Imo State University Teaching Hospital Research Articles

Local risk factors in genital human papilloma virus infection in cervical smears.

Background:Infection with human papilloma virus (HPV) is the main cause of cervical cancer, but the local risk factors have not been sufficiently assessed.Aim:The study is aimed at determining the prevalence and to evaluate the local risk factors of HPV infection in cervical smears at the Imo State University Teaching Hospital, Orlu, Nigeria.Subjects and Methods:The participants involved 445 randomly selected sexually active women attending the antenatal, postnatal, gynecology and family planning clinics in the Department of Obstetrics and Gynecology of the university between April 2004 and May 2012. A questionnaire assessing various socio-demographic characteristics of the participants was administered. The pap smears of the participants were examined microscopically for evidence of HPV infection. The SPSS version 17.0 (Chicago, Illinois, USA) was used to compute and analyze the results. The results were presented in tables as simple percentages. Tests of significance using the Chi-square and fisher exact tests were applied where appropriate.Results:The prevalence rate of HPV was 10.3%. The peak age-specific prevalence of 11.7% occurred in the 15-19 years age group. There were significant associations between the occurrence of HPV and multiple sexual partners, coital frequency, multiparity, contraceptive use, marital status, low socio-economic status, abnormal vaginal discharge, irregular menstruation, post-coital and post-menopausal bleeding, (P < 0.05).Conclusion:All sexually active women including teenagers should be screened for cervical HPV infection in an organized systematic program equipped with a good call and recall system. There is, therefore, a need to move emphasis from the current practice of opportunistic screening to a systematic screening of the whole population at risk despite cost implications.

Human papilloma virus vaccine: Awareness and acceptability amongst female medical students and health workers in a University Teaching Hospital in Eastern Nigeria

Background: Cervical cancer is the leading cause of cancer deaths in women in the developing countries. Human papilloma virus (HPV) has been implicated as the causative agent. Cervical cancer can primarily be prevented by vaccinating girls and women against HPV infection. Acceptability is demonstrated by the willingness of health workers to use these strategies themselves and to recommend them to their daughters and others. Aim: The aim of this study is to determine the awareness and acceptability of HPV vaccine among female health workers and female medical students in Orlu, Imo State, South-eastern Nigeria. Materials and Methods: A questionnaire based cross-sectional survey using 150 female health workers including female clinical medical students selected randomly from the Imo State University Teaching Hospital, Orlu. Results: The awareness of HPV vaccine was high (74.0%). The majority (57.3%) got the information either from conferences or class lectures. Other sources of information were radio, television and journals 5 (28.0%), while 14.6% got the information from their colleagues. Most of the health workers (67.3%) would recommend the vaccine to their adolescent daughters and clients. Most (64.6%) of the respondents did not think that the vaccine would lead to promiscuity. A good number of the respondents think that the vaccine would reduce the incidence of cervical cancer. Conclusion: The awareness of HPV vaccine and among female health workers in Orlu is high. This is very encouraging these female health workers will help in the dissemination of information regarding the use of this vaccine in the primary prevention of cervical cancer.

Appraisal Of Caesarean Section At The Imo State University Teaching Hospital, Orlu, Southeastern Nigeria.

Background: There is a general aversion to caesarean section among Nigerian women. However, with increasing safety of the procedure and better enlightenment, more women are beginning to accept the procedure. To maintain this increasing acceptability, Caesarean section rate as well as its attendant morbidity and mortality must be reduced to the barest minimal levels. The aim of the study is to determine the rate and the complications associated with Caesarean section at the Imo State University Teaching Hospital, Orlu.Methods: A four-year descriptive study from June 2004 to May 2008 from the Obstetrics Department of Imo State University Teaching Hospital, Orlu was conducted. All pregnant women that delivered by Caesarean section was included. The data were analyzed using simple percentages, p-value and chi-square where necessary.Results: There were 363 (33.2%) mothers who underwent Caesarean sections out of 1094 deliveries in the unit during the period under review. Postoperative complications occurred in 52 patients (14.5%). The complications cut across all reproductive age groups and parity. The commonest complications encountered were wound infection (11.5%), postpartum haemorrhage (10.1%) and anaemia (6.4%). The mortality rate was 0.8%.Conclusion: The caesarean section rate of 33.2% and complication rate of 14.5% are still high even though they are less than the figures quoted for some environments. There is still need to reduce this rate to the barest minimum for us to be able to sustain the gains of the past.

