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Biomedical subjects

C A Klufio

Publications and source records attributed to C A Klufio.

At least 19 recordsLinked to original sources
PubMed2004

Hepatitis C virus seroprevalence among mothers delivering at the Korle-Bu Teaching Hospital, Ghana.

OBJECTIVES: To determine the Hepatitis C virus (HCV) carrier rate among mothers, and to determine if selected sociodemographic characteristics are associated with HCV seropositivity. DESIGN: Maternity Unit of the Korle-Bu Teaching Hospital (KBTH). SETTING: A cross-sectional serological survey of mothers delivering at the KBTH. METHODS: Women who had singleton live births and fresh stillbirths in the two labour wards of the KBTH were randomly selected for screening from 1st March to 30th September, 2001. A structured pre-tested questionnaire was used by trained research assistants to collect and record data on medical and sociodemographic characteristics of the subjects. Maternal blood samples were taken and stored at the Public Health Reference Laboratory. The second generation Murex diagnostics ELISA kit was used to test the maternal sera for HCV antibodies. RESULTS: Sixteen (2.5%, 95% CI, 1.5-4.1%) of the 638 subjects were HCV seropositive. None of the medical and sociodemographic characteristics examined showed any association with HCV seropositivity. No subject or her sexual partner was a drug injector. CONCLUSION: The carrier rate of 2.5% of HCV infection found in this study is near the top end of the range found in unselected pregnant populations from other parts of the world. Knowing the prevalence rate of HCV infection in our pregnant population will help policy-makers on the cost effectiveness of available intervention measures.

Adult↗
PubMed2002

Socio-demographic and reproductive characteristics of mothers delivered at the Korle-Bu Teaching Hospital, Ghana.

OBJECTIVES: To measure selected socio-demographic and reproductive history characteristics of parturients at the Korle-Bu Teaching Hospital (KBTH), Accra, Ghana, and to compute the risk load. DESIGN: A non-randomised cross-sectional survey. SETTING: Korle-Bu Teaching Hospital, Accra, Ghana. SUBJECTS: Korle-Bu Teaching Hospital, a tertiary institution delivers about 11,000 women annually. From 1st November to 12th December 1994, 961 parturients were studied out of 978 delivered during the study period. Seventeen questionnaires were excluded from analysis because of errors and omissions that could not be corrected before the parturients' discharge from hospital. METHODS: The data sources were the patients' antenatal and delivery records, and a structured interviewer-administered questionnaire. RESULTS: More than three percent of the subjects were less than 18 years, and 10.8% were over 35 years of age. Before the index delivery, 5.8% were grand multiparae. Eighteen per cent had never been to school. Seventeen per cent of parous subjects had experienced a perinatal death. The non-educated had significantly more births. The mean birth interval was less than two years in 26.4%. Fifty percent of those who had been previously pregnant had a history of at least one induced-abortion. Only 21.0% of the 961 subjects had ever used a family planning method. The risk load was 53.0%. CONCLUSION: Analysis of the historical factors of parturients surveyed at the KBTH showed a high risk load related mainly to lack of education. Formal education of the female child and family health education of our women are recommended to reduce the high past abortion rate and risk load. Additionally, postpartum tubal ligation for those who have completed their families will further reduce the risk load.

Adolescent↗
PubMed2001

Birthweight distribution at Korle-Bu Teaching Hospital, Ghana.

OBJECTIVES: To determine the birthweight distribution of singleton births at the Korle-Bu Teaching Hospital and to determine if selected socio-demographic and reproductive characteristics that are known to be associated with birthweight would show the association in our setting. DESIGN: A non-randomised cross-sectional survey of all deliveries within the study period. SETTING: Korle-Bu Teaching Hospital, a tertiary institution, delivering about 11,000 women a year. STUDY POPULATION: From 1st November to 12th December 1994, 866 singleton normally formed livebirths and fresh stillbirths were sequentially enrolled. DATA SOURCES: Data sources were the antenatal and delivery records of the subjects and an interviewer-administered questionnaire. RESULTS: The mean birthweight for the total sample was 3070 g +/- 616 g. One hundred and fifteen (13.3%) babies were low birthweight. The mean birthweight for those with reliable dates and born at term was 3262 g +/- 488.8 g. Multiple logistic regression analysis showed lack of antenatal malaria chemoprophylaxis and a history of previous low birthweight to be significantly associated with low birthweight. CONCLUSION: Although the mean birthweight of Korle-Bu babies was lower than those of USA and UK babies, it was comparable with those from other developing countries. Antenatal malaria chemoprophylaxis is a practical intervention that can produce an increase in mean birthweight and reduce the risk of low birthweight in our population.

