Introduction: The coronavirus disease (COVID-19) infection rate and mortality among Nigerian health care workers appear to be on the increase. This study determined the level of knowledge, attitude, practices, and impact of COVID-19 infection on healthcare workers (HCWs) working in a South-Eastern Nigerian state. Methodology: This was a web-based, cross-sectional study conducted among healthcare workers in South-eastern, Nigeria during the lockdown period. Socio-demographic profile, knowledge of COVID-19, fears and impact concerning COVID-19, attitude of health workers to work, preventive practices during this pandemic period were obtained. Data were analysed using STATA 16.0. Chi-square and Fisher’s exact tests of association were used to determine the association between variables, with the significance level set at p < 0.05. Results: A total of 403 health care workers participated in the study. Majority of participants (n = 357, 88.59%) had good knowledge and good preventive practices (n = 328, 81.39%) of COVID-19. A significant proportion of respondents had a poor attitude to work (n = 101, 25.06%) and an attitude of indifference (n = 233, 57.82%). Almost half (48.64%) of participants had been negatively affected by COVID-19. Knowledge significantly influenced practice (p = 0.029). Lack of Personal protective equipment, fear of dying and going to common places, had a significant impact on the attitude of workers. Conclusion: Good knowledge which influenced practice, high use of preventive practices, with associated poor and indifferent attitude was noted among healthcare workers. Fear of death and lack of personal protective equipment had a strong impact on attitude. Female HCWs had poorer attitude to work than males.

BackgroundThe study evaluated the pattern of severe maternal outcome, near miss indicators and associated patient and healthcare factors at a private referral hospital in rural Nigeria.MethodsThis was a cross sectional study conducted from September 2014 to August 2015 in Madonna University Teaching Hospital Elele, Rivers State, Nigeria. Pregnant and postpartum women were recruited for the study using Nigeria near miss network proforma which was adopted from the WHO near miss proforma. We explored administrative, patient related and medical delays. Statistical analysis was done using SPSS version 20.ResultsOf the 262 deliveries, 5 women died and 52 women had a near miss event. The maternal mortality rate was 1908/100,000. The maternal near miss mortality ratio was 11.4: 1 while the mortality index was 8.8%. Three out of the five deaths that occurred were in the age category of 20–24 years. Abortive outcome was the leading cause of maternal mortality contributing 2 of the 5 maternal mortality. The severe maternal outcome ratio was 218/1000 and maternal near miss incidence ratio was 198/1000. Hypertensive disorders of pregnancy contributed 16(28.1%) of the 57 cases with severe maternal outcome while Obstetrics hemorrhage and abortive outcome each contributed 14(24.6%). 6(10.5%) received treatment within 30 min of diagnosis while 19(33.3%) waited for greater than 240 min before they received intervention. There was a statistically significant association between time of intervention and final maternal outcome (p-value = 0.003). Administrative delay was noted in 20 cases, while patient related delay was noted in 44 cases.ConclusionThere is a high burden of near miss and unmet need for reproductive health services in rural areas of Nigeria. Different levels of delays abound and contribute to the disease burden. Periodic reviews will aid in elimination of the delays. There should be better communication between different levels of care and emphasis should be on early identification and referral of women for prompt management.

The study showed an unacceptably high rate of stillbirth in rural Nigeria. Early recognition of complications and prompt referral may reduce stillbirth rate.

INTRODUCTIONUterine inversion is an un-common complication of parturition which often occurs in the immediate postpartum period. The chronic (non-puerperal) uterine inversion is rarer and most times tumour associated.PRESENTATION OF CASEA 51-year old grand multiparous lady presented with a month history of abnormal vaginal bleeding associated with offensive vaginal discharge, lower abdominal pain and dizziness. The initial evaluation suggested severe anaemia secondary to advanced cervical cancer. Examination under anaesthesia (EUA), staging and biopsy was attempted but this was however inconclusive due to profuse haemorrhage. A repeat EUA revealed chronic uterine inversion secondary to fundal submucous uterine leiomyoma. Myomectomy was done with tissue histology confirming benign uterine leiomyoma. Two weeks later, a modified Haultain's procedure was done followed by simple hysterectomy and posterior colpoperineorrhaphy. She had satisfactory recovery.DISCUSSIONThis is the first reported case of chronic non-puerperal uterine inversion in our hospital. When it occurs, it is usually tumour associated with the commonest tumour being prolapsed myoma and leiomyosarcoma. The diagnosis is based on high index of suspicion.CONCLUSIONChronic uterine inversion is a rare gynaecological condition and can be misdiagnosed as advanced cervical cancer or other causes of severe genital haemorrhage in women. A high index of suspicion is needed for its proper diagnosis. Sometimes, an EUA and biopsy was required to determine the cause here and conveniently it could be described as a “gynaecolological near miss”.

BackgroundAccurate HIV testing in pregnancy is critical to the prevention of mother to child transmission of HIV infection and linkages to other preventive strategies.Aims and objectivesThis study determined the sensitivity, specificity negative and positive predictive value of serial rapid testing of HIV among pregnant women in Nnewi, south east Nigeria.MethodologyThis was a comparative descriptive study conducted over a 4-month period. Serial rapid testing algorithm was compared with conventional ELISA testing after obtaining informed consents from the pregnant women. All positive and discordant results were confirmed with western blot HIV test. Participants also completed a questionnaire. Data analysis was done using SPSS version 20.ResultA total of 166 pregnant women participated in this study. The mean age of the participants was 29 ± 4.3 years. The HIV prevalence was highest in the 25–29 years category. This was also the modal age category. Majority of the women were multiparous. The prevalence of HIV infection was 12 %. The sensitivity, specificity, negative and positive predictive value of serial rapid HIV testing was 95, 100, 99.3 and 100 % respectively.ConclusionThe sensitivity of the serial rapid test algorithm was high but still lower than the WHO recommended 99 % and above. The 100 % specificity and positive predictive value makes it a good diagnostic test strategy. There is need for regular review of HIV test kits and policy.