Appraisal Of Caesarean Section At The Imo State University Teaching Hospital, Orlu, Southeastern Nigeria.

Background: There is a general aversion to caesarean section among Nigerian women. However, with increasing safety of the procedure and better enlightenment, more women are beginning to accept the procedure. To maintain this increasing acceptability, Caesarean section rate as well as its attendant morbidity and mortality must be reduced to the barest minimal levels. The aim of the study is to determine the rate and the complications associated with Caesarean section at the Imo State University Teaching Hospital, Orlu.Methods: A four-year descriptive study from June 2004 to May 2008 from the Obstetrics Department of Imo State University Teaching Hospital, Orlu was conducted. All pregnant women that delivered by Caesarean section was included. The data were analyzed using simple percentages, p-value and chi-square where necessary.Results: There were 363 (33.2%) mothers who underwent Caesarean sections out of 1094 deliveries in the unit during the period under review. Postoperative complications occurred in 52 patients (14.5%). The complications cut across all reproductive age groups and parity. The commonest complications encountered were wound infection (11.5%), postpartum haemorrhage (10.1%) and anaemia (6.4%). The mortality rate was 0.8%.Conclusion: The caesarean section rate of 33.2% and complication rate of 14.5% are still high even though they are less than the figures quoted for some environments. There is still need to reduce this rate to the barest minimum for us to be able to sustain the gains of the past.

Appraisal Of Caesarean Section At The Imo State University Teaching Hospital, Orlu, Southeastern Nigeria.

Background: There is a general aversion to caesarean section among Nigerian women. However, with increasing safety of the procedure and better enlightenment, more women are beginning to accept the procedure. To maintain this increasing acceptability, Caesarean section rate as well as its attendant morbidity and mortality must be reduced to the barest minimal levels. The aim of the study is to determine the rate and the complications associated with Caesarean section at the Imo State University Teaching Hospital, Orlu.Methods: A four-year descriptive study from June 2004 to May 2008 from the Obstetrics Department of Imo State University Teaching Hospital, Orlu was conducted. All pregnant women that delivered by Caesarean section was included. The data were analyzed using simple percentages, p-value and chi-square where necessary.Results: There were 363 (33.2%) mothers who underwent Caesarean sections out of 1094 deliveries in the unit during the period under review. Postoperative complications occurred in 52 patients (14.5%). The complications cut across all reproductive age groups and parity. The commonest complications encountered were wound infection (11.5%), postpartum haemorrhage (10.1%) and anaemia (6.4%). The mortality rate was 0.8%.Conclusion: The caesarean section rate of 33.2% and complication rate of 14.5% are still high even though they are less than the figures quoted for some environments. There is still need to reduce this rate to the barest minimum for us to be able to sustain the gains of the past.

Appraisal Of Caesarean Section At The Imo State University Teaching Hospital, Orlu, Southeastern Nigeria.

Appraisal Of Caesarean Section At The Imo State University Teaching Hospital, Orlu, Southeastern Nigeria.

Appraisal Of Caesarean Section At The Imo State University Teaching Hospital, Orlu, Southeastern Nigeria.

Appraisal Of Caesarean Section At The Imo State University Teaching Hospital, Orlu, Southeastern Nigeria.

