Serum Iron Parameters among Pre-Eclamptic and Normotensive Pregnant Patients in The Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.

Objective-To compare the serum iron parameters in parturients with and without preeclampsia Study design- Acase-control study Materials and Methods-Thirty-nine pre-eclamptic patients who presented in labour or about to be delivered by Caesarean section were selected as cases while fifty-eight normotensives admitted within the same period served as the controls. Blood samples were taken from informed participants before delivery and sent to the laboratory for analysis. Relevant bio-data was obtained from case records of the participants while the results of serum iron, ferritin, binding capacity and percentage saturation were recorded. Results-There were no statistically significant differences between the two groups regarding maternal age, parity, birth weight and gestational age at delivery, p>0.05.There were no differences also between the two groups with regard to the mode of delivery and fetal outcome, p>0.05. Even though total iron binding capacity was lower in preeclamptic patients, it didn't reach statistical significance. However, statistically significant differences were found between the two groups regarding serum iron and ferritin, p<0.05. Conclusion -Serum iron and ferritin were increased in patients with preeclampsia which may promote oxidative stress and therefore preeclampsia. More studies with larger sample sizes are advocated to validate the reliability of these findings.

Seroprevalence of hepatitis B virus infection among pregnant women at the antenatal booking clinic of a Tertiary Hospital in Lagos Nigeria.

OBJECTIVES: The objectives were to determine the seroprevalence of hepatitis B virus (HBV) infection and assess the major risk factors among Nigerian pregnant women. SUBJECTS AND METHODS: This was a cross-sectional descriptive study carried out among pregnant women at the antenatal clinic of a Tertiary Hospital in Lagos, Nigeria. A total number of 150 consenting pregnant women were selected for the study. A structured pretested interviewer-administered questionnaire was used for the data collection. Sera were collected and tested for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg). RESULTS: Of the 150 women screened during the study, 11 (7.3%) were seropositive for HBsAg. Of these 11 women, 4 (36.4%) were also positive for HBeAg. There was no statistically significant difference in the mean ages of participants who were seropositive for HBsAg and those who were negative for the virus (P=0.888). There were statistically significant differences in the seroprevalence of HBsAg recorded among respondents with previous surgery (odd ratio [OR]-2.97; 95% confidence interval [CI]-1.08-16.67; P=0.046), previously affected sibling or spouse (OR-5.03; 95% CI-1.11-25.27; P=0.001) and those with two or more lifetime sexual partners (OR-4.11; 95% CI-2.85-9.22; P=0.024). CONCLUSION: The sero-prevalence rate of HBV infection and also its infectivity is high in Lagos, Nigeria. These findings thus support the need for a nationwide policy of routine and widespread HBV screening among pregnant women.

Epidemiology and Risk Factors for Diabetes in Semi-Urban Communities in South West, Nigeria.

BACKGROUND: Diabetes mellitus (DM) is a growing public health problem both in developing and developed countries. The prevalence of diabetes has doubled in the last 20 years. This study aimed to assess the burden of type 2 diabetes in semi-urban communities in Ekiti, South-West Nigeria. STUDY DESIGN: This study was part of a larger study to assess the prevalence of cardiovascular risk factors among adults (>18 years) dwellers in 10 semi-urban communities. A total of 750 respondents took part in the study, using stratified sampling method to recruit participants within these communities. They had their clinical history assessed, fasting blood glucose (FBG) determined and body mass indices measured. RESULTS: Of the 750 participants recruited 529 (70.5%) were females, 51 (6.8%) had FBG >7.0mmol/L (126mg/dl), hence were diagnosed as having DM and 45 participants (6.0%) had Impaired fasting glucose (IFG). Both DM and IFG were higher in males than females but the differences not statistically significantly. All indices of anthropometry (BMI, WC and WHR) were significantly higher in females than males. Family history of diabetes, age, BMI, WC and systolic hypertension were significantly associated with DM. CONCLUSION: The prevalence and risk factors for the development of DM and IFG are high in these communities. This requires prompt and adequate health promotion so as to reduce the burden of these conditions in this environment.

Prehospital transport of spinal cord-injured patients in Nigeria.

