Rivers State University Teaching Hospital Research Articles

Knowledge, Attitude and Practice of Diarrhoea, Home Management and Prevention among Mothers/Care-Givers Attending a Paediatric Outpatient Clinic in Rivers State, Nigeria

Introduction: Diarrhoea is a major contributor to under-five morbidity and mortality. A good knowledge of the disease and caregivers’ ability to commence appropriate treatment at home is key in reducing childhood mortality. Aim: To assess caregivers’ knowledge, attitude and practice of diarrhoea home management and prevention in a paediatric outpatient clinic in Nigeria. Method: The study took place in the paediatric outpatient clinic of Rivers State University Teaching Hospital. A questionnaire was used to collect data on biodata, knowledge, attitude and practice of diarrhoea home treatment and prevention from mothers/caregivers. Each question answered correctly was awarded a mark. The participants were grouped into having good, fair and poor knowledge, attitude and practice based on their scores. Results: Overall, 69.7% of the participants had good attitude while only 31.1% and 34.8% had good knowledge and practice of diarrhoea home management. Majority of the participants (83.3%) correctly defined diarrhoea and knew that diarrhoeal illness could have complications (90.3%), but only few knew the signs of dehydration (34.2%) and identified danger signs of diarrhoea (22.4%). About 43% commenced treatment at home when their children had diarrhoea but only 14% gave the right treatment. The caregivers age, parity and educational level were significantly associated with good knowledge and attitude, while socioeconomic class of the mothers/caregivers was associated with good practice of diarrhoea home management and prevention. Conclusion: Mothers/caregivers’ knowledge and practice of home management/prevention of diarrhoeal disease was suboptimal. Health workers and community educators therefore need to do more to improve the narrative. Keywords: Diarrhoea, Knowledge, Attitude, Practice, Mothers/caregivers, Home management, Prevention, Nigeria

Caregiver Burdens of Cancer Patients in Rivers State University Teaching Hospital (RSUTH)

Cancer causes significant physical and emotional impairments in its sufferers. Not only patients, cancer may indirectly affect many of whom are the primary caregivers. This work investigated the caregiver burdens of cancer patients in Rivers State University Teaching Hospital (RSUTH). The study hypotheses were developed and a population size of 100 respondents was determined using Taro Yamane’s formula. A questionnaire was designed and validated while data was collected from primary and secondary sources. Data collected were analyzed using a frequency table, percentage and mean score analysis while the nonparametric statistical test (Chi-square) was used to test the formulated hypothesis using SPSS. The results obtained from the three hypotheses which include the test: (i) that there was no level of care burdens among informal caregivers of cancer patients, (ii) that there was no quality of life of informal caregivers of cancer patients, and (iii) that there was no correlation between burdens of care and quality of life of family caregivers of cancer patients revealed that the majority of the respondents were of the opinion that there was a level of care burdens among informal caregivers of cancer patients. Secondly, there was a quality of life of informal caregivers of cancer patients and thirdly, there was a correlation between burdens of care and quality of life of family caregivers of cancer patients in RSUTH.

Prevalence of ectopic pregnancy in surgical patients at a tertiary hospital in Rivers State, Nigeria

Background: Ectopic pregnancy is the most common cause of maternal mortality in the first trimester of pregnancy. Presentation is usually late especially in the developing countries of the world. Surgery is the preferred management modality compared to other management options because of challenges with monitoring in cases of un-ruptured ectopic pregnancies. The estimated global prevalence of ectopic pregnancy is 1-2%%. Aim: To determine the prevalence of ectopic pregnancy in surgical patients at the Rivers State University Teaching Hospital (RSUTH). Method: This study was a one-year retrospective research of Surgical (Surgery and Obstetrics/gynaecology departments) patients who had ectopic pregnancy at the RSUTH. The patients comprised of all the consecutive cases of the surgeries in these departments for the period under review. Permission for the study was obtained from the Head Department of obstetrics and gynaecology RSUTH. Structured profoma was used to extract information from patients’ case notes and analyzed using SPSS version 25. Result: The subjects for the study were 250, comprising of 98 (39.2%) males and 152 (60.8%) females. The age range was 22 years to 56 years. The mean age was 31 years of which 132 (52.8%) were obstetrics and gynaecological surgeries while 118 (47.2%) were non-gynaecological surgeries; 16 (6.4%) had ectopic pregnancy of which 12 (4.8%) were ruptured and 4 (1.6%) were unrutured. All the patients that had ectopic pregnancy had laparotomy with salpingectomy. Conclusion: The prevalence of ectopic pregnancy in surgical patients at the RSUTH was 6.4%. Majority of the patients present with ruptured ectopic pregnancy. All of the patients had surgical intervention (emergency laparotomy with salpingectomy).

