Malaria Prevalence and Drug Management in Pregnant Women Attending Remotely Located Daura General Hospital, North West Nigeria (Published)
Health authorities in Nigeria have for many years promoted national malaria control measures such as the use of insecticide treated bed nets (ITNs), indoor residual spray of insecticides (IRS), intermittent preventive treatment (IPTp) for pregnant women and children and the use of artemisinin combined therapy (ACT) as first line of treatment to reduce the prevalence of the disease in the country. In order to evaluate the effectiveness of these control measures, there is the need for continued disease monitoring and management across different zones of the country, especially among high risk cohorts such as children and pregnant women at remote locations. A 13 months study (July 2014 to July 2015) was carried out to establish the current prevalence of malaria among female patients attending Daura General Hospital in North West Nigeria, using standard laboratory procedures. Daura is a remotely located town that lies in the semi-arid zone of northern Nigeria at the intersection of roads from Katsina, Kano and Zinder in Niger Republic, with coordinates of 130 2’11’’ North, 80 19’4’’ East and 1,558 feet (474 meters) above sea level. Of the 8413 patients that tested positive for malaria parasite during the period, 1119 (13.30%) were children, 3721 (44.23%) were women, 2609 (30.99%) were men and 966 (11.48%) were the elderly. Among the infected women population, 2105 (56.57%) were pregnant (PGW), while 1616 (43.23%) were non-pregnant (NPW) women, indicating statistical significance in malaria prevalence between the two cohorts (p<0.05). Age related prevalence was significantly higher (p<0.05) in the 11 – 20 years group (32.68%) of the PGW and 21 – 30 years group (44.43%) of the NPW than the 25.89% recorded in the 21 – 30 years group and 21.05 and 20.38% recorded in the 31 – 40 years and 41 – 50 years groups of the PGW respectively. The highest seasonal prevalence rate was recorded during the late rainy season (LRS) months of July to September (10.86% for PGW and 8.83% for NPW) followed by the 7.73% recorded for PGW and 7.24% recorded for NPW during the early dry season (EDS) months of October to December. The lowest rates (5.67 and 5.46% for PGW and 6.50% for NPW) were recorded during the early rainy (ERS, April – June) and late dry season (LDS, January – March) months respectively. Monthly prevalence rates were highest during August (15.63%), September (15.11%) and October (11.26%) for the PGW, while corresponding prevalence figures for these months among the NPW were significantly lower (p<0.05) at 8.29, 9.22 and 7.80% respectively. Major drugs prescribed for the prevention of malaria during the second and third trimesters once foetal quickening is noticed include sulphadoxine/pyrimethamine given monthly, while for cure and treatment during all trimesters quinine SO4, arthessunate, α-β arteate and arthessunate/lumefantrim were prescribed. Analgesics, electrolytes and vitamins were also indicated. Malaria is a major cause of hospital visits pregnant women especially during the rainy season months, indicating the need to improve advocacy on intervention control measures among these groups in the study area.
Data clustering is a vital tool when it comes to understanding data items with similar characteristics in a data set for the sake of grouping. Clustering may be for understanding or utility. Clustering for understanding, which is the focus of this work deals with grouping items with common characteristics in order to better understand a dataset and to identify possible or pre-interest sub-groups that could be formed from such data. The HIV prevalence statistics in Nigeria is measured bi-annually across 36 states and FCT which were zoned under 6 geo-political zones happens to be a suitable data to implement this subject matter. Cluster Analysis was implemented through the general methods of Hierarchical (agglomerative nesting) and Partitioning methods (K-Means). These techniques where implemented on the platform of R (Statistical Computing Language) to cluster HIV prevalence rate in Nigeria so as to find out states that could be considered same category and to investigate the concentration of the disease in respect to geo-political zones. Relative type of validation was used for cluster validation (a mechanism for evaluating the correctness of clustering).