BACKGROUND: Well-organised and efficient prehospital transport is associated with an improved outcome in trauma patients. In Nigeria there is a paucity of information on prehospital transport of spinal cord-injured patients and its relation to mortality. OBJECTIVE: To determine whether prehospital transportation is a predictor of mortality in spinal cord-injured patients in Nigeria. DESIGN: Prospective cohort study. METHODS: Prehospital transport-related conditions, injury-to-arrival intervals and persons who brought spinal cord-injured patients to the casualty departments at the University of Abuja Teaching Hospital, Gwagwalada, and the National Orthopaedic Hospital, Lagos, were noted. Data were analysed using descriptive statistics, the chi-square test and multiple logistic regressions. MAIN OUTCOME MEASURES: Mortality within 6 weeks of admission. Results. During the review period, 168 patients with spinal cord injury presented to the casualty departments. Most presented 24 hours or more after the injury (67.9%) and were brought to casualty by their relatives (58.3%). Saloon cars were the most common mode of transportation (54.2%), most patients (55.4%) lying on their back during transfer. The majority of the patients (75%) had been taken to at least one other hospital before arriving at our casualty departments. The mortality rate was 16.7%. Multivariate analysis after adjusting for age, gender and means of transportation revealed that age (odds ratio (OR) 63.41, 95% confidence interval (CI) 9.24 - 43.53), a crouched position during transfer (OR 23.52, 95% CI 7.26 - 74.53), presentation after 24 hours (OR 5.48, 95% CI 3.20 - 16.42) and multiple hospital presentations (OR 7.94, 95% CI 1.89 - 33.43) were associated with death within 6 weeks of admission. CONCLUSION: Well-organised and efficient prehospital transport would reduce mortality in spinal cord-injured patients. Providing information on prehospital transport would also reduce mortality.

Prehospital transport of patients with spinal cord injury in Nigeria.

BACKGROUND: A well-organized and efficient prehospital transport is associated with improved outcome in trauma patients. In Nigeria, there is paucity of information on prehospital transport of patients with spinal cord injury (SCI) and its relation to mortality. OBJECTIVE: To determine if prehospital transportation is a predictor of mortality in patients with SCI in Nigeria. DESIGN: Prospective cohort study METHODS: Prehospital transport related conditions, injury arrival intervals and persons that brought patients with SCI to the casualty were noted. Data analyzed using descriptive statistics, the chi-square test and multiple logistic regressions. MAIN OUTCOME MEASURES: Mortality within 6 weeks on admission RESULTS: 168 patients with SCI presented in the casualty during this review period. Majority (67.9%) presented after 24 hrs of the injury. Majority (58.3%) were conveyed into the casualty by their relatives. Salon car (54.2%) was the most common mode of transportation where majority (55.4%) laid on their back during the transfer. Majority (75%) of the patients had multiple hospital presentation before reporting in our casualty. The mortality observed was 16.7%. Multivariate analysis after adjusting for age, gender, and means of transportation revealed that age (OR= 63.41, 95% CI= 9.24-43.53), crouched position during transfer (OR= 23.52, 95% CI= 7.26-74.53), presentation after 24 hrs (OR=5.48, 95% CI=3.20-16.42) and multiple hospital presentation (OR= 7.94, 95% CI= 1.89-33.43) were associated with mortality within 6 weeks of admission. CONCLUSION: A well-organized and efficient prehospital transport would reduce mortality in spinal cord injured patients. Public enlightenment campaign on factors that could reduce road traffic injury would help reduce mortality.

The use of the sisterhood method for estimating maternal mortality ratio in Lagos state, Nigeria.

Summary Estimates of maternal mortality are crucial to inform the planning of reproductive health programmes and guide advocacy. The aim of this study was to obtain a population-based estimate of maternal mortality in Lagos State, Nigeria. The sisterhood method was used in 2008 to carry out the survey using a questionnaire in which respondents were asked about their sisters who died during pregnancy, childbirth or within 6 weeks after childbirth. The survey involved 4,315 respondents who provided information on 9,910 ever married sisters. The life-time likelihood (risk) of maternal death for women aged 15-49 years was found to be 0.0239 or 1 in 42. The estimated maternal mortality ratio was 450 per 100,000 live births with a 95% CI of 360 and 530. Out of 111 reported deaths, 35 (31.5%) occurred during pregnancy, 49 (44.1%) occurred during delivery and 27 (24.3%) within 6 weeks of delivery.

Complications and causes of death in spinal cord injury patients in Nigeria.

