Obstetrics. & Gynecology
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Item Attitudes of women and men living with HIV and their healthcare providers towards pregnancy and abortion by HIV-positive women in Nigeria and Zambia(Routledge, 2015) Moore, A. M.; Bankole, A.; Awolude, O.; Audam, S.; Oladokun, A.; Adewole, I.Fertility decisions among people living with HIV/AIDS (PLWHA) are complicated by disease progression, the health of their existing children and possible antiretroviral therapy (ART) use, among other factors. Using a sample of HIV-positive women (n = 353) and men (n = 299) from Nigeria and Zambia and their healthcare providers (n = 179), we examined attitudes towards childbearing and abortion by HIV-positive women. To measure childbearing and abortion attitudes, we used individual indicators and a composite measure (an index). Support for an HIV-positive woman to have a child was greatest if she was nulliparous or if her desire to have a child was not conditioned on parity and lowest if she already had an HIV-positive child. Such support was found to be lower among HIV-positive women than among HIV-positive men, both of which were lower than reported support from their healthcare providers. There was wider variation in support for abortion depending on the measure than there was for support for childbearing. Half of all respondents indicated no or low support for abortion on the index measure while between 2 and 4 in 10 respondents were supportive of HIV-positive women being able to terminate a pregnancy. The overall low levels of support for abortion indicate that most respondents did not see HIV as a medical condition which justifies abortion. Respondents in Nigeria and those who live in urban areas were more likely to support HIV-positive women’s childbearing. About a fifth of HIV-positive respondents reported being counselled to end childbearing after their diagnosis. In summary, respondents from both Nigeria and Zambia demonstrate tempered support of (continued) childbearing among HIV-positive women while anti-abortion attitudes remain strong. Access to ART did not impart a strong effect on these attitudes. Therefore, pronatalist attitudes remain in place in the face of HIV infection.Item Knowledge of the human papilloma virus vaccines, and opinions of gynaecologists on its implementation in Nigeria(2013-06) Morhason-Bello, I. O.; Adesina, O. A.; Adedokun, B. O.; Awolude, O.; Okolo, C. A.; Aimakhu, C. O.; Akinwunmi, B. O.; Oladokun, A.; Adewole, I. F.The objective of this study was to determine the knowledge and perception of Nigerian Obstetricians and Gynaecologists towards human papilloma virus vaccine use in Nigeria. A cross sectional study was conducted amongst participants that attended the 42nd Society of Gynaecology and Obstetrics of Nigeria. The findings revealed that 44.5% knew the correct HPV vaccine schedule. Regarding implementation in Nigeria, 87.4% suggested its incorporation into the national immunization program and about a third agreed that it should be a precondition for school enrolment. Regression analysis showed that senior residents were more likely to have adequate knowledge of the vaccine compared to junior residents (AOR 7.181 95% CI OR=1.792 – 28.782). We conclude that the knowledge of eligibility and schedule is poor. It is recommended that adequate information should be provided to this group of health workers because of their strategic position in its implementation in NigeriaItem 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 Service uptake and performance of the prevention of mother-to-child transmission (PMTCT) programme in Ibadan, Nigeria(2010) Oladokun, R. E.; Awolude, O. A.; Brown, B. J.; Adesina, O. A.; Oladokun, A.; Roberts, A.; Odaibo, G. N.; Osinusi, K.; Olaleye, D. O.; Adewole, I. F.; Kanki, P.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 Asymptomatic bacteriuria among HIV positive pregnant women(2010) Awolude, O. A.; Adesina, O. A.; Oladokun, A.; Mutiu, W. B.; Adewole, I. F.The prognostic significance of asymptomatic bacteriuria resides in the observation that the prevalence is, relatively, high in persons with certain medical conditions, such as diabetes mellitus and pregnancy. This prevalence might, even, be higher in patients with human immunodeficiency virus infection. Hence, this study set out to determine the prevalence of asymptomatic bacteriuria among symptom free and newly enrolled HIV infected pregnant women attending PMTCT unit of Antiretroviral Clinic of University College Hospital, Ibadan, Nigeria between 1st May and 30th September 2007. Information was obtained on the socio-demographic characteristics of the subjects, CD4 count and viral load. Microbial culture was carried out on aseptically collected urines from the patients. Statistical