Obstetric Fistula in Ilorin, Nigeria
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ABSTRACT:
SUBMITTER: Browning A
PROVIDER: S-EPMC523825 | biostudies-literature | 2004 Oct
REPOSITORIES: biostudies-literature
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Project description:BackgroundObstetric fistula continues to have devastating effects on the physical, social, and economic lives of thousands of women in many low-resource settings. Governments require credible estimates of the backlog of existing cases requiring care to effectively plan for the treatment of fistula cases. Our study aims to quantify the backlog of obstetric fistula cases within two states via community-based screenings and to assess the questions in the Demographic Health Survey (DHS) fistula module.MethodsThe screening sites, all lower level health facilities, were selected based on their geographic coverage, prior relationships with the communities and availability of fistula surgery facilities in the state. This cross-sectional study included women who presented for fistula screenings at study facilities based on their perceived fistula-like symptoms. Research assistants administered the pre-screening questionnaire. Nurse-midwives then conducted a medical exam. Univariate and bivariate analyses are presented.ResultsA total of 268 women attended the screenings. Based on the pre-screening interview, the backlog of fistula cases reported was 75 (28% of women screened). The backlog identified after the medical exam was 26 fistula cases (29.5% of women screened) in Kebbi State sites and 12 cases in Cross River State sites (6.7%). Verification assessment showed that the DHS questionnaire had 92% sensitivity, 83% specificity with 47% positive predictive value and 98% negative predictive value for identifying women afflicted by fistula among women who came for the screenings.ConclusionsThis methodology, involving effective, locally appropriate messaging and community outreach followed up with medical examination by nurse-midwives at lower level facilities, is challenging, but represents a promising approach to identify the backlog of women needing surgery and to link them with surgical facilities.
| S-EPMC3905156 | biostudies-literature
Project description:OBJECTIVE: To determine the prevalence of asymptomatic bacteriuria, bacteriology and sensitivity pattern in Ilorin using the gold standard of urine culture. METHODS: A prospective study was carried out from 1st July to 31st October 2007, at the University of Ilorin Teaching Hospital (UITH) on 125 consenting asymptomatic pregnant women. A structured proforma was used to collect information from the women and a midstream urine specimen collected for bacteriological culture. RESULTS: Of the 125 pregnant women, 50 had bacteriuria on urine culture giving a prevalence of 40%. The mean age of the women was 28.5 years with a standard deviation of 4.95. The age ranged between 14 and 40 years. Staphylococcus aureus was the commonest pathogen isolated (72%), followed by Proteus spp (14%). Most of the organisms showed good sensitivity to Nitrofurantoin and gentamicin. CONCLUSION: The prevalence of asymptomatic bacteriuria in Ilorin is high and routine urine culture is advocated for all pregnant women at booking.
| S-EPMC3282126 | biostudies-other
Project description:BackgroundAdenovirus co-infections in HIV patients cause wide-spread morbidity in sub-Saharan Africa, but little research has documented the burden and distribution of these pathogens. This study was conducted between December, 2010 and March, 2011 to investigate the prevalence of Adenovirus Respiratory Tract and HIV co-infections in Patients attending the University of Ilorin Teaching Hospital Ilorin, Nigeria.MethodOne Hundred and Eighty Four (184) patients were recruited with confirmed HIV positive status. Investigation was done by serology using the Human Adenovirus IgG ELISA Kit to test for the presence of the Immunoglobulin G (antibody) against the virus. This was conducted and juxtaposed simultaneously with responses received from the questionnaires provided to each participant to correlate the relationship of the co-infections to their socio-demographic factors (Age, Gender, Occupation and location of residence), risk factors (Average hours of exposure per day (time spent outdoor daily), proximity of their apartments to livestock settlements), recent occurrence of respiratory tract infections/conjunctivitis and their ART status.ResultsThis study recorded a prevalent rate of 38% (70 patients) to the co-infections. Nevertheless, 62% (114 patients) tested negative to the co-infections.ConclusionThere was statistical significance between the ages of HIV patients and Adenovirus co-infection (p<0.05). However, there was no significance with respect to gender of the subjects (p>0.05). The findings also showed that there were statistical significance for all the risk factors; Occupation, Location and Proximity to Livestock settlement, recent respiratory tract infection/conjunctivitis, and ART status in relation to Adenovirus and HIV co-infections (p<0.05).
