scholarly journals Transitioning Adolescents with Perinatally Acquired HIV from Paediatric to Adult Centered Care: Caregivers’ Perspective

2021 ◽  
pp. 40-50
Author(s):  
Chigozirim Ogubuike ◽  
Eme Olukemi Asuquo ◽  
Ajibola Alabi
Keyword(s):  
Infectious Diseases ◽  
Teaching Hospital ◽  
Transition Process ◽  
University Teaching ◽  
Transition To Adult Care ◽  
State University ◽  
Adult Care ◽  
Centered Care ◽  
Perinatally Acquired ◽  
Rivers State

Aim: To investigate caregivers’ attitude towards transitioning HIV-positive adolescents from paediatric to adult centered care as well as understanding their perspective of transition inhibitors and facilitators. Study Design: We used a descriptive qualitative design and purposively selected principal caregivers of adolescents aged 15 to 19 years with perinatally acquired HIV who had been attending the paediatric infectious diseases clinic for at least 12 months before the study. Place and Duration of Study: Rivers State University Teaching Hospital, Port Harcourt, Nigeria. The study was conducted from August 2020 to November 2020. Methodology: We included principal caregivers whose wards were not cognitively impaired, whose HIV serostatus had    been disclosed to them and who had been attending the Rivers State University Teaching Hospital paediatric infectious diseases clinic for at least 12 months before the onset of the study. Fifteen In-depth interviews were conducted and data was analyzed using the thematic analysis method with Atlas ti data qualitative software version 7.5.21. The sample size was determined when data saturation was reached. Results: Most principal caregivers did not understand their role and were not involved in preparing their wards for the transition to adult care. Perceived inhibitors to transition were anxiety on severing the long-term relationship with the paediatric health care team and concern that adult physicians may not be as caring as those in the paediatric clinic. Seropositive caregivers suggested that taking their wards along with them to their appointment at the adult clinic would facilitate transition.  Conclusion: Principal caregivers were unaware of their roles in the transition process, healthcare providers should actively involve and educate them to ensure a smooth transitioning to the adult centered care.

scholarly journals Prevalence and Demographic Correlates of Seropositive HIV and HBsAg Cases among Women Booking for Antenatal Care at the Rivers State University Teaching Hospital, Nigeria

2019 ◽  
pp. 1-9
Author(s):  
P. A. Awoyesuku ◽  
D. A. Macpepple ◽  
B. O. Altraide ◽  
D. H. John
Keyword(s):  
Pregnant Women ◽  
Teaching Hospital ◽  
Educational Status ◽  
University Teaching ◽  
P Value ◽  
Seroprevalence Rate ◽  
State University ◽  
Global Public Health ◽  
The Mean ◽  
Rivers State

Background: Infection with hepatitis B (HBV) and human immunodeficiency virus (HIV) are global public health problems. These infections during pregnancy increase the risk of maternal morbidity and mortality, and also pose a risk to the fetus due to mother to child transmission. Objective: To determine the prevalence of seropositive HIV and HBsAg cases amongst pregnant women at the Rivers State University Teaching Hospital (RSUTH). Methodology: A retrospective review of hospital and laboratory records of all pregnant women booked at RSUTH in two years, from May 2017 to April 2019, was carried out. Data on patients’ age, parity and educational level and reactivity of HIV and HBsAg test at booking were retrieved using structured proforma and analyzed using Epi Info Version 7. Test for significance using Chi-square was set at a significant level of P<0.05. Results: 3560 patients had HIV and HBsAg screening out of which 148 (4.2%) and 9 (0.3%) respectively were positive. The comorbidity rate in this study was 0.06%. The mean age was 31.5±4.7 years and the mean gestational age at booking was 22.1±6.8 weeks. There was no significant relationship between their age (χ2 = 2.690, p-value=0.442) and parity (χ2 = 3.759, p-value = 0.145) with HIV seropositivity, but these were significant for HBsAg (χ2 = 13.691, p-value = 0.003) (χ2 = 13.121, p-value=0.001).  Educational status was significant for HIV (χ2 = 16.188, p-value=0.000) but not for HBsAg (χ2 = 0.229, p-value=0.892). Conclusion: The seroprevalence rate of HIV and HBsAg in this study were low. HIV seroprevalence was significantly affected by lower education, while HBsAg seroprevalence was significantly affected by younger maternal age and nulliparity. Continued screening of pregnant women for these infections remains valuable and further community-based studies to identify risk factors are recommended.

