Effects of a mHealth voice messaging intervention on antenatal care utilisation at primary care level in Lagos, Nigeria: a cluster randomised trial

Background

Nigeria has one of the lowest antenatal care (ANC) utilization rates compared to other low- and middle-income nations. In order to ensure a positive pregnant experience, the World Health Organization recommends at least eight ANC visits during pregnancy. This study intends to examine the impact of a mobile phone-based voice message intervention on ANC use in Lagos, Nigeria.

Methods

In this cluster-randomized experiment, primary healthcare centres were divided into five intervention and five control groups using multistage simple random sampling. The intervention consisted of a weekly voice message transmitted through mobile phone from the time of recruitment in the first trimester until two weeks postpartum. Attending at least eight ANC visits before birth was the primary outcome. STATA v17.0 was used to conduct descriptive and bivariate analyses as well as multivariate linear models to calculate crude risk ratios.

Results

458 women participated. All intervention group women (269 women, or 58.7% of the sample) received the text message. These ladies were mostly married, Christian, had several children, and had completed high school. Women who received the intervention were more likely to attend eight ANC visits.

Conclusion

A voice message-based intervention can boost ANC utilization, according to the conclusion. This contributes to the existing body of information about the influence of mHealth treatments on maternal health outcomes and serves as a useful tool for ensuring that no woman is left behind.

Feasibility and acceptability of early infant screening for sickle cell disease in Lagos, Nigeria-A pilot study

In Nigeria, about 150000 babies are born annually with sickle cell disease (SCD), and this figure has been estimated to increase by 100% by the year 2050 without effective and sustainable control strategies. Despite the high prevalence, newborn screening for SCD which allows for early prophylactic treatment, education of parents/guardians and comprehensive management is not yet available. This study explored a strategy for screening in early infancy during the first and second immunization visits, determined the prevalence, feasibility and acceptability of early infant screening for SCD and the evaluation of the HemoTypeSC diagnostic test as compared to the high-performance liquid chromatography (HPLC) gold standard. A cross-sectional study was conducted in two selected primary health care centres in Somolu local government area (LGA) in Lagos, Nigeria. Two hundred and ninety-one mother-infant pairs who presented for the first or second immunization visit were consecutively enrolled in the study following written informed consent. The haemoglobin genotype of mother-infant pairs was determined using the HemoTypeSC rapid test kit. Confirmation of the infants’ Hb genotype was done with HPLC. Data were analysed with SPSS version 22. Validity and Predictive value of HemotypeSC rapid screening test were also calculated. Infant screening for SCD was acceptable to 86% of mothers presenting to the immunization clinics. The prevalence of SCD among the infant cohort was 0.8%. The infants diagnosed with SCD were immediately enrolled in the paediatric SCD clinic for disease-specific care. The HemoTypeSC test had 100% sensitivity and specificity for sickle cell disease in early infancy compared to HPLC. This study affirms that it is feasible and acceptable for mothers to implement a SCD screening intervention program in early infancy in Lagos State. The study also demonstrates the utility of the HemotypeSC rapid testing for ease and reduced cost of screening infants for SCD.

Knowledge, attitude and preventive practices of sexually transmitted infections among unmarried youths in an urban community in Lagos State, Nigeria

BACKGROUND

Sexually transmitted infections (STIs) are of public health importance as over 1 million STIs are acquired daily worldwide. One-third of the new cases of curable STIs affect younger persons aged less than 25 years. Sexually transmitted infections can lead to severe complications beyond the immediate impact of infections as such.

AIM

This study assessed knowledge of, attitude towards and preventive practices of STI among young unmarried persons in Surulere local government area (LGA) of Lagos State, Nigeria.

SETTING

The study was conducted among young unmarried persons in Surulere LGA, Lagos State, Nigeria, between June and November 2018.