| S-EPMC4289325 | biostudies-literature
Project description:ObjectiveObstetric fistula, also known as vesicovaginal fistula or rectovaginal fistula, is an abnormal opening between the vagina and rectum caused by prolonged obstructed labour that causes substantial long-term harm to women. It is most prevalent in low resource settings and although preventative measures have been proposed, they have not, to date, taken women's own views into account. The objective of this study was to explore the views of North Nigerian women on obstetric fistula risk factors and prevention.DesignThis study was conducted using Interpretive Description methodology, which is a qualitative approach underpinned by Symbolic Interactionism. A semistructured questionnaire was used to explore the views of 15 women living with obstetric fistula about risk factors and prevention of the condition. Data were collected in one-to-one in-depth interviews conducted between December 2020 and May 2021. All interviews were audio-recorded and transcribed verbatim, and a thematic approach to data analysis was employed.Sampling and settingThe setting for this study was a fistula repair centre in north-central Nigeria. The sample was formed of a purposively selected 15 women who had experienced obstetric fistula at a repair Centre in north-central Nigeria.ResultsFour core themes emerged from women's views on obstetric fistula risk factors and prevention: (1) Women's autonomy, (2) Economic empowerment, (3) Infrastructure/transportation and (4) Provision of skilled healthcare services.ConclusionThe findings from this study highlight previously unknown women's views on obstetric fistula risk factors and prevention in north-central Nigeria. Analysis of insights from women's voices directly affected by obstetric fistula demonstrated that in their views and experiences, giving women autonomy (decision-making power) to choose where to birth safely, economic empowerment, enhancement of transportation/infrastructure and provision of skilled healthcare services may mitigate obstetric fistula in Nigeria.
| S-EPMC10277036 | biostudies-literature
Project description: Not available
| S-EPMC10953869 | biostudies-literature
Project description:Indoor air quality is essential, so its quality cannot be compromised. Hence, this research assessed indoor gaseous air pollutant concentrations from sources in thirty-three residential kitchens within the 4-zone of Ilorin-South Local Government, Kwara, Nigeria. The work focused on SO2, NO2, and CO emission concentration quantification, determination of the air quality index (AQI), estimation of health assessment risk, and deduced their health implications on the residents. The concentrations of NO2 and SO2 were determined by the Saltzman method using a Gilair-3 air sampler, while the concentration of CO was determined using an MSA Altair-5x multigas detector. Three types of eleven kitchen environments each (kitchens where liquefied petroleum gas (LPG), charcoal, and firewood were used as fuel sources) were considered. The concentrations of NO2, SO2, and CO were higher in kitchens that used charcoal and firewood. The major health risks were deduced in percentages from the questionnaire administered, where headaches had the highest percentage (20.7). The model indicated that the concentrations of the pollutants in the evening, irrespective of the sampling points, were higher than those in the morning. Firewood contributed significantly more than charcoal and LPG (p < 0.05). The results of the health assessment risk showed that the risk estimated for normal exposure to the pollutants in all the households studied revealed a hazard quotient of <1.0 except for SO2 from firewood for infants and children = 1.09. The AQI results showed the worst health conditions for households that used firewood (0.103-4.760 ppm NO2; 0.327-0.647 ppm SO2; and 12.30-57.83 ppm CO). The study concluded that the use of LPG should be preferred as a source of fuel for cooking.
| S-EPMC9402372 | biostudies-literature
Project description:Dermatophilus congolensis, the aetiological agent of dermatophilosis, is a pleomorphic, Gram-positive actinomycete, which infects animals and humans. Often, there is a wrong diagnosis of the infection in animals because of the close resemblance of the organism with other members of the family Actinomycetaceae. In this study, molecular tools were applied to suspected isolates of D. congolensis obtained from naturally infected cattle in Nigeria for confirmation of dermatophilosis. DNA extraction from 54 suspected pure colonies of D. congolensis was carried out using the QIAamp® DNA Mini extraction kit. PCR targeted at the 16S rRNA gene was employed for the confirmation of D. congolensis using 5'-ACATGCAAGTCGAACGATGA-3' and 5'-ACGCTCGCACCCTACGTATT-3' as forward and reverse primers, respectively. Positive amplicons were then sequenced directly using Big Dye Terminator Cycle Sequencing Kit with the forward primers and AmpliTaq-FS DNA Polymerase. Nucleotide sequences were aligned using bioedit (Ibis Biosciences Carlsbad, CA USA) and the phylogenetic analysis was carried out using mega 5.2 (Center for Evolutionary Medicine and Informatics, The Biodesign Institute, Tempe, Arizona, USA) software programme. The aligned nucleotide sequences of 10 positive D. congolensis isolates had between 94% to 99% homology with the sequences of D. congolensis satellite DNA in GenBank. This result also revealed that the sequenced D. congolensis are of different strains. Phylogenetic analysis revealed that D. congolensis, though closely related to Nocardia brasiliensis (NR 074743.01) and Streptomyces sp. (JN 400114.1), belongs to different genus. In conclusion, molecular tools employed in the study were able to confirm the identity of the test organisms as D. congolensis. It can also be concluded that two strains of D. congolensis obtained from the study can still be accommodated within the previously listed strains available in GenBank while the remaining eight may be different strains of D. congolensis not yet listed in GenBank.
