Objective To investigate IUD-related vaginitis in IUD users at the University College Hospital Ibadan, South-western Nigeria.Methods A prospective cohort study in IUD users present with abnormal vaginal discharge at t...Objective To investigate IUD-related vaginitis in IUD users at the University College Hospital Ibadan, South-western Nigeria.Methods A prospective cohort study in IUD users present with abnormal vaginal discharge at the family planning clinic of the University College Hospital, Ibadan was conducted between lOth of October, 2008 and 31st of May 2009. High Vaginal Swabs were taken from the clients for microbiology, culture and drug sensitivity test. Diagnosis of bacterial vaginosis was made based on gram stained vaginal smear using the standard Nugents criteria. Other aetiological agents were identified either on wet preparation or culture using standard techniques. Treatment given was by the family planning nurse, as was the protocol at the family planning clinic.Results Twenty-four IUD users present at the Jamtty ptannmg ctmtc with vaginal discharge were studied. Their ages ranged 28-51 years（38.14 ± 5.9 years）, Mean parity was 4.4 ± 1.4, All the women were married and all used CuT 380A. The mean duration of lUCD use was 2.5 years only. Majority （46%） had used it for more than 3 years and most （75%） of the visits were unscheduled. All the clients complained of abnormal vaginal discharge which was copious, watery and foul smelling, or clumpy. Nine users （37.5%） complained of pruritus vulvae, 3 users （12.5%） lower abdominal pain, 1 user （4,2%） dyspareunia and vaginosis was made in 16 （66. 7%） and 1 （4.2%） dysuria. The diagnosis of bacterial vaginal candidiasis in 8 （33.3%）. Age less than 40 years, Christianity and IUD use more than 3 years were associated with a higher risk of bacterial vaginosis （OR=1.29, 1.67 and 6.6, respectively）, while women above 40 years, Muslims and women with lower educational status had a higher risk of candida-related vaginitis （OR=1.67 and 4.2, respectively）. Eight clients （33.3%） were treated for candidiasis with antifungals （3 empirically, and 5 after obtaining results of vaginal swab）, 9 （37.5%） were given oral metronidazole, 3 patients were referred to the gynaecological emergency unit on account of abdominal pain and 4 did not return for follow up.Conclusion IUD associated vaginitis is a disturbing condition causing unscheduled visits among IUD users. Bacterial vaginosis and Candidia albicans are major aetiologies in south western Nigeria Ibadan. Persistent discharge is a documented reason for discontinuation of lUD use. Periodic empirical treatment for candidiasis and bacterial vaginosis with antifungals and oral metronidazole is advocated. This may reduce the discomfort caused by IUD-related vaginitis, the risk of PID and other risks exposed to the IUD users and ensure continued use of the IUD.展开更多
Objective To determine the pattern of biosocial characteristics of the new IUD acceptors and describe their concerns. Methods This was a retrospective review of records of new IUD acceptors at the University Colleg...Objective To determine the pattern of biosocial characteristics of the new IUD acceptors and describe their concerns. Methods This was a retrospective review of records of new IUD acceptors at the University College Hospital, Ibadan, Nigeria from January to December 2007. Results The age range of subjects was 19 to 49 years with a mean of 33.5 ±% 2.4 years. The commonest source （46.0%） of clientele referral was through the health care providers -doctors and nurse/midwife. Other referral patterns were from friends/ relative （23.5%）, media -TV and radio （17.0%）, outreach programmes （7.3%）, self referral （5.2%） and others -the source was not indicated （1.2%）. Of the total participants, only 239 （56.1%） reported for follow-up visits. Majority had at least one visit; about a third had two, while others had three or four and above visits. About 43.2% of those at follow-up visits had complaints. The commonest （37.5%） complaint was menstrual irregularity. Other complaints were cramping abdominal pain （22.2%）, vaginal discharge （19.6%）, amenorrhoea （10.3%）, penile discomfort during sexual intercourse （4.3%）, expulsion of IUD （3.8%） and 2.2% of missing IUD. Conclusion This audit shows that new IUD acceptors are largely referred by health care providers and are mainly offered the TCu380A version. Community outreach programmes as alternative strategy is likely to boost the uptake of this particular method in Nigeria.展开更多
