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Background: Infection with hepatitis B (HBV) and human immunodeficiency virus (HIV) are global public health problems. These infections during pregnancy increase the risk of maternal morbidity and mortality, and also pose a risk to the fetus due to mother to child transmission.Objective:To determine the prevalence of seropositive HIV and HBsAg cases amongst pregnant women at the Rivers State University Teaching Hospital (RSUTH).Methodology:A retrospective review of hospital and laboratory records of all pregnant women booked at RSUTH in two years, from May 2017 to April 2019, was carried out. Data on patients’ age, parity and educational leveland reactivity of HIV and HBsAgtest at booking were retrieved Original Research Article using structured proforma and analyzed using Epi Info Version 7. Test for significance using Chi-square was set at a significant level of P<0.05.Results:3560 patients had HIV and HBsAg screening out of which 148 (4.2%) and9 (0.3%) respectively were positive. The comorbidity rate in this study was 0.06%. The mean age was 31.5±4.7 years and the mean gestational age at booking was 22.1±6.8 weeks. There was no significant relationship between their age (χ2 = 2.690, p-value=0.442) and parity (χ2 = 3.759, p-value=0.145) with HIV seropositivity, but these were significant for HBsAg (χ2 = 13.691, p-value=0.003) (χ2 = 13.121, p-value=0.001). Educational status was significant for HIV (χ2 = 16.188, p-value=0.000) but not for HBsAg (χ2 = 0.229, p-value=0.892).Conclusion: The seroprevalence rate of HIV and HBsAg in this study were low. HIV seroprevalence was significantly affected by lower education, while HBsAg seroprevalence was significantly affected by younger maternal age andnulliparity. Continued screening of pregnant women for these infections remains valuable and further community-based studies to identify risk factors are recommended
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Background: Untreated maternal syphilis is strongly associated with adverse birth outcomes. The WHO recommends routine serological screening in pregnancy. Some workers have advised a reappraisal of this practice, having demonstrated low seroprevalence in their antenatal population.Objective:To determine the prevalence of seropositive VDRL cases amongst pregnant women at the Rivers State University Teaching Hospital (RSUTH) in order to justify the need and cost-effectiveness for continued routine syphilis screening using VDRL alone.Methodology:A retrospective review of hospital and laboratory records of all pregnant women booked for antenatal care (ANC) at RSUTH in a two-year period, from May 2017 to April 2019, was carried out. Data on patients’ age, parity and educational level, and reactivity of VDRL test at booking were retrieved using structured pro-forma and analyzed using Epi Info Version 7. Test for significance using Chi-square was set at significant level of P<0.05.Results:3560 clinic patients had VDRL screening out of which 63 were positive. The overall prevalence rate in this study was 1.8%. The mean age was 31.5±4.7 years and the mean gestational age at booking was 22.1±6.8 weeks. There was no significant relationship between their age (χ2 = 0.403, p-value=0.940), parity (χ2 = 3.707, p-value=0.0.157), and educational status (χ2 = 1.853, p-value=0.396),and seropositivity. The cost of VDRL test per patient in RSUTH is $3, to detect the 63 cases the sum of $10,680 was spent.Conclusion: The seroprevalence rate of syphilis in this study was low. Initial screening using VDRL alone is neither justified nor cost effective. Selective screening based on risk factors and specific test with TPHA is recommended.
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Background: Caesarean section commonly causes moderate to severe pain in the first 24 hours after surgery with associated discomfort, delayed ambulation, difficulty initiating breastfeeding and prolonged hospital stay. Receiving adequate analgesia after caesarean section is very important for the patient’s comfort, overall wellbeing and recovery.Objective:To compare the efficacy, time to rescue-analgesia and side effects of single agent rectal diclofenac versus its combination with intramuscular pentazocine for pain management after caesarean section in Rivers State University Teaching Hospital (RSUTH). Methodology:A randomized double-blind clinical trial was carried out at the RSUTH. A total of 120 patients scheduled for either elective or emergency caesarean section were recruited. Group ‘A’ received rectal diclofenac 100mg and intramuscular placebo (unimodal group) while group ‘B’ received rectal diclofenac 100mg and intramuscular pentazocine 30mg (multimodal group). Socio-demographic information was collected via structured proforma, while Visual Analog Scale (VAS) was used to assess the level of pain. Data were analyzed using SPSS version 20 and statistical significance was set at p< 0.05.Results:The mean ages of respondents in unimodal and multimodal groups were 31.7 ± 4.3 years and 31.3 ± 5.2 years respectively. The difference in the median pain score and range was significant only at 8 hours between the groups, there was no significant difference before and after 8 hours. Although the mean time (in minutes) to first rescue-analgesia was shorter in the unimodal (147.5 ± 60.1) as compared to the multimodal group (170.0), this difference was not statistically significant. There was no side effect noticed in either of the two groups.Conclusion: The combined agents (diclofenac and pentazocine) had a superior analgesic effect to the single agent (diclofenac alone) when given as used in the study.
