Improving Treatment Outcome for Cervical Cancer Using 2-Point Assessment of Quality of Life Among Nigerian Women: A Protocol for a Multi-Center Study.

Background: Cervical cancer is the fourth most common cancer among women globally, with quality of life (QOL) being a major concern for patients with cervical cancer, especially in low- and middle-income countries (LMICs). This is largely due to the advanced nature of the disease at presentation. Although there are a higher number of studies focusing on the QOL of high-income countries, the QOL of cervical cancer patients in LMICs is not available. The aim of this study is to evaluate QOL among women with cervical cancer in Nigeria using a 2-point assessment. Methods: A multi-center prospective cohort study will be conducted in 6 tertiary health facilities randomly selected from the 6 geopolitical zones of Nigeria and consisting of a 2-point assessment of the QOL of participants at the time of diagnosis of cervical cancer and after treatment. Women who were recently diagnosed with histologically confirmed cervical cancer (treatment naïve) will be included. QOL will be assessed using Quality of Life Questionnaire domains (EORTC QLQ30) as developed by the European Organization for Research and Treatment of Cancer (EORTC). In addition to the QOL assessment, relevant and clinicopathological variables will be obtained using a self-structured data extraction sheet designed for this study. All data will be anonymized and will be analyzed using SPSS version 25. Levels of QOL will be calculated using EORTC QLQ30. Ethical approval was obtained from National Health Research Ethics Committee (NHREC/01/01/2007-08/11/2021). Discussion: In view of the paucity of data on QOL in LMICs like Nigeria, where most women with cervical cancer present with advanced disease, this research was designed to help in formulating evidence-based interventions to improve the QOL and treatment outcomes provided to women with cervical cancer in Nigeria and other LMICs. The study is expected to fill these knowledge gaps.

A Systematic Review and Meta-Analysis of the Prevalence of Triplex Infections (Combined Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus) among Pregnant Women in Nigeria.

Objective: We systematically identified the prevalence of triplex infections (combined human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV)) in pregnancy. Methods: To gather information on the frequency of triplex infections, we searched the databases of PubMed, CINAHL, and Google Scholar. Without regard to language, we utilized search terms that covered HIV, HBV, HCV, and pregnancy. Pregnant women with triplex infections of HIV, HBV, and HCV were included in studies that also examined the prevalence of triplex infections. Review Manager 5.4.1 was employed to conduct the meta-analysis. Critical appraisal and bias tool risk data were provided as percentages with 95% confidence intervals (95% CIs), and I2 was used as the statistical measure of heterogeneity. The checklist was created by Hoy and colleagues. The study protocol was registered on PROSPERO, under the registration number CRD42020202583. Results: Eight studies involving 5314 women were included. We identified one ongoing study. Pooled prevalence of triplex infections was 0.03% (95% CI: 0.02-0.04%) according to meta-analysis. Subgroup analysis demonstrated a significantly high prevalence of 0.08% (95% CI: 0.06-0.10%; 3863 women) in HIV-positive population than 0.00% (95% CI:-0.00-0.00; 1451 women; P < 0.001) in general obstetric population. Moreover, there was a significant difference in the pooled prevalence between studies published between 2001 and 2010 and between 2011 and 2021 (0.14% (95% CI: 0.12 to 0.16 versus 0.03% (95% CI: 0.02 to 0.04%; P < 0.001))) and participants recruited in the period between 2001 and 2011 and between 2012 and 2021 (0.13% (95% CI: 0.05 to 0.21; p=0.002 versus 0.00% (95% CI: -0.00 to 0.00%; p=1.00))), respectively. Conclusion: The combined prevalence of prenatal triplex infections was 0.03%, with rates notably higher among the group of pregnant women who were HIV-positive and during the recruitment period that took place before 2012. This prevalence still necessitates screening for these infections as necessary.

Seroprevalence and risk factors for rubella infection in pregnant women attending a tertiary hospital in Kano-Nigeria.

