Hepatitis B Virus Infection amongst Pregnant Women in North-Eastern Nigeria- A Call for Action

Background: It is well known that Hepatitis B virus infection is endemic in Nigeria. Even though studies have been carried out on Hepatitis B virus infection in different parts of Nigeria; and in different sub-groups of individuals; information regarding the prevalence of Hepatitis B virus infection in pregnant women is scanty especially from the North-eastern region of Nigeria. We therefore determined the seroprevalence of Hepatitis B surface antigen (HBsAg) amongst pregnant women in North Eastern Nigeria. Materials and Methods: A hospital-based cross-sectional study was carried out. The setting was the ante-natal clinic of the Federal Medical Centre; Yola; Nigeria. The duration of the study was from July 2008 to December 2008. Two hundred and thirty-one consecutively recruited pregnant women were screened for Hepatitis B surface antigen. Positive samples were re-tested using ELISA to eliminate false positives. Their biodata were obtained using a questionnaire to establish the presence of possible risk factors such as blood transfusion; surgery; etc. Written informed consent was obtained from each woman. Results: Out of the 231 pregnant women tested; nineteen of them were seropositive for Hepatitis B virus infection giving an infection rate of 8.2. Women in the age group 25-29 years had the highest HBV infection rate. Conclusion: This study confirms a high seroprevalence of Hepatitis B virus infect ion amongst pregnant women. It is recommended that pregnant women should be routinely screened for Hepatitis B virus infection as part of antenatal care services

Hepatitis B Virus Infection amongst Pregnant Women in North-Eastern Nigeria- a Call for Action

Background: It is well known that Hepatitis B virus infection is endemic in Nigeria. Even though studies have been carried out on Hepatitis B virus infection in different parts of Nigeria; and in different sub-groups of individuals; information regarding the prevalence of Hepatitis B virus infection in pregnant women is scanty especially from the North-eastern region of Nigeria. We therefore determined the seroprevalence of Hepatitis B surface antigen (HBsAg) amongst pregnant women in North Eastern Nigeria. Materials and Methods: A hospital-based cross-sectional study was carried out. The setting was the ante-natal clinic of the Federal Medical Centre; Yola; Nigeria. The duration of the study was from July 2008 to December 2008. Two hundred and thirty-one consecutively recruited pregnant women were screened for Hepatitis B surface antigen. Positive samples were re-tested using ELISA to eliminate false positives. Their biodata were obtained using a questionnaire to establish the presence of possible risk factors such as blood transfusion; surgery; etc. Written informed consent was obtained from each woman. Results: Out of the 231 pregnant women tested; nineteen of them were seropositive for Hepatitis B virus infection giving an infection rate of 8.2. Women in the age group 25-29 years had the highest HBV infection rate. Conclusion: This study confirms a high seroprevalence of Hepatitis B virus infect ion amongst pregnant women. It is recommended that pregnant women should be routinely screened for Hepatitis B virus infection as part of antenatal care services

Vesicovaginal Fistula: a Review of Nigerian Experience

BACKGROUND: Vesicovaginal fistula is a preventable calamity; which has been an age-long menace in developing countries. OBJECTIVE: To review the causes; complications; and outcome of vesicovaginal fistula in Nigeria. METHODS: Studies on vesicovaginal fistula were searched on the internet. Information was obtained on Pubmed (medline); WHO website; Bioline Innternational; African Journal on Line; Google scholar; Yahoo; Medscape and e Medicine. RESULTS: Many Nigerian women are living with vesicovaginal fistula. The annual obstetric fistula incidence is estimated at 2.11 per 1000 births. It is more prevalent in northern Nigeria than southern Nigeria. Obstetric fistula accounts for 84.1-100of the vesicovaginal fistula and prolonged obstructed labour is consistently the most common cause (65.9-96.5) in all the series. Other common causes include caesarean section; advanced cervical cancer; uterine rupture; and Gishiri cut. The identified predisposing factors were early marriage and pregnancy; which were rampant in northern Nigeria; while unskilled birth attendance and late presentation to the health facilities was common nationwide. Among the significant contributory factors to high rate of unskilled birth attendance were poverty; illiteracy; ignorance; restriction of women's movement; non-permission from husband; and transportation. All but one Nigerian studies revealed that primiparous women were the most vulnerable group. Pregnancy outcome was dismal in most cases related to delivery with still birth rate of 87-91.7. Stigmatization; divorce and social exclusion were common complications. Overall fistula repair success rate was between 75and 92in a few centres that offer such services. CONCLUSION: Vesicovaginal fistula is prevalent in Nigeria and obstetric factors are mostly implicated. It is a public health issue of concern