Medical Biomonitoring of Maternal and Fetal Exposure to Carbon Monoxide and its Modification by Demographic and Obstetric Characteristics.

There is a paucity of organized human biomonitoring, including that of carbon monoxide (CO) in the Niger Delta, Nigeria. The study aims to quantify the impact of maternal exposure to CO in the first trimester of pregnancy and its modification by maternal demographic and obstetric factors. It was of cross-sectional design conducted at the Rivers State University Teaching Hospital (RSUTH) in Nigeria. Four hundred and ninety consecutive pregnant women in the first trimester were recruited from the antenatal clinic from January 2021 to January 2022. Demographic, social, and obstetric characteristics were recorded. Maternal exhaled CO concentration (ECOC) and maternal and fetal carboxyhaemoglobin concentrations (MCOHC and FCOHC) were measured with the aid of a smokelyzer. Data were analyzed, using SPSS version 25.0 software. Ethical approval was obtained from the RSUTH Ethics Committee. The mean values of ECOC, MCOHC, and FCOHC were 3.25±2.51 ppm, 1.15±0.40%, and 0.93±0.72% respectively and the severity (mild, moderate, and severe) of the impact was inversely proportional to the number of women affected. There were statistically significant differences in the mean values of ECOC, MCOHC, and FCOHC in the following maternal characteristics: age, educational levels, BMI, gravidity, and parity. In the case of FCOHC, the measures of the differences were as follows: p:<0.019, <0.020, <0.0001, <0.0001, and <0.038 for age categories, educational levels, BMI, gravidity, and parity respectively. There were statistically significant positive correlations between the BMI and the mean values of ECOC, MCOHC, and FCOHC. The higher the severity of exposure to CO (mild, moderate, and severe), the lower the number of impacted pregnant women. There were statistically significant differences in the mean values of ECOC, MCOHC, and FCOHC in women of different ages, educational levels, BMI, gravidity, and parity categories.

Relationship between serum selenium deficiency and preeclampsia among pregnant women at the Rivers State university teaching hospital, Port Harcourt, Nigeria

Relationship between serum selenium deficiency and preeclampsia among pregnant women at the Rivers State university teaching hospital, Port Harcourt, Nigeria

Relationship between serum selenium deficiency and preeclampsia among pregnant women at the Rivers State university teaching hospital, Port Harcourt, Nigeria

Background: Preeclampsia is a multi-system disorder of pregnancy. It is associated with a significantly increased risk of maternal and fetal morbidity and mortality. Oxidative stress has been implicated. Selenium is a very important trace element in the synthesis of endogenous antioxidants which help to balance the effects of oxidative free radicals. This study sought to determine the relationship between serum selenium deficiency and preeclampsia among pregnant women. Method: A prospective case-control study was carried out on consenting preeclamptic (135) and normotensive (135) pregnant women in their second half of pregnancy. Blood samples were taken for serum selenium estimation and analyzed using Atomic Absorption Spectrophotometry (AAS). Their Socio-demographic information was collected through a structured proforma. Data were analyzed using SPSS version 20. A P-value of &lt; 0.05 was considered to be statistically significant. Results: There was no significant difference in characteristics between the two groups. The mean selenium level of the preeclamptic women (0.52 ± 0.31µmol/l) was significantly (P=0.001) lower than that of the normotensive women (0.73 ± 0.24µmol/l). Bivariate analysis showed that preeclamptic women were 3.6 times more likely to have a deficiency in selenium compared to normotensive women (OR=3.61; P=0.001; 95%CI: 2.13-6.10). No significant difference was noted in the serum level of selenium in patients with mild versus severe preeclampsia. Conclusion: This study showed that pregnant women with selenium deficiency were 3.6 times more likely to develop preeclampsia compared to healthy normotensive pregnant women. However, there was no significant difference between levels in mild compared to severe preeclamptic women.

