Prevalence and outcome of pregnancy among elderly primigravida in Aminu Kano teaching hospital, Kano: a 5 year review

Background: As women increasingly delay child bearing, the proportion of women having their first delivery at ''advanced maternal age'' is expected to rise. These elderly primigravidae have traditionally been considered to be at increased risk of adverse maternal and perinatal outcomes compared to their younger counterparts, because of associated pregnancy and labour complications. Objectives: To determine the prevalence of elderly primigravidae and compare their pregnancy outcome with that of younger primigravidae in Aminu Kano Teaching Hospital, Kano. Materials And Methods: This was a retrospective case control study comparing the pregnancy outcome of primigravid mothers aged 35 years and above (elderly primigravidae) with those of younger primigravidae aged 20-25 years, who delivered at Aminu Kano Teaching Hospital between January 2009 and December 2013. Results: There were 18,452 deliveries during the period under review, out of which 295 were primigravidae aged 35 years or above giving a prevalence of 1.6%. There was statistically significant higher preterm delivery rate ( X2= 10.30, P= 0.001) and caesarean delivery rate (X2= 12.15, P= 0.0001) among the elderly primigravidae compared to younger primigravidae. The elderly primigravidae were more prone to hypertensive disorders in pregnancy (X2=23.96, P=0.0001) and diabetes (X2=4.689, P=0.030) compared to the younger primigravidae. The prevalence of antepartum haemorrhage (X2=6.434, P=0.011) and uterine fibroids (X2=5.549, P=0.019) were also statistically significant among the elderly primigravidae compared to the younger primigravidae. There was no significant difference in the other maternal and foetal outcome measures. Conclusion: The prevalence of elderly primigravidae in this study was 1.6%. The prevalence of obstetric complications such as preterm delivery, antepartum haemorrhage, uterine fibroids coexisting with pregnancy and medical conditions like hypertensive disorders in pregnancy and diabetes mellitus are higher among elderly primigravidae compared to younger primigravidae. The elderly primigravidae were also more liable to have caesarean deliveries than the younger primigravidae. However there was no difference in the fetal outcome in the two groups

Bacterial Profiles Associated With Captive Non-Human Primates in Jos Zoo, Nigeria.

Non-human primates (NHPs) are distributed worldwide and have several unique features that may account for opportunistic and pathogenic zoonotic bacteria. Aim: To evaluate the incidence of enteric organisms with zoonotic and biohazard potential in captive NHPs in a zoo setting. Study Design: Descriptive study. Place and Duration of Study: This study was conducted in Jos, Plateau State, Nigeria between June-September, 2012. Methodology: We examined 33 clinically healthy young adult monkeys and apes over a three months interval. The animals were sampled at six weeks intervals by faecal culture. Samples were inoculated on appropriate media using specific selective culture methods. Suspect isolates potentially transmissible to humans were purified and identified based on their cultural and biochemical characteristics. Results: The survey revealed six (6) bacterial pathogens using API 20E, Escherichia coli (100.0%), Salmonella paratyphi A 31(93.9%), Proteus mirabilis 14(42.4%), Campylobacter species 6(18.2%), Citrobacter ferundii 7(21.2%), and Yersinia enterocolitica 3(9.1%). Conclusion: The incidence of infections during the period of study (first week and the twelfth week) indicated increased patterns of transmission between species of primates. Research among primate populations has the potential to predict which pathogens might enter human populations as human contact with these animals both in captivity and in the wild is on the increase.

From mental health policy development in Ghana to implementation: what are the barriers?

Objective: This paper identifies the key barriers to mental health policy implementation in Ghana and suggests ways of overcoming them. Method: The study used both quantitative and qualitative methods. Quantitatively; the WHO Mental Health Policy and Plan Checklist and the WHO Mental Health Legislation Checklist were employed to analyse the content of mental health policy; plans and legislation in Ghana. Qualitative data was gathered using in-depth interviews and focus group discussions with key stakeholders in mental health at the macro; meso and micro levels. These were used to identify barriers to the implementation of mental health policy; and steps to overcoming these. Results: Barriers to mental health policy implementation identified by participants include: low priority and lack of political commitment to mental health; limited human and financial resources; lack of intersectoral collaboration and consultation; inadequate policy dissemination; and an absence of research-based evidence to inform mental health policy. Suggested steps to overcoming the barriers include: revision of mental health policy and legislation; training and capacity development and wider consultation. Conclusion: These results call for well-articulated plans to address the barriers to the implementation of mental health policy in Ghana to reduce the burden associated with mental disorders