文摘Objective To investigate IUD-related vaginitis in IUD users at the University College Hospital Ibadan, South-western Nigeria.Methods A prospective cohort study in IUD users present with abnormal vaginal discharge at the family planning clinic of the University College Hospital, Ibadan was conducted between lOth of October, 2008 and 31st of May 2009. High Vaginal Swabs were taken from the clients for microbiology, culture and drug sensitivity test. Diagnosis of bacterial vaginosis was made based on gram stained vaginal smear using the standard Nugents criteria. Other aetiological agents were identified either on wet preparation or culture using standard techniques. Treatment given was by the family planning nurse, as was the protocol at the family planning clinic.Results Twenty-four IUD users present at the Jamtty ptannmg ctmtc with vaginal discharge were studied. Their ages ranged 28-51 years（38.14 ± 5.9 years）, Mean parity was 4.4 ± 1.4, All the women were married and all used CuT 380A. The mean duration of lUCD use was 2.5 years only. Majority （46%） had used it for more than 3 years and most （75%） of the visits were unscheduled. All the clients complained of abnormal vaginal discharge which was copious, watery and foul smelling, or clumpy. Nine users （37.5%） complained of pruritus vulvae, 3 users （12.5%） lower abdominal pain, 1 user （4,2%） dyspareunia and vaginosis was made in 16 （66. 7%） and 1 （4.2%） dysuria. The diagnosis of bacterial vaginal candidiasis in 8 （33.3%）. Age less than 40 years, Christianity and IUD use more than 3 years were associated with a higher risk of bacterial vaginosis （OR=1.29, 1.67 and 6.6, respectively）, while women above 40 years, Muslims and women with lower educational status had a higher risk of candida-related vaginitis （OR=1.67 and 4.2, respectively）. Eight clients （33.3%） were treated for candidiasis with antifungals （3 empirically, and 5 after obtaining results of vaginal swab）, 9 （37.5%） were given oral metronidazole, 3 patients were referred to the gynaecological emergency unit on account of abdominal pain and 4 did not return for follow up.Conclusion IUD associated vaginitis is a disturbing condition causing unscheduled visits among IUD users. Bacterial vaginosis and Candidia albicans are major aetiologies in south western Nigeria Ibadan. Persistent discharge is a documented reason for discontinuation of lUD use. Periodic empirical treatment for candidiasis and bacterial vaginosis with antifungals and oral metronidazole is advocated. This may reduce the discomfort caused by IUD-related vaginitis, the risk of PID and other risks exposed to the IUD users and ensure continued use of the IUD.
文摘Objective To determine the pattern of biosocial characteristics of the new IUD acceptors and describe their concerns. Methods This was a retrospective review of records of new IUD acceptors at the University College Hospital, Ibadan, Nigeria from January to December 2007. Results The age range of subjects was 19 to 49 years with a mean of 33.5 ±% 2.4 years. The commonest source （46.0%） of clientele referral was through the health care providers -doctors and nurse/midwife. Other referral patterns were from friends/ relative （23.5%）, media -TV and radio （17.0%）, outreach programmes （7.3%）, self referral （5.2%） and others -the source was not indicated （1.2%）. Of the total participants, only 239 （56.1%） reported for follow-up visits. Majority had at least one visit; about a third had two, while others had three or four and above visits. About 43.2% of those at follow-up visits had complaints. The commonest （37.5%） complaint was menstrual irregularity. Other complaints were cramping abdominal pain （22.2%）, vaginal discharge （19.6%）, amenorrhoea （10.3%）, penile discomfort during sexual intercourse （4.3%）, expulsion of IUD （3.8%） and 2.2% of missing IUD. Conclusion This audit shows that new IUD acceptors are largely referred by health care providers and are mainly offered the TCu380A version. Community outreach programmes as alternative strategy is likely to boost the uptake of this particular method in Nigeria.
