Predictive value of the number of oocytes retrieved at ultrasound-directed follicular aspiration with regard to fertilization rates and pregnancy outcome in intracytoplasmic sperm injection treatment cycles

OBJECTIVE: To determine the number of oocytes sufficient for satisfactory fertilization and pregnancy rates in intracytoplasmic sperm injection cycles. DESIGN: A retrospective analysis. SETTING: A private assisted conception unit. PATIENT(S): Women in whom at least one oocyte was retrieved in consecutive ultrasound-directed follicular aspirations between June 1999 and June 2001. INTERVENTION(S): Standard protocol for pituitary down-regulation and ovarian stimulation. MAIN OUTCOME MEASURE(S): Number of oocytes retrieved, embryos transferred, fertilization, and pregnancy rates. RESULT(S): The numbers of oocytes obtained per cycle were classified into groups A, B, C, and D, consisting of 110, 124, 96, and 122 cycles, with 1-5, 6-10, 11-15, >15 oocytes retrieved from each patient in each group, respectively. The chance of not obtaining a viable oocyte for injection was highest in group A (5.5%). Most fertilization failures occurred in group A (11.8%). Total cleavage failure occurred in the greatest percentage of cycles in group A (3.6%) with a significantly lower mean number of embryos (1.9 +/- 1.7) being transferred. The clinical pregnancy rate was also lowest in group A (7.1%) compared with groups B (25.8%), C (20.8%), and D (23.8%). CONCLUSION(S): Retrieval of between 6 and 10 oocytes per patient and transfer of a maximum of three cleavage-stage embryos results in high pregnancy rates.     

Correlates of HIV Knowledge and Sexual Risk Behaviors Among Female Military Personnel

Uniformed services personnel are at an increased risk of HIV infection. We examined the HIV/AIDS knowledge and sexual risk behaviors among female military personnel to determine the correlates of HIV risk behaviors in this population. The study used a cross-sectional design to examine HIV/AIDS knowledge and sexual risk behaviors in a sample of 346 females drawn from two military cantonments in Southwestern Nigeria. Data was collected between 2006 and 2008. Using bivariate analysis and multivariate logistic regression, HIV/AIDS knowledge and sexual behaviors were described in relation to socio-demographic characteristics of the participants. Multivariate logistic regression analysis revealed that level of education and knowing someone infected with HIV/AIDS were significant (P < 0.05) predictors of HIV knowledge in this sample. HIV prevention self-efficacy was significantly (P < 0.05) predicted by annual income and race/ethnicity. Condom use attitudes were also significantly (P < 0.05) associated with number of children, annual income, and number of sexual partners. Data indicates the importance of incorporating these predictor variables into intervention designs.     

Autologous blood transfusion--a review

The discovery of HIV and other transfusion-transmissible infections has increased the demand for alternatives to allogeneic blood transfusion. One such alternative is autologous transfusion. This review presents an analysis of autologous transfusion. We conclude that autologous transfusion should form part of a strategy to minimise the risk associated with allogeneic transfusion in Nigeria and other developing countries.     

Effectiveness of a video-based motivational skills-building HIV risk-reduction intervention for female military personnel

Anecdotal evidence suggests that the HIV/AIDS prevalence rates in several African armed forces are high, with gender inequality rendering female military personnel more vulnerable to the disease. The objective of this study was to replicate a successful videotape-based HIV prevention intervention among Nigerian female military personnel in an effort to establish the cross-cultural stability, feasibility and cost-effectiveness of this approach in resource-limited countries. Enlisted women (N346) were recruited from two cantonments in Southwestern Nigeria and randomly assigned to either (a) a 5-session video-based, small group, cognitive-behavioral, HIV prevention intervention, or (b) a 5-session, video-based, contact-matched, HIV education control condition. Participants provided self-report of their HIV/AIDS-related knowledge and sexual behaviors at baseline, 3 and 6 months after completing the intervention. The results indicate that the motivational skills-building intervention did not improve participants' knowledge of HIV/AIDS any better than did the HIV education control condition at each assessment period, but it significantly increased condom use among women in this group by 53.6% at 3-month follow-up. HIV preventive behaviors among women in the motivational skills-building intervention group improved significantly, being 2 and 3 times more, compared to women in the HIV education control group at 3-month and 6-month follow-up assessments. The intervention also significantly improved behavioral intentions of participants as well as reduced alcohol use before sex by 25%, after 3 months; and number of sexual partners by 12% after 6 months. Women in the intervention group were five times more likely than women in HIV education control group to suggest that their new male partners use condom. These findings indicate that a videotape-based, HIV prevention intervention is a feasible and effective approach to HIV prevention among female military personnel from sub-Saharan Africa.     

