Trends in the Use of Reversible Modern Contraceptives in Burkina Faso between 2010 and 2015

Background: In Burkina Faso, efforts have been made between 2010 and 2015 to address the low levels of contraceptive utilization. However, the socio-cultural context in the country still reinforces traditional gender roles, low status for women, and a strong desire for larger families. The objectives of this study are twofold: 1) to analyze the trends in reversible modern contraceptive prevalence, and 2) to identify the factors influencing the use of reversible modern contraceptives, comparing the urban and rural areas. Data and Methods: We conducted an analysis using data from Burkina Faso sourced from the 2010 Demographic and Health Survey (DHS) and the 2015 Demographic and Health Module (DHM). The 2010 DHS received responses from 17,087 women aged 15 - 49 years, achieving a response rate of 98.4%. Similarly, the 2015 DHM garnered responses from 11,504 women aged 15 - 49 years, with a response rate of 96.6%. Results: Our findings revealed that while advancements were observed in urban areas, the majority of underprivileged women still faced limited access to modern contraception. Moreover, we did not observe any significant interaction effects between age and parity with the year of the survey. However, there was a slight decrease in the impact of marital status, although the difference between married and non-married women remained significant in 2015. It is noteworthy that family planning discussions and approval continued to play crucial roles. Conclusion: The initiatives to subsidize contraceptive costs and establish mobile clinics have proven inadequate in facilitating rural, impoverished, and young women’s access to modern contraception. Additional endeavors are required to enhance geographical accessibility to modern contraceptives by expanding the availability of supply sources, particularly in rural areas. Furthermore, providing psychosocial support has the potential to empower women in making informed contraceptive decisions and exercising greater control over their reproductive choices.

Trends of Inequalities in the Use of Long-Term Reversible Contraceptives in Burkina Faso between 2010 and 2015

Background: Efforts have been made in Burkina Faso, a French-speaking country, since 2010 to improve healthcare access and provide affordable contraceptive methods to women. With the increasing prevalence of modern contraceptives in Burkina Faso, it is important to examine the socio-demographic factors that contribute to this new pattern of contraceptive use. This study aims to analyze the changes in socio-demographic factors associated with long-term contraceptive use and provide scientific evidence to guide policy development and action planning in family planning. Data and Methods: We utilized data from the 2010 Demographic and Health Survey, which included 17,087 women aged 15 - 49 years, and the 2015 Demographic and Health Module, which included 11,504 women in the same age group. For the analysis of contraceptive use, we focused on women who were in need of contraception (either met or unmet), of reproductive age, non-pregnant, and either married or sexually active but not married. We included users of modern reversible methods and excluded non-users, as well as users of traditional or permanent methods. Results: Our findings revealed a high prevalence of long-term contraceptive use across all categories;however, certain challenges were identified, such as lower levels of information about contraceptive methods among users and the persistence of inequalities. Family planning discussions and partner approval did not influence long-term contraceptive choice. Additionally, some providers selectively offered specific methods based on women’s life course characteristics, such as parity and marital status, despite evidence suggesting that young and nulliparous women can effectively use long-term methods. Conclusion: Given the high effectiveness of long-term contraceptive methods, it is crucial to address barriers that hinder their utilization among young and nulliparous women, as well as those who desire to delay pregnancy. Efforts should focus on improving knowledge and dispelling misconceptions surrounding long-term methods. Providers play a pivotal role in this process by adopting counseling strategies that enhance users’ understanding and facilitate informed decision-making regarding contraceptive options.