scholarly journals Prevalence of Diabetes Mellitus in Pregnancy amongst Antenatal Clinic Attendees at Booking at the Rivers State University Teaching Hospital

2020 ◽  
pp. 7-8
Author(s):  
S. Eli ◽  
D. G. B. Kalio ◽  
K. E. Okagua ◽  
A. A. Aloku ◽  
B. O. A. Atraide ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Family History ◽  
Teaching Hospital ◽  
Antenatal Clinic ◽  
University Teaching ◽  
State University ◽  
History Of ◽  
Rivers State ◽  
Prevalence Of Diabetes Mellitus ◽  
In Pregnancy

Background: The prevalence of diabetes mellitus (DM) have tripled from 1980 till date as a result of many factors of which obesity/excessive weight gain is a closely related factor of DM. There are many adverse challenges of DM in pregnancy with its associated fetal and maternal consequences. Aim: To determine the prevalence of DM in pregnancy amongst antenatal clinic (ANC) at booking at the Rivers State University Teaching Hospital (RSUTH). Methods: It was a cross sectional study of ANC attendees at booking at the RSUTH. Simple random sampling method was used. The Information was coded and analyzed using SPSS version 25. Results: A total of 99 pregnant women were recruited at booking in the ANC of the RSUTH. The mean age was 32.2 years and the modal parity was 1.0.The number of ANC attendees with weight equal to or greater than 90 Kg were 21 (21.2%), number with weight greater than equal to 90 Kg with glucose in urine were 10 (10.1%) Three (3.0%) of the subjects were known diabetic whereas 12 (12.1%) had family history of DM. Conclusion: The study revealed the prevalence of DM amongst ANC attendees at the RSUTH as 3.0%. There was corresponding glycosuria in 10.1% of the ANC attendees. ANC attendees had family history of DM were 12.1%. Advocacy is needed to educate the populace on the predisposing factors of DM and its adverse effect on maternal and child health.

scholarly journals Prevalence of Seropositive VDRL Cases amongst Pregnant Women at the Rivers State University Teaching Hospital, Nigeria: Is Routine Screening for Syphilis Using VDRL Still Relevant?

2019 ◽  
pp. 1-7
Author(s):  
P. A. Awoyesuku ◽  
D. A. MacPepple ◽  
N. J. Kwosah
Keyword(s):  
Pregnant Women ◽  
Teaching Hospital ◽  
University Teaching ◽  
P Value ◽  
Seroprevalence Rate ◽  
State University ◽  
Serological Screening ◽  
Specific Test ◽  
The Mean ◽  
Rivers State

