Prisca Olabisi Adejumo

Characteristics and risk factors of preterm births in a tertiary center in Lagos, Nigeria

Introduction Preterm birth is a dire complication of pregnancy that poses huge long-term medical and financial burdens for affected children, their families, and the health care system. The aim of the present study was to identify characteristics associated with preterm births at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria from 2011 to 2013. Methods We obtained Information from 5,561 maternal, fetal/neonatal and obstetric records from the labor ward. We excluded delivery at less than 22 weeks (0.25%), post-term birth at ≥42 weeks gestation (1.3%), and unknown gestation (1.4%). Additionally, we excluded records of multiple births (5.4%) and stillbirths (8.3%) leaving 4,691 records of singleton live-births for analysis. Logistic regression analysis was performed comparing preterm birth (22-36 weeks gestation) to term birth (37-41 weeks gestation). Multiple variable models adjusting for maternal age, parity, fetal position, delivery method and booking status were also evaluated. Multinomial regression was used to identify characteristics associated with preterm birth (PTB) defined as early PTB (22-31 weeks gestation), moderate PTB (32-34 weeks gestation), late PTB (35-36 weeks gestation), compared to term birth (37-41 completed weeks gestation). Results From our data, 16.8% of the singleton live-birth deliveries were preterm (<37 weeks gestation). Of these, 4.7% were early (22-31 weeks), 4.5% were moderate (32-34 weeks) and 7.7% were late (35-36) PTBs. Older maternal age (≥35 years) [odds ratio (OR) = 1.41], hypertension (OR = 3.44) and rupture of membranes (OR = 4.03) were significantly associated with increased odds of PTB. Women being treated for the prevention of mother-to-child transmission of HIV were at a significantly decreased risk for PTB (OR = 0.70). Sixteen percent of women in this cohort were not registered for antenatal care in LUTH. These non-registered subjects had significantly greater odds of all categories of PTB, including early (odds ratio (OR) = 20.8), moderate (OR = 8.68), and late (OR = 2.15). Conclusion PTB and risks for PTB remain high in Nigeria. We recommend that any high risk pregnancy should be referred to a tertiary center for prenatal care in order to significantly reduce adverse birth outcomes such as PTBs.

Cultural Determinants of Care and Support for People Living with AIDS in Yoruba Communities of Ibadan and Ilesa, Nigeria

ABSTRACT This paper examines social and cultural factors influencing care and support for Persons Living with HIV/AIDS (PLWHA) in two selected Yoruba communities of Southwestern Nigeria. The increase in morbidity and mortality associated with HIV/AIDS especially in Nigeria is attributed to poor attention giving to PLWHA. Reasons for this poor attention seem to be relative on culture basis. Among the Yoruba, the cultural conception of HIV/AIDS and the perception of PLWHA by the people, have negative impacts on care and support for PLWHAs. Despite the various attempts to alleviate the burdens of HIV/ AIDS on PLWHAs, the problems continue as a nightmare in that society, and contribute to an increase in the number of people down with HIV/AIDS. To understand the problem, an ethnographic study was conducted in Ilesa and Ibadan where 217 respondents were interviewed through the combination of key-informant, in-depth interviews, focus group discussions and case study analyses. Data revealed that Yoruba conception of HIV/AIDS and the peoples perceptions of PLWHAs create barriers against better care for PLWHA. In addition, it was revealed that poverty, illiteracy and inadequate hospital facilities constitute other hindering factors affecting better care and support for PLWHAs.

Effect of standardized nursing language continuing education programme on nurses' documentation of care at University College Hospital, Ibadan

The study assessed the documentation of nursing care before, during and after the Standardized Nursing Language Continuing Education Programme (SNLCEP). It evaluates the differences in documentation of nursing care in different nursing specialty areas and assessed the influence of work experience on the quality of documentation of nursing care with a view to provide information on documentation of nursing care. The instrument used was an adapted scoring guide for nursing diagnosis, nursing intervention and nursing outcome (Q‐DIO).

Knowledge of Genetic Counseling Among Patients With Breast Cancer and Their Relatives at a Nigerian Teaching Hospital

Breast cancer prevalence continues to increase globally, and a significant proportion of the disease has been linked to genetic susceptibility. As we enter the era of precision medicine, genetics knowledge and skills are increasingly essential for achieving optimal cancer prevention and care. However, in Nigeria, patients with breast cancer and their relatives are less knowledgeable about genetic susceptibility to chronic diseases. This pilot study collected qualitative data during in-depth interviews with 21 participants. Of these, 19 participants were patients with breast cancer and two were relatives of patients with breast cancer. Participants were asked questions regarding their knowledge of breast cancer, views on heredity and breast cancer, and views on genetic counseling. Participants’ family histories were used as a basis with which to assess their hereditary risk of breast cancer. Participant responses were audio recorded and transcribed manually. The study evaluated patients’ and relatives’ knowledge of genetic counseling and the use of family history for the assessment of familial risk of breast cancer. This will serve as a guide to the processes of establishing a cancer risk assessment clinic.

Appraisal of HIV Counseling and Testing Services Provided for Pregnant Women in Selected Government Hospitals in Ibadan Metropolis, Nigeria:

HIV counseling and testing (HCT) is a critical gateway to treatment, care, and support services. For pregnant women, it is to access prevention of mother-to-child-transmission (PMTCT) services. However, not much has been done to appraise this service from the perspective of the recipients in Nigeria. This study documents the appraisal of the HCT services received at the antenatal care (ANC) services in three government hospitals in Ibadan, Nigeria, from the perspectives of pregnant women. Data were collected using focus group discussion guide among purposively selected 40 (21 primigravida and 19 multigravida) pregnant women. Observation and inventory checklists were used to collect data on procedures and basic requirements of HCT. Content analysis was used to analyze the data. Participants were neither counseled nor given opportunity to voluntarily participate in HCT services as it was made compulsory before accessing ANC. Test results were reportedly handed over directly to participants without post-test counseling. Observation of HCT procedure showed that guidelines for counseling were not strictly adhered to. Inventory of facilities, staff, and materials revealed inadequate staffing, lack of a dedicated counseling room, and inadequate antiretroviral drugs and test kits. The HCT services as provided for pregnant women are fraught with procedural inadequacies. Training and supervision of health care workers as well as provision of resources are needed to address the situation.

Habitual physical activity, peripheral neuropathy, foot deformities and lower limb function: characterising prevalence and interlinks in patients with type 2 diabetes mellitus

Background: Patients with type 2 diabetes mellitus (T2DM) may have diverse foot problems, but how these problems are linked with physical activity is not clear. This study investigated the prevalence of foot problems among patients with T2DM and investigated how the problems were related to physical activity. Methods: Habitual physical activity, peripheral neuropathy, lower limb functions and foot deformities of 246 T2DM patients were respectively assessed with the Baecke Physical Activity Questionnaire, Michigan Neuropathy Screening Instrument, Lower Limb Function Scale, and a self-designed foot deformity audit form. Results: Habitual physical activity index (3.2 ± 0.83) was highest in work-related activities; 69 (26.1 %) patients presented with peripheral neuropathy and 52 (19. 7%) had the lowest limb function. Pes planus was the most prevalent foot deformity (20.1%). Significant differences existed in physical activity indices across deformity groups (p < 0.05) and total activity index was related to neuropathic and lower limb function scores (p < 0.05). Conclusion: A higher work-related but reduced participation in sports and leisure time physical activity among the patients was observed. Habitual physical activity was lowest in patients with a forefoot deformity, higher neuropathic scores and lesser lower limb function scores. Patients with T2DM in these categories may be a target for special physical activity intervention programmes.