Academic submissions (CHS)

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Browsing Academic submissions (CHS) by Subject "Antenatal"
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    Prevalence and factors associated with visual inspection with acetic acid (VIA) positive cervical lesions among women attending antenatal at Kawempe Hospital
    (Makerere University, 2019-07) Kaaya, Dickson Nsambu
    Background: Cervical cancer is one of the most preventable and curable cancers if detected early. Cervical cancer is the leading cause of gynaecologic cancer death among women in Uganda. There are various cervical cancer screening methods, but most target the non-pregnant population. There is no opportunistic screening program targeting antenatal women in Uganda, yet available evidence shows a high 1st ANC attendance of up to 97%, but a low postnatal attendance of 54% within two days following delivery (UDHS 2016). Therefore, the antenatal period is a missed opportunity for screening. Objective: To determine the prevalence and factors associated with VIA positive lesions among women attending antenatal at Kawempe hospital Methods: The study was a hospital based cross sectional study targeting women attending antenatal clinic at Kawempe Hospital. 527 eligible participants were recruited using consecutive sampling method. We completed a structured interviewer administered questionnaire on bio data and factors associated with VIA positive result. Prevalence of VIA positive lesions was calculated using number with VIA positive lesions over total number screened. Bivariate and multivariate analysis were used to determine the factors associated with VIA positivity. Statistical significance was set at P<0.05. Results: Between November 2018 and May 2019, 527 participants were recruited and tested with VIA. The median age was 32 years, the median age at initiation of sexual intercourse was 18 years in our study. The prevalence of positive visual inspection with acetic acid amongst the 527 participants was 8.5% (n=45). In multivariate analysis, early sexual debut ≤16years was found to be an independent predictor increasing the risk of VIA positive by 2 times (AOR [95 % CI] = 2.0 [6.4- 11.3]) and tertiary education was found to reduce risk of VIA positivity Conclusion: Prevalence of VIA positives was found to be high and early age of sexual debut was found to increase the risk, while tertiary education was found to reduce the risk of VIA positivity. Recommendations: Pregnant women with history of sexual debut before 16 years be screened for cancer cervix, young girls should be educated against early sexual debut and efforts should be made to keep young girls in school.
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    Risk factors for hyperemesis gravidarum among pregnant women attending antenatal clinic at Kawempe Hospital : A case-control study
    (Makerere University, 2019-10-21) Muwonge, Collins
    Introduction: Hyperemesis gravidarum is the most severe form of nausea and vomiting during pregnancy. The occurrence of HG varies in different areas, affecting approximately 0.5%-4.8% of pregnant women. HG is the commonest indication for admission to hospital in the first trimester of pregnancy. Not enough emphasis is placed on the risk factors for HG despite their higher association with maternal and fetal morbidity and mortality risk. In Uganda, no studies have been carried out to determine the risk factors for HG. Identifying the risk factors for HG could help reduce maternal and fetal complications by providing close follow up for those at risk. Objective: To determine the risk factors for Hyperemesis gravidarum among pregnant women attending antenatal clinic at Kawempe Hospital. Methods: Unmatched case-control study was conducted at Kawempe Hospital. A total of 135 pregnant women attending antenatal clinic (45 cases and 90 controls) were recruited. For each case, two controls were included in the study. Cases were defined as pregnant women of any gestational age and parity with history of vomiting of more than 5 times per day in this pregnancy and not treatment for malaria or urinary tract infection whereas controls were defined as pregnant women of any gestational age and parity without history of vomiting of more than 5 times per day. Data were entered into Kobo Collect online version and exported to Stata version 14.1 for bivariate analysis. Multivariate logistic regression analysis was done to assess the risk factors independently associated with HG. A significant association was declared at a p-value less than 0.05. Results: Among various factors studied, having a previous history of abortion (AOR= 4.23; 95% CI=1.42-12.54) and family history of HG (AOR= 4.88; 95% CI=1.81-13.16) were the only factors found to be associated with HG. Conclusion: Having a previous history of abortion and family history of HG were associated with HG during pregnancy. Recommendations: These factors are not easily modifiable, but identification of these factors may be useful in determining those women at risk for developing HG and providing active screening for those at risk and frequent reviews especially in the first trimester. HG should be managed as they present as no modifiable factors were found.