RESUMEN
Despite the high burden of household air pollution from biomass fuel in sub-Saharan Africa, the association of prenatal biomass fuel exposure and birth weight as a continuous variable among term births has not been extensively studied. In this study, our primary aim is to estimate the association between biomass cooking fuel and birth weight among term births in Kaduna, northwestern Nigeria. For replication, we also evaluated this association in a larger and nationally representative sample from the 2018 Nigerian Demographic and Health Survey (DHS). Our primary analysis included 1,514 mother-child pairs recruited from Kaduna, in northwestern Nigeria, using the Child Electronic Growth Monitoring System (CEGROMS). Replication analysis was conducted using data from 6,975 mother-child pairs enrolled in 2018 Nigerian DHS. The outcome variable was birth weight, and the exposure was cooking fuel type, categorized in CEGROMS as liquefied petroleum gas, kerosene, or biomass fuel, and in the DHS as low pollution fuel, kerosene, or biomass fuel. We estimated covariate adjusted associations between birth weight and biomass fuel exposure in CEGROMS using linear regression and using linear mixed model in the DHS. In CEGROMS, adjusting for maternal age, education, parity, BMI at birth, and child sex, mothers exposed to biomass fuel gave birth to infants who were on average 113g lighter (95% CI -196 to -29), than those using liquified petroleum gas. In the 2018 Nigeria DHS data, compared to low pollution fuel users, mothers using biomass had infants weighing 50g (95% CI -103 to 2) lower at birth. Exposure to biomass cooking fuel was associated with lower birth weight in our study of term newborns in Kaduna, Nigeria. Data from the nationally representative DHS provide some support for these findings.
RESUMEN
BACKGROUND: Prevalence of infertility in sub-Saharan Africa is high yet fertility care, its development and access is limited in resource-poor countries like Nigeria so infertile women resort to different forms of treatment. This study aimed to determine the use and pattern of previous treatments. METHODOLOGY: This was a descriptive Cross Sectional study conducted at a tertiary hospital in North-Western Nigeria. Interviewer administered pretested questionnaires were administered to 236 consenting clients seen at their first visit to the gynaecology clinic with complaints of inability to conceive, between January 2016 to March 2018. We collected information on demographic and reproductive characteristics, previous fertility treatment and other data relevant to infertility. Descriptive analysis was done using SPSS software version 22. RESULTS: Two hundred and thirty six clients participated in the study and majority were 20-29 years (44.5%), with a mean age of 31.5 ± 7.4, while the mean age of their husbands was 41 ± 8.0. More clients were educated up to secondary level or above (80.9%), with more Muslims (65%) than Christians. All clients were married except one, most clients had been married for 5 years or more, 18.2% were in their second order of marriage and 28% were in polygamous marriages. Many of the clients were homemakers (46.6%) and earned an average monthly income of less than fifty thousand naira. About 59.3% of clients presented with primary infertility, with 15.7% being infertile for duration of more than 10 years. One hundred and forty six respondents (61.9%) had received previous hospital treatments before presentation to our facility, 37% had visited more than three hospitals, 70% did not have adequate investigations done, treatment was successful in 15% while 40.7% received traditional treatments. Husbands of women receiving previous treatment were slightly older (p value < 0.05). CONCLUSION: Majority of woman have multiple and unnecessary visits to several hospitals for infertility care with little positive results despite time and resources spent. Quality of infertility care needs to be improved.