A Decade of Jadelle Subdermal Implant Contraception in a Tertiary Health Institution in Port Harcourt, Southern Nigeria

Background: Jadelle, a long acting reversible progesterone contraceptive, has been in use in our centre for over 10 years and has not been comprehensively evaluated. Objectives: To determine the acceptance, efficacy, and safety profile associated with the use of Jadelle contraceptive implant in the University of Port Harcourt Teaching hospital, Port Harcourt. Methods: This is a 10-year retrospective study of clients who accepted and used Jadelle for contraception in the university of Port Harcourt Teaching Hospital (UPTH), Port Harcourt. The case files were retrieved and information on their socio demographic profile, source of information, side effects, failures and reason for removal were extracted using a proforma. Data were filled into a spread sheet, analyzed using SPSS version 21.0 and presented in tables of frequencies and percentages. Results: Within the period under review, March 2007 to February 2017, 569 clients used Jadelle out of the 3829 women who accepted and used modern contraceptive in the UPTH. The mean age of users was 33.7 ± 4.2, 536 (94.2%) were multipara with a mean parity of 4.5 ± 3.8 while 541 (95.1%) had secondary education and above. The major side effect was irregular vaginal bleeding 36 (60.9%) while the main reason for removal of the device was expiration of method 272 (53.9%). A pregnancy was recorded during this period giving a pearl index of 0.002. Conclusion: Jadelle is a popular and a very effective means of contraception with increasing acceptance among our clients. The safety profile is high.

Perceptions of Couples Who Use Jadelle Implant in Blantyre District, Malawi

Malawi has a high total fertility rate of 5.7 per woman and Jadelle implant may be an ideal option for couples who want to practice family planning. Jadelle is a long term contraceptive which is inserted just under the skin of a woman’s upper, inner arm by a nurse or midwife and prevents a woman from getting pregnant for a period of five years. But the use of Jadelle for family planning depends on perceptions of couples. The purpose of this study was to explore the perceptions of couples who choose Jadelle as their family planning method at a Central Hospital in Blantyre district. This study used a descriptive qualitative design. A purposive sample of 5 couples was used. Ethical clearance was granted by relevant authorities. Data was analysed through content analysis. The findings showed that the following nine themes emerged from the qualitative data: 1) men and women perspectives about mode of action of Jadelle;2) knowledge about effectiveness and efficacy of Jadelle among men and women;3) sources of information about Jadelle;4) information given to Jadelle users by providers;5) benefits of Jadelle;6) challenges associated with Jadelle;7) myths associated with Jadelle;8) attitudes of providers of Jadelle and 9) role played by men regarding use of Jadelle. In conclusion, this study found that both men and women generally lacked knowledge of Jadelle. Men play a vital role when couples are choosing contraceptives. Every opportunity should be utilised at antenatal, postnatal and family planning clinics to teach individuals about family planning. This may allow women and men to make informed choices about the use of Jadelle.

Evaluation of the Use of Jadelle Contraceptive Implant by Women in the City of Parakou in 2016

Introduction: Maternal mortality is still very high in Benin. Being one of the methods of reducing this mortality, contraception is still very rarely used in Benin, particularly in Borgou district. The objective of this work was to evaluate the experience of using Jadelle contraceptive implants by women in the city of Parakou in the Borgou department. Methodology: This was a descriptive cross-sectional study, with retrospective and prospective data collection over the period from March 1 to July 31, 2016. Results: A total of 320 women were involved in the study. The mean age was 28.29 years, with extremes of 16 and 44 years. Socio-professionally, housewives predominated (56.88%). Sixty-eight point forty-four percent of women were educated and only 111 (34.69%) women had reached secondary school;married women were mostly represented. Obstetrically, multi-gestures were the most affected (43.75%). Birth spacing was the main reason for choosing Jadelle (48.13%). Majority of patients had their husbands consent to use Jadelle contraceptive method (85.31%). Sixty-eight point fifty-two percent of women had used this contraceptive method for 2 to 4 years. Jadelle had been chosen by the majority (78.75%) of the women, for its long duration of action and its easy use. The dropout rate for Jadelle was 35/320 (10.94%) after 3 years of use. The failure rate for this method was 0.31% (1/320). The satisfaction rate was 87.5%. Conclusion: Jadelle contraceptive implants are an important part of contraceptive methods in Parakou.

Ovarian Cysts in Users of Two Kinds of Progestin-only Contraceptives Implants

Objective To evaluate the prevalence of functional ovarian cysts in users of two different types of contraceptive implants. Methods A total of 239 women were enrolled at 3 months of use of the etonogestrelreleasing implant （Implanon） and the levonorgestrel-releasing implant （Jadelle）. Bimanual pelvic examination and vaginal ultrasound were performed during routine 3, 6 and 12-month visits of asymptomatic women（control group）. Women with ovarian cysts （or enlarged ovarian follicles 〉25 mm） （cysts group） were assessed weekly until disappearence or reduction of the image （including estradiol （E2） and progesterone measurement and women with no ovarian enlargement underwent same evaluation for the same period of time. Results Ovarian cysts were detected in 5.1% and 13.0% of users of Implanon and Jadelle, respectively, at 3rd month. At the 6th month of use, prevalences were 7.1% and 7.8%, and at 12th month rates were 25.7% and 14.7% in the two groups, respectively. E2 levels were significantly higher in cysts group than in control group. The time until disappearance of the ovarian cyst was similar in Implanon and Jadelle group. There were more cases of menorrhagia in patients rveth ovarian cysts than in patients with no ovarian enlargement. Conclusions The finding of ovarian cysts or enlarged ovarian follicles during the first year of use of Implanon and Jadelle implants is common and transient and should not be interpreted as a pathologic ovarian cyst. No further medical interventions are necessary.

Uptake of Hormonal Implants Contraceptive in Zaria, Northern Nigeria

Objective: To document our experience on the use of Jadelle/Implanon contraceptives that was recently introduced into Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria. It is pertinent to generate data on the experiences in the use of this contraceptive in a cross sectional study within Zaria, Northern Nigeria. Method: Data on consecutive clients that accepted Jadelle/ Implanon from June 2009 to November 2013 at ABUTH were extracted from their cards and analyzed using SPSS version 17. Out of a total of 11,502 clients that were for contraception during the period under review, 798 accepted Jadelle/Implanon accounting for 7% of the total clients. All the clients were married. About 67.8% were Muslims while 27.2% were Christians and 5% belong to other sect. 4140 (36%) had tertiary education. Most of the client has been on one form of modern contraception;only 16% were first time users who accepted implant after counselling. 37% of the?clients are full time housewives. The discontinuation rate was found to be 26% for Jadelle and 19%?for Implanon. No pregnancy was recorded during this period. Conclusion: Jadelle/Implanon account for 7% of contractive uptake and a high discontinuation rate was found among the users.