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Prevalence and predictors of postpartum depression among postnatal women in Lagos, Nigeria
Get PDFBackground: Globally, postpartum depression is one of the most common
but often unrecognized complications of childbirth, yearly affecting
about 10\u201315% of postnatal women. This study aimed to determine
the prevalence of postpartum depression and its predictors among
postnatal women in Lagos. Methods: A descriptive cross-sectional study
was conducted among 250 mothers in Eti-Osa Local Government Area of
Lagos State, Nigeria, attending six Primary Health Care centers for
infant immunization at six weeks post-delivery. Data was collected
using a pretested semi-structured interviewer administered
questionnaire which included the Edinburgh Postnatal Depression Scale.
Analysis was carried out using SPSS version 23TM. Chi-square and
logistic regression analyses were used to determine associations and
predictive relationships between various factors and the presence of
postpartum depression. The level of significance was set at <0.05.
Results: The prevalence of postpartum depression was 35.6%.
Multiparity, delivery by cesarean section, mother being unwell after
delivery, and not exclusively breastfeeding the baby were the factors
linked with postpartum depression. Following multiple logistic
regression, having postpartum blues (p=0.000; OR=32.77;
95%CI=7.23-148.58)., not getting help with caring for the baby
(p=0.008; OR=2.64; 95%CI=1.29-5.42), experiencing intimate partner
violence (p=0.000; OR=5.2; 95%CI=2.23-11.91) and having an unsupportive
partner (p=0.018; OR=2.6; 95%CI=1.17-5.78) were identified as
predictors of postpartum depression. Conclusion: This study revealed a
high prevalence of postpartum depression, identifying both the
obstetric and psychosocial predictors. Social support for women both in
the pre- and postnatal periods and routine screening of women for
postpartum depression should be encouraged for early detection and
immediate intervention
Health care workers experiences in emergency obstetric care following implementation of an in-service training program: case of 2 Referral Hospitals in Botswana
Get PDFBackground: Maternal mortality rate remains a challenge in many
developing countries. Objectives: This study explored experiences of
Health Care Workers on Emergency Obstetrics Care (EMOC) in-service
training and its effect on maternal mortality. Methods: Descriptive
qualitative study design was conducted using in-depth interviews and
focus group discussions. Participants were EMOC trained midwives and
doctors purposively selected from the 2 referral hospitals in the
country. Data were transcribed verbatim, coded, and analysed using
Grounded Theory approach. Results: Four themes emerged including
training, EMOC implementation, maternal death factors and EMOC
prioritisation. The duration of training was viewed inadequate but
responsiveness to and confidence in managing obstetric emergencies
improved post EMOC training. Staff shortage, HCWs non-adherence and
negative attitude to EMOC guidelines; delays in instituting
interventions, inadequate community involvement, minimal or no health
talk to women and their partners and communities on sexual reproductive
matters and non-prioritisation of EMOC by authorities were concerns
raised. Conclusion: Strengthening health education at health facility
levels, stakeholders\u2019 involvement; and prioritising EMOC
in-service training are necessary in reducing the national maternal
mortality
Prevalence and factors associated with hypertension among rural community dwellers in a local government area, South West Nigeria
Get PDFBackground: Many African countries including Nigeria are said to be at
various stages of an epidemiological transition from communicable to
non-communicable diseases (NCD). Objective: This study determined the
current pattern and correlates of hypertension among adults in some
rural communities in South West Nigeria. Methods: It was a descriptive
cross-sectional study of 1012 individuals across 16 rural communities.
The respondents\u2019 blood pressure, weight, height and waist
circumference were measured. Bivariate and multivariate analyses were
done. Results: Among the participants, 461 (45.6%) had hypertension out
of whom 217 (47.1%) and 244 (52.9%) had stage 1 and stage 2
hypertension respectively. The systolic, diastolic and mean arterial
blood pressures increased with age. The significant predictors of
hypertension were; increasing age (p<0.001), higher waist
circumference (p = 0.01) and overweight / obesity (p = 0.03). While
systolic blood pressure (SBP) had the strongest correlation with age,
waist circumference (WC) was the strongest correlate of diastolic blood
pressure (DBP). Conclusion: Despite being a rural population, there was
a high prevalence of hypertension in the study area
Medical mortality in an emergency department in Nigeria: the transition is obvious!