Evaluation of Changes in Haemostatic Parameters in Pregnancy and Puerperium in Women attending Antenatal Clinic at Rivers State University Teaching Hospital, Nigeria

Evaluation of Changes in Haemostatic Parameters in Pregnancy and Puerperium in Women attending Antenatal Clinic at Rivers State University Teaching Hospital, Nigeria

Prevalence of Hepatitis D Virus among People Attending the Antiretroviral Clinic and the Effect on the Liver Function Enzymes

Hepatitis D virus is an incomplete RNA virus requiring the assistance of the hepatitis B virus, specifically the HBsAg, to be infectious in humans. This study was designed to determine the prevalence of HDV among HIV patients and the effect on liver enzymes. The study was conducted at the Rivers state University Teaching hospital, Port Harcourt, Rivers State. Blood samples were obtained through vein puncture from 93 adults of which 41(44%) were males while 52(56%) were females between the ages 18 and 70 years attending the antiretroviral clinic and CD4+ cell count was also obtained. The samples were preserved at -20ºC. Each of the samples was tested using a SWE-Care rapid strip (China) for the presence of HBsAg. HDV antibody was detected using a Dia. Pro ELISA kit (Italy). The AST, ALT and ALP were determined. SPSS 21 was used to analyze the data and P values were determined. From the total samples collected, 7(7.5%) of them were positive to the HBsAg test of which 3(3.2%) were males, while 4(4.3%) of them were females. Of the 7 people positive to the HBsAg, 6(6.4%) were positive to the HDV antibody with 3(3.2%) females and 3(3.2%) males. There was significant depletion of the CD4+ cells across the groups. For the liver function test, the P values were ˃ 0.05 for AST, ALT and ˂ 0.05 for ALP. The HDV infection from the study was not gender, nor age based and suggests a negative impact on the CD4 cells. The liver function enzyme analysis, suggest higher risk of hypertension in HIV/HBV/HDV infection.

Pattern of Hb genotype in surgical patients at a tertiary hospital in Southern, Nigeria

Background: Haemoglobin (Hb) genotype is not a routine test in adult pre-operative investigations in majority of clinical settings, though in the obstetric and gynaecological patients already have their Hb genotype as a part of the routine antenatal investigations. However, in paediatric work up for surgical procedures Hb genotype is a routine investigation. This is due to sickle cell endemicity in our locality. Aim: To determine the pattern of HB Genotype in surgical patients at the Rivers State University Teaching Hospital (RSUTH). Method: This was a one-year retrospective study of surgical patients (Surgery and Obstetrics/Gynaecology departments) of the RSUTH. The patients comprised of all the consecutive cases of the surgeries in these departments for the period under review. Ethical clearance was obtained from ethical committee of the Rivers State Hospital Management Board. Structured profoma was used to extract information from patients’ case notes and analyzed using SPSS version 25. Result: There were a total of 370 subjects that were recruited for the study under review. There were 146 (39.5%) males and 224 (60.5%) females. The mean age was 31 years. The age range was 22 years to 56 years. One hundred and ninety four (52.4%) were obstetrics and gynaecological surgeries while 176 (47.6 %) were non-gynaecological surgeries. The commonest indication for surgery was caesarean representing 126 (34.1%) of the subject. The most common Hb genotype was AA 246 (66.5%)of which females contributed to 148 (40%) and males 98(26.5%)had Hb AA while 124 (33.5%)of the subjects were Hb AS. Females that were Hb As were 74 (20%) while males were 50 (13.5%). There were no subjects that were Hb SS. Conclusion: This study showed the most prevalent Hb Genotype as AA (66.5%) in surgical patients at the Rivers State University Teaching Hospital (RSUTH), while 33.5% had Hb AS genotype. None of these subjects had sickle cell (HbSS) homozygous trait

Prevalence of Rhesus negative blood group in surgical patients in a tertiary hospital in Rivers State, Nigeria