BACKGROUND: There have been many reports on the problems of spinal cord injury (SCI) in Nigeria but few have reported on the complications and causes of death in spinal cord injured patients. OBJECTIVE: The objective of this study was to determine the complications, causes of death and associated risk factors in patients with SCI within six months post injury. METHODS: Patients were retrospectively identified from the hospital trauma database from January 1997 to December 2007. Complications and cause of death within the first six months of SCI were determined along with associated risk factors. RESULTS: Five hundred and eighty-two patients were eligible for analyses and data were obtained for 422 (72.5%) patients with a mean age of 37.2 (±14.2) years at six months follow-up. Muscle spasms 417 (98.8%) and neurogenic pain 382 (94.5%) were the main complications noted. The mortality during the review period was 144 (34.1%). Respiratory failure (44.4%) was the commonest cause of death. The independent predictors of mortality were mainly age, GCS<9, Frankel Type A at presentation and cervical spine injury (CSI) and while CSI and Frankel Type A injury were the main predictors of complications. CONCLUSION: Most common complication and cause of death following SCI are muscle spasm and respiratory failure respectively. The risk factors associated with mortality are age, GCS<9, cervical spinal injury, and complete neurologic injury and those for complications were cervical spinal injury and Frankel Type A injury.

A fast and cost-efficient method to detect ethanol as adulterant in gasoline.

Adulteration of fuel is a global problem that needs to be curbed. Studies have proved that no technically easy solution has been developed and easily accessible to the Oil and gas industry to detect adulterated gasoline. The need therefore arises for adequate and substantial methods for easy detection of adulterated gasoline.•This study developed an effective and cost-efficient method to detect adulterated gasoline at the point of sales of Petroleum Product through the means of piece of litmus paper testing.•The method provides the marketers and gasoline users to easily detect adulterated fuel at the point of sales of Petroleum Product, to avoid damage to the combustion engine.•This method of developing a paper indicator is however efficient and meets the requirements of the issue of detection of gasoline adulteration.

Role of healthcare in childbearing decision-making of WLHA in Nigeria: Application of PEN-3 cultural model.

Healthcare experiences among women living with HIV/AIDS (WLHA), determine their utilisation of sexual and reproductive health services, which ultimately influences their decisions on childbearing. This study aimed to understand the importance of healthcare support in the childbearing decision-making processes of WLHA, and its impact on eliminating new paediatric HIV infections. We conducted in-depth interviews between July and August 2012 with 15 WLHA receiving clinical HIV care at a teaching hospital in Lagos. Using PEN-3 cultural model, as a guide we explored perceptions of healthcare support pre- and post-partum. Findings indicate that faith in God for the delivery of a healthy child is significant during the pre-partum period, while the advice of healthcare workers concerning childbearing and access to available healthcare services carry more weight post-partum. Our findings have important implications for HIV treatment and care programmes geared towards WLHA considering childbearing, and ultimately the UN Global plan to eliminate mother-to-child transmission of HIV, as we move towards the 2030 agenda for sustainable development.

Voluntary counselling and testing (VCT) for Human Immunodeficiency Virus: a study on acceptability by Nigerian women attending antenatal clinics.

This study was carried out among 345 pregnant women attending antenatal clinics at two health facilities in Lagos, Nigeria. It was undertaken to determine their knowledge and acceptability of HIV voluntary counselling and testing in pregnancy as a strategy for the prevention of mother-to-child transmission (PMTCT) of HIV. Data were collected on issues relating to mother-to-child transmission of HIV, willingness to go for voluntary counselling and testing, actions to be taken if a pregnant woman was found to be HIV positive including infant feeding options. Majority of the women (89.9%) had good knowledge of the modes of HIV transmission, however, knowledge of specific aspects of PMTCT was poor. Close to half of the women (41.7%) were not aware of the association between breast milk and HIV transmission. Almost all the women (96.1%) were willing to undergo HIV testing in pregnancy particularly if it would assist preventing transmission of HIV to their babies; but only few would undergo the test if the result would be shared with relatives. Many of the women would still prefer breastfeeding even if they were found to be HIV positive. Awareness of anti-retroviral drugs among the study group was very poor. As the country is about to embark on its PMTTCT programme, there is need to increase the level of knowledge, acceptability and adoption of VCT and other PMTCT strategies among potential beneficiaries. Innovative information and education techniques need to be developed to provide HIV positive mothers with knowledge and skills that can enable them to make informed choices about infant feeding options and other forms of care.

Contraceptive usage among abortion seekers in Nigeria.