The impact of combined oral contraceptives on ocular tissues:a review of ocular effects

The aim of this manuscript is to review the action and adverse effects of combined oral contraceptives(COCs) on ocular tissues.The percentage of unwanted pregnancies and the subsequent abortions make contraception crucial worldwide.Over 100 million women around the world use common contraceptive methods,including intrauterine devices,combined estrogen and progestin oral contraceptives,as well as progestin only preparations(oral contraceptives,implants or injections).COCs are widely used for contraception,but they are also indicated in menorrhagia,endometriosis,acne and hirsutism,fibroid uterus and premenstrual syndrome.However,they have been associated with high rates of cardiovascular events,venous thromboembolic disease,ischemic strokes and breast cancer.The incidence of COCs-related ocular complications is estimated to be 1 in 230 000,including dry eye symptoms,corneal edema,lens opacities and retinal neuro-ophthalmologic or vascular complications.We may infer that the serious ocular complications of COCs can be prevented by eliminating the estrogen dosage and choosing third-generation progestins.In any case,doctors should take into consideration the systemic and ocular history of the patients before selecting any method of contraception.

Use of oral contraceptives and risk of pancreatic cancer in women:A recalculated meta-analysis of prospective cohort studies

In a recent systematic review and meta-analysis of observational studies,the author found potential errors in the selection and extraction processes.The recalculated summary relative risks and the results of a dose-response metaanalysis showed that oral contraceptive use may not be associated with the risk of pancreatic cancer in women.

Impact of Social Determinants of Health on the Choice and Use of Long Acting Reversible Contraceptives

Modern women have increased options for birth control with the development of Long Acting Reversible Contraceptives (LARCs). These methods are reliable, easy to use, and require less daily maintenance while providing contraception for an extended period of time. However, despite the surge of LARCs as contraceptive options, the prevalence of unintended pregnancies is still alarmingly high in the United States. As LARCs are the most effective reversible method of birth control at preventing pregnancy, and therefore the potential social, financial, and medical complications associated, we examined whether social determinants of health play a role in LARC usage. While parity and marriage do not seem to affect LARC utilization, increased research is needed to determine the effects of race. Age can affect the type of LARC implemented, as younger women prefer implants to intrauterine devices (IUDs). Insurance coverage was an apparent influencer of LARC usage, as low out-of-pocket costs translate to increased utilization. This is linked to socioeconomic status (SES), as lower SES is associated with decreased access to healthcare in general. Increased research is needed in order to draw conclusions about the effects of education, intimate partner violence, geographic location, and other SDH on LARC usage.

Awareness and Factors Associated with Postpartum Modern Contraceptives Use among Women of Reproductive Age in Bukombe District, Geita Region

Introduction: Pregnancies that occur during the first year postpartum are more likely to be unplanned. This leads to an increased risk of adverse maternal and perinatal outcomes. However, modern contraceptive use during this period helps to reduce unplanned pregnancies and its associated adverse outcomes. There is scant data on postpartum contraceptives in pastoral communities in Tanzania. This study aimed to assess awareness and factors associated with postpartum modern contraceptives use among women of reproductive age in Bukombe District, Geita Region. Method: A community based cross-sectional study was conducted in a predominant pastoral community of Bukombe district in Geita region in north-western Tanzania from May-June 2018. A total of 511 postpartum women who were in their first year after child birth were studied. A multistage sampling technique was used to select study participants. Data analysis was performed using SPSS version 21. Multivariable logistic regression analysis was used to determine independent predictors of postpartum modern contraceptive use. Results: Most (97.3%) of the participants were aware about modern contraceptives. The prevalence of postpartum modern contraceptive use was 11.9%. The most frequent used contraceptive method was Implant 6.5%. Majority (75%) of women started to use the contraceptive at the first three months after delivery. Living in urban (AOR = 1.84, 95% CI: 1.20 - 3.79), business women’s (AOR = 2.34, 95% CI: 1.31 - 2.28), having last born aged 3 - 4 months (AOR = 3.30, 95% CI: 1.11 - 9.85) and menses resumption (AOR = 9.23, 95% CI: 3.60 - 23.72) were associated with postpartum modern contraceptive use. Fear of side effects, poor knowledge about contraceptives, husband restrictions, distance to health facility and availability of contraceptive were the barriers for use of contraceptive use. Conclusion: We found low uptake of postpartum modern contraceptive use in this population. Numerous factors were associated with modern contraceptive use. Therefore, health communication targeting this group is warranted to improve modern contraceptive uptake.