Introduction: rubella is a leading cause of vaccine preventable birth defects especially in developing countries. Acquisition of infection with the rubella virus in early pregnancy exposes the fetus to a very high chance of developing congenital rubella syndrome. The neonate is born with multiple abnormalities with the triad of congenital cataract, deafness and cardiovascular abnormalities like ventricular septal defect or patent ductus arteriosus. Limited data exist on the seroprevalence of rubella antibodies in pregnant women in Nigeria. The aim of this study was to determine the seroprevalence of rubella antibodies in pregnant women attending antenatal clinic in Aminu Kano Teaching Hospital, Kano State. Methods: the study was a cross-sectional study involving one hundred and sixty-three pregnant women attending antenatal clinic of Aminu Kano Teaching Hospital in Kano, Nigeria. Interviewer administered questionnaire was used to collect sociodemographic data and risk factors. Blood samples were taken from consenting pregnant women during antenatal care and samples were subjected to antibody testing (IgG and IgM). Descriptive analysis was done for sociodemographic data and seroprevalence of rubella. Chi-square tests were used to determine associations. Results: one hundred and sixty-three pregnant women were recruited for the study. The participants´ age ranged from 18 to 41 years with mean age of 27.60±5.7 years. The overall rubella seroprevalence was found to be 68.7%. The seroprevalence of specific anti-Rubella virus IgM and IgG was found to be 58.4% and 37.3% respectively while prevalence of having both anti-Rubella virus IgG and IgM in the women was found to be 26.4%. Non-formal education and immunodeficiency was found to be associated with rubella infection (P-value of 0.018 and 0.001 respectively). Conclusion: the study found a high prevalence of anti-Rubella virus immunoglobulins in asymptomatic pregnant women attending antenatal care in our facility with immunodeficiency and non-formal education found to be significant risk factors.

Mother-to-child transmission of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among pregnant women with single, dual or triplex infections of human immunodeficiency virus, hepatitis B virus and hepatitis C virus in Nigeria: A systematic review and meta-analysis.

Objectives: To systematically review literature and identify mother-to-child transmission rates of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among pregnant women with single, dual, or triplex infections of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in Nigeria. PRISMA guidelines were employed. Searches were on 19 February 2021 in PubMed, Google Scholar and CINAHL on studies published from 1 February 2001 to 31 January 2021 using keywords: "MTCT," "dual infection," "triplex infection," "HIV," "HBV," and "HCV." Studies that reported mother-to-child transmission rate of at least any of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among pregnant women and their infant pairs with single, dual, or triplex infections of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in Nigeria irrespective of publication status or language were eligible. Data were extracted independently by two authors with disagreements resolved by a third author. Meta-analysis was performed using the random effects model of DerSimonian and Laird, to produce summary mother-to-child transmission rates in terms of percentage with 95% confidence interval. Protocol was prospectively registered in PROSPERO: CRD42020202070. The search identified 849 reports. After screening titles and abstracts, 25 full-text articles were assessed for eligibility and 18 were included for meta-analysis. We identified one ongoing study. Pooled mother-to-child transmission rates were 2.74% (95% confidence interval: 2.48%-2.99%; 5863 participants; 15 studies) and 55.49% (95% confidence interval: 35.93%-75.04%; 433 participants; three studies), among mother-infant pairs with mono-infection of human immunodeficiency virus and hepatitis B virus, respectively, according to meta-analysis. Overall, the studies showed a moderate risk of bias. The pooled rate of mother-to-child transmission of human immunodeficiency virus was 2.74% and hepatitis B virus was 55.49% among mother-infant pairs with mono-infection of HIV and hepatitis B virus, respectively. No data exists on rates of mother-to-child transmission of hepatitis C virus on mono-infection or mother-to-child transmission of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among mother-infant pairs with dual or triplex infection of HIV, hepatitis B virus and HCV in Nigeria.

Pregnant women's hepatitis B vaccination coverage in Nigeria: a national pilot cross-sectional study.

OBJECTIVE: To determine the hepatitis B vaccination coverage, full-dose (⩾3) coverage and the associated factors affecting uptake among pregnant women. METHODS: This was a cross-sectional study among pregnant women attending antenatal care in six tertiary hospitals across all the geopolitical zones of Nigeria. Pregnant women who consented to the study completed screening questions about their hepatitis B vaccination status and coverage. The main outcome measures were hepatitis B vaccination coverage rate, dose, and factors affecting uptake. Bivariate analysis was performed by the chi-square test and conditional logistic regression analysis was used to determine variables associated with uptake of the vaccination. Odds ratios (ORs) and adjusted odds ratios (aORs) were calculated and statistical significance was accepted when p-value was < 0.05. RESULTS: Of 159 pregnant women who completed the interview questions, 21 [13.2%, 95% confidence interval (CI) 7.9-18.5%] were vaccinated for hepatitis B for one to three doses. The numbers of doses received were: three doses (8/159, 5.0%), two doses (5/159, 3.1%), and one dose (8/159, 5.0%). The reasons for non-uptake of vaccination included: lack of awareness of the vaccine 83/138 (60.1%), inadequate access to vaccine 11/138 (8.0%), and positivity to hepatitis B virus 10/138 (7.2%). The uptake of hepatitis B vaccination was significantly affected by the level of education (OR 0.284, 95% CI 0.08-1.01, p = 0.041), but in multivariable logistic regression, adjusted for confounders, the association between hepatitis B vaccination and participants' level of education (aOR 3.09; 95% CI 0.95-10.16; p = 0.061) did not remain significant. CONCLUSIONS: In Nigeria, the national hepatitis B vaccination coverage among pregnant women appears poor, with the full-dose coverage even poorer. The level of education was not positively associated with uptake of hepatitis B vaccination, while lack of awareness of the vaccine was the commonest reason for non-uptake. FUNDING: TETFund National Research Fund 2019 (grant number TETFund/DR&D/CE/NRF/STI/33).

