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Obstetrics, malaria

R L Goldenberg, J B Griffin, B D Kamath-Rayne, M Harrison, D J Rouse, K Moran, B Hepler, A H Jobe, E M McClure
OBJECTIVE: Stillbirths are among the most common adverse pregnancy outcomes, with 98% occurring in low-income countries. More than one-third occur in sub-Saharan Africa (SSA). However, the medical conditions causing stillbirths and interventions to reduce stillbirths from these conditions are not well documented. We estimated the reductions in stillbirths possible with combinations of interventions. DESIGN: We developed a computerised model to estimate the impact of various interventions on stillbirths caused by the most common conditions...
October 5, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Florence Mgawadere, Regine Unkels, Adetoro Adegoke, Nynke van den Broek
BACKGROUND: Assessing the feasibility of conducting a prospective Reproductive Age Mortality Survey (RAMOS) study in the low-income setting of Mangochi District, Malawi to obtain cotemporaneous estimates of the number, cause of and conditions associated with maternal deaths (MD) in all women of reproductive age (WRA) (n = 207 688). METHODS: MD among all deaths of WRA were identified using the ICD-10 definition. Cause of death and contributing conditions identified by a panel of experts using the classification system for deaths during pregnancy, childbirth and puerperium (ICD-MM)...
September 29, 2016: BMC Pregnancy and Childbirth
Joseph Ngonzi, Yarine Fajardo Tornes, Peter Kivunike Mukasa, Wasswa Salongo, Jerome Kabakyenga, Masembe Sezalio, Kristien Wouters, Yves Jacqueym, Jean-Pierre Van Geertruyden
BACKGROUND: Maternal mortality is highest in sub-Saharan Africa. In Uganda, the WHO- MDG 5 (aimed at reducing maternal mortality by 75 % between 1990 and 2015) has not been attained. The current maternal mortality ratio (MMR) in Uganda is 438 per 100,000 live births coming from 550 per 100,000 in 1990. This study sets out to find causes and predictors of maternal deaths in a tertiary University teaching Hospital in Uganda. METHODS: The study was a retrospective unmatched case control study which was carried out at the maternity unit of Mbarara Regional Referral Hospital (MRRH)...
2016: BMC Pregnancy and Childbirth
Habib Md Reazaul Karim, Prithwis Bhattacharyya, Sonai Datta Kakati, Tridip Jyoti Borah, Md Yunus
Scrub typhus and malaria can involve multiple organ systems and are notoriously known for varied presentations. However, clinical malaria or scrub typhus is unusual without fever. On the other hand, altered sensorium with or without fever, dehydration, hemorrhage and hemolysis may lead to low blood pressure. Presence of toxic granules and elevated band forms in such patients can even mimic sepsis. When such a patient is in the peripartum period, it creates a strong clinical dilemma for the physician especially in unbooked obstetric cases...
2016: Qatar Medical Journal
Lucky Osaheni Lawani, Chukwuemeka Anthony Iyoke, Robinson Chukwudi Onoh, Peter Onubiwe Nkwo, Isa Ayuba Ibrahim, Kenneth Chinedu Ekwedigwe, Atombosoba Adokiye Ekine
This study determined the obstetric benefits and compared the obstetric indices and pregnancy outcome of enrollees and non-enrollees of the national health insurance scheme (NHIS). A prospective cohort study of enrollees and non-enrollees of NHIS was conducted over 2 years. Data was analysed with Epi-info statistical software. Malaria (25.3% versus 8.0%, p value ≤0.001), anaemia (11.3% versus 3.3%, p value ≤0.0001), preterm delivery (8.0% versus 2.7% p value = 0.00001), antenatal default rate (22.7% versus 6...
May 18, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Rabi Ndeserua, Adinan Juma, Dominic Mosha, Jaffu Chilongola
BACKGROUND: Prevention and treatment of malaria during pregnancy is crucial for reduction of malaria in pregnancy and its adverse outcomes. The spread of parasite resistance to Sulphadoxine-Pyrimethamine (SP) used for Intermittent Preventive Treatment for malaria in pregnancy (IPTp), particularly in East Africa has raised concerns about the usefulness and the reliability of the IPTp regimen. We aimed to assess the effectiveness of two doses of SP in treating and preventing occurrence of adverse pregnancy outcomes...
September 2015: African Health Sciences
Felix Sayinzoga, Leon Bijlmakers, Jeroen van Dillen, Victor Mivumbi, Fidèle Ngabo, Koos van der Velden
OBJECTIVE: Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. DESIGN: Nationwide facility-based retrospective cohort study. SETTINGS: All cases of maternal death audited by district hospital-based audit teams between January 2009 and December 2013 were reviewed...
