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15 7 regr ession was performed, t o identify the more important predictive factors. The r e s u l t s o f t h i s analysis are pr e s e nted i n TABLE 4.1 below. TABLE " . 1 PRE DICTORS OF UP PER GENIT AL TRACT I NFECT IO N : RESULTS OF MