Antichlamydia Antibodies and Sperm Quality among Male Partners of Infertile Couples in Nigeria

: The impact of Chlamydia trachomatis on semen quality has been studied with varied results. Aim: To determine the prevalence of antichlamydial antibodies and their relationship with sperm quality among male partners of infertile couples in Enugu, South-East Nigeria. Materials and Methods: It was a cross-sectional study of infertile male partners of couples attending infertility clinics at the University of Nigeria Teaching Hospital (UNTH) Ituku-Ozalla, Enugu, Nigeria. Their sera were assayed for antichlamydial antibodies, and semen analysis and culture were done for each participant. Results: Two hundred and eighty-two (282) male partners of infertile couples were studied. Infertility was commoner among participants aged 40 years or more (45.1%) and was mainly of the "primary type" (62.1%). Antichlamydia antibody was detected in 156 (55.3%) participants and was significantly associated with sperm quality (P = 002; OR = 2.294; 95% CI = 1.36­3.88). Overall, 81 (28.7%) had abnormal sperm quality. The sperm count, progressive motility, and vitality were significantly lower in participants with abnormal sperm quality than those with normal sperm quality (P < 0.001) while morphology, volume, and liquefaction time did not differ significantly (P > 0.05). Staphylococcus aureus was the predominant organism isolated from culture (122/282, 43.3%) while Streptococcus species were the least (4/262, 1.4%). There was significantly more Staphylococcus aureus isolated from the semen of participants that were seropositive to antichlamydial antibodies than those that were seronegative (80/156, 51.3% vs. 42/126, 33.3%; OR = 2.105; 95% CI = 1.30­3.42; P = 0.003). Conclusion: The prevalence of antichlamydial antibodies among male partners of infertile couples in Enugu, Nigeria is high and there is a significant association with sperm quality, sperm count, and bacterial isolates in seminal culture. Male partners of infertile couples in Enugu should be screened for antichlamydial antibodies and appropriate treatment offered wherever indicated. There is a need for increased public awareness and advocacy campaigns on the impact of Chlamydia infection on male factor infertility. This primary preventive measure may help in reducing the burden of Chlamydia infection and male factor infertility.

Acceptability of Human Papilloma Vrus Vaccine and Cervical Cancer Screening among Female Health-Care Workers in Enugu; Southeast Nigeria

Background: Cervical cancer; a leading cause of cancer deaths in women in developing countries can be prevented primarily by vaccinating adolescent girls and women against infection by the human papillomavirus (HPV) before their first sexual exposure; and secondarily through screening and treatment of identified precancerous lesions. Aim: To determine the awareness and acceptability of the HPV vaccine and screening for cervical cancer among female health-care workers in Enugu; southeastern Nigeria. Materials and Methods: Questionnaires were administered to a cross-section of 177 female health-care workers selected systematically from the University of Nigeria Teaching Hospital (UNTH); Enugu; Nigeria. Statistical analysis was both descriptive and inferential at 95confidence level using the Statistical Package for Social Sciences (SPSS) computer software version 16. A P value of less than 0.05 was considered statistically significant. Results: The awareness of screening for cervical cancer (91) was significantly higher than that of the HPV vaccine (62.7) [odds ratio (OR): 0.17; 95 confidence interval (CI): 0.09-0.30]. However; the acceptability rate of the HPV vaccine (91.0) was significantly higher than that of cervical screening (71.4) (OR: 4.04;95 CI: 1.94-8.42)]. Only 25 (14.1) of the health-care workers had done cervical screening; but 30 (49.2) of the 61respondents with adolescent daughters had immunized their daughters with the HPV vaccine. Although no reason was given for the low participation in cervical screening; cost and availability of HPV vaccine was a major deterrent for the latter. Conclusion: With more public enlightenment; available and affordable HPV vaccine appears to hold the key for prevention of cervical cancer in developing countries where the burden is high

A Five-year Survey of Caesarean Delivery at a Nigerian Tertiary Hospital

Background: The rising global rate in caesarean delivery has been a source of concern to obstetricians worldwide. In spite of remarkable improvement in the safety of anaesthesia and surgical techniques; caesarean section has higher risks of maternal death when compared with normal vaginal delivery. Thus; the current emphasis is to limit the rising rate of caesarean section to as much as possible. Objective: To determine the rate of caesarean section; pregnancy out-come; major indications and complications of caesarean section. Methods: A five year (January 1st 2005 to December 31st 2009) retrospective analysis of clinical data from the ward admissions and discharge books; patients' folders and the operating theatre record books at the University of Nigeria Teaching Hospital; Ituku Ozalla; Enugu. Results: Out of the 3;554 deliveries during the study period; 980 cases were by caesarean section; giving a rate of 27.6. Most cases 918 (93.7) were by emergency caesarean sections; with elective procedure accounting only for 6.3of the cases. The age range of the women was between 16-48yrs. Four hundred and seven (41.5) were primigravidae; 503(51.4) were between para one and para four; while 70 (7.1) were grand-multipara. The rate of caesarean section was higher amongst the booked patients; 563 (57.5) than the unbooked patients 355 (36.2). Two previous caesarean section was the commonest indication for caesarean section 211(21.5); followed by cephalopelvic disproportion 198 (20.2); and foetal distress188 (19.2). A total of 1009 babies were delivered through caesarean section by the 980 women; 955 cases of singleton gestations and 25 cases of multiple gestations (21 twins and 4 triplets). Majority of the babies 918 (91) were delivered by emergency procedure. More than half of the babies 582(57.7) had birth asphyxia and there were 39 (3.9) perinatal deaths. All the cases of perinatal deaths and 549 (94.3) of birth asphyxia were following emergency procedure. Anaemia was the commonest postpartum morbidity and the maternal case fatality rate was 0.7. Conclusion: There is now a further rise in rate of caesarean section after a slight drop that followed the initial high 1.5fold rise from previous studies. The perinatal outcome is poor especially following emergency caesarean section. Reducing primary caesarean section rate and more encouragement of vaginal delivery after one previous caesarean section may reduce the prevalence of two previous caesarean sections which is the leading indication for caesarean section in the hospital