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REPRODUCTIVE AWARENESS BEHAVIOUR AND PROFILES OF ADOLESCENT POST ABORTION PATIENTS IN BLANTYRE, MALAWI
No full textABSTRACTBackground: Adolescent sexuality and its sequelae are now acknowledged as major publichealth, social and economic problems in Malawi, for which appropriate programmes andservices are being designed and implemented.Objectives: To identify the profiles of adolescent post abortion patients, their reproductiveand contraceptive knowledge and factors related to the index pregnancy.Setting: Queen Elizabeth Central Hospital, Blantyre, Malawi.Design: Cross-sectional, descriptive study.Methods: All adolescents treated for incomplete abortion, January to December 1997 wereeligible. Data was collected by means of interviewer-administered questionnaire, one foreach, during reproductive health education and/or post abortion contraceptive counsellingand service provision. This was subsequently analysed using EPI-INFO 6.0 data analysispackages.Results: Of the 465 adolescents treated during this period, 446 (95.9%) were enrolled in thestudy. Their mean age was 17.5 years (SD 1.3), that at menarche and sexual debut 14.3 years(SD 1.4) and 15.7 years (SD 1.75) respectively. The unmarried adolescents formed 43.9%,while students comprised 38.6% of the total. Their level and accuracy of knowledge onreproductive biology was poor. While their contraceptive knowledge was high, its use wasvery low, 70.9% vs 9.5% respectively. The number of sexual partners one had had rangedfrom 1 to 10 with a median of 1. The index pregnancy was reportedly unwanted by 45.1 %.The young (< 16 years), more educated, single and students were more likely to haveunwanted pregnancy.Conclusions: Sexual activity starts early in Malawi, with poor contraception, thus predisposingto unwanted pregnancy. Lack of appropriate reproductive awareness appears to be partlyresponsible for that. These need to be addressed through the national reproductive healthprogrammes and services
ADVANCE PROVISION OF ORAL CONTRACEPTIVES TO FAMILY PLANNING CLIENTS IN KENYA
No full textObjective: In sub-Saharan Africa, many family planning programmes do not encourageadvance provision of oral contraceptives to clients who must wait until menses to initiate pilluse. Since some resistance to advance provision of pills is due to provider fears that thepractice may be harmful, we conducted a study in Kenya in 1997 to compare pill-takingoutcomes between 20 “advance provision” clients and 280 “standard” clients.Design: Prospective observational study.Setting: Six family planning clinics in Central and Western Kenya.Subjects: Women presenting as new clients at MOH family planning clinics.Interventions: Researchers used prospective tracking to compare indicators of pill-takingsuccess between non-menstruating clients given pills to carry home for later use andmenstruating clients who began pill use immediately.Main outcome measures: Pill-taking outcomes such as side effects, compliance, knowledge,satisfaction, and a continuation proxy.Results: Among clients returning for re-supply, those receiving advance provision of pills didno worse than, and often had superior outcomes to, their counterparts who started takingpills immediately after the clinic visit.Conclusions: Advance provision of pills, already practiced worldwide, is safe and feasible.Explicit mention should be made of advance provision of pills in national family planningguidance documents and training curricula in Kenya and throughout sub-Saharan Africa
IMMUNOPHENOTYPING OF ACUTE LEUKAEMIAS BY FLOW CYTOMETRY: A REVIEW
No full textObjective: To provide an overview of the utility of flow cytometry for phenotyping ofacute leukaemias and selection of monoclonal antibodies.Data sources: The literature review was obtained through internet, journals andchapters in the relevant books.Data selection: Relevant articles and chapters on immunophenotyping of acuteleukaemias were selected from respected international journals and books in the fieldof haematology and were reviewed.Data extraction and synthesis: Complete articles relevant to the topic were selectedand reviewed and the necessary information extracted for this review.Conclusions: Flow cytometry has been used extensively in recent years to characterisehaemopoeitic malignancies and done routinely in the developed world. This techniquehas greatly improved the diagnosis and classification of haemopoeitic malignanciesand has been recommended by World Health Organisation classification (WHO) oftumours of haemopoeitic and lymphoid tissue. Application of flow cytometry for thediagnosis of leukaemias has been recently introduced in Kenya and is currently beingundertaken in research using limited but appropriate panels of monoclonal antibodies.It is hoped that findings of this research will inform the use of flow cytometry as anancillary diagnostic technique in our resource-constrained set up