RESUMO
Background: The aim of the study was to determine the performance of history of risk factors and universal HBA1c testing as screening tools for diabetes mellitus in the first trimester of pregnancy using OGTT as a gold standard.Methods: A prospective cross-sectional study conducted between 8 and 13±6 weeks in 305 consecutive pregnancies in the antenatal clinics of the University of Port Harcourt Teaching (UPTH) and Rivers State University Teaching Hospital (RSUTH) between January and August 2020. Each woman had oral glucose tolerance test (OGTT), and glycosylated haemoglobin (HBA1c) levels estimation. Multivariate logistic regression analysis was carried out with history of risk factors and HBA1c level as independent variables and OGTT as the dependent variable for the assessment of their predictive performances.Results: The prevalence of DM was 28.85%, 2.62% and 31.48% for GDM, pre-gestational and for both respectively. Family history of DM was associated with high specificity (91.4%) and negative predictive value (NPV) of 68.7% but low sensitivity (9.4%) and positive predictive value (PPV) (33.3%). The receiver operator characteristic curve for HBA1c revealed a significant area under the curve value: 0.653 (CI: 058-0.72), p<0.01. The optimal cut-off for HBA1c from Youden index was 5.25%. HBA1c levels had high specificity (88.5%) and NPV (75.2%) with low sensitivity (36.5%) and PPV (59.3%). Multivariate logistic regression analysis showed HbA1c as the only independent predictor of GDM (p=0.0001).Conclusions: The high prevalence of diabetes (31.48%), underscores the need for universal screening in early pregnancy. The high NPV and specificity of the risk factors for GDM and HBA1c levels better predict pregnancies that are not likely to develop GDM, but they are not suitable for diagnosis because of the low sensitivity and PPV.
RESUMO
Background: Infertility is a common reason for gynecological clinic visits in Nigeria. Men contribute significantly to the cause of infertility; however male factor infertility remain underreported compared to commonly reported female factor infertility. This study aimed to evaluate the abnormalities of semen parameters among male partners of infertile couples in Irrua Specialist Teaching Hospital in Edo State, Nigeria.Methods: A prospective cross-sectional study of 285 semen samples of male partners of infertile couples was conducted at Irrua specialist teaching hospital. The laboratory staff carried out analysis of the semen samples using set parameters outlined by the World Health Organization laboratory manual for the examination and processing of human semen. Socio-demographic data of the participants was also taken in a proforma. The data obtained was then analyzed with the Statistical Package for Social Sciences.Results: The age range of participants in this study was 20 to 65 years, with a mean age of 33.38 years. A total of 80.7% of the cases reviewed had one or more abnormal semen parameters. In 45.6%, 51.6%, and 47.0% of the analyzed samples, sperm cell count, morphology and total motility were below the WHO reference level, respectively. The severe forms of abnormal semen analysis findings detected in this study were asthenozoospermia (47%), oligozoospermia (15.8%), azoospermia (45.6%), and oligoasthenoteratozoospermia (15.5%). There was also statistically significant finding of rising cases of oligospermia with increasing age among the participantsConclusions: Male factor infertility although grossly under reported, contributes significantly to the burden of infertility in our setting. There is a need to raise awareness so that men are properly evaluated and treated.