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Item Seroprevalence and factors associated with hepatitis C coinfection among HIV-positive pregnant women at the University College Hospital, Ibadan, Nigeria(Wolters Kluwer - Medknow, 2016) Adesina, O. A.; Akinyemi, J. O.; Ogunbosi, B. O.; Michael, O. S.; Awolude, O. A.; Adewole, I. F.Aim: This study estimated the hepatitis C virus (HCV) prevalence in a population of human immunodeficiency virus (HIV) infected pregnant women, compared women who were positive or negative for HCV and described risk factors associated with HCV infection. Materials and Methods: A retrospective, case control study was conducted at the University College Hospital, Ibadan among 1821 women. Twenty‑six (1.65%) women were HCV positive, 139 (8.83%) were HBsAg positive and 1407 (89.33%) were negative for both viruses. Three patients (0.19%) were positive for both viruses. These patients, i.e., the HBsAg positive women and 246 women with no result, for either virus were excluded from analysis. Data from 1433 pregnant women is presented. Chi square test and student’s t‑test examined associations, with level of significance set at P < 0.05. Results: Overall, the mean age of the HCV positive women was lower (26.77 ± 6.53 vs. 28. 95 years ± 5.33; P = 0.04), most women had attained primary (28.49%) or secondary (42.44%) education, over 90% were married and heterosexual sex (88.67%) was the most likely risk for HIV. HCV prevalence was higher in the lower age groups (5% in the ≤ 19 years group, P = 0.021). The coinfected had more unmarried women (3.6% vs. 1.7%; P = 0.164) and more likely to indicate blood transfusion as a risk factor for HIV (6.2%; P = 0.34). Conclusion: Only age showed any significant association with HCV infection. Lack of identifiable risk factors sum up challenges for developing screening strategies in sub‑Saharan Africa. Further studies will identify factors facilitating HCV transmission in the region.Item Community attitudes toward childbearing and abortion among HIV-positive women in Nigeria and Zambia(2013) Kavanaugh, M. L.; Moore, A. M.; Akinyemi, J.; Adewole, I.; Dzekedzeke, K.; Awolude, O.; Arulogun, O.Although stigma towards HIV-positive women for both continuing and terminating a pregnancy has been documented, to date few studies have examined relative stigma towards one outcome versus the other. This study seeks to describe community attitudes towards each of two possible elective outcome of an HIV-positive woman’s pregnancy – induced abortion or birth – to determine which garners more stigma and document characteristics of community members associated with stigmatising attitudes towards each outcome. Data come from community-based interviews with reproductive-aged men and women, 2401 in Zambia and 2452 in Nigeria. Bivariate and multivariate analyses revealed that respondents from both countries overwhelmingly favoured continued childbearing for HIV-positive pregnant women, but support for induced abortion was slightly higher in scenarios in which anti-retroviral therapy (ART) was unavailable. Zambian respondents held more stigmatising attitudes towards abortion for HIV-positive women than did Nigerian respondents. Women held more stigmatising attitudes towards abortion for HIV positive women than men, particularly in Zambia. From a sexual and reproductive health and rights perspective, efforts to assist HIV-positive women in preventing unintended pregnancy and to support them in their pregnancy decisions when they do become pregnant should be encouraged in order to combat the social stigma documented in this paper.Item Risk of anaemia in HIV positive pregnant women in Ibadan, Southwest Nigeria(2011) Adesina, O.; Oladokun, A.; Akinyemi, O.; Akingbola, T.; Awolude, O.; Adewole, I.Anaemia in pregnancy is an important cause of maternal and neonatal mortality. It is a recognized co-morbidity of HIV infection. This study aimed to determine the risk of anaemia in HIV positive pregnant women. Methodology- This is a cross sectional study of healthy pregnant women attending Adeoyo Hospital, a secondary health centre in South-western Nigeria over a 1- month period (January 2007). During the