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Introduction: In low-resource settings, magnesium sulphate (MgSO4)  for preeclampsia is administered majorly through an injection into the gluteal muscles 4-hourly for 24 hours. The repeated injections are very painful and may lead to infection, abscess formation and reduced compliancy. Objective: To determine the acceptability of Springfusor® pump for the administration of Magnesium Sulphate in preeclampsia and eclampsia. Design: Randomized Open Label Clinical Trial Method: Study was conducted at Kawempe National Referral Hospital. Eligible women had systolic blood pressure of >140mmHg and or diastolic blood pressure >90mmHg, proteinuria >+1, and physician’s decision to start on MgSO4. Four-hundred-ninety-six participants were randomized to Springfusor® pump group or control (standard of care) administration of MgSO4. Intervention group had loading dose (4gm of 50% MgSO4 intravenously over 20 minutes) and maintenance therapy (1gm of 50% MgSO4 intravenously per hour for 24 hours) administered using the Springfusor®.  The control group received a loading dose of 4gm of 20% MgSO4 IV over 15-20 minutes, followed by 10gm of 50% MgSO4 intramuscular (5gm in each buttock) and maintenance dose of 5gm of 50% MgSO4 was administered IM every 4 hours for 24 hours. Both arms received the rest of the care for preeclampsia/eclampsia as per the hospital guidelines. Acceptability of method of administration was assessed using a Likert scale (1-5; 1 and 2: acceptable and 3-5: unacceptable). Pain at site of MgSO4 administration was assessed using Visual Analogue Scale 1-7, (1 minimal pain and 7 worst pain). Comparisons were assessed with X-square and Students’ t-test. Results: Baseline characteristics were similar in both arms. Intervention arm was; more acceptable than the standard of care arm, (94.9% vs70.3%; p<0.001), had lower pain score (2.2±1.3 vs. 4.1±1.6; p <0.001) and fewer side effects. Maternal mortality was comparable between groups (0.8% in intervention arm vs 1.2% in the IM arm).

Background Sub-Saharan Africa has the highest rates of curable sexually transmitted infections (STIs) globally with the greatest morbidity due to Neisseria gonorrhoea and Chlamydia trachomatis falling on women. In response to a demand for comprehensive reproductive health screening, we proposed that providing additional N. gonorrhoea and C. trachomatis testing within a cervical cancer screening programme involving self swabbing for HPV, would be acceptable and effective. Methods As part of a cervical cancer screening project in Kisenyi, a densely populated urban community in Kampala, Uganda with low socio-economic-indicators, women aged 30 to 69 were offered N. gonorrhoea and C. trachomatis testing using self-collected swabs. Women were recruited in each sub-division by local health workers, after informed consent, a brief demographic and attitudes survey was completed and the method of swab collection was explained. Specimens were transported for PCR analysis within Kampala. Participants were contacted by mobile phone and asked to attend the local health clinic to receive appropriate treatment if found to be positive. Results Out of 206 women approached, 203 provided a self collected swab for analysis. Twenty-six women (13%) were found to have C. trachomatis, 2 (< 1%) were positive for N. gonorrhoea and one participant was co-infected. Of the women infected, 76% were successfully contacted and of these 62% attended follow-up to receive appropriate treatment. Women reporting no condom use in the last month accounted for 93% of those with C. trachomatis while use of the oral contraceptive pill was not associated with higher rates of either infection. The self-reported HIV positivity rate was 9.5%. Discussion The acceptance and uptake of testing for common STIs in this urban sub-Saharan environment was very positive. Due to the high burden of disease inferred by these easily treated infections, further integration of appropriate screening should be incorporated into existing reproductive health programmes. Background According to Kenya's PMTCT guidelines, all HIV positive women who present for antenatal care should be tested for TB.Methods HIV-positive, pregnant women were recruited from two maternity hospitals in Nairobi, Kenya. The results presented here are based on surveys completed at baseline as well as 48 hour follow up. This data was collected from 505 women as part of a study on the use of mobile technology in PMTCT programmes. Questionnaires included questions on socio-economic characteristics, history of current and previous pregnancies, knowledge of PMTCT, TB screening and treatment and the use of Nevirapine. Chi-square tests and multivariable logistic regression were used to assess statistically significant associations between variables of interest and TB screening.Results Overall screening for TB in our sample was 10.3% with no significant difference between the two hospitals (11.4% versus

Background The ‘Primary HIV Prevention among Pregnant and Lactating Ugandan Women’ (PRIMAL) randomized controlled trail aimed to assess an enhanced counseling strategy linked to extended repeat HIV testing among HIV-negative pregnant and lactating women aged 18-49 years and 410 of their male partners to address the first pillar of the WHO Global Strategy for the Prevention of Mother-to-Child HIV transmission. Methods: PRIMAL Study participants were enrolled from two antenatal care clinics and randomized 1:1 to an intervention or control arm. Both arms received repeat STI and HIV testing at enrollment, labor and delivery, and at 3, 6, 12, 18 and 24 months postpartum. The intervention consisted of enhanced quarterly counseling on HIV risk reduction, couple communication, family planning and nutrition delivered by study counselors. Control participants received repeat standard post-test counseling. Eighteen focus group discussions and 44 key informant interviews were held to evaluate study participants’ and service providers’ perceptions and acceptance of the intervention and understand the effects of the intervention on risk reduction, couple communication, and emotional support from partners. Results: At baseline participants mentioned multiple sexual partners and lack of condom use as the main risks for pregnant and lactating women to acquire HIV. The main reasons for having multiple sexual partners were 1) the cultural practice not to have sex in the late pre-natal and early post-natal period; 2) increased sexual desire during pregnancy; 3) alcohol abuse; 4) poverty; and 5) conflict in couples. Consistent condom use at baseline was limited due to lack of knowledge and low acceptance of condom use in couples. The majority of intervention participants enrolled felt enhanced counselling improved understanding, faithfulness, mutual support and appreciation within their couple. Another benefit mentioned by participants was improvement of couple communication and negotiation, as well as daily decision-making around sexual needs, family planning and condom use. Participants stressed the importance of providing counselling services to all couples. Conclusions: This study shows that repeat postpartum testing and enhanced individual and couple counselling increased condom use, supported risk reduction, and improved support, communication and decision-making about sexual and reproductive health for pregnant and lactating women.