Birth Weight↗
PubMed1999

Anaemia and perinatal outcome in Port Moresby.

In 1987, a computerized obstetric database was set up at the Port Moresby General Hospital. Between 1987 and 1992, 27,117 births took place. The mean haemoglobin value amongst the 83% of women in whom a haemoglobin value was tested was 10.0 +/- 1.7 g/dL. High stillbirth rates (94 per 1,000) were associated with a haemoglobin value < 6 g/dL. The stillbirth rate was slightly lower (14 per 1,000) in woman whose lowest haemoglobin value was in the range 10.0-10.9 g/dL than in those with a haemoglobin value > or = 11 g/dL (18 per 1,000). The stillbirth rate was increased in women with haemoglobin values > or = 14.0 g/dL. With respect to low birth-weight (< 2,500 g), the rates were also higher when the haemoglobin value was above 14.0 g/dL. The reason for these findings is not apparent and may be due to the impact of an uncharacterized confounding variable rather than the haemoglobin value.

Anemia↗
PubMed1999

Antenatal haemoglobin profile at Korle-Bu Teaching Hospital.

OBJECTIVE: To determine the frequency of haemoglobin (Hb) measurement and some socio-demographic characteristics in women attending antenatal clinic. DESIGN: Prospective cross-sectional study. SETTING: Antenatal clinic, Korle-Bu Teaching Hospital. SUBJECTS: Nine hundred and thirty two pregnant mothers attending antenatal clinic at the hospital. Patients with sickle cell disease, thalassaemia, sickling test positive or unknown sickling status were excluded. MAIN OUTCOME MEASURES: Proportion of patients whose records showed various frequencies of Hb determinations and the proportion of those with anaemia at 26 weeks and 34 weeks gestations. RESULTS: One hundred and seventy five (18.8%) patients did not have antenatal Hb measurement; 248 (26.6%) had two, and 251 (26.9%) had more than two measurements. The mean of booking Hb was 10.6 + 1.53 gm/dl. Of the 458 subjects with reliable dates, 293 had their booking Hb measurement at < 26 weeks. For this sub-group the mean was 10.8 +/- 1.43 gm/dl. (22.5% were < 10 gm/dl). For 272 subjects with reliable dates whose last Hb measurement was at > 34 weeks, the mean last Hb was 11.0 +/- 1.37 gm/dl. (last Hb was < 10 gm/dl in 19.1%). Nulliparity and booking antenatal weight < 64.0 kg were significantly associated with Hb < 10 gm/dl at some time during pregnancy. CONCLUSION: Anaemia in pregnancy is common in this urban population. Combined effects of iron-folate supplementation, malaria chemoprophylaxis as well as early booking and a waiver of antenatal care user fees for needy patients are suggested as remedial measures.

Anemia↗
PubMed1997

A survey of under-18 year old and 20-29 year old primigravidae delivered at the Port Moresby General Hospital: a comparative study of their sociodemographic and sexuality characteristics and contraceptive knowledge and experience.

From July 1992 to August 1993, 330 under-18 year old primigravidae (cases) and 330 randomly selected 20-29 year old primigravidae (controls) who were delivered at the Port Moresby General Hospital were sequentially studied, using a standardized, pretested, precoded questionnaire. In stepwise logistic regression analysis, significantly more of the cases had menarche at less than 15 years of age, learned before menarche that sex causes pregnancy, were of highland origin, were unemployed, or had partners who were unemployed; significantly fewer of the cases thought that one sexual act could cause pregnancy, had knowledge of or had ever used a family planning method, or had planned this pregnancy.

Adolescent↗
PubMed1996

A case-control study of meconium staining of amniotic fluid in labour at Port Moresby General Hospital to determine associated risk factors and perinatal outcome.