Awareness and prevalence of hepatitis C virus infection among pregnant women in Nigeria: A national pilot cross-sectional study.

BACKGROUND: There are no national data on hepatitis C virus awareness and burden among pregnant women to justify its routine screening. OBJECTIVES: To investigate awareness, seroprevalence and risk factors for hepatitis C virus infection among pregnant women in Nigeria. METHODS: A total of 159 pregnant women from antenatal clinics across six geopolitical zones in Nigeria consented to anti-hepatitis C virus testing which was confirmed using polymerase chain reaction technique. Confirmed hepatitis C virus positive women were further tested for hepatitis B and HIV. Participants were evaluated for risk factors for hepatitis C virus. Odds ratios, adjusted odds ratios, and their 95% confidence intervals (CIs) were determined, and p-values of <0.05 were considered significant. RESULTS: Of 159 participants, 77 (48.4%; 95% confidence interval = 38.2%-60.5%) were aware of hepatitis C virus infection and awareness of hepatitis C virus was associated with young age (odds ratio = 2.21; 95% confidence interval = 1.16-4.21), high educational level (odds ratio = 3.29; 95% confidence interval = 1.63-6.64), and participants' occupation (odds ratio = 0.51; 95% confidence interval = 0.26-0.99). In multivariable logistic regression, adjusted for confounders, the association between awareness of hepatitis C virus and participants' young age (adjusted odds ratio = 1.60; 95% confidence interval = 1.09-2.35; p = 0.018) and high educational level (adjusted odds ratio = 1.48; 95% confidence interval = 1.17-1.86; p = 0.001) remained significant. Hepatitis C virus seroprevalence was found to be 1.3% (95% confidence interval = 0.2%-4.5%). All (100.0%, 95% confidence interval = 12.1%-100.0%) the hepatitis C virus-positive participants and 99 (63.1%, 95% confidence interval = 51.3%-76.8%) hepatitis C virus-negative participants had identifiable hepatitis C virus risk factors. Dual seropositivity of anti-hepatitis C virus/anti-HIV and anti-hepatitis C virus/hepatitis B surface antigen each accounted for 0.6%. The most identified risk factors were multiple sexual partners (15.7%), shared needles (13.8%), and blood transfusion (11.3%). There was no significant association between the risk factors and hepatitis C virus positive status. CONCLUSION: Awareness of hepatitis C virus infection among pregnant women in Nigeria is low and those aware are positively influenced by young age and high educational level. The prevalence of hepatitis C virus infection is high and provides preliminary evidence to justify antenatal routine screening.

Doppler velocimetry indices of human immunodeficiency virus-positive pregnant women and their controls at Aminu Kano Teaching Hospital, Kano.

Background: Nigeria is among the countries having a large number of human immunodeficiency virus (HIV)-infected people in Africa with growing number of HIV-positive children, mainly infected by their mothers. Traditional tests diagnose high-risk fetuses very late. Doppler sonography has a potential for detecting high at-risk fetus at a much early stage, so that appropriate measures could be instituted to improve outcomes. This study compared umbilical artery velocimetric parameters among HIV-positive women on highly active antiretroviral therapy (HAART) and their matched controls to determine the possible abnormalities and correlates. Methodology: This was a comparative study that was conducted among HIV-positive pregnant women and their matched controls (HIV-negative pregnant women matched for gestational age and parity) at Aminu Kano Teaching Hospital. History and physical examination, transabdominal ultrasound examination were done on each subject to obtain the basic obstetric parameters. Detailed evaluations of the umbilical arteries on gray scale and duplex Doppler protocols using a 3.5-MHz curvilinear transducer were also done. The data were analyzed using SPSS Version 19.0. Independent samples t-test was used for continuous data. Chi-square test and Fisher's exact test were used for categorical data. P < 0.05 was considered statistically significant. Results: The mean age ± standard deviation (SD) was 30.8 ± 5.50 and 27.6 ± 5.34 for HIV and control groups, respectively. The mean amniotic fluid indices and that of estimated fetal weight for the HIV and control groups showed no statistically significant difference between the two groups. The mean (±SD) umbilical artery diameter of the HIV-infected mothers is wider than their negative controls. Conclusion: The study showed no statistically significant difference between the Doppler indices of HIV-positive pregnant women on HAART and their matched controls.

