Automated ABR screening for hearing loss and its clinical determinants among newborns with hyperbilirubinemia in National Hospital, Abuja, Nigeria.

Background: Severe neonatal hyperbilirubinemia is a known risk factor for sensorineural hearing loss which is usually undiagnosed in our environment until school age due to a lack of routine screening programs. Materials and Methods: This cross-sectional study conducted between August 2020 and February 2021 employed a universal sampling of consecutive eligible participants after their mothers' consent. Hearing screening was conducted using an automated auditory brainstem response (AABR) device (Otoport OAE + ABR®). The proportion of AABR screening failure was assessed while associated clinical risk factors were determined using logistic regression. Statistical significance was set at 5% for all comparative analyses. Results: One hundred and sixty newborns below 28 days of age, delivered at 34 weeks gestation and above, who had jaundice were recruited. The prevalence of screening AABR failure in at least one ear was 26.2%. Significant risk factors for AABR screening failure in addition to extreme and hazardous hyperbilirubinemia were acute bilirubin encephalopathy (ABE) (Odds Ratio (OR) =4.44, 95% CI = 3.19-6.17), birth weight below 2500 g (OR = 3.16, 95% CI = 1.48-6.77), dull tympanic membrane (TM) (OR = 5.94, 95% CI = 2.36-14.92) and exchange blood transfusion (OR = 4.84, 95% CI = 1.87-12.58). Conclusion and Recommendations: The prevalence of AABR screening failure was high, and a dull TM was its strongest predictor among late preterm and term neonates with hyperbilirubinemia. Otoscopy should be included in the care of newborn with hyperbilirubinemia and screening programs established to mitigate hearing loss among high-risk neonates in Abuja.

Awareness and Knowledge of Birth Defects among Antenatal Clinic Attendees at the University College Hospital, Ibadan, South-West, Nigeria.

BACKGROUND: The burden of birth defects is disproportionately higher in developing countries. OBJECTIVES: This study assessed the knowledge of risk factors and prevention of birth defects among ante-natal clinic attendees at the University College Hospital, Ibadan, Oyo State, Nigeria. METHODS: This was a cross-sectional study among 415 mothers who presented at the antenatal clinic. A semi-structured questionnaire was used to obtain information on respondents' socio-demographic profile, pregnancy, birth history, knowledge on prevention and risk factors for birth defects. Descriptive statistics was used to present results, independent t-test and ANOVA were used to determine the factors associated with mean of overall knowledge of birth defects. Test statistics was done at a 5% level of statistical significance. RESULTS: The mean age of the women was 31.7 ± 4.8 years. Overall, 93 (22.4%) of the women were above 35 years, 118 (29.9%) were skilled workers and 343 (84.9%) had tertiary education. More than half (219, 52.8%) of the respondents had good knowledge of birth defects (56.4% had good knowledge of prevention and 66.0% had good knowledge of risk factors). Antenatal clinic attendees in their first trimester had higher mean overall knowledge score (8.3 ± 4.9) compared to those in second (7.9 ± 4.5) and third (7.9 ± 4.9) trimesters but this was not statistically significant (p=0.873). However, respondents in skilled/ semi-skilled occupation (8.62) had a significantly higher mean knowledge score compared with those in unskilled occupation/ unemployed (7.33) (p=0.005). CONCLUSION: Knowledge of birth defects is relatively low among women. To reduce the occurrence and severity of birth defects, there is a need to educate mothers on the knowledge, prevention and importance of screening for birth defects.

CONTEXTE: Le fardeau des malformations congénitales est disproportionnellement plus élevé dans les pays en développement. OBJECTIFS: Cette étude a évalué les connaissances sur les facteurs de risque et la prévention des malformations congénitales chez les patientes des consultations prénatales de l'University College Hospital, Ibadan, État d'Oyo, Nigéria. MÉTHODES: Il s'agissait d'une étude transversale auprès de 415 mères qui se sont présentées à la clinique prénatale. Un questionnaire semi-structuré a été utilisé pour obtenir des informations sur le profil sociodémographique des répondantes, la grossesse, l'histoire de la naissance, les connaissances sur la prévention et les facteurs de risque de malformations congénitales. Des statistiques descriptives ont été utilisées pour présenter les résultats, un test indépendant et une ANOVA ont été utilisés pour déterminer les facteurs associés à la moyenne de la connaissance globale des malformations congénitales. Les statistiques du test ont été effectuées à un niveau de signification statistique de 5 %. Soins prénatals, Santé de l'enfant, Connaissances. RÉSULTATS: L'âge moyen des femmes était de 31,7 ± 4,8 ans. Dans l'ensemble, 93 (22,4%) des femmes avaient plus de 35 ans, 118 (29,9%) étaient des travailleurs qualifiés et 343 (84,9%) avaient un diplôme de l'enseignement supérieur. Plus de la moitié (219, 52,8%) des répondants avaient une bonne connaissance des malformations congénitales (56,4% avaient une bonne connaissance de la prévention et 66,0% avaient une bonne connaissance des facteurs de risque). Les patientes en consultation prénatale au cours de leur premier trimestre avaient un score de connaissance global moyen plus élevé (8,3 ± 4,9) par rapport à celles des deuxième (7,9 ± 4,5) et troisième (7,9 ± 4,9) trimestres, mais cela n'était pas statistiquement significatif (p = 0,873). Cependant, les répondants exerçant une profession qualifiée/semi-spécialisée (8,62) avaient un score moyen de connaissances significativement plus élevé que ceux exerçant une profession non qualifiée/chômeur (7,33) (p=0,005). CONCLUSION: La connaissance des malformations congénitales est relativement faible chez les femmes. Pour réduire l'occurrence et la gravité des malformations congénitales, il est nécessaire d'éduquer les mères sur les connaissances, la prévention et l'importance du dépistage des malformations congénitales. MOTS-CLÉS: Malformations congénitales.