Stillbirth rate in a teaching hospital in South-eastern Nigeria: A silent tragedy

Background:Stillbirths often are not seen as a major public health problem, for despite increasing attention and investment on maternal, neonatal, and child health, stillbirths remain invisible.Aim:The objective of this study was to determine the stillbirth rate at the Imo State University Teaching Hospital, Orlu.Subjects and Methods:Analysis of the case records of stillbirths that occurred in the institution over a 5-year period from 1st July 2005 to 30th June 2010 was made. Data retrieved was analyzed for age of the women, parity, presumptive risk factor for the stillbirth, and booking status of the women. Also, the total births during the period of study were obtained. A P-value of <0.05 is said to be significant at confidence level of 95% (95/100).Results:There were a total of 1,142 deliveries within the study period, out of which 206 resulted in stillbirths. This gave an institutional stillbirth rate of 18% (180/1000 deliveries). One-hundred and fifty-five 75.2% (155/206) of the stillbirths were macerated stillbirth. The age range of the women was 15-44 years. The modal age was 31 years. The age group of 26-30 years had the highest prevalence rate of stillbirths of 79 (38.3%, 79/206), while age group of more than 40 years contributed the least with four stillbirths 4 (1.9%, 4/206).Conclusion:The stillbirth rate at the institution is too high and efforts must be made to reduce it.

Appraisal Of Caesarean Section At The Imo State University Teaching Hospital, Orlu, Southeastern Nigeria.

Appraisal Of Caesarean Section At The Imo State University Teaching Hospital, Orlu, Southeastern Nigeria.

Epidemiology and socio-economic consequences of malaria in pregnant women in Imo State Nigeria

Human infected with malaria parasites (Plasmoodium sp.) and its socio-economic consequences were investigated in parts of Imo State Nigeria between August 2007 and September 2008 using standard parasitological and socio-economic methods. Blood samples were collected by vein puncture from 2,871 consenting pregnant women registered for ante natal care at Federal Medical Centre, Owerri, Imo State University Teaching Hospital, Orlu and Okigwe General Hospital Okigwe as well as Imo State University Teaching Hospital Community Health Outreach Centre, Ogbaku, Mbaitoli L. G. A. The samples were analysed parasitologically for detection of malaria parasite using three different methods namely Quantitative Buffy Coat (QBC) technique, Slide smear technique and Plasmodium falciparium antigen. Similarly, questionnaires were administered to the same patients to elicit vital information on socio-economic consequences of malaria. The results showed that out of 2,871 persons examined, 2,323 (80.9%), 2,301 (80.1%) and 1,801 (62.7%) had malaria parasite determined by the QBC stained smear and P. falciparium antigen techniques respectively. The total loss due to malaria in pregnancy within a six month period was estimated at 5.8 million naira. The study has confirmed that the burden of malaria in pregnant women in Imo State Nigeria is high. Key words: Epidemiology, socio-economic, consequences, malaria, pregnant women, Imo State, Nigeria.

Experience with the use of vacuum-assisted closure therapy in the management of sickle cell leg ulcers

Leg ulcers are the commonest cutaneous manifestation of sickle cell disease, typically running an indolent course. They commonly occur around the distal third of the leg, an area notorious for difficult-to-heal wounds. The vacuum-assisted closure (VAC) device has been found efficacious in the management of chronic ulcers of varying aetiologies. However, reports on its use in the management of sickle cell ulcers are at best scanty. The purpose of this study was to determine the usefulness of VAC therapy in the management of sickle cell ulcers. Over an 18-month period, consecutive patients presenting at the plastic surgery centre of the Imo State University Teaching Hospital were managed using VAC therapy and subsequent skin grafting for extensive ulcers. Data were extracted from the case records after completion of wound care and analysed using descriptive statistics. There were seven males and two females aged 14–34 years with 15 ulcers affecting the distal third of the leg. Ulcer duration before commencement of VAC care ranged from 2.5 to 84 months. All wounds showed remarkable reduction in size, had healthy granulation tissue and were ready for skin grafting within 6–10 days of VAC care. Graft take was 98% to 100%. Use of the VAC device is valuable in the management of sickle cell ulcers. This device rapidly improves the vascularity of the wound bed and permits early successful coverage of sickle cell ulcers.

The prevalence of gynaecological diseases at the Imo State University Teaching Hospital, Orlu, Nigeria

The prevalence of gynaecological diseases at the Imo State University Teaching Hospital, Orlu, Nigeria

Gestational age at booking in Imo State University Teaching Hospital.

Gestational age at booking in Imo State University Teaching Hospital.

