Murtala Muhammed Specialist Hospital Research Articles

Demographic and Clinical Characteristics of Stroke Cases in Murtala Muhammed Specialist Hospital, Kano, Nigeria: A retrospective study

Stroke is a cerebrovascular disease that disturbs or damages the blood supply to the brain. This study aimed to evaluate the demographic and clinical characteristics of stroke cases in Murtala Muhammed Specialist Hospital, Kano, Nigeria. Five years of records of three hundred (300) stroke patients comprised of biodata and clinical data were collected. The data were expressed as mean±SD, while simple percentage and Chi-square (χ2) tests were used to determine the incidence and association between the variables respectively using Minitab 17.0 software. The results showed an incidence of 182 (61%) males and 118 (39%) females, 265 (78%) and 65 (22%) for the above and below 40 years age groups respectively. The Hausa, Yoruba and Igbo ethnic groups have an incidence of 258 (86%), 24 (8%), and 18 (6%) respectively. The yearly incidence was 40 (13%), 50 (17%), 20 (7%), 56 (17%), and 134 (45%) for 2017 through 2021, respectively. The incidence of hemorrhagic, ischaemic, and transient ischaemic attack strokes were, 222 (74%), 63 (21%), and 15 (5%), while that of left, right, and both sides impairments were 144 (48%), 138 (46%), and 18 (6%), respectively. The common risk factors were hypertension (50%) and hypotension (20%), diabetes mellitus 54 (18%), and others 12 (4%) and 3 (1%) respectively. No association between sex and stroke types (P = 0.553). Conclusively, although intracerebral hemorrhagic stroke, right-side impairment, and hypertension were the most common stroke types, disabilities, and risk factors, respectively there was no association obtained between sex and the incidence of stroke type.

Sonographic patterns of retained products of conception among women attending Murtala Muhammed Specialist Hospital Kano, Nigeria

Retain products of conception (RPOC) remains a major concern because its complications are among the leading cause of morbidity and mortality among women with postpartum uterus. Every locality should have a documented findings of postpartum uterus predicting retained products of conception. This study was aimed at evaluating the sonographic pattern of RPOC among women attending Murtala Muhammad Specialist Hospital, Kano. The study was prospective, conducted from January 2021 to August 2021. A total of 200 patients referred on the suspicion of RPOC on the basis of history or clinical examination were enrolled in the study. Transabdominal ultrasound with 3.5MHtz transducer was performed in all referred cases. The findings obtained were recorded on data capture sheet. Data was analyzed using SPSS Version 23.0. Mean age of the patients was 21.7 ±6.7 years and the mean gestational age was 11.7 ±4.8 weeks. Most of the patients present with per vaginal bleeding, lower back pain or fever as their clinical history. Sonographic findings of RPOC were mix-echogenic content 106(53%), hypoechoic fluid collection 52(26%) and hyperechoic mass 42 (21%). The correlation between clinical history and sonographic pattern of RPOC shows a significant weak positive correlation (r= 0.15 and p= 0.03). The correlation between RPOC size and gestational age also shows a significant weak positive correlation (r= 0.27 and p= 0.00). Sonography is an accurate tool for diagnosis of retained products of conception, with mixed echogenic content as the most common sonographic pattern RPOC.

Prescription patterns of evidence-based heart failure medications in a Tertiary Hospital in North-Western Nigeria—A retrospective study