METHODS

A descriptive cross-sectional study was conducted among 450 young unmarried persons selected using a multistage sampling technique. An interviewer-administered questionnaire was used to obtain data. Analysis was carried out with Epi-Info 7.2.2.2 software. Chi-square was used to test for associations. Level of significance was at p ≤ 0.05.

RESULTS

The mean age was 19.9 + 2.5 years. Majority of the respondents (84.7%) had heard of STIs. About two-third (65.6%) had good knowledge, while majority (98.6%) had good attitude towards the prevention of STIs, but less than half (34.0%) had good preventive practices. Knowledge of STI was statistically significantly associated with age, level of education, attitude and preventive practices of the respondents.

CONCLUSION

Most of the respondents were aware and had good attitude towards prevention of STI, but gaps exist in knowledge and preventive practices. Hence, targeted education to improve the knowledge and preventive practices against STI among young unmarried persons is recommended.

Knowledge, attitude and uptake of human papillomavirus vaccination among female undergraduates in Lagos State, Nigeria

Background and Aims

Human papillomavirus (HPV) is a known cause of cervical cancer which is the second-most common cancer among women worldwide. HPV vaccination is a primary prevention to reduce the occurrence of cervical cancer. This study assessed knowledge, attitude and uptake of HPV vaccine among female undergraduates in Lagos State Polytechnic (LASPOTECH).

Methods

A descriptive cross-sectional survey was conducted among 400 female undergraduates of LASPOTECH in August 2018. Participants were selected using a multi-stage sampling technique and data was collected with a pretested, self-administered, semi-structured questionnaire. Univariate and bivariate analyses were conducted using IBM SPSS version 20. Statistically significant level was set at P ≤ 0.05.

Results

Mean age of respondents was 21.3 ± 2 years. Only 11 (3%) of the respondents had good knowledge of HPV and the vaccine. However, majority of the respondents 356 (92.7%) had positive attitude towards uptake of HPV vaccine. Only 10 (2.6%) of the respondents had received a single dose of HPV vaccine. Age, level of study and number of sexual partners of the respondents were statistically significantly associated with knowledge and attitude towards the HPV vaccine (P ≤ 0.05). The most common reason stated by the respondents for none uptake of HPV vaccine was lack of information.

Conclusion

Knowledge and uptake of HPV vaccination among the respondents were poor. However, majority had positive attitude towards uptake of the vaccine. It is recommended that information on HPV and the vaccine should be made available to increase the knowledge and the uptake among female undergraduates in Lagos State.

Fetal Congenital Anomaly in Tertiary Hospital in Lagos, South-West Nigeria: A Review of Presentation and its Outcome

BACKGROUND

Congenital Anomalies are a major contributor to perinatal deaths worldwide. The World Health Organization (WHO) estimates that 303,000 newborns die within the first 4 weeks of life worldwide as a result of it. The exact cause is often difficult to determine and as such efforts are geared towards prevention AIM AND OBJECTIVE: This study was done to determine the common presentations as well as epidemiological features of pregnant women with anomalous fetus and at the Lagos University Teaching Hospital. This may help to develop strategies for patient counseling and management.

METHOD

This study is a retrospective, cross sectional hospital based study conducted at the department of Obstetrics and Gyneacology of the Lagos University Teaching Hospita,l Idi-Araba during the period Jan 2012-Dec 2016. Relevant information regarding maternal age, parity, gestational age and pregnancy outcomes was documented from the delivery records of the mothers.

RESULTS

One hundred (100) babies out of the total of 5,747 babies within the period under study were born with congenital anomalies giving a prevalence rate of 1.7% at the Lagos University Teaching Hospital. The commonest congenital anomaly seen was hydrocephalus, others were omphalocele, anorectal anomalies and multiple congenital anomalies (in particular neural tube defects coexisting with various forms of limb defects).

CONCLUSIONS

Public awareness of the importance of preconceptional care, elimination of environmental risk factors as well as provision of prenatal diagnostic facilities and improvement of antenatal care are of great benefit in early detection and management of congenital anomalies.