Background: The Rhesus-D negative blood group is not as common in Africans when compared to Caucasians thus the need to optimize surgical patients prior to surgical procedures. Blood group “O” Rh-D negative blood is a universal donor hence its importance in emergency situations where there is no time to type and cross match blood.This is because surgical patients may need blood transfusion pre-operatively, intra-operatively or post-operatively. Aim: To determine the prevalence of rhesus negative blood group in surgical patients in the Rivers State University Teaching Hospital (RSUTH). Method: This was a one-year retrospective study of surgical patients (Surgery and Obstetrics/Gynaecology departments) of the RSUTH. The patients comprised of all the consecutive cases of the surgeries in these departments for the period under review. Ethical clearance was obtained from ethical committee of the Rivers State Hospital Management Board. Structured profoma was used to extract information from patients’ case notes and analyzed using SPSS version 25. Result: A total of 370 patients were attended to pre-operatively. There were 146 (39.5%) males and 224 (60.5%) females. The mean age was 31 years. The age range was 22 years to 56 years. One hundred and ninety four (52.4%) were obstetrics and gynaecological surgeries while 176 (47.6 %) were non-gynaecological surgeries. The commonest indication for surgery was caesarean representing 126 (34.1%) of the subject.The distribution of Rh-D positive blood and Rh-D negative blood were 337 (91.7%) and 33 (8.9%) respectively. The prevalence of Rh-D negative blood group was 33 (8.9%) with blood group O Rh-D negative as the commonest 15 (4.1%). Conclusion: Our showed the prevalence of Rh-D negative blood group in surgical patients at the Rivers State Teaching Hospital as 8.9%. Rhesus–D “O” negative blood group was the most common representing 4.1% of Rhesus D-negative blood group. This makes it important in emergency surgical practice as universal donor when there may be to time for typing and matching prior blood transfusion.

Cervical dilatation rate following augmentation of dysfunctional labour with oxytocin alone versus oxytocin and drotaverine among term nulliparas in the Rivers State University Teaching Hospital, Port Harcourt, Nigeria

Cervical dilatation rate following augmentation of dysfunctional labour with oxytocin alone versus oxytocin and drotaverine among term nulliparas in the Rivers State University Teaching Hospital, Port Harcourt, Nigeria

Cervical dilatation rate following augmentation of dysfunctional labour with oxytocin alone versus oxytocin and drotaverine among term nulliparas in the Rivers State University Teaching Hospital, Port Harcourt, Nigeria

Background: Dysfunctional labour is the commonest abnormality of the first stage of labour. It complicates 50% of nulliparous deliveries and is associated with increased perinatal morbidity and mortality. Dysfunctional labour occurs when the progress in the active phase of labour is abnormally slow (&lt;1 cm/hr). It is largely due to ineffective uterine contractions or slow cervical dilatation. Augmentation of labour with oxytocin is the standard management of dysfunctional labour as it enhances uterine contractions. In many cases, despite good uterine contractions slow progress persists due to cervical smooth muscle spasms. Drotaverine a smooth muscle relaxant can be used to relieve cervical smooth muscle spasms. Aim/objective: This study compared the cervical dilatation rate in term nulliparas following augmentation of dysfunctional labour with oxytocin versus oxytocin and drotaverine. Methods: The study was a single-blinded randomized clinical trial involving 156 term nulliparous women with dysfunctional labour, who were randomized into two groups. Each group had 78 participants and received either oxytocin with a placebo or oxytocin with drotaverine. They were monitored until delivery and the cervical dilatation rates in both groups were compared. Data obtained were analysed using SPSS version 23 software. The level of significance was set at 0.05. Results: The two groups were similar in their baseline characteristics, the mean pre-intervention cervical dilatation rate were also similar (0.53 cm/hr vs. 0.52 cm/hr, p = 0.85). Following augmentation, the cervical dilatation rate in the oxytocin-drotaverine group was significantly faster than in the oxytocin-placebo group (1.60 cm/hr vs. 1.20 cm/hr, p &lt; 0.01). Conclusion: The use of drotaverine with oxytocin in managing dysfunctional labour in term nulliparous women leads to a faster cervical dilatation rate.

