An unintended pregnancy is a pregnancy that is either mistimed or unplanned. The objectives of this study were to determine the prevalence of unintended pregnancy as well as to document the determinant factors among p...An unintended pregnancy is a pregnancy that is either mistimed or unplanned. The objectives of this study were to determine the prevalence of unintended pregnancy as well as to document the determinant factors among pregnant women attending antenatal clinics at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Rivers State, Nigeria. It was a descriptive, cross-sectional study of 215 women attending the antenatal clinic of UPTH from July to August 2022. Information on socio-demographic characteristics, reproductive history, desirability of the current pregnancy at the time of conception, knowledge and use of contraceptive methods were collected using a pretested questionnaire and analyzed using SPSS version 26.0. Chi-square test was used for test of associations with the level of significance set at P < 0.05. The prevalence rate of unintended pregnancy from the study was 16.28% (≈16%). The contraceptive awareness was very high (209, 97.21%), however, 101 (46.98%) participants had never used any form of contraceptives. Univariate analysis using Chi-square test showed a statistically significant association between age and unintended pregnancy (P = 0.042), level of education and unwanted pregnancy (P = 0.033) as well as parity and unintended pregnancy (P = 0.019). The prevalence of unintended pregnancy among women attending antenatal clinics was high, possibly due to low contraceptive usage. More efforts should be geared towards ensuring access to comprehensive contraceptive care and contraceptive methods, this will enhance uptake and reduce the rate of unintended pregnancy.展开更多
BACKGROUND. The intensive care unit provides critically ill patients with the necessary monitoring, care and supports to optimize their organ/system functions. Parturients are often at risk of sudden deteriorations or...BACKGROUND. The intensive care unit provides critically ill patients with the necessary monitoring, care and supports to optimize their organ/system functions. Parturients are often at risk of sudden deteriorations or exacerbation of chronic illnesses from direct or indirect causes and would often require admissions into the intensive care or high dependency unit. This study is aimed at looking at the trends of maternal admissions in 365 days at the intensive care unit of a tertiary teaching hospital in Southern part of Nigeria, a country that contributes significantly to the global proportion of maternal morbidity and mortality. METHODS. The study adopted a retrospective approach. All critically ill parturients admitted and requiring organ support or close monitoring in the ICU had their files and ICU documents reviewed. The review was held from January-December 2018. RESULTS. Thirty-nine (39) parturients with a mean age (years) of 33 ± 1.3 were admitted, representing 2.9% of annual deliveries. All admissions were postnatal and came predominantly from the unbooked labour ward (51%) and the time lag from maternal deteriorations to presentation to the ICU was 72 ± 10 hours. The main indications for admissions were due to postpartum haemorrhage (33.3%), complications of hypertensive disorders of pregnancy (30.9%) and sepsis (25.6%). Nineteen (48.7%) patients died from obstetric haemorrhage, complications of hypertensive disorders of pregnancy, sepsis and pulmonary embolism. CONCLUSION. The trend of maternal admissions at this specific time frame reflects the burden of maternal critical care in our environment. It highlights the need to holistically tackle the known scourge with improved care.展开更多
Introduction: Tuberculosis (TB) still causes significant morbidity and mortality amongst adults and children despite all the efforts which have been put into the control of the disease. However, the prevalence of the ...Introduction: Tuberculosis (TB) still causes significant morbidity and mortality amongst adults and children despite all the efforts which have been put into the control of the disease. However, the prevalence of the disease in school age children is unknown because of scarcity of TB screening surveys in Nigerian schools. The aim of this study was to evaluate the proportion of school age children treated for TB in the Directly Observed Treatment Short Course (DOTS) clinic of University of Port Harcourt Teaching Hospital (UPTH). Methods: The records of all children 6 to 18 years who were treated in the DOTS clinic from 2011 to 2014 were reviewed. Information sought included age, sex, sputum Acid Fast Bacillus (AFB) status, Human Immunodeficiency Virus (HIV) status and treatment outcome. Results: One hundred and forty children aged 6 to 18 years were treated in the University Port Harcourt Teaching Hospital DOTS clinic, representing 41.79% of childhood TB cases seen over the study period. Seventy one (50.71%) patients were males and 69 (49.29%) were females. Their mean age was 12 ± 3.86. Thirty-one (22.14%) had smear positive TB. Sputum smear positivity was commonest (54.84%) among those who were 16 years and above compared to the other age groups and this is statistically significant (x2 = 17.72, p = 0.001). Forty-one (35%) patients were HIV positive and 6 (4.29%) were positive for both HIV and AFB. Ninety (64.29%) patients recovered fully following treatment, 48 (34.29%) were referred to other DOTS centres and 2 (1.43%) died. Gender, age group, AFB and HIV status showed no relationship with treatment outcome. Conclusion: School age children 6 to 18 years made up a large proportion of childhood TB cases seen within the study period in the DOTS clinic. More than one third of them were HIV/TB co-infected. An effective School Health Services should be established in schools in Port Harcourt to curb the spread of TB and other communicable diseases within the schools.展开更多
Background: While the combined oral contraceptive pill (COCP) is one of the most commonly used methods of birth control especially in the developed countries, robust and current information on the pill use in developi...Background: While the combined oral contraceptive pill (COCP) is one of the most commonly used methods of birth control especially in the developed countries, robust and current information on the pill use in developing countries including Nigeria is at best lacking. Objectives: The study was conducted to determine the prevalence rate, efficacy and side effects of COCP at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Southern Nigeria. Methods: It was a retrospective analysis of all clients who used the COCP between 1st January 1997 and 31st December, 2016, at the family planning clinic of UPTH Port Harcourt. Data on sociodemographic profile, side effects and source of information were extracted from the clients’ case notes coded and fed into Excel spread sheet and analysed. Results: Of the 8310 new acceptors of modern contraceptive methods in UPTH, 399 clients used the COCP, giving a prevalence rate of 4.8%. The mean age of the acceptors was 26.42 ± 4.27 years while the mean parity was 1.90 ± 0.36. Menstrual disruption was the most common complications with 78 episodes constituting 47.0% of all the complications. One unintended pregnancy occurred during the period of observation, giving a Pearl index of 0.01. Conclusion: The study showed that although COCP is very effective, readily available, safe and reliable method of fertility control, the acceptance rate is very low and the patronage rapidly declining and may therefore go into extinction as a family planning method in Port Harcourt, Southern, Nigeria.展开更多
Background: Hepatitis B virus (HBV) infection causes significant morbidity and mortality worldwide. Occupational exposure of health care workers and medical students increases their risk of acquiring HBV infection, an...Background: Hepatitis B virus (HBV) infection causes significant morbidity and mortality worldwide. Occupational exposure of health care workers and medical students increases their risk of acquiring HBV infection, and many authorities recommend vaccination. However, significant proportions of health care workers do not receive HBV immunization, and remain at increased risk to HBV infection. Objective: To determine the hepatitis B vaccination rate among Medical students at the University of Port Harcourt Teaching Hospital (UPTH) and to determine their knowledge of HBV infection. Result: Three hundred and sixteen medical students at UPTH completed self-administered questionnaires which included questions about demographic characteristics, HBV vaccination status, knowledge of hepatitis B vaccine and reasons for not receiving the vaccine. All (100%) of the respondents had heard of hepatitis B vaccine. Two hundred and twenty two (70.2%) of them thought they were at risk of acquiring hepatitis. Two hundred and seventy (85.4%) had received at least one dose of hepatitis B vaccine while 46 (14.6%) had never received the vaccine. One hundred and ten of the respondents had received 3 doses of hepatitis B vaccine, giving a vaccination rate of 34.8%. One hundred and sixteen (36.7%) had received 2 doses, while 44 (13.9%) had received one dose. There was a statistical significant relationship among marital status (p = 0.01), clinical level (p = 0.02) and hepatitis B vaccine uptake. Conclusion: The hepatitis B vaccination rate among medical students at the University of Port Harcourt Teaching Hospital is low. National and institutional legislation for adult vaccination against Hepatitis B should be promulgated for those at higher risk.展开更多