RésuméContexte: Le Nigéria fait partie des pays ayant un grand nombre de personnes infectées par le virus de l'immunodéficience humaine (VIH) en Afrique avec un nombre croissant d'enfants séropositifs, principalement infectés par leur mère. Les tests traditionnels diagnostiquent très tardivement les fœtus à haut risque. L'échographie Doppler a un potentiel pour détecter les fœtus à haut risque à un stade beaucoup plus précoce, de sorte que des mesures appropriées pourraient être instituées pour améliorer les résultats. Cette étude a comparé les paramètres vélocimétriques de l'artère ombilicale chez les femmes séropositives sous traitement antirétroviral hautement actif (HAART) et leurs témoins appariés pour déterminer les anomalies et les corrélations possibles. Méthodologie: Il s'agit d'une étude comparative menée auprès de femmes enceintes séropositives et de leurs témoins appariés (femmes enceintes séronégatives appariées pour l'âge gestationnel et la parité) à l'hôpital universitaire Aminu Kano. Anamnèse et examen physique, échographie transabdominale ont été réalisés sur chaque sujet pour obtenir les paramètres obstétricaux de base. Des évaluations détaillées des artères ombilicales sur des protocoles d'échelle de gris et Doppler duplex à l'aide d'un transducteur curviligne de 3,5 MHz ont également été effectuées. Les données ont été analysées à l'aide de SPSS version 19.0. Un test t d'échantillons indépendants a été utilisé pour les données continues. Le test du chi carré et le test exact de Fisher ont été utilisés pour les données catégorielles. P <0,05 était considéré comme statistiquement significatif. Résultats: L'âge moyen ± écart type (ET) était de 30,8 ± 5,50 et 27,6 ± 5,34 pour le VIH et les groupes témoins, respectivement. Les indices moyens du liquide amniotique et celui du poids fœtal estimé pour les groupes VIH et contrôle n'ont montré aucune différence statistiquement significative entre les deux groupes. Le diamètre moyen (± ET) de l'artère ombilicale des mères infectées par le VIH est plus large que leurs témoins négatifs. Conclusion: L'étude n'a montré aucune différence statistiquement significative entre les indices Doppler des femmes enceintes séropositives sous HAART et leurs témoins appariés.

Prevalence, seroconversion and mother-to-child transmission of dual and triplex infections of HIV, hepatitis B and C viruses among pregnant women in Nigeria: study protocol.

BACKGROUND: Nigeria contributes significantly to the global burden of HIV, Hepatitis B and C infections, either singly or in combinations, despite progress in HIV care regionally and globally. Although some limited data on mono infection of HIV, Hepatitis B and C virus infections do exists, that of dual and triplex infections, including seroconversion and mother-to-child transmission (MTCT) rates necessary for planning to address the scourge of infections in pregnancy are not available. OBJECTIVES: To determine the seroprevalence, rate of new infections, MTCT of dual and triple infections of HIV, Hepatitis B and C viruses and associated factors, among pregnant women in Nigeria. METHOD: A multicenter prospective cohort study will be conducted in six tertiary health facilities randomly selected from the six geopolitical zones of Nigeria. All eligible pregnant women are to be tested at enrollment after informed consent for HIV, Hepatitis B and C virus infections. While those positive for at least two of the infections in any combination will be enrolled into the study and followed up to 6 weeks post-delivery, those negative for the three infections or positive for only one of the infections at enrolment will be retested at delivery using a rapid diagnostic test. On enrolment into the study relevant information, will be obtained, and laboratory test of CD4 count, liver function test and full blood counts, and prenatal ultrasonography will also be obtained/performed. Management of mother-newborns pairs will be according to appropriate national guidelines. All exposed newborns will be tested for HIV, HBV or HCV infection at birth and 6 weeks using PCR technique. The study data will be documented on the study case record forms. Data will be managed with SPSS for windows version 23. Ethical approval was obtained from National Health Research Ethics Committee (NHREC) (NHREC/01/01/2007-23/01/2020). CONCLUSION: Pregnant women with multiple of HIV, HBV and HCV infections are at increased risk of hepatotoxicity, maternal and perinatal morbidity and mortality. Additionally, infected pregnant women transmit the virus to their unborn baby even when asymptomatic. Children born with any of the infection have significantly poorer quality of life and lower five-year survival rate. Unfortunately, the seroconversion and MTCT rates of dual or triplex infections among pregnant women in Nigeria have not been studied making planning for prevention and subsequent elimination of the viruses difficult. The study is expected to fill this knowledge gaps. Nigeria joining the rest of the world to eliminate the triple infection among children rest on the availability of adequate and reliable data generated from appropriately designed, and powered study using representative population sample. The establishment of the three-in-one study of prevalence, rate of new infection, rate and risk factor for MTCT of dual and triple infection of HIV, Hepatitis B and C viruses among pregnant women in Nigeria is urgently needed for policy development and planning for the improvement of the quality of life of mothers and the elimination of childhood triplex infection.

The efficacy of two doses versus 7 days' course of prophylactic antibiotics following cesarean section: An experience from Aminu Kano Teaching Hospital.

Background: Postcesarean wound infection is a leading cause of prolonged hospital stay. Considerable debates still exist regarding choice of antibiotics, dose, and duration of use. Objectives: The objective is to compare the efficacy of 2 doses of amoxicillin-clavulanic acid versus a 7 days combination of amoxicillin-clavulanic acid and metronidazole as prophylactic antibiotics following cesarean section (CS). Methodology: It was a randomized controlled trial that was conducted among 160 women undergoing CS at Aminu Kano Teaching Hospital. Women were randomized into two groups. Group I (study group) received 2 doses of 1.2 g amoxicillin-clavulanic acid. Group II (control group) received a 7 days course of amoxicillin-clavulanic acid and metronidazole. The data obtained were analyzed using SPSS version 17. Categorical (qualitative) variables were analyzed using Chi-square test and Fisher's exact test as appropriate while continuous (quantitative) variables were analyzed using independent sample t-test. P < 0.05 was considered statistically significant. Results: There was no statistically significant association in the occurrence of fever (12.8% vs. 15.8%, P = 0.6), wound infection (6.4% vs. 10.5%, P = 0.36), endometritis (7.7% vs. 11.8%, P = 0.38), UTI (6.4% vs. 5.3%, P = 1.00), mean duration of hospital stay (129.7 vs. 134.2 h, P = 0.48), and neonatal outcomes between the two groups. There was statistically significant difference in the mean cost of antibiotics (₦2883/US$9.5 vs. ₦7040/US$23.1, P < 0.001) and maternal side effects (10.3% vs. 26.3%, P < 0.001) between the study and the control groups, respectively. Conclusion: This study found no statistically significant difference in infectious morbidity, duration of hospital stay, and neonatal outcomes when two doses of amoxicillin-clavulanic acid was compared with a 7 days course of prophylactic antibiotic following CS. The use of two doses of amoxicillin-clavulanic acid has the advantages of reduced cost and some maternal side effects. The two doses were cheaper with minimal side effects.