Background: Untreated maternal syphilis is strongly associated with adverse birth outcomes. The WHO recommends routine serological screening in pregnancy. Some workers have advised a reappraisal of this practice, having demonstrated low seroprevalence in their antenatal population. Objective: To determine the prevalence of seropositive VDRL cases amongst pregnant women at the Rivers State University Teaching Hospital (RSUTH) in order to justify the need and cost-effectiveness for continued routine syphilis screening using VDRL alone. Methodology: A retrospective review of hospital and laboratory records of all pregnant women booked for antenatal care (ANC) at RSUTH in a two-year period, from May 2017 to April 2019, was carried out. Data on patients’ age, parity and educational level, and reactivity of VDRL test at booking were retrieved using structured pro-forma and analyzed using Epi Info Version 7. Test for significance using Chi-square was set at significant level of P<0.05. Results: 3560 clinic patients had VDRL screening out of which 63 were positive. The overall prevalence rate in this study was 1.8%. The mean age was 31.5±4.7 years and the mean gestational age at booking was 22.1±6.8 weeks. There was no significant relationship between their age (χ2 = 0.403, p-value=0.940), parity (χ2 = 3.707, p-value=0.0.157), and educational status (χ2 = 1.853, p-value=0.396), and seropositivity. The cost of VDRL test per patient in RSUTH is $3, to detect the 63 cases the sum of $10,680 was spent. Conclusion: The seroprevalence rate of syphilis in this study was low. Initial screening using VDRL alone is neither justified nor cost effective. Selective screening based on risk factors and specific test with TPHA is recommended.

scholarly journals Maternal and perinatal outcome in severe preeclampsia and eclampsia at the Rivers State university teaching hospital, Nigeria

2020 ◽  
Vol 9 (11) ◽  
pp. 4389
Author(s):  
Peter A. Awoyesuku ◽  
Dickson H. John ◽  
Dickson H. John ◽  
Lewis B. Lebara ◽  
Lewis B. Lebara
Keyword(s):  
Birth Weight ◽  
Teaching Hospital ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
Case Fatality ◽  
Severe Preeclampsia ◽  
University Teaching ◽  
State University ◽  
The Mean ◽  
Rivers State

Background: Severe preeclampsia and eclampsia remain a challenge in tropical obstetric practice. It is a major contributor to feto-maternal morbidity and mortality in developing countries. This study seeks to determine the prevalence, associated risk factors and the feto-maternal outcome of severe preeclampsia and eclampsia at the rivers state university teaching hospital (RSUTH).Method: A retrospective study of all women who had severe preeclampsia and eclampsia and were delivered at the RSUTH in a two-year period, 1ST January 2018 to 31ST December 2019, was carried out. Data on patients’ age, parity, education, booking status, gestational age at delivery, diagnosis, complications, mode of delivery and fetal sex, birth weight and Apgar scores were retrieved using structured pro-forma. Data were analyzed using SPSS version 20.Results: There were 4496 deliveries of which 128 had severe preeclampsia and eclampsia, giving a prevalence of 2.85%. Of these, 94 (73.4%) had severe preeclampsia and 34 (26.6%) had eclampsia. The mean age of the women ± SD was 29.84±5.44 years, median parity was para 1, and mean gestational age ± SD was 35.38±3.84 weeks. There were 10 maternal deaths giving case fatality of 7.8%. The mean birth weight ± SD was 2.61±0.91 kg and stillborn rate was 14.4%. There was significant association with maternal age, education, booking status, method of delivery and Apgar score of the baby.Conclusion: The prevalence in this study is high with associated high maternal mortality and stillborn rates. Timely and appropriate intervention including primary management and judicious termination of pregnancy will reduce mortality of mother and fetus.

scholarly journals Prevalence of post-operative anaemia in surgical patients at the Rivers State University Teaching Hospital

2021 ◽  
Vol 10 (1) ◽  
pp. 218-223
Author(s):  
Kalio DGB ◽  
Eli S ◽  
Okagua KE ◽  
Allagoa DO
Keyword(s):  
Teaching Hospital ◽  
Cross Sectional Study ◽  
University Teaching ◽  
World Health ◽  
Surgical Patients ◽  
State University ◽  
Cross Sectional ◽  
Health Organization ◽  
Rivers State ◽  
Work Up