Uterine didelphys: A Case report of successful term pregnancies in each endometrial cavity

Background: Uterine didelphys is a rare congenital anomaly that may increase the risk of pregnancy loss and adverse perinatal outcome. There is limited knowledge of specific increased risk related to uterine didelphys. Uterine didelphys occurs in approximately 1 in 3000 women and accounts for 8 -10% of all mullerian duct anomalies (MDAs). Aim: To present this rare congenital clinical condition and offer management modality experience from the Rivers State University Teaching Hospital (RSUTH). Case report: Mrs. MC was a 33 year old booked G3 Para 1+ 1 (alive), previous caesarean section, who presented for antenatal care. Her index pregnancy was complicated by premature uterine contractions and ante – partum haemorrhage at 29 weeks and 30 weeks gestation respectively which were managed successfully. Obstetric ultrasound scan revealed a second uterine cavity with separate endometrial plate in keeping with uterine didelphys. She subsequently had an elective repeat caesarean section at 38 weeks gestation for transverse lie and uterine anomaly. Findings were a gravid left uterus and an empty right uterus with a lower segment scar. The left uterus contained a live male neonate in transverse lie with a birth weight of 3.5 kg and good Apgar scores. The baby was successfully managed for neonatal Jaundice. The mother developed postpartum haemorrhage which was successfully managed. The mother and baby were discharged on the 5th and 12th post-operative day respectively in good clinical state. The mother was given appointment to the family planning clinic. Conclusion: We presented a patient with a rare congenital clinical condition – uterine didelphys who conceived spontaneously. She had a previous successful pregnancy on the right uterus followed by a spontaneous miscarriage and successfully carried the index pregnancy on the left uterus to term and was delivered by an elective repeat caesarean section with good fetal and maternal outcome.

The pattern of mortality among children hospitalized in the children emergency ward of a single tertiary hospital in Nigeria

Purpose: This study was performed to review the mortality pattern at the emergency ward (EW) of the Rivers State University Teaching Hospital, Port Harcourt, Nigeria.Methods: A retrospective review of mortality among children hospitalized in the EW was conducted from January 2015 through May 2017. Information on their age, sex, weight, diagnosis, and mortality was recorded. The data were expressed in frequencies, and logistic regressions were performed with mortality as the dependent variable.Results: The median age of the 1,020 children hospitalized in the EW was 1.0 year (interquartile range, 0.6-4.0) with death recorded in 60 children, a 5.9% mortality rate. Mortality was higher in the children younger than 2 years, boys, and those with infectious diseases. Of the 60 dead children, infectious diseases were the leading cause of mortality (53 [88.3%]) with sepsis (22 [36.7%]), gastroenteritis (10 [16.7%]), and meningitis (6 [10.0%]), accounting for the highest contributors to mortality. The highest case fatality rates were noted in tetanus (1/1 [100%]), human immunodeficiency virus (5/14 [35.7%]), and tuberculosis (2/7 [28.6%]). The logistic regression showed that age of 13-16 years (adjusted odds ratio, 4.59; 95% confidence interval, 1.80-11.20; compared with age &lt; 2 years) and presence of infectious diseases (4.65; 1.80-12.10) significantly increased the risk of mortality. Conclusion: The mortality rate in our EW during the study period was 5.9%. Infectious diseases remained significant contributors to mortality in our practice. Greater efforts at prevention and control of the diseases are required to correct this negative trend.

Hysterosalpingographic Indications and Findings among Women Presenting to Radiology Department of Rivers State University Teaching Hospital

Background: Hysterosalpingography (HSG) is one of the imaging modality used in evaluating females presenting with complaints of infertility. Infertility is not just the issue of the couples alone both the extended family is involved in the typical African environment, therefore it is essential to identify possible causes and proffer solutions where possible.&#x0D; Aim: This study is aimed at documenting the indications and findings among women presenting for hysterosalpingographic studies in the Radiology Department of Rivers State University teaching Hospital (RSUTH).&#x0D; Setting and Design: A retrospective study, was conducted at the Radiology and the Obstetrics and Gynaecology Departments of a tertiary hospital.&#x0D; Materials and Methods: Assessment of patients who had Hysterosalpingography (HSG) done from 1st January, 2020 to 31st May, 2022 in the Radiology Department of RSUTH. Biodata and indications for the study were obtained from the request forms and the HSG findings were also obtained from results pool.&#x0D; Statistical Analysis: Data were analyzed using SPSS 21.0 version. The level of statistical significance was set at p&lt;0.05.&#x0D; Results: A total of 305 women data were analyzed. The age of the study group was between 21 to 48years with a mean age of 35.21±5.48years. Majority of the age group was 31-35years (n=96, 31.5%). Secondary infertility (n=216, 70.8%) was the most common indication for HSG. Normal HSG was seen in 84(27.5%) of the patients and others had one pathology or the other. Commonest uterine pathology is uterine fibroids (n=100, 32.8%) and bilateral tubal occlusion (n=47, 20.8%) is the most frequent tubal pathology. There was a significant association between age and tubal occlusion (P=0.007).&#x0D; Conclusion: HSG is still a valuable tool for investigating women in gynaecological clinics. Tubal occlusion is the prevailing pathology from this study and secondary infertility is the most common indication for HSG.