RésuméContexte: L'infection des plaies post-césariennes est l'une des principales causes d'hospitalisation prolongée. Des débats considérables existent toujours concernant le choix antibiotiques, dose et durée d'utilisation. Objectifs: L'objectif est de comparer l'efficacité de 2 doses d'acide amoxicilline-clavulanique par rapport à 7 jours association d'acide amoxicilline-clavulanique et de métronidazole comme antibiotiques prophylactiques après une césarienne (CS). Méthodologie: c'était un essai contrôlé randomisé mené auprès de 160 femmes subissant une CS à l'hôpital universitaire Aminu Kano. Les femmes ont été randomisées en deux groupes. Le groupe I (groupe d'étude) a reçu 2 doses d'acide amoxicilline-clavulanique de 1,2 g. Le groupe II (groupe témoin) a reçu 7 jours de l'acide amoxicilline-clavulanique et du métronidazole. Les données obtenues ont été analysées à l'aide de SPSS version 17. Catégorie (qualitative) les variables ont été analysées à l'aide du test du chi carré et du test exact de Fisher, selon le cas, tandis que les variables continues (quantitatives) ont été analysées en utilisant un test t pour échantillon indépendant. P <0,05 était considéré comme statistiquement significatif. Résultats: Il n'y avait pas d'association statistiquement significative en cas de fièvre (12,8% vs 15,8%, P = 0,6), infection des plaies (6,4% vs 10,5%, P = 0,36), endométrite (7,7% vs 11,8%, P = 0,38), IVU (6,4% contre 5,3%, P = 1,00), durée moyenne de séjour à l'hôpital (129,7 contre 134,2 h, P = 0,48) et résultats néonatals entre les deux groupes. Il y avait une différence statistiquement significative dans le coût moyen des antibiotiques (83 2883 / US $ 9,5 contre ₦ 7040 / US $ 23,1, P <0,001) et côté maternel effets (10,3% contre 26,3%, P <0,001) entre l'étude et les groupes témoins, respectivement. Conclusion: Cette étude n'a trouvé aucune statistique différence significative dans la morbidité infectieuse, la durée du séjour à l'hôpital et les résultats néonatals lorsque deux doses d'amoxicilline-clavulanique l'acide a été comparé à un traitement antibiotique prophylactique de 7 jours après la CS. L'utilisation de deux doses d'acide amoxicilline-clavulanique a avantages du coût réduit et de certains effets secondaires maternels. Les deux doses étaient moins chères avec des effets secondaires minimes.

The efficacy of two doses versus 7 days' course of prophylactic antibiotics following cesarean section: An experience from Aminu Kano Teaching Hospital

Postcesarean wound infection is a leading cause of prolonged hospital stay. Considerable debates still exist regarding choice of antibiotics, dose, and duration of use. Objectives: The objective is to compare the efficacy of 2 doses of amoxicillin-clavulanic acid versus a 7 days combination of amoxicillin-clavulanic acid and metronidazole as prophylactic antibiotics following cesarean section (CS). Methodology: It was a randomized controlled trial that was conducted among 160 women undergoing CS at Aminu Kano Teaching Hospital. Women were randomized into two groups. Group I (study group) received 2 doses of 1.2 g amoxicillin-clavulanic acid. Group II (control group) received a 7 days course of amoxicillin-clavulanic acid and metronidazole. The data obtained were analyzed using SPSS version 17. Categorical (qualitative) variables were analyzed using Chi-square test and Fisher's exact test as appropriate while continuous (quantitative) variables were analyzed using independent sample t-test. P < 0.05 was considered statistically significant. Results: There was no statistically significant association in the occurrence of fever (12.8% vs. 15.8%, P = 0.6), wound infection (6.4% vs. 10.5%, P = 0.36), endometritis (7.7% vs. 11.8%, P = 0.38), UTI (6.4% vs. 5.3%, P = 1.00), mean duration of hospital stay (129.7 vs. 134.2 h, P = 0.48), and neonatal outcomes between the two groups. There was statistically significant difference in the mean cost of antibiotics (₦2883/US$9.5 vs. ₦7040/US$23.1, P < 0.001) and maternal side effects (10.3% vs. 26.3%, P < 0.001) between the study and the control groups, respectively. Conclusion: This study found no statistically significant difference in infectious morbidity, duration of hospital stay, and neonatal outcomes when two doses of amoxicillin-clavulanic acid was compared with a 7 days course of prophylactic antibiotic following CS. The use of two doses of amoxicillin-clavulanic acid has the advantages of reduced cost and some maternal side effects. The two doses were cheaper with minimal side effects

A three-year review of caesarean delivery at a secondary health facility in north-western Nigeria

Background: Caesarean section is today one of the commonest surgical operations performed on women. The increased refinement in anaesthetics and surgical skills has reduced the morbidity and mortality associated with the procedures. Most of the studies on caesarean rates in Nigeria are from tertiary centres in the main cities. They may not reflect the situation in secondary facilities in rural and sub-urban areas which do not have the adequate number of staff, equipment and logistic support. Objectives: To determine the rates of caesarean section, indications and outcome in the general hospital located in Dutse, Jigawa, North-Western Nigeria. Methods: It was a retrospective review of records of women that had caesarean delivery between January 2013 and December 2015. Socio-demographic and obstetric information were extracted and analysed using SPSS statistical software. Analysis of the data was done using descriptive statistics. Ethical approval was obtained from the state ministry of health research ethics committee. Results: There were a total of 9,362 deliveries of which 543 were caesarean births giving a caesarean section rate of 5.8%. Majority of the procedures were emergency (90%). More than half of the women had prolonged obstructed labour as the indication. Mean age (±SD) of the women was 25.5 ±7.21 years. There were 69 stillbirths and 4 maternal deaths. The main complication was wound breakdown seen among 9.8% of patients. Conclusion: The rate of caesarean section was lower compared to other secondary and tertiary facilities in Nigeria. Nine out of every 10 caesarean sections were emergency and were associated with high perinatal and maternal morbidity

The role of traditional contraceptive methods in family planning among women attending primary health care centers in Kano.