Background: The evaluation of the uterus and its tubes cannot be overemphasized in the management of infertile women. Transvaginal saline sonohysterosalpingography (SHG) is another novel method with certain advantages...Background: The evaluation of the uterus and its tubes cannot be overemphasized in the management of infertile women. Transvaginal saline sonohysterosalpingography (SHG) is another novel method with certain advantages for uterine and tubal assessment in women. Objective: To determine the accuracy of saline SHG findings by comparing it with conventional Hysterosalpingography (HSG) findings in infertile women. Result: The concordance between saline sonohysterosalpingography and hysterosalpingography for the diagnosis of submucous fibroids, uterine adhesions and tubal patency in this study was over 94%. The saline SHG had sensitivity and specificity of 93.8% and 94.1% respectively for diagnosis of uterine fibroids (submucous) and a sensitivity and specificity of 62.5% and 98.9% in the diagnosis of intrauterine adhesions. It also had a sensitivity and specificity of 98.9% and 78.6% respectively in the detection of patent fallopian tubes. Conclusion: The ability of saline SHG to diagnose uterine pathology and tubal patency was comparable to that of conventional HSG. Saline SHG has the potential to replace HSG as the first-line test for the evaluation of uterine or tubal disease in infertile women.展开更多
Objective:To elucidate the awareness and approach to pre-operative human immunodeficiency virus(HIV) testing and emphasis on the attendant components of HIV testing.Methods: The study was conducted at the theatres of ...Objective:To elucidate the awareness and approach to pre-operative human immunodeficiency virus(HIV) testing and emphasis on the attendant components of HIV testing.Methods: The study was conducted at the theatres of the University of Port Harcourt Teaching Hospital among 123 nursing,anaesthetic,and operating staff.A descriptive cross sectional design was adopted with stratified sampling.The study instrument was a structured,self administered pro forma.Results:All respondents were all aware of HIV infection and all had transmission through infected blood and tissues(100.0%).88.6%had infection through needle stick injuries, 62.6%through vertical transmission,and 98.4%through blood transfusion.Sixty three percent of respondents correctly knew what preoperative testing was,while 58.5%were aware of the preoperative testing policy of the hospital.All respondents favoured the policy of preoperative testing.Attitudinal values to seropositive patients were not very different as 72.4%of respondents claimed they treated every patient as high risk,and all respondents used personal protective equipment.Conclusions:Routine HIV testing now represents a conventional means providing patients with knowledge of their HIV status.Such testing should be accompanied by informed consent,counselling,confidentiality,protection,and access to treatment.展开更多
Objective:To explore the prevalence,pathogenicity,and antibiotic susceptibility patterns of urinary tract infections at the University of Port Harcourt Teaching Hospital.Methods:Samples from 400 patients with a presum...Objective:To explore the prevalence,pathogenicity,and antibiotic susceptibility patterns of urinary tract infections at the University of Port Harcourt Teaching Hospital.Methods:Samples from 400 patients with a presumptive diagnosis of urinary tract infection including 250 non pregnant females and 150 males were used for this study.They were distributed into two groups: children aged 2 to 17(Croup A) and adults aged 18 to 75(Croup B).The standard wire loop and agar diffusion technique were employed for culture and susceptibility testing,respectively.Data obtained were analysed using SPSS,version 14.Results:30.0%of Group A and 41.0%of Group B had significant bacteriuria with 66.7%and 79.3%as females,respectively.The commonest isolates cultured were Escherichia coli(32.8%),Staphylococcus aureus(17.2%),and Klebsiella spp.(16.4%).About 76.6%of isolates were sensitive to the fluorinated quinolones,31.2%to the aminoglycosides,and 22.7%to the urinary antiseptic,nitrofurantoin.The isolates were nonsensitive to tetracycline(93.8%),cotrimoxazole(92.2%),and nalidixic acid(86.7%).Most isolates showed non-uniform sensitivity patterns to the cephaloporins(cefuroxime and ceftazidime). Pseudomonas spp.isolates were generally resistant to the fluorinated quinolones.Conclusion: Though the fluorinated quinolones are still largely effective for empirical therapy in urinary tract infections,the importance of prior sensitivity testing in checking the emergence of bacterial antibiotic resistance can not be overemphasized.展开更多
Background: Despite the fact that Tuberculosis (TB) is preventable, treatable and curable, it has remained a significant cause of childhood morbidity and mortality. Identifying patterns of TB and its treatment outcome...Background: Despite the fact that Tuberculosis (TB) is preventable, treatable and curable, it has remained a significant cause of childhood morbidity and mortality. Identifying patterns of TB and its treatment outcome which is the aim of this study is relevant for TB control programmes. Methodology: This was a retrospective cross-sectional study carried out over a three-month period from April-June 2019 at the directly observed treatment Short course (DOTS) clinic of the University of Port Harcourt Teaching Hospital (UPTH), Nigeria. Relevant information on all children 0 - 18 years with tuberculosis over a four-year period from January 2015 to December 2018 was retrieved and analysed. Information retrieved included the age, sex, HIV status, method of diagnosis of tuberculosis, type of Tuberculosis and the treatment outcome of the patients. Results: There were 202 childhood (0 - 18 years) cases seen over the study period. Out of these, 109 (53.96%) were males and 93 (46.04%) females. Majority of them (40.59%) were 1 - 4 years of age. There were 194 (96.04%) new cases, 6 (2.9%) transfer and 2 (0.99%) retreatment cases. One hundred and six (80.69%) had pulmonary TB, 23 (11.39%) TB adenitis, 10 (4.95%) had TB spine, 3 (1.49%) TB abdomen and 3 (1.49%) TB meningitis. TB/HIV co-infection rate was 48.45%. One hundred and eight completed treatment, 10 (4.95%) were cured, 22 (10.89%) died, 46 (22.77%) defaulted and 16 (7.92%) were transferred out. Successful treatment outcome rate was 58.41%. Conclusion: Pulmonary TB was the commonest type of TB found and treatment success rate was just above average.展开更多
Background: Studies have suggested epidemiological transition in the mortality pattern in Nigeria from communicable to non-communicable diseases of which Diseases of the cardiovascular system (DCVS) is prime. DCVS is?...Background: Studies have suggested epidemiological transition in the mortality pattern in Nigeria from communicable to non-communicable diseases of which Diseases of the cardiovascular system (DCVS) is prime. DCVS is?thus a growing public health concern but its mortality profile is under-studied?in Port Harcourt. This study was therefore designed to review the mortality profile of DCVS in Port Harcourt. Methodology: A retrospective case controlled study of deaths ascribed to DCVS at the University of Port Harcourt Teaching Hospital (UPTH) between January 2012 and December 2017. The composite diseases were grouped using the ICD10 scheme and analyzed using SPSS version 23. Minitab version 16 was used for trend analysis. Results: Of the overall 1902 deaths recorded within the period, 566 (29.8%) were cardiovascular system related. Of these, 301 (53.3%) were males and 265 (46.7%) were females. The elderly of 50 - 99 years were most commonly affected (65.5% of the mortalities). Cerebrovascular accidents (CVA) accounted for 322 deaths (56.9%);various types of shock caused 116 deaths (20.5%) while?congestive cardiac failure (CCF) accounted for 114 deaths (20.1%). Pulmonary?embolism, myocardial infarction, carotid aneurysm, and hypertensive encephalopathy caused 1.8%, 0.4%, 0.2%, and 0.2% deaths respectively. Peak annual mortality of 143 (25.3%) was recorded in 2013. Although the trend of mortality was undulating, there was an overall increase in annual incidence over the years.?Conclusion: DCVS constitute the commonest systemic cause?of death in Port Harcourt. Governmental and donor agencies involved in public health policy planning and implementation should scale-up strategies for the prevention and control of DCVS in order to stem the rising tide of associated mortalities.展开更多