Association between serum CA125 levels in preeclampsia and its severity among women in Lagos, South-West Nigeria

BACKGROUND

Preeclampsia is a syndrome of unknown etiology characterized by hypertension, proteinuria, and/or organ dysfunction. CA125 is an antigenic determinant recognized by the murine monoclonal antibody OC125 quantified by radioimmunoassay. Its role in obstetrics is yet to be fully understood as most clinical trials advocating its uses are widely experimental in nature and unacknowledged.

AIM

This study was done to assess the relationship between serum concentration of CA125 in normal pregnancies and those complicated with preeclampsia.

METHODS

A case-control study involving 70 women diagnosed with preeclampsia and 70 healthy controls matched for age, parity, and gestational age at enrollment. Venous samples were collected from each participant after informed consent was obtained. The preeclampsia group was further subdivided into mild and severe preeclampsia and all participants were followed up till delivery with records of delivery, maternal, and neonatal outcomes obtained thereafter. Serum CA125 levels were determined by standard enzyme-linked immunosorbent assay (ELISA) method. Hypothesis testing was done using chi-square test for categorical variables, and the independent-samples t-test and ANOVA for numerical variables. All significances were reported at P < 0.05.

RESULTS

The mean serum level of CA125 in women with preeclampsia was significantly greater than those with normal pregnancy (54.17 IU/mL vs. 12.49 IU/mL, P < 0.05). CA125 level also correlated positively with systolic blood pressure (r = 0.406, P < 0.05), diastolic blood pressure (r = 0.433, P < 0.05), serum uric acid levels (r = 0.407, P = 0.001), platelet levels (r = 0.341, P = 0.001), and urinary protein levels (r = 0.325, P = 0.002). The CA125 levels between the three categories of participants in the study were: normotensive control (12.49 ± 6.62 mIU/L), mild preeclampsia (29.43 ± 3.7 mIU/L), and severe preeclampsia (64.25 ± 9.21 mIU/L), respectively (P = 0.023).

CONCLUSION

We can infer from this study that increased maternal serum CA 125 levels are associated with the preeclampsia and its severity. However, further validation of these findings with more robust multicenter prospective and longitudinal characterization of maternal serum CA125 profiles in pregnancy should be carried out in subsequent investigations to determine its suitability as a predictive biomarker for preeclampsia in women of African descent.

Selenium deficiency and pregnancy outcome in pregnant women with HIV in Lagos, Nigeria

OBJECTIVE

To investigate the prevalence of maternal selenium deficiency and its effects on pregnancy outcomes in pregnant women with HIV in Lagos, Nigeria.

METHODS

The present descriptive cross-sectional study enrolled women aged 15-49 years with HIV who were at 14-26 weeks of a singleton pregnancy and were attending Lagos University Teaching Hospital, Lagos, Nigeria, between August 1, 2016, and April 30, 2017. Participants were selected by consecutive sampling and baseline data were collected through interviews. Venous blood samples were obtained to measure selenium concentrations, and associations between low maternal selenium concentrations (defined as <0.89 μmol/L) and pregnancy outcomes were examined using bivariate and multivariate analysis.

RESULTS

The final analysis included 113 patients; selenium deficiency was recorded in 23 (20.4%) patients. Women with selenium deficiency had an approximately eight-fold higher risk of preterm delivery (adjusted odds ratio 7.61, 95% confidence interval 4.37-18.89; P=0.031) and of delivering a term neonate with a low delivery weight (adjusted odds ratio 8.11, 95% confidence interval 3.27-17.22; P=0.012), compared with women with a normal selenium concentration.

CONCLUSION

The prevalence of selenium deficiency among pregnant women with HIV in Lagos was relatively high. The significant associations observed between maternal selenium deficiency and adverse pregnancy outcomes could have implications for the future management of HIV in pregnancy.