A study on contraceptive usage among abortion seekers in 150 randomly selected health institutions in the most and the least urbanized states of the health zone B representing the South Western states of Nigeria was conducted over a period of 2 months. There were 1839 abortion seekers during the period. About 30.4% (559) of the respondents admitted to ever used any form of contraceptive methods. Most of the respondents who admitted to ever used any form of contraceptives i.e. 81.2% (454/559) were not using the contraceptive methods regularly and this cut across all the methods. Oral contraceptive pill was the commonest method used, though not on regular basis. The most frequent reason for not ever used contraceptive methods was ignorance. There is a need for intensification of strategies for promotion of use of family planning methods, which can be achieved through good counselling, sexuality education, and availability of cheap, and affordable contraceptive methods and services.

Knowledge of, Perception of, and Attitude towards Uterine Fibroids among Women with Fibroids in Lagos, Nigeria.

Objectives. The study was to assess the level of knowledge of, perception of, and attitude towards uterine fibroids among women diagnosed with the condition. Methods. It is a cross-sectional descriptive study carried out among women diagnosed as having uterine fibroids in two gynaecological clinics in Lagos, Nigeria. Eligible women were recruited and a structured interviewer-administered questionnaire was used to collect the required information. Statistical analysis of data was done using EPI Info 2008. Results. Knowledge of fibroids was reported in 98.6% of the respondents and the information on uterine fibroids was obtained from radio, parents/relatives, health workers, and television in 29%, 27.3%, 18.7%, and 18.3%, respectively, by the respondents. Most of the women believed that being black, being nulliparous, or having positive family history predisposes women to having uterine fibroids. Up to 69.0% of the respondents believed that fibroid is a spiritual problem and many thought it requires spiritual healing. Fear of complications of surgery keeps most sufferers away from the hospital until fibroids become advanced or associated with complications. Conclusion. Awareness of uterine fibroids is high, but correct knowledge on aetiology and proper treatment is low. Intensive enlightenment of the populace using the mass media by trained personnel is recommended.

Substance use and sexual behaviour among female students in Nigerian universities.

Substance use continues to constitute social and health problems, more so among adolescents and young adults. One consequence is risky sexual behavior, a major problem in sub-Saharan Africa already facing the synergistic problems of poverty and HIV/AIDS. This study of female students aged ≥ 18 years in two universities in Nigeria uses a multi-stage stratified random sampling method, and each subject that gave consent to the study was administered with a structured questionnaire by trained interviewers; 2,408 female students were studied (1,854 from the University of Ibadan and 554 from the Bayero University, Kano). The mean age of the respondents was 21.6 (SD = 2.9), and about two-thirds (65.7%) were aged between 20-24, with 2,204 (91.5%) being single and 4.3% married. In all, 23.4% of the subjects used one form of substance. Alcoholic drinks of palm wine, alcoholic wine, and beer were the most common of substances used (22.7%), followed by tobacco (2%) and cannabis (1%). Substance use was significantly associated with religious affiliation of the students (p < 0.001), as the prevalence of substance use was least among Muslim students (11.7%) and highest among those who professed traditional religion (39.4%). Alcohol use was also positively associated with sexual activity (p < 0.001). Among the 547 students who used alcohol, 147 (26.9%) had sex in the 4 weeks prior to the survey, while among the 1,861 non-users, only 8.9% did so. The practice of unprotected sex was found not to be associated with substance use: a slightly lower proportion (29.5% vs. 36.6%) of substance users engaged in unprotected sex in their last encounter compared to non-users. There is need to scale up public health education on the dangers of substance use and its associated sexual risk behavior.

Haemoglobin and ferritin concentrations in cord blood in a tertiary health centre in Nigeria.

BACKGROUND: Haemoglobin(Hb) and serum ferritin (SF) concentrations of cord blood of babies born at term at the Lagos State University Teaching Hospital, Maternity Centre (Ayinke House), Ikeja in the South-Western part of Nigeria were determined to establish mean values for these substances in our locality. OBJECTIVES: To establish the mean values for haemoglobin and serum ferritin concentrations of cord blood of babies born at term in our environment and to determine the prevalence of foetal anaemia and low iron store in cord blood in our locality. METHODS: Haemoglobin and ferritin levels in cord blood of 142 newborns were determined. Two millilitres of blood was collected from the cord of each newborn into EDTA bottle for complete blood count analysis and another 2mls into a plain bottle for serum ferritin assay. Cut-off values for cord blood Hb and serum ferritin concentrations were 12.5g/dL and 60 microg/L respectively. RESULTS: The mean Hb and ferritin values were 13.024 +/- 2.41 g/dL and 70.85 +/- 97.07 microg/dL respectively. The prevalence of foetal anaemia is 32.4 %. About 59.2% of full term newborns had low iron store. Birth weight was significantly associated with Hb concentration (p=0.039) and apga sscore (p=0.002). CONCLUSION: The prevalence of foetal anaemia was 32.4%. More than half (59.2%) of the newborns had low cord blood serum ferritin.

