Placental Malaria and Its Associations with Pregnancy Outcome.

Background: Placental malaria constitutes a risk for both the pregnant women and their unborn child hence there is need to demonstrate the adverse associations between placental malaria and pregnancy outcome. Aim: To demonstrate the adverse maternal and fetal associations with placental malaria Study Design and Setting: This is a cross sectional study carried out at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South East, Nigeria between 1st August, 2012 and 31st January, 2013. Result: Two hundred placentae were analyzed, 141(70.5%) were positive for malaria, Placental malaria was associated with lower maternal pcv (30.67±1.60 vs 32.51±2.82, p-value < 0.001), preterm delivery (OR=4.99, C.I=1.15 – 45.08, p- value=0.020), and low birth weight (OR = 4.71, C.I=1.08 – 42.71, p-value=0.027) but not associated with maternal anaemia (OR=2.27, C.I= 0.90-6.47, p-value=0.063) and perinatal deaths (OR=Infinity, C.I =0.38 – infinity, p-value = 0.143). Conclusion: Placental malaria was associated with low birth weight, lower pcv and preterm delivery but associated neither with maternal anaemia nor perinatal deaths.

Prevalence and Risk Factors for Placental Malaria in Nnewi, South East Nigeria.

Background: Placental malaria is one of the complications of malaria in pregnancy and is associated with poor pregnancy outcome. Demonstration of its prevalence and risk factors will help in modifying the measures in the prevention of malaria in pregnancy and strengthens the effective pre-existing preventive measures in our community. More so, there is paucity of studies of placental malaria in our environment using histology which is the gold standard. Aim: To determine the prevalence and the risk factors for placental malaria. Study Design and Setting: This is a cross sectional study carried out at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South East, Nigeria between 1st August, 2012 and 31st January, 2013. Materials and Methods: A cross section of pregnant women who delivered in the labour ward was recruited for the study. The following data were obtained from those who met the inclusion criteria: age, parity, gestational age, the booking status, educational level and husband’s occupation. The history of Intermittent preventive therapy (IPT), Insecticide treated net (ITN), HIV status, Blood group and Haemoglobin genotype were also obtained. Descriptive analysis of the results was done using the statistical package for social sciences (SPSS) version 16. Univariate analysis and logistic regression were used and the results expressed in Odd ratios (OR) and Confidence interval (C.I). P-value <0.05 was taken as significant level. Result: Out of 200 placentae analyzed, 141 were positive for malaria, giving a prevalence of 70.5%. The commonest form of parasitisation was chronic infection (68.09%) followed by past infection (19.14%) and acute infection (12.77%). Using univariate analysis, the potential risk factors were young age, primigrividity, unbooked status and non use of IPT, non use of ITN, low social class, HIV positivity and haemoglobin genotype AA. However when these were subjected to logistic regression, the independent risk factors identified were young age, primigrividity, unbooked status, non use of IPT and non use of ITN. Conclusion: This study highlighted high prevalence of placental malaria in our environment. The independent risk factors noted were young age, primigrividity, unbooked status, non use of IPT and non use of ITN.

Clinical Presentation of Uterine Fibroids in Nnewi; Nigeria: A 5-Year Review

Background: Uterine leiomyomas are the commonest benign tumors in women; with a higher preponderance amongst Africans. Several etiological factors have been suggested; with subtle variations in clinical presentation being reported in different studies. This may constitute a determinant for the management measures undertaken. Aim: To review the clinical presentation and management measures undertaken for uterine leiomyoma. Subjects and Methods: A retrospective study was conducted at Nnamdi Azikiwe University Teaching Hospital (NAUTH); Nnewi; from January 2002 to December 2006. A review of case records of patients with a diagnosis of uterine leiomyoma was done. The data were analyzed and presented in tables using comparative percentages. Results: Uterine leiomyoma constituted 117 of the 1094 gynecological admissions during this study period (10.7;117/1094). The mean (SD) age of presentation was 35.7 (6.1) years. Most of the patients were nulliparous (76.7;79/103) and 51.5 (53/103) were married. The commonest mode of presentation was lower abdominal mass (66.9;67/103) and the least was recurrent abortion (1;1/103). Surgery was employed in all cases; with myomectomy being the commonest modality used in 90.3 (93/103) of cases. The common postoperative complications were prolonged pain (49.5;51/103) and postoperative pyrexia (34.9;36/103). Conclusion: The symptom of lower abdominal mass correlates with late presentations in our setting. This makes the application of newer therapies like laparoscopic myomectomy difficult even when they are available. Other therapies which are independent of fibroid size (like uterine artery embolization) are not readily available in our environment. This further emphasizes the importance of myomectomy as the most important treatment modality in our environment