2016: BMJ Open
Florent Ymele Fouelifack, Jeanne Hortence Fouedjio, Jovanny Tsuala Fouogue, Zacharie Sando, Loic Dongmo Fouelifa, Robinson Enow Mbu
BACKGROUND: Obesity is a rising public health issue worldwide. Guidelines regarding maternal body mass index (BMI) and gestational weight gain (GWG) are missing in Cameroon where maternal mortality rate remains very high. We hypothesized that obesity and inappropriate GWG are associated with poor pregnancy outcomes. We aimed at assessing associations of BMI and GWG with pregnancy outcomes. METHODS: This was a retrospective cohort study at the Yaoundé Central Hospital...
2015: BMC Research Notes
Valeria Urso, Maria Adele Signorini, Matteo Tonini, Piero Bruschi
ETHNOPHARMACOLOGICAL RELEVANCE: Mopane woodlands play an important role in the livelihood strategies of local populations; however, they have been scarcely investigated by ethnobiologists and very little is currently known about plants traditionally used by local communities, especially about medicinal plants. AIM OF THE STUDY: Our investigation was aimed to document ethnobotanical knowledge in seven communities living in conditions of extreme poverty in a Mopane area of southern Angola (Namibe province)...
January 11, 2016: Journal of Ethnopharmacology
Patricia E Bailey, Emily Keyes, Allisyn C Moran, Kavita Singh, Leonardo Chavane, Baltazar Chilundo
BACKGROUND: The paper's primary purpose is to determine changes in magnitude and causes of institutional maternal mortality in Mozambique. We also describe shifts in the location of institutional deaths and changes in availability of prevention and treatment measures for malaria and HIV infection. METHODS: Two national cross-sectional assessments of health facilities with childbirth services were conducted in 2007 and 2012. Each collected retrospective data on deliveries and maternal deaths and their causes...
2015: BMC Pregnancy and Childbirth
Geoffrey Roberts, Charlotte Roberts, Amy Jamieson, Caris Grimes, Gemma Conn, Robert Bleichrodt
BACKGROUND: The Lancet recently sponsored a commission examining the role of surgery in global health. There is a paucity of published information on the cost-effectiveness of surgery in low- and middle-income countries, a key metric in the prioritisation of limited resources. METHODS: All patients undergoing emergency laparotomy, elective and emergency inguinal hernia repair, elective and emergency caesarean section, amputation, fracture manipulation, or fracture fixation over a 3 months period in a single district African hospital were assessed...
January 2016: World Journal of Surgery
Cynthia Fiorella Anticona Huaynate, Monica Jehnny Pajuelo Travezaño, Malena Correa, Holger Mayta Malpartida, Richard Oberhelman, Laura L Murphy, Valerie A Paz-Soldan
BACKGROUND: Worldwide, rural communities face barriers when accessing health services. In response, numerous initiatives have focused on fostering technological innovations, new management approaches and health policies. Research suggests that the most successful innovations are those involving stakeholders at all levels. However, there is little evidence exploring the opinions of local health providers that could contribute with further innovation development and research. The aims of this study were to explore the perspectives of medical doctors (MDs) working in rural areas of Peru, regarding the barriers impacting the diagnostic process, and ideas for diagnostic innovations that could assist them...
October 5, 2015: BMC Health Services Research
Barthélémy Tandu-Umba, Andy Muela Mbangama
BACKGROUND: Maternal anemia, a common situation in developing countries, provokes impairment of nutrients/oxygen supply to the placenta-fetus unit that leads to Great obstetrical syndromes (GOS). In our setting, however, occurrence of GOS has been found also depending on variables existing prior to pregnancy such as diabetes in family, hypertension in family, previous macrosomia, stillbirth, SGA and pre-eclampsia as well as overweight/obesity. Our study thus aimed to determine the magnitude of maternal anemia and its association with these pre-pregnancy high-risk variables in occurrence of GOS...
2015: BMC Pregnancy and Childbirth
Shingairai A Feresu, Siobán D Harlow, Godfrey B Woelk
BACKGROUND: Low birth weight (LBW) remains the main cause of mortality and morbidity in infants, and a problem in the care of pregnant women world-wide particularly in developing countries. The purpose of this study was to describe the socio-demographic, nutritional, reproductive, medical and obstetrical risk factors for delivering a live LBW infant at Harare Maternity Hospital, Zimbabwe. METHODS: A secondary data analysis from data obtained through a questionnaire and delivery records was conducted...
