Obstetrics. & Gynecology
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Item Determinants of cervical cancer screening uptake among women attending selected family planning clinics in Ibadan, Oyo State, Nigeria.(2020) Ndikom, C. M.; Ajibade, A. B.; Oluwasola, T. A. O.Background: Cervical cancer screening (CCS) continuously has low awareness and is poorly utilized in developing countries despite higher incidence of cervical cancer (CC). Increasing incidence of CC has been associated with late reporting of symptoms, ignorance about the disease, and its preventive measures. This study was conducted to further investigate the determinants of CCS uptake among women attending selected family planning clinics in Ibadan, Nigeria. Materials and Methods: Adopting a cross‑sectional design, 205 consenting respondents attending family planning clinics were interviewed using an interviewer‑administered questionnaire. The data collected were analyzed using Statistical Package for the Social Sciences version 21. The hypotheses were tested using Chi‑square, odds ratio, and logistic regression at P < 0.05. Results: The mean age of the respondents was 33 ± 8 years; 176 (85.9%) were married and 72 (35.1%) had tertiary education. Although 71% of the respondents were aware of CC, only 37.1% had good knowledge and 16.1% had previously utilized CCS. About two‑thirds (68.8%) of the respondents were willing to uptake CCS, except for perceived barriers such as lack of understanding of the disease and inadequate information about the services coupled with limited availability of the CCS services. There was a significant association between uptake of CCS and knowledge (χ2 = 17.944, P < 0.001), education (χ2 = 7.724, P < 0.024), and income (χ2 = 32.22, P < 0.001). On logistic regression, the uptake CCS remained influenced mainly by income of >40,000 Naira (OR = 5.355, CI = 1.678–17.083) and knowledge (OR = 3.112, CI = 1.247–7.768). Conclusion: Family planning clinics are readily available centers for increasing the knowledge base of the women on the need for regular CCS. This needs to be duly incorporated into our routine services.Item Comparative effectiveness of 50g glucose challenge test and risk factor based screening in detection of gestational diabetes mellitus in Ibadan, Nigeria.(2015) Bello, O. O.; Oluwasola, T. A. O.; Adeleye, J. O.; Adedapo, K. S.; Maxwell, O.; Odukogbe, A. A.Context: Gestational diabetes mellitus (GDM) complicates 3-5% of pregnancies. Prompt diagnosis helps to prevent its subsequent complications and one-step effective screening method is desirable for our environment. Objective: To compare the effectiveness of 50g glucose challenge test (GCT) with risk factors alone in screening for GDM. Study Design: Prospective study of booked, consenting pregnant women with no previous history of diabetes mellitus. Fasting sample of venous blood was obtained for plasma glucose, followed by administration of SOg oral glucose and collection of blood sample an hour later. The process was repeated after a week using 7Sg oral glucose; each patient serving as her own control. Threshold blood glucose of 140mg/dl was used for both post-ingestion tests. Statistical analysis was done using SPSS version 17. Results: All the seventy-nine study participants completed the 2 arms. Mean maternal and gestational ages at recruitment were 30.8+1.2 years and 24.2+1.6 weeks respectively. Among the respondent, 3S( 44.3%)were nulliparous while24(30.3%) had positive risk factors for GDM. The 50g GCT was abnormalin 10 patients (12.7%) while GDM was confirmed in 2 patients giving an incidence rate of2.5%. The 50g GCT was normal in 89.6% of women withnormat75g OGTT and it was more predictive of GDM (Positive Predictive Value, PPV -20%) compared to risk factors only (PPV-11.1 %). Conclusion: Using 50g GCT will enhance selection of patients for confirmatory test for GDM as compared to risk factors alone. It would therefore be of great benefit in this environment.Item Awareness of cervical cancer and screening in a Nigerian female market population(Wolters Kluwer Medknow Publications, 2005) Ogunbode, O. O.; Ayinde, O. A.Background: Cervical cancer, although largely preventable, remains a leading cause of cancer death among females in the developing world. The study was aimed at providing useful information on awareness of market women, who are from diverse social backgrounds, about cervical cancer and evaluate U1e extent of utilisation of Papanicolaou's smear by them, It was also aimed at determining the prevalence of risk factors for development of cervical cancer among the population. Methods: TI1is cross-sectional descriptive survey was carried out among market women at Aleshinloye market in November 2003, among 483 randomly selected respondents. A questionnaire probing into their sexual history, awareness about cervical cancer and the extent of utilisation of Pap smear was the survey instrument. Results: The majority (79.5%) of the women were sexually active. One hundred and eighty-six (38.5%) had early sexual debut and 163 (33.7%) had multiple sexual partners. Only 197 respondents (40.8%) were aware of cervical cancer. Of these, 95 (19.7%) were aware of Pap smear as a screening test. The common media of awareness were radio and television (46.6%), public lecture (27.8%) and friends/ relatives (19.9%). However, only 25 respondents (5.2%) have had previous Pap smear done. Conclusion: Though the market women are at considerable risk of developing cancer of the cervix, they are poorly informed about the disease and its prevention. Therefore, there is need for continuous awareness campaign and well-organized screening programmes among this unique category of women.Item Society of obstetrics and gynecologOkapani, A.y of Nigeria – clinical practice guidelines: guidelines for the prevention of cervical cancer(Wolters Kluwer - Medknow, 2019) Ezechi, O. C.; Okusanya, B. O.; Aimakhu, C. O.; Adesina, O. A.; Ohihoin, A. G.; Usman, H. A.; Umeora, O. U.; Akinola, R. I.; Anorlu, R.; Sagay, S. A.; Audu, B.; Fasubaa, O.; Oguntayo, B. A.; Awolude, O. A.; Ezeanochie, M.; Fawole, A.; Ijaiya, M.; Onyebuchi, A.; Dattijo, L.; Osagie, O. E.; Fabanwo, A.; Iketbuson, F.; Fawole, A. O.; Afolabi, B.; Agbogoroma, C.; Sadauki, H.; Okapani, A.; Yakasai, Y.; Muthir, J.; Okonta, P.Clinical practice guidelines have been developed by professional societies globally. Each guideline although based on published scientific evidence reflected each country’s socioeconomic peculiarities and unique medical environment. The Society of Obstetrics and Gynaecology of Nigerian has published guidelines in other clinical areas; however, this is the first edition of practice guidelines for the prevention of cervical cancer. The Guidelines Committee was established in 2015 and decided to develop the first edition of this guideline following Delphi pool conducted among members which selected cervical cancer prevention as the subject that guideline is urgently needed. These guidelines cover strategies for cervical cancer prevention, screening, and management of test results. The committee developed the draft guideline during a 2‑day workshop with technical input from Cochrane Nigeria and Dr. Chris Maske, Lancet Laboratories, South Africa. The recommendations for each specific area were developed by the consensus, and they are summarized here, along with the details. The objective of these practice guidelines is to establish standard policies on issues in clinical practice related to the prevention of cervical cancer.Item Multimoda hyperspectroscopy screening in women at risk of cervical cancer: results of a pilot study in a developing country(Wolters Kluwer - Medknow, 2017) Awolude, O. A.; Akinwunmi, B. O.; Adewole, I. F.Background: Screening and treatment of pre-cancerous lesions is important for prevention of cervical cancer. Currently, most available screening tests for cervical cancer are limited by low sensitivity, prohibitive costs, logistics and technical concerns. This study evaluates the role of multimodal hyperspectroscopy (MHS) as a cost-effective, sensitive and user-friendly point-of-care machine for early detection in women at risk of pre-cancer lesions. Materials and Methods: Multimodal hyperspectroscopy of the cervix using the LuViva® Advanced Cervical Scan was performed first in a 1-minute procedure among 100 previously screened for cervical cancer using either visual inspection after application of acetic acid (VIA) or cytology within the last 120 days. This was then followed by obtaining human papilloma virus (HPV) samples and biopsies from women for histology. Results: Of the 22 women with abnormal Pap tests of at least low‑grade squamous intraepithelial lesion, 3 had CIN2+, 6 had CIN1, 4 were free of dysplasia at histopathology while 9 had cervicitis. All 3 of the CIN2+ recorded high likelihood of CIN2+ by MHS. However, HPV was negative for all 3 women. The machine classified 1 of 1 CIN1s and 7 of the 13 women without dysplasia or cervicitis as low or moderate risk for CIN2+ (40% specificity); of the 37 women who were VIA+, 81% were classified as high risk, and 66% of 37 women with normal Pap tests and biopsy were either at moderate or low risk. Conclusions: The findings from this pilot study show that MHS reduced the percentage of unnecessary colposcopy and biopsy by 37.5%. It was also able to differentiate between VIA+ and Pap negative women suggesting its potential of being a point-of-care primary and objective screening test.Item Consensus recommendations for the prevention of cervical cancer in Sub-Saharan Africa(2013) Adewole, I. F.; Abauleth, Y. R.; Adoubi, I.; Amorissani, F.; Anorlu, R. I.; Awolude, O. A.; Botha, H.; Byamugisha, J. K.; Cisse, L.; Diop, M.; Doh, S.; Fabamwo, A. O.; Gahouma, D.; Galadanci, H. S.; Githanga, D.; Magure, T. M.; Mabogunje, C.; Mbuthia, J.; Muchiri, L. W.; Ndiaye, O.; Nyakabau, A. M.; Ojwang, S. B. O.; Ramogola-Masire, D.; Sekyere, O.; Smith, T. H.; Taulo, F. O. G.; Wewege, A.; Wiredu, E.; Yarosh, O.Cervical cancer is the second most common cancer and the leading cause of cancer-related death in women in sub-Saharan Africa. It is estimated that more than 200 million females older than 15 years are at risk in this region. This paper highlights the current burden of cervical cancer in sub-Saharan Africa, reviews the latest clinical data on primary prevention, outlines challenges in the region, and offers potential solutions to these barriers. Based on these factors, clinical recommendations for the prevention of cervical cancer from the sub-Saharan African Cervical Cancer Working Group expert panel are presented.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.