Effect of Hormonal Contraceptives on the Total Antioxidants Status of Women from Isolo, Lagos State, Nigeria

The use of hormonal contraceptives has been implicated in the depletion of serum antioxidants and resultant promotion of oxidative stress which is associated with various disorders including cardiovascular disease and cancer. This study investigated serum total antioxidant status (TAS) in women taking hormonal contraceptives and compared their results with non-contraceptive users (age- and sex-matched). Sixty women aged 30 - 45 years, were enrolled for the study which included forty-five users of hormonal contraceptives from the Planned Parenthood Federation of Nigeria, Isolo, Lagos state and fifteen age-matched, apparently healthy, non-contraceptive users from the same geographical location were selected as controls. The in vitro determination of the serum total antioxidant status (TAS) was performed using Biorex enzymatic kit. Data obtained were statistically analyzed using student’s t-test and P < 0.05 was considered significant. The serum levels of TAS in the users of hormonal contraceptives were significantly lower than non-users (P < 0.05). The study concluded that women on hormonal contraceptives especially those taking either combined oral or combined injectable contraceptives were at risk of developing disorders associated with reduced levels of serum antioxidants.

The Use of Hormonal Contraceptives and Preeclampsia among Ghanaian Pregnant Women

Hormonal contraceptives (HC) are thought to play a role in the pathogenesis of cardiovascular diseases. The study evaluated the use of HC as a primary cause of preeclampsia (PE) among Ghanaians. This study comprised 30 preeclamptic women and 30 healthy normotensive pregnant women with over 20 weeks of gestation at the Comboni Hospital, Ghana using a randomized case-control study. Blood pressure, weight, height, socio-demographics, medical and previous obstetric history were taken and recorded. Blood samples were collected for the estimation of homocysteine and fasting lipids. Estimated foetal weight (EFW) and infant birthweight (BWT) were obtained from maternal records. This study was carried out in 2019. 80.0% of women with PE used the hormonal contraceptive “depot medroxyprogesterone acetate” (DMPA) prior to pregnancy. The use of DMPA was associated with about thirty-fold increase in the odds of developing PE (OR = 29.71, p < 0.001). Systolic blood pressure (P < 0.001), diastolic blood pressure (P < 0.001), triglycerides (P = 0.024), LDL-C (P = 0.026), and homocysteine levels (P < 0.001) were significantly elevated in the PE cases than the normal pregnant (NP) women, whilst EFW (P < 0.001), BWT (P < 0.001) and HDL-C levels (P = 0.001) were significantly reduced in the PE cases when compared to NP women. 50% and 47% of PE cases had intrauterine growth restriction and low birthweight infants, respectively. In conclusion, DMPA use predisposes women to a high risk of developing PE. DMPA could partly contribute to endothelial dysfunction, hyperhomocysteinaemia, dyslipidaemia and excessive weight gain, all of which characterize PE.

Progestogen-Only Injectable Contraceptives: The Profile of the Acceptors, Side Effects and Discontinuation in a Low Resource Setting, Nigeria

Progestogen-only injectable contraceptive is a highly effective, long lasting and reversible agent of fertility control. The objective is to determine the profile of the acceptors, side effects and indication for discontinuation of progestogen-only injectable contraceptives at UCTH, Calabar. This was a retrospective study of the clients who used progestogen-only injectable contraceptives at the family planning unit between 1st January 2008 and 31st December 2014. A total of 1392 clients used the injectable progestogen-only contraceptive out of 5986 total contraceptive users giving the prevalence rate of 23.3% over the period. Of these, 60.4% of the clients accepted the depot medroxyprogesterone acetate, while 39.6% accepted the norethisterone enanthate. It was mostly utilized by multiparous women, clients with tertiary education and those in their third decade of life. Secondary amenorrhea was the commonest side effect in 47.7% of the clients. Over the study period, 243 (19.8%) discontinued the method and 48.1% discontinued due to secondary amenorrhea while 31.4% was due to desire to get pregnant. Progestogen-only injectable contraceptive was associated with multiple side-effects, with secondary amenorrhea being the most common, and menstrual irregularity was the main reason for discontinuation. Providing adequate information to clients about this method of contraception and its probable side effects, supportive counseling during initiation of contraception and re-enforcement during follow-up visit can go a long way in enhancing patient satisfaction and hence continuation of progestogen-only injectable contraceptive despite minor side effects.

