BackgroundRecent studies have identified HIV as a leading contributor to preterm delivery and its associated morbidity and mortality. However little or no information exists in our sub-region on this subject. Identifying the factors associated with preterm delivery in HIV positive women in our country and sub-region will not only prevent mother to child transmission of HIV virus but will also reduce the morbidity and mortality associated with prematurity and low birth weight. This study was designed to determine the incidence and risk factors for preterm delivery in HIV positive Nigerians.MethodThe required data for this retrospective study was extracted from the data base of a cohort study of the outcome of prevention of mother to child transmission at the Nigerian Institute of Medical Research, Lagos. Only data of women that met the eligibility of spontaneous delivery after 20 weeks of gestation were included. Ethical approval was obtained from the Institution’s Ethical Review Board.Results181 women out of the 1626 eligible for inclusion into the study had spontaneous preterm delivery (11.1%). The mean birth weight was 3.1 ± 0.4 kg, with 10.3% having LBW. Spontaneous preterm delivery was found to be significantly associated with unmarried status (cOR: 1.7;1.52-2.57), baseline CD4 count <200 cells/mm3(cOR: 1.8; 1.16-2.99), presence of opportunistic infection at delivery (cOR: 2.2;1.23-3.57), multiple pregnancy (cOR 10.4; 4.24 – 26.17), use of PI based triple ARV therapy (eOR 10.2; 5.52 – 18.8) in the first trimester (cOR 2.5; 1.77 – 3.52) on univariate analysis. However after multivariate analysis controlling for potential confounding variables including low birth weight, only multiple pregnancy (aOR: 8.6; CI: 6.73 – 12.9), presence of opportunistic infection at delivery (aOR: 1.9; CI: 1.1 – 5.7), and 1st trimester exposure to PI based triple therapy (aOR: 5.4; CI: 3.4 – 7.8) retained their significant association with preterm delivery.ConclusionThe spontaneous preterm delivery rate among our cohort was 11.1%. HIV positive women with multiple pregnancies, symptomatic HIV infection at delivery and first trimester fetal exposure to PI based triple therapy were found to be at risk of spontaneous preterm delivery. Early booking and non-use of PI based triple therapy in the first trimester will significantly reduce the risk of preterm delivery.

ASB is common in HIV positive pregnant women in our environment and is associated with previous UTI, high viral load, low CD4 count and maternal hemoglobin <11 g/dl.

The aim of this study was to explore healthcare professionals' views on the development of multicomponent interventions for obese pregnant women. A cohort of 22 healthcare professionals was interviewed. The interview transcripts were analysed thematically. Three key themes were highlighted by the interviews: (1) the lack of existing services for obese pregnant women in south-east London; (2) the barriers and challenges that need to be overcome (e.g. ethnic and cultural) when considering the creation of a new service for obese women who are pregnant; (3) the possible components of a new intervention. The findings of this study will inform the design of a programme to combat maternal obesity.Keywords Obesity, overweight, pregnancy, programmes.Please cite this paper as: Oteng-Ntim E, Pheasant H, Khazaezadeh N, Mohidden A, Bewley S, Wong J, Oke B. Developing a community-based maternal obesity intervention: a qualitative study of service providers ' views. BJOG 2010;117:1651-1655. IntroductionObesity is a global epidemic and, if current trends continue, 50% of the UK female population is predicted to be obese by 2050.1 An escalating proportion of pregnant women are obese, 2 and obesity is associated with an increased rate of complications in mother and baby, e.g. maternal death, pre-eclampsia, gestational diabetes, stillbirth and neonatal death.2 Maternal obesity is also a major contributor to the development of childhood obesity. The national prevalence of maternal obesity is estimated to be 15%. However, the Confidential Enquiry into Maternal and Child Health (CEMACH) found that 27% of women who died between 2003 and 2005 were obese, and that 30% of mothers who had a stillbirth or neonatal death were obese, 3 suggesting that obesity is a contributor to poor outcome. In response to these findings, CEMACH provided recommendations for the management of maternal obesity, including the need for the development of national guidelines. The English Government has put in place a strategy to tackle obesity (Healthy Weight, Healthy Lives), recognising the challenge posed by obesity in pregnancy and making recommendations to mitigate its effect. At a local level, Primary Care Trusts (PCTs) are expected to commission or develop services that assist with the identification and treatment of pregnant obese women. However, recent systematic reviews on weight management in pregnancy have concluded that there is no evidence of the effectiveness of dietary 4 and/or physical activity interventions 5 in pregnancy. No published study could be found in the literature on providers' views of interventions to address obesity in pregnancy. The aim of this study was to gain an insight into the thoughts and views of healthcare providers managing obese pregnant women in order to help inform the development of an effective intervention. MethodsA total of 22 service providers was identified. Twelve were internal to the National Health Service (NHS), eight of which were clinical, and 10 were external, three of which were experienced in tackling mat...

Anaemia was found to be high at 42.5 % among the HIV positive women studied and was found to be independently associated with short inter birth interval, presence of OIs, advanced HIV disease and use of zidovudine containing HAART regimen.

Introduction: The co-infection of Human immunodeficiency virus (HIV), Hepatitis B and C viruses remains a public health problem particularly in resource limited setting like Nigeria. Studies on these co-infections have been done principally among adult and pregnant women with limited information on the pediatric population. The study aims at documenting the burden and the patterns of HIV/HBV, HIV/HCV and HIV/HBV/HCV co-infections in children in Lagos, Nigeria.

ABSTRACT

Rotavirus is the major etiology of acute gastroenteritis in infants and young children worldwide. It has been estimated that about 39% of childhood diarrhoea hospitalizations are caused by the virus and nearly half a million children die from the infections each year especially in developing countries on the Asian subcontinent, Africa, and Latin America where health care facilities are in short supply. Stool specimens collected from the first to fourth days of illness are optimal for detection of the infection. Diagnosis was originally performed using electron microscopy, which is still occasionally used in centers where it is available. Routine diagnosis is however, now performed by antigen detection on feces using commercially available, simple, rapid immunochromatographic dipstick style kits which have superseded the earlier latex agglutination and enzyme immunoassay methods whose usefulness in diagnosis is still relevant. Reverse transcription polymerase chain reaction of feces is also available in some reference and research centers, and is particularly useful for identification of outbreaks due to serogroups other than group A. Similarly viral culture and serology are also available but do not play much roles in diagnosis of acute disease. Rotavirus infection is indeed a public health problem and early, rapid, accurate and reliable diagnostic techniques are essential for effective patient management and infection control.

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