Context: Several large clinical trials on the use of medical therapy in the management of heart failure have shown angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), beta blockers (BBs), and mineralocorticoid receptor antagonists (MRAs) to be of proven benefit and are recommended by guidelines. Aim: The aim of this study is to describe the trend of prescription and dosing of evidence-based medications used for chronic heart failure (CHF) in our population. Settings and Design: This is a retrospective study on the pattern of prescription of evidence-based heart failure medications on 200 consecutive patients with CHF who attended the cardiology clinic or were admitted into the Medical wards from January 2020 to December 2020 at Murtala Muhammed Specialist Hospital, Kano, North-Western Nigeria. The data was obtained from patients' records. Statistical Analytics Used: Data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 23 software. (SPSS Inc. Illinois, USA). Results: ACE inhibitors or ARBs were prescribed in 89 (44.5%), BBs in 76 (38%), and MRAs, in 192 (96%). None of the patients were prescribed angiotensin receptor-neprilysin inhibitors (ARNi) or sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors). Conclusion: Evidence-based heart failure medications are underutilized in patients with CHF in our population. Improved uptake and up-titration are needed for better patients' outcomes.

Advancing Healthcare Outcomes for Sickle Cell Disease in Nigeria Using Mobile Health Tools

Nigeria leads the world in the number of cases of sickle cell disease (SCD). An estimated 150,000 babies are born annually in Nigeria with SCD, a heredity disorder, and 70-90% die before age 5. Only a small portion of affected infants and children in sub Saharan Africa (SSA) reach adolescence. Over 650 children die per day in sub-Saharan Africa from SCD. These dismal statistics are in sharp contrast to outcomes in high-income countries (HICs) where more than 90% of SCD patients reach adulthood. The World Health Organization (WHO) estimates that 70% of deaths could be prevented with a low cost diagnostic and treatment plan. Meaningful preventive care and treatment cannot be implemented without a structured plan for early diagnosis and patient tracking.Early diagnosis requires improved access to parents and guardians of children with SCD, and gaining this access remains a challenge in most of SSA. In 2015, Nigeria's Kano state government, with support from foreign partners, established a community-based program for newborn registration. This platform provides unique access to newborn babies in one of Nigeria's most populous cities, but still lacks a functioning patient testing, tracking, and monitoring system, which we plan to address in our ongoing study. This study will introduce mobile health in a low-income country with low literacy rate and hopefully accustom that segment of the population to more varied mobile health applications that will ultimately improve their health in the long run. Our current operational platform in Kano, Nigeria provides access to a large population with a high prevalence of SCD. We have previously completed pilot testing of 315 subjects for SCD using our microchip electrophoresis test. We are planning to test up to 4,500 additional subjects less than 5 years of age at Murtala Muhammed Specialist Hospital. The hospital staff includes 97 physicians and 415 nurses and outpatient clinics serve about 30,000 patients monthly. The maternity department has a 200-bed capacity and the antenatal clinic performs about 1,000 deliveries and serves an average of 3,000 mothers monthly. Enrollment is planned to start on September 15, 2019 and medical staff are currently being trained to run the tests. Our study is registered in the United States National Library of Medicine's ClinicalTrials.gov (Identifier: NCT03948516). Our technology is uniquely paired with an automatic reader and an Electronic Medical Record (EMR) and patient management solution to record POC test results, register new cases, and track patients for follow-up (Fig. 1). The reader enables automated interpretation of test results, local and remote test data storage, and includes geolocation (Global Positioning System) (Fig. 2). The system will generate reports for all cases of SCD, track hospital visits, appointments, lab tests, and will have mobile and dashboard applications for tracking patients and samples. The application will be installed on mobile devices provided to users. The proposed system will be compliant with the existing privacy standards to handle medical data (e.g., HIPAA in the US and GDPR in the EU). All communications between the parties will be secured via end-to-end encryption as a safeguard. We anticipate that our project will increase the rates of screening, diagnosis and timely treatment of SCD in Kano State of Nigeria. The project's broader impact will likely be the ability to track and monitor screening, disease detection, diagnosis and treatment, which can be scaled up to the whole nation of Nigeria, then to sub-Saharan Africa. The data obtained and analyzed will be the first of their kind and will be used to inform the design of programs to improve access to, and availability of, effective care for this underserved populations. The importance of increased access to diagnosis and treatment should not be underestimated - it is crucial for realizing effective management of people with SCD. The impact can be enhanced by complementing diagnosis and patient tracking with education for the families so they can provide or seek the necessary preventative treatment. Identification of the location of the patients in need would help identify the areas where family, parent, caregiver education should be provided. Disclosures Fraiwan: Hemex Health, Inc.: Equity Ownership, Patents & Royalties. Hasan:Hemex Health, Inc.: Equity Ownership, Patents & Royalties. An:Hemex Health, Inc.: Patents & Royalties. Thota:Hemex Health, Inc.: Employment. Gurkan:Hemex Health, Inc.: Consultancy, Employment, Equity Ownership, Patents & Royalties, Research Funding.