Electrical Activities and Pressure Pain Threshold in Oral Contraceptives Users and Nonusers

The aim is to evaluate the influence of oral contraceptive intake and menstrual cycle on the electrical activity and pressure pain threshold from anterior temporal and masseter muscles. Twenty-eight women on reproductive age were selected, 13 OC users and 15 nonusers. They were weekly submitted to electromyography and algometry of the anterior temporal and masseter muscles during three consecutive menstrual cycles. Electrical activities at rest position and PPTs of temporal and masseter muscles were not affected by menstrual cycle or by OCs uses. Comparison between groups demonstrated that working side electrical activity was increased in OC users in both muscles, except during lutheal phase for the anterior temporal. However, comparison within weeks did not demonstrate statistical difference. It was suggested that, in healthy women, oral contraceptive use may influence electrical activity, but different phases of the cycle may not.

Suppressed response to hormonal contraceptives in women of Khairpur, Sindh, Pakistan

Objective: Contraception has gained gradual popularity in many parts of the developing world including Pakistan. Despite this increase in acceptance, the birth rate remains high. Failure of contraception has been reported in the literature, which made us aim to conduct this study. The efficiency of hormonal contraceptives in the study area was assessed and this is the first report from Pakistan. Methods: A total of 200 women (aged 20-30 and 31-40 years;n = 100 each) with minimum consistent use of hormonal contraceptives in the form of pills (Combined oral contraceptives) for 12 months were enrolled in this study. Blood samples were collected from women of each age group and corresponding control groups (n = 100) from local hospitals and reproductive health service center. Serum levels of the fertility hormones viz leutinizing and follicle stimulating hormones were measured through ELISA technique. Results: Our data revealed that over all in the both age groups, 72% women had normal, 16% increased and 12% showed decreased levels of leutinizing hormone (p > 0.05) and 67% women showed normal, 33% showed decreased and no increased levels were found for follicle stimulating hormone (p > 0.05). No age-wise significant difference in response was observed among both the age groups tested. Conclusion: Statistically insignificant difference in serum leutinizing hormone and follicle stimulating hormone seen among both the age groups of hormonal contraceptive users and control group indicates less effective hormonal contraception response in the study area.

LARCs after unsafe abortion in Libreville (Gabon): Women accept quickly but the time interval for the insertion is longer than that of injectable contraceptives

Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptives. Patients and Methods: This is a prospective, descriptive and comparative study conducted in Libreville (Gabon), from February 1, 2013 to August 31, 2013. After receiving post-abortion care (PAC), all patients with stable general states were counseled about three types of contraceptive methods: combined oral contraceptive pills, LARCs (Jadelle? implants, Copper IUDs) and injectable Medroxyprogesterone Acetate (DMPA). Results: 231 women received PAC and among them 215 (93%) wanted to use one of the three proposed contraceptive methods. At the end of the study, only 193 women (89.7%) used contraception and 22 others (10.3%) abandoned their intentions. LARCs were used by 31 (16.0%) women. The average period for the insertion of LARCs was 15.4 ± 15.5 days with extremes of 1 to 53 days. This period for the insertion of LARCS was significantly longer than that of other methods (p < 0.001). LARCs were inserted more often after the 2nd day than immediately (same day) with a highly significant difference (p < 0.0001). Conclusion: LARCs could constitute an appropriate approach to reducing unintended pregnancies in Gabon. However, in order to increase their rates of use, it is necessary to improve women awareness.

