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  Access statistics : Table of Contents
   2019| July-September  | Volume 9 | Issue 3  
    Online since January 5, 2022

 
 
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ORIGINAL ARTICLES
Prevalence of group B Streptococcus colonisation and antimicrobial susceptibility pattern among pregnant women attending a tertiary health facility in Ogun State, Southwest Nigeria
Oluwole Olutola Ojo, DO Awonuga, Iyabode Olabisi Florence Dedeke, Victor Ugochukwu Nwadike, Olaide Rufus Adenaya, Oluwaseyi Isaiah Odelola
July-September 2019, 9(3):8-14
DOI:10.4103/jwas.jwas_26_21  
Background: Genital colonisation by group B Streptococcus (GBS) in pregnant women in their third trimester has been shown to be a known risk factor for morbidity and mortality among newborns. Aim: The aim of the study was to determine the prevalence of GBS colonisation among pregnant women in Abeokuta, its associated sociodemographic factors, and the neonatal outcome among exposed babies. Design: Longitudinal cohort study. Setting: Department of Obstetrics and Gynaecology, Federal Medical Centre, Abeokuta, Ogun State. Methodology: One hundred sixty pregnant women presenting for routine antenatal care between 35 and 41 weeks were recruited consecutively. Swabs were taken from the vagina and then the rectum using a single swab. The samples were processed at the hospital’s Medical Microbiology Laboratory using standard microbiological methods. Babies whose mothers were positive had their bodies swabbed and the samples sent for GBS isolates. They were also screened for early-onset neonatal sepsis with C-reactive protein. Results: Prevalence of GBS vaginal colonisation was 4.3%. There was no significant association between GBS colonisation status and age, level of education, or occupation; however, women of parity ≤1 had significantly higher prevalence of GBS colonisation than those of parity ≥2. There was no incidence of GBS infection observed in the babies. The GBS isolates were 100% sensitive to cefuroxime and 83.3% resistant to ampicillin. Conclusion: The prevalence of GBS is low in our environment. The organisms were highly sensitive to cefuroxime, erythromycin, and ceftriaxone. Routine screening of all pregnant women may be unnecessary. However, women at risk of GBS who present in labour without a recent GBS screening should be offered intrapartum prophylactic cefuroxime.
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Perception of primary school teachers on pupils’ eye health in the Ga West Municipality, Greater Accra Region, Ghana
Winston Ceesay, Imoro Z Braimah, Benjamin Abaidoo
July-September 2019, 9(3):15-20
DOI:10.4103/jwas.jwas_902_19  
Background: Eye health education is lacking in low- and middle-income countries due to limited availability of eye care personnel in the school setting. Teachers have been considered possible human resource for maintaining eye health in schoolchildren. Objective: The aim of this article is to determine the knowledge of teachers on the nature of eye problems among schoolchildren and their ability to recognize visual disorders. Materials and Methods: This was a descriptive cross-sectional survey among primary school teachers in the Ga West Municipality. Cluster sampling was used to select 140 teachers from 12 public and private schools. A structured questionnaire was used in assessing teachers’ knowledge about the features of a healthy and diseased eyes, common causes of visual impairment (VI) and blindness, and recognizing and preventing eye problems in the children. Aggregate scores were computed for correct responses concerning healthy and diseased eyes, and scores were categorized into poor (0–25%), fair (26–50%), good (51–75%), and very good (76–100%) knowledge. Results: Eighty-six (61.4%) of the teachers were females. The mean age was 33 ± 9.1 years. Most teachers were found to have good knowledge about healthy and diseased eyes (75.0% and 60.0%). Hypermetropia, red eye, allergy, and cataract were cited by 50.0–57.9% as the most common causes of VI and blindness. Between 27.1% and 92.1% of teachers identified difficulties seeing the writing board, inability to concentrate in class, holding the book close to the eye to read, and squinting as ways of recognizing eye problems. Most respondents, 132 (94.3%), were of the view that teachers should be involved in screening schoolchildren for ocular morbidities. Conclusion: Teachers in the Ga West Municipality had good knowledge of the characteristics of healthy eyes and a fair knowledge of the causes of VI in primary schoolchildren. Teachers require further training if they are to serve as focal persons for vision screening and eye health education in primary schools.