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Background: Formal education, antenatal care, and improved health services still remain the key to a large-scale reduction in maternal mortality in developing countries. Pregnancy and labourcomplications are most prevalent among unbooked patients compared to booked patients. Prompt and effective treatment will go a long way to reduce these complications.Objective:To determine the pattern of Obstetric referral cases to the Rivers State University Teaching Hospital (RSUTH) and assess time to response by the hospital.Methodology:A retrospective review of hospital records of all pregnant women referred to RSUTH for maternal delivery and care in a six months period, 1stApril to 30thSeptember2015, was carried out. Data on patients’ age, educational level, marital status, gestational age, parity, booking status, time interval between admission and intervention, obstetric diagnoses and outcome were retrieved using structured pro-forma. Data were analyzed using United States CDC Epi Info Version 7.Results:There were 460 cases referred to the hospital, which represents 42.6% of all maternal deliveries, with a mean age of 28.7±4.6 years and median age of 27.0 years. A majority, 73.7% had secondary education, 55.4% were Primigravidae, 55.4% had term pregnancies and 77.8% were booked elsewhere. Over 60% of diagnoses comprised of difficult labour, Pre-eclampsia/Eclampsia and prolonged pregnancy. About 75% of the cases had intervention carried out within 12 hours of arrival to hospital.Conclusion: The pattern of referral cases to our hospital are mainly young educated primigravidae at term, who have had some form of antenatal care and presenting with common complications associated with this group. The intervention response time is good, but we recommend that high risk pregnancies should ab initio be registered at centers properly equipped to handle such cases to avoid calamity
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Background: Early screening for cervical cancer is a key intervention in reduction of maternal deaths. Health care workers have a significant role to improve cervical cancer screening practice among women. Their attitude and practice to such an issue might positively or negatively influence people they come into contact with. Objective: To determine the knowledge, uptake and barriers to Pap smear test among female workers in the Rivers State University Teaching Hospital.Methodology:A hospital-based cross-sectional study was conducted between September and November 2015. A structured and pre-tested questionnaire was used to collect data from 265 female hospital workers on socio-demographic characteristics, knowledge of Pap smear, attitude towards, as well as utilization of Pap smear test. The data obtained were analyzed using SPSS version 20.0.Results:Of the 265 respondents, 237 (89.4%) were aware of Pap smear while 28 (10.6%) had no knowledge; of those that had knowledge only 40 (16.9%) had Pap smear test done at least once previously. There is significant difference in the knowledge of Pap smear among the professionals and those with tertiary education. Common sources of information about Pap smear were Books (58.2%) and Medical Workers (50.6%). Most common reason for not wanting to be screened was No interest (43.6%).Conclusion: Although the knowledge of Pap smear is high, the uptake is low among hospital workers. To improve utilization, public health education on the need for health workers to take up screening is crucial as it will impact positively on the general populace
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Background:Effective contraception can prevent unwanted pregnancy, unsafe abortion and ensure adequate birth spacing. The choice of a method depends on consideration of its advantages and disadvantages based on individual perception and interpretations.Objective:To assess contraceptive choices and acceptability among new clients at the family planning clinic of a tertiary health facility in Rivers State, Nigeria.Methodology: This was a one-year retrospective review of clinical records of new clients attending the Family Planning Unit of the Rivers State University Teaching Hospital from January 1, to December 31, 2018. Data on age, education, marital status, parity, contraceptive choice and reason for contraception were retrieved and analyzed using Epi-Info version 7.1.4.Results:A total of 124 female clients were enrolled during the time period. The mean age of the participants was 33.8±5.1 years and the median parity was 3. The most common method of contraception accepted by the clients was implants 87 (70.2%), followed by intrauterine device 32 (25.8%), then injectable 4 (3.2%) and oral contraceptive pills 1(0.8%). Reasons proffered for use of contraceptive was mainly completed family size 69 (55.6%), pregnancy prevention 53 (42.8%) and child spacing 2 (1.6%). There was no significant difference on comparism of mean age and median parity of clients by choice of contraceptive method.Conclusion: The implant methods were the most commonly accepted, while theoral contraceptive pill was the least preferred. Completed family size was the most common reason for contraception