Risk factors for pregnancy-associated breast cancer: a report from the Nigerian Breast Cancer Study.

PURPOSE: Little is known about risk factors for pregnancy-associated breast cancer (PABC), diagnosed during pregnancy or postpartum. METHODS: We enrolled 1715 premenopausal women from the Nigerian Breast Cancer Study from 1998 to 2011. Based on recency of last pregnancy from diagnosis, breast cancer cases were categorized as (1) PABC diagnosed 2 years or longer postpartum, (2) PABC diagnosed 3 to 5 years postpartum, or (3) non-PABC diagnosed more than 5 years postpartum. Controls were matched to cases on recency of last pregnancy. Multiple logistic regressions were performed comparing cases and controls within each group. RESULTS: Of the 718 cases, 152 (21.2%) had PABC 2 or more years postpartum, and 145 (20.2%) 3 to 5 years postpartum. Although not statistically significant, women with higher parity tend to have an elevated risk of PABC but reduced risk of non-PABC (p for heterogeneity = 0.097). Family history of breast cancer might be a strong predictor particularly for PABC 2 or more years postpartum (odds ratio, 3.28; 95% confidence interval, 1.05-10.3). Compared with non-PABC cases, PABC 2 or more years postpartum cases were more likely to carry BRCA1/2 mutations (P = .03). CONCLUSIONS: Parity may have different roles in the development of PABC versus other premenopausal breast cancer in Nigerian women. Prospective mothers with multiple births and a family history of breast cancer may have an elevated risk of breast cancer during their immediate postpartum period.

Knowledge of malaria and preventive measures among pregnant women attending antenatal clinics in a rural local government area in Southwestern Nigeria.

OBJECTIVE: This study determined the level of knowledge of malaria and preventive measures among pregnant women and its influence on the uptake of preventive measures. METHODS: A cross-sectional survey was carried out among 209 participants selected from pregnant women attending antenatal clinics in primary healthcare centres in Irepodun/Ifelodun, a local government area in Ekiti state, Nigeria. RESULTS: Knowledge of malaria was found to be very good, average and poor among two (1.0%), 165 (78.9%) and 42 (20.1%) respondents, respectively. Of the 109 (52.2%) respondents who had heard about intermittent preventive treatment, eight (7.3%) scored "very good" on knowledge, while 53 (48.6%) and 48 (44.1%) scored "average" and "poor," respectively. Of the 144 (68.9%) respondents who had heard about insecticide-treated nets, 95 (66.0%) scored "good" on knowledge, while 49 (34.0%) scored "poor." Factors that significantly influenced knowledge about malaria were occupation, level of education, months at first appearance at antenatal clinic and transportation cost. Knowledge significantly influenced uptake of insecticide-treated nets and intermittent preventive treatment in pregnancy ( p < .05). CONCLUSION: There is a need to intensify efforts to provide health education on malaria and preventive measures as well as to encourage preventive practices among pregnant women.

Knowledge and utilization of intermittent preventive treatment for malaria among pregnant women attending antenatal clinics in primary health care centers in rural southwest, Nigeria: a cross-sectional study.

BACKGROUND: Intermittent preventive treatment for prevention of malaria in pregnancy (IPTp) is a key component of malaria control strategy in Nigeria and sulfadoxine-pyrimethamine (SP) is the drug of choice. Despite the evidence of the effectiveness of IPTp strategy using SP in reducing the adverse effects of malaria during pregnancy the uptake and coverage in Nigeria is low. This study set out to assess the use of IPTp among pregnant women attending primary health centres in the rural area and determine factors that influence the uptake. METHODS: A cross-sectional study was carried out between July and August 2007 among 209 pregnant women selected by systematic random sampling from antenatal care attendees at primary health care in a rural Local Government Area of Ekiti State, Nigeria. Information on knowledge of IPT, delivery, adherence and acceptability was obtained using an interviewer administered questionnaire. Descriptive statistics such as means, range, proportions were used. Chi-square test was used to examine association between categorical variables. All analyses were performed at 5% level of significance. RESULTS: One hundred and nine of 209 (52.2%) respondents have heard about IPTp but only 26 (23.9%) were able to define it. Fifty seven (27.3%) reported to have received at least one dose of IPTp during the index pregnancy and all were among those who have heard of IPTp (52.3%). Twenty one of the 57 (36.8%) took the SP in the clinic. Only three of the twenty-one (14.3%) were supervised by a health worker. Twenty two of the 36 women (61.1%) who did not take their drugs in the clinic would have liked to do so if allowed to bring their own drinking cups. Almost half (43.9%) of those who had used IPTp during the index pregnancy expressed concern about possible adverse effect of SP on their pregnancies. Periodic shortages of SP in the clinics were also reported. CONCLUSION: In this study, IPTp use among pregnant women was very low and there was poor adherence to the Directly Observed Therapy (DOT) scheme. Concerted effort should be made to increase awareness of IPTp among the public especially women of child bearing age. Health workers should also be trained and monitored to ensure adherence.