Dermatophytoses are the most common dermatological conditions but they are however not life threatening or debilitating hence medical care is sought usually due to aesthetic reasons and chronicity of the lesions despi...Dermatophytoses are the most common dermatological conditions but they are however not life threatening or debilitating hence medical care is sought usually due to aesthetic reasons and chronicity of the lesions despite several self-medications. The purpose of this study was to determine the distribution pattern of dermatophytes isolated in the medical microbiology laboratory of University of Port Harcourt teaching hospital (UPTH). This is a 5-year desk review of the Dermatophytes isolated in the medical microbiology laboratory of UPTH. Relevant Patients’ data were retrieved and analyzed. A total of seventy (70) dermatophytes were isolated over the five-year period as follows: Trichophyton species accounted for 55 (79%), Epidermophyton species were 8 (11%) and Microsporum species 7 (10%). The peak age range of patients from which dermatophytes were isolated was 31 - 40 years with a male to female ratio of 1:1.7. The majority of patients being 49 (70%) were referred from the dermatology outpatient clinic (DOPC) and the most frequent clinical diagnosis was Tinea corporis. Trichophyton species were the commonest cause of dermatophytoses in adult patients in Port Harcourt where the most common clinical presentation was Tinea corporis.展开更多
Background: HIV encephalopathy (HIVE) is associated with cognitive impairment in children with HIV infection, early diagnosis and initiation of HAART may reduce the morbidity associated with HIVE. Objective: To determ...Background: HIV encephalopathy (HIVE) is associated with cognitive impairment in children with HIV infection, early diagnosis and initiation of HAART may reduce the morbidity associated with HIVE. Objective: To determine the prevalence of HIVE and associated comorbiditiesin children at the UPTH. Methodology: This was a retrospective study carried out from January to June 2017. The case notes of all HIV positive children presenting to the Paediatric Department of the University of Port Harcourt Teaching Hospital (UPTH) were studied. Children who met the diagnostic criteria for HIVE according to the Centre for Disease Control (CDC) definition were selected. The socio-demographic characteristics of the patients, mode of HIV transmission, CD4 count and associated comorbidities in these children were retrieved from the case notes. Obtained data was analyzed using Epi Info version 7.2. Comparisms of subgroups was carried out using the chi square test while statistical significance at 95% confidence interval was p value Results: A total of thirty five out of the 196 HIV positive children presenting to the hospital had HIV encephalopathy (HIVE) giving a prevalence rate of 17.9%. Of these 35 children, 18 were males and 17 females, giving a male to female ratio of 1:1. The mean age of the children was 5.7 ± 3.1 years. The mean age for the males was 6.4 ± 3.2 years and 5.0 ± 2.8 years for the females. There was no statistically significant difference observed between the sexes (t = 1.35, p = 0.187). Thirty (85.7%) of the patients with HIVE were on HAART at diagnosis. The mean age at diagnosis of HIV was 3.2 ± 3.1 years and the mean age at diagnosis of HIV encephalopathy was 3.4 ± 3.2 years. The documented route of transmission for all the subjects was mother-to-child-transmission (MTCT). Seventy five percent of the children were breastfed from birth and at 6 months all the mothers had discontinued breastfeeding. The mean CD4 count was 1053 ± 630 cells/ml. Tuberculosis was the most prevalent co-morbidity occurring among the patients. Conclusion: The prevalence of HIVE in children at the UPTH is high and Tuberculosis is the commonest comorbidity. Early infant diagnosis, use of modern diagnostic tool and early initiation of HAART are advocated to reduce its associated morbidity.展开更多
Background: Cerebrospinal fluid analysis is a very important tool in the diagnosis of bacterial meningitis in the new born. Bacterial meningitis is a potent cause of morbidity and mortality in the neonatal age group, ...Background: Cerebrospinal fluid analysis is a very important tool in the diagnosis of bacterial meningitis in the new born. Bacterial meningitis is a potent cause of morbidity and mortality in the neonatal age group, with a very high incidence of neurological complications. Aim: To identify the bacterial pathogens isolated from the cerebrospinal fluids of neonates at the University of Port Harcourt Teaching Hospital (UPTH) and their sensitivity patterns. This will assist the neonatologist in the choice of empirical antibiotic treatment. Study Design: Retrospective, descriptive, cross sectional study. Place and duration of study: University of Port Harcourt Teaching Hospital, from 1 January 2009 to 31 December 2014. Methods: Records of bacterial analysis of cerebrospinal fluid from neonates seen at the special care baby unit of the University of Port Harcourt Teaching Hospital with clinical suspicion of meningitis between 1 January 2009 and 31 December 2014 were retrieved from the microbiology record book. Data on patients age, sex, appearance of Cerebrospinal fluid, cell count, microscopy/gram stain, culture and antibiotic sensitivity were retrieved from laboratory record books and entered into a Microsoft? excel spread sheet and analysed using SPSS version 20.0. Results: One hundred and thirteen neonates: 70 (61.95%) of these patients were male while 43 (38.05%) were females. Only 1 (0.89%) was positive for culture yielding a growth of Escherichia coli which was sensitive to Imipenem, moderately sensitive to Ampicillin, Gentamicin, ceftazidime, cefuroxime, ciprofloxacin and Amoxicillinclavulanic acid. It was resistant to cefotaxime. 112 (99.11%) of the neonates had presumed neonatal meningitis while only 1 (0.89%) had proven neonatal meningitis. Conclusions: There is a low yield of organisms in cerebrospinal fluid of neonates at the University of Port Harcourt Teaching Hospital.展开更多
Multi-drug resistance (MDR) in Enterobacteriaceae poses critical public health threat in Nigeria and the global world. This resistant mechanism might be plasmid mediated or chromosomal. Escherichia coli are Gram negat...Multi-drug resistance (MDR) in Enterobacteriaceae poses critical public health threat in Nigeria and the global world. This resistant mechanism might be plasmid mediated or chromosomal. Escherichia coli are Gram negative pathogen with a global distribution rate. The study was carried out to determine MDR and plasmid profiling of E. coli isolates from urine, feaces and poultry litter. The samples were cultured on eosine methylene blue agar and incubated for 24 hours at 37°C. Results obtained showed a percentage prevalence of 30% for the urine samples which were the most prevalent, while the prevalence of E. coli from the feacal and poultry litter was 8% and 28% respectively. Identified E. coli were screened for antibiotic susceptibility by Kirby Bauer diffusion method. The results on susceptibility of E. coli to tested antibiotics before plasmid curing showed 100% resistance to cefuroxime and augumentin, while 75% resistance was observed in gentamicine, ciprofloxacin and ofloxacine. Cefixime and cefdazidime resistance were 62.5% on E. coli and the least resistance was observed in nitrofurantion (25%). The poultry litter and urine isolates recorded lower resistance level to antibiotics, compared to the feacal isolates. After plasmid curing the percentage of resistance reduced. The only antibiotics that responded positively was nitrofurantion, with high sensitivity of 87% for feacal isolate, 100% for urine isolates, and 78% for poultry litter isolates after plasmid curing. Twenty (20) of the thirty seven (37) isolates were still resistant to more than two antibiotics after the plasmid curing. Of the twenty isolates, 18 (90%) were found to harbor single plasmid, while 2 (10%) did not possess plasmid. This study concludes that nitrofurantion was the most effective antibiotics on Escherichia coli and plasmids were responsible partly for resistance.展开更多
Background: Certain ovarian cancers that were previously common in postmenopausal women are now increasingly observed in women of reproductive age. The research on using β-HCG as a diagnostic biomarker for ovarian ca...Background: Certain ovarian cancers that were previously common in postmenopausal women are now increasingly observed in women of reproductive age. The research on using β-HCG as a diagnostic biomarker for ovarian cancer in women of reproductive age is ongoing. Aim: This study assessed the level of serum β-HCG in non-pregnant women of reproductive age and determined its potential association with suspicious ovarian ultrasonography results. Methods: The study was conducted in Port Harcourt, Nigeria. This study adopted a cross-sectional design on a quota sample of 224 case notes of women aged 18 - 40 years obtained from eight diagnostic centres. A data extraction form was used for data collection. Data analysis employed descriptive statistics, Chi-square, Fisher’s exact test, and Odds Ratio at 95% confidence and 5% significance levels. Results: About 5.8% of the participants exhibited detectable levels of serum β-HCG above 5 IU/L (World Health Organization reference) at a mean concentration of 5.87 (±1.75) IU/L. About 4.0% of the participants had suspicious ovarian lesions identified through ultrasonography. Participants with elevated serum β-HCG levels above the WHO reference were 59 times more likely to have suspicious ovarian lesions (Odds ratio: 59.4, 95%CI: 12.3 - 287.8, p β-HCG level and age (p = 0.041) as well as parity (p Conclusion: Serum β-HCG levels above the WHO reference in non-pregnant women were associated with suspicious ovarian lesions. More rigorous primary research, systematic reviews, and meta-analyses are needed to confirm the findings of this study.展开更多