Prevalence of malaria infection among patients attending Murtala Muhammed specialist hospital Kano, Nigeria

Malaria is one of the most common diseased conditions in Nigeria and across most developing countries triggered by one of four species of Plasmodium. The objective of this study was to screen and detect for the presence of Plasmodium species via microscopic analysis on Malaria patients attending a healthcare facility Northern Nigeria and present the epidemiological data of malaria.Finger prick blood samples, Thick and Thin Giemsa-stained blood smears, were collected from 350 malaria-suspected individuals representing all age groups. The Giemsa-stained blood smears were examined microscopically. Demographic information on rural and urban dwellings, use of insecticides and mosquito nets were collected using structured questionnaires. Malaria cases were detected in in 227 (64.9%) of the participants with a higher infection rate amongst the males (147) than the females (80). The predominant specie found was Plasmodium falciparum. All age groups in this study were vulnerable in the order of 61-above>31-40>51-60>41-50>1-10>21-30> 11-20 years of age.A large number of participants dwelling in urban area (219) were tested positive for malaria in contrast to eight(8) from the rural area. Not using insecticides and mosquito treated nets were significantly associated with the prevalence of malaria as 59.4% of participants who were tested positive for Plasmodium falciparum infection utilized insecticides, while 66.9% of those who did not were also tested positive. Individuals residing close to gutters and bushes were the most susceptible (85.6%) to Plasmodium infection.Keywords: Prevalence, Malaria, Plasmodium falciparum, Kano.

Effects of aerobic training on cardiovascular parameters of diabetic patients attending Murtala Muhammed Specialist Hospital, Kano Nigeria

This study investigated the effects of aerobic training on cardiovascular parameters of diabetic patients attending Murtala Muhammed Specialist Hospital, Kano (MMSHK). The population of this study consisted of 522 diabetic patients attending MMSHK. A sample of 24 type 1 and 24 type 2 diabetic patients were purposively selected and randomly assigned into experimental (n=12) and control (n=12) for both types 1 and type 2 diabetic patients. However only 40 of the subjects completed the study 10 each for type 1 and 2 experimental and control groups. The participants in the experimental groups were engaged in run/walk training three times (on alternate days) weekly for 16 weeks. Both experimental and control groups continued their medications. The control groups were advised to continue with their normal sedentary daily life. The systolic BP, diastolic BP, resting HR and Vo2max of all the subjects were measured before and after the 16 weeks training. Analysis of Covariance (ANCOVA) was used to test the stated hypotheses at 0.05 level of significance. The results revealed a significant reduction in the systolic blood pressure, diastolic blood pressure, resting HR, while the Vo2max increased significantly after the training among the experimental groups both type 1 and type 2 diabetic patients. The implication of the findings is that engaging diabetes patients both type 1 and type 2 in regular aerobic exercises will surely assist in the management and control of the illness due to the prevention of obesity which is known factor of diabetes. Based on the findings of the this study, it is recommended among others, that aerobic exercise (walk/run) should be used as an intervention in the management of both type 1 and 2 diabetes

Beta-lactamase production by bacteria isolated from the gastrointestinal, urogenital and urinary tracts of patients at Murtala Muhammed specialist hospital and decent laboratory, Kano