Background: Traditional contraceptive methods (TCMs) have been used by our ancestors for a long time in child spacing before the advent of the modern contraceptive methods but even with the introduction of the modern methods some women prefer and are still using TCMs. Aim: The aim of this study was to assess the utilization of traditional contraceptives in child spacing and its association with family size among women of child-bearing age attending primary healthcare centers in Kano. Materials and Methods: This was a cross-sectional study among 400 women attending primary healthcare centers in Kano. Their sociodemographic characteristics, number of children, knowledge, and use of traditional contraceptives were recorded on a pretested questionnaire. Results: The mean age ± standard deviation (SD) was 29.1 ± 6.22 years. The mean number of children (±SD) was 3.9 ± 2.27. A total number of 280 (70.0%) participants knew about TCMs, but only 147 (36.8%) used these methods and among those that used TCMs, herbal medicine was the most used method (n = 67, 45.6%). There was no statistically significant difference between the mean number of children of the respondents who used traditional contraceptives and those who did not (t = 0.382, df = 398, P = 0.703, 95% confidence interval:-0.374-0.555). Educational status was significantly associated with the use of traditional contraceptives (χ2 = 8.327, P = 0.005). Conclusion: There was more knowledge of traditional than modern contraceptive methods. Herbal medicine was the most commonly used method. There was poor utilization of the modern contraceptive methods and fair utilization of the TCMs. The study showed no clear benefit of traditional contraceptive usage over its nonuse in reducing family size.

RésuméContexte: Les méthodes contraceptives traditionnelles (MTC) ont longtemps été utilisées par nos ancêtres dans l'espacement des naissances avant l'avènement des méthodes contraceptives modernes, mais même avec l'introduction des méthodes modernes certaines femmes préfèrent et utilisent encore les MTC. But: Le but de cette étude est d'évaluer l'utilisation des contraceptifs traditionnels dans l'espacement des naissances et son association avec la taille de la famille parmi les femmes en âge de procréer fréquentant les centres de soins de santé primaires à Kano. Matériels et méthodes: Il s'agissait d'une étude transversale parmi 400 femmes fréquentant les centres de soins de santé primaires à Kano. Leurs caractéristiques sociodémographiques, le nombre d'enfants, la connaissance et l'utilisation de les contraceptifs traditionnels ont été enregistrés sur un questionnaire pré-testé. Résultats: L'âge moyen ± écart type (ET) était de 29,1 ± 6,22 ans. Le nombre moyen d'enfants (± écart-type) était de 3,9 ± 2,27. Un chiffre de 280 (70,0%) connaissait les MTC, mais seulement 147 (36,8%) utilisaient ces méthodes et parmi celles qui utilisaient des MTC, la phytothérapie était la méthode la plus utilisée (n = 67, 45,6%). Il n'y avait pas de différence statistiquement significative entre le nombre moyen d'enfants des répondants qui ont utilisé des contraceptifs traditionnels et ceux qui ne l'ont pas fait (t = 0,382, df = 398, P = 0,703, Intervalle de confiance de 95%: -0,374-0,555). Le statut éducatif était significativement associé à l'utilisation des contraceptifs traditionnels (χ2 = 8,327, P = 0,005). Conclusion: Il y avait plus de connaissance des méthodes contraceptives traditionnelles que modernes. La phytothérapie était la plus méthode couramment utilisée. Les méthodes modernes de contraception et l'utilisation équitable des MTC ont été mal utilisées. L'étude a montré pas de bénéfice clair de l'utilisation traditionnelle de la contraception par rapport à sa non-utilisation pour réduire la taille de la famille. Mots-clés: Planification familiale, rôle, méthodes contraceptives traditionnelles.

Low back pain in pregnant women attending antenatal clinic: The Aminu Kano teaching hospital experience.