Need for blood transfusion during cesarean section in rivers state university teaching hospital

Background: Cesarean Section (CS) has been associated with major intra operative Blood loss. Obstetric hemorrhage has been identified as a major cause of direct maternal mortality, maternal near miss and Maternal morbidity. Blood transfusion is often associated with CS. With the advent of various medical and surgical techniques to prevent excessive blood loss during CS, the need for blood trans fusion in every CS procedure need to be reviewed. High risk pregnancy cases may require blood transfusion. However, 90% of low risk pregnancy cases may not require blood transfusion, especially when the application of blood loss preventive measures are put in place.Aim: The aim of this study is to ensure thorough review of patients peri-operatively, and to find out if intra-operative measures can reduce the need for blood transfusion during CS.Method: This was a retrospective cross sectional study of 1000 patients who had Cesarean section between January 2020 to December 2021. Five hundred (500) of them were cases associated with high risk factors for massive hemorrhage at CS, and thus with increased need for blood transfusion.The other 500 were low risk cases for intra operative hemorrhage during CS. It was expected that blood transfusion will be minimal within this group. The result was that these blood loss preventive measures helped to reduce intra-operative blood loss, thus reduced the need for blood transfusion. In addition, the modal units of blood transfused was 2units, unlike previous studies where modal Transfusion was 3 units [1, 3, 4]. Two hundred and three (203) 40.6% were transfused in the high risk group. Only 11(2.2%) were transfused in the low risk group.Conclusion: The need for blood transfusion during cesarean section was reduced with adequate peri-operative preparations. Optimizing maternal hemoglobin concentration during the antenatal period may reduce the incidence of cesarean section related blood transfusion.

Prevalence of low back pain amongst antenatal clinic attendees at a tertiary hospital in Rivers State, Nigeria

Background: Low back pain is a worrisome complaint amongst antenatal clinic attendees. Management of low back pain in pregnancy is multidisciplinary especially in chronic cases for patient’s satisfaction. Eighty five percent (85%) of women with low back pain in previous pregnancies will develop low back pain in the index pregnancy. Aim: To determine the prevalence of low back pain amongst antenatal clinic (ANC) attendees at the Rivers State University Teaching Hospital (RSUTH) and offer management modalities. Method: The study was a cross sectional study, involving 200 antenatal clinic attendees, drawn from the Rivers State University Teaching Hospital. Information was coded and analysed using SPSS version 25. Results: The mean age was 31.1years; the modal parity was Para 0. Twenty one (20.5%) of the antenatal clinic attendees were housewives, civil servants were 67 (33%) and 79 (39%) were self- employed. For the educational status 144 (72%) had tertiary level, 48 (24%) had secondary level, 4 (2%) had primary level of education, while 4 (2%) of the respondents did not provide their educational status. The prevalence of low back pain was 87 (43.5%). Seventy nine (91.8%) had low back pain lasting less than 6 months while 8 (9.2%) had low back pain lasting greater than 6 months or in previous pregnancies. None of those antenatal mothers were referred to orthopaedic surgeons. Conclusion: The study revealed the prevalence of low back pain amongst ANC attendees at the RSUTH to be 43.5%. In addition, the study revealed that no patient with low back pain had orthopaedic referral. The optimum management for ANC attendees with low back pain is multi-disciplinary involving the obstetricians, the orthopaedic surgeons, physiotherapist, nurses and social workers.