analysis was done with SPSS 12 package. There were 161 analyzable samples from the participants. The mean age and gestational age at presentation of participants was 30.49 ± 4.3 years and 27.3 ± 3.2 weeks, respectively with modal parity of 2. Twenty-five (15.5%) of the urine samples significantly grew bacteria. The CD4 cells were significantly lower and the viral loads significantly higher (250.52 vs. 355.57 cells/mm3; 88,731 vs. 55,384 copies/ml; p = <0.0000) for the urine culture positive patients. Eshcherichia coli were isolated in 48%, Proteus in 16.0%, Klebsiella in 8.0% and Staphylococcus aureus in 28.0% of the urine positive cultures. The study showed that the prevalence of asymptomatic bacteriuria among PLWHAs is high. The microbial isolate from the urine samples were not different from those of HIV-negative patients.Item Correlates of HIV sero-disclosure and partner status at a PMTCT centre, UCH, Ibadan(2010) Adesina, O. A.; Awolude, O. A.; Akinyemi A.; Oladokun, A.; Adewole, I. F.; Kanki, P.Item Postpartum Haemorrhage(2017) Morhason-Bello, I. O.; Oladokun, A.Item Knowledge of the human papilloma virus vaccines, and opinions of gynaecologists on its implementation in Nigeria(Women’s Health and Action Research Centre, 2013) Morhason-Bello, I. O.; Adesina, O. A.; Adedokun, B. O.; Awolude, O.; Okolo, C. A.; Aimakhu, C. O.; Akinwunmi, B. O.; Oladokun, A.; Adewole, I. F.The objective of this study was to determine the knowledge and perception of Nigerian Obstetricians and Gynaecologists towards human papilloma virus vaccine use in Nigeria. A cross sectional study was conducted amongst participants that attended the 42nd Society of Gynaecology and Obstetrics of Nigeria. The findings revealed that 44.5% knew the correct HPV vaccine schedule. Regarding implementation in Nigeria, 87.4% suggested its incorporation into the national immunization program and about a third agreed that it should be a precondition for school enrollment. Regression analysis showed that senior residents were more likely to have adequate knowledge of the vaccine compared to junior residents (AOR 7.181 95% CI OR=1.792 – 28.782). We conclude that the knowledge of eligibility and schedule is poor. It is recommended that adequate information should be provided to this group of health workers because of their strategic position in its implementation in Nigeria.Item Care providers’ knowledge and practice of malaria control measures in pregnancy in Ibadan, South west Nigeria(College of Medicine, University of Ibadan, Ibadan, 2012) Oladokun, A.; Adesina, O. A.; Oladokun, R. E.Background: Effective prevention and control of malaria during pregnancy include prompt and effective case management of malaria combined with prevention of infection by the use of insecticide-treated nets and intermittent preventive treatment in pregnancy (IPTp). Care givers knowledge and practice of malaria control is pivotal to effective implementation of these guidelines. The objective of this study was to determine the awareness of care providers in facilities offering maternity services in Ibadan of the National Malaria Treatment Guideline and Policy in Nigeria. The study also aimed to describe the prescription practice, for malaria chemoprophylaxis and case management in pregnancy, by these care providers. Materials and method: The study was a cross-sectional survey of the; lead care givers in all registered hospitals and maternity centres in Ibadan over one year (April 2008 to April 2009), using structured questionnaires. The list of the one hundred and thirty-two (132) registered centres was obtained from the State Ministry of Health. The lead care givers provided information, on their awareness of the new government policy and antimalarials believed to be effective and prescribed for malaria prevention and case management in pregnancy. Results: Over two thirds (84.2%) of the facilities were operated by either Medical Officers with only basic medical training or by Nurses/Mid wives. The modes of prevention most commonly reported as being effective were the use of insecticide spray, window nets and ITN. The drugs most commonly prescribed for chemoprophylaxis were sulphadoxine-pyrimethamine (SP) (65.2%), Proguanil (45.5%) and pyrimethamine (42.4%). The drugs most commonly prescribed for case management were ACIfe (66.7%), amodiaquine (59.8%) and artemether (47.7%). Quite a number of respondents were unsure of the frequency (81.8%) and timing (56.5%) of administration of sulphadoxine- pyrimethamine for prophylaxis. Conclusion: This study demonstrates awareness but lack of in-depth knowledge of control measures. Also, there is poor use of the recommended agent for IPT. The factors militating against the use of these preventive measures need to be urgently explored and addressed.