media partnerships, school outreach); community engagement; community ownership; and community involvement (community health workers, leaders, religious figures). Conclusion: We found similar interventions used to generate demand, with strategies aligned with the 5C constructs. Categorizing interventions by drivers of demand may help strategic planning and the division of resources; decision makers may choose to implement our suggested interventions. Assessing the 5Cs allows decision-makers to operationalize demand generation into concrete interventions and policies, and determine the individual impact of these constructs on the population and focus efforts on interventions tailored to a specific need.

An introduction is presented in which the editor discusses the survelliance system and it's role in the maternal deaths in countries with a low income.

In Zambia, potato (Solanum tuberosum L.) cultivation is ranked the third most important among root and tuber crops after cassava (Manihot esculenta Crantz) and sweet potato (Ipomoea batatas (L.) Lam.). In spite of its importance, the productivity and cultivation of potato remain low. In the light of this, a survey was conducted in Mbala district to obtain and document farmers’ knowledge on potato cultivation and understand the constraints associated with potato cultivation and management. Four agricultural camps in Mbala district were purposefully sampled due to the high potato cultivation activity. Data were collected from 116 potato farmers through structured questionnaires and focus group discussions. Results showed that three major constraints in potato cultivation were white grub (Phyllophaga spp.), foliar wilts (Ralstonia spp. and Verticillium spp.) and seed source, with a farmer-ranked mean-derived score of 3.75, 3.5 and 2.75, respectively. Farmers ascribed 70% crop damage to white grub (Phyllophaga spp.) and 60% crop damage to foliar wilts (Ralstonia spp. and Verticillium spp.). Other information obtained indicated that the majority of the farmers (>85%) were married, above 35 years and had at least primary education. The majority of the farmers involved in the study had less than 0.25 ha under potato production. To reduce the cultivation constraints for increased potato production in Mbala, direct breeding efforts, potato crop protection and other measures need to be employed.

Introduction: The essential components of a vaccine delivery system are well-documented, but robust evidence on how and why the related processes and implementation strategies prove effective at driving coverage is not well-established. To address this gap, we identified critical success factors associated with advancing key policies and programs that may have led to the substantial changes in routine childhood immunization coverage in Zambia between 2000 and 2018. Methods: We identified Zambia as an exemplar in the delivery of childhood vaccines through analysis of DTP1 and DTP3 coverage data. Through interviews and focus group discussions at the national and subnational levels, we investigated factors that contributed to high and sustained vaccination coverage. We conducted a thematic analysis through application of implementation science frameworks to determine critical success factors. We triangulated these findings with quantitative analyses using publicly available data. Results: The following success factors emerged: 1) the Inter-agency Coordinating Committee was strengthened for long-term engagement which, complemented by the Zambia Immunization Technical Advisory Group, is valued by the government and integrated into national-level decision-making; 2) the Ministry of Health improved the coordination of data collection and review for informed decision-making across all levels; 3) Regional multi-actor committees identified development priorities, strategies, and funding, and iteratively adjusted policies to account for facilitators, barriers, and lessons learned; 4) Vaccine messaging was disseminated through multiple channels, including the media and community leaders, increasing trust in the government by community members; 5) The Zambia Ministry of Health and Churches Health Association of Zambia formalized a long-term organizational relationship to leverage the strengths of faith-based organizations; and 6) Neighborhood Health Committees spearheaded community-driven strategies via community action planning and ultimately strengthened the link between communities and health facilities. Conclusion: Broader health systems strengthening and strong partnerships between various levels of the government, communities, and external organizations were critical factors that accelerated vaccine coverage in Zambia. These partnerships were leveraged to strengthen the overall health system and healthcare governance.