Background: Infectious diseases associated with Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV) continue to pose significant public health challenges that necessitate continuou...Background: Infectious diseases associated with Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV) continue to pose significant public health challenges that necessitate continuous surveillance and interventions. This study investigates the prevalence of HIV, HBV and HCV infections within the academic community of Rivers State University, Port Harcourt, Nigeria. Given the potential for transmission in university settings and the importance of early detection and intervention, this research explores the extent of these infections and evaluates the outcomes of a medical outreach program aimed at addressing them. Methodology: A cross-sectional study design was employed to recruit 513 participants using a convenience sampling approach between the 20<sup>th</sup> and 22<sup>nd</sup> of April 2022. Participants included students and staff members who voluntarily consented to the medical outreach and study. Serological assays were utilized to identify HIV, HBV and HCV infections. The medical outreach program’s design, implementation, and outcomes were evaluated, focusing on testing uptake, counselling utilization, and linkage to care. Statistical analysis employed GraphPad Prism version 9 software. Result: The study revealed low prevalence rates of HIV (0.6%), HBV (1.2%), and HCV (0.6%) infections within the university population. Age-based analysis indicated a slightly higher prevalence in the 15 - 24 age group. Gender-wise, HBV showed a marginal difference, with 1.3% among females and 0.9% among males. The medical outreach program achieved a testing uptake of 80.8%, with 75% utilizing counselling services, and 75% of those identified with infections successfully linked to care. Conclusion: This study provides valuable insights into the prevalence of infections and the effectiveness of a medical outreach program within a university community. While low prevalence rates are encouraging, the findings emphasize the continued importance of awareness and prevention efforts. The success of the outreach program in encouraging testing, providing counselling, and facilitating care linkage underscores its potential as a model for future interventions. Further research should delve into determinants of infection prevalence and barriers to care linkage for a more comprehensive understanding and improved intervention strategies.展开更多
Background: The most common surgical treatment for symptomatic uterine fibroids, particularly in women with fertility concerns, is open myomectomy. Given the high vascularity of the uterus, haemorrhage during the proc...Background: The most common surgical treatment for symptomatic uterine fibroids, particularly in women with fertility concerns, is open myomectomy. Given the high vascularity of the uterus, haemorrhage during the procedure is a serious risk that is often mitigated with a uterine tourniquet. Aim and Objectives: To evaluate the effect of uterine artery occlusion with a tourniquet during open myomectomy on ovarian reserve using serial anti-Mullerian hormone (AMH) measurements. Materials and Methods: This was a prospective longitudinal study with a quasi-experimental design and a convenient sampling technique. The study enrolled 47 women who had abdominal myomectomy between September 1, 2021, and March 31, 2022, at the University of Port Harcourt Teaching Hospital. Blood samples were collected before anaesthesia was administered in theatre, on day two, and three months after open abdominal myomectomy for anti-Mullerian hormone assay. The data was collected using a semi-structured proforma, entered into an Excel spreadsheet, and analyzed using SPSS version 25.0 with a 95% confidence interval. Statistical significance level was set at 0.05. Results: The pre-surgery AMH mean value was 1.67 ± 1.44 ng/ml, while the values after using a uterine tourniquet at myomectomy on the second day and three months later were 1.22 ± 1.24 ng/ml and 1.59 ± 1.43 ng/ml, respectively. There was no statistically significant change in AMH levels, and there was no statistically significant relationship between blood loss and tourniquet time and AMH after open abdominal myomectomy. Conclusion: The use of a uterine tourniquet and blood loss during open myomectomy has no effect on ovarian reserve.展开更多
Background: Low contraceptive use among all other factors have been implicated in rapid population growth seen in low and lower middle-income countries (LLMICs). This can be attributed to poor knowledge and attitude o...Background: Low contraceptive use among all other factors have been implicated in rapid population growth seen in low and lower middle-income countries (LLMICs). This can be attributed to poor knowledge and attitude of the populace towards use of modern contraceptives. Aim: To determine the knowledge, attitude and practice of contraception among pregnant women attending ANC at the University of Port Harcourt Teaching Hospital (UPTH) in Port Harcourt, Rivers State, Nigeria from July 1 to August 31, 2021. Methods: This quantitative study was designed as a descriptive cross-sectional study that recruited 529 women. They were administered with a semi-structured questionnaire which was used to collect their data and responses. The data was analysed using Statistical Product and Service Solutions (SPSS) version 25. Results: According to the findings, 57.3% and 47.1% of the women had poor knowledge and negative attitude towards contraception respectively. About a tenth of the women (9.8%) utilised contraceptives of which 44.2% and 42.3% used the natural method and male condoms respectively. The study also revealed the major reason behind the low use as desire for more children (36.3%). Conclusion: The study showed that the women had poor knowledge and negative attitude towards contraceptives and this translated to poor contraceptive use. Hence, awareness campaigns should be intensified by health workers towards enlightening the populace on the different types, uses and benefits of modern contraceptives.展开更多
Eclampsia is a common complication of hypertensive disorders of pregnancy and in the puerperium with the attendant risk to both the mother and baby. Although it is a multi-systemic disorder, its manifestation that aff...Eclampsia is a common complication of hypertensive disorders of pregnancy and in the puerperium with the attendant risk to both the mother and baby. Although it is a multi-systemic disorder, its manifestation that affects the brain and resulting in altered sensorium demands brain imaging to define the possible brain lesions and the implications for critical care management and outcome. We evaluated the CT brain lesions in the patients with eclampsia who were admitted in the intensive care unit, University of Port Harcourt, Port Harcourt Nigeria. Objective: To analyse the CT brain images of eclamptic parturients and the outcome following their admission in the intensive care unit. Methods: We undertook this observational study after obtaining ethical exemption from the University of Portharcourt Teaching Hospital ethical review board, and commenced the review between March 2021 to February 2023. We included all parturients that were admitted into the intensive care unit of the University of Portharcourt Teaching Hospital, a nine-bedded open intensive care unit with the clinical diagnosis of eclampsia. Every admitted parturient was required to obtain a brain computed tomography (CT) by local protocol. The brain CT images were retrieved for review from the parturients’ relatives, radiology department and the ICU. Parturients included were aged ≥ 18 years. The radiological reports of these brain images which were also reviewed by a neurosurgeon in case of any need for secondary opinion were subjected to statistical analysis. Result: Thirty-one parturients were admitted with eclampsia with a mean age of 30 years ± 5.29. Sixteen (16) parturients died representing 52%. Only twenty-four (24) CT brain images were retrieved for review (77%). The following brain lesions were identified from the brain CT and they comprised the following: intracerebral haemorrhage, including extensions into the ventricles 7 (29.17%), cerebral oedema 12 (50%), subdural hematoma 1 (4.17%) and normal imaging 4 (16.66%). The subdural haematoma was promptly evacuated with a good outcome. Conclusion: Neuro imaging comprising computed tomography and magnetic resonance imaging of the brain are basic ancillary investigations for patients with eclampsia presenting with neurologic deficits and low GCS. Early presentation and access to brain CT could influence outcome as it was demonstrated in the prompt intervention in the patient with subdural haematoma which was evacuated with a satisfactory outcome.展开更多