Beta-lactamase production by bacteria isolated from the gastrointestinal, urogenital and urinary tracts of patients at Murtala Muhammed specialist hospital and decent laboratory, Kano

Liver function biomakers in Malaria and Hepatitis B co-infection among patients with febrile illness

Introduction: Malaria and Hepatitis B Virus (HBV) co-infections present major threat to public health throughout tropical and Sub-Saharan Africa. This study was carried out to analyze the status of liver enzymes and serum protein in HBV and malaria co-infected patients in Murtala Muhammed Specialist Hospital (MMSH) Kano. Methods: Standard microscopy and rapid diagnostic test (RDT) were used separately to screen for mono and co-infections among 200 outpatients presented with fever. Their serum protein and liver enzymes were investigated. Results: Among the total subjects studied 25.5% were malaria positive. Females had higher rate of malaria infection (18%) than males (7.5%). Age group 15-24 had the highest malaria prevalence (11%). Thirteen (6.5%) subjects were HBV positive. Males had higher rate of infection (4.5%) than females (2.0%). Male subjects had higher prevalence of co-infection representing 4.5% and age groups 25-34 were observed to have highest co-infection rate of 1.5%. Biochemical parameters analyzed on all the categories of subjects shows significant difference in their mean values as compared to other groups (P<0.05). However no significant difference was observed in the value of ALP in all the groups. Statistical difference was also established in ALB values between the co-infection and malaria groups (P=0.037) and between malaria and control group (P=0.022). There is also a statistical difference in the mean value of total bilirubin among the groups P<0.05 and mean value of DB between HBV and control groups (P=0.022). Conclusion: The study showed that co-infection of malaria and HBV infection had no profound effect on the level of serum protein and liver enzyme activities in the serum.

Malaria and Hepatitis B co-infection in patients with febrile illnesses attending general outpatient unit of the Murtala Muhammed Specialist Hospital, Kano, Northwest Nigeria

Malaria and Hepatitis B Virus (HBV) infections are co-endemic throughout much of the tropical and sub-Saharan Africa and both present major threat to public health. A study on the prevalence of HBV and Malaria co-infection was carried out on 200 patients presenting with fever at the General Outpatient Department (GOPD) of the Murtala Muhammed Specialist Hospital (MMSH), Kano using Gold Standard microscopy and rapid diagnostic test (RDT). The effect of mono and co-infection on hematological parameters was also investigated. Fifty one (25.5%) out of the 200 patients studied were Malaria positive. Females had higher prevalence rate(18%) of Malaria infection than males with 7.5%. Age group 15-24 had the highest Malaria prevalence (11%) followed by age group 25-34 with 6.5%. Higher mean parasite density (1,200/il) was recorded among subjects with monoinfection of Malaria than mean parasite density (518/il) obtained among the co-infected. Mean parasite density was higher in female than male subjects. Thirteen (6.5%) subjects were HBV positive. Males had higher rate of infection with 4.5% prevalence than females with 2.0%. Nine individuals representing 4.5% of the total population had co-infection with higher prevalence (3%) among the males. Age groups 25-34 were observed to have high co-infection rate of 1.5% and the least prevalence was observed among the age group 15-24 with 0.5% prevalence for both males and females. Hematological evaluation carried out on all the categories of subjects shows significant difference in mean values of PCV (P=0.041), Hb (P=0.018) between the co-infection group and those with malaria infection and control groups. However, no significant difference (P>0.05) was observed in the values of WBC, PLT and Red cell indices among the co-infected and other test group. It was concluded that co-infection with the two ailments had no profound effect on hematologic parameters. Keywords : Co-Infection, Hepatitis B, Kano, Malaria, MMSH, Prevalence

Correlates of psychosocial stress and white blood cell count following exercise training program: A randomized controlled trial on men with essential hyperten sion

