Obstetrics. & Gynecology
Permanent URI for this communityhttps://repository.ui.edu.ng/handle/123456789/525
Browse
20 results
Search Results
Item Challenges of gynaecological cancer care in Nigeria – A review article.(2018) Oluwasola, T. A. O.; Oladewa, A. C."Background: Gynaecological cancers and their management in the tropics constitute a big challenge to the gynaecological oncologist considering the overwhelming economic burden of care on patients and their relatives. These challenges arc numerous and present at different levels vis-a-vis of prevention, diagnosis, treatment of the disease and patients’ follow up. The main thrust of this review was to illustrate the challenges affecting gynaecological cancer care in Nigeria and proffer potential opportunities for their early identification while making recommendations that may be beneficial in ameliorating their effects and impacts. Methodology: Electronic search of local and international literatures was conducted in major databases including PubMed, Web of Science, Science direct, EMBASE, SpringerLink, Scopus, JSTOR, JaypccDigital, and Google Scholar using appropriate MESH terms either individually or in combination. All relevant peer-reviewed article and publications were identified, retrieved and reviewed. Results: Challenges of management of gynaecological cancers are enormous and diverse. They vary at different levels of care and included poverty, lack of access to health care inadequate or absence of basic infrastructure for cancer care and lack of political will. Delay at different levels of care leading to late presentation remains a leading factor that negatively contributes to survival. Conclusion: Gynaecological cancer care in the tropics is a big challenge to health care providers. Efforts should be intensified in prompt identification of these challenges and offering solutions that will help in improving the health of our women. "Item 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-friendlyItem Prevalence of obesity among women attending a Nigerian primary care clinic(College of Health Sciences, University of Ilorin, 2010-01) Ogunbode, A. M.; Ladipo, M. M. A.; Ajayi, I. O.; Ogunbode, O. O.; Adebusoye, L. A.; Fatiregun, A. AThe objective was to determine the prevalence of obesity and associated risk factors among women in a Nigerian Out-Patient clinic. A pre-tested structured questionnaire was administered on women at the General Outpatients’ Department (G. O. P.D) of the University College Hospital (U.C.H), Ibadan. The prevalence of obesity was 41.8%. Age was significantly associated with obesity, p=0.001. Majority of the obese participants (68.9%) in comparison to non-obese (46.4%) were traders, p=0.001. Many of the obese respondents were married (82.6%) in comparison to non-obese respondents who were widows (67.4%), p=0.001. Many of the obese respondents were multiparous (44.3%) having more than 4 children in comparison to the non-obese respondents with the highest proportion of women with no children (36.1%), p=0.001. Fewer of the obese women had no formal education (28.1%) and no primary education (26.4%), in comparison to the non-obese with 32.2% having secondary education and 27% having secondary education and 27% having post-secondary education, p=0.015. Majority of the obese women (62.3%) were pre-menopausal in comparison to the non-obese with 79.0% being pre-menopausal, p=0.001. Multivariate analysis done using logistic regression showed that risk factors for obesity included age group 50-59 years (odds Ratio 15.914, 95% CI=1.389-182.26, p=0.026), and being menopausal (Odds Ratio 1.452.95% CI=0.587-3.594, p=0.017). Having greater than five children was also found to be a risk factor for obesity (OR=3.321, 95%CI=1.236-8.921,p=0.017). The prevalence of obesity among Nigerian women remains high. There is a need to plan and implement measures for control.Item Demographic and epidemiological characteristics of HIV opportunistic Infections among older adults in Nigeria(2017) Akinyemi, J. O.; Ogunbosi, B. O.; Fayemiwo, A. S.; Adesina, O. A.; Michael, O.; Kuti, M. A.; Awolude, O. A.; Olaleye, D. O.; Adewole, I. F.Background: In view of the maturing HIV epidemic in sub-Saharan Africa, better understanding of its epidemiology among older adults is necessary in order to design appropriate care and treatment programmes for them. Objectives: To describe the demographic and epidemiological characteristics of HIV opportunistic infections among newly enrolled patients aged 50 years and above in Ibadan, South-West Nigeria. Methods: Analysis of data extracted from electronic records of 17, 312 subjects enrolled for HIV/AIDS care and treatment between January 2006 and December 2014 at the ART clinic, University College