Study to Toxoplasma, Rubella, CMV, Chlamydia and Herpes of women with recurrent spontaneous abortion in Babylon Province (Published)
Background: The acute and chronic infections which are caused by Toxoplasma gondii, Rubella virus, Cytomegalovirus (CMV) and the Herpes Simplex Virus (HSV ) during pregnancy are often associated with adverse foetal outcomes and reproductive failures. Objective: This study aims at evaluating IgM, IgG antibodies for acute and chronic infection for more causes of abortion spreading that is Toxoplasma, Rubella, CMV, Chlamydia and Herpes Methods.Methods and Materials: Sera were collected from the women with Bon and they were tested for the presence of specific IgM, IgG antibodies against the Toxoplasma gondii, Rubella virus, Cytomegalovirus (CMV) and the Herpes Simplex Virus (HSV ) infections by ELISA. The specific IgM antibodies were found to be positive :Result toxoplasmosis, in 126 (30.4%) cases for the Rubella virus, in 130 (34.7%) cases for CMV and in 151 samples (33.5%) for the HSV-2 infections.Alsospecific IgG antibodies were found to be positive in 74(19.4%) cases for toxoplasmosis, in 126 (30.4%) cases for the Rubella virus, in 130 (34.7%) cases for CMV and in 151samples (33.5%) for the HSV infections .Conclusion: The present study demonstrates a strong association between the infectious agents (Toxoplasma gondii, Rubella virus, Cytomegalovirus (CMV) and the Herpes Simplex Virus (HSV )) and abortion inwomen. It is thereforrecommended that all antenatal cases with such historyshould be routinely screened for these agents (IgM and IgG).
Prevalence, Associated Factors, Bacterial and Antimicrobial Susceptibility Patterns of Urinary Tract Infections in a Sample of Iraqi Pregnant Women in Al-Najaf (Published)
Urinary tract infections (UTIs) are rendered as the most common bacterial infections prevailing among humans, both in the community and hospital settings. In pregnancy, UTI can lead to poor maternal and perinatal outcomes. The current cross-sectional study was undertaken to estimate the prevalence of UTI in pregnant women, to determine its association with sociodemographic, obstetrical and other factors, and to identify causative agents with antibiotic sensitivity. A total of 300 pregnant women at Al-Zahraa teaching hospital / Al-Najaf from the 1st of April 2014 to 30th July 2014, with and without the symptoms of urinary tract infection (UTI), were recruited for this study. Midstream urine samples were taken and general urine examination with culture was performed. Sensitivity tests were also performed for the isolated organisms. The data pertaining to the associated risk factors were collected by using a structured questionnaire form. The results revealed that the overall prevalence of significant bacteriuria in pregnant women was 37 %, representing symptomatic and asymptomatic (23%, 14% respectively). The predominant bacterial pathogen was Escherichia coli (28.8 %), which was found to be resistant to penicillin (100 %) and cephalosporins group (40%), but sensitive to garamycin (95%) and Amikacin (90%). Factors such as type of past delivery, previous history of UTI, symptomatic patients and vaginitis were found to be significantly associated with higher rates of UTI. Significant bacteriuria was found in both symptomatic and asymptomatic pregnant women, which was significantly higher among those with lower age.
Effects of Nutrition Education among Pregnant Women using Fruits and Vegetables for the achievement of MDG5 in Odogbolu LGA, Ogun State (Published)
Background: Nutrition education being a component of health education is propitious to create awareness on how to source, prepare, combine and use food resources for promoting good health among all groups of human beings; especially pregnant women who need adequate nutrition for their physiological needs and improve the health of both the mother and fetus. Studies have suggested that women have low dietary intake of fruits and vegetables. The Millennium Development Goals (MDGs) are a framework globally agreed for measuring development, progress, and poverty reduction through focusing efforts on achieving significant measureable improvement in people’s lives. One of the components of MDG5 is nutrition in pregnancy; this component is the main focus of this study. Method: a quasi-experimental study for quantitative method adopting pre-and post test control experimental analysis was used while 194 pregnant women were purposively selected from 11 randomly selected antenatal clinics in Odogbolu local government area to participate. The nutrition intervention was for 3 months. FGD together with structured-validated questionnaire administered before and after the intervention were used to collect data. ANCOVA was used to test the two hypotheses at 0.05 alpha level.Result: There were significant effects of the intervention on the knowledge (F (2.174) = 1554.466, P <.05) and attitude (F (2.134) = 19.866, P <.05) of the women on fruits and vegetables consumption. The findings revealed a positive effect of the intervention; the participants were relatively aware of the importance of fruit and vegetables consumption in pregnancy after the intervention. Conclusion: The nutrition education intervention appears to have changed the attitude of pregnant women after the post test evaluation. Pregnant women apparently consumed more fruits and vegetables than they were doing before the intervention. Therefore, intensive health education should continuously be given to pregnant women on the value of fruit and vegetable.