Objective: The aim of this study was to determine the effect of continuous training program on the correlates of white blood cell count (WBCc) and psychosocial stress in black African (Nigerian) male subjects with essential hypertension. Materials and Methods: Male subjects with diagnosis of essential hypertension attending the hypertensive clinic of Murtala Muhammed Specialist Hospital (MMSH), Kano, Nigeria form the population for the study. Two hundred and seventeen subjects with stage 1 and 2 [systolic blood pressure (SBP) between 140 and 180 and diastolic blood pressure (DBP) between 90 and 109 mmHg) hypertension were age matched and randomly grouped into continuous (112) and control groups (105). The continuous group involved in an 8 weeks continuous training (60-79% HR max) of between 45 and 60 minutes, three times per week, while the controls group remain sedentary. Blood pressure (SBP and DBP), WBCc, VO 2 max and psychosocial status were assessed. Student t test and Pearson correlation test were used in data analysis. Results: The study revealed significant beneficial effect of continuous training programs on VO 2 max, SBP, DBP, WBCc and psychosocial status (P Conclusion: This study supports the recommendations of moderate intensity (continuous) training program as an adjunct multi-therapy in blood pressure, inflammatory, and psychosocial stress management in hypertension.

Pattern of facial palsy in a typical Nigerian specialist hospital

Data on incidence of facial palsy is generally lacking in Nigeria. To assess six years' incidence of facial palsy in Murtala Muhammed Specialist Hospital (MMSH), Kano, Nigeria. The records of patients diagnosed as facial problems between January 2000 and December 2005 were scrutinized. Data on diagnosis, age, sex, side affected, occupation and causes were obtained. A total number of 698 patients with facial problems were recorded. Five hundred and ninety four (85%) were diagnosed as facial palsy. Out of the diagnosed facial palsy, males (56.2%) had a higher incidence than females; 20-34 years age group (40.3%) had a greater prevalence; the commonest cause of facial palsy was found out to be Idiopathic (39.1%) and was most common among business men (31.6%). Right sided facial palsy (52.2%) was predominant. Incidence of facial palsy was highest in 2003 (25.3%) and decreased from 2004. It was concluded that the incidence of facial palsy was high and Bell's palsy remains the most common causes of facial (nerve) paralysis.

Obstetrics fistula repairs in Kano, Northern Nigeria: The journey so far

Background: Obstetric fistulae are still very common in developing countries with many patients living with this agony due to the huge backlog of untreated cases. This study aim to look at the large number of cases repaired and the good outcome they had, from a single center in Northern Nigeria, over a 12 months period, at Murtala Muhammed Specialist Hospital, Kano. Materials and Methods: We review case files of 288 patients that had fistula repair between October 2011 and September 2012. The result was analyzed using statistical Package for the Social Sciences version 18 and presented in tabular forms. Results: A total of 343 patients were seen at the center with vesicovaginal fistula, rectovaginal fistula or both. 288 (83.97%) had the repair and all were successfully closed with only 11.1% of those repaired having stress incontinence. All cases were done through the vaginal route using spinal anesthesia and had no significant surgical or anesthesia-related complications. Conclusions: We believe with good commitment and training of more fistula surgeons the reservoir of untreated patients in developing countries will reduce. Effective health education, provision of skilled birth attendant at delivery and presence of adequate obstetric emergency facilities is corners stone in obstetric fistulae prevention.

Effects and correlates of continuous training programme on psychosocial status and white blood cell count in men with essential hypertension: A randomized controlled trial

