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.

Pattern of Cervical Cytology and High Risk Human Papillomavirus Strains in Non HIV Positive Women Presenting for Cervical Cancer Screening in Port Harcourt, Nigeria

Background: The high risk human papilloma virus (hrHPV) is largely associated with cervical cancer with identifiable dysplastic changes on cytology. The use of cervical cancer screening strategies has largely improved the general outcome of cervical malignancies globally. Objective: To compare cervical cytological features against human papilloma virus genotypes in non HIV positive patients presenting for cervical cancer screening in UPTH. Method: A cross sectional prospective study of 82 non HIV positive women who presented for cervical cancer screening at the University of Port Harcourt Teaching hospital. A prestructured questionnaire was used to obtain socio demographic information. Cytobrush extracts of cervical samples were subjected to cytology and human papilloma virus DNA genotyping using real-time polymerase chain reaction. The information obtained was analyzed using SSPP version 20 and results presented as frequency tables, percentages and tested for significance using student t-test and chi square with p value Results: The mean age of the women was 36.61 ± 7.75 with an age range of 22 - 58 years. The prevalence of HrHPV was 4.88%. Twenty-two of the respondent have abnormal cytological pattern. While the 4 cases of HrHPV positivity were of normal cytological pattern and occurred in respondents that were in their reproductive age, the 22 that showed abnormal cervical cytology were mainly of low grade squamous intraepithelial lesion (LGSIL). There was no case of high grade squamous cell intraepithelial lesion (HGSIL). Conclusion: HrHPV prevalence rate of 4.88% occurring in low socioeconomic class patients. All the cervical abnormalies were of LGSIL, hence the risk of transformation into cervical cancer is equally low. There may be no correlation between hrHPV and cervical cytology in low risk patients.