Obstetrics. & Gynecology

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A comparative review of the efficacy of 24-hour versus 48-hour dose regimen of amoxicillin/ clavulanic acid prophylaxis for postoperative infections following elective caesarean section at the University College Hospital, Ibadan, Nigeria.
(Zambia Medical Association, 2022) Oloko, O.O.; Ogunbode, O.O.; Obajimi, G.O.; Arowojolu, A.O
Objectives: To compare the efficacy of 24 hour versus 48 hour prophylaxis of amoxicillin/clavulanic acid in the prevention of postoperative infections. Study Design: This study was a randomized controlled clinical trial conducted in a tertiary hospital in Ibadan, Nigeria. Two hundred and fifty - two pregnant women scheduled for elective caesarean section were randomly assigned into two groups. After the initial pre-incision antibiotic a dmi n i s t r a t i o n , g r o u p A r e c e i v e d t h e Amoxicillin/Clavulanic Acid for 24 hours while group B received the same drug for 48hours. Main Outcomes: Participants were examined on the3rd, 10th and 17th post-operative days for evidence of infections. All entry and analysis of data was by computer using the Statistical Package for Social Sciences version 22 (IBM, New York).Statistically significant differences were determined at p value of< 0.05. Results: The incidence of postoperative wound infection, postoperative fever and endometritis in this study was 5.2%, 9.1% and 5.6% respectively. There were no significant differences in the incidence of postoperative wound infection, postoperative fever and endometritis between the two regimens of antibiotics.
Abortion: manual vacuum aspiration
(World Health Organization, 2017) Ogunbode, O. O.
Acceptability of artificial insemination by donor among infertile women attending the Gynaecological Clinic of the University College Hospital, Ibadan
(Wolters Kluwer - Medknow, 2017) Obajimi, G. O.; Ogunbode, O. O.; Adetayo, C. O.; Ilesanmi, A. O.
Background: Artificial insemination by donor (AID) is specifically indicated in cases of incurable male infertility. Acceptability depends on perceptions largely influenced by religious and sociocultural perspectives. Male factor accounts for 20-50% of the causes of infertility and shows geographic variation in Nigeria. Method: A descriptive cross-sectional survey of all infertile women attending the gynecology clinic of the University College Hospital, Ibadan, between January and June 2014. 181 self-administered questionnaires were distributed to all consenting infertile women, however only 163 were suitable for analysis. Data analysis was descriptive and inferential at 95% confidence interval and a P value of less than 0.05 was considered statistically significant. Result: The mean duration of infertility was 5.7 ± 4.33 years. Fifty seven (35.0%) respondents were willing to accept artificial insemination by donor, while ninety three (57.1%) were unwilling to accept artificial insemination. Socio-cultural factor (48.1%) was the major reason for non-acceptability of artificial insemination by donor. Acceptability of AID was influenced by adequate knowledge about the procedure (P < 0.01). Sixty percent of the respondents had good knowledge and over half of them obtained the information from the news/print media. In this Study, acceptability of AID was not influenced by the age of the respondents, family structure, duration or type of infertility or educational status. (P > 0.05). Conclusion: This study revealed a low acceptance rate for Artificial insemination by donor. Providing information on AID as a treatment option during counseling and routine infertility management may be the needed drive to improve awareness and promote uptake when necessary.
Acceptability of counseling and testing for HIV infection in women in labour at the University College Hospital, Ibadan, Nigeria
(Makerere University, 2011-03) Bello, F.; Ogunbode, O. O.; Adesina, O. A.; Olayemi, O.; Awonuga, O. M.; Adewole, I. F.