BACKGROUND: The profound physiologic effects of pregnancy affect the musculoskeletal system. Pregnant women are at increased risks of low back/pelvic girdle pains. OBJECTIVE: To determine the incidence of low back/pelvic girdle pains among pregnant women. MATERIALS AND METHODS: This was a cross-sectional study conducted from May 1 to June 30, 2016, among consenting pregnant women at Aminu Kano Teaching Hospital. Ethical approval was obtained from the Hospital Ethics Committee. Information was obtained in a questionnaire on consecutive pregnant women. Data obtained were analyzed using SPSS version 18 (SPSS Inc., Chicago, Illinois, USA, 2012). Fisher's exact test was used for categorical data, and P ≤ 0.05 was considered statistically significant. RESULTS: A total of 309 pregnant women were recruited from May 1 to June 30, 2016. The mean age ± standard deviation was 28.4 ± 5.86 years. The incidence of low back pains (LBPs) and pelvic girdle pains among the pregnant women was 106 (34.3%) and 178 (57.6%), respectively. The pain was severe among 26 (9.2%) pregnant women, which warranted analgesic usage. Pain radiation was reported in> 50% of cases. There was an incidental finding of urinary incontinence in 36 (12.6%) cases. Low back/pelvic girdle pain was not associated with body mass index (BMI) (P = 0.390). CONCLUSION: The incidence of LBPs and pelvic girdle pains was high and found to be 34.3% and 57.6%, respectively. Analgesics were used especially among those with severe pains. There was an incidental finding of urinary incontinence among pregnant women with complaints of low back/pelvic girdle pains. There was no statistically significant association between LBPs and maternal BMI.

Age at menarche and its association with overweight/obesity among adolescents in Kano

Background: There was a dramatic decline of adolescents' menarcheal age worldwide; Africa is witnessing a secular trend of this reducing menarcheal age among its black adolescents. A transition of overweight/obesity among adolescent is believed to be associated with reduced menarcheal age. Materials and Methods: It was a descriptive cross-sectional study that was conducted among female adolescent girls from January to December, 2016. Ethical approval was obtained from the management concerned. All consenting adolescents were recruited for the survey. Information was recorded on a structured, pretested questionnaire. Their respective weight and height were also measured. Body mass index (BMI) was calculated using the formula: BMI = weight (kg)/height (m2). The data obtained were analyzed using the Statistical Package for the Social Sciences version 18.0 (SPSS Inc., SPSS Statistics for Windows, Chicago, IL, USA). Fishers' exact test was used, and the P ≤ 0.05 was considered statistically significant. Results: Two hundred and nineteen female adolescents participated in the survey. The mean age ± SD at menarche was 12.83 ± 1.312 years. The median and modal ages were both 13 years. There was no statistically significant association between the mean age at menarche and the ethnic groups (P(Fishers') = 0.150). However, mean age at menarche was statistically associated with their BMI (P(Fishers') = 0.00). Obesity was associated with reduced menarcheal age. Conclusion: The median and mean ages at menarche were 13.0 and 12.8 years respectively, which were in accordance with secular trend of reduced menarcheal age among black adolescents. Our study also showed an inverse association between the age at menarche and overweight or obesity among adolescents

Contraceptive choices among grand multiparous women at Murtala Mohammed Specialist Hospital, Kano.

BACKGROUND: Grand multiparity is known to be associated with pregnancy complications. Nigeria with a contraceptive prevalence of <15% and culture of early marriage in the northern part of the country, many women get to grand multiparity early in their obstetric carriers. These women contribute significantly to the bad obstetric performance indices in the country. The present study was to explore the contraceptive choices among grand multiparous women. METHODS: This study was a descriptive cross-sectional study among grand multiparous women attending an antenatal clinic. Data were collected on sociodemographic characteristics, contraceptive choices, and factors that influence such choices. The data were analyzed using Statistical Package for the Social Sciences version 18. RESULTS: There were 219 respondents. The mean age was 33.05 ± 3.17, and the mean parity was 6.48 ± 1.83. Most of the respondents (208, 95.50%) were aware of modern contraceptive methods, and oral contraceptive was the method of most of the respondents (197, 90.00%). Only 92 (42.00%) were currently using a modern contraceptive method. Being convenient for the lifestyle was the reason for the choice of a contraceptive method by many of the respondents (42, 19.10%). CONCLUSION: There was high awareness of modern contraceptive methods; however, there was low use prevalence among respondents, and the desire for more pregnancy was the reason for the nonuse.