Qualitative Assessment of Knowledge, Attitude, and Practice of Contraceptives among Women Attending Postnatal Care in a Health Facility in Jos, Plateau State, Nigeria

Background: Contraceptive acceptance and utilization in society has been a huge challenge for communities in developing countries. There is a need to support the increase in the utilization of contraception and family planning services. In all this, good knowledge and practice of contraception services will enable women to select the best methods. The study seeks to qualitatively assess the knowledge, attitude, and practice of contraceptive use among women attending postnatal care in a health facility in Jos, Plateau State, Nigeria. Methods: This qualitative study was conducted in Bingham University Teaching Hospital, Jos, Plateau State in September 2019. This study utilized Focus Group Discussions among 36 women recruited using the purposive sampling technique. There were four (4) sessions involving nine (9) women per session. Findings: Of the 36 women, a majority (88.9%) had positive perception regarding contraception, all agreed that contraception and family planning is beneficial to families and communities. A majority felt that communities are yet to accept contraception. Most (83.3%) of the women had good knowledge of contraception. Three-quarters (77.8%) of the women have used contraception in the past, and about half (41.7%) are using it currently. Attitude towards adoption of contraceptives after current pregnancy was generally good. About half (52.7%) of the participants stated they required spousal approval before they adopt a method of contraception. Conclusion: There is a need for health agencies, development partners, and government to continue the health education, community sensitization, and support towards making contraception and family planning commodities available and accessible.

Oral Contraceptives and Health Outcomes:an Umbrella Review of Systematic Reviews and Meta-analyses in Women and Offspring

Aim We herein provide an umbrella review of systematic reviews(SR)and meta-analyses(MAs)of studies of the association of oral contraceptives(OCs)with the risks of multiple health outcomes in women and their descendants.Methods Two investigators retrieved publications from four electronic databases,including PubMed,Embase,Web of Science,and the Cochrane Database of Systematic Reviews up to March 15,2021.For each association,random/fixed-effects summary effect size and 95%CIs were estimated.Heterogeneity and publication bias were also assessed.The method quality and evidence level for each publication were respectively assessed utilizing the AMSTAR and GRADE checklists.Results A total of 68 articles with 82 unique outcomes were included based on the eligibility criteria.Numerous lines of evidence indicated that OCs had effects on nearly all cardiovascular disease-related outcomes,especially for cerebral venous sinus thrombosis(OR=7.59,95%CI:3.82-15.09).Harmful associations were also found for vulvar vestibulitis(OR=2.31,95%CI:1.03-5.16),preterm birth(OR=1.17,95%CI:1.07-1.27),miscarriage(OR=1.13,95%CI:1.02-1.72),ulcerative colitis(OR=1.22,95%CI:1.06-1.41),Crohn's disease(OR=1.24,95%CI:1.09-1.40),alveolar osteitis(RR=1.86,95%CI:1.66-2.08),dry socket(RR=1.8,95%CI:1.33-2.43),and interstitial cystitis(OR=2.1,95%CI:1.26-3.49).However,oral contraceptives did not increase the risk of cancer except breast and cervical cancer.Maternal exposure to OCs was linked to an increased risk for the development of respiratory atopic disorders such as asthma(OR=1.1,95%CI:1.02-1.19)and rhinitis(OR=1.34,95%CI:1.07-1.68).Conclusion In summary,although their use obviously reduces the risk of pregnancy-and parturition-related morbidity and mortality for women,OCs were frequently related to more harm than benefit in terms of other health outcomes.This was true for both women and their descendants in this umbrella review.More large-scale prospective studies analysing different doses,structures,and durations of treatment with estrogen and progestin are needed to confirm these effects.

Determinants of Modern Contraceptive Uptake among the Youth in Akuse Township in the Lower Manya Krobo Municipality, Ghana