Background: Many patients are referred to labour ward as emergencies, and therefore do not benefit from the antenatal HIV counselling and testing and treatment offered to registered patients. Objective: To assess the acceptability and suitability of offering HIV counselling and testing to women of unknown HIV status presenting in labour. Methods: A cross-sectional study comprising counselling and obtaining consent for HIV testing among 104 unregistered patients who presented in labour over a 3-month period. Rapid and enzyme-linked immunosorbent assay screening was performed for 90 consenting respondents. Reactive results were confirmed by Western blot. Appropriate therapy was instituted. Results: Acceptance rate for HIV testing was 86.5%, prevalence of HIV was 6.7%. Women of lower educational status were more likely to accept testing in labour (OR: 0.3; 95% CI: 0.1-0.7; p=0.01); age, parity, occupation and knowledge of HIV had no influence. Most women (66.3%) had satisfactory knowledge of HIV. No one admitted to feeling coerced to test in fear of being denied care. Most refusals for screening were to avoid needle pricks (28.6%). Compared to ELISA screening test, specificity of the rapid test was 100%, sensitivity 85.7%, positive predictive value 100% and negative predictive value 98.8%. Attitude to testing was maintained on post-partum re-evaluation. Conclusion: The prevalence of HIV amongst unregistered parturients showed the importance of offering point-of-care HIV testing and intervention, especially in an environment where antenatal clinic attendance is poor. Rapid testing appeared to be acceptable and feasible in labour to prevent the mother-to-child transmission of HIV.
Acceptability of counselling and testing for HIV infection in women in labour at the University College Hospital, Ibadan, Nigeria
(The Faculty of Medicine, Makerere University, 2011-03) Bello, F. A.; Ogunbode. O. O.; Adesinsa, O. A.; Olayemi, O.; Awonuga, O. M.; Adewole, I. F.
Background: Many patients are referred to labour ward as emergencies, and therefore do not benefit from the antenatal HIV counselling and testing and treatment offered to registered patients. Objective: To assess the acceptability and suitability of offering HIV counselling and testing to women of unknown HIV status presenting in labour. Methods: A cross-sectional study comprising counselling and obtaining consent for HIV testing among 104 unregistered patients who presented in labour over a 3-month period. Rapid and enzyme-linked immunosorbent assay screening was performed for 90 consenting respondents. Reactive results were confirmed by Western blot. Appropriate therapy was instituted. Results: Acceptance rate for HIV testing was 86.5%, prevalence of HIV was 6.7%. Women of lower educational status were more likely to accept testing in labour (OR: 0.3; 95% CI: 0.1-0.7; p=0.01); age, parity, occupation and knowledge of HIV had no influence. Most women (66.3%) had satisfactory knowledge of HIV. No one admitted to feeling coerced to test in fear of being denied care. Most refusals for screening were to avoid needle pricks (28.6%). Compared to ELISA screening test, specificity of the rapid test was 100%, sensitivity 85.7%, positive predictive value 100% and negative predictive value 98.8%. Attitude to testing was maintained on post-partum re-evaluation. Conclusion: The prevalence of HIV amongst unregistered parturients showed the importance of offering point-of-care HIV testing and intervention, especially in an environment where antenatal clinic attendance is poor. Rapid testing appeared to be acceptable and feasible in labour to prevent the mother-to-child transmission of HIV.
Acquired Clitoromegaly Cyst: Consequence of Persistent Unorthodox Practice in the 21st Century
(Fortune Journals, 2019) Awolude, O. A.; Akinyotu, O.
Objective: To present case report a patient with clitoral cyst, following type II female genital cutting performed in childhood, management and literature review. Design: Report of cases managed and review of available current literatures. Setting: University College Hospital Ibadan. Patients: The case was a 30 year old Para 2+0 , 2 alive, known hypertensive, with perineal swelling since childhood. She presented 30 years later with increasing size of the clitoral swelling associated with pain. Management: Surgical excision of the cyst following thorough evaluation of the patients. Results: Better cosmetic outcome, vulvar discomfort subsided and improved sexual satisfaction post-operatively. Conclusion: While a good cosmetic and stoppage of vulvar discomfort can be managed with acceptable outcomes, these case, again, brings to attention of persistence of unacceptable female genital cutting with attendant effects even in the 21st century. Also, to let us know that there is need for more and continuous awareness creation of the need to stop this dehumanizing practice, of female genital cutting, which is of no health importance, rather numerous adverse sequelae.
Adaptation of evidence-based approaches to promote HIV testing and treatment engagement among high-risk Nigerian youth
(Public Library of Science (PLoS), 2021) Kuhns, L. M.; Johnson, A. K.; Adetunji, A.; Kuti, K. M.; Garofalo, R.; Omigbodun, O.; Awolude, O. A.; Oladeji, B. D.; Berzins, B.; Okonkwor, O.; Amoo, O. P.; Olomola, O.; Taiwo, B.