Hepatitis B (HBV) and Hepatitis C (HCV) are significant global public health burdens associated with liver cirrhosis, liver cancer and are responsible for over a million deaths yearly. Prisons and other confined facil...Hepatitis B (HBV) and Hepatitis C (HCV) are significant global public health burdens associated with liver cirrhosis, liver cancer and are responsible for over a million deaths yearly. Prisons and other confined facilities offer opportunities for the acquisition and transmission of infectious diseases such as hepatitis B and C during and after imprisonment. This study aimed to investigate the seroprevalence of Hepatitis B and Hepatitis C as well as their associated risk factors among inmates in the Port Harcourt Maximum Security Custodial Centre. A cross-sectional study was conducted among inmates incarcerated in the Port Harcourt Maximum Security Custodial Centre from July to December 2022, and 200 consenting subjects completed a structured questionnaire in addition to screening for the presence of HBsAg and anti-HCV antibodies. Data generated from this study was represented as frequency and percentages, and inferential statistics were carried out using chi-square with the aid of GraphPad Prism Software Version 9. Statistical significance was defined as a p-value of less than 0.05 at a 95% confidence interval. The seroprevalence of HBV was 4% while 3.5% was recorded for HCV with no cases of co-infections reported. HBV seroprevalence was significantly associated with blood oath and a history of surgery (p p < 0.05). The findings from the current study highlight a relatively lower prevalence of HBV and HCV amongst inmates in Port Harcourt in comparison to studies in Nigeria. These infections can be further controlled by multifaceted approaches by the prison personnel, administration, and Government by employing combative measures such as regular screening, easy access to therapy, awareness, and vaccination programs for HBV are crucial to prevent the transmission of these diseases.展开更多
文摘An unintended pregnancy is a pregnancy that is either mistimed or unplanned. The objectives of this study were to determine the prevalence of unintended pregnancy as well as to document the determinant factors among pregnant women attending antenatal clinics at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Rivers State, Nigeria. It was a descriptive, cross-sectional study of 215 women attending the antenatal clinic of UPTH from July to August 2022. Information on socio-demographic characteristics, reproductive history, desirability of the current pregnancy at the time of conception, knowledge and use of contraceptive methods were collected using a pretested questionnaire and analyzed using SPSS version 26.0. Chi-square test was used for test of associations with the level of significance set at P < 0.05. The prevalence rate of unintended pregnancy from the study was 16.28% (≈16%). The contraceptive awareness was very high (209, 97.21%), however, 101 (46.98%) participants had never used any form of contraceptives. Univariate analysis using Chi-square test showed a statistically significant association between age and unintended pregnancy (P = 0.042), level of education and unwanted pregnancy (P = 0.033) as well as parity and unintended pregnancy (P = 0.019). The prevalence of unintended pregnancy among women attending antenatal clinics was high, possibly due to low contraceptive usage. More efforts should be geared towards ensuring access to comprehensive contraceptive care and contraceptive methods, this will enhance uptake and reduce the rate of unintended pregnancy.
文摘BACKGROUND. The intensive care unit provides critically ill patients with the necessary monitoring, care and supports to optimize their organ/system functions. Parturients are often at risk of sudden deteriorations or exacerbation of chronic illnesses from direct or indirect causes and would often require admissions into the intensive care or high dependency unit. This study is aimed at looking at the trends of maternal admissions in 365 days at the intensive care unit of a tertiary teaching hospital in Southern part of Nigeria, a country that contributes significantly to the global proportion of maternal morbidity and mortality. METHODS. The study adopted a retrospective approach. All critically ill parturients admitted and requiring organ support or close monitoring in the ICU had their files and ICU documents reviewed. The review was held from January-December 2018. RESULTS. Thirty-nine (39) parturients with a mean age (years) of 33 ± 1.3 were admitted, representing 2.9% of annual deliveries. All admissions were postnatal and came predominantly from the unbooked labour ward (51%) and the time lag from maternal deteriorations to presentation to the ICU was 72 ± 10 hours. The main indications for admissions were due to postpartum haemorrhage (33.3%), complications of hypertensive disorders of pregnancy (30.9%) and sepsis (25.6%). Nineteen (48.7%) patients died from obstetric haemorrhage, complications of hypertensive disorders of pregnancy, sepsis and pulmonary embolism. CONCLUSION. The trend of maternal admissions at this specific time frame reflects the burden of maternal critical care in our environment. It highlights the need to holistically tackle the known scourge with improved care.
文摘Introduction: Tuberculosis (TB) still causes significant morbidity and mortality amongst adults and children despite all the efforts which have been put into the control of the disease. However, the prevalence of the disease in school age children is unknown because of scarcity of TB screening surveys in Nigerian schools. The aim of this study was to evaluate the proportion of school age children treated for TB in the Directly Observed Treatment Short Course (DOTS) clinic of University of Port Harcourt Teaching Hospital (UPTH). Methods: The records of all children 6 to 18 years who were treated in the DOTS clinic from 2011 to 2014 were reviewed. Information sought included age, sex, sputum Acid Fast Bacillus (AFB) status, Human Immunodeficiency Virus (HIV) status and treatment outcome. Results: One hundred and forty children aged 6 to 18 years were treated in the University Port Harcourt Teaching Hospital DOTS clinic, representing 41.79% of childhood TB cases seen over the study period. Seventy one (50.71%) patients were males and 69 (49.29%) were females. Their mean age was 12 ± 3.86. Thirty-one (22.14%) had smear positive TB. Sputum smear positivity was commonest (54.84%) among those who were 16 years and above compared to the other age groups and this is statistically significant (x2 = 17.72, p = 0.001). Forty-one (35%) patients were HIV positive and 6 (4.29%) were positive for both HIV and AFB. Ninety (64.29%) patients recovered fully following treatment, 48 (34.29%) were referred to other DOTS centres and 2 (1.43%) died. Gender, age group, AFB and HIV status showed no relationship with treatment outcome. Conclusion: School age children 6 to 18 years made up a large proportion of childhood TB cases seen within the study period in the DOTS clinic. More than one third of them were HIV/TB co-infected. An effective School Health Services should be established in schools in Port Harcourt to curb the spread of TB and other communicable diseases within the schools.
文摘Background: While the combined oral contraceptive pill (COCP) is one of the most commonly used methods of birth control especially in the developed countries, robust and current information on the pill use in developing countries including Nigeria is at best lacking. Objectives: The study was conducted to determine the prevalence rate, efficacy and side effects of COCP at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Southern Nigeria. Methods: It was a retrospective analysis of all clients who used the COCP between 1st January 1997 and 31st December, 2016, at the family planning clinic of UPTH Port Harcourt. Data on sociodemographic profile, side effects and source of information were extracted from the clients’ case notes coded and fed into Excel spread sheet and analysed. Results: Of the 8310 new acceptors of modern contraceptive methods in UPTH, 399 clients used the COCP, giving a prevalence rate of 4.8%. The mean age of the acceptors was 26.42 ± 4.27 years while the mean parity was 1.90 ± 0.36. Menstrual disruption was the most common complications with 78 episodes constituting 47.0% of all the complications. One unintended pregnancy occurred during the period of observation, giving a Pearl index of 0.01. Conclusion: The study showed that although COCP is very effective, readily available, safe and reliable method of fertility control, the acceptance rate is very low and the patronage rapidly declining and may therefore go into extinction as a family planning method in Port Harcourt, Southern, Nigeria.