Background: Access to safe and effective contraception is crucial for sexual and reproductive health to be at its best. This allows improved pregnancy results and the avoidance of unintended births. Teenagers’ views on using contraceptives are influenced by the information available at their disposal. The study assessed the influential factors affecting the utilization of modern contraceptives among the youth in Akuse in the Eastern Region of Ghana. Methods: The data for the study were gathered from 378 consented youth aged 15 - 24 years using a quantitative cross-sectional study design and a well-structured questionnaire. Person’s Chi-Square test was adopted to measure the association between the outcome variable and selected independent variables. Logistic regression models were utilized to measure the odds of the factors influencing modern contraceptive use among the respondents. Results: The results of the study suggested a high knowledge level of contraceptives;however, the prevalence of utilization was low. The level of education and age were factors found to influence the uptake of contraceptives. A bivariate analysis to examine the association between selected socio-demographic variables revealed that educational level (p = 0.044), religious affiliation (p = 0.002), and ethnicity (p = 0.016) were statistically associated with modern contraceptive use among the respondents. All other tested demographic variables including the age groups, gender, marital status, and residential status proved otherwise at the observed p-values greater than the 0.05 threshold. Respondents who indicated staying with partners were 6.79 times more likely to use contraceptives compared to their counterparts staying with a parent, after controlling for all other covariates. Conclusions: Based on the findings of this study, it was concluded that high contraceptive knowledge influences the choice of contraceptive preferred by the youth, and contraceptive use is also influenced by the advancement in age and educational level of the youth. It is however recommended that parents, guidance, and teachers be entreated to offer relevant and timely sexual information or education as these will most likely improve the uptake of modern contraceptives among the targeted population.

Successful Laparoscopic Management of a Migrated Intrauterine Contraceptive Device in the Pelvic Cavity: A Case Report

Background: An Intrauterine device (IUD) is a long-acting reversible contraceptive commonly used in clinical practice. Its insertion in the uterus is simple and safe. But sometimes, complications can occur. Case Report: Herein, we report a case of successful laparoscopic removal of a missing IUD Copper-T, mis-inserted in a 32-year-old woman, 4 months after she delivered by caesarian section, and presented persistent lower abdominal pain lasting 6 months. Uterine ultrasound was unremarkable, but a plain abdominopelvic X-ray confirmed the presence of the Copper-T inside the abdominal cavity. Conclusion: Insertion of IUD is simple and safe. When the diagnosis of uterine perforation following its insertion is clinically suspected and radiologically confirmed, laparoscopy, when available, remains one of the best options for removal.

Female Contraception: Comparative Study of Biometrics and Vascularization of the Uterus at Sylvanus Olympio University Hospital (Togo)

Female contraception uses both hormonal and non-hormonal methods. The aim of the study is to determine the impact of female contraception on uterine vascularisation and the endometrium. Method: It was a descriptive comparative study with an analytical aim. It took place at the University Clinic of Obstetrics Gynaecology and the Radiology and Medical imaging Department of Sylvanus Olympio University Hospital in Lomé over a two-month period from May 15, 2023 to July 15, 2023. Group 1 included women using a modern contraceptive method and group 2 women not using a modern contraceptive method. Epidata 3.1 and R 4.0.4 software were used to process the data. Results: Each group included 50 women. There were no significant differences in uterine and endometrial biometrics. All women on contraception had their zone 1 vascularized, without vascularisation of zone 2, without significant difference with women without contraception The pulsatility index was greater than 3 in 51% (n = 51) of women, including 62.7% (n = 32) of women without contraception and 37.3% (n = 19) of women on contraception, with a statistically significant difference (p = 0.009). Conclusion: Contraceptive methods do not influence the biometry of the uterus. However, uterine artery Doppler indices can predict abnormal uterine bleeding.

Factors Influencing the Choice between IUD and Implant among Long-Acting Reversible Contraceptive (LARCs) Users in Burkina Faso