Background Nigeria has the second highest number of people living with HIV (PLWH) globally, and evi- dence-based approaches are needed to achieve national goals to identify, treat, and reduce new infections. Youth between the ages of 15–24, including young men who have sex with men (YMSM), are disproportionately impacted by the Nigerian HIV epidemic. The purpose of this study was to inform adaptation of evidence-based peer navigation and mHealth approaches (social media outreach to promote HIV testing; short messaging service text message reminders to promote HIV treatment engagement) to the local context within iCARE Nigeria, a multi-phase study designed to investigate combination interventions to promote HIV testing and care engagement among youth in Nigeria. Methods To elicit expert and community perspectives, a local group of advisors from academia, com- munity, and governmental sectors provided feedback on intervention adaptation, which then informed a series of focus groups with stakeholders in Ibadan, Nigeria. Focus group data were collected over a period of three days in December of 2018. Participants in focus groups included YMSM and HIV-positive youth in care ages 16–24, and HIV service providers from local AIDS service organizations (ASO). Groups were stratified by HIV serostatus, gender, and stakeholder type. Focus group sessions were conducted using a semi-structured interview guide, audio-recorded, transcribed verbatim, and analyzed using a content analy- sis approach. Results Local experts recommended intervention adaptations specific to the status of peer naviga- tors as volunteers, peer characteristics (slightly older age, high maturity level, HIV/YMSM status), and intervention characteristics and resources (low navigator to peer ratio; flexible matching by demographic and social characteristics; social media platforms and content). Five focus group discussions with stakeholders, including 27 participants were conducted to elicit feedback on these and other potential adaptations. Youth participants (n = 21) were mean age 20 years (range = 16–24); 76% HIV-positive, 76% men and 48% MSM. Service providers (n = 6) represented both HIV prevention and care services. Participants across stratified subgroups reported largely positive perceptions and high perceived acceptability of both mHealth and peer navigation strategies, and echoed the recommendations of the advisory group for volunteer-based navigators to promote altruism, with a low navigator- peer ratio (1:5). Participants emphasized the need to incorporate minimal mobile data use strategies and popular social media platforms among YMSM (e.g., Facebook, Grindr) for widespread access and reach of the interventions. Conclusions In Ibadan, Nigeria, stakeholders support the adaptation of combined mHealth and peer navi- gation strategies to promote HIV testing and care engagement among high-risk youth. Rec- ommended adaptations for the local context reflect concerns about the feasibility and sustainability of the intervention and are expected to improve accessibility and acceptability.
Adverse childhood experiences and risky sexual behaviour among undergraduates in Ibadan
(Society of Gynaecology and Obstetrics of Nigeria (SOGON), 2015) Ogunbode, O. O.; Bello, F. A.; Sekoni, O.O; Ogunbode, A. M.; Akinola, I. T.; Adeniyi, A. A.
Age-specific burden of cervical cancer associated with HIV: A global analysis with a focus on sub-Saharan Africa
(Wiley, 2021) Khalil, A. I.; Mpunga, T.; Wei, F.; Baussano, I.; de Martel, C.; Bray, F.; Stelzle, D.; Dryden-Peterson, S.; Jaquet, A.; Horner, M. J.; Awolude, O. A.; Trejo, M. J.; Mudini, W.; Soliman, A. S.; Sengayi-Muchengeti, M.; Coghill, A. E.; van Aardt, M. C.; DeVuyst, H.; Hawes, S. E.; Broutet, N.; Dalal, S.; Clifford, G. M.
