ABSTRACT
Background: Human immunodeficiency virus (HIV) infected pregnant women represent a unique population and co-infection with hepatitis B Virus (HBV) is considered a major health problem worldwide. Aims: This study was undertaken to determine the prevalence and determinants of hepatitis B infection among a group of HIV positive pregnant women in Jos, Nigeria. Study Design: Descriptive cross sectional study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Jos University Teaching Hospital, Jos, between December 2011 and May, 2012. Methodology: A cross sectional study among consecutive HIV positive pregnant women at the antenatal clinic of the Jos University Teaching Hospital (JUTH), Jos, over a 5-month period. Hepatitis B surface antigen (HBsAg) detection was done using in vitro diagnostic kit. Reactive samples were confirmed by Enzyme Linked Immunosorbent assay (ELISA) kit. Information on socio-demographic characteristics and other risk factors associated with the prevalence of HBsAg among HIV positive pregnant women were obtained from participants using pre-tested questionnaires. Data was analyzed using Epi info statistical software version 3.5.1 (CDC, Atlanta Georgia, USA). Results: Among the 124 HIV positive pregnant women studied, 15 (12.1%) were positive for HBsAg. HIV/ HBV co-infection rates were highest among the age group 31–40 years, unmarried, uneducated, multigravidae, those at third trimester of pregnancies, with multiple sex partners, and those with history of STI, low CD4 count and high viral load. Statistical analysis showed significant association between multiple sex partners (P = 0.017), history of jaundice (P = 0.001), low CD4 count (P = 0.006), high HIV viral load (P = 0.001) and hepatitis B infection among the study population. Conclusion: Prevalence of hepatitis B virus infection among HIV positive pregnant women among this group of Nigerian women is high. Intensive free hepatitis B screening among HIV positive pregnant women attending ante-natal clinics as a policy especially those with history of multiple sexual partners, jaundice, low CD4 count and high viral load is recommended so as to immunize those without HBV infection.
ABSTRACT
Aims: The aim of the study was to evaluate the accuracy of the symphysio-fundal height (SFH) in comparison to the last menstrual period (LMP) for gestational age assessment. Study Design: Hospital-based prospective cross sectional study. Place and Duration of Study: Maternity unit of the Jos University Teaching Hospital, Jos, Nigeria, between December 2012 and April 2013. Methodology: A total of 289 consecutive consenting women with singleton uncomplicated pregnancies at gestational ages of less than or equal to 20 weeks were recruited at the maternity unit of Jos University Teaching Hospital between December 2012 and April 2013. Ultrasound scan (USS) was used to confirm eligibility after which other information including the LMP were documented on a questionnaire. The women returned after 22 weeks’ gestation based on ultrasound recorded GA for SFH assessment and some weeks thereafter for a second SFH assessment. Results: Mean age of the women was 28.9±4.8 years with a range of 16-42 years. Most of them were of parity 1 – 4 (58.1%). The mean GA at booking was 15.3±3.1 weeks based on LMP and 14.9±3.1 from early ultrasound scan. The mean percentage accuracy for SFH method compared to USS dating was 95.8% while that of LMP was 91.0%. This difference was found to be statistically significant (P = .02). Conclusion: The study showed a significant difference between the LMP and early ultrasound scan dating but not between SFH and early ultrasound scan. Also, the mean percentage accuracy was statistically higher for SFH, suggesting that SFH was a more accurate tool for gestational age assessment among these women.
ABSTRACT
Aim: To determine the prevalence and determinants of anaemia in HIV positive pregnant women attending ante-natal clinic at Jos University Teaching Hospital, North-Central Nigeria. Methods: A cross sectional study was carried out among HIV positive pregnant women as the study group and HIV negative pregnant women as control group at the ante-natal clinic of the Jos University Teaching Hospital (JUTH) Jos, North-Central Nigeria from January to December 2007. The prevalence of anaemia in the experimental group was determined. The possible determinants of anemia were ascertained and the relationship between variables determined using methods of linear regression and chi square test. Results: A total of 230 pregnant women were recruited for the study (115 HIV positive versus 115 HIV negative). The overall prevalence of anemia was 27.6%. The prevalence among HIV positive pregnant women was 33.7%, compared to a prevalence of 21.7% among HIV negative pregnant women. This difference was however not statistically significant. There was a statistically significant relationship between the use of antiretroviral therapy and the development of anaemia (X2 = 5.98, P = 0.014, OR = 1.15). An inverse relationship was established between haemoglobin status and viral load. Conclusion: The prevalence of anemia is high among HIV positive pregnant women. There is an inverse relationship between viral load and haemoglobin status. The use of highly active anti-retroviral therapy (HAART) for the management of these patients can be regarded as good practice since ART reduces viral load.
ABSTRACT
Background: HIV/AIDS is a scourge that has seriously compromised the lives of millions of people; especially those living in sub-Saharan Africa. With continued high prevalence; there is a high risk of healthcare workers; especially those in the surgical specialties; acquiring the infection. This study was done to investigate the impact of HIV on the choice of surgical specialties in a training institution located in Jos; north-central Nigeria. We hypothesized that the awareness of the risk of acquiring infections associated with surgical practice has no significant impact on the choice of surgical specialties among final-year medical students and house officers at our institution. Method: A cross-sectional questionnaire based survey was conducted on final-year medical students and house officers during their training in Jos University Teaching Hospital (JUTH); Jos. Two hundred questionnaires were randomly distributed to final year medical students and house officers who volunteered to participate in the survey. The completed questionnaires were returned to the researchers and information obtained was analyzed using Epi info 3.3. Results: Of the 200 questionnaires distributed; 135 with relevant information were returned for analysis; giving a response rate of 67.5. Of these respondents; 96.3said they planned to specialize after their basic medical training and the majority of these (97.8) were aware of the increased risk associated with surgical specialties; with 83.7acknowledging the transmission of HIV and hepatitis B as being the greatest risk. About 53.0of the respondents said they planned to pursue surgical specialties. Fifty three percent (53.3) and sixteen Percent (16.3) based their choice of specialty on job satisfaction and favourable work schedule respectively. The knowledge of the risk of acquiring HIV/AIDS affected choice of specialty in only 21of the respondents. Conclusion: The awareness of most recently graduated medical doctors and final-year medical students of the risk of acquiring HIV in surgical specialties seems to have not deterred them from wanting to pursue surgical specialties. We recommend improvements in the work environment and adherence to universal precautions to reduce the risk of transmission of HIV and other infections to surgeons practicing in the region