Background: Long-acting and reversible contraceptive methods hold great potential as solutions to address the unmet need for contraception and the significant discontinuation rates, especially in sub-Saharan Africa. Among these methods, the Implant has gained popularity in sub-Saharan Africa, whereas the utilization of Intrauterine Devices (IUDs) has remained comparatively low, particularly in Burkina Faso. This study aims to evaluate the shifts in IUD and Implant usage from 2010 to 2020 and to pinpoint the factors influencing the choice of IUDs among LARCs users in Burkina Faso. Data and Methods: We conducted an analysis using data from Burkina Faso, drawn from the 2010 Demographic and Health Survey (DHS) and the 2020 PMA Phase 1 data. The 2010 DHS garnered responses from 17,087 women aged 15 - 49, achieving a response rate of 98.4%. The 2020 PMA data collected responses from 6590 women aged 15 - 49, with a response rate of 95.8%. The final sample of Long-Acting Reversible Contraceptives (LARCs) users consisted of 1502 women, including 576 women from the 2010 survey and 926 women from the 2020 survey. Results: The study demonstrates an expansion of IUD usage to include socioeconomically disadvantaged segments among LARC users. However, higher levels of education, older age, and decisions influenced by healthcare providers are correlated with the preference for IUDs over Implants. The choice of IUDs is also connected to a comprehensive understanding of contraceptive methods, suggesting potential biases in the counseling process. Conclusion: Facilitating the broader adoption of IUDs among disadvantaged groups could be achieved by improving the accessibility of IUD products and services in rural areas. Nevertheless, there should be focused initiatives to enhance access to removal services, as this factor could dissuade specific users. Further efforts are required to train healthcare providers, aiming to mitigate biases in delivering Long-Acting Reversible Contraceptives (LARCs). Providers should provide impartial counseling, irrespective of the selected type of LARC.

An Investigation on the Utilization of Intra Uterine Contraceptive Device among Women in Kabwe, Central Province

Introduction: Intrauterine contraceptive device (IUCD) is an effective long acting reversible contraceptive but its use is low. This study examined factors contributing to the utilization of intrauterine contraceptive devices (IUCDs) among women in Kabwe Central Province. Methodology: This was an analytical cross sectional study. Primary data was collected from 150 respondents in using simple random sampling method. Data was analysed using the statistical package of social sciences (SPSS) version 22. Chi-square test was used to test associations among the dependent and independent variables. Logistic regression analysis was conducted. The confidence interval was set at 95% and significant level was at 0.05%. Findings: The study found that 44% of the respondents had high level of knowledge about IUCD. About 28% of the respondents, said that they used IUCD because it maintains menstrual bleeding, 26% said that they used because IUCD it does not cause infections, and 19% said that they used IUCD because it does not migrate to other body parts. Majority (81%) of the respondents agreed with a statement that age contributes to underutilization of IUCD. About 77% of the respondents agreed with a statement that marital status contributes to underutilization of IUCD and 75% agreed with a statement that, education level contributes to underutilization of IUCD and was significant. Furthermore, 91% of the respondents agreed with a statement that lack of knowledge about IUCD contributes to underutilization of IUCD and 74% agreed with a statement that religion contributes to underutilization of IUCD. Age (p = 0.003), marital status (p = 0.002), education level (p = 0.003), and employment status (p = 0.02), were found to have a significant relationship with the utilization of IUCD. About 36% of the respondents said that knowledge or education affects the utilization of IUCD at a large extent. The study showed a positive relationship between the utilization of IUCD and all explanatory variables such as age, education/knowledge, marital status, religion, family size and income and acceptability which had a positive correlation ranging from 0.543 to 0.815. Older women with higher education levels were more inclined to use IUCDs compared to younger individuals and those with only a primary education. Religious affiliation influenced IUCD use with Muslim women being less likely to opt for IUCDs. Moreover, being married was associated with lower IUCD utilization. Conclusion: Based on these findings, the study identified age, education/knowledge, marital status, religion, family size and income, and acceptability as the primary drivers of IUCD usage. The study recommends that, there should be a conduct of educational workshops, there should be community awareness programs and there should be comprehensive family Planning Services.

Hepatic Adenoma Secondary to Long-Term Oral Contraception Use in a Young Female

Hepatic adenomas are a rare byproduct of oral contraceptive pill (OCP) use. Laboratory workup is often inconclusive. Diagnosis can be made via MRI;however, select cases may require further testing such as fine needle aspiration or core needle biopsy. We report a case of a 36-year-old female who was referred to gastroenterology for further evaluation of several liver lesions found incidentally on imaging. Due to risk factors, such as age, long-term oral contraceptive use and obesity, adenoma was high on the differential. Although infrequent, this case emphasizes the importance of a detailed history, including medication review, and physical examination.