HIV substantially worsens human papillomavirus (HPV) carcinogenicity and contributes to an important population excess of cervical cancer, particularly in subSaharan Africa (SSA). We estimated HIV- and age-stratified cervical cancer burden at a country, regional and global level in 2020. Proportions of cervical cancer (a) diagnosed in women living with HIV (WLHIV), and (b) attributable to HIV, were calculated using age-specific estimates of HIV prevalence (UNAIDS) and relative risk. These proportions were validated against empirical data and applied to age- specific cervical cancer incidence (GLOBOCAN 2020). HIV was most important in SSA, where 24.9% of cervical cancers were diagnosed in WLHIV, and 20.4% were attributable to HIV (vs 1.3% and 1.1%, respectively, in the rest of the world). In all world regions, contribution of HIV to cervical cancer was far higher in younger women (as seen also in empirical series). For example, in Southern Africa, where more than half of cervical cancers were diagnosed in WLHIV, the HIV-attributable fraction decreased from 86% in women <34 years to only 12% in women >55 years. The absolute burden of HIV-attributable cervical cancer (approximately 28 000 cases globally) also shifted toward younger women: in Southern Africa, 63% of 5341 HIV-attributable cervical cancer occurred in women <45 years old, compared to only 17% of 6901 non-HIV-attributable cervical cancer. Improved quantification of cervical cancer burden by age and HIV status can inform cervical cancer prevention efforts in SSA, including prediction of the impact of WLHIV-targeted vs general population approaches to cervical screening, and impact of HIV prevention.
An assessment of ovarian cancer histologic types across the African Diaspora
(2021) George, S. H. L.; Omotoso, A.; Pinto, A.; Mustapha, A.; Sanchez-Covarrubias, A. P.; Umar, U. A.; Umar, A. B.; Oluwasola, T. A. O.; Okolo, C. A.; Anthony, U. U.; Ukekw, F. I.; Bakari, M. A.; Dahiru, A. M. C.; Abdullahi, H. I.; Abimiku, B. A.; Abdurrahman, A.; Usman, A.; Ahmed, S. A.; Usman, H. A.; Kabir, A.; Eleje, G. U.; Chiemeka, M. E.; Nzeribe, E.; Nweke, I.; Kadas, S. A.; Suleiman, D. E.; Ekanem, E.; Uche, U. M.; Paul, J.; Agwu, U. M.; Edegbe, F. O.; Anorlu, R. I.; Banjo, A.; Ajenifuja, K. O.; Fawole, A. A.; Kazeem, I. O. O.; Magaji, F.; Silas, O.; Athanasius, B. P.; Tamunomie, N. K.; Abudu, E. B. K.; Ango, I. G.; Abdullahi K.; Lawal, I.; Kabir, S. A.; Ekanem, V.; Ezeanochie, M.; Yahaya, U. R.; Castillo, M. N.; Bahall, V.; Chatrani, V.; Brambury, I.; Bowe, S.; Halliday, D.; Bruney, G.; Butler, R.; Ragin, C.; Odedina, F.; Chamala, S.; Schlumbrecht, M.; Audu, B.
Objective: Ovarian cancer in Black women is common in many West African countries but is relatively rare in North America. Black women have worse survival outcomes when compared to White women. Ovarian cancer histotype, diagnosis, and age at presentation are known prognostic factors for outcome. We sought to conduct a preliminary comparative assessment of these factors across the African diaspora. Methods: Patients diagnosed with ovarian cancer (all histologies) between June 2016- December 2019 in Departments of Pathology at 25 participating sites in Nigeria were identified. Comparative population-based data, inclusive of Caribbean-born Blacks (CBB) and US-born Blacks (USB), were additionally captured from the International Agency for Research on Cancer and Florida Cancer Data Systems. Histology, country of birth, and age at diagnosis data were collected and evaluated across the three subgroups: USB, CBB and Nigerians. Statistical analyses were done using chi-square and student’s t-test with significance set at p<0.05. Results: Nigerians had the highest proportion of germ cell tumor (GCT, 11.5%) and sexcord stromal (SCST, 16.2%) ovarian cancers relative to CBB and USB (p=0.001). CBB (79.4%) and USB (77.3%) women were diagnosed with a larger proportion of serous ovarian cancer than Nigerians (60.4%) (p<0.0001). Nigerians were diagnosed with epithelial ovarian cancers at the youngest age (51.7± 12.8 years) relative to USB (58.9 ± 15.0) and CBB (59.0± 13.0,p<0.001). Black women [CBB (25.2 ± 15.0), Nigerians (29.5 ± 15.1), and USB (33.9 ± 17.9)] were diagnosed with GCT younger than White women (35.4 ± 20.5, p=0.011). Black women [Nigerians (47.5 ± 15.9), USB (50.9 ± 18.3) and CBB (50.9 ± 18.3)] were also diagnosed with SCST younger than White women (55.6 ± 16.5, p<0.01). Conclusion: There is significant variation in age of diagnosis and distribution of ovarian cancer histotype/diagnosis across the African diaspora. The etiology of these findings requires further investigation.