文摘Background: Hepatitis B virus (HBV) infection causes significant morbidity and mortality worldwide. Occupational exposure of health care workers and medical students increases their risk of acquiring HBV infection, and many authorities recommend vaccination. However, significant proportions of health care workers do not receive HBV immunization, and remain at increased risk to HBV infection. Objective: To determine the hepatitis B vaccination rate among Medical students at the University of Port Harcourt Teaching Hospital (UPTH) and to determine their knowledge of HBV infection. Result: Three hundred and sixteen medical students at UPTH completed self-administered questionnaires which included questions about demographic characteristics, HBV vaccination status, knowledge of hepatitis B vaccine and reasons for not receiving the vaccine. All (100%) of the respondents had heard of hepatitis B vaccine. Two hundred and twenty two (70.2%) of them thought they were at risk of acquiring hepatitis. Two hundred and seventy (85.4%) had received at least one dose of hepatitis B vaccine while 46 (14.6%) had never received the vaccine. One hundred and ten of the respondents had received 3 doses of hepatitis B vaccine, giving a vaccination rate of 34.8%. One hundred and sixteen (36.7%) had received 2 doses, while 44 (13.9%) had received one dose. There was a statistical significant relationship among marital status (p = 0.01), clinical level (p = 0.02) and hepatitis B vaccine uptake. Conclusion: The hepatitis B vaccination rate among medical students at the University of Port Harcourt Teaching Hospital is low. National and institutional legislation for adult vaccination against Hepatitis B should be promulgated for those at higher risk.
文摘Background: The evaluation of the uterus and its tubes cannot be overemphasized in the management of infertile women. Transvaginal saline sonohysterosalpingography (SHG) is another novel method with certain advantages for uterine and tubal assessment in women. Objective: To determine the accuracy of saline SHG findings by comparing it with conventional Hysterosalpingography (HSG) findings in infertile women. Result: The concordance between saline sonohysterosalpingography and hysterosalpingography for the diagnosis of submucous fibroids, uterine adhesions and tubal patency in this study was over 94%. The saline SHG had sensitivity and specificity of 93.8% and 94.1% respectively for diagnosis of uterine fibroids (submucous) and a sensitivity and specificity of 62.5% and 98.9% in the diagnosis of intrauterine adhesions. It also had a sensitivity and specificity of 98.9% and 78.6% respectively in the detection of patent fallopian tubes. Conclusion: The ability of saline SHG to diagnose uterine pathology and tubal patency was comparable to that of conventional HSG. Saline SHG has the potential to replace HSG as the first-line test for the evaluation of uterine or tubal disease in infertile women.
文摘Objective:To elucidate the awareness and approach to pre-operative human immunodeficiency virus(HIV) testing and emphasis on the attendant components of HIV testing.Methods: The study was conducted at the theatres of the University of Port Harcourt Teaching Hospital among 123 nursing,anaesthetic,and operating staff.A descriptive cross sectional design was adopted with stratified sampling.The study instrument was a structured,self administered pro forma.Results:All respondents were all aware of HIV infection and all had transmission through infected blood and tissues(100.0%).88.6%had infection through needle stick injuries, 62.6%through vertical transmission,and 98.4%through blood transfusion.Sixty three percent of respondents correctly knew what preoperative testing was,while 58.5%were aware of the preoperative testing policy of the hospital.All respondents favoured the policy of preoperative testing.Attitudinal values to seropositive patients were not very different as 72.4%of respondents claimed they treated every patient as high risk,and all respondents used personal protective equipment.Conclusions:Routine HIV testing now represents a conventional means providing patients with knowledge of their HIV status.Such testing should be accompanied by informed consent,counselling,confidentiality,protection,and access to treatment.
文摘Objective:To explore the prevalence,pathogenicity,and antibiotic susceptibility patterns of urinary tract infections at the University of Port Harcourt Teaching Hospital.Methods:Samples from 400 patients with a presumptive diagnosis of urinary tract infection including 250 non pregnant females and 150 males were used for this study.They were distributed into two groups: children aged 2 to 17(Croup A) and adults aged 18 to 75(Croup B).The standard wire loop and agar diffusion technique were employed for culture and susceptibility testing,respectively.Data obtained were analysed using SPSS,version 14.Results:30.0%of Group A and 41.0%of Group B had significant bacteriuria with 66.7%and 79.3%as females,respectively.The commonest isolates cultured were Escherichia coli(32.8%),Staphylococcus aureus(17.2%),and Klebsiella spp.(16.4%).About 76.6%of isolates were sensitive to the fluorinated quinolones,31.2%to the aminoglycosides,and 22.7%to the urinary antiseptic,nitrofurantoin.The isolates were nonsensitive to tetracycline(93.8%),cotrimoxazole(92.2%),and nalidixic acid(86.7%).Most isolates showed non-uniform sensitivity patterns to the cephaloporins(cefuroxime and ceftazidime). Pseudomonas spp.isolates were generally resistant to the fluorinated quinolones.Conclusion: Though the fluorinated quinolones are still largely effective for empirical therapy in urinary tract infections,the importance of prior sensitivity testing in checking the emergence of bacterial antibiotic resistance can not be overemphasized.
文摘Background: Despite the fact that Tuberculosis (TB) is preventable, treatable and curable, it has remained a significant cause of childhood morbidity and mortality. Identifying patterns of TB and its treatment outcome which is the aim of this study is relevant for TB control programmes. Methodology: This was a retrospective cross-sectional study carried out over a three-month period from April-June 2019 at the directly observed treatment Short course (DOTS) clinic of the University of Port Harcourt Teaching Hospital (UPTH), Nigeria. Relevant information on all children 0 - 18 years with tuberculosis over a four-year period from January 2015 to December 2018 was retrieved and analysed. Information retrieved included the age, sex, HIV status, method of diagnosis of tuberculosis, type of Tuberculosis and the treatment outcome of the patients. Results: There were 202 childhood (0 - 18 years) cases seen over the study period. Out of these, 109 (53.96%) were males and 93 (46.04%) females. Majority of them (40.59%) were 1 - 4 years of age. There were 194 (96.04%) new cases, 6 (2.9%) transfer and 2 (0.99%) retreatment cases. One hundred and six (80.69%) had pulmonary TB, 23 (11.39%) TB adenitis, 10 (4.95%) had TB spine, 3 (1.49%) TB abdomen and 3 (1.49%) TB meningitis. TB/HIV co-infection rate was 48.45%. One hundred and eight completed treatment, 10 (4.95%) were cured, 22 (10.89%) died, 46 (22.77%) defaulted and 16 (7.92%) were transferred out. Successful treatment outcome rate was 58.41%. Conclusion: Pulmonary TB was the commonest type of TB found and treatment success rate was just above average.
文摘Background: Studies have suggested epidemiological transition in the mortality pattern in Nigeria from communicable to non-communicable diseases of which Diseases of the cardiovascular system (DCVS) is prime. DCVS is?thus a growing public health concern but its mortality profile is under-studied?in Port Harcourt. This study was therefore designed to review the mortality profile of DCVS in Port Harcourt. Methodology: A retrospective case controlled study of deaths ascribed to DCVS at the University of Port Harcourt Teaching Hospital (UPTH) between January 2012 and December 2017. The composite diseases were grouped using the ICD10 scheme and analyzed using SPSS version 23. Minitab version 16 was used for trend analysis. Results: Of the overall 1902 deaths recorded within the period, 566 (29.8%) were cardiovascular system related. Of these, 301 (53.3%) were males and 265 (46.7%) were females. The elderly of 50 - 99 years were most commonly affected (65.5% of the mortalities). Cerebrovascular accidents (CVA) accounted for 322 deaths (56.9%);various types of shock caused 116 deaths (20.5%) while?congestive cardiac failure (CCF) accounted for 114 deaths (20.1%). Pulmonary?embolism, myocardial infarction, carotid aneurysm, and hypertensive encephalopathy caused 1.8%, 0.4%, 0.2%, and 0.2% deaths respectively. Peak annual mortality of 143 (25.3%) was recorded in 2013. Although the trend of mortality was undulating, there was an overall increase in annual incidence over the years.?Conclusion: DCVS constitute the commonest systemic cause?of death in Port Harcourt. Governmental and donor agencies involved in public health policy planning and implementation should scale-up strategies for the prevention and control of DCVS in order to stem the rising tide of associated mortalities.