Rubella-specific IgG antibodies in non-pregnant women in Rivers State, Nigeria

Background: Rubella is a contagious virus-borne disease. The study aimed to test a cohort of non-pregnant women in Rivers State for rubella virus IgG antibodies and identify their susceptibility to the viral infection. Methods: The study included 92 consenting non-pregnant women attending Rivers State University Teaching Hospital in Rivers State. The sera were evaluated for detectable anti-rubella IgG antibodies using ELISA kits according to the manufacturer's instructions. Results: Eighty-five (92.4 per cent) of the 92 samples tested positive for rubella Immunoglobulin G antibodies, while 7 (7.6 per cent) tested negative. Rubella IgG seroprevalence was unrelated to age, education, or occupation. Conclusion: Given the high level of rubella IgG among non-pregnant women tested in Rivers State, it is likely that the virus is prevalent in the research area. As a result, a robust surveillance system and the organization of screening for anti-rubella IgG antibodies in pregnant women would be critical for future protection against the illness.

Mean gestational age at booking amongst antenatal clinic attendees at a Tertiary Hospital in Rivers State, Nigeria

Background: Many literature have reported that the first 14 weeks as recommendation for pregnant women to book for antenatal care. The World Health Organization (WHO) has recommended that pregnant women register for antenatal care (ANC) in the first 12 weeks of pregnancy or after two missed periods. However, there are challenges of late booking in the developing countries of the world due to illiteracy, socio-cultural beliefs, economy and religious ideologies. Aim: To determine the mean gestational age at booking amongst ANC attendees at Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Rivers State, Nigeria. Method: The present cross-sectional and observational study was conducted after informed consent was given by antenatal clinic attendees. Antenatal women who attended antenatal clinic were recruited for the study during January to June 2019. Data was collected from the consented women using a pretested questionnaire. Data were expressed in absolute numbers and percentage scale. Permission for the study was obtained from the ethical committee of the Rivers State Hospital Management Board. The information was entered into a spread sheet and analyzed using SPSS Version 25. Result: A total of 500 questionnaires were distributed and 488 questionnaires retrieved. The mean age was 31.44 years and the modal parity was 0. For the educational status 357 (73.2%) had tertiary level, 126 (25.8%) had secondary level, 5 (1%) had primary level of education, while 5 (1%) of the respondents did not provide their educational status. The mean gestational age (GA) at booking was 19 weeks. Eighty one (16.6%) of the ANC attendees registered for ANC in the third trimester. Total number of ANC attendees that registered late for ANC were 414 (84.8%). Conclusion: The study revealed that majority of antenatal clinic attendees at the RSUTH registered late for ANC representing 84.8% of the pregnant women at booking. There is need to educate women of reproductive age to register early for ANC to prevent adverse maternal and perinatal outcome.

Pattern of Neonatal Mortality at a Special Care Baby Unit in Rivers State, Nigeria

Background: Neonatal mortality rate is an important indicator which does not only reflect the overall health of a child and well-being but also assesses the social and economic development of a country.&#x0D; Aim: The study was carried out to determine the pattern and factors associated with neonatal mortality.&#x0D; Methods and Materials: It was a retrospective study carried out in the Special care Baby Unit of the Rivers State University Teaching Hospital from January 2016 to December 2020.&#x0D; Results: Of 2,944 neonatal admissions, 358 died giving a mortality of 12.2% with male preponderance (M:F ratio of 1.5:1). Majority of the neonates who died were admitted within the first 24 hours of life 289(80.7%) and were delivered via Caesarean section 195(54.4%). Most deaths occurred in the first 7 days of life 189(52.8%). The commonest cause of mortality was neonatal sepsis 183 (51.1%) followed by perinatal asphyxia 178(49.7%) and prematurity 176(49.2%). Most mortalities occurred between 4.00pm and 7.59 am 218(61.0%) outside regular work hours. The lowest annual mortality was recorded in the year 2020 (6.36%) while the highest was in the year 2018 (19.27%). There was significant mortality within 24hours of admission among neonates &lt; 1.5 kg as well as those with sepsis, anaemia and neonatal jaundice.&#x0D; Conclusion: The mortality rate of neonates in the Rivers State University Teaching Hospital was high, 12.2% with neonatal sepsis, perinatal asphyxia and prematurity being the commonest causes which are largely preventable. There is therefore need to improve obstetric and newborn care to improve neonatal outcome.