An overview of the genetics of cervical cancer.
(2018) Gbadegesin, M. A.; Soremekun, O.; Oluwasola, T. A. O.; Okolo, C. A.; Oluwasola, A. O.
Cervical cancer is the fourth most common cancer in women, and the seventh of all human cancers. It is the most rampant cancer of the female genital tract in the developing world and manifests in two common histological subtypes: squamous cell carcinoma which is derived from squamous cells of the cervix and cervical adenocarcinoma which arose from the glandular cells. Most cases of deaths from cervical cancer occur in the less developed countries of the world where there are ineffective screening systems. Factors that increase the risk for developing cervical cancer include infection by Human Papilloma Virus (HPV) as the main direct factor and other indirect factors such as smoking, dietary habits, age, race, socioeconomic status, sexual history, use of oral contraceptives, high parity and the human immunodeficiency virus infection. Identifying the genetic alterations that predispose to or associate with cervical cancer will help in the screening of patients at risk of the cancer thereby allowing early diagnosis and prompt management with better outcomes. In this review we describe the role of HPV DNA integration into the host cellular genome, the effects of viral E6 and E7 proteins, and the loss of heterozygosity as genetic factors in cervical cancer.
Anaemia and its associated risk factors among pregnant women in the Gambia.
(2024) Oluwasola, T. A. O.; Amadi, A. O
Background: Anaemia is a global health problem affecting about a third of the world’s population. In pregnancy, it is a public health concern with consequences for mothers and infants, including maternal death and infant mortality. In low-income countries, 25% indirect maternal mortality and 30% neonatal deaths are due to anaemia in pregnancy. This study aimed to determine the prevalence of anaemia among pregnant women in The Gambia and identify common risk or predisposing factors associated with anaemia in pregnancy among them. Methods: This was a cross-sectional study of 180 consenting pregnant women, who attended two secondary-care level hospital for antenatal care between March and May 2023. They were selected by using a simple random sampling technique. Data were collected using a validated structured questionnaire and participants’ current antenatal cards while SPSS software version 26.0 was used for analyzing data. Results: The findings of this study shows that 21.7% and 8.3% of the pregnant women were anaemic at booking using 11.0g/dl and 10.0g/dl as cut off respectively with the mean haemoglobin concentration of 11.76+-1.36g/dl. The study revealed that anaemia during pregnancy is associated with factors such as educational level (p=0.048) and the average income per month (p=0.039). Majority of the women, (166, 92.2%), have taken malaria prophylaxis but only 95 (52.8%) admitted to sleeping under insecticide-treated mosquito nets which shows the low prevalence of Malaria among the participants (5.6%) Conclusion: The prevalence of anaemia among pregnant women in the Gambia is 21.7% which implies that anaemia is still a public health problem. Therefore, it is important for actions like early booking and improvement on health and nutritional education to be taken in order to reduce anaemia among pregnant women.
Anaemia in pregnancy
(Springer International, 2021) Ogunbode, O.; Ogunbode, O.
Anaesthesia considerations for the HIV positive parturient
(Association of Resident Doctors, University College Hospital, Ibadan, Nigeria, 2009-06) Adesina, O.; Oladokun, A.
The HIV epidemic in children parallels that among women on account of perinatal transmission. A combination of antiretroviral therapy and elective caesarean section reduces the rate of vertical transmission to <2%. Elective caesarean section independent of antiretroviral therapy decreases the risk of HIV vertical transmission from mother to baby. However, a caesarean section is a major surgical intervention that has well-reported complications. Women infected with HIV have been reported to be more susceptible to such complications. The multi-organ nature of HIV poses challenges at the time of surgery and anesthesia. Preoperative evaluation will allow a good prediction for the perioperative risk of the HIV-patient. The anesthesiologist should be aware of the possible toxic side effects or the possible interaction of antiretroviral drugs with the anesthetics. Some of these adverse effects may mimic signs and symptoms of the HIV disease itself. Regional anesthesia has been shown to be associated with reduced morbidity and mortality in a wide range of patients, including HIV positive parturients. Finally, the possibility of transmission in the health care setting highlights the need for anesthetists to enforce rigorous infection control policies to protect themselves, other health workers and their patients.