Aim: The aim of this study was to determine the effect and relationship of continuous training programme on WBCc and psychosocial status of black African (Nigerian) subjects with hypertension. Methods: Nigerian subjects with diagnosis of hypertension attending the hypertensive clinic of Murtala Muhammed Specialist Hospital (MMSH), Kano, Nigeria form the population for the study. 217 subjects with mild to moderate (systolic blood pressure [SBP] between 140-180 & diastolic blood pressure [DBP] between 90-109 mmHg) essential hypertension were age matched and randomly grouped into continuous (112) & control groups (105). The continuous group involved in an 8 weeks continuous training (60%-79% HR max) of between 45 minutes to 60 minutes, 3 times per week, while the controls group remain sedentary. SBP, DBP, WBCc, VO2max and psychosocial status were assessed. Student t test and Pearson correlation test were used in data analysis. Results: The study revealed a significant beneficial effect of continuous training programmes on VO2max, SBP, DBP, WBCc and psychosocial status (p tively and negatively correlated respectively with VO2max at p junct multi-therapy in blood pressure, inflammatory and psychosocial stress management in hypertension.

Effects of aerobic exercise training on psychosocial status and serum uric Acid in men with essential hypertension: a randomized controlled trial.

Background:Chronic psychosocial stress and serum uric acid (SUA) level have been implicated in the etiology and cardiovascular events risk factors in hypertension. Studies have reported significant benefit of exercise in the overall management of hypertension. However, studies on the effect of exercise on psychosocial stress and SUA in the management of hypertension seem scanty.Aim:The aim of this study was to determine the effect of continuous training program on SUA and psychosocial status of black African (Nigerian) population with hypertension.Subjects and Methods:Age-matched randomized controlled trial was used; subjects with diagnosis of hypertension attending the hypertensive clinic of Murtala Muhammed Specialist Hospital (MMSH), Kano, Nigeria form the population for the study. Two hundred and seventeen subjects with mild to moderate (systolic blood pressure (SBP) between 140 and180 and diastolic blood pressure (DBP) between 90 and 109 mmHg) essential hypertension were grouped into continuous (112) and control groups (105). The continuous group involved in an 8 weeks continuous training (60%-79% HR max) of between 45 and 60 min, 3 times per week, while the controls group remain sedentary. SBP, DBP, SUA, VO2 max and psychosocial status were assessed. Student t-test and Pearson correlation test were used in data analysis.Results:The study revealed significant beneficial effect of continuous training programs on VO2 max, SBP, DBP, SUA, and psychosocial status (P < 0.05). Psychosocial status and SUA was significantly and positively and negatively correlated respectively with VO2 max at P < 0.01.Conclusions:This study concludes and supports the recommendations of moderate intensity (continuous) training program in blood pressure reduction, SUA and psychosocial stress management in hypertension.

Prevalence and Risk Factors of Low Back Pain among Nurses in Africa: Nigerian and Ethiopian specialized Hospitals survey.

Objective: The purpose of this study was to determine the prevalence and risk factors for low back pain (LBP) among nurses in two typical African Specialized Hospitals.Methods: This was a cross-sectional study designed to determine the prevalence and risk factors for LBP among nurses at Murtala Muhammed Specialist Hospital [MMSH]), Nigeria and Jimma University Specialized Hospital [JUSH]) in Ethiopia. A department-to-department enquiry was conducted using a self structured valid and reliable questionnaire. Simple percentage (%) and Chi square were used to analyze variables of interest.Results: Five hundred and eight respondents (178 [35%] males and 330 [65%] females) participated in the study. The 12 month prevalence of low back pain (LBP) was 360 (70.87%). LBP was more prevalent among female nurses (76.07%) than the male nurses (59.55%). It was also associated with occupational hazard and poor knowledge of back care ergonomics. The prevalence of LBP was highest among nurses in Obstetrics and Gynecology Unit (26.67%) and least among tutors (4.17%). There was no significant difference between Nigerian and Ethiopian nurses' response in the etiology of LBP. However, there was a significant associationbetween gender, knowledge of back-care ergonomics and prevalence of LBP at p< 0.05. The prevalence of LBP at MMSH (Nigeria) and JUSH (Ethiopia) is comparable to levels recorded outside Africa. However, in this study, LBP did not feature as a major cause of sickness or absence from the work place contrary to those reported outside Africa.Keywords: Low back pain; nurses; ergonomics; Nigeria;Ethiopia.

