Contraceptive Practice in a Tertiary Hospital in South-South Nigeria

Background: The high maternal and infant mortality in sub-Saharan Africa has been associated with unplanned pregnancy; high parity and short birth intervals. Use of effective contraceptive methods significantly reduce maternal and infant mortality and improved quality of life. This study determines the contraceptive practice among clients in a tertiary hospital. Method: The record cards of all clients that accepted contraceptive methods in the family planning clinic at the University of Uyo Teaching Hospital; Uyo over a 7-year period were reviewed. Results: There were 1094 new contraceptive acceptors during the study period. The modal age group of the clients was 25 - 34 years (59.3); majority of the clients were multiparous (59.8); christians (99.6) and 71.0had at least secondary school education. The most commonly accepted contraceptive methods were the intrauterine contraceptive device (45.0) and oral contraceptive pills (28.1); while clinic personnel (63.1); and friends and relatives (20.1) were the most common sources of information on contraception. Conclusion: Intrauterine contraceptive device and oral contraceptive pills were the most frequently accepted methods of contraception. We advocate increase in the contraceptive options including implants. The print and electronic media should be more involved in the awareness programs on contraception

A Controlled study of effect of counseling on psychological symptoms among people living with HIV/AIDS in Uyo, Nigeria

Psychological symptoms are common complications of HIV/AIDS. More often; decision making during management neglects the use of counseling; a common but important therapy in people living with HIV/AIDS. The increasing morbidity due to maladjustment to supportive care often results in poor quality of life. The objectives of this study were to determine the effect of counseling in people living with HIV/AIDS and compare the levels of anxiety and depression in them. Four hundred and twenty newly diagnosed persons living with HIV/AIDS referred to the University of Uyo Teaching Hospital in January 2007 were randomly divided into two groups; 1 and 2. Group 1 was instantly assessed for symptoms of anxiety and depression; using the Hospital Anxiety and Depression Scale (HADS); while; Group 2 was assessed one month later after undergoing intensive counseling. A total of 392 respondents; consisting of 210 in group 1 and 182 in group 2 were analyzed; 28 (13.3) respondents in group 2 defaulted from the clinic and were excluded from the study. The sociodemographic characteristics of the respondents in both groups were similar. Majority; 162 (77.1) respondents in group 1 and 137 (58.8) in group 2 aged between 20-49 years. Although; anxiety and depression were markedly reduced in 137 (34.9) and 35 (19.2) respondents in group 2 with counseling compared to 199 (50.8) and 90 (42.8) respondents in group 1 without counseling; the demographic variables of the respondents did not influence the level of anxiety and depression. However; depression was high in 24 (54.9) respondents in group 2 who had counseling and were unemployed; depression was associated with occupation (P0.04). Counseling reduces psychological symptoms in people living with HIV/AIDS. Therefore its use should be encouraged in people living with the disease to boost self-esteem needed for improved quality of life

A review of t the prevalence and rate of utilisation of measures offered to HIV-positive women during delivery in a tertiary hospital in South-South Nigeria

Background: Vertical or mother-to-child transmission of HIV which accounts for over 90 of paediatric HIV infection is increasingly becoming a major mode of transmission in developing countries. Aim: To determine the prevalence of HIV infection among pregnant women that deliver at the University of Uyo Teaching Hospital and also review the interventions they are offered when they present in labour. Methods: The case records of all HIV positive patients who delivered between 1st July 2005 and 31st December 2007 were reviewed. Results: There were 2;851 deliveries out of which 188 patients were HIV positive giving a prevalence of 6.6. The modal age group of the HIV-positive patients was 26-30 years (40.4). Most (68.6) of the patients were multiparous and 89.3of them had regular antenatal care in the hospital. HIV was diagnosed in the antenatal clinic in 71.8of the patients. Most (72.3) of them had a single dose of nevirapine in labour while 5.8received highly active anti-retroviral therapy. About 63.8of the patients had spontaneous vertex delivery while 33.5were delivered by Caesarean section. All the babies had single doses of nevirapine within 72 hours of birth. Most (84.0) of the mothers chose to feed their babies exclusively with breast milk substitutes. There were 3 maternal (1.6) and 16 (8.5) perinatal deaths.Conclusion: The prevalence of HIV infection among women who deliver in our hospital (6.6) is relatively high. The treatment of HIV positive pregnant women in labour with respect to the prevention of mother-to-child transmission fell short of acceptable standards in some of our patients. Efforts should be made to ensure the adoption of anti-retroviral therapy as recommended in the Nigerian national guidelines

Profile of intrauterine contraceptive device acceptors at the University of Uyo Teaching Hospital, Uyo, Nigeria

Background: Use of modern contraceptive methods has been shown to reduce unwanted pregnancy; high parity and maternal mortality. Intrauterine contraceptive devices which are among the safest and most effective reversible contraceptives available; are particularly suitable for women in developing countries as they are affordable; convenient to use; do not require re-supply visits and are very cost-effective. The aim of this study is to determine the socio-demographic characteristics of intrauterine contraceptive device acceptors; the pattern of insertions and complications at the University of Uyo Teaching hospital; Uyo. Method: The record cards of all clients who had intrauterine contra- ceptive device inserted at the family planning clinic over a six-year period were reviewed. Results: During the study period; there were 852 new contraceptive acceptors out of which 39.7accepted the intrauterine contraceptive device. The modal age group of the clients was 25-29 years (32.5). Acceptance of intrauterine contraceptive device was most common among multiparous clients (65.1). Majority of the acceptors were married (90.0); Christians (98.8) and 72.8had at least secondary school education. Clinic personnel (65.7) and friends/relatives (21.3) were the most common sources of information on contraception. Most (93.5) of the clients had their intrauterine contraceptive devices inserted within 7 days of menstruation. Lower abdominal pain (5.5) and vulval/vaginal itching (5.3) were the most common complications. Conclusion: The acceptors of intrauterine contraceptive devices in our center were young; multiparous and educated women. Increasing mass media involvement in the dissemination of accurate information about intrauterine contraceptive devices to the general populace; the introduction of postpartum and post-abortal intrauterine contraceptive device insertions and the encouragement of our grandmultiparous women to accept intrauterine contraceptive device would lead to an increase in its acceptance and use