Haemoglobin and ferritin concentrations of pregnant women at term.

BACKGROUND: Anaemia in pregnancy is defined as haemoglobin (Hb) concentrations of less than 11 g/dL while low ferritin is defined as serum ferritin (SR) levels of less than 10 µg/L. Hb and ferritin concentrations of pregnant women at term were determined to establish their mean values and to determine the prevalence of anaemia in our locality. METHODS: Haemoglobin and ferritin levels of 170 non-smoking and HIV-negative pregnant women were determined at term. The majority 143 of 170 (84.1%) of the pregnant women recruited for the study, booked at the beginning of the second trimester and received 200 mg elemental iron in three divided doses and 5 mg folic acid daily which were commenced at booking. Five millilitres of blood were collected from each patient at term into EDTA bottles for full blood count analysis and another 5 mL into plain bottles for SR assay. RESULTS: The mean Hb and ferritin values were 10.9 ± 1.9 and 47.84 ± 98.39 µg/L, respectively. The prevalence of anaemia at term was 46.4%. Only 11.2% (19 of 170) of pregnant women at term had low SR (iron stores). A statistically significant relationship was found between women's education and SR (P = 0.032). Booking status also correlated directly with SR and haemoglobin concentrations, while increasing age and parity did not. CONCLUSION: About half of the patients were anaemic. Iron deficiency is not the major cause of anaemia in pregnancy in this study because the majority of the pregnant women had normal iron stores. Education and booking status are possible factors that contribute to anaemia.

Efficacy of HIV PCR techniques to diagnose HIV in infants born to HIV infected mothers at LASUTH.

BACKGROUND: There has been so many difficulties encountered in the diagnosis of HIV infection in infants < 18 months of age born to HIV-infected mother. In these infants, definitive diagnosis can only be carried out by antigen based techniques which are expensive and not widely available in developing countries. OBJECTIVE: To generate information on the rate of mother to child transmission in Nigeria and to compare the efficacies of both the HIV-1 RNA and HIV-1 DNA PCR techniques in the diagnosis of this infections in infants. METHOD: Ninety (90) whole blood samples were obtained from 45 HIV positive mothers and 45 infants born to these mothers from the Department of Obstetrics and Gynaecology, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos. The presence of HIV was determined using the Amplicor HIV-1 DNA test and an in-house RNA PCR method. RESULTS: All the infants were HIV antibody positive, however, only 5 infants were positive by HIV-1 DNA PCR, indicating an 11% rate of transmission from HIV positive mothers. Among the 5 infants positive by the DNA PCR, only 4 were positive for the in-house RNA PCR. CONCLUSION: The 11% transmission rate recorded in this study was similar to that from mothers' who had Nevirapine ART interventions and both the HIV-1 DNA test and the in-house RNA PCR tests were sensitive and specific in the diagnosis of infection in infants, depending on the level/ state of HIV infection in infants.

Efficacy of visual inspection of the cervix using acetic acid in cervical cancer screening: a comparison with cervical cytology.

Screening programmes for the early detection of premalignant lesions of the cervix are expensive and technically difficult, especially in resource-challenged settings. There is a need for cheaper and equally effective alternative screening methods. This study compared the efficacy of visual inspection of the cervix using acetic acid (VIA) with the Pap smear method. A total of 186 subjects had a Pap smear followed by visual inspection of the cervix using 3 - 5% acetic acid with biopsies taken from suspicious acetowhite positive lesions. Cases of abnormal cytology were recalled for biopsies. A total of 150 subjects were negative for both tests; 30 (16.2%) were positive for VIA, while six were positive for both VIA and Pap smear. VIA detected one lesion missed by Pap smear on biopsy. The sensitivity of VIA was 100%, while that of Pap smear was 85.7%. The negative predictive value of VIA was 100%, while the positive predictive value was 20%. The sensitivity of VIA equals the reported rates for Pap smear. VIA is proposed as a credible alternative to Pap smear in resource-challenged settings.