Preliminary report of sexual assaults at Ekiti Sexual Assault Referral Centre, Ado-Ekiti, Southwest, Nigeria (Moremi Clinic).

There has been a surge in the incidence and severity of sexual assaults globally with the insurgence of COVID-19 owing to lockdown restrictions. Ekiti Sexual Assault Referral Centre, Ado-Ekiti also known as Moremi Clinic was established in June 2020 as a multisectoral response centre to this surge. Seventy-four survivors accessed medical services from June 2020 to May 2021. Adolescents made up 54.1% while the median age was 14.5 years. Only seven survivors were seen within 24 h of the event and around a quarter had follow-up visits. A quarter of survivors reported repeat episodes of sexual assault. Complications documented were sexually transmitted infections (13.5%), depression (4.1%) and posttraumatic stress disorder (5.4%). There was a failure of contraception in 4.5% of survivors who had taken emergency contraceptive pills. For improvements in quality of care, strategies to ensure early presentation and encourage follow-up visits must be introduced.

Utilization of Long-Acting Reversible Contraceptive (LARC) Methods in a tertiary hospital in southwestern Nigeria: A Mixed Methods Study.

BACKGROUND/PURPOSE: There is an increasing trend in the utilization of long-acting reversible contraceptive (LARC) methods globally. The study assessed the utilization of LARC methods and its determinants in a tertiary hospital, southwestern Nigeria using a mixed method study. METHODS: A cross-sectional study of women attending the Family Planning Clinic of the tertiary hospital was conducted between November 1, 2018 and October 31, 2019 using both quantitative and qualitative methods. Quantitative data was collected using structured questionnaire while in-depth interviewer topic guide was used to obtain qualitative data from the respondents. The quantitative and qualitative data obtained from the respondents were analyzed using SPSS version 22 and open code version 3.6.2, respectively, and the determinants of utilization of LARC methods were identified using multivariate regression model. RESULTS: The current utilization rate of LARC methods was 65.6% and implants accounted for 75% of LARC used. Higher education (p = 0.035), more than 3 living children (p = 0.030), previous use of LARC (p = 0.028), good knowledge (p = 0.025) and positive attitude of the women about LARC (p = 0.026) were significant determinants of utilization among the women. Limiting size of family was the commonest reason among LARC users, while partner disapproval, fear of procedure and side effects were reasons given by non-users. CONCLUSIONS: The utilization rate of LARC methods are high, and this should be sustained through improved information dissemination, education of women and involvement of male partners in reproductive health matters including family planning.

Oral misoprostol for induction of labor at term: a randomized controlled trial of hourly titrated and 2 hourly static oral misoprostol solution.

Background: Misoprostol has been shown to be effective in induction of labor (IOL) with different dosages and routes of administration.Objectives: This study compared the efficacy and safety of hourly titrated and 2-hourly static low dose oral misoprostol for IOL in Ekiti State University Teaching Hospital, Ado-Ekiti.Methods: One hundred fifty women with singleton pregnancy at term admitted for IOL were randomized into the two groups. Oxytocin augmentation was done as necessary. The primary outcome is rate of vaginal delivery within 24 hours. Data were analyzed using SPSS.Results: Vaginal delivery was achieved within 24 hours in 40 (67.8%) women who received hourly titrated-doses oral misoprostol and 42 (70.0%) women who received 2-hourly static-dose of oral misoprostol, p > .05. The rate of vaginal delivery, oxytocin augmentation, induction delivery time and cesarean section rate were similar in both groups, p > .05. Occurrence of uterine hyperactivity did not differ significantly among the women (p > .05) and no cases of uterine rupture were recorded. There were no adverse neonatal outcomes.Conclusions: The hourly titrated oral misoprostol is as effective and safe as the 2-hourly static oral misoprostol for IOL. Both can be utilized in IOL without the fear of adverse outcomes.

Prevalence of bacterial vaginosis in pregnancy in a tertiary health institution, south western Nigeria.

INTRODUCTION: Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of child bearing age. Bacterial vaginosis has emerged as a global health issue due to the adverse outcome in pregnancy and in the puerperium. The study determined the prevalence of BV and outcome of delivery among pregnant women. METHODS: Socio-demographic data and vaginal swab samples were obtained from 362 consecutive pregnant women with abnormal vaginal discharge attending antenatal clinic in Ekiti State University Teaching Hospital, Ado-Ekiti. Data were analysed using SPSS statistical software 21 and association between variables was compared using Chi square. RESULTS: The prevalence of BV among pregnant women with abnormal vaginal discharge in this study was 16.6%. Age group 25-34yrs, multiparity and higher education were significantly associated with BV, p < 0.05. Symptoms such as vulvar itching, dyspareunia, lower abdominal pains and characteristic of vaginal discharge such as colour and consistency were significantly associated with BV, p < 0.05. Women with bacterial vaginosis significantly had prelabour rupture of fetal membrane and their babies were born prematurely with low birth weight and Apgar score of less than 5 at one minute, p < 0.05. However, there was no difference statistically in rate of admission into special care baby unit among the women, p > 0.05. CONCLUSION: The findings of this study suggest that there should be screening for BV in pregnant women presenting with abnormal vaginal discharge so that they could be treated accordingly. This will mitigate the complications arising from bacterial vaginosis.