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.
Antenatal care utilisation among adolescent mothers in Ngozi Province, Burundi
(Wolters Kluwer ‑ Medknow, 2024) Iradukunda, L. I.; Ogunbode, O. O.; Arulogun, O. S.
Background: Globally pregnancy and childbirth complications are the leading cause of death among adolescents, with evidence showing that antenatal care (ANC) is a very effective preventive intervention. In Burundi, there is limited information on the extent to which pregnant adolescents utilise such services. Objective: To assess the ANC utilisation and factors associated with its use among adolescent mothers in Ngozi Province, Burundi. Materials and Methods: A cross-sectional, health facility-based study among 216 adolescent mothers who had given birth within two years preceding this study, using structured questionnaires and records from previous ANC booklets. A multistage random sampling technique was used to select respondents while the utilisation of ANC was determined by the frequency of ANC visits and the time when the women enrolled for the first ANC visit. Results: The majority (98.1%) of adolescent mothers in Ngozi Province used ANC services. Most respondents (64.8%) initiated ANC services within the first trimester while 57.8% attained the minimum of four recommended ANC visits. Marital status (P = 0.001), geographical location (P = 0.009), occupation of the partner (P = 0.002) and type of the last pregnancy (P = 0.012) were associated with ANC initiation within the first trimester while marital status (P < 0.001), respondent’s employment (P = 0.003) and type of last pregnancy (P < 0.001) were associated with appropriate ANC frequency. Conclusion: This study revealed a high use of ANC services among adolescent mothers, although more than one-third attended ANC late. There is therefore the need to put more effort into improving early booking for ANC.
Antenatal care visits’ absenteeism at a secondary care medical facility in Southwest Nigeria.
(Taylor & Francis, 2016) Oloko, O. O.; Ogunbode, O. O.; Roberts, O.; Arowolo, A. O.
Antenatal care (ANC) is a specialised pattern of care organized for pregnant women with the goal of maintaining good health and promoting safe delivery of healthy infants. It is an indispensable part of effective maternity care services. This study identified the factors responsible for absenteeism from ANC follow-up visits. It was a hospital-based prospective cross-sectional descriptive study conducted at a faith based secondary healthcare facility in Ibadan, Nigeria. Relevant data were retrieved using interviewer administered structured questionnaires and antenatal health record cards. The major reasons identified for absenteeism were delay in receiving hospital services due to long queues at service points and understaffing. The pregnant women aged 35 years and above were the most likely to miss the visits. Therefore, there is the need for hospital administrators and health care givers to make the services patient-friendly
Application of bayesian non parametric estimation on cervical cancer: A case study of University College Hospital, Nigeria.
(2021) Onatunji, A. P.; Folorunso, S. A.; Oluwasola, T. A. O.; Adesina, O. A.; Uthman, K. T.
Cervical cancer is the third most common malignancy in women worldwide, and in developing countries, it remains a leading cause of cancer-related death for women. The disease is a significant illness in women in Sub Sahara Africa Countries like Nigeria. Cervical cancer ranks as the 2nd most prevalent cancer among women in Nigeria and the most prevalent cancer among ages 15 – 44 years. Some of the identified risk factors of this disease have been wrongly captured in some statistical models. This consequentially makes the result of the analysis wrongly interpreted and concluded when the risk factors are continuous. This study is aimed at examining the Bayesian estimation of cervical cancer on a woman's age and survival period of the disease using the application of non-parametric techniques. The study is a means to apply Bayesian Nonparametric estimation on cervical cancer. The study findings reveal that women between ages 40 - 60 years have a significant increase in the probability of mortality from cervical cancer when the survival period is between stage I-IV. Also, there is an increase in woman's age and survival period of living with the disease which is significantly likely to decrease the mortality from cervical cancer in the study area.
Assessment of antenatal care satisfaction amongst postpartum women at the University College Hospital, Ibadan, Nigeria.
