Sexual experiences of married HIV positive women in Osogbo, southwest Nigeria: role of inappropriate status disclosure.

BACKGROUND: Worldwide heterosexual sex is the most common mode of HIV transmission, with the marital heterosexual route becoming a major contributor in sub-Sahara Africa. This study examined the role of inappropriate HIV status disclosure, after diagnosis, on marital sexual experiences of HIV positive women. METHODS: The study employed a descriptive cross-sectional design. An interviewer administered questionnaire that elicited information about HIV status disclosure to partners, sexual experiences, condom use and parity was administered to 122 married women living with HIV/AIDS. Participants were referred from peripheral health centres to receive comprehensive HIV care at the State Specialist Hospital, Osogbo, Nigeria. RESULTS: Mean age (SD) of respondents was 33.8 (8.9) years. Only 23.8% of partners had HIV screening, with 3.3% being HIV positive. A majority (62%) of respondents reported experiencing marital sex deprivation since their partners became aware of their HIV status. There was a reported rejection (74.3%) of condom use by partners during sexual intercourse. Fear of becoming infected (85.7%) and blaming the women for their positive status (85.7%) were the main reasons the respondents gave for being sexually deprived by their partners. CONCLUSION: Inappropriate status disclosure due to poor HIV counseling and testing (HCT) practices resulted in sexual deprivation of married HIV positive women. Adequate training and retraining of health care workers on HCT and HIV status disclosure will reduce experience of sexual deprivation among married HIV positive women.

Predictors of vaginal delivery in nulliparous mothers.

BACKGROUND: Nulliparity is an obstetric high-risk group whose labor, compared with multiparae, are more likely to develop labor abnormalities that requires intervention. The aim of this report is todetermine factors that influence vaginal delivery in nulliparae. MATERIALS AND METHODS: A prospective cross-sectional study was done on 286 eligible booked nulliparae in labor, to determine factors associated with vaginal delivery. Information about each patient's social demographic factors, and physical characteristics such as height and weight, events in labor and mode of delivery were recorded in the data sheet. Bivariate analysis was done using Chi square, while multivariate analysis was done using logistic regression. Level of significance was put at P < 0.05. RESULTS: Of a total of 944 primigravidae delivered in the unit during the study period, 286 (30.3%) were eligible for the study. Vaginal delivery was achieved in 214 (74.8%) of the eligible parturient, while 72 (25.2%) had emergency caesarean delivery. Indications for the caesarean delivery were: failure to progress (46; 63.9%), fetal distress (20; 27.8%), maternal distress (5; 8.0%), and rapidly developing pre-eclampsia in labor (1, 0.3%). The birth weight of the baby ranged between 2.0 and 4.5 kg with mean weight of 3.1 ± 0.4 kg. Birth weight (odd ratio [OR] = 0.40, 95% confidence interval [CI] = 0.21-0.78), fetal head engagement in early labor (OR = 10.30, 95% CI = 1.35-78.69), and maternal body mass index (BMI) (odd ratio [OR] = 2.08, 95% confidence interval [CI] = 1.03-4.20) were found to be predictors of vaginal delivery. CONCLUSION: Normal range of maternal BMI, fetal head engagement and normal range of fetal birth weight were found to be the factors associated with vaginal delivery in nulliparae. Variations in these three factors may be the underlying reason for failure to progress, which is the most common indication for caesarean section among this population of parturient.

Predictors of vaginal delivery in nulliparous mothers

Background: Nulliparity is an obstetric high-risk group whose labor, compared with multiparae, are more likely to develop labor abnormalities that requires intervention. The aim of this report is todetermine factors that influence vaginal delivery in nulliparae. Materials and Methods: A prospective cross-sectional study was done on 286 eligible booked nulliparae in labor, to determine factors associated with vaginal delivery. Information about each patient's social demographic factors, and physical characteristics such as height and weight, events in labor and mode of delivery were recorded in the data sheet. Bivariate analysis was done using Chi square, while multivariate analysis was done using logistic regression. Level of significance was put at P < 0.05. Results: Of a total of 944 primigravidae delivered in the unit during the study period, 286 (30.3%) were eligible for the study. Vaginal delivery was achieved in 214 (74.8%) of the eligible parturient, while 72 (25.2%) had emergency caesarean delivery. Indications for the caesarean delivery were: failure to progress (46; 63.9%), fetal distress (20; 27.8%), maternal distress (5; 8.0%), and rapidly developing pre-eclampsia in labor (1, 0.3%). The birth weight of the baby ranged between 2.0 and 4.5 kg with mean weight of 3.1 ± 0.4 kg. Birth weight (odd ratio [OR] = 0.40, 95% confidence interval [CI] = 0.21-0.78), fetal head engagement in early labor (OR = 10.30, 95% CI = 1.35-78.69), and maternal body mass index (BMI) (odd ratio [OR] = 2.08, 95% confidence interval [CI] = 1.03-4.20) were found to be predictors of vaginal delivery. Conclusion: Normal range of maternal BMI, fetal head engagement and normal range of fetal birth weight were found to be the factors associated with vaginal delivery in nulliparae. Variations in these three factors may be the underlying reason for failure to progress, which is the most common indication for caesarean section among this population of parturient

Effect of different modes of delivery on cord blood oxidative stress markers.