Hospital, Ibadan. Results: Age of the patients ranged from 18 to 90 years with a mean of 36.4 years (SD= 10.3) with older adults constituting 12.0% (2075). Among older adults, about half (52.9%) were females. Majority (59.1%) were currently married while 25.9% were widowed. Prevalence of opportunistic infections was 46.6%. The commonest opportunistic infections (OIs) were: oral candidiasis (27.6%), chronic diarrhoea (23.5% and peripheral neuropathy (14.8%). Significant factors associated with opportunistic infections in older adults were: CD4 count less than 350 (OR=3.12, CI: 2.29-4.25) and hepatitis C virus co-infection (OR=2.17, CI: 1.14-4.13). Conclusion: There is need for prompt response to the peculiar challenges associated with the emerging shift in the epidemiology of HIV and associated infections in sub-Saharan Africa.Item Roles of the librarian in a research library in the digital era: challenges and the way forward(Taylor & Francis, 2013) Ilesanmi, T. C.This article describes the roles of librarians in a research library, particularly in the digital era. Librarians’ roles vary from the custodian of resources to providers of a diverse nature of activities ranging from collection development, organization of knowledge, information services, preservation and conservation, and management. Librarians perform the aforementioned functions traditionally by using printed tools ranging from collection development tools (e.g., publishers’ catalogues, books in print, Ulrich, bibliography); cataloguing tools (e.g., classification schemes such as Library of Congress Classification [LCC] and Dewey Decimal Classification [DDC]); information services (e.g., bulletin, notice board, flyers); preservation and conservation (e.g., clean shelves, use of acid free boxes); and so forth. The traditional ways of performing these functions is being eroded by modern technology. This calls for changes in the products and services of research libraries to the research community served. These changes and the roles that librarians play are discussed in this article. Also enumerated are the challenges, such as dwindling budgets, capacity building, inadequate facilities, among others, of optimizing innovative ways of achieving more enhanced services. Some suggestions that could move the profession forward are also profferedItem Patterns and determinants of dropout from maternity care continuum in Nigeria(2016) Akinyemi, J. O.; Afolabi, R. F.; Awolude, O. A.Background: The maternal, newborn and child health care continuum require that mother/child pair should receive the full package of antenatal, intrapartum and postnatal care in order to derive maximum benefits. Continuity of care is a challenge in sub-Saharan Africa. In this study, we investigate the patterns and factors associated with dropout in the continuum of maternity (antenatal, delivery and postnatal) care in Nigeria. Method: Using women recode file from the 2013 Nigeria Demographic and Health Survey, we analysed data on 20,467 women with an index birth within 5 years prior to data collection. Background characteristics and pattern of dropouts were summarised using descriptive statistics. The outcome variable was dropout which we explored in three stages: antenatal, antenatal-delivery, delivery-6 weeks postnatal visit. Multilevel logistic regression models were fitted to identify independent predictors of dropout at each stage. Measure of effect was expressed as Odds Ratio (OR) with 95 % confidence interval (CI). Results: Overall, 12,392 (60.6 %) of all women received antenatal care among whom 38.1 % dropout and never got skilled delivery assistance. Of those who received skilled delivery care, 50.8 % did not attend postnatal visit. The predictors of dropout between antenatal care and delivery include problem with getting money for treatment (OR = 1. 18, CI: 1.04–1.34), distance to health facility (OR = 1.31, CI: 1.13–1.52), lack of formal education, being in poor wealth quintile (OR = 2.22, CI: 1.85–2.67), residing in rural areas (OR = 1.98, CI: 1.63–2.41). Regional differences between North East, North West and South West were significant. Between delivery and postnatal visit, the same factors were also associated with dropout. Conclusion: The rate of dropout from maternity care continuum is high in Nigeria and driven by low or lack of formal education, poverty and healthcare access problems (distance to facility and difficulty with getting money for treatment). Unexpectedly, dropouts are high in South east and South south as well as in the Northern regions. Intervention programs focusing on community outreach about the benefits of continuum of maternal healthcare package should be introduced especially for women in rural areas and lower socio-economic strata.