There are wide global variations in the prevalence of caesarean section in developed, developing and underdeveloped countries. The objective of this this study was to determine the trends in caesarean section at Calabar General Hospital, Cross River State. This paper used a retrospective review of clinical records at the maternity units of Calabar General Hospital from 2009 to 2013. Findings from this study showed that Cesarean section rate ranged from 3.85% in 2009 to 7.38% in 2013 with an average cesarean section rate of 5.39%. Based on available data, elective cesarean section progressed substantially from 17.2% in 2009 and slightly declined to 15.3% in 2010, then increased again from 22.5% in 2011, 29.6% in 2012 to 31.0% in 2013. Emergency cesarean section on the other hand increased progressively from 82.8% in 2009 to 84.7% in 2010 then declined from 77.5% in 2011, 70.4% in 2012 to 69.0% in 2013. In conclusion improvement of obstetric services should be a priority in all health care settings.
PERCEPTION OF THE DETERMINANTS OF MATERNAL MORTALITY IN CALABAR SOUTH LOCAL GOVERNMENT AREA OF CROSS RIVER STATE, NIGERIA (Published)
Objective: To identify perceived determinants of maternal mortality in Calabar South Local Government Area of Cross River State. Study design: A cross-sectional study design was used to identify perceived determinants of maternal mortality in Calabar South Local Government Area of Cross River State. About 360 respondents were selected using multi-stage sampling technique and a structured questionnaire was used to generate data from the respondents. Data collected were analysed using SPSS version 16.0 and chi-square was used to test for association between variables at 0.01 level of significance. Results: The results showed that maternal death were known to occur at home (24.7%), health facilities (24.4%), Traditional Birth Attendant homes (12.5%), churches (0.3%) and 7.5% in prayer houses. About 45% of maternal deaths were believed to occur outside the health facilities. Bleeding (39.2%), prolonged obstructed labour (17.2%), eclampsia (4.2%), abortions (3.3%), infections (1.7%), anaemia (1.9%) and malaria (0.8%) were perceived causes of maternal deaths. Delays in taking actions when danger signs occurred (24.7%), delivery of high risks pregnant women outside the health facility (28.2%), non-utilisation of Antenatal services (19.7%) and non-chalant attitude of health workers towards pregnant women (19.6%) were reported to perpetuate maternal deaths. This study also showed that educational status (P<0.01), socio-economic status (P<0.01) of pregnant women and socio-cultural practices influence maternal outcomes. Conclusion: Improving obstetric services in health facilities would facilitate optimal use of ANC and delivery services among pregnant women.
KNOWLEDGE AND ATTITUDE OF PREGNANT WOMEN TOWARDS FOCUSED ANTE NATAL CARE SERVICES IN UNIVERSITY OF CALABAR TEACHING HOSPITAL, CALABAR, CROSS RIVER STATE, NIGERIA (Published)
The study investigated pregnant women’s knowledge and attitude towards focused antenatal care in University of Calabar Teaching Hospital, Calabar. Three research questions and two hypotheses were formulated to guide the study. The literature was conceptually, empirically and theoretically reviewed based on the main variables under study. The study adopted a descriptive design and the sample size was 174 pregnant women attending antenatal care clinic in UCTH from January – May, 2014. The instrument for data collection was a three section questionnaire. The instrument had a correlation coefficient of 0.79. Questionnaire was administered through face to face interaction and on the spot collection of completed questionnaire. The data collected from questionnaires were analyzed using frequencies and percentages, while chi-square test analysis was used to test the hypotheses. Findings of the study revealed that majority of the respondents had good knowledge and favourable attitude towards focused antenatal care. In testing the hypothesis using chi-square analysis, hypothesis one showed a statistical association between knowledge and attitude towards focused antenatal care, when the chi-square calculated of 20.6 was greater than the critical chi-square of 5.991 at 0.05 level of significance with 2 degrees of freedom. Although knowledge towards focused antenatal care high and attitude was favourable, some weakness still exist which posed as hindrance to utilization. Based on the above, intensive awareness creation on focused antenatal care for pregnant women recommended. Retraining of health workers and monitoring and supervision of health workers to improve on the hindrance identified as barriers to utilization was also recommended.