Reliability of urine multistix and gram stain in the detection of asymptomatic bacteriuria in pregnancy.

BACKGROUND: urinary tract infection is a common problem during pregnancy. Asymptomatic bacteriuria can cause the development of serious complications affecting both the mother and foetus. Urine culture, the traditional screening test is relatively expensive, time consuming and requires a microbiology laboratory and trained staff. However simpler, less expensive tests which include urine multistix and urine gramstain better suited for developing countries are available. OBJECTIVE: to determine the sensitivity, specificity and predictive values of multistix nitrite, leucocyte esterase (LE) and urine gram staining for asymptomatic bacteriuria in pregnancy. METHODS: A cross-sectional study was carried out from 1st July to 31st October 2007, at the University of Ilorin Teaching Hospital (UITH) on 125 consenting asymptomatic pregnant women. A structured proforma was used to collect information from the women and a midstream urine specimen collected in two sterile bottles. One was tested with Multistix® for the presence of nitrite and leucocyte esterase and the other for bacteriological culture and urine gram stain. RESULTS: using the gold standard of urine culture, the sensitivities of Multistix® nitrite and leucocyte esterase were each 14% and the specificity 100% and 96% respectively. Urine gram stain had a sensitivity of 98% and a specificity of 74.7%. CONCLUSION: multistix® nitrite and leucocyte esterase are not sufficiently sensitive to be used as a screening tool for asymptomatic bacteriuria. Urine gram stain can be used in areas where facilities are inadequate for culture but cannot replace it. More studies are required to determine the accuracy of urine gram-stain.

Plasma lipids and lipoproteins during first trimester in pregnant Nigerian women: Ilorin experience.

Thirty-two pregnant women in their first trimester with a mean age of 29.5 years, 32 age matched non-pregnant controls were included in this study. They were bled after 14-hour fasting. This study was between October 2000 and October 2001. Plasma total cholesterol, triglyceride and HDL- cholesterol were assayed. LDL-cholesterol was obtained through Frieldwald formula average as mean were calculated using Epi info version 6.0 and level of significant difference decided at p<0. 05. The mean age of the subjects was 9.5 years. Compared to the concentration in non-pregnant women [controls] the plasma level of total cholesterol and HDL-cholesterol were found to be significantly lower p<0.05. However the levels of plasma triglyceride and LDL-cholesterol were found to be significantly higher in the pregnant women than the control group [p<0.05]. This study revealed that the level of total plasma cholesterol is low in middle part of first trimester. We therefore suggest that in interpreting the result of total cholesterol in first trimester the gestation age should be put into consideration.

Obstetric urogenital fistula: the Ilorin experience, Nigeria.

A study of thirty-four cases of obstetric urogenital fistula managed over a ten-year period (1st January, 1989 to 31st December, 1998) at the University of Ilorin Teaching Hospital is reported. The incidence of obstetric urogenital fistula is 1.1 per 1000 births. The condition is associated with illiteracy and poorly supervised delivery. The peak incidence is in 15-19 years age group and primipara accounting for 26.5% and 50% respectively. Prolonged obstructed labour was the most common aetiological factor in 28 (82.4%) of cases. Juxta-cervical region was the most common site of obstetric urogenital fistula. Eight (23.5%) patients were separated/divorced from their husbands. Obstetric urogenital fistula can be prevented by improving socio-economic condition of the populace, educating the populace to utilize health facilities and advice against teenage pregnancy. Labour should be supervised by trained health personnel and difficult labour referred early to appropriate health care facility.

Cancer of the cervix in Ilorin, Nigeria.

OBJECTIVE: The purpose of this study is to review our experience with carcinoma of the cervix in Ilorin, Nigeria. METHOD: From 1st January 1990 to 31st December 1999, a total of 169 cases of invasive cervical cancer wereseen at the Department of Obstetrics and Gynaecology of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. RESULTS: Carcinoma of the cervix accounted for 63.1 % of histologically confirmed gynaecological cancers. Most of the patients were married 147 (98.7 %) and of low socio-economic status 132 (88.6%). One hundred and three (89.1 %) patients were in the age bracket 40-69 years with highest frequency in 40-49 years age group. The disease is associated with high parity with grandmultiparous patients constituting 119 (79.9 %) of the cases. Irregular vaginal bleeding 109 (73.2 %), vaginal discharge 58 (38.9%) and postcoital bleeding 31(20.5%) were the common symptoms. Nineteen (12.8%) patients reported at the hospital within one month of onset of symptoms. About three quarter ofthe patients had advanced disease and stage III disease was the most common stage 75 (50.4 %). CONCLUSION: This study has shown a high incidence of carcinoma ofcervix at the University of Ilorin Teaching Hospital.