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 A review of vulvar and vaginal cancers in Ibadan, Nigeria(2013) Okolo, C. A.; Odubanjo, M. O.; Awolude, O. A.; Akang, E. E. U.The objectives of this study are to give an update on the previous studies on vulvar and vaginal cancers from the University College Hospital (UCH), Ibadan, Nigeria, to elucidate any changes in pattern, and to enumerate some of the factors affecting the management of these cancers at the UCH today. All the cases of cancer of the vulva and vagina seen at the UCH between January 1981 and December 2008 were reviewed and re-classified according to the World Health Organization (WHO) histological classification of 2004. The results are as follows: Vaginal and vulvar cancers were the 4th (1.4%) and 5th (1.2%) most common of the 5913 gynecological cancers seen. The mean age was 49.7 years. Squamous cell carcinoma (SCC) was the most common histological type. Notably, vulvar cancer is more common than vaginal cancer in the US and the UK and this opposes our findings. We studied time periods before and after the year 2000, and found vaginal cancer to be more common before and vulvar cancer after the year 2000. We suggest that this may be related to the introduction of the FIGO guidelines in 2000. We conclude that it is important to strictly adhere to the FIGO guidelines in determining the primary site of origin of these cancers in patients with advanced local disease as this distinction has implications for clinical management. The objectives of this study are to give an update on the previous studies on vulvar and vaginal cancers from the University College Hospital (UCH), Ibadan, Nigeria, to elucidate any changes in pattern, and to enumerate some of the factors affecting the management of these cancers at the UCH today. All the cases of cancer of the vulva and vagina seen at the UCH between January 1981 and December 2008 were reviewed and re-classified according to the World Health Organization (WHO) histological classification of 2004. The results are as follows: Vaginal and vulvar cancers were the 4th (1.4%) and 5th (1.2%) most common of the 5913 gynecological cancers seen. The mean age was 49.7 years. Squamous cell carcinoma (SCC) was the most common histological type. Notably, vulvar cancer is more common than vaginal cancer in the US and the UK and this opposes our findings. We studied time periods before and after the year 2000, and found vaginal cancer to be more common before and vulvar cancer after the year 2000. We suggest that this may be related to the introduction of the FIGO guidelines in 2000. We conclude that it is important to strictly adhere to the FIGO guidelines in determining the primary site of origin of these cancers in patients with advanced local disease as this distinction has implications for clinical management.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 Condom use among antiretroviral therapy patients in Ibadan, Nigeria(2010) Akinyemi, J. O.; Awolude, O. A.; Awolude, O. A.; Adewole, I. F.; Kanki, P. J.Background: While antiretroviral treatment (ART) has improved the health status of people living with HIV, new challenges to their sexual and reproductive health (SRH) needs and their ability to prevent secondary HIV infections have risen. This study aimed to determine the level and factors that affect condom use among ART-experienced patients at the premier teaching hospital in Nigeria. Methodology: This longitudinal study involved patients who initiated treatment at the University College Hospital, Ibadan, Nigeria, between January and December 2006. Sexually active patients who had received treatment for at least six months and had not defaulted on clinic follow-up schedules were studied. Data on socio-demographic characteristics and condom use were extracted from clinic records. Chi square test and logistic regression were employed to determine factors associated with condom use. Results: The study involved 866 patients, specifically, 306 (35.3%) men and 560 (64.7%) women aged 40.7 (SD 7.6) and 33.3 (SD 6.5) years respectively. Condoms usage before treatment and at last clinic visits was 14.0% and 43.3% respectively. Overall reports of condom use at specified periods were as follows: 1 – 6 months (33.0%); 7 – 12 months (37.3%) and above 12 months (53.8%). Patients in a marital union and those with higher education were more likely to use condoms. Conclusions: Condom use is significantly influenced by marital status and educational level. Although condom use increases together with follow-up time, the level can be improved. Primary and secondary prevention efforts targeting high-risk sexual behaviour among ART patients need to receive greater and continual attention.