study period, 2,737 eligible women presented for antenatal care. About 98% (2,682) of these women consented to HIV testing. Over all, their mean (± S.D) packed cell volume was 30.96% (±4.13). The prevalence of HIV infection was 2.9% (95% Cl 2.3% - 3.6%) and the overall prevalence of anaemia was 33.1%. Frequency of anaemia was significantly higher in HIV +ve women (57.3% vs. 42.7%, p= 0.00. OR=2.81., CI=1.72-4.58). HIV +ve women presented more frequently with moderate or severe anaemia. In the logistic regression analysis only HIV infection (OR=2.4, 95%CI=1.37- 4.21) and primigravidity (OR=1.25,95% 0=1.04-15.2) remained independently associated with anemia. Anaemia is common in HIV positive pregnant women in this environment. Care providers must endeavor to determine the HIV status of every pregnant woman especially if she presents with anaemia with a view to providing appropriate interventions.Item Human immuno-deficiency virus and hepatitis B virus coinfection in pregnancy at the University College Hospital, Ibadan(2010) Adesina, O.; Oladokun, A.; Akinyemi, O.; Adedokun, B.; Awolude, O.; Odaibo, G.; Olaleye, D.; Adewole, I. F.Human Immuno-deficiency virus (HIV) and Hepatitis B Virus (HBV) share common modes of transmission which include blood borne and the vertical routes. Although, the natural course of HTV does not appear altered by HBV, the rate of liver-related deaths is several times higher among HIV/HBV co-infected persons. Clinicians providing care for HIV positive individuals, including pregnant women, need to be aware of this problem. This is a 2-year cross-sectional study that commenced in January 2006, among HIV positive pregnant women seen at the University College Hospital, Ibadan. During the study period, 721 HIV positive pregnant women were screened for hepatitis B virus infection. Sixty-four women (8.9%) were positive for HBsAg, 14(1.9%) were HCV positive and 642 (89.2%) were negative for both HBV and HCV. One patient was positive for both HBV and HCV. There were no remarkable differences between HIV infected and IIIV-HBV coinfected patients in terms of the hematological, albumin and bilirubin measurements. Alanine transaminase was however higher in the HIV-HB V co-infected patients than HIV patients and this was statistically significant (17.5 iu/ ml vs. 15.0 iu/ml, p value- 0.009). In addition, the CD4 cell count was lower and the viral load marginally higher in the hepatitis B virus positive patients. The differences were however not statistically significant (p value- 0.114 and 0.644 respectively). HIV- HBV co-infection in HTV positive pregnant women is not of negligible proportions as demonstrated in this study. Thus, HIV positive pregnant women should be screened for HBV and assisted to access care targeted at preventing morbidity and vertical transmission.Item Anemia in pregnancy at two levels of health care in Ibadan, south west Nigeria(Annals of African Medicine Society, 2011-12) Adesina, O.; Akinyemi, O.; Oladokun, A.Background: In Africa, anemia in pregnancy contributes to non-attainment of the MDG goals 4 and 5. This study examined the prevalence and some risk factors for anemia at two levels of health care in the Ibadan metropolis. Methods: This was a retrospective study of the booking records of pregnant women at the University College Hospital (UCH, a profit-making tertiary institution) and Adeoyo Maternity Hospital (AMH, a secondary level institution offering free services) in Ibadan, September 1, 2008 to December 31, 2008. Eligible women had singleton pregnancies and no known chronic illnesses. Anemia was defined as packed cell volume (PCV) <30%, and degrees of anemia as mild (PCV 27–29%), moderate (PCV 19–26%), and severe (PCV below 19%). Statistical analysis was done by the Chi-square test, Fisher exact test, and t-test. A P value of <0.05 was considered significant. Results: Data from 2702 women (384 and 2318 from UCH and AMH, respectively) were available for analysis. About 30% of the women were anemic. The patients in UCH had higher mean PCV (33.03± 4.32 vs. 31. 