MANAGEMENT OUTCOME OF PREMATURE RUPTURE OF MEMBRANES IN A TERTIARY HEALTH FACILITY IN SOUTH WESTERN NIGERIA.

Background: Pre-labour Rupture of Membranes (PROM) contributes immensely to the potential risk of maternal morbidity and mortality. Objective: To explore the incidence and management outcome of PROM at Ladoke Akintola University of Technology Teaching Hospital (LTH), Ogbomoso, Nigeria. Methods: A retrospective study of 61 cases of PROM managed at LTH, Ogbomoso over a 3-year period. Information on the socio-demographics and obstetrics characteristics, management instituted, and outcomes were obtained using a structured proforma. Data were analysed using SPSS version 20. Level of statistical significance was set at <0.05 and 95% confidence interval. Results: The incidence of PROM was 4.1% with a perinatal mortality rate of 0.18 per 1000 deliveries. Twenty (33%) were pre-term while 41 (67%) were term PROM with 10% of the perinatal death occurring among those with preterm PROM. The mean age of the women was 36.9 (SD=2.1) years and median parity of 1(range 1-5) children. There was a significant association between the women's gestational age at which PROM occurred with the latency period (p< 0.001). Fetal birth weight, APGAR score and Neonatal Intensive Care Unit (NICU) admission were all significantly associated with the gestational age at which PROM occurred (p<0.05). There was a significant difference between the intervention instituted and mode of delivery (p=0.009). Conclusion: The incidence of PROM at term was high and conservative/ expectant management was effective. The latency period and fetal outcomes such as birth weight, apgar score and NICU admission were determined by the gestational age at which PROM occurred.

Pattern and outcome of prenatally diagnosed major congenital anomalies at a Nigerian Tertiary Hospital.

INTRODUCTION: The prevalence of major congenital anomalies (CAs) shows wide variations depending on geographical location and may range from <1% to 8% and it causes between 20% and 30% of perinatal deaths. In Nigeria, the prevalence of CAs may be underestimated with the general reliance on mostly livebirths ranging between 0.5% and 2.8% exempting cases of miscarriage and abortions. The purpose of this study was to determine the epidemiologic pattern and outcome of major CAs detected prenatally at the University College Hospital, Ibadan, Nigeria, over a 4-year period. METHODS: This hospital-based descriptive study highlights the prevalence and pattern of prenatally diagnosed fetal anomalies among the pregnant women who presented for routine prenatal ultrasound screening within the study period. Demographic details, associated risk factors, and fetal anomaly type in the fetuses were recorded using a prepared pro forma and were analyzed. RESULTS: Prenatal ultrasound screening for fetal anomalies was performed on 989 fetuses (including 15 sets of twins and 1 set of triplets) during the study period, out of which 62 (6.3%) had CAs. Of the 62 with CAs, 37 (59.7%) were major and 25 (40.3%) were minor. Majority of the fetuses with major anomalies were found among women aged 30-34 years and most were detected during the routine 18-22 weeks' anomaly scan. The major anomalies were most common in central nervous system. Nine (14.5%) pregnancies were terminated before term and 8 (29.6%) babies had different postnatal surgical interventions. Eleven (17.7%) of the fetuses with anomalies died in the perinatal period. CONCLUSION: CAs remain a major contributor to perinatal morbidity and mortality in Nigeria. Since most are idiopathic, early prenatal detection with ultrasound may facilitate improved diagnosis and the reduction of overall perinatal morbidity and mortality in the Nigerian setting.

Lassa Fever in Pregnancy: Report of 2 Cases Seen at the University College Hospital, Ibadan.

