Secondary Health Care Institutions Research Articles

Prevalence Of Antiphospholipid Antibodies In Pregnant Women At A Secondary Health Care Institution In Lagos

OBJECTIVE: The presence of antiphospholipid antibody has been associated with complications in pregnancy; hence the need to determine the prevalence of this antibody in pregnant women attending the ante-natal clinic in a secondary health care institution inLagos metropolis using screening tests.SUBJECTS AND METHODS A cross-sectional study was carried out on a total of one hundred and thirty one (131) women attending obstetrics and gynaecology clinic at the General hospital Surulere Lagos from 1 st to 18 th February 2005. Out of these attendees, 37 were non-pregnant, 31 were pregnant with no complications in pregnancy (apparently normal) and 63 pregnant women with complications in pregnancy. Blood samples were collected from ante-natal patients after obtaining informed consent. The plasma of all the samples were subjected to kaolin clotting time and the serum of forty-three (43) of the samples were run on an enzyme-linked immunosorbent assay (ELISA) for the semi quantitative determination of IgG and IgM anticardiolipin antibodies.RESULTS: A prevalence of 9.3% was obtained for the antiphospholipid antibodies by the coagulation-based kaolin clotting time, and 2.3% by a more sensitive immunological-based ELISA test on the same set of patients.CONCLUSION: In order to avoid false positive results, it is recommended that immunological-based ELISA test be carried out on patients that test positive to kaolin clotting time and/or have clinical features suggestive of the presence of antiphospholipid antibody before they are commenced on therapy.

Assessment of Generic Drugs in the Caribbean

In Caribbean countries the public sector is the largest purchaser of medicines. Patients may receive these medicines either at no cost or for very nominal charges at primary, secondary, or tertiary health care institutions. A limited drug list determined by the country's experts or the national formulary influences decisions for purchase of medications. Patent rights on branded drugs are honored and generic equivalents are not purchased until patent expiry. Though cost-containment issues are forceful determinants of the selection of generic products, brand name products may be offered at more economical prices, as in Trinidad. Currently, approximately 35–55% of each country's requirement is generic substitution; this is likely to increase. Bioavailability data are usually submitted while tendering for new introductions of generic products.Standard bioavailability laboratories doing drug testing are not present in the region. The Caribbean Regional Drug Testing Laboratory in Jamaica undertakes analysis for...