The prevalence of Plasmodia parasitaemia among donors in the Niger delta of Nigeria

Giemsa-stained blood films from 1018 consecutively recruited blood donors was examined quantitatively for plasmodium species to determine the prevalence of transfusion-transmissible malaria among blood donors. The overall prevalence rate was 104 (10.2%). Infection rate was highest among donors aged 10-19 years (16.7%) and was significantly higher among commercially remunerated donors (17.8%) compared with family replacement donors (4.8%) (chi(2) = 45.19; P < 0.001). Pre-donation mean haemoglobin value was significantly lower among malaria-parasitized donors and commercial donors (12.3+/-0.30 and 12.63+/-0.57 g/dL) compared with non-parasitized and family replacement donors (13.5+/-1.01 and 13.9+/-0.96 g/dL) (chi(2) = 143.88; P = 0.001) and (chi(2) = 392.7; P = 0.001), respectively. This study confirms a high prevalence of transfusion-transmissible malaria among blood donors and lays bare the need to routinely treat transfusion recipient with anti-malaria as a prophylactic measure.     

Factors Associated with the Process of Adaptation Among Pakistani Adolescent Females Living in United States

This study explored post-migration experiences of recently migrated Pakistani Muslim adolescent females residing in the United States. In-depth, semi-structured interviews were conducted with thirty Pakistani Muslim adolescent females between the ages of 15 and 18 years living with their families in Houston, Texas. Data obtained from the interviews were evaluated using discourse analysis to identify major reoccurring themes. Participants discussed factors associated with the process of adaptation to the American culture. The results revealed that the main factors associated with adaptation process included positive motivation for migration, family bonding, social support networks, inter-familial communication, aspiration of adolescents to learn other cultures, availability of English-as-second-language programs, participation in community rebuilding activities, and faith practices, English proficiency, peer pressure, and inter-generational conflicts. This study provided much needed information on factors associated with adaptation process of Pakistani Muslim adolescent females in the United States. The results have important implications for improving the adaptation process of this group and offer potential directions for intervention and counseling services.     

Modeling Covariates of Self-Perceived and Epidemiologic Notions of Risk for Acquiring STIs/HIV among Military Personnel: A Comparative Analysis

This study examined the socio-demographic and selected behavioral characteristics associated with self-perceived and epidemiologic notions of risk for acquiring STIs/HIV infection using data from a cross-sectional survey involving 346 consenting female military personnel from two cantonments in Southwestern Nigeria. Findings revealed significant discordance in participants’ risk status based on the two assessment methods, with Kappa coefficients ranging from ?0.021 to 0.115. Using epidemiologic assessment as the “gold standard”, 45.4% of the study population were able to accurately assess their risk levels through self-perception with significant (P < 0.01) socio-demographic variations. Multivariate logistic regression analyses indicate that STIs/HIV risk models using both self-perceived and epidemiologic notions of risk were significantly determined by different set of covariates. It is recommended that STIs/HIV prevention intervention should integrate the identified covariates and be targeted at changing individual risk behaviors and perceptions, as well as the social contexts in which risky behaviors occur in the military population.     

HIV Infection in Long-Distance Truck Drivers in a Low Income Setting in the Niger Delta of Nigeria

The aim of this study was to determine the seroprevalence, and correlates of HIV infection among long-distance truck drivers in Port Harcourt, Nigeria. A total of one hundred (100) long-distance truck drivers aged between 21 and 60 years and mean age of 42.36 ± 5.23 years were screened for the presence of HIV antibodies. The results showed that, out of the total number screened 10 (10%) were positive for HIV while 90 (90%) were negative. The prevalence of HIV was significantly higher in the 31–40 years age group 6/26 (23%) compared to 1/13 (7.6%) in the 21–30 years age group and 2/37 (7.4%) in the 51–60 years age group (P = 0.04).The lowest prevalence of HIV occurred in the 41–50 years age group 1/24 (4.2%). HIV 1 was the predominant viral subtype among the subjects 9 (90%) while 1 (10%) had HIV-2. None of the HIV-positive subjects had dual HIV 1 and 2 infections. The mean CD4 lymphocyte count for subjects positive for HIV was 380 ± 68.0 (range 312–448 cells/μl) while CD4 count for HIV negative subjects was 780 ± 76 cells/μl (range 704–856 cells/μl. A significant negative correlation was observed between HIV positivity and CD4 count r = −0.010 (P = 0.01). It is recommended that intensive preventive measures be instituted coupled with the implementation of a vigorous enlightenment campaign targeting behavioral change from high risk culture among truckers. Efforts are urgently needed to provide access to sexual health education, treatment services and HIV testing facilities to reduce their vulnerability to HIV infection.