Maternal hiv positive sero-prevalence at delivery at a tertiary hospital in south-eastern Nigeria

The duo of HIV/AIDS infection has become a Global public health problem. This study was conducted to determine the maternal HIV positive seroprevalence at delivery at the Imo State University Teaching Hospital, Orlu. A retrospective analysis of the case records of women (both booked and unbooked) who tested positive to Human Immune-deficiency Virus at delivery at the Imo State University Teaching Hospital (IMSUTH), Orlu from 1st May 2005 to 30th April 2010 was made. The biosocial, obstetric and fetal sex data were extracted and analysed. The maternal HIV positive sero-prevalence at delivery was 6.9%. The highest sero prevalence rate of 42.4% occurred in the age group of 31-35 years. Sixty three (68.5%) of the women were multiparous (para 1-4). The male: female birth ratio was 1:1.42. Forty one (44.6%) of the women were unbooked. None of the women were symptomatic of Acquired Immunodeficiency Syndrome (AIDS) on presentation. There is high maternal HIV seroprevalence at delivery at IMSUTH, Orlu. There should be improvement on interventions to reduce this ugly trend. There should also be early booking and adequate antenatal care services.

The choice of contraceptives among women in Orlu, Nigeria

Background: Remarkable progress has been recorded in the turn of the century towards the development of more efficient and safer contraceptives. Previous studies from some parts of the country showed an increase in the percentage of clients changing from one contraceptive method to another. With the advent of the HIV/AIDS pandemic at the turn of the new millennium there may still be further changes in the choice of contraceptives in different parts of the world, Nigeria inclusive. Aim: To study the choice of contraceptive usage and the factors predictive of such choices in Orlu, southern Nigeria. Design: A cross sectional study Setting: Imo state University Teaching Hospital, Orlu, Nigeria. Subjects: Clients attending the family planning clinic. Main outcome variables: contraceptive choice, reason for choice, awareness and source of awareness about contraceptives. Results: Five hundred and three clients were reviewed. Ninety one percent knew at least one method of contraception. Their ages ranged between 18 and 52 years with majority in the 33-37 years age bracket. Most of the women were housewives (46.5%). Clients who had attained post secondary school education or more constituted 29.4%, majority were married (84.7%), in monogamous marriages (81.7%) and grandmultiparous (45.9%). The commonest contraceptive choice was the injectables (44.3%) while nurses and midwives formed the commonest source of knowledge about contraception and referral. Conclusion: The most commonly used contraceptive method in Orlu, Nigeria is the injectables. The HIV/AIDS pandemic may likely change or affect this trend. Keywords: Contraceptive choice, Source of awareness, Referral, Orlu Normal 0 false false false MicrosoftInternetExplorer4

Asymptomatic bacteriuria in pregnant women at the outpatient clinic of some governmental hospitals in Imo State, Nigeria

Asymptomatic bacteriuria among pregnant women in Imo State, Nigeria was studied. All pregnant women attending antenatal at Federal Medical Center, Owerri, General Hospital, Okigwe, and Imo State University Teaching Hospital, Orlu, between January and April 2006 and who agreed to enter the study were clinically evaluated to exclude signs of urinary tract infection. Samples of 10-15 ml urine were examined for bacteria, pus cells and parasitic ova. The samples were further cultured on cysteine lactose electrolyte deficient agar and colony counts yielding bacterial growth of 105 or more of pure isolates were deemed significant. Of the 630 pregnant women, 111 had significant bacteriuria giving a prevalence rate of 17.6%. The highest agespecific prevalence was found in the 31-40 year-olds and the lowest in the 41-50 year-olds. Socioeconomic status of the respondents had effect on the prevalence of bacteriuria and also, there was an increase in the prevalence with increase in age of gestation. The dominant isolates were Staphylococcus species and Klebsiella species with most of the isolates obtained in respondents from Owerri and Okigwe study areas.Keywords: Prevalence, Bacteriuria, UTI, Bacteria isolates.

