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Improving maternal health in the face of tuberculosis: the burden and challenges in Ile-Ife, Nigeria.


IO Awowole
OO Badejoko
BO Badejoko
ON Makinde
OM Loto
TO Okunola

Abstract

Context: The super-imposition of tuberculosis on the demands of pregnancy confers a grim prognosis.
Objectives: To determine the prevalence, pattern of presentation, management and outcome of tuberculosis among pregnant women in Ile-Ife during the first 10 years of the Millennium Development Goal-driven intervention.
Study Design: A retrospective analysis of 29 women managed for tuberculosis during pregnancy and the puerperium at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife between 2001 and 2010 was done using SPSS version 16.0. Prevalence was determined using the total deliveries over the same period. Social class was determined using the Olusanya et al classification and assessment for congenital tuberculosis was done with Cantwell's diagnostic criteria.
Results: There were 29 women with tuberculosis in pregnancy and puerperium, with 15,194 deliveries during the review period; giving a prevalence of 191 cases/100,000 deliveries. Cough and weight loss were the commonest complaints, and 53% of screened subjects were retroviral positive. Only 24% of these women were successfully treated using Directly Observed Treatment Short course; strike action and financial constraints being the hindering factors in 36% of them. The mean weight and EGA at birth were 1.87±0.69kg and 35.1±4.0 weeks respectively. Maternal and fetal case-fatality rates were 16.6% and 31.6% respectively.
Conclusion: The high prevalence of tuberculosis in pregnancy in Ile-Ife is comparable to the national figures. The associated high feto-maternal morbidity and mortality rates also contribute to the unhealthy statistics of the country. Prevention of HIV infection and consistent health service delivery are advocated to reduce this scourge figures. The associated high feto-maternalmorbidity and mortality rates also contribute to the unhealthy statistics of the country. Prevention ofHIV infection and consistent health service delivery are advocated to reduce this scourge.


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eISSN: 0189-5117