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
Background: Pregnancy and childbirth are thought to be associated with development of lower urinary tract symptoms (LUTS). The study aimed at ascertaining prevalence rates of LUTS before and during pregnancy; the determinants and perceived effects of these symptoms on the life of the women. Materials and Methods: Questionnaires in which LUTS were defined according to recommendations of International Continence Society was administered on consecutive women who delivered at ?37 weeks' gestation to ascertain the presence or absence of LUTS before and during pregnancy and perceived effects on their life. Data was also collected on their socio-demographic and obstetric features. Descriptive statistics and relationship between LUTS and other variables were analyzed using SPSS version 16. Results: Prevalence rates of LUTS before and during pregnancy were 52.9 and 89.2; respectively; and mostly included nocturia and stress urinary incontinence. Women were more likely to develop LUTS during pregnancy (P = 0.002; OR 4.99; 95 CI 1.793 - 13.906). Only 14.4 and 41.7 reported any burden on their daily life before and during pregnancy; respectively. Previous vaginal delivery (P = 0.01; OR 3.12; 95 CI 2.91-5.62); grand-multiparity (P = 0.04; OR 4.15; 95 CI 3.82-7.24) were associated with LUTS prior to pregnancy while presence of LUTS before pregnancy (P = 0.001; OR 10.80; 95 CI 4.24-27.52); previous vaginal delivery (P = 0.002; OR 6.38; 95 CI 4.25-12.43) and moderate maternal obesity (P = 0.03; OR 2.56; 95 CI 1.82-3.47) were predictive of LUTS during pregnancy. Conclusion: LUTS are common among women both before and during pregnancy but most of them were not bothered by the LUTS. Those with previous vaginal delivery and are grand-multiparous are more likely to develop LUTS prior to pregnancy while the presence of LUTS before pregnancy; vaginal delivery and maternal obesity are determinants of LUTS during pregnancy