(2023) Adedeji, O. A.; Oluwasola, T. A. O.; Adedeji, F. M.
Background: Maternal mortality is unacceptably high especially in developing countries. About 287,000 women died during and following pregnancy and childbirth in 2020. The vast majority of these deaths (95 %) occurred in low and lower middle countries in 2020 and most could have been prevented. Every day in 2020, approxi-mately 800 women died from preventable causes related to pregnancy and childbirth. Utilization of antenatal visit has been shown to improve birth outcome as well as the maternal outcome during pregnancy-related events, giving a positive impact when the visit frequency and care are adequate while satisfaction has equally been an important outcome measures of quality of care. In order to improve feto-maternal outcome and turn the tide against maternal deaths, it is expedient to assess the satisfaction of women who had experienced antenatal care with the aim of identifying areas requiring additional attention. Objective: This study aimed to assess the level of antenatal care satisfaction of postpartum women and factors associated with satisfaction at the University College Hospital (UCH), Ibadan and their future intention for subsequent utilization of antenatal care. Methods: A descriptive cross-sectional study of 261 women in the postnatal ward using simple random sampling technique was conducted with an interviewer-administered structured questionnaire. Items in the questionnaire included sociodemographic and obstetric variables, assessment of quality of amenities, waiting time and level of satisfaction. Data was entered, cleaned and analyzed by computer using the Statistical Package for Social Sci-ences Version 23.0 (SPSS, IBM). The variables were summarized using frequencies, proportions, means and standard deviation. Chi Square was used for test of significance with the p-value set at P <0.05. Results: Of the 261 participants 176 (67.5 % percent) were aged 25–34 years; majority (244,93.5 %) had tertiary education while (189, 72.4 %) were skilled workers or professionals. Most of the women (243, 93.2 %) were Para 1–3 and the pregnancy was planned (80.8 %) while financing was mostly out of pocket (60.9 %). Only one-third of the participants has at least eight (8) antenatal contacts. In overall rating, most women (90.0 %) were satisfied with the antenatal care services received. The highest rating of satisfaction was with the competence of the service providers (90.4 %) especially with the care given to them and their unborn babies (90.4 %). The parity, distance of their home from antenatal clinic, number of antenatal contacts, number of health education sessions attended, total time spent, attitude of health workers, cost of services and desire to register again at the facility were statistically associated with patient’s satisfaction. Also, the number of antenatal visits was statistically associated with the fetal outcome. Conclusion: There is a high overall level of satisfaction with antenatal services among postpartum women in UCH. It is important to encourage women to register early to ensure they have adequate number of antenatal contacts and also participate in the health education sessions.
Assessment of Infrastructural and Human Resource for Health Status and Readiness for HPV Vaccination in Rural Communities in Nigeria
(Fortune Journals, 2019) Awolude, O. A.; Oyerinde, S. O.
Introduction: Human papillomavirus vaccination remains an important primary preventive measure for cervical cancer. Its inclusion in preventive messages and service provision by first-line health care workers in low- and middle-income countries needs to be routine. However, there is paucity of data on willingness by health care workers (HCWs) working in rural communities, to counsel and/or provide service to beneficiaries of HPV vaccination programs. This study evaluated available facilities for cervical cancer prevention and willingness to vaccinate daughters for HPV by these HCWs. Materials and Methods: This was a descriptive, cross-sectional study among HCWs in all the primary and secondary health care facilities in the three local government areas of Ibarapa health zone of Oyo state, Nigeria. Descriptive statistics such as mean ± SD, frequency and proportion were used for socio-demographic data, awareness and willingness to vaccinate daughters by the study population. Results: We observed that despite good awareness about cervical cancer (79.1%), awareness about HPV vaccine (41.9%) and their availability in Nigeria (31.0%) were low. Also, the uptake of the vaccine was low (1.8%). However, the majority of the respondents (78.6%) were willing to vaccinate their daughters. This, we believe, can be leveraged on the opportunity of already existing structure for childhood immunization in 77.8% of the facilities where the respondents practise. Conclusion: It is important that narrowing of an existing gap between awareness of cervical cancer and practice of cervical cancer prevention should be initiated. Provision of more cervical cancer prevention educational programs and HPV vaccination opportunities will be key to achieving this.