AIM: To identify sociodemographic and obstetric characteristics which could be used as markers for thick meconium staining of the amniotic fluid (MSAF) in labour. METHODS: The design was an unmatched case-control study. The setting was the Port Moresby General Hospital labour ward. The eligibility criteria were: patients with a singleton pregnancy, cephalic presentation and baby alive at the time of admission in labour. Cases were parturients who had MSAF during labour. The cases were sequentially enrolled according to the time of delivery recorded in the labour ward register. A control was a patient who did not have MSAF and who was the first to deliver after a case. Data were collected using an interviewer-administered questionnaire and patients' hospital records. RESULTS: Logistic regression analysis showed the following variables to have a positive significant association with MSAF: low social status, betelnut chewing, grand multiparity, past history of perinatal death and rupture of membranes to delivery interval. Preterm delivery was negatively associated with MSAF. Compared with the controls, the cases had a higher caesarean section rate; more of their babies were admitted to the Special Care Nursery (SCN); the mean stay of their babies in the SCN was longer; and the perinatal mortality was higher.

Adolescent↗
PubMed1995

A survey of Papua New Guinean parturients at the Port Moresby General Hospital: family planning.

A survey of 673 consecutive Papua New Guinean parturients at the Port Moresby General Hospital, in May and June 1990, showed that 28% had ever used a family planning (FP) method, chiefly a hormonal method (93% of ever-users). Only seventeen of 239 (7.1%) nulliparae had ever used an FP method, compared with 170 of 434 (39.2%) parous subjects. Education of mother and of husband were independently and significantly associated with FP ever-use. Seventeen (4.9%) of 347 women who had a surviving child, had not breast-fed the child. The interval between the birth of the surviving child and the start of the index pregnancy was significantly associated with the duration of breast-feeding; the longer the duration of breast-feeding, the longer the inter birth interval.

Adolescent↗
PubMed1995

Prevalence of vaginal infections with bacterial vaginosis, Trichomonas vaginalis and Candida albicans among pregnant women at the Port Moresby General Hospital Antenatal Clinic.

A clinico-sociodemographic and microbiological survey was carried out at the Port Moresby General Hospital Antenatal Clinic to determine the prevalences of bacterial vaginosis, Trichomonas vaginalis and Candida albicans vaginal infections in pregnancy and to examine if the infections had any association with some suspected sociodemographic risk factors. The study was carried out between December 1990 and January 1991. Of 206 consecutive subjects surveyed, 79 (38%) had symptomatic infection. However, on speculum examination, abnormal discharge was seen in 188 (91%). 118 (57%) had microbiologically confirmed infection. The prevalences of the individual infections were T. vaginalis 19%, C. albicans 23% and bacterial vaginosis 23%. Combined infection, i.e. two infections occurring together in the same subject, was uncommon. None of the infections had an association with any of the sociodemographic characteristics studied. Of the 118 positive subjects, 52 (44%) complained of vaginal discharge and 55 (47%) complained of pruritus.

Adult↗
PubMed1993

Abdominal pain in pregnancy.

Abdominal pain in pregnancy is most commonly caused by complications of the pregnancy, e.g., abortion, ectopic pregnancy and abruptio placentae. A careful history and methodical physical examination and, if necessary, simple ultrasonographic investigations will reveal the cause in most of these conditions. In a few cases of abdominal pain in pregnancy a gynaecological condition, such as torsion of an ovarian cyst, or a nongynaecological (medical or surgical) one is the cause. Some of these conditions are serious, e.g., acute appendicitis, and unless the correct diagnosis is made and the appropriate management promptly instituted both the mother and her baby may suffer tragic consequences. Moreover, these conditions are more likely to be misdiagnosed during pregnancy. This is because the anatomical and physiological changes which occur in pregnancy tend to change and obtund the expected clinical features and laboratory data which are used to diagnose these conditions. Their early diagnosis therefore requires a high index of suspicion together with awareness of the ways in which they may present in pregnancy.

Abdominal Pain↗
PubMed1993

Longitudinal fetal biometry of normal pregnant Melanesian Papua New Guineans to construct standards of reference for Papua New Guinea.

In a longitudinal study at the Port Moresby General Hospital Antenatal Clinic between May 1990 and December 1991, 1514 biparietal diameter (BPD), 1294 femur length (FL) and 1229 abdominal circumference (AC) measurements were made on 425 fetuses during normal pregnancy. Weekly mean values with 2 standard deviations were calculated for BPD, FL and AC between 12 and 42 weeks. Growth curves were also constructed. Ethnic origin, height, parity, weight gain per week and socioeconomic status made no difference to these measurements. The mean values for BPD were compared with those obtained from studies in Africa and Europe. No differences were found.