Background: Post-operative anaemia is often a reflection of pre-operative pre-operative work-up and pre-operative anaemia. In addition. Post-operative anaemia is also determined by co-morbidities of patients prior to surgery. The prevalence of post-operative anaemia varies based on surgical specialties and the experience of the surgeon; prevalence rates as high as 85% have been recorded in orthopaedic surgeries. Aim: To determine the prevalence of post-operative anaemic in surgical patients at the Rivers State University Teaching Hospital (RSUTH). Method: This was a six months cross sectional study of the post-operative anaemia of patients who had operation at the Surgery and Obstetrics/Gyaecology departments of The Rivers State University Teaching Hospital. The permission for the study was granted by the head of department of obstetrics and gynaecology in conjunction with the head of .the hospital management. The yard stick for anaemia was packed cell volume less than 33% in line with the World Health Organization (WHO). A structured proforma was used to obtain information from patient’s case notes and analyzed using SPSS version 25. Result: Three hundred and eigthy subjects were recruited for the study. Males subjects were 150 (39.5%) while females were 230 (60.5%) respectively. The mean age was 31 years. One hundred and ninety nine (52.4%) were obstetrics and gynaecological surgeries while 181 (47.6 %) were non-gynaecological surgeries. The commonest indication for surgery was caesarean section representing 130 (34.2%) of the subjects. Two hundred and sixty six of the subjects (70%) had PCV less than 33%. One hundred and fifty two (40%) women had PCV less than 33% while 114 (30%) of the men had PCV less than 33%. Conclusion: The study revealed that prevalence of post-operative anaemia amongst surgical patients at RSUTH was 70 %. The post-operative anaemia amongst women was worrisome. The need to optimize patients prior to surgery cannot be over-emphasized to prevent morbidities and mortalities post-operative.

scholarly journals Contraceptive Choices and Acceptability among New Clients Attending the Family Planning Unit of Rivers State University Teaching Hospital, Nigeria

2019 ◽  
pp. 1-7
Author(s):  
P. A. Awoyesuku ◽  
B. O. A. Altraide
Keyword(s):  
Oral Contraceptive ◽  
Family Planning ◽  
Family Size ◽  
Teaching Hospital ◽  
University Teaching ◽  
State University ◽  
Planning Unit ◽  
The Family ◽  
Completed Family Size ◽  
Rivers State

Background: Effective contraception can prevent unwanted pregnancy, unsafe abortion and ensure adequate birth spacing. The choice of a method depends on consideration of its advantages and disadvantages based on individual perception and interpretations. Objective: To assess contraceptive choices and acceptability among new clients at the family planning clinic of a tertiary health facility in Rivers State, Nigeria. Methodology: This was a one-year retrospective review of clinical records of new clients attending the Family Planning Unit of the Rivers State University Teaching Hospital from January 1, to December 31, 2018. Data on age, education, marital status, parity, contraceptive choice and reason for contraception were retrieved and analyzed using Epi-Info version 7.1.4. Results:  A total of 124 female clients were enrolled during the time period. The mean age of the participants was 33.8±5.1 years and the median parity was 3. The most common method of contraception accepted by the clients was implants 87 (70.2%), followed by intrauterine device 32 (25.8%), then injectable 4 (3.2%) and oral contraceptive pills 1(0.8%). Reasons proffered for use of contraceptive was mainly completed family size 69 (55.6%), pregnancy prevention 53 (42.8%) and child spacing 2 (1.6%). There was no significant difference on comparism of mean age and median parity of clients by choice of contraceptive method. Conclusion: The implant methods were the most commonly accepted, while the oral contraceptive pill was the least preferred. Completed family size was the most common reason for contraception.

scholarly journals Prevalence, trend and outcome of twin pregnancy in Rivers State University Teaching Hospital, Southern Nigeria

2021 ◽  
Vol 10 (7) ◽  
pp. 2571
Author(s):  
Felix Chikaike Clement Wekere ◽  
Dickson H. John ◽  
Gift A. F. Clement-Wekere ◽  
Rose S. Iwo-Amah
Keyword(s):  
Preterm Delivery ◽  
Teaching Hospital ◽  
Perinatal Care ◽  
Multiple Pregnancy ◽  
University Teaching ◽  
State University ◽  
Live Births ◽  
Risk Pregnancy ◽  
The Mean ◽  
Rivers State