Get PDFIntroduction: The emergency department (ED), a major entry point into
the hospital, provides an insight to the type of cases seen, the
quality of care and mortality spectrum in a health institution. We aim
to identify the spectrum of medical causes of mortality in our ED, the
demographic pattern and duration of stay before death. Method: This is
a retrospective study that looked at medical mortality in the ED from
January 2004 to December 2009. We obtained data on the demographics and
causes of death from the medical records and case notes of the
deceased. Results: A total of 16587 patients were admitted during the
period under review, of these 1262 (7.61%) died in the ED. The male to
female ratio was 1.58:1.0 [772 males (61.2%), and 489 females (38.8%)].
Mortality was highest among the 20-45years age range, followed by 46-65
years, >65years and < 20 years in decreasing frequency
[589(46.7%), 421(33.4%), 186 (14.8%) and 66(5.2%) respectively]. The
three most common causes of death were stroke 315(25%), HIV related
illnesses 126(10.0%), and heart failure 123(9.7%). Most deaths occurred
less than 24hours of admission, 550(43.6%), followed by one day (36.0%)
and two days (10.8%) post admissions respectively. Conclusion: The
commonest cause of death in the ED was stroke. The burden of death was
highest in the younger age group, with most occurring less than 24
hours of admission
Bacterial profile and their antimicrobial susceptibility patterns in patients admitted at MaddaWalabu University Goba Referral Hospital, Ethiopia: a cross sectional study
Get PDFBackground: Hospital acquired infections (HAIs) are one of the global
concerns in resource limited settings. The aim of the study was to
determine bacteria profile and their antimicrobial susceptibility
patterns among patients admitted at surgical and medical wards.
Methods: A hospital based cross-sectional study was conducted from
November 2016 to July 2017 in MaddaWalabu University Goba Referral
Hospital. Urine and wound swabs were processed and standard disk
diffusion test was done to assess susceptibility pattern. Association
among variables was determined by Chi-square test. Results: Among 207
patients enrolled, 24.6% developed HAI, of which, 62.7% and 37.3% were
from surgical and medical wards, respectively. The male to female ratio
was 1.5:1. The age ranged from 19 to 74 years with a mean of
41.65(\ub116.48) years. A total 62 bacteria were isolated in which
majority of the isolates were gram negative bacteria. Most isolates
were resistance to most of the antibiotics tested but sensitive to
Ceftriaxone, Norfloxacin and Ciprofloxacin. Conclusion: Due to the
presence of high level drug resistant bacteria, empirical treatment to
HAI may not be effective. Therefore, treatment should be based on the
result of culture and sensitivity
Evaluation of PCR pncA-restriction fragment length polymorphism and PCR amplification of genomic regions of difference for the identification of M. bovis strains in lymph nodes cultures
Get PDFBackground: A rapid accurate identification of Mycobacterium bovis is
essential for surveillance purposes. Objectives: A PCR pncA-Restriction
Fragment Length Polymorphism (RFLP) and a multiplex PCR based on the
detection of 3 regions of difference (RD-PCR): RD9, RD4 and RD1 were
evaluated for the identification of M. bovis in lymph nodes cultures,
in Tunisia, during 2013-2015. Methods: Eighty-two M. tuberculosis
complex strains were identified using the biochemical tests, GenoType
MTBC assay, PCR pncA-RFLP and RD-PCR. Results: The PCR pncA-RFLP showed
that 54 M. bovis strains, identified by GenoType MTBC, had a mutation
at position 169 of pncAi> gene. Twenty-eight strains did not show
any mutation at this position 27 M. tuberculosis isolates and one M.
caprae . The PCR pncA-RFLP had a sensitivity of 100.0% (95%CI: 93.3
-100.0) and a specificity of 100.0% (95%CI: 87.9-100.0) for identifying
M. bovis. The RD-PCR showed that all M. bovis strains had the RD9 and
RD4 deleted but presented RD1. RD-PCR also presented high sensitivity
and specificity in detecting M. bovis strains (100.0%). Conclusions:
PCR pncA-RFLP and RD-PCR represent very accurate and rapid tools to
identify M. bovis. They can be easily implemented in each laboratory
due to their low cost and easy use
Interface between biomedical and traditional systems of treatment and care among HIV positive fisher folk in two fishing communities on Lake Victoria, Uganda
Get PDFBackground: Fisherfolk have been identified as a key population in the
HIV response in Uganda due to high HIV prevalence and low engagement in
HIV services. While studies have examined lifestyles and risk, much
remains to be understood about help and health seeking experiences,
including the combined use of biomedical and traditional health care.