2015: PloS One
Kerryn A Moore, Julie A Simpson, Kyla H Thomas, Marcus J Rijken, Lisa J White, Saw Lu Moo Dwell, Moo Kho Paw, Jacher Wiladphaingern, Sasithon Pukrittayakamee, François Nosten, Freya J I Fowkes, Rose McGready
Estimating gestational age in resource-limited settings is prone to considerable inaccuracy because crown-rump length measured by ultrasound before 14 weeks gestation, the recommended method for estimating gestational age, is often unavailable. Judgements regarding provision of appropriate obstetric and neonatal care are dependent on accurate estimation of gestational age. We determined the accuracy of the Dubowitz Gestational Age Assessment, a population-specific symphysis-fundal height formula, and ultrasound biometry performed between 16 and 40 weeks gestation in estimating gestational age using pre-existing data from antenatal clinics of the Shoklo Malaria Research Unit on the Thai-Myanmar border, where malaria is endemic...
2015: PloS One
Caroline Charlier, Paul-Henri Consigny
Pregnancy is a physiological situation that requires specific and careful preparation before travel. Malaria, dengue fever and viral hepatitis E are more severe in pregnancy and at higher risk of adverse obstetrical outcome. Medical and obstetrical contra-indications to travel should be listed during pre-travel evaluation. Vaccine indications are the same as in the general population, and must be discussed after a rigorous benefit-risk analysis. Pregnant women should avoid or delay travel in areas of high malarial chloroquino-resistance...
June 2015: La Presse Médicale
John M Benjamin, Brioni R Moore, Sam Salman, Madhu Page-Sharp, Somoyang Tawat, Gumal Yadi, Lina Lorry, Peter M Siba, Kevin T Batty, Leanne J Robinson, Ivo Mueller, Timothy M E Davis
The tolerability, safety, and disposition of dihydroartemisinin (DHA) and piperaquine (PQ) were assessed in 32 pregnant (second/third trimester) and 33 nonpregnant Papua New Guinean women randomized to adult treatment courses of DHA-PQ (three daily doses) or sulfadoxine-pyrimethamine (SP)-PQ (three daily PQ doses, single dose of SP). All dose adminstrations were observed, and subjects fasted for 2 h postdose. Plasma PQ was assayed by using high-performance liquid chromatography, and DHA was assessed by using liquid chromatography-mass spectrometry...
July 2015: Antimicrobial Agents and Chemotherapy
Charles O Odongo, Kuteesa R Bisaso, Freddy Kitutu, Celestino Obua, Josaphat Byamugisha
BACKGROUND: In Uganda, treatment of clinical malaria and intermittent preventive treatment with sulphadoxine-pyrimethamine (SP) are common during pregnancy. As a result, both formal and informal reports from antenatal sources suggest possible misuse of SP for malaria treatment among pregnant women. The objective of this study was to investigate anti-malarial drug use patterns among women who had recently suffered malaria illness before and during pregnancy. METHODS: A cross-sectional study in which a structured questionnaire (interviewer-administered) was used to collect data from pregnant women attending an urban antenatal clinic...
2015: Malaria Journal
Annettee Nakimuli, Scovia N Mbalinda, Rose C Nabirye, Othman Kakaire, Sarah Nakubulwa, Michael O Osinde, Nelson Kakande, Dan K Kaye
BACKGROUND: Neonatal near miss cases occur more often than neonatal deaths and could enable a more comprehensive analysis of risk factors, short-term outcomes and prognostic factors in neonates born to mothers with severe obstetric complications. The objective was to assess the incidence, presentation and perinatal outcomes of severe obstetric morbidity in two referral hospitals in Central Uganda. METHODS: A prospective cohort study was conducted between March 1, 2013 and February 28, 2014, in which all newborns from cases of severe pregnancy and childbirth complications were eligible for inclusion...
2015: BMC Pediatrics
Elisa Sicuri, Silke Fernandes, Eusebio Macete, Raquel González, Ghyslain Mombo-Ngoma, Achille Massougbodgi, Salim Abdulla, August Kuwawenaruwa, Abraham Katana, Meghna Desai, Michel Cot, Michael Ramharter, Peter Kremsner, Laurence Slustker, John Aponte, Kara Hanson, Clara Menéndez
BACKGROUND: Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is recommended in HIV-negative women to avert malaria, while this relies on cotrimoxazole prophylaxis (CTXp) in HIV-positive women. Alternative antimalarials are required in areas where parasite resistance to antifolate drugs is high. The cost-effectiveness of IPTp with alternative drugs is needed to inform policy. METHODS: The cost-effectiveness of 2-dose IPTp-mefloquine (MQ) was compared with IPTp-SP in HIV-negative women (Benin, Gabon, Mozambique and Tanzania)...
2015: PloS One
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