Antichlamydia antibodies and sperm quality among male partners of infertile couples ins Nigeria

Background

The impact of Chlamydia trachomatis on semen quality has been studied with varied results.

Aim

To determine the prevalence of antichlamydial antibodies and their relationship with sperm quality among male partners of infertile couples in Enugu, South-East Nigeria.

Materials and Methods

It was a cross-sectional study of infertile male partners of couples attending infertility clinics at the University of Nigeria Teaching Hospital (UNTH) Ituku-Ozalla, Enugu, Nigeria. Their sera were assayed for antichlamydial antibodies, and semen analysis and culture were done for each participant.

Results

Two hundred and eighty-two (282) male partners of infertile couples were studied. Infertility was commoner among participants aged 40 years or more (45.1%) and was mainly of the "primary type" (62.1%). Antichlamydia antibody was detected in 156 (55.3%) participants and was significantly associated with sperm quality (P = 002; OR = 2.294; 95% CI = 1.36-3.88). Overall, 81 (28.7%) had abnormal sperm quality. The sperm count, progressive motility, and vitality were significantly lower in participants with abnormal sperm quality than those with normal sperm quality (P < 0.001) while morphology, volume, and liquefaction time did not differ significantly (P > 0.05). Staphylococcus aureus was the predominant organism isolated from culture (122/282, 43.3%) while Streptococcus species were the least (4/262, 1.4%). There was significantly more Staphylococcus aureus isolated from the semen of participants that were seropositive to antichlamydial antibodies than those that were seronegative (80/156, 51.3% vs. 42/126, 33.3%; OR = 2.105; 95% CI = 1.30-3.42; P = 0.003).

Conclusion

The prevalence of antichlamydial antibodies among male partners of infertile couples in Enugu, Nigeria is high and there is a significant association with sperm quality, sperm count, and bacterial isolates in seminal culture. Male partners of infertile couples in Enugu should be screened for antichlamydial antibodies and appropriate treatment offered wherever indicated. There is a need for increased public awareness and advocacy campaigns on the impact of Chlamydia infection on male factor infertility. This primary preventive measure may help in reducing the burden of Chlamydia infection and male factor infertility.

The impact of COVID-19 on the birth rate in Nigeria: a report from population-based registries

Background and objectives

Coronavirus disease 2019 (COVID-19) is a pandemic that has become a major source of morbidity and mortality worldwide, affecting the physical and mental health of individuals influencing reproduction. Despite the threat, it poses to maternal health in sub-Saharan Africa and Nigeria, there is little or no data on the impact it has on fertility, conception, gestation and birth. To compare the birth rate between pre-COVID and COVID times using selected months of the year.

Materials and methods

This was a secondary analysis of cross-sectional analytical study data from the birth registries of three tertiary hospitals, comparing two years [2019 (Pre-COVID)] versus [2020 (COVID era)] using three months of the year (October to December). The data relied upon was obtained from birth registries in three busy maternity clinics all within tertiary hospitals in South-East Nigeria and we aimed at discussing the potential impacts of COVID-19 on fertility in Nigeria. The secondary outcome measures were; mode of delivery, booking status of the participants, maternal age and occupation.

Results

There was a significant decrease in tertiary-hospital based birth rate by 92 births (P = 0.0009; 95% CI: -16.0519 to -4.1481) among mothers in all the three hospitals in 2020 during the COVID period (post lockdown months) of October to December. There was a significant difference in the mode of delivery for mothers (P = 0.0096) with a 95% confidence interval of 1.0664 to 1.5916, as more gave birth through vaginal delivery during the 2020 COVID-19 period than pre-COVID-19.

Conclusion

Tertiary-hospital based birth rates were reduced during the pandemic. Our multi-centre study extrapolated on possible factors that may have played a role in this decline in their birth rate, which includes but is not limited to; decreased access to hospital care due to the total lockdowns/curfews and worsening inflation and economic recession in the country.

Cesarean section rate and outcomes during and before the first wave of COVID-19 pandemic

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.

Pregnant women utilization of dental services: still a challenge in low resource setting

Background

Poor oral health in pregnancy can be associated with poor pregnancy outcome, however, dental consultation among pregnant women appears to be low.

Methods

This was a questionnaire-based study of 413 women who attended the antenatal clinic of University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu. The information obtained was analyzed using SPSS version 22. A p-value of less than 0.05 was considered statistically significant.

Results

Only 36 (8.7%) of the respondents had dental consultations in index pregnancy for complaints such as tooth ache and decay (66.7%) and pain as well as swelling of the gum (33.3%). The most common reason given for not visiting a dentist during the index pregnancy was the visit not being relevant to their pregnancy outcome (69.2%). After counseling them, only 249 (60.3%) agreed to have dental consultation during subsequent pregnancies. The relationship between visiting the dentist and place of residence (< 0.001), occupation (0.019) and frequency of brushing/ changing of brush (0.005, < 0.001 respectively) were statistically significant.

Conclusion

The prevalence of dental consultation during pregnancy is very low. Pregnant women should be encouraged to have routine dental consultation with oral health counseling and check-up incorporated as part of routine antenatal care.

Prevalence and Predictors of Alcohol Consumption during Pregnancy in South-Eastern Nigeria

INTRODUCTION

Alcohol consumption during pregnancy is a major public health problem because of the enormous deleterious effects on a developing fetus. Sub-Saharan Africa (SSA) is among the highest per capita rates of alcohol consumption in the world, thus suggesting a high burden of Fetal Alcohol Syndrome Disorder (FASD) in the sub-region. Despite this, there is limited data on alcohol exposed pregnancies for most SSA countries including Nigeria.

AIM

To determine the prevalence and predictors of alcohol consumption during pregnancy in Enugu, South-Eastern Nigeria.

MATERIALS AND METHODS

It was a cross-sectional study of 380 consecutive consenting parturients accessing antenatal care at the University of Nigeria Teaching Hospital, Enugu, Nigeria. The information sought for, included the women's socio-demographic characteristics, alcohol use in pregnancy, awareness of the harmful effects of alcohol on the babies including FASD, sources of initial information on awareness, type and quantity of alcohol ingested, reasons for taking alcohol and willingness to stop alcohol ingestion in pregnancy after counseling on the risk of alcohol use in pregnancy. Statistical analysis was both descriptive and inferential at 95% confidence level. A p-value of less than 0.05 was considered statistically significant.

RESULTS

The prevalence of alcohol consumption in pregnancy was 22.6%. The most common brand of alcoholic beverage consumed was stout beer (62.8%, 54/86). A total of 135 (35.5%) respondents were aware that alcohol is harmful to the fetus. Maternal age 30 years or less, nulliparity, less than tertiary education, pre-pregnancy alcohol consumption and lack of awareness of the harmful effect of alcohol on the fetus, were associated with alcohol consumption during pregnancy (p< 0.05).

CONCLUSION

The prevalence of alcohol consumption during pregnancy among women in Enugu, South-Eastern Nigeria is high and lack of awareness of harmful effect of alcohol on fetus was a major predictor. There is need for a concerted public health campaign to improve the awareness of harmful effects of alcohol on the fetus.