Objective: To examine the use of biomedical and traditional health care
in two fishing communities around Lake Victoria in Uganda. Methods:
Exploratory, in-depth qualitative study involving semi-structured
interviews with 42 HIV positive fisherfolk. Results: Prior to HIV
diagnosis, participants who described becoming ill sought different
forms of help including biomedical treatment prescribed by health
workers or self-prescribed; biomedical and herbal medicines together;
herbal medicines only; or no form of treatment. Following HIV
diagnosis, the majority of participants used ART exclusively, while a
smaller number used both ART and traditional care strategies, or
reported times when they used alternative therapies instead of ART.
Prior to HIV diagnosis, fisherfolk\u2019s health care seeking
practices inhibited engagement with HIV testing and access to
biomedical HIV treatment and care. After HIV diagnosis, most resorted
only to using ART. Conclusion: Study findings provide insight into how
fisherfolk\u2019s use of biomedical and traditional care prior to
diagnosis influences subsequent engagement with HIV treatment. Efforts
are needed to reach fisherfolk through everyday health seeking networks
to ensure HIV is diagnosed and treated as early as possible
Knowledge, attitude, and preferred strategies towards HIV/AIDS prevention among adolescents attending secondary schools in South Western Uganda
Get PDFBackground: Globally, HIV/AIDS continues to rise among adolescents.
Ugandan studies have examined knowledge and attitudes regarding
HIV/AIDS among adult populations. This study specifically paid
attention to this particular age group of adolescents 12-19 years. Aim:
To explore HIV knowledge and attitudes among adolescents attending
secondary schools Mbarara Uganda. Methods: A qualitative descriptive
study was conducted in three secondary schools in South Western Uganda.
Forty eight (48) adolescents with age range between 12-19 years were
purposively recruited in the study. Data were collected from six focus
groups and analyzed thematically. Ethical approval received from MUST
(#05/10-17) and UNSCT (#SS4535) review committees. Results: Four themes
emerged: Knowledge about HIV, sources of information, attitudes towards
persons with HIV and prevention strategies. Most adolescents had the
basic knowledge of HIV from multiple sources like social media, health
workers, peers, and parents. Their attitudes toward individuals with
HIV included compassion, shock, and uneasiness. Participants suggested
prevention programs to be implemented in the schools emphasizing HIV
education, life skills, sex education and the formation of peer groups.
Conclusions: The findings showed that most participants had knowledge
about HIV and how it can be prevented however few had knowledge gap
thinking that HIV does not exist
Relationships of depression and anxiety to readmission rates among patients with diabetes from Harare and Parirenyatwa referral hospitals in Zimbabwe
No full textBackground: The knowledge of determinants of readmission among
individuals with diabetes minimises relapse and decreases diabetes
associated morbidity and mortality. Objectives: To explore the
prevalence of depression and anxiety as well as determinants of
readmission in individuals with diabetes from Harare, Zimbabwe.
Methods: A cross sectional study was carried out at Parirenyatwa and
Harare group of hospitals. Participants were recruited through
purposive sampling and interviewed at the diabetic clinics. Depression
and anxiety were measured using the Hospital Anxiety and Depression
Scale. Binary logistic regression was used to determine predictors of
readmission. Results: In total 65 participants took part, 36.9% were
males. The mean age \ub1SD was 44.89\ub114.2 years. Anxiety
affected 40% and 20% were at risk of anxiety, while depression was
reported in 27.7% and 30.8% were at risk of depression. Depression
[OR=0.64, 95%CI: 0.42-0.97 (p=0.037)] and checking of blood glucose
[OR=0.06, 95%CI: 0.01-0.71 (p=0.025)] were significant negative
predictors of readmission among diabetic patients while anxiety was a
significant positive predictor OR=1.55, 95%CI: 1.09-2.21 (p=0.015).
Conclusions: Mental health conditions in people living with diabetes
are factors contributing to increased re admissions and are more
prevalent with aging. Psychotherapy and education interventions are
recommended for the elderly diabetic population