文摘Dermatophytoses are the most common dermatological conditions but they are however not life threatening or debilitating hence medical care is sought usually due to aesthetic reasons and chronicity of the lesions despite several self-medications. The purpose of this study was to determine the distribution pattern of dermatophytes isolated in the medical microbiology laboratory of University of Port Harcourt teaching hospital (UPTH). This is a 5-year desk review of the Dermatophytes isolated in the medical microbiology laboratory of UPTH. Relevant Patients’ data were retrieved and analyzed. A total of seventy (70) dermatophytes were isolated over the five-year period as follows: Trichophyton species accounted for 55 (79%), Epidermophyton species were 8 (11%) and Microsporum species 7 (10%). The peak age range of patients from which dermatophytes were isolated was 31 - 40 years with a male to female ratio of 1:1.7. The majority of patients being 49 (70%) were referred from the dermatology outpatient clinic (DOPC) and the most frequent clinical diagnosis was Tinea corporis. Trichophyton species were the commonest cause of dermatophytoses in adult patients in Port Harcourt where the most common clinical presentation was Tinea corporis.
文摘Background: HIV encephalopathy (HIVE) is associated with cognitive impairment in children with HIV infection, early diagnosis and initiation of HAART may reduce the morbidity associated with HIVE. Objective: To determine the prevalence of HIVE and associated comorbiditiesin children at the UPTH. Methodology: This was a retrospective study carried out from January to June 2017. The case notes of all HIV positive children presenting to the Paediatric Department of the University of Port Harcourt Teaching Hospital (UPTH) were studied. Children who met the diagnostic criteria for HIVE according to the Centre for Disease Control (CDC) definition were selected. The socio-demographic characteristics of the patients, mode of HIV transmission, CD4 count and associated comorbidities in these children were retrieved from the case notes. Obtained data was analyzed using Epi Info version 7.2. Comparisms of subgroups was carried out using the chi square test while statistical significance at 95% confidence interval was p value Results: A total of thirty five out of the 196 HIV positive children presenting to the hospital had HIV encephalopathy (HIVE) giving a prevalence rate of 17.9%. Of these 35 children, 18 were males and 17 females, giving a male to female ratio of 1:1. The mean age of the children was 5.7 ± 3.1 years. The mean age for the males was 6.4 ± 3.2 years and 5.0 ± 2.8 years for the females. There was no statistically significant difference observed between the sexes (t = 1.35, p = 0.187). Thirty (85.7%) of the patients with HIVE were on HAART at diagnosis. The mean age at diagnosis of HIV was 3.2 ± 3.1 years and the mean age at diagnosis of HIV encephalopathy was 3.4 ± 3.2 years. The documented route of transmission for all the subjects was mother-to-child-transmission (MTCT). Seventy five percent of the children were breastfed from birth and at 6 months all the mothers had discontinued breastfeeding. The mean CD4 count was 1053 ± 630 cells/ml. Tuberculosis was the most prevalent co-morbidity occurring among the patients. Conclusion: The prevalence of HIVE in children at the UPTH is high and Tuberculosis is the commonest comorbidity. Early infant diagnosis, use of modern diagnostic tool and early initiation of HAART are advocated to reduce its associated morbidity.
文摘Background: Cerebrospinal fluid analysis is a very important tool in the diagnosis of bacterial meningitis in the new born. Bacterial meningitis is a potent cause of morbidity and mortality in the neonatal age group, with a very high incidence of neurological complications. Aim: To identify the bacterial pathogens isolated from the cerebrospinal fluids of neonates at the University of Port Harcourt Teaching Hospital (UPTH) and their sensitivity patterns. This will assist the neonatologist in the choice of empirical antibiotic treatment. Study Design: Retrospective, descriptive, cross sectional study. Place and duration of study: University of Port Harcourt Teaching Hospital, from 1 January 2009 to 31 December 2014. Methods: Records of bacterial analysis of cerebrospinal fluid from neonates seen at the special care baby unit of the University of Port Harcourt Teaching Hospital with clinical suspicion of meningitis between 1 January 2009 and 31 December 2014 were retrieved from the microbiology record book. Data on patients age, sex, appearance of Cerebrospinal fluid, cell count, microscopy/gram stain, culture and antibiotic sensitivity were retrieved from laboratory record books and entered into a Microsoft? excel spread sheet and analysed using SPSS version 20.0. Results: One hundred and thirteen neonates: 70 (61.95%) of these patients were male while 43 (38.05%) were females. Only 1 (0.89%) was positive for culture yielding a growth of Escherichia coli which was sensitive to Imipenem, moderately sensitive to Ampicillin, Gentamicin, ceftazidime, cefuroxime, ciprofloxacin and Amoxicillinclavulanic acid. It was resistant to cefotaxime. 112 (99.11%) of the neonates had presumed neonatal meningitis while only 1 (0.89%) had proven neonatal meningitis. Conclusions: There is a low yield of organisms in cerebrospinal fluid of neonates at the University of Port Harcourt Teaching Hospital.
文摘Multi-drug resistance (MDR) in Enterobacteriaceae poses critical public health threat in Nigeria and the global world. This resistant mechanism might be plasmid mediated or chromosomal. Escherichia coli are Gram negative pathogen with a global distribution rate. The study was carried out to determine MDR and plasmid profiling of E. coli isolates from urine, feaces and poultry litter. The samples were cultured on eosine methylene blue agar and incubated for 24 hours at 37°C. Results obtained showed a percentage prevalence of 30% for the urine samples which were the most prevalent, while the prevalence of E. coli from the feacal and poultry litter was 8% and 28% respectively. Identified E. coli were screened for antibiotic susceptibility by Kirby Bauer diffusion method. The results on susceptibility of E. coli to tested antibiotics before plasmid curing showed 100% resistance to cefuroxime and augumentin, while 75% resistance was observed in gentamicine, ciprofloxacin and ofloxacine. Cefixime and cefdazidime resistance were 62.5% on E. coli and the least resistance was observed in nitrofurantion (25%). The poultry litter and urine isolates recorded lower resistance level to antibiotics, compared to the feacal isolates. After plasmid curing the percentage of resistance reduced. The only antibiotics that responded positively was nitrofurantion, with high sensitivity of 87% for feacal isolate, 100% for urine isolates, and 78% for poultry litter isolates after plasmid curing. Twenty (20) of the thirty seven (37) isolates were still resistant to more than two antibiotics after the plasmid curing. Of the twenty isolates, 18 (90%) were found to harbor single plasmid, while 2 (10%) did not possess plasmid. This study concludes that nitrofurantion was the most effective antibiotics on Escherichia coli and plasmids were responsible partly for resistance.
文摘Background: Certain ovarian cancers that were previously common in postmenopausal women are now increasingly observed in women of reproductive age. The research on using β-HCG as a diagnostic biomarker for ovarian cancer in women of reproductive age is ongoing. Aim: This study assessed the level of serum β-HCG in non-pregnant women of reproductive age and determined its potential association with suspicious ovarian ultrasonography results. Methods: The study was conducted in Port Harcourt, Nigeria. This study adopted a cross-sectional design on a quota sample of 224 case notes of women aged 18 - 40 years obtained from eight diagnostic centres. A data extraction form was used for data collection. Data analysis employed descriptive statistics, Chi-square, Fisher’s exact test, and Odds Ratio at 95% confidence and 5% significance levels. Results: About 5.8% of the participants exhibited detectable levels of serum β-HCG above 5 IU/L (World Health Organization reference) at a mean concentration of 5.87 (±1.75) IU/L. About 4.0% of the participants had suspicious ovarian lesions identified through ultrasonography. Participants with elevated serum β-HCG levels above the WHO reference were 59 times more likely to have suspicious ovarian lesions (Odds ratio: 59.4, 95%CI: 12.3 - 287.8, p β-HCG level and age (p = 0.041) as well as parity (p Conclusion: Serum β-HCG levels above the WHO reference in non-pregnant women were associated with suspicious ovarian lesions. More rigorous primary research, systematic reviews, and meta-analyses are needed to confirm the findings of this study.