Lassa fever (LF), an acute viral haemorrhagic fever, is an endemic zoonotic viral infection in West Africa countries with up to 15% case fatality rate. Though a rodent-borne infection, it can also be transmitted from person to person during the care of sick relations or more commonly in health care settings as a nosocomial infection. Vertical transmission from mother to child has been documented. We report 2 cases of LF among pregnant women which were managed at the University College Hospital, Ibadan, between September and October 2014. Both patients were in their early 20s with only one surviving the disease. Both had supportive therapy but none had antiviral therapy. This report emphasized the importance of early presentation, high index of suspicion, prompt diagnosis, and early commencement of supportive therapy in the management of patients suspected with LF especially in the era of other viral haemorrhagic infections.

Awareness and attitude towards HPV and its vaccines among market women in Bodija Market, Ibadan.

Background: Cervical cancer, commonest among cancers of the female genital tract continued to pose major challenge to women of reproductive age in developing countries though infection by its causative agent, human papilloma virus (HPV) is preventable.This study aimed to assess awareness and attitude of market women concerning HPV and its vaccines in prevention of cervical cancer. Materials and Methods: A cross sectional study involving 329 market women, using multistage sampling technique. Instrument was an Interviewer--administered questionnaire on socio-demographic characteristics, knowledge and awareness of HPV and its vaccine, sexual history and attitude towards HPV vaccines. Data analysis was done using SPSS version 20.0 with statistical significance level set at p<0.05. Results: Mean age of respondents was 29.49 ± 3.65 years. All respondents were sexually active with majority (94.8%) having multiple sexual partners. Awareness of HPV vaccine and Pap smear test was among 1.2% and 9.4% respectively. Attitude towards HPV vaccination was good in 304 (92.4%) with 302 (91.8%) willing to take the HPV vaccines. There was significant association between attitude towards HPV vaccine and willingness to take HPV vaccine x2=111.8, p<0.01). Conclusions: Awareness of HPV and its vaccines is low among market women in our community. Policies and actions to step up information dissemination are urgently needed in order to stem the scourge of cervical cancer in our society.

Perception and satisfaction with quality of antenatal care services among pregnant women at the university college hospital, ibadan, Nigeria.

BACKGROUND: Antenatal care is an important health service which detects and sometimes reduces the risk of complications among pregnant women. The quality of care is likely to influence effective utilization and compliance with interventions. OBJECTIVES: This study evaluated clients' perception of antenatal care quality at the University College Hospital (UCH), Ibadan and determined levels of client satisfaction. METHODS: Women presenting for antenatal care at the study centre were interviewed in a cross-sectional design using a structured questionnaire. Items in the questionnaire included sociodemographic and obstetric variables, assessment of quality of amenities, waiting time and level of satisfaction. Data analysis was done using frequency tables, Chi-square cross tabulations and logistic regression. The p-value was set at P<0.05. RESULTS: There were 239 participants; 74% percent of the women were aged 25-34 years; majority of the respondents (86%) had tertiary education while 49.4% were skilled workers or professionals. In 57.7% of women, the gestational age was between 13 and 27 weeks while 66.1% were Para 1-4. Amenities and water supply were regarded as unsatisfactory in 60.7% and 61.9% respectively. The clinic services were regarded as good in 81.1% of respondents; the only significant association with patient satisfaction was the desire to register in the same facility in the next pregnancy. CONCLUSION: There is a high overall level of satisfaction with antenatal services among pregnant women in UCH. Policy makers and health providers should however address improvement of amenities, reduction of waiting time and ensure that health interventions are available for all clients.

Perception and Satisfaction with Quality of Antenatal Care Services among Pregnant Women at the University College Hospital; Ibadan; Nigeria

Background: Antenatal care is an important health service which detects and sometimes reduces the risk of complications among pregnant women. The quality of care is likely to influence effective utilization and compliance with interventions. Objectives: This study evaluated clients' perception of antenatal care quality at the University College Hospital (UCH); Ibadan and determined levels of client satisfaction. Methods: Women presenting for antenatal care at the study centre were interviewed in a cross-sectional design using a structured questionnaire. Items in the questionnaire included sociodemographic and obstetric variables; assessment of quality of amenities; waiting time and level of satisfaction. Data analysis was done using frequency tables; Chi-square cross tabulations and logistic regression. The p-value was set at P0.05. Results: There were 239 participants; 74 percent of the women were aged 25-34 years; majority of the respondents (86) had tertiary education while 49.4 were skilled workers or professionals. In 57.7 of women; the gestational age was between 13 and 27 weeks while 66.1 were Para 1-4. Amenities and water supply were regarded as unsatisfactory in 60.7 and 61.9 respectively. The clinic services were regarded as good in 81.1 of respondents; the only significant association with patient satisfaction was the desire to register in the same facility in the next pregnancy. Conclusion: There is a high overall level of satisfaction with antenatal services among pregnant women in UCH. Policy makers and health providers should however address improvement of amenities; reduction of waiting time and ensure that health interventions are available for all clients