Use and pattern of previous care received by infertile Nigerian women.

BACKGROUND: Prevalence of infertility in sub-Saharan Africa is high yet fertility care, its development and access is limited in resource-poor countries like Nigeria so infertile women resort to different forms of treatment. This study aimed to determine the use and pattern of previous treatments. METHODOLOGY: This was a descriptive Cross Sectional study conducted at a tertiary hospital in North-Western Nigeria. Interviewer administered pretested questionnaires were administered to 236 consenting clients seen at their first visit to the gynaecology clinic with complaints of inability to conceive, between January 2016 to March 2018. We collected information on demographic and reproductive characteristics, previous fertility treatment and other data relevant to infertility. Descriptive analysis was done using SPSS software version 22. RESULTS: Two hundred and thirty six clients participated in the study and majority were 20-29 years (44.5%), with a mean age of 31.5 ± 7.4, while the mean age of their husbands was 41 ± 8.0. More clients were educated up to secondary level or above (80.9%), with more Muslims (65%) than Christians. All clients were married except one, most clients had been married for 5 years or more, 18.2% were in their second order of marriage and 28% were in polygamous marriages. Many of the clients were homemakers (46.6%) and earned an average monthly income of less than fifty thousand naira. About 59.3% of clients presented with primary infertility, with 15.7% being infertile for duration of more than 10 years. One hundred and forty six respondents (61.9%) had received previous hospital treatments before presentation to our facility, 37% had visited more than three hospitals, 70% did not have adequate investigations done, treatment was successful in 15% while 40.7% received traditional treatments. Husbands of women receiving previous treatment were slightly older (p value < 0.05). CONCLUSION: Majority of woman have multiple and unnecessary visits to several hospitals for infertility care with little positive results despite time and resources spent. Quality of infertility care needs to be improved.

Pattern of pediatric HIV/AIDS: a five-year experience in a tertiary hospital.

OBJECTIVES: to determine the mode of transmission, clinical presentation and the outcome in children with HIV/AIDS at the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. METHODOLOGY: a five-year retrospective study of children with HIV/AIDS from January 2001 to December 2005. Screening was based on World Health Organization criteria. Confirmation of HIV seropositivity was from a positive ELISA and then a western blot assay. RESULTS: 10,107 children were admitted over the said five-year period; 1,359 died, giving a mortality rate of 13.5%. Eight-hundred-forty (8.3%) of the admitted children had HIV/AIDS; 305 (36.3%) died. Mother-to-child transmission accounted for the highest mode of transmission, 794(94.5%). There were 44 (5.3%) cases of unidentified route of infection and two (0.2%) cases of sexual abuse in males aged 11 and 13 years. Fever (81.3%), diarrhea (75.0%), vomiting (41.4%), difficulty in breathing (39.8%) and refusal of feeds (39.8%) were the commonly encountered clinical features. Septicemia (49.5%) and acute respiratory tract infections (40.9%) were the major admitting diagnoses and major causes of deaths. Deaths from HIV infection accounted for 22.4% of the total deaths for the study period. CONCLUSIONS: Mother-to-child transmission of HIV is still high in the area of study, and pediatric HIV/AIDS remains a significant cause of childhood morbidity and mortality. Present efforts to strengthen and sustain prevention of mother to child transmission are highly encouraged. Advocacy for protection of children against sexual abuse should be strengthened.

The use of the condom-catheter for the treatment of postpartum haemorrhage - the Sokoto experience.

Postpartum haemorrhage (PPH) is the most common cause of maternal mortality globally. In about 50% of cases PPH is due to uterine atony. When conservative and medical methods of treating PPH due to uterine atony fail, surgical intervention is required to save the woman's life. As an alternative in such cases, intrauterine tamponade has been used successfully to stop bleeding, thus avoiding surgery. We report four cases of PPH due to uterine atony in which intrauterine tamponade with an inflated condom was effective in arresting haemorrhage. We advocate the use of a similar device in carefully selected cases, especially in low-resource settings.

Carcinoma of the Cervix in Sokoto, Northern Nigeria

Background: Cancer of the cervix, a preventable disease, is the second most common cause of cancer-related morbidity and mortality in women in the developing world. Experience of the disease in Sokoto is lacking in the literature. The aim of this study is to determine the demographic characteristics, clinical features, stage of the disease at presentation and outcome in cases of carcinoma of the cervix in the Usmanu Danfodiyo University Teaching Hospital(UDUTH), Sokoto. Materials and Methods: A descriptive retrospective study of all patients diagnosed with carcinoma of the cervix between January 1998 and December 2003 at UDUTH, Sokoto. Results: There were 100 cases of carcinoma of the cervix during the 6-year study period. The peak age incidence was in the 50-59 year age group(30), and mean age was 48 years. Parity ranged from 0 to 13. Sixty-seven percent(67) of patients were Para 5 and above. The main clinical features were irregular vaginal bleeding, postmenopausal bleeding, offensive vaginal discharge and abdominal/pelvic pain. Eighty-nine percent (89) of patients presented in advanced stages of the disease(Stage IIb to IV). Most patients were not able to receive radiotherapy and were lost to follow-up. Conclusions: Carcinoma of the cervix in Sokoto is a disease of grandmultiparous women who usually present at the advanced stages. Prognosis is poor due to late presentation and inability to afford the cost of radiotherapy. It is recommended that measures to prevent carcinoma of the cervix must be put in place, chief amongst which is the implementation of a population-based screening programme