Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing ...Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing nations emphasis is placed on childbirth and inability to fulfill this role can be very distressing. There is an unmet need for assisted reproductive technology (ART) in many developing countries and where facilities exist, they are mostly privately owned, expensive and concentrated in urban areas. To bridge this gap, public fertility clinics have been established to provide subsidized care. Evaluating the characteristics and peculiarities of clientele presenting at these public facilities will aid planning and prioritization of care. Methodology: A descriptive retrospective study of 116 infertile patients presenting to the fertility clinic of the University College Hospital, Ibadan, Nigeria from inception on the 14<sup>th</sup> of February 2019 and 31<sup>st</sup> of December 2022.Data was analyzed using the Statical Package for Social Sciences (IBM, SPSS, New York) version 23. Descriptive statistics were used to summarize the results which were presented with the aid of bar charts and frequency tables. Result: The mean age of the patients was 40.70 ± 6.62 years. Post-menopausal patients accounted for about one-fifth of the study population while 80.2% (93 women) were older than 35 years. The mean duration of infertility was 9.39 ± 6.11years and nine patients (7.8%) had a duration greater than 2 decades. Secondary infertility occurred in 67.2% of the women. Twenty-nine women (25%) had undergone myomectomy prior to presentation. Hypertension (11.2%) was the most prevalent comorbidity. Nineteen patients (16.4%) had used contraceptives in the past with the male condom (36.8%)being the most preponderant. Sixty-seven patients had experienced pregnancy losses before 28 weeks of gestation while just 16 patients (13.8%) had undergone ART, and none was successful. Conclusion: Secondary infertility was the prevalent type of infertility and may not be unconnected with the low contraceptive usage and high risk of sexually transmitted infection. Late presentation coupled with a large proportion of post-menopausal clientele suggests delayed health-seeking behavior most probably due to the prohibitive cost of ART. The need to streamline services offered in public fertility clinics is paramount in low-income countries grappling with scarce resources. A pragmatic approach will involve the provision of low-cost ART, while enhancing gamete donation programs through the implementation of gamete sharing policies. This will invariably bridge the unmet need and skewed access to ART in developing countries.展开更多
Background: Infertility is a dramatic situation for a couple, especially in the Sub-Saharan area, known as extremely pro-natalist. Until this day infertility of tubal origin due to infection sexually transmitted, post...Background: Infertility is a dramatic situation for a couple, especially in the Sub-Saharan area, known as extremely pro-natalist. Until this day infertility of tubal origin due to infection sexually transmitted, post abortum or postpartum origin is the most frequent. Worldwide we are witnessing the transition of pathologies: from infectious to non-communicable ones. Objective: To analyze the evolution of infertile couples’ profiles over time to improve management in the future. Setting: University clinic of Kinshasa and a private clinic, the Edith Medical Center. Design: A cross-sectional analytical study. Patients: A total of 4456 patients who sought care for infertility from January 1999 to December 2014 were enrolled. Main Outcome: The evolution of socio-demographic, clinical and paraclinical parameters of infertile couples over time. Results: The average age of female patients was 33.1 ± 5.7 years and it increased by 36 days every year and the male partner by 29 days per year. The average number of cigarette rods consumed decreased by 5% per year. The average intercourse frequency per week decreased by 2% every year. A fifth of patients (21.8%) were obese. And the average BMI increased by 0.04 kg/m2 per year. Tubal occlusion was the main lesion found in hysterosalpingogram and diagnostic laparoscopy. Conclusion: Patients were more and more aged and gaining weight. A part from infection which is the main cause of infertility this day;in the future, infertility care providers will be facing non-communicable diseases, namely obesity.展开更多
This paper presents a case study of implementing a trauma registry in Mozambique, a low-income country with limited current trauma surveillance. An outline of the importance of trauma registries is presented followed ...This paper presents a case study of implementing a trauma registry in Mozambique, a low-income country with limited current trauma surveillance. An outline of the importance of trauma registries is presented followed by an evidence-based approach to building a sustainable and ethical partnership with local stakeholders.展开更多
文摘Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing nations emphasis is placed on childbirth and inability to fulfill this role can be very distressing. There is an unmet need for assisted reproductive technology (ART) in many developing countries and where facilities exist, they are mostly privately owned, expensive and concentrated in urban areas. To bridge this gap, public fertility clinics have been established to provide subsidized care. Evaluating the characteristics and peculiarities of clientele presenting at these public facilities will aid planning and prioritization of care. Methodology: A descriptive retrospective study of 116 infertile patients presenting to the fertility clinic of the University College Hospital, Ibadan, Nigeria from inception on the 14<sup>th</sup> of February 2019 and 31<sup>st</sup> of December 2022.Data was analyzed using the Statical Package for Social Sciences (IBM, SPSS, New York) version 23. Descriptive statistics were used to summarize the results which were presented with the aid of bar charts and frequency tables. Result: The mean age of the patients was 40.70 ± 6.62 years. Post-menopausal patients accounted for about one-fifth of the study population while 80.2% (93 women) were older than 35 years. The mean duration of infertility was 9.39 ± 6.11years and nine patients (7.8%) had a duration greater than 2 decades. Secondary infertility occurred in 67.2% of the women. Twenty-nine women (25%) had undergone myomectomy prior to presentation. Hypertension (11.2%) was the most prevalent comorbidity. Nineteen patients (16.4%) had used contraceptives in the past with the male condom (36.8%)being the most preponderant. Sixty-seven patients had experienced pregnancy losses before 28 weeks of gestation while just 16 patients (13.8%) had undergone ART, and none was successful. Conclusion: Secondary infertility was the prevalent type of infertility and may not be unconnected with the low contraceptive usage and high risk of sexually transmitted infection. Late presentation coupled with a large proportion of post-menopausal clientele suggests delayed health-seeking behavior most probably due to the prohibitive cost of ART. The need to streamline services offered in public fertility clinics is paramount in low-income countries grappling with scarce resources. A pragmatic approach will involve the provision of low-cost ART, while enhancing gamete donation programs through the implementation of gamete sharing policies. This will invariably bridge the unmet need and skewed access to ART in developing countries.
文摘Background: Infertility is a dramatic situation for a couple, especially in the Sub-Saharan area, known as extremely pro-natalist. Until this day infertility of tubal origin due to infection sexually transmitted, post abortum or postpartum origin is the most frequent. Worldwide we are witnessing the transition of pathologies: from infectious to non-communicable ones. Objective: To analyze the evolution of infertile couples’ profiles over time to improve management in the future. Setting: University clinic of Kinshasa and a private clinic, the Edith Medical Center. Design: A cross-sectional analytical study. Patients: A total of 4456 patients who sought care for infertility from January 1999 to December 2014 were enrolled. Main Outcome: The evolution of socio-demographic, clinical and paraclinical parameters of infertile couples over time. Results: The average age of female patients was 33.1 ± 5.7 years and it increased by 36 days every year and the male partner by 29 days per year. The average number of cigarette rods consumed decreased by 5% per year. The average intercourse frequency per week decreased by 2% every year. A fifth of patients (21.8%) were obese. And the average BMI increased by 0.04 kg/m2 per year. Tubal occlusion was the main lesion found in hysterosalpingogram and diagnostic laparoscopy. Conclusion: Patients were more and more aged and gaining weight. A part from infection which is the main cause of infertility this day;in the future, infertility care providers will be facing non-communicable diseases, namely obesity.
文摘This paper presents a case study of implementing a trauma registry in Mozambique, a low-income country with limited current trauma surveillance. An outline of the importance of trauma registries is presented followed by an evidence-based approach to building a sustainable and ethical partnership with local stakeholders.
