Prevalence of vaginal group-b-streptococcus, antibiotic and antigen sensitivity amongst parturients at the federal medical center owerri, Nigeria

BACKGROUND: Group B streptococcus (GBS) is one of the principal agents of early onset neonatal sepsis, pneumonia and meningitis with significant morbidity for newborns and parturients.AIM: This study was done to determine the prevalence of vaginal group B streptococcus amongst parturients in FMC Owerri. It also aimed to elucidate the antibiotic sensitivity of the strains of GBS isolated while comparing the sensitivity of antigen detection tests of GBS to culture.PATIENTS AND METHODS: This cross-sectional study was done at the labour ward and lying-in units of the Federal Medical Center, Owerri,from February 2015 to October, 2015. It involved one hundred and eighty (180)womenrecruitedsystematically. Two swab samples, high vaginal and rectal were collected from the parturients intrapartum and cultured. The babies were examined and weighed immediately after delivery, seen on the second and tenth days after delivery for features of fever or any other complaints. RESULTS: The overall prevalence of GBS amongst parturients was found to be 6.1%. Prevalence of vaginal colonization was 3.3% and that of the rectum was 2.8%, (2c=0.1282, df=1,p=0.502). Neonates with colonized mothers all had complaints of fever postpartum which was statistically significant (=55.86, df=1, p<0.001). All the microbes showed 100% sensitivity to penicillin G, erythromycin, gentamycin and ceftriaxone. Antibiotic resistance was discovered in augmentin (67%), Cloxacillin (55.6%) and ofloxacin (33.3%). Antigen detection tests gave Sensitivity=100%, specificity=96.4%, positive predictive value (PPV) = 64.7%, negative predictive value (NPV) =100%. Detection in both vaginal (=60.290, p=0.000) and rectal (=50.799, p=0.000) samples were statistically significant. CONCLUSION: The prevalence of GBS in parturients in the Centre is low. Strains of GBS isolated amongst the sampled population in FMC Owerri had a high sensitivity to penicillin G, erythromycin, gentamycin and 3 generation cephalosporins. Antigen detection method for screening of GBS though very sensitive is however not specific with a significant false positive detection rate due to antigen cross reaction. It is however recommended that antigen detection be employed as intrapartum measure in high risk cases to reduce turnover time whilst supported by culture results later. There was associated significant neonatal sequaelae and further research to establish causal relationship will be advised

Stillbirth Rate in a Teaching Hospital in South-eastern Nigeria: A Silent Tragedy

Stillbirths often are not seen as a major public health problem; for despite increasing attention and investment on maternal; neonatal; and child health; stillbirths remain invisible. Aim: The objective of this study was to determine the stillbirth rate at the Imo State University Teaching Hospital; Orlu. Subjects and Methods : Analysis of the case records of stillbirths that occurred in the institution over a 5-year period from 1 st July 2005 to 30 th June 2010 was made. Data retrieved was analyzed for age of the women; parity; presumptive risk factor for the stillbirth; and booking status of the women. Also; the total births during the period of study were obtained. A P-value of 0.05 is said to be significant at confidence level of 95 (95/100). Results : There were a total of 1;142 deliveries within the study period; out of which 206 resulted in stillbirths. This gave an institutional stillbirth rate of 18 (180/1000 deliveries). One-hundred and fifty-five 75.2 (155/206) of the stillbirths were macerated stillbirth. The age range of the women was 15-44 years. The modal age was 31 years. The age group of 26-30 years had the highest prevalence rate of stillbirths of 79 (38.3; 79/206); while age group of more than 40 years contributed the least with four stillbirths 4 (1.9; 4/206). Conclusion : The stillbirth rate at the institution is too high and efforts must be made to reduce it

Preliminary Outcome of the Management of Eclampsia at the Imo State University Teaching Hospital

Background: Eclampsia continues to be a major cause of maternal and perinatal mortality in developing countries. Early identification and management of pre-eclampsia will help reduce the mortality due to eclampsia. Aim: This study aims at determining the prevalence and management outcome of eclampsia in our centre with a view to proffering solutions for an optimal or near optimal care.Methods: A retrospective review of the case records of patients managed for eclampsia at the Imo State University Teaching Hospital (IMSUTH); Orlu from 1st October 2004 to 30th September 2009 was carried out. Data on socio-demographic characteristics as well as clinical management and outcome were extracted and analyzed.Results: The prevalence of eclampsia was 2.7of all the deliveries. The prevalence was significantly higher in the unbooked than the booked patients (p0.05). The prevalence was also significantly higher in primigravidae than in multiparae (p0.05). Twenty-eight (93.3) of the eclampsia occurred antepartum. Twenty-eight (93.3) had severe hypertension on presentation. Twenty nine (95.8) of the patients had 2-5 episodes of convulsions prior to presentation to the hospital. Twenty-six (86.7) of the patients had emergency Caesarean section was carried out; mostly for unfavourable cervix. The perinatal mortality was 6.7while maternal mortality was 3.3. Complications included acute renal failure; aspiration pneumonitis and abruptio placentae. Conclusion: The prevalence of eclampsia is unacceptably high in our centre. Early antenatal booking; antenatal care follow-up to identify the imminent signs and prompt treatment of cases of pre-eclampsia will reduce the burden of eclampsia in this environment

HIV/AIDS: what do Secondary School Students know and think ?

Objective: To determine the level of awareness; knowledge and attitude of secondary school students in Owerri to HIV/AIDS. Methods: Semi-structured questionnaires were administered to six hundred randomly selected secondary school students from four secondary schools and the results were analyzed. Results: There was no significant difference in results from both sexes. All the students were aware of the disease. Viral aetiology was mentioned by 77.2 of all the students while 74.8 and 85.4 mentioned mother- to- child transmission and sexual intercourse respectively as modes of transmission. Blood transfusion and sharing of needles and syringes were mentioned by 92.8 and 96.4 of the students respectively. Only 58.1 knew about the condom as a method of prevention. The students demonstrated a poor attitude to HIV/AIDS positive patients as 78.2 would not employ them while 10.6 want them isolated and 36.8 would avoid them. Mass media ;television ( (32.4 ) ; radio ( 23.5)) and health sources ( 26;1 ) were the major means of information. Conclusion: Because of the deficiencies in knowledge and the poor attitude of the students; these highlighted areas should be emphasized in media adverts. The introduction of reproductive health studies in secondary school curricula may also help in addressing these identified deficiencies