Objectives: The objective of the study was to assess how the current COVID-19 pandemic has affected cesarean section (C-section) rates, indications, and peripartum outcomes. Methods: This was a retrospective cross-sectional study that compared a 3-month rates of and indications for C-sections at three tertiary health care institutions in Nigeria before (October 2019–December 2019) and during the first wave of COVID-19 pandemic (March 2020–May 2020). Primary outcomes were C-section rate and indications between the two periods. Data were analyzed using SPSS 26.0 IBM Corporation. Rates and odds ratios with 95% confidence intervals were used to quantify indications and peripartum outcomes and statistical significance was accepted when p value was <0.05. Results: The baseline characteristics of the two groups were similar. The C-section rate during the COVID-19 period was significantly less than the period prior to the pandemic (237/580, 40.0% vs 390/833, 46.8%; p = 0.027). The rates of postdatism (odds ratio = 1.47, 95% confidence interval = 1.05–2.05, p = 0.022), fetal distress (odds ratio = 3.06, 95% confidence interval = 1.55–6.06, p = 0.017), emergency C-section (odds ratio = 1.43, 95% confidence interval = 1.01–2.05, p = 0.042), and anemia (odds ratio = 1.84, 95% confidence interval = 1.12–3.03, p = 0.016) were significantly higher during the pandemic than prepandemic. Conclusion: The overall C-section rate during the first wave of COVID-19 was significantly lower than the prepandemic period. There were higher rates of postdatism, fetal distress, emergency C-section, and postpartum anemia. Further studies on this changing C-section trend during the pandemic are needed.
Aims: To determine medical students’ knowledge of COVID-19 pandemic and their willingness to participate in medical response to it and the associated factors. Study Design: Cross-sectional study involving use of online self-administered questionnaire developed by the author was administered to clinical level medical students. Place and duration of study: Enugu State University College of Medicine from 16th September 2020 to 27th November 2020. Methodology: There were 177 participants in this study comprised of 79 males and 89 females with 21, 24, 110, and 22 at 300 level, 400 level, 500 level and 600 level of study respectively. The questionnaire was sent to the representative of each class after discussions with them about the research work. They then transmitted the questionnaire to their class WhatsApp platform with an accompanying request for the completion of the questionnaire. Result: Most participants (145; 81.9%) have good knowledge level of the virus and pandemic. Age (p<.05) and year of study (p=<.05) significantly affect knowledge level. Most students, 113(63.8%) were willing to participate in the response to the pandemic; the most avowed reasons were to gain skill as future members of the health team, 100(88.5%) and as a sense of duty if called upon by government 69(61.1%). Main reason for unwillingness was fear of contracting the infection (20; 90.9%) coupled with lack of PPE (16; 72.7%). Knowledge level about the pandemic did not significantly affect willingness to participate in the response to it. Most respondents were more willing to participate in non-PPE-requiring tasks 103(91.2%) than in others. Conclusion: Medical students in our center are knowledgeable regarding COVID-19 pandemic and are willing to participate in response to COVID-19 pandemic especially if suitable environment is provided.
Background: Human immunodeficiency virus (HIV) infection is a leading cause of morbidity and mortality among women of reproductive age and it is a major contributor to maternal, infant and child morbidity and mortality. Globally, in 2015, an estimated, 78 million people had become infected with HIV while 35 million people had died from Acquired Immune Deficiency Syndrome (AIDS)-related illness since the start of the epidemic. In Nigeria, a national HIV prevalence rate of 3.4% was reported in 2012 with 1.3% in Enugu State. HIV retesting is a WHO recommendation that was adopted by Nigerian her national guideline. The essence of antenatal HIV retesting includes the identification of pregnant women who were first tested during their window periods and subsequently sero-converted, and those who acquired new HIV infection after their initial screening test given the fact that a single HIV testing may not be enough to diagnose HIV with findings of high rates of incident HIV infection during pregnancy and at the post-partum periods. It has been shown that the rate of MTCT was higher from sero-converting women compared with women with already established HIV infection. Hence, this study which gave a clue to the rate of HIV sero-conversion among our antenatal women which may possibly popularize the concept of retesting especially among these women. Aim: To determine the prevalence of HIV sero-conversion and the associated risk factors among previously sero-negative antenatal clinic attendees in Enugu State University of Science and Technology Teaching Hospital, (ESUTTH). Methods: This was a prospective, cohort study involving 415 sero-negative HIV women recruited from antenatal clinic in ESUTH from January to April, 2019 and followed up for 12 weeks. Information on their socio-demographic characteristics, pregnancy history, sexual lifestyle, and clinical profile were obtained using an interviewer-administered questionnaire. HIV tests were done at booking and repeated after 12 weeks using the Rapid Diagnostic Test kits by the parallel algorithm format. Data was analyzed with the IBM SPSS version 23.0. Measures of associations were determined with the Chi-Square test and binary logistic regression. P-value < 0.05 was assessed as statistically significant. Results: The mean age of the participants was 29.44±4.91SD years with a range of 16-43 years. Majority of them were married (397; 95.7%) and had post-secondary education (321; 77.3%). The incidence of HIV sero-conversion was 1.0%. Less than 35 years of age, being single, tobacco use, multiple sexual partners in pregnancy and knowledge of partners’ HIV status were significantly associated with HIV sero-conversion (p < 0.05). However, none of these factors was a significant predictor following logistic regression. Conclusion: The rate of HIV sero-conversion in pregnancy is of public health importance in Enugu and obligatory repeat testing, especially among women with these identified associated risk factors is therefore advised to forestall the menace of HIV to the child and the society at large.
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