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BackgroundIn Ghana, adolescents represent 22% of the total population. The rates of adolescent pregnancies are high. Of all births registered in the country in 2014, 30% were by adolescents, and 14% of adolescents aged between 15 and 19 years had begun childbearing. Pregnancies and deliveries of adolescents are accompanied by more risks as compared to older women. The aim of the study was to explore the long-term effects of adolescent pregnancies on subsequent pregnancies and births and on the socioeconomic status of the women.MethodA cross-sectional interviewer-performed survey of a purposive sample of 400 women in one community of Northern Ghana was conducted. Relationships between the age at first pregnancy and complications such as cesarean section, preterm or stillbirth and others were explored in 143 patients using the statistical program SPSS (Statistical Package for the Social Sciences).ResultResults show that adolescent women (<19 years at their first pregnancy) have an 80% higher risk for a cesarean section for the first and subsequent births as compared to older women (≥ 19 years). Furthermore, younger mothers have a 45% higher risk of stillbirths and a 30% increased risk of losing their baby within the first 6 weeks after birth. There was no difference in the socioeconomic status between the two age groups.ConclusionAdolescent pregnancies are risk factors for the outcome of subsequent pregnancies of these mothers. This study, for the first time, shows that not only the first pregnancy and birth of very young women are negatively influenced by the early pregnancy but also subsequent pregnancies and births. While this study is of a purposive sample of women in one community, the clinical relevance of this study should not only be interesting for healthcare practitioners in Northern Ghana and other African regions but also for prevention campaigns in these regions.

The vesico-vaginal fistula from prolonged obstructed labor has become a rarity in the industrialized West but still continues to afflict millions of women in impoverished Third World countries. As awareness of this problem has grown more widespread, increasing numbers of American and European surgeons are volunteering to go on short-term medical mission trips to perform fistula repair operations in African and Asian countries. Although motivated by genuine humanitarian concerns, such projects may serve to promote 'fistula tourism' rather than significant improvements in the medical infrastructure of the countries where these problems exist. This article raises practical and ethical questions that ought to be asked about 'fistula trips' of this kind, and suggests strategies to help insure that unintended harm does not result from such projects. The importance of accurate data collection, thoughtful study design, critical ethical oversight, logistical and financial support systems, and the importance of nurturing local capacity are stressed. The most critical elements in the development of successful programs for treating obstetric vesico-vaginal fistulas are a commitment to developing holistic approaches that meet the multifaceted needs of the fistula victim and identifying and supporting a 'fistula champion' who can provide passionate advocacy for these women at the local level to sustain the momentum necessary to make long-term success a reality for such programs.

Hepatitis B virus (HBV) infection is a major health problem, with 5% of the world population being chronic carriers, and parts of Africa and the Middle and Far East have a disproportionately higher carrier rate of 10% to 15%. Persistent HBV infection is an important risk factor for hepatocellular cancer, one of the most common cancers in adults in Ghana [1].Perinatal transmission has remained the most important means of spreading of HBV worldwide [2]. This study was conducted to determine HBV seroprevalence among parturients at the Korle-Bu teaching hospital (KBTH) in Accra, Ghana, and whether selected medical and socio-demographic characteristics are associated with HBV seropositivity.Women delivered at KBTH were randomly selected, and medical and socio-demographic characteristics were recorded using a standardised questionnaire. Maternal sera were tested for HBV surface antigen (HBsAg), HIV I and HIV II antibodies, and hepatitis B e-antigen (HBeAg) if the participant tested positive for HBsAg.The data were analysed using Centers for Disease Control and Prevention-issued software Epi Info 2000. Associations between hepatitis B seropositivity and the selected characteristics were examined. P b 0.05 was considered significant.Of the 638 women tested, 67 (10.5%) tested positive for HBsAg, and 5 (7.5%) of these 67 also tested positive for HBeAg. The overall rate of HIVpositive women was 2.7%, but it was 4.5% in the HbsAg-positive group.The socio-demographic and medical characteristics, which included slum residence, duration of schooling, age below 20 or above 35 years, nulliparity, marriage, history of jaundice, and HIV seropositivity, showed no significant association with HBV seropositivity (Table 1).In 1991, in an attempt to reduce the global impact of HBV infection, the World Health Organi-0020-7292/$ -see front matter D

Introduction Hepatitis B virus infection is a global public health problem. Though, the disease is endemic in sub-Saharan Africa, little is known about its epidemiology among pregnant women in Ghana. This study sought to determine the seroprevalence of Hepatitis B virus infection and associated factors among pregnant women attending antenatal care at Korle-Bu Teaching Hospital; Ghana's largest hospital. Methods We conducted a facility-based cross-sectional survey among 232 antenatal attendants. Participants were recruited using systematic random sampling technique and screened with HBsAg Rapid Test. Data was analyzed with the aid of Statistical Package for Social Sciences (SPSS), version 23.0. Results were presented using descriptive statistics, Fisher's Exact test and Logistic Regression analysis. Results Two hundred and twenty-one (221) of the total sample (n = 232) agreed to participate in this study; representing a response rate of 95%. The mean age of the participants was 31 years and standard deviation of 5.3. The mean gestational period at recruitment was 28 weeks and standard deviation of 6.8. Majority of the participants were married (83.3%), parous (69.6%), educated (91.4%) and employed (90.5%). The prevalence of HBsAg was 7.7%. We found no significant association between socio-demographic characteristics of the participants and HBV infection. Conclusion Seroprevalence of 7.7% indicates moderate endemicity. Socio-demographic characteristics did not influence HBV infection among pregnant women attending antenatal care at Korle