文摘Background: Infectious diseases associated with Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV) continue to pose significant public health challenges that necessitate continuous surveillance and interventions. This study investigates the prevalence of HIV, HBV and HCV infections within the academic community of Rivers State University, Port Harcourt, Nigeria. Given the potential for transmission in university settings and the importance of early detection and intervention, this research explores the extent of these infections and evaluates the outcomes of a medical outreach program aimed at addressing them. Methodology: A cross-sectional study design was employed to recruit 513 participants using a convenience sampling approach between the 20<sup>th</sup> and 22<sup>nd</sup> of April 2022. Participants included students and staff members who voluntarily consented to the medical outreach and study. Serological assays were utilized to identify HIV, HBV and HCV infections. The medical outreach program’s design, implementation, and outcomes were evaluated, focusing on testing uptake, counselling utilization, and linkage to care. Statistical analysis employed GraphPad Prism version 9 software. Result: The study revealed low prevalence rates of HIV (0.6%), HBV (1.2%), and HCV (0.6%) infections within the university population. Age-based analysis indicated a slightly higher prevalence in the 15 - 24 age group. Gender-wise, HBV showed a marginal difference, with 1.3% among females and 0.9% among males. The medical outreach program achieved a testing uptake of 80.8%, with 75% utilizing counselling services, and 75% of those identified with infections successfully linked to care. Conclusion: This study provides valuable insights into the prevalence of infections and the effectiveness of a medical outreach program within a university community. While low prevalence rates are encouraging, the findings emphasize the continued importance of awareness and prevention efforts. The success of the outreach program in encouraging testing, providing counselling, and facilitating care linkage underscores its potential as a model for future interventions. Further research should delve into determinants of infection prevalence and barriers to care linkage for a more comprehensive understanding and improved intervention strategies.
文摘Background: The most common surgical treatment for symptomatic uterine fibroids, particularly in women with fertility concerns, is open myomectomy. Given the high vascularity of the uterus, haemorrhage during the procedure is a serious risk that is often mitigated with a uterine tourniquet. Aim and Objectives: To evaluate the effect of uterine artery occlusion with a tourniquet during open myomectomy on ovarian reserve using serial anti-Mullerian hormone (AMH) measurements. Materials and Methods: This was a prospective longitudinal study with a quasi-experimental design and a convenient sampling technique. The study enrolled 47 women who had abdominal myomectomy between September 1, 2021, and March 31, 2022, at the University of Port Harcourt Teaching Hospital. Blood samples were collected before anaesthesia was administered in theatre, on day two, and three months after open abdominal myomectomy for anti-Mullerian hormone assay. The data was collected using a semi-structured proforma, entered into an Excel spreadsheet, and analyzed using SPSS version 25.0 with a 95% confidence interval. Statistical significance level was set at 0.05. Results: The pre-surgery AMH mean value was 1.67 ± 1.44 ng/ml, while the values after using a uterine tourniquet at myomectomy on the second day and three months later were 1.22 ± 1.24 ng/ml and 1.59 ± 1.43 ng/ml, respectively. There was no statistically significant change in AMH levels, and there was no statistically significant relationship between blood loss and tourniquet time and AMH after open abdominal myomectomy. Conclusion: The use of a uterine tourniquet and blood loss during open myomectomy has no effect on ovarian reserve.
文摘Background: Low contraceptive use among all other factors have been implicated in rapid population growth seen in low and lower middle-income countries (LLMICs). This can be attributed to poor knowledge and attitude of the populace towards use of modern contraceptives. Aim: To determine the knowledge, attitude and practice of contraception among pregnant women attending ANC at the University of Port Harcourt Teaching Hospital (UPTH) in Port Harcourt, Rivers State, Nigeria from July 1 to August 31, 2021. Methods: This quantitative study was designed as a descriptive cross-sectional study that recruited 529 women. They were administered with a semi-structured questionnaire which was used to collect their data and responses. The data was analysed using Statistical Product and Service Solutions (SPSS) version 25. Results: According to the findings, 57.3% and 47.1% of the women had poor knowledge and negative attitude towards contraception respectively. About a tenth of the women (9.8%) utilised contraceptives of which 44.2% and 42.3% used the natural method and male condoms respectively. The study also revealed the major reason behind the low use as desire for more children (36.3%). Conclusion: The study showed that the women had poor knowledge and negative attitude towards contraceptives and this translated to poor contraceptive use. Hence, awareness campaigns should be intensified by health workers towards enlightening the populace on the different types, uses and benefits of modern contraceptives.
文摘Eclampsia is a common complication of hypertensive disorders of pregnancy and in the puerperium with the attendant risk to both the mother and baby. Although it is a multi-systemic disorder, its manifestation that affects the brain and resulting in altered sensorium demands brain imaging to define the possible brain lesions and the implications for critical care management and outcome. We evaluated the CT brain lesions in the patients with eclampsia who were admitted in the intensive care unit, University of Port Harcourt, Port Harcourt Nigeria. Objective: To analyse the CT brain images of eclamptic parturients and the outcome following their admission in the intensive care unit. Methods: We undertook this observational study after obtaining ethical exemption from the University of Portharcourt Teaching Hospital ethical review board, and commenced the review between March 2021 to February 2023. We included all parturients that were admitted into the intensive care unit of the University of Portharcourt Teaching Hospital, a nine-bedded open intensive care unit with the clinical diagnosis of eclampsia. Every admitted parturient was required to obtain a brain computed tomography (CT) by local protocol. The brain CT images were retrieved for review from the parturients’ relatives, radiology department and the ICU. Parturients included were aged ≥ 18 years. The radiological reports of these brain images which were also reviewed by a neurosurgeon in case of any need for secondary opinion were subjected to statistical analysis. Result: Thirty-one parturients were admitted with eclampsia with a mean age of 30 years ± 5.29. Sixteen (16) parturients died representing 52%. Only twenty-four (24) CT brain images were retrieved for review (77%). The following brain lesions were identified from the brain CT and they comprised the following: intracerebral haemorrhage, including extensions into the ventricles 7 (29.17%), cerebral oedema 12 (50%), subdural hematoma 1 (4.17%) and normal imaging 4 (16.66%). The subdural haematoma was promptly evacuated with a good outcome. Conclusion: Neuro imaging comprising computed tomography and magnetic resonance imaging of the brain are basic ancillary investigations for patients with eclampsia presenting with neurologic deficits and low GCS. Early presentation and access to brain CT could influence outcome as it was demonstrated in the prompt intervention in the patient with subdural haematoma which was evacuated with a satisfactory outcome.
文摘Hepatitis B (HBV) and Hepatitis C (HCV) are significant global public health burdens associated with liver cirrhosis, liver cancer and are responsible for over a million deaths yearly. Prisons and other confined facilities offer opportunities for the acquisition and transmission of infectious diseases such as hepatitis B and C during and after imprisonment. This study aimed to investigate the seroprevalence of Hepatitis B and Hepatitis C as well as their associated risk factors among inmates in the Port Harcourt Maximum Security Custodial Centre. A cross-sectional study was conducted among inmates incarcerated in the Port Harcourt Maximum Security Custodial Centre from July to December 2022, and 200 consenting subjects completed a structured questionnaire in addition to screening for the presence of HBsAg and anti-HCV antibodies. Data generated from this study was represented as frequency and percentages, and inferential statistics were carried out using chi-square with the aid of GraphPad Prism Software Version 9. Statistical significance was defined as a p-value of less than 0.05 at a 95% confidence interval. The seroprevalence of HBV was 4% while 3.5% was recorded for HCV with no cases of co-infections reported. HBV seroprevalence was significantly associated with blood oath and a history of surgery (p p < 0.05). The findings from the current study highlight a relatively lower prevalence of HBV and HCV amongst inmates in Port Harcourt in comparison to studies in Nigeria. These infections can be further controlled by multifaceted approaches by the prison personnel, administration, and Government by employing combative measures such as regular screening, easy access to therapy, awareness, and vaccination programs for HBV are crucial to prevent the transmission of these diseases.