  900 71 -
Clinical determinants of vaginal and abdominal hysterectomy for benign conditions at the University Teaching Hospital, Yaounde-Cameroon
Tebeu P M, Tayou R, Antaon J S S, Mawamba Y N, Koh V M, Ngou-Mve-Ngou J P
July-September 2019, 9(3):1-7
DOI:10.4103/jwas.jwas_900_19  
Background: Little is known about training and the practice of vaginal hysterectomy in many sub-Saharan Africa countries. Objective: The aim of this study was to identify the clinical determinants of choice of hysterectomy route for benign conditions at the University Teaching Hospital in Yaoundé, Cameroon (UTHYC). Methods: This was a retrospective cross-sectional study at the UTHYC from January 1, 2000 to December 31, 2008. Non-emergency hysterectomies for benign conditions were divided into two surgical approaches: vaginal and abdominal. Patients’ files and registers were used for data collection. Variables of interest were socio-demographic, reproductive health, and clinical characteristics, including indications and surgical route. Analysis was performed using Epi-Info version 3.5.1. Logistic regression analysis was conducted to determine the association between clinical variables and surgical routes. Odds ratios with their 95% confidence intervals (CI) were calculated. The level of significance was set up at P < 0.05. Results: One hundred and sixty-three women who underwent hysterectomy for benign conditions were included in the study. Thirty-seven (22.7%) were by vaginal route and 126 (77.3%) by abdominal route. Indications for hysterectomy were: cervical premalignant lesions, symptomatic uterine fibroids, prolapsed uterus, endometrial hyperplasia, recurrent cervical condyloma, and dysfunctional uterine bleeding.All 61 women with estimated uterine size of more than 12 weeks were operated on by abdominal route. At bivariate analysis, compared to women who had vaginal hysterectomy, factors associated with the choice of abdominal route were secondary/tertiary level of formal education, previous history of laparotomy/caesarean section, premenopausal status, age less than 50 years, and symptomatic uterine fibroids as surgical indication. At multivariate analysis, factors remaining independently associated with the choice of abdominal route were: age <50 years (AOR: 2.99 [1.9–4.71]), P < 0.001); previous laparotomy/cesarean section (AOR: 2.95[2.13–4.08], P = 0.001); premenopausal status (AOR: 1.55 [1.06–2.25]; P = 0.001); and myoma as surgical indication (AOR: 7.49.4[3.2–14.4]; P = 0.0001). Conclusion: Less than a quarter of hysterectomies for benign conditions were performed vaginally. All patients with uterine sizes larger than 12 weeks had laparotomy. The determinants of the choice of the abdominal route included age less than 50 years, previous laparotomy/caesarean section, premenopausal status, and fibroid as surgical indication.
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Testicular cancer at the University of Port Harcourt Teaching Hospital: A 10-year retrospective review
V Abhulimen, EJ Raphael
July-September 2019, 9(3):21-26
DOI:10.4103/jwas.jwas_903_19  
Background: Testicular cancers are rare malignancies. They are however very common in males aged 15–40 years. Reports of increasing incidence of testicular cancer in western countries have been noted. Despite the increasing incidence, mortality has remained low in these countries. There are few publications on the management of testicular tumors in Nigeria. Aim: The aim of this study was to determine the hospital prevalence and highlight our experience in the management of patients with testicular cancer. Materials and Methods: This was a 10-year retrospective study on patients diagnosed with histologically confirmed testicular cancer from January 2009 to December 2018. The case records were retrieved. Data obtained included biodata, clinical presentation, investigations, treatment received and outcomes. Data analysis was carried out using SPSS version 20.0. Results: Eleven patients with testicular cancer were managed during the study period, constituting 0.01% of new cases seen in the hospital. Peak age was 20–29 years (54.55%), with a mean age of 29.27 ± 9.51yrs. The most common presentation was painless scrotal swelling, observed in nine (81.8%) patients. Nine (81.8%) patients presented six months or more after onset of symptoms with advanced disease. Distant metastasis was seen in two (18.2%) patients. Right sided disease was found in seven (63.6%) and left sided disease in four (36.4%). All had radical inguinal orchidectomy. The most common histological diagnosis was seminoma in 8 (72.7%) patients. All the subjects were offered four courses of chemotherapy with bleomycin, etoposide and cisplatin. However, only four (36.4%) completed the chemotherapy. A statistically significant association was observed between the duration of symptoms and the disease stage (P = 0.003), and between number of chemotherapy sessions and survival (P = 0.02). Conclusion: Testicular cancer was an uncommon condition in the catchment area of the University of Port Harcourt Teaching Hospital, affecting relatively young men. The commonest presenting complaint was painless scrotal swelling. Most patients presented with Stage II disease, with seminoma being the commonest histopathology. All had surgical treatment; adjuvant chemotherapy improved 5-year survival. Public education is necessary to surmount sociocultural barriers to effective management of testicular tumors in our environment.
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