Obstetrics. & Gynecology
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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 Missed opportunities for prevention of mother-to-child transmission of HIV (PMTCT) in Ibadan, Southwest Nigeria(Scientific Research, 2014) Ogunbosi, B. O.; Oladokun, R. E.; Awolude, O.; Brown, B. J.; Adeshina, O. A.; Kuti, M.; Taiwo, B.; Berzins, B.; Kyriacou, D. N.; Chadwick, E. G.; Osinusi, K.; Adewole, I. F.; Murphy, R. L.Background: Nigeria has the largest paediatric HIV-infected population in the world. Missed opportunities for prevention of mother-to-child transmission of HIV (PMTCT) compromise efforts at eliminating new pediatric HIV infections. Methods: Six hundred children, aged < 15 years, presenting to the pediatric units of the University College Hospital (UCH), Ibadan Southwest Nigeria between June to December 2007 were studied. The demographics, HIV status and socioeconomic status of mothers and their children were studied. A 4-step hierarchy was used to assess the missed opportunities for PMTCT. Step 1: utilization of a health facility for antenatal care and delivery; Step 2: maternal HIV status determination during pregnancy; Step 3: provision of antiretroviral medication to HIV-infected mother and baby; and Step 4: avoidance of mixed feeding in HIV-exposed children. The rates of missed opportunities for PMTCT services at different steps in the PMTCT cascade, perinatal transmission rates, and associated factors were reported. Results: There were 599 mothers and 600 children (one set of twins), 60 (10%) were HIV infected and 56 (93.3%) of these were adjudged perinatally infected. Of 78 HIV-infected women, 7 (9.0%) accessed all interventions in the PMTCT cascade and 71 (91.0%) had missed opportunities for PMTCT. Missed opportunities for PMTCT occurred 42.9% in cascade Step 1, 64.2% in Step 2, 52.6% in step 3 and 73.7% in Step 4. All mother-baby pairs who accessed complete PMTCT interventions received care at a teaching hospital. Among infants with perinatal HIV infection, 53 (94.6%) were born to mothers who had missed opportunities for PMTCT. Most women with missed opportunities attended antenatal care outside the teaching hospital setting and belonged to low socioeconomic status. Conclusion: It is imperative to expand PMTCT access to women who receive antenatal care outside the teaching hospitals and to those of low socioeconomic status.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.Item Knowledge and utilization of malaria control measures by pregnant and newly delivered mothers in Ibadan, Nigeria(Makerere University, 2011-12) Oladokun, A.; Oladokun, R. E.; Adesina, O. A.Background: The World Health Organisation (WHO) guidelines for the control of malaria during pregnancy include prompt and effective case management of malaria combined with prevention of infection by insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (IPTp). Despite this the uptake is poor. Objective: To describe the malaria prevention measures utilized by these women in this environment. Methods: Information was obtained from consented pregnant and newly delivered women on their socio-demographic characteristics, knowledge and use of malaria chemoprophylaxis Results: One Thousand three hundred thirty (1330) pregnant and newly delivered women in 132 facilities within the Ibadan metropolis were surveyed. The mean age of the respondents was 29. 67 years (±5.21). The modes of prevention most commonly reported as being effective were the use of insecticide spray, window nets and ITN. Only 28.2% were using ITNs in the index pregnancy, and 67.2% of the women had had a drug administered for prophylactic purposes in the index pregnancy. Conclusion: This study demonstrates awareness but poor use of control measures. Additionally, 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.