Prevalence And Risk Factors Of Low Back Pain Among Nurses In Africa: Nigerian And Ethiopian Specialized Hospitals Survey Study

The mechanical hazards in the hospitals include low back pain (LBP) from manual lifting (lifting patients in particular) which makes nursing one of the occupations most affected by LBP. Nurses are required to lift and transport patients or equipments, often in difficult environment particularly in developing nations like Africa, where lifting aids are not always available or practicable. The objective of this study was to determine the prevalence and risk factors of LBP among nurses in African. A cross-sectional study was designed and used to determine the prevalence and risk factors for LBP among nurses in a typical Nigerian (Murtala Muhammed Specialist Hospital [MMSHI) and Ethiopian (Jimma University Specialized Hospital [JUSH]) Specialized Hospitals. A department-to-department enquiry was conducted using a self structured valid and reliable questionnaire. Simple percentage (%) and Chi square were used to analyze variables of interest. Five hundred and eight respondents (178 [35%] males and 330 [65%] females) participated in the study. The 12 month prevalence of low back pain (LBP) was 360 (70.87%). LBP was more prevalent among female nurses (67.5%) than the male nurses (32.5%). It was also associated with occupational hazard and poor knowledge of back care ergonomics. The prevalence of LBP was highest among nurses in Obstetrics and Gynecology Unit (26.67%) and least among tutors (4.17%).There was no significant difference between Nigeria and Ethiopian nurses' responses in prevalence, etiology and knowledge of back care. However, there was a significant association between gender, knowledge of back-care ergonomics and prevalence of LBP at p< 0.05. The prevalence of LBP at MMSH (Nigeria) and JUSH (Ethiopia) is comparable to levels recorded outside Africa. However, in this study LBP did not feature as a major cause of sickness absence in the work place contrary to those reported outside Africa. Nurses only lost 202 days (0.15%) of the total working (131,400) days, this is considerably very low. Though, longer sick leaves (7563 days) were medically advised and applied for, However, only about 2.7% of the applied sick leaves was granted on technical or/and administrative grounds against medical recommendation and advices. It was concluded that poor back care ergonomics, duty stress and unavailability of lifting equipments are the major predisposing factors of LBP among nurses in Africa. It was recommended that regular refresher courses on back care ergonomics are essential.

Knowledge, attitude and practice of contraceptives among grand multiparous women attending antenatal clinic in a specialist hospital, Kano, Nigeria

Background: Nigeria is the most populous country in Africa. Worldwide the country has the second highest maternal mortality ratio. The fertility rate is 5.38 children per woman. Grand multiparity with its associated risks contributes to the high maternal mortality ratio. This study was conducted to find out the knowledge, attitude and practice of contraception among grand multiparous women attending the antenatal clinic in a specialist hospital, Kano. Methods: It was a descriptive cross-sectional study conducted among grand multiparous women attending antenatal care clinic at Murtala Muhammed Specialist Hospital, Kano from 1st September to 31st December 2013. All consenting grand multiparous women were recruited within the study period. Data were collected on a predesigned questionnaire and analysed using SPSS version 17 (SPSS Inc., IL, Chicago, USA). The descriptive statistics was used for categorical variables and Chi-square was used for test of significance. A P ≤0.05 was considered statistically significant for inference. Results: Three hundred and thirty four grand multiparas were recruited. The mean age was 37.23 ± 3.17 years. Majority of them (80.20%) got their contraceptive knowledge from the nurses and/or midwives. Up to 88.60% agreed have used contraceptives. The most popular and used contraceptive among the grand multiparous women was oral contraceptive pills (OCP) (89.80%). The major cause of the non-use of contraceptives was the fear of side effects (77.20%). Conclusion: Grand multiparous women mainly obtain their contraceptive knowledge from the nurses/midwives. OCP was the most used methods. Major causes of non-use of contraceptives were the fear of side effects and desire for more children.