ABSTRACT
A case-control study of unbooked mothers delivering at the maternity unit of the Port Moresby General Hospital was undertaken over a period of 7 months. 48 mothers who had no antenatal attendances during pregnancy were recruited with 96 booked controls. Reasons for non-attendance, understanding of the importance of antenatal clinics and socioeconomic and demographic factors were recorded to assess likely risk factors for non-attendance. Almost half the mothers cited financial difficulties as the reason for non-attendance at antenatal clinics despite most of them knowing that it was important to have antenatal care during pregnancy. The two most important risk factors for being unbooked were mothers having no education (p <0.001) and the type of employment of their spouse (p <0.01). Unbooked mothers were more likely to have preterm babies (OR 16.1; 95%CI 3.4-75.7) and all 6 perinatal deaths occurred in babies born to unbooked mothers. Remedial approaches would need to take into account maternal education, education of partners and the fact that despite free antenatal services in urban clinics financial difficulties in terms of other costs involved still remain an obstacle to overcome.
Subject(s)
Parturition , Prenatal Care/economics , Adult , Age Distribution , Case-Control Studies , Educational Status , Employment , Fathers , Female , Hospitals, General/statistics & numerical data , Humans , Infant Mortality , Infant, Newborn , Male , Occupations , Papua New Guinea , Parity , Pregnancy , Prenatal Care/statistics & numerical data , Residence Characteristics , Risk FactorsABSTRACT
BACKGROUND: Amplified DNA probes provide powerful tools for the detection of infectious diseases, cancer, and genetic diseases. Commercially available amplification systems suffer from low throughput and require decontamination schemes, significant hands-on time, and specially trained laboratory staff. Our objective was to develop a DNA probe system to overcome these limitations. METHODS: We developed a DNA probe system, the BDProbeTecTMET, based on simultaneous strand displacement amplification and real-time fluorescence detection. The system uses sealed microwells to minimize the release of amplicons to the environment. To avoid the need for specially trained labor, the system uses a simple workflow with predispensed reagent devices; a programmable, expandable-spacing pipettor; and the 96-microwell format. Amplification and detection time was 1 h, with potential throughput up to 564 patient results per shift. We tested 122 total patient specimens obtained from a family practice clinic with the BD ProbeTecET and the Abbott LCx(R) amplified system for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae. RESULTS: Based on reportable results, the BDProbeTecET results for both organisms were 100% sensitive and 100% specific relative to the LCx. CONCLUSIONS: The BDProbeTecET is an easy-to-use, high-throughput, closed amplification system for the detection of nucleic acid from C. trachomatis and N. gonorrhoeae and other organisms.