Abdomen↗
PubMed1993

The prevalence of toxoplasma antibodies in pregnant patients attending the Port Moresby General Hospital antenatal clinic: a seroepidemiological survey.

In a survey of 197 consecutive pregnant patients who were attending the Port Moresby General Hospital antenatal clinic for the first time in the index pregnancy, the prevalence of IgG antibodies to Toxoplasma gondii was 18%. Only one patient had IgM antibodies. Of the sociodemographic characteristics examined, only highlands origin of the patient had a significant association with the presence of IgG antibodies.

Animals↗
PubMed1992

Endocervical Chlamydia trachomatis infection in pregnancy: direct test and clinico-sociodemographic survey of pregnant patients at the Port Moresby General Hospital antenatal clinic to determine prevalence and risk markers.

The prevalence of endocervical C. trachomatis infection in 181 consecutive antenatal clinic patients at the first attendance and who had not received antibiotic therapy in the previous 4 weeks, was 17.7%. The direct fluorescent antibody test was used for diagnosis. There was no significant clinical or sociodemographic factor which distinguished patients who tested positive from those who tested negative.

Adult↗
PubMed1992

Malaria in pregnancy.

In its booklet 'Tropical Diseases 1990' the World Health Organization (WHO) Division of Control of Tropical Diseases (CTD) said, "Malaria remains the most important of the tropical diseases--widespread throughout the tropics, but also occurring in many temperate regions". The size of the malarial scourge was estimated as: number of people infected 267 million; clinical cases 107 million/year; mortality 1-2 million/year; number of people at risk 2100 million. Immunity to malaria is reduced in pregnancy. This makes the disease particularly dangerous for pregnant women, especially for nulliparae. Malaria causes a significant portion of the large number of perinatal and maternal illnesses and deaths in the tropical countries. It is the leading cause of indirect obstetric deaths. Even so, it is impossible to measure its full impact in this respect. It may masquerade as anaemia. A maternal death may be attributed to obstetric haemorrhage, when in fact it was malarial anaemia which tipped the scales. Fortunately, the disease can be prevented through chemoprophylaxis and personal protection. This is one of the most rewarding functions of antenatal care.

Antimalarials↗
PubMed1992

Normal birthweight at Port Moresby General Hospital: a retrospective survey of normal term births to determine birthweight distribution.

A retrospective survey was carried out of term babies born to Papua New Guinean parents at the Port Moresby General Hospital. Only babies of known gestational age from uncomplicated pregnancies who were delivered after 37 and before 42 completed weeks were included in the study. The purpose of the study was to determine the birthweight distribution at term of uncomplicated pregnancies for Papua New Guineans at the Port Moresby General Hospital. The sources of the data were the patients' case records and the labour ward register. The Epi Info V5 (CDC and WHO) statistical software package was used for the analysis. 404 subjects were studied; 116 of these were nulliparae before the index delivery. For the whole study population some of the findings were as follows: mean birthweight 3251g, standard deviation 403.5, mode 3100g, median 3250g, 10th percentile 2713g, 90th percentile 3750g. Birthweight at 41-42 weeks was significantly greater than at 37-38 completed weeks. The height and parity of the mother and sex of the baby also had significant effects on birthweight but the latest birth interval had no significant influence. Babies of highland mothers were significantly heavier than babies of Papuan mothers.

Age Factors↗
PubMed1992

Antepartum haemorrhage at the Port Moresby General Hospital: a retrospective study of 130 consecutive cases.

In a retrospective study of 130 out of 141 consecutive cases of antepartum haemorrhage admitted to the Obstetrics Unit of the Port Moresby General Hospital in the three years 1987 to 1989, 33% had abruptio placentae, 48% had placenta praevia and in 19% the cause of the APH could not be determined. Delivery was by caesarean section in 56% of cases compared to a caesarean section rate of 3% for the total obstetric population. Stillbirth rates per 1000 total births were 223 for all the 130 cases, 81 for the praevia group, 488 for the abruptio group and 120 for the indeterminate group. The stillbirth rate for all deliveries in the hospital in the year 1989 was 21.5/1000.

Abruptio Placentae↗