Caesarean section related morbidity and mortality at the Imo State University Teaching Hospital Orlu

Background: There is a general aversion to Caesarean section among Nigerian women. However, with increasing safety of the procedure and better enlightenment, more women are beginning to accept the procedure. To maintain this increasing acceptability, Caesarean section related morbidity and mortality must be reduced to the barest minimal levels. Aim: To determine the incidence and the complications associated with Caesarean section at the Imo State University Teaching Hospital, Orlu. Methods: A four-year descriptive study from June 2004 to May 2008 from the Obstetrics Department of Imo State University Teaching Hospital, Orlu was conducted. All pregnant women that were delivered by Caesarean section were included. Results: There were 363 (33.2%) mothers who underwent Caesarean sections out of 1094 deliveries in the unit during the period under review. Postoperative complications occurred in 52 patients (14.5%). The complications cut across all reproductive age groups and parity. The commonest complications encountered were wound infection (71.9%), postpartum haemorrhage (63.2%) and anaemia (40.4%). The mortality rate was 1.2%. Conclusion: The Caesarean section complication rate of 14.5% is still high, even though it is less than the figures quoted for some environments. There is still the need to reduce this rate to the barest minimum for us to be able to sustain the gains of the recent past. Key words: Caesarean section, Morbidity, Mortality, Orlu

Presentation and management fo uterine leiomyoma at Imo State University Teaching Hospital, Orlu, Nigeria

Presentation and management fo uterine leiomyoma at Imo State University Teaching Hospital, Orlu, Nigeria

Childhood burns in south eastern Nigeria

Burns injuries are recognized as a major health problem worldwide. In children and, particularly, in our environment where poverty, ignorance and disease are still high, they constitute significant morbidity and mortality. Previous studies on this topic in parts of Nigeria either lumped adults and children together or were retrospective. We, therefore, prospectively studied the current trends in burns in children. This prospective study of burns spanned over a period of 18 months (June 2006-December 2007) at the Paediatric Surgery Units of the Imo State University Teaching Hospital, Orlu, and the Federal Medical Centre, Owerri, Imo State. Data were collected and analysed for age, sex, cause/type of burn, place of burn, presence or absence of adult/s, initial prehospital intervention, interval between injury and presentation, surface area and depth of burn and treatment and outcome. Fifty-three patients were studied, 31 (58.4%) were male and 22 (41.6%) were female (M:F = 1.4:1). Patients mostly affected were aged 2 years and below. The most common cause of burns was hot water in 31 (58.5%) patients. The vast majority of these injuries happened in a domestic environment (92.5%) and in the presence of competent adult/s (88.7%). Outcome of treatment was good: there were two (3.8%) deaths and 46 (86%) patients had complete recovery. Burns is still a major health problem among children in south eastern Nigeria. Fortunately, outcome of appropriate treatment is good. However, we think that poor safety consciousness among parents is a major predisposing factor. Public enlightenment on measures to ensure safe home environment may be necessary to avoid or limit childhood burns.

The prevalence of cryptosporidiosis and other intestinal protozoa infections among HIV patients in Imo State, Nigeria

The prevalence of cryptosporidiosis and other intestinal protozoa infections amongst HIV patients seen at Imo State University Teaching Hospital, Orlu, was studied between March 2006 and April 2007. Stool samples were collected in sterile screw cap bottles from 1,202 male and female respondents aged 1 to 50 years. The samples were brought to the Parasitology Laboratory, Imo State University Teaching Hospital, Orlu, and examined by direct wet mount and concentration technique. The findings showed that 1,021 (84.94%) were infected with Cryptosporidium species and other intestinal protozoa. Of this number, 890 (74.04%) had mixed infection while 131 (10.90%) had single infection of cryptosporidiosis or other intestinal protozoa. The highest prevalence of infection (92.75% males and 89.11% females) was observed amongst male patients aged 1-10 years, while the least (78.31%) was observed amongst patients aged 21-30 years. This study showed that impaired immunity exacerbated by HIV infection could lead to increased incidence of cryptosporidiosis and other intestinal parasites. Keywords : Cryptosporidiosis, intestinal protozoa, HIV patients. Nigerian Journal of Parasitology Vol. 29 (1) 2008 pp. 50-55