Background: Multiple pregnancy is a high-risk pregnancy associated with a higher maternal and perinatal complications compared to singleton pregnancy. Twinning is the commonest form of multiple pregnancy, and its prevalence varies across the globe, with lowest value in Japan and highest in Nigeria.Methods: The aim of the study was to review twin births in Rivers State University Teaching Hospital (RSUTH), to determine its prevalence, trend, and management outcome.Results: During the period under review, there were 13516, and 263 twin births, giving the prevalence of twinning in RSUTH as 19.5 per 1000 live births or 1 in 51 deliveries. The rate of twinning increased from 7.6 per 1000 deliveries in 2015 to 35.7 per 1000 deliveries in 2019. Mean age of patients was 31 SD 4.82 years, 95% CI: 30.42, 31.59, and modal age group was 30-34 years. Patients’ parity ranged from 0 to 7 with modal parity being para-1. Majority (51.7%) had secondary level education, and were Christians. Preterm delivery rate was 62.4%. The mean gestational age at delivery was 35.7 SD 2.9 weeks, 95% CI: 35.3, 36.0. The mean birth weights of the first and second twins were 2.39 SD 0.67 and 2.30 SD 0.69 respectively. Majority (92%) of the foetuses were alive at birth. Still birth and perinatal mortality rate were 4.2 and 7.8 per 1000 live births. There was no case of maternal mortality.Conclusions: The rate of twining in our setting is high, with an increasing trend. Most of the parturient had preterm delivery, and improved perinatal care services would ensure best perinatal outcome. 

scholarly journals Decision-Delivery Interval for Emergency Caesarean Section at the Rivers State University Teaching Hospital

2020 ◽  
pp. 1-2
Author(s):  
S. Eli ◽  
D. G. B. Kalio ◽  
A. Dan- Jumbo ◽  
J. Ikimalo
Keyword(s):  
Caesarean Section ◽  
Teaching Hospital ◽  
Developed Countries ◽  
Fetal Outcome ◽  
Emergency Caesarean Section ◽  
University Teaching ◽  
State University ◽  
Cephalopelvic Disproportion ◽  
Emergency Caesarean ◽  
Rivers State

Decision-Delivery interval when carrying out emergency caesarean section (EmCS) cannot be over-emphasized especially with regards to maternal and fetal outcome. There are variety of factors that may contribute to these intervals such as logistics, personal delay, delay in obtaining of informed consent, lack of blood, and availability of theatre space. Aim: To determine the decision-delivery interval and causes of delay in EmCS at the Rivers State University Teaching Hospital (RSUTH). Methods: It was prospective study conducted at the RSUTH between July 1, 2018 to January 31, 2019. Information was obtained using a self structured questionnaire and analyzed using version SPSS 25. Results: There were 481 patients admitted into labour ward for the period under review of which 71(14.8 %) had EmCS. The mean age was 31 years. The commonest indication for EmCS was Cephalopelvic disproportion (CPD) represented by 23 (32.4%) of the subjects. The average time for decision - delivery interval was 1 to 2 hours represented by 29 (40.8%). The shortest decision - delivery interval was less than 30 minutes 1(1.3%).The decision – delivery interval time greater than 5 hours were 9 (12.7%). The 3 commonest reasons for delay with respect to average decision – delivery intervals were personal delay 21 (20.8%), logistics 19 (18.8%) and lack of blood 13 (12.9%). Conclusion: The study revealed that the average decision - delivery interval was 1 – 2 hours represented by 40.5% of the subjects. This was relatively long when compared to developed countries of the world. The commonest reason for delay in carrying out EmCS was personal delay (20.8%). The commonest indication for EmCS was CPD (32.4%). Addressing the reasons for the decision – delivery interval will help improve our practice and reduce adverse effects to mother and baby.

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