04 ± 4.09, P = 0.00). A higher proportion of anemia was seen in patients presenting in Adeoyo (32.4% vs. 16.7%, P = 0.00). Factors associated with anemia included young age (P = 0.00), low parity (P = 0.00), and hospital type (P = 0.00). Parity and hospital type remained significant on logistic regression. Conclusion: Lower prevalence of anemia at the tertiary hospital maybe attributed to the higher socioeconomic status of the clientele. Short-term early antenatal management of anemia and long-term economic/educational empowerment is advocated.Item Prevalence and pattern of violence in pregnancy in Ibadan, South-west, Nigeria(Taylor and Francis, 2011) Adesina, O.; Oyugbo, I.; Oladokun, A.Violence against women is embedded in most cultures with pregnancy associated with higher rates. This study assessed the pattern of violence in pregnancy in two maternity centres in Ibadan, Nigeria. This was a cross-sectional study of antenatal clinic attendees, between 1 and 31 March, 2007 at the University College Hospital (UCH) and the Adeoyo Maternity (AMH). By systematic random sampling, 404 women were interviewed. Analysis was done by means, x(2)-test (at 5% level of significance) and logistic regression. At UCH and AMH, 156 (38.7%) and 248 (61.3%) were studied, respectively. The prevalence of abuse was 17.1% (69 women). The perpetrator was most often an intimate partner (48, 66.1%). The commonest act of violence was a threat of abuse (23, 33.3%). The most frequent reason for the abuse was demand for money. Women in polygamous unions (p=0.035), attending Adeoyo hospital (p=0.00) or with secondary school or less education (p=0.004) had higher levels of abuse. Regression analysis revealed women attending AMH were 3.6 times more likely to be abused (95% CI for OR=1.69–7.81). Violence is not uncommon in this population. Education and employment may reduce these acts.Item Routine antenatal syphilis screening In South West Nigeria- a questionable practice(Association of Resident Doctors, University College Hospital, Ibadan, Nigeria, 2010-06) Adesina, O.; Oladokun, A.Backgroud: Untreated maternal syphilis is strongly associated with adverse birth outcomes, especially in women with high titre syphilis. The WHO recommends routine serological screening in pregnancy. Some workers have advised a reappraisal of this practice, having demonstrated low sero-prevalence in their antenatal population. In view of this, the aim of this study was to determine the seroprevalence of syphilis in the antenatal population presenting at a major hospital in south-west Nigeria. Methods: This was a cross sectional study of healthy pregnant Nigerian women attending Adeoyo Maternity Hospital in the capital of Oyo State. The case record of every pregnant woman presenting for their first antenatal clinic visit over a 4-month period (September 1st to December 31st 2006) was reviewed. Results: During the study period, two thousand six hundred and seventy-eight women sought antenatal care. Three hundred and sixty-nine women (369; 13.4%) had incomplete records and were excluded from analysis. The records of the 2,318(86.6%) women with adequate records were subsequently reviewed. The mean age of the women was 27.4 years (± 5.34) and the mean gestational age 26.4 weeks (±6.36). The modal parity was 0. Only three patients were found to be reactive for syphilis giving a prevalence of 0.13%. Conclusion: The sero- prevalence value in this study is quite low and may justify the call to discontinue routine antenatal syphilis screening. However, a more rigorous screening program using diagnostic tests with higher sensitivity maybe necessary before jettisoning this traditional aspect of antenatal care.Item Repeat ipsilateral ectopic gestation: a series of 3 cases(College of Medicine, University of Ibadan, Ibadan, 2006) Okunlola, M. A.; Adesina, O. A.; Adekunle, A. O.Ectopic pregnancy remains an important cause of maternal mortality and morbidity as well as early foetal wastage in Nigeria and in other developing countries. We report 3 different cases of repeat ipsilateral ectopic pregnancy seen in the gynaecological emergency unit of the University College Hospital, Ibadan. Cases of repeat ectopic pregnancy often gives rise to diagnostic dilemma, and this becomes more difficult when it occurs at an ipsilateral location.