Anthropometric Predictors of Health-Related Quality of Life in Obese Patients Attending a Tertiary Hospital in Nnewi, South-East Nigeria: A Cross-Sectional Study.

BACKGROUND: Obesity as a disorder with excess body fat directly decreases quality of life. While Body Mass Index (BMI) has been used largely in health studies as a measure of obesity, it is largely unable to differentiate between body fat and lean body mass, hence other anthropometric measures can be used to assess body fat. OBJECTIVE: To determine the association of anthropometric indicators with health-related quality of life (HRQoL) in obese adults. MATERIALS AND METHODS: A cross-sectional study of obese adults (BMI ≥30kg/m2) attending the general outpatient clinic was conducted over four months. The quality of life was assessed using the short form-36 (SF-36) questionnaire. The anthropometric indicators used were BMI, waist circumference (WC), waist hip ratio (WHR), and waist-height ratio (WHtR). RESULTS: Physical component summary (PCS) was significantly related to BMI, WHtR, and WC. After adjusting for co-variables (gender, age, occupation, and marital status), they remained significantly associated with PCS. Mental component summary (MCS) was significantly related to BMI, WHtR, and WC. After adjusting for the known determinants of HRQoL, only BMI remained significantly associated with MCS (P = -0.004; r = -0.146). When all the indicators were included in the same regression model, no anthropometric indicator was significantly related to MCS while only WHtR was significantly associated with PCS (P = 0.001; r = -0.465). CONCLUSION: HRQoL in obese patients is related to measures of body fat. The physical and mental components of health-related quality of life are correlated differently with the various anthropometric measures of obesity. The WHtR was found to be an independent predictor of the physical component of HRQoL.

Is routine antenatal venereal disease research laboratory test still justified? Nigerian experience.

OBJECTIVE: To determine the seroreactivity of pregnant women to syphilis in order to justify the need for routine antenatal syphilis screening. METHODS: A multicenter retrospective analysis of routine antenatal venereal disease research laboratory (VDRL) test results between 1 September 2010 and 31 August 2012 at three specialist care hospitals in south-east Nigeria was done. A reactive VDRL result is subjected for confirmation using Treponema pallidum hemagglutination assay test. Analysis was by Epi Info 2008 version 3.5.1 and Stata/IC version 10. RESULTS: Adequate records were available regarding 2,156 patients and were thus reviewed. The mean age of the women was 27.4 years (±3.34), and mean gestational age was 26.4 weeks (±6.36). Only 15 cases (0.70%) were seropositive to VDRL. Confirmatory T. pallidum hemagglutination assay was positive in 4 of the 15 cases, giving an overall prevalence of 0.19% and a false-positive rate of 73.3%. There was no significant difference in the prevalence of syphilis in relation to maternal age and parity (P>0.05). CONCLUSION: While the prevalence of syphilis is extremely low in the antenatal care population at the three specialist care hospitals in south-east Nigeria, false-positive rate is high and prevalence did not significantly vary with maternal age or parity. Because syphilis is still a serious but preventable and curable disease, screening with VDRL alone, without confirmatory tests may not be justified. Because of the increase in the demand for evidence-based medicine and litigation encountered in medical practice, we may advocate that confirmatory test for syphilis is introduced in routine antenatal testing to reduce the problem of false positives. The government should increase the health budget that will include free routine antenatal testing including the T. pallidum hemagglutination assay.

Barriers to postnatal care and exclusive breastfeeding among urbanwomen in southeastern Nigeria.

BACKGROUND: Available evidence shows that only a small proportion of Nigerian women access postnatal care and practice exclusive breastfeeding. Given that both interventions are critical to the survival of both the mother and the new born, it is important to identify factors that militate against an effective postnatal care and exclusive breastfeeding in the country, in order to scale up services. The aim was to determine the major barriers to postnatal care and exclusive breastfeeding among urban women in southeastern Nigeria. MATERIALS AND METHODS: A cross-sectional survey of 400 urban market women using semistructured questionnaires and focus group discussions. RESULTS: Out of 400 women interviewed, 365 (91.7%) attended postnatal clinic. Lack of knowledge about postnatal care services (42.2%; n = 14), distant location of the hospitals (36.4%; n = 12) and feeling that postnatal visits was not necessary (21.1%; n = 7) were the main reasons for non-attendance to postnatal clinic. With respect to exclusive breastfeeding, 143 (35.9%) of the women practiced EBF. The main reasons for nonpractice of EBF were that EBF was very stressful (26.2%; n = 67), mother's refusal (23.5%; n = 60), and the feeling that EBF was not necessary (18.1%; n = 46). Thirty five (13.7%) of the women were constrained by time while the husband's refusal accounted for 1.5% (n = 3) of the reasons for nonpractice of exclusive breastfeeding. CONCLUSION: Poor knowledge and inaccessibility to health facilities were the main obstacles to postnatal care while the practice of exclusive breastfeeding was limited by the stress and mothers refusal.

Barriers to Postnatal Care and Exclusive Breastfeeding among Urban Women in Southeastern Nigeria

Available evidence shows that only a small proportion of Nigerian women access postnatal care and practice exclusive breastfeeding. Given that both interventions are critical to the survival of both the mother and the new born; it is important to identify factors that militate against an effective postnatal care and exclusive breastfeeding in the country; in order to scale up services. The aim was to determine the major barriers to postnatal care and exclusive breastfeeding among urban women in southeastern Nigeria. Materials and Methods: A cross-sectional survey of 400 urban market women using semistructured questionnaires and focus group discussions. Results: Out of 400 women interviewed; 365 (91.7) attended postnatal clinic. Lack of knowledge about postnatal care services (42.2; n = 14); distant location of the hospitals (36.4; n = 12) and feeling that postnatal visits was not necessary (21.1; n = 7) were the main reasons for non-attendance to postnatal clinic. With respect to exclusive breastfeeding; 143 (35.9) of the women practiced EBF. The main reasons for nonpractice of EBF were that EBF was very stressful (26.2; n = 67); mother's refusal (23.5; n = 60); and the feeling that EBF was not necessary (18.1; n = 46). Thirty five (13.7) of the women were constrained by time while the husband's refusal accounted for 1.5 (n = 3) of the reasons for nonpractice of exclusive breastfeeding. Conclusion: Poor knowledge and inaccessibility to health facilities were the main obstacles to postnatal care while the practice of exclusive breastfeeding was limited by the stress and mothers refusal