Quality of life in women of reproductive age: a comparative study of infertile and fertile women in a Nigerian tertiary centre.

The study examined the quality of life in women of reproductive age and the aim was to evaluate and compare the quality of life (QoL) scores among fertile and infertile women. A cross-sectional study was carried out among women attending the Gynaecology and Postnatal Clinics of Ekiti State University Teaching Hospital comparing their QoL using the World Health Organisation Quality of Life-BREF (WHOQOL-BREF) questionnaire. The age of fertile women was significantly higher than the age of infertile women (p < .05), while a significantly higher proportion of the infertile and fertile women and their spouses were civil servants (p < .05). Infertile women obtained significantly higher scores than fertile women in the physical domain (QoL) and significantly lower scores than fertile women in the social domain (QoL), (p < .05). Among the infertile women, those with secondary infertility had significantly better overall QoL scores, (p < .05). Logistic regression showed that infertility and unemployment in women were associated with significantly lower QoL scores in psychological and social domains (p < .05). The quality of life is significantly lower among infertile women compared to fertile ones and this should be borne in mind when attending to these women. Impact statement What is already known on this subject: Infertility has been shown to be associated with poor quality of life. Most of these studies were conducted in developed countries. What the results of this study add: The findings of this study revealed that women who were infertile had low quality of life scores compared to the fertile ones in physical, social and psychological domains. What the implications are of these findings for clinical practice and/or further research: A community-based and multicultural study involving more participants may shed more light on this topic in future research. Counselling sessions should be incorporated as part of the holistic approach in the day-to-day management of the infertile women.

Birth preparedness and complication readiness among prenatal attendees in a teaching hospital in South West Nigeria.

OBJECTIVE: To assess birth preparedness and complication readiness (BPCR) as well as knowledge of danger signs during pregnancy, labor/delivery, and the postpartum period. METHODS: A cross-sectional study was undertaken of pregnant women attending the prenatal clinic at a tertiary hospital in Nigeria between October and December 2016. A pretested and structured questionnaire was used to collect data on BPCR, and logistic regression was performed to determine factors affecting BPCR. RESULTS: Of 325 participants, 274 (84.3%) had knowledge of BPCR components, and 265 (81.5%) were well prepared for birth and its complications. However, only 89 (27.4%) knew key danger signs during labor/delivery and 81 (24.9%) knew those in the first 2 days after delivery. Older age, higher parity, tertiary education of women, paid employment of women and their spouses, higher social class, frequent prenatal visits, and knowledge of danger signs were significantly associated with BPCR (P<0.05). Higher parity, maternal government employment, and knowledge of danger signs during pregnancy remained determinants of BPCR on logistic regression (P<0.05). CONCLUSION: Although there was a high level of knowledge and practice of BPCR, knowledge of key danger signs was low. Therefore, prenatal education needs to be improved with an emphasis on teaching pregnant women to recognize key danger signs.

Healthcare workers knowledge and attitude toward palliative care in an emerging tertiary centre in South-west Nigeria.

BACKGROUND: Palliative care is an emerging area of medicine with potential to affect positively many chronically ill patients. This study investigated the knowledge and attitude of healthcare workers in a tertiary level hospital in Nigeria where a palliative care unit is being established. MATERIAL AND METHODS: The study was a cross-sectional questionnaire-based study carried out among healthcare workers in Ekiti State University Teaching Hospital, Ado-Ekiti, south-west Nigeria. The questionnaire had sections about definition of palliative care, its philosophy, communication issues, medications, and contexts about its practice. The information obtained from the questionnaire was coded, entered, and analyzed using IBM SPSS version 19. RESULTS: A total of 170 questionnaires were returned within the stipulated time frame with response rate of 66.7%. Majority, (135, 86%) respondents felt palliative care was about the active management of the dying while 70.5% of respondents equated palliative care to pain management. Regarding the philosophy of palliative care, 70 (57.9%) thought that it affirms life while 116 (78.4%) felt palliative care recognizes dying as a normal process. One hundred and twenty-two (78.7%) respondents were of the opinion that all dying patients would require palliative care. The patient should be told about the prognosis according to 122 (83%) respondents and not doing so could lead to lack of trust (85%). Regarding the area of opioid use in palliative care, 76% of respondents agreed that morphine improves the quality of life of patients. CONCLUSION: There are plausible gaps in the knowledge of the healthcare workers in the area of palliative care. Interventions are needed to improve their capacity.