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?

Author(s):  
P. A. Awoyesuku ◽  
D. A. MacPepple ◽  
N. J. Kwosah

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.

Author(s):  
P. A. Awoyesuku ◽  
D. A. Macpepple ◽  
B. O. Altraide ◽  
D. H. John

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.


Author(s):  
Peter A. Awoyesuku ◽  
Dickson H. John ◽  
Dickson H. John ◽  
Lewis B. Lebara ◽  
Lewis B. Lebara

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.


Author(s):  
Felix Chikaike Clement Wekere ◽  
Dickson H. John ◽  
Gift A. F. Clement-Wekere ◽  
Rose S. Iwo-Amah

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. 


Author(s):  
Tamunoiyowuna Grace Okari ◽  
Boma Awoala West

Background: Post neonatal tetanus, a vaccine preventable disease is a cause of childhood morbidity and mortality in many developing countries including Nigeria. This study was carried out to determine the prevalence, clinical profile and outcome of children with post-neonatal tetanus. Methods: This prospective observational study carried out over 3years in the Paediatric ward of the Rivers State University Teaching Hospital, was among children older than 28days and up to 16years. Result: Of 966 children admitted during the period of study, 12 had post-neonatal tetanus giving a prevalence of 1.2%. Six (50%) were > 10years old with a M:F ratio of 5:1, 5(41.7%) resided in rural areas and all (100%) were of low socioeconomic status. Six (50%) did not receive tetanus toxoid vaccine and no child had booster doses. Portal of entry for the infection was majorly via injuries on their limbs, 7(58.3%). The mean incubation period was 10.58±7.39 days while the mean onset interval was 31.58±27.85 hours. Three (25%) children had severe tetanus using Ablett’s classification with spasm 11(91.7%) documented as the commonest symptom. Half, 6(50%) of the children had autonomic complications and an overall case fatality rate of 25%. Conclusion: The prevalence of post-neonatal tetanus in the Rivers State University Teaching Hospital was low being 1.2%, although unacceptable. The mortality rate of post-neonatal tetanus of 25% was high. Thus, there is a need to strengthen existing immunization program and immediately adopt the commencement of booster doses of tetanus toxoid vaccines for eligible children in Nigeria.


Author(s):  
S. Eli ◽  
D. G. B. Kalio ◽  
N. C. T. Briggs ◽  
K. E. Okagua

Introduction: Female Genital Mutilation (FGM) or Female Circumcision (FC) have been influenced by religion, culture and medicine. The practice of FGM have been associated with myriads of negative health consequences, resulting in its abolishment by the World Health Organization (WHO). This is unlike male circumcision which is well accepted by most religions of the world, culture and medically. Aim: To ascertain the influence of religion, culture and medicine as regards FGM amongst antenatal clinic (ANC) attendees at the Rivers State University Teaching Hospital (RSUTH). Methods: It was a cross sectional study of ANC attendees at The RSUTH. The Information was retrieved using a self structured questionnaire which was coded and analyzed using SPSS version 25. Results: A total number 84 ANC attendees were recruited for the study. The mean age was 30.7 years and the modal parity was 1. The mean gestational age was 15.8 weeks. Twenty (23.8%) respondents had FC, all of whom were Christians. Eighteen (21.4%) of the respondents were of the opinion that FGM was a good practice; while 66 (78.6%) respondents believed that FGM was a wrong practice. The 2 most common reasons for FGM were to prevent promiscuity 7 (8.3%) and cultural reasons 7 (8.3%). The commonest known complication by respondents following FGM was  bleeding  from the genital tract 24 (28.6%). Conclusion: The prevalence of FGM from the study was 23.8% amongst ANC attendees at the RSUTH. Religion, culture and medicine may play vital roles in the eradication of FGM in our sub-region as recommended by WHO.