Mounting assertions of the increased benefits of foreign trade integration, in terms of increased wages and labour, as well as factor productivity and resource reallocations, are accompanied by subsequent concerns of coexisting job destruction, particularly for countries with evidently rising unemployment and poverty levels. Such is the case for a post-apartheid South African economy, ravaged by persistently high unemployment rates amid increased trade liberalisation. In drawing meaningful inherences, this study examined the effects of South Africa’s trade openness, the real effective exchange rate and foreign direct investment (FDI) on job creation or employment in selected non-tradable sectors. A quantitative approach was used, with the aforementioned trade-related factors as explanatory variables. Employment in the non-tradable sector’s construction, finance, and the wholesale and retail trade sector served as dependent variables. A quarterly dataset from 1995Q1 to 2021Q1 was employed. While the standard Autoregressive Distributed Lag (ARDL) model was used to gauge short-run and long-run relationships. Further econometric methods such as the correlations analysis were conducted to obtain additional understanding of the nature of the set variables. Findings showed that trade liberalisation effects induce varying implications on employment in the considered non-tradable sectors, perhaps due to idiosyncratic characteristics in the nature and operational structure of each sector. Trade openness was shown to have exhibited significant long-run implications on job creation in all the sectors, whereas the parameters of the rest of the explanatory series were not significant in the long-run. Results further showcased mixed short-run effects of trade factors on employment in all sectors, with significant parameters for the real effective exchange rate and trade openness with employment in the construction sector. Including significant short-run relationships for the real effective exchange rate with employment in the finance sector. Significant parameters for employment in the wholesale and retail trade sector with FDI and the real effective exchange rate were established. Further inferences were made in expounding on the established dynamics. Article history: Received 8 Ferbruary 2022; Revised 3 May 2022; Accepted 15 May 2022; Available online 30 June 2022; Available print 30 August 2022. JEL Classification: E24, F16, F31, O49

The soundness of the capital market is crucial in establishing resilient financial market deepening and general economic progress. Equally, the health of the financial market’s commodity market is undoubtedly a key determinant of inclusion, equitability, including sustained growth and development, especially in commodity-dependent countries. However, countries worldwide are faced with the continued challenge of falling commodity prices, presenting varied negative effects. Understanding the performance of the commodity market through lenses of fundamental or real-side indicators, other than just micro-specific financial or monetary variables, could prove helpful in constructing better inferences of the commodity market from an industrial, investor and policy standpoint. This study conducted a comprehensive evaluation of South Africa’s official component series of the business cycle indicators (BCI), to assess their potential and capacity to serve as explanatory signals for commodity market prices. The study utilized the cross-correlations tests, Granger causality tests, variance decomposition and charting techniques to assess the co-movement and concordance between business cycle component series (regressors) and the All-commodity index (regressand). Monthly observations from June 2003 to November 2017 were employed. Evidence of existing co-movement or concordance was established between the commodity market and most of the BCIs. Significant BCIs were identified as leading, lagging and coincident indicators for the commodity market based on the underlying properties established in the empirical estimates of the study. Article history: Received 10 December 2021; Revised 17 January 2022; Accepted 7 February 2022; Available online 30 May 2022; Available print 30 May 2022. JEL Classification: Q02, F44

The human immunodeficiency virus (HIV) can be transmitted vertically through the placenta in utero , during labour and delivery and through breast milk. In Nigeria, about 5.8% of women attending antenatal clinics were HIV infected as of December 2002. It was projected that by the end of the year 2002, there were about 849 000 orphans resulting from AIDS and about 755 000 established paediatric AIDS in this country. Interventions to prevent mother-to-child transmission of HIV include voluntary counselling and testing (VCT), administration of antiretroviral drugs (ARV), modification of obstetric practices and infant feeding options in HIV infection. Over the period July 2002 - June 2003, 262 pregnant women received VCT at the antenatal clinic of the University of Maiduguri Teaching Hospital, and 207 (79%) agreed to be tested. Thirty-one (11.8%) were HIV positive. The majority of the HIV positive mothers received nevirapine in labour while 35% had combination ARV drugs in pregnancy. All the infants received nevirapine suspension within 72 hours of delivery. Expensive and slow testing facilities, insufficient and inconsistent counsellors, lack of ARV drugs for both mother and baby as well as unaffordable caesarean delivery were some of the constraints being faced at this centre. It is recommended that the governments at various levels should show more commitment to the programme of preventing mother-to-child transmission of HIV. [ABSTRACT FROM AUTHOR]