Clinical Presentation of Uterine Fibroids in Nnewi; Nigeria: A 5-year review

Uterine leiomyomas are the commonest benign tumors in women; with a higher preponderance amongst Africans. Several etiological factors have been suggested; with subtle variations in clinical presentation being reported in different studies. This may constitute a determinant for the management measures undertaken. Aim: To review the clinical presentation and management measures undertaken for uterine leiomyoma. Subjects and Methods: A retrospective study was conducted at Nnamdi Azikiwe University Teaching Hospital (NAUTH); Nnewi; from January 2002 to December 2006. A review of case records of patients with a diagnosis of uterine leiomyoma was done. The data were analyzed and presented in tables using comparative percentages. Results: Uterine leiomyoma constituted 117 of the 1094 gynecological admissions during this study period (10.7; 117/1094). The mean (SD) age of presentation was 35.7 (6.1) years. Most of the patients were nulliparous (76.7; 79/103) and 51.5 (53/103) were married. The commonest mode of presentation was lower abdominal mass (66.9; 67/103) and the least was recurrent abortion (1; 1/103). Surgery was employed in all cases; with myomectomy being the commonest modality used in 90.3 (93/103) of cases. The common postoperative complications were prolonged pain (49.5; 51/103) and postoperative pyrexia (34.9; 36/103). Conclusion: The symptom of lower abdominal mass correlates with late presentations in our setting. This makes the application of newer therapies like laparoscopic myomectomy difficult even when they are available. Other therapies which are independent of fibroid size (like uterine artery embolization) are not readily available in our environment. This further emphasizes the importance of myomectomy as the most important treatment modality in our environment

Pattern of Semen Fluid Abnormalities in Male Partners of Infertile Couples in Southeastern; Nigeria

Background: A retrospective study of all the semen samples of male partners of infertile couples sumitted for analysis to the microbiology laboratory of Nnamdi Azikiwe University Teaching Hospital; Nnewi Nigeria between 1 January 2006 and 31 December 2006 The reports of the semen fluid analysis were retrieved from the records department and suplemented with the laboratory register. Methods:Aretrospective study of all the semen samples of male partners of infertile couples sumitted for analysis to the microbiology laboratory of Nnamdi Azikiwe University Teaching Hospital; Nnewi Nigeria between 1 January 2006 and 31 December 2006 The reports of the semen fluid analysis were retrieved from the records department and suplemented with the laboratory register. Results :Out of the 348 semen sample reports evaluated; 237 (68.0) had semen fluid abnormalities. 104(30.0) had single factor abnormalities while 133(38.0) had combined factor anomalies. Asthenozoospermia 58(16.7) was the main single abnormality; while Astheno-oligozoospermia 51(14.7) and Astheno-oligoteratozoospermia (13.2) were the major combined factor abnormalities detected. Very few 5(1.4) of the patients had azospermia.Conclusion : The study showed a high rate of semen fluid abnormalities among the male partners of infertile women in our environment. The high preponderance of poor motility emphasizes the need to include men in programmes aimed at reducing sexually transmitted infections in Nigeria

The Pattern of Cervical Cytology in Obstetrics and Gynaecology Clinics in Nnewi; South-Eastern Nigeria

Background: Cervical cytology screening has decreased the incidence of and mortality from invasive cervical cancer in developed and even some developing countries. The story is still different in Nigeria because there is no national screening programme in place.Objectives: The aim of this study was to evaluate the pattern of cervical cytology and relate it to some known risk factors such as age; parity; age at coitarche; number of sexual partners and clinical presentation.Subjects and Methods: A total of 100 women were seen at two Obstetrics and Gynaecology clinics in Nnewi over a three month period (May-July 2005) were screened. Conventional method of staining was used. The first fifty sexually active women that consented to completing the study questionnaire in the two clinics were included.Main Outcome Measures: The work noted the pattern of reports in relation to some known risk factors and adequacy of the sampling.Results: Sampling adequacy was 93; epithelial cell abnormality was reported in only one smear; 58 were reported as normal; 14 showed benign cellular changes (i.e. infective); and 18 reactive changes (i.e. atrophy). Conclusion: Now that infective aetiology has been established in cancer of the cervix; the co-factors may be some of these causes of benign cellular changes of the cervix

Knowledge Attitude and Practice of Cervical Cancer Screening among Sexually Active Women in Onitsha; Southeast Nigeria

Background: Cervical cancer is a major cause of death in the developing world. This high fatality is due to late presentation. It is believed that widespread screening of women for precursor lesion and early detection of the invasive disease can lead to a reduction in cervical cancer and cervical cancer deaths. This study assesses the knowledge; attitude and practice of cervical cancer among sexually active women in Onitsha Southeast Nigeria. Methods: Three major layouts in Onitsha were chosen as the areas of study. In these areas; 5 sites each where major economic activities take place were chosen for the distribution of the questionnaire. A total of 400 pretested questionnaires were administered to women who gave their verbal consent to participate in this study. The data were analyzed using SPSS package for windows version 11.0. Results: The result showed that 76(26.85) of the respondents were aware of cervical cancer screening. Thirty six (47.4) of the aware group knew that the test was a screening test for cervical cancer. There was significant association between the educational status and the knowledge of Pap test but there was no significant association between the educational status and the utilization of the Pap test. Conclusion: This study shows that there is poor awareness and utilization of cervical screening test in our environment. There is therefore an urgent need to establish an aggressive and sustainable awareness campaign on the preventive nature of cervical cancer and further establish an organized cancer screening programme