RESUMEN
INTRODUCTION: the World Health Organization (WHO) reviewed the threshold values required for the diagnosis of Gestational Diabetes Mellitus (GDM) in 2013 and the implementation of the new diagnostic criteria have been associated with increase in the prevalence of GDM in some populations. The new cohort of pregnant women that will be labeled to have GDM by the 2013 WHO diagnostic criteria but not by the 1999 WHO diagnostic criteria will pose additional burden to specialized antenatal care, though their pregnancy outcome may not warrant such care. It is thus important to first determine the effect of the implementation of these new consensus diagnostic criteria on the prevalence of GDM in our environment. METHODS: this is a prospective hospital-based study that compared the implementation of both 1999 and 2013 WHO GDM diagnostic criteria among 117 pregnant women who were initially screened with 50-gram Glucose Challenge Test (50-g GCT). Women with a positive Glucose Challenge Test (GCT) result underwent a 75-gram Oral Glucose Tolerance Test (75-g OGTT), which was used as the actual diagnostic test for GDM using both 2013 WHO and 1999 WHO diagnostic criteria. Associations between variables were tested using Chi-square, Fisher's exact and t-test as appropriate. Significance level was set at P value < 0.05. RESULTS: the prevalence rates of GDM in the study were 2.6% and 7.7% for 1999 WHO and 2013 WHO criteria respectively. Clinical characteristics were similar in women with GDM and women without GDM. The fasting component of the OGTT identified all the women with GDM. CONCLUSION: the implementation of the 2013 WHO diagnostic criteria is associated with a 2.5 to 3-fold rise in the prevalence of GDM. Selective risk-factor based screening may be clinically irrelevant with the adoption of the 2013 WHO diagnostic criteria. A minimum of fasting plasma glucose in resource poor settings can be considered to identify women with GDM since it appeared to have 100% sensitivity in our study.
Asunto(s)
Diabetes Gestacional/diagnóstico , Tamizaje Masivo/métodos , Atención Prenatal/métodos , Población Rural , Adulto , Estudios de Cohortes , Diabetes Gestacional/epidemiología , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Nigeria , Embarazo , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Organización Mundial de la Salud , Adulto JovenRESUMEN
Breast cancer is the most common female malignancy linked with high levels of morbidity and mortality in developing countries due to delayed diagnosis. This research assessed the knowledge of signs and risk factors of breast cancer and practice of self breast examination (SBE) among female nurses in a rural tertiary Hospital. Eighty-five nurses ages 20 to 60 years were sampled by simple randomization over a period of eight weeks through a self-administered semi-structured questionnaire. The analysis was done using statistical package for social science version 17. Sixteen (15.3%) nurses had adequate knowledge of breast cancer, having a relative with breast cancer (51.8%) and a woman of any age (56.5%) were recognized by majority as risk factors for breast cancer. Majority (68.2%) were not practicing monthly SBE and not confident on how to do it. This study pointed out the gaps in the knowledge and awareness of breast cancer and practice of SBE among the nurses. Opportunity should therefore be sought in various health facilities to educate nurses who are supposed to be closer to the patients.