Author(s):  
Boma Awoala West ◽  
Adaku Arthur ◽  
Josephine Enekole Aitafo ◽  
Hannah Omunakwe

Aim: There is paucity of literature on the prevalence of neonatal anaemia globally thus aim of the study was to evaluate the prevalence, determine the associations and the clinical outcome of neonates with anaemia. Study Design: This was a descriptive prospective cross-sectional study. Place and Duration of Study: Study was carried out among neonates admitted in the Special Care Baby Unit of Rivers State University Teaching Hospital over one year. Methodology: A convenient sampling size of 402 neonates who met the inclusion criteria were consecutively recruited. Data was analysed using SPSS version 23. Results: Of 402 neonates assessed, 106(26.4%) had anaemia with PCV less than 42%.   Anaemia was observed more in males 56(52.8%), neonates delivered via Caesarean section 74(69.8%) and at gestational age less than 37 weeks 53(50%). Mild anaemia was observed mostly, 66(62.3%). Common pregnancy complications of mothers with anaemic babies were prolonged rupture of membranes 17(35.4%) and hypertension in pregnancy 14(29.2%) while the commonest morbidities in these neonates were probable sepsis 65(63.8%), neonatal jaundice 53(52%) and prematurity 53(52%). There was significant difference in anaemic and non-anaemic neonates with regards to mothers with gestational diabetes (P value < 0.0001). The factors associated with severe anaemia were probable sepsis and the duration of stay. Blood transfusion was carried out in 27(25.5%) neonates. An overall mortality of 7.5% was documented, severe anaemia being highest (21.4%). Conclusion: The prevalence of anaemia was high being 26.4% and was observed more in males, preterms and babies delivered via Caesarean section. There was significant difference in anaemic and non-anaemic neonates with regards to mothers with gestational diabetes. Probable sepsis and duration of stay were significantly associated with severe anaemia. The mortality rate in neonates with anaemia was 7.5% thus there is need to assess newborns for anaemia with prompt intervention to prevent morbidity, mortality and long term sequelae.


Author(s):  
S. Eli ◽  
D. G. B. Kalio ◽  
K. E. Okagua ◽  
A. A. Aloku ◽  
B. O. A. Atraide ◽  
...  

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.


Author(s):  
Abdulateef O. Kareem ◽  
Akinsegun A. Akinbami ◽  
Ebele I. Uche ◽  
Aishatu M. Suleiman ◽  
Rafah A. Bamiro ◽  
...  

<p class="abstract"><strong>Background:</strong> The elderly have limited regenerative abilities thus predisposing them to various diseases. Measuring both serum ferritin and transferrin serve as biomarkers of iron deficiency. This study, using enzyme-linked immunosorbent assay (ELISA) determined the serum levels of ferritin and transferrin in the elderly. Full blood count was also done and correlated with serum ferritin and transferrin levels of every participant.</p><p class="abstract"><strong>Methods:</strong> This was a cross-sectional study at the Geriatric Clinic of Lagos State University Teaching Hospital (LASUTH). Following receipt of written consents from ninety (90) elderly participants, venous samples were drawn for full blood count (FBC) and samples for serum ferritin and transferrin ELISA assay collected and stored at -40<sup>o</sup>C until the required sample size was obtained. Data were analyzed using SPSS version 23.0 (Statistical Package for Social Sciences, Inc., Chicago, Ill). The Pearson chi-square test was used for statistical analysis. P value was considered to be statistically significant when &lt;0.05.  </p><p class="abstract"><strong>Results:</strong> Participants consisted of 50 (55.6%) females and 40 (44.4%) males. The mean age of all participants was 71.31±7.38 years. The Majority, 90% (36 of 40) of the males had haemoglobin values lower than 13 gm/dl, while 66% (33 of 50) of females had haemoglobin values lower than 12 gm/dl. The mean ferritin concentration of all participants was 196.19 ±121.21ng/ml. The overall mean serum transferrin was 0.187±0.157 ng/ml with a minimum of 0.03 ng/ml and a maximum of 1.18 ng/ml.</p><p class="abstract"><strong>Conclusions:</strong> Anaemia in the elderly is very common using the World Health Organization (WHO) haemoglobin cut-off values, however, iron deficiency anaemia prevalence is low.</p>


2021 ◽  
Vol 10 (1) ◽  
pp. 218-223
Author(s):  
Kalio DGB ◽  
Eli S ◽  
Okagua KE ◽  
Allagoa DO

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.


Sign in / Sign up

Export Citation Format

Share Document