A total of 2456 deliveries took place at the University of Maiduguri Teaching Hospital, Maiduguri, between January 1995 and December 1996 inclusive. Two hundred and five women were delivered by caesarean giving a caesarean section rate of 8·3%. One hundred and ninety-eight (96·6%) case records were retrieved for analysis. Eighty-eight patients (44·4%) had one or more intra- and/or postoperative complications. Sepsis was the commonest complication involving 62 (70·4%) women. All were cases of emergency caesarean section. The incidence of other complications were anaemia, 59 (67%); hemorrhage, 38 (43·2%); and wound dehiscence, 11 (12·5%). There were two maternal deaths (2·3%) due to an anaesthetic accident and septicaemia respectively. The factors resulting in complications of the caesarean deliveries were prolonged obstructed labour, prolonged rupture of fetal membranes, previous caesarean sections, antepartum haemorrhage and severe pre-eclampsia and eclampsia. A review of the use of prophylactic antibiotics in selected cases, early recourse to operation in cases with cephalo-pelvic disproportion, and the acquisition of trained anaesthetists are advocated. [ABSTRACT FROM AUTHOR]

OBJECTIVE:To determine the pregnancy outcome among HIV positive women attending ANC at the University of Maiduguri Teaching Hospital, Maiduguri. Method: A prospective cohort study of 500 women attending the ANC between 12th August 2009 – 21st December 2010 was carried out. Initial HIV screening was done using single rapid tests, while diagnosis for those found positive was done with an additional second rapid test, while confirmation is done with 'Western Blot' technique. Sociodemographic and obstetrics variables were obtained and analyzed. Results: Out of the 500 pregnant mothers that were counseled and tested for HIV, 52 were found to be HIV positive giving a seroprevalence rate of 10.4%. The HIV positive women are used as cases while out of the remaining cohort 162 patients that are matched for age and parity were used as control. The perinatal transmission rate was 11.5%. The HIV positive women were more educated and younger than the control. More than 90% of the HIV positive women booked for ANC between 2nd and 3rd trimester with average gestational age at booking of 29.3 weeks. Elective caesarean section (ELCS) was offered to 11(21.2%) and all the babies delivered through ELCS were negative for HIV. Prematurity, low birth weight and birth asphyxia were more in HIV positive women than control. Advanced maternal age (X2 =33.53 P =0.000), Low CD4 count (X2 =15.58 P =0.016), high maternal viral load (X2 =21.85 P =0.005), prematurity (X2= 9.872 P= 0.007), low birth weight (X2 = 63.80 P= 0.000) and birth asphyxia (X2 = 24.149 P= 0.000) were the major determinants of perinatal transmission of HIV infection in this study. Conclusion: The Seroprevalence and MTCT of HIV infection in pregnancy is high in our environment. HIV infection was also found to be associated with increases risk of elective caesarean section and neonatal asphyxia. Efforts should be intensified to improve the situation

One hundred and five consecutive women had transvaginal sonography (TVS) at less than 12 weeks gestation to establish the normal size and shape of the secondary yolk sac (YS) and to assess the YS measurements in predicting pregnancy outcome in the first trimester. A yolk sac diameter more or less than two standard deviation (2SD) from the mean predicted abnormal pregnancy outcome with a sensitivity of 91.4%, specificity of 66% and a positive predictive value of 88.8%. A normal YS size predicted normal pregnancy outcome with a sensitivity of 66%, specificity of 91.4% and a positive predictive value of 95.6%. It is recommended that patients at risk of poor pregnancy outcome should have routine TVS before 12 weeks gestation to assess their YS and those with an abnormal yolk sac should be followed-up closely to exclude fetal abnormalities before 24 weeks gestation. [ABSTRACT FROM AUTHOR]

The human immunodeficiency virus (HIV) infection has been shown to be a risk factor for premalignant and malignant conditions of the cervix. Patients attending the gynaecological clinic of the University of Maiduguri Teaching Hospital received voluntary counselling and testing (VCT) for HIV. All patients who were screened for HIV also had their pap smear taken. Cervical dysplasia was significantly commoner among HIV infected women than those that were HIV negative (31.3% vs 7.8%, respectively). The incidence of cervical dysplasia was also proportional to the degree of immunosuppression as women with low CD4 count had higher incidence of cervical dysplasia. The population studied was generally promiscuous irrespective of their HIV status, with over 90% of them having multiple sexual partners. It is recommended that health education in this population should be aimed at discouraging multiple sexual partners. Gynaecologists should be co-care providers to all HIV?+ women in view of the menace of cervical dysplasia. [ABSTRACT FROM AUTHOR]