BACKGROUND: Normal pregnancy has been associated with oxidative stress injury. Oxidative stress has been linked with poor perinatal outcome and birth asphyxia. The severity of this oxidative stress in newborn may be related to stress of different modes of delivery. METHODS: Eighty seven newborn babies were recruited in both labour ward and operating theatre of Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria. Fourty one of them was delivered via spontaneous vertex delivery, 26 via emergency caesarean section and the rest, 20 were delivered through elective caesarean section. Cord blood sample was collected from new born babies immediately after delivery. Plasma was extracted and used for the laboratory measurement of total antioxidant status, malondialdehyde and Uric acid. RESULTS: There were no significant (P>0.05) changes among the studied groups in mean plasma levels of malondialdehyde, total antioxidant status and uric acid. However, a trend was observed in these parameters. Mean plasma total antioxidant status/mmol/l was observed to be highest in subjects delivered through ECS (2.35 ± 0.05) and lowest in subjects delivered through SVD (2.03 ± 0.08). Similarly mean plasma UA/mg/dl was also observed to be highest in subjects delivered through ECS (3.61 ± 0.16) lowest in those delivered through SVD (3.49 ± 0.71). The highest mean plasma level of MDA/µmol/l was found in subjects delivered through SVD (5.78 ± 1.56) while the lowest was found in subjects delivered through ECS (5.01 ± 1.21). CONCLUSION: There is no significant relationship between oxidative stress markers in neonate and the mode of delivery.

Pattern and determinants of obesity among adolescent females in private and public schools in the Olorunda Local Government Area of Osun State, Nigeria: a comparative study.

The prevalence of obesity has continued to rise at an alarming rate worldwide to such an extent that it has been described as a global epidemic. Our study aims to investigate the pattern and determinants of obesity among adolescent females in private and public schools in the Olorunda Local Government Area of Osun State, Nigeria. This is a cross-sectional descriptive study. Using the multistage sampling technique, 520 pre-tested, semi-structured questionnaires were administered to 257 girls from private schools and 263 girls from public schools. Most of the respondents from private schools (65.2%) had good knowledge about obesity and related matters while most of those from public schools (65.9%) had poor knowledge. The dietary practice of the majority of the girls from private schools (60.2%) was unhealthy while most of the girls from public schools (68.7%) had healthy dietary practices. Most of the respondents from private schools (64.2%) lived sedentary lifestyles while most from public schools (64.0%) lived active lifestyles. Using the BMI, the majority of the girls from private schools were underweight (52%), 10 (4.0%) were overweight and 3 (1.2%) were obese. For public schools, the majority (55.4%) fell within the normal group, 6 (2.3%) were overweight and none was obese. The prevalence of being overweight and of obesity was higher among the girls in private schools than among girls attending public schools. We concluded that awareness should be created to promote a healthy balance of food, drink and physical activity within and outside the school.

Screening for syphilis during pregnancy in Nigeria: a practice that must continue.

OBJECTIVE: To determine the seroprevalence rate of syphilis among pregnant women attending the antenatal clinics of a teaching and a state specialist hospital in Nigeria, in order to ascertain whether maternal screening should be incorporated into routine antenatal care of our hospitals. METHODS: A screening for syphilis for 505 newly registered pregnant women was carried out using the qualitative rapid plasma reagin (RPR) test. All reactive sera were then subjected to the quantitative RPR test to estimate the titre of each sample. The Treponema pallidum haemagglutination antibody (TPHA) test was used as confirmatory test of all positive RPR sera. RESULTS: A total of 50 women (9.9%) were positive for RPR; 15 (2.97%) were positive for TPHA, giving a seroprevalence rate of 2.97%. A total of 32 women (6.34%) were RPR positive at 1:2, 7 (1.39%) at 1:4 and 11 (2.2%) at 1:8. Of the women positive for RPR at 1:2, 2 were also TPHA positive, 2 of the 7 positive at 1:4 were TPHA positive, while all 11 positive women at 1:8 were TPHA positive. In all, 70% of all RPR positive women screened were biological false positives. Eleven of the 15 women had high titre active syphilis (RPR > or = 1:8, TPHA+) while 4 had low titre active syphilis (RPR <1:8, TPHA+). CONCLUSIONS: The 2.97% seroprevalence rate obtained after accounting for biological false positives was considered high. Screening for syphilis in pregnancy should be incorporated into routine antenatal practice in Nigerian hospitals.

Prevalence of anti-hepatitis C virus antibodies in pregnant women and their offspring in a tertiary hospital in Southwestern Nigeria.

BACKGROUND: The aim of this prospective study was to determine the prevalence of HCV antibodies among pregnant women and their corresponding offspring in a tertiary medical centre in Southwestern Nigeria. METHOD: Anti-HCV antibodies (anti-HCV antibodies) were analyzed in blood samples from mothers and cord samples from their corresponding offspring using the Enzyme Linked Immunosorbent Assay (ELISA) method. The results obtained from the study were expressed in simple percentages. RESULTS: Out of the 272 consenting pregnant women screened for anti-HCV antibodies, 25 (9.2%) of them were positive. As none of the pregnant women had multiple births, screening the 272 cord sera from their offspring for the same antibodies revealed that 3 (1.10%) of them were also positive. Thus, the prevalence of anti-HCV antibodies in the pregnant women and their offspring were 9.2% and 1.1% respectively. CONCLUSION: If vertical transmission of HCV were to be based on the acquisition of anti-HCV antibodies alone, the prevalence of vertical transmission from HCV infected mothers to offspring in the study was 12.0%. Further studies on vertical transmission are suggested to include analysis for HCV-RNA quantification in pregnant mothers and their offspring as well as a long-term follow-up of neonates seropositive for HCV markers. Such studies are necessary to justify any recommendations to be made for the purpose of reducing HCV infection through vertical transmission.