ABSTRACT
This is a comparative study on the adequacy of cervical smears obtained using the Papcone® sampling device or wooden Ayre's spatula conducted from two tertiary health facilities -- Nnamdi Azikiwe University Teaching Hospital Nnewi and Chukwuemeka Odumegwu Ojukwu University Teaching Hospital Awka, in Anambra State, Nigeria. Slides from smears obtained using both devices were read by a cytopathologist blinded for the study. The primary outcome was the proportion of smears with an adequate endocervical component. Significantly higher adequate cervical smears were obtained in 177/192 (92.2%) women using the Papcone® sampling device, compared to 152/192 (79.2%) using wooden Ayre's spatula (p < 0.001). Kappa analysis showed moderate inter-rater agreement between the two devices. We recommend the use of the Papcone device when it is available, as the adequacy of cervical smears obtained with the Papcone® was better than that obtained using wooden Ayre's spatula.
ABSTRACT
Nigeria has restrictive abortion laws; unsafe abortion and its complications are major public health challenges. Access to reproductive health services in Nigeria, including medical abortion, is poor. We determined the socio-demographic characteristics, patterns of abortion practices, and experiences of medical abortions among abortion seekers in southeastern Nigeria. We carried out a descriptive, cross sectional survey of 100 consecutive medical abortion seekers in southeastern Nigeria. Subjects had a mean age of 23.5 + 4.4 years. Fifty-five percent of respondents were students. Sixty-four percent had a secondary educational level, 33% had a tertiary education level and 3% had a primary educational level. Fifty-eight percent of subjects were ages 18-20 years at coitarche; 25% had one or more previous deliveries and 49% had a previous termination of pregnancy. Forty-eight percent had used drugs for pregnancy terminations. Drugs used for termination included quinine combined with other drugs in 8%; gynaecosid alone in 6%, gynaecosid combined with other drugs in 6% menstrogen combined with other drugs in 6% and an unclassified drug in 14%. Thirty-three percent of subjects purchased their abortion drugs in a pharmacy. Three percent, 2%, and 0% of subjects had a knowledge of misoprostol, mifepristone and methotrexate, respectively. One percent of respondents had used misoprostol. We detected serious information gaps regarding abortion and poor access to reproductive health services. There is a need for policies and program to bridge this gap, and a need for revision of the present Nigerian abortion law.
