Background: Early screening for cervical cancer is a key intervention in reduction of maternal deaths. Health care workers have a significant role to improve cervical cancer screening practice among women. Their attitude and practice to such an issue might positively or negatively influence people they come into contact with. Objective: To determine the knowledge, uptake and barriers to Pap smear test among female workers in the Rivers State University Teaching Hospital. Methodology: A hospital-based cross-sectional study was conducted between September and November 2015. A structured and pre-tested questionnaire was used to collect data from 265 female hospital workers on socio-demographic characteristics, knowledge of Pap smear, attitude towards, as well as utilization of Pap smear test. The data obtained were analyzed using SPSS version 20.0. Results: Of the 265 respondents, 237 (89.4%) were aware of Pap smear while 28 (10.6%) had no knowledge; of those that had knowledge only 40 (16.9%) had Pap smear test done at least once Awoyesuku et al.; JAMMR, 30(4): 1-9, 2019; Article no.JAMMR.50502 2 previously. There is significant difference in the knowledge of Pap smear among the professionals and those with tertiary education. Common sources of information about Pap smear were Books (58.2%) and Medical Workers (50.6%). Most common reason for not wanting to be screened was No interest (43.6%). Conclusion: Although the knowledge of Pap smear is high, the uptake is low among hospital workers. To improve utilization, public health education on the need for health workers to take up screening is crucial as it will impact positively on the general populace. Original Research Article
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.
Background: Maternal mortality ratios (MMR) are still unacceptably high in many low- and middle-income countries especially in sub-Saharan Africa. Background Data for the causes of maternal deaths are needed to inform policies to improve maternal healthcare and reduce maternal mortality. Objective: This study sought to determine the magnitude and trend in maternal mortality and the causes at a tertiary hospital over a seven-year study period. Methodology: This was a retrospective review of maternal mortality and causes from 2012 to 2018. Data on number of maternal deaths, deliveries and causes of death were retrieved from the departmental annual reports and hospital records and entered into Microsoft Excel 2013. Data were presented as line graphs, charts and frequency tables. Results: One hundred and ten (110) maternal deaths occurred out of 17,080 total births during the study period giving an overall MMR of 644. The MMR increased progressively from 580 in 2012 to 785 in 2018 with a sharp rise to the highest and subsequent decline to the lowest, values at the midpoint. The commonest causes of maternal deaths were Pre-eclampsia (PET) and Eclampsia 44(40%), Postpartum Haemorrhage (PPH) 25(22.7%) and Ruptured Uterus 13(11.8%). Conclusion: The maternal mortality ratio is high and the trend is worsening. The leading causes of maternal deaths were PET/Eclampsia and Postpartum haemorrhage accounting for about two-thirds of all deaths. Efforts must be geared towards improvements in the management of these cases, if this trend is to be reversed.
Background: Contraceptive discontinuation and switching to less effective methods, often leads to unintended pregnancies and reduces the impact of family planning programs. To understand what drives contraceptive use behavior, it is important to identify factors that influence discontinuation and switching. This study sought to determine the discontinuation rates, reasons for discontinuation or switching, and assess associated factors among women in Port Harcourt.Methods: A retrospective descriptive study, of women 15-48 years who accepted a modern method, over a five-year period from 1st January 2014 to 31st December 2018 was carried out. Information on age, parity, education, contraceptive use intention, method and duration of use, reason for discontinuation, and method switching, were extracted from their hospital records. Coded data were entered into Excel spreadsheet and exported to SPSS version 20 for statistical analysis at significance level of P<0.05.Results: There were 349 women with complete data. Their mean age was 32±56 years and median parity was 3. The all-method discontinuation rate was 29.0% at 12 months and 31.5% by 24 months. Method specific discontinuation at 12 months were injectables 53.3%, IUCD 38.2% and implants 23.8%, the difference was significant P=0.018. Reasons for discontinuation were reduced need-64.5%, method problems-26.8% and expiration-7.2%. Majority 79.7% abandoned further use, 6.5% renewed their method and 13.8% switched to other methods.Conclusions: The discontinuation rate was high, with associated poor switching behaviour. Proper counseling on contraceptive options and reinforcing switching are critical to reduce unwanted pregnancies that might result from poor method use and discontinuation.
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