| S-EPMC5645858 | biostudies-literature
Project description: Not available
| S-EPMC6220961 | biostudies-literature
Project description:BACKGROUND:Obstetric fistula (OF) is a maternal morbidity associated with high rates of stillbirth, amenorrhea, and sexual dysfunction. Limited data exists on the reproductive outcomes of women in the years following a fistula repair. The objective of this study is to describe the fertility outcomes and family planning practices in a population of Malawian women 1-4 years after fistula repair. METHODS:Women who had enrolled into a clinical database of OF patients and undergone OF repair between January 1, 2012 and July 31, 2014 were recruited and enrolled to complete a home-based survey of their demographic and reproductive health data 1-4 years after their repair. Pregnancy, amenorrhea, and sexual function were described using frequency analysis, and we compared antimüllerian hormone (AMH) concentrations between women with menses or pregnancy with women with amenorrhea or no pregnancy using Wilcoxon rank sum tests. RESULTS:Of 297 women with a prior OF repair, 148 had reproductive potential and were included in this analysis. Overall 30 women of these women (21%) became pregnant since their fistula repair, with most pregnancies ending with cesarean delivery. Of the 32 women who were amenorrheic at the time of repair, 25 (78.1%) had resumption of menses. Only 11 (8.6%) of sexually active women reported dyspareunia, and among women who were not trying to conceive, 53.1% were currently using a method of family planning. No significant differences were found in AMH concentrations between those who were pregnant or had menses versus those without pregnancy or menses, respectively. CONCLUSIONS:In this long-term follow-up study of women after OF repair, many women were able to achieve a pregnancy with a live birth, have normal menses, be sexually active, and access contraception. These achievements will further assist a population of women whose reintegration and restoration of dignity is closely tied to their ability to achieve their reproductive goals. TRIAL REGISTRATION:ClinicalTrials.gov Identifier: NCT02685878 .
| S-EPMC5704560 | biostudies-literature
Project description:BackgroundAccessing surgical repair poses challenges to women living with female genital fistula who experience intersectional vulnerabilities including poverty, gender, stigma and geography. Barriers to fistula care have been described qualitatively in several low- and middle-income countries, but limited effort has been made to quantify these factors. This study aimed to develop and validate composite measures to assess barriers to accessing fistula repair in Nigeria and Uganda.MethodsThis quantitative study built on qualitative findings to content validate composite measures and investigates post-repair client surveys conducted at tertiary hospitals in Northern and Southern Nigeria and Central Uganda asking women about the degree to which a range of barriers affected their access. An iterative scale development approach included exploratory and confirmatory factor analyses of two samples (n = 315 and n = 142, respectively) using STATA 13 software. Reliability, goodness-of-fit, and convergent and predictive validity were assessed.ResultsA preliminary 43-item list demonstrated face and content validity, triangulated with qualitative data collected prior to and concurrently with survey data. The iterative item reduction approach resulted in the validation of a set of composite measures, including two indices and three sub-scales. These include a Financial/Transport Inaccessibility Index (6 items) and a multidimensional Barriers to Fistula Care Index of 17 items comprised of three latent sub-scales: Limited awareness (4 items), Social abandonment (6 items), and Internalized stigma (7 items). Factor analyses resulted in favorable psychometric properties and good reliability across measures (ordinal thetas: 0.70-0.91). Higher levels of barriers to fistula care are associated with a woman living with fistula for longer periods of time, with age and geographic settings as potential confounders.ConclusionsThis set of composite measures that quantitatively captures barriers to fistula care can be used separately or together in research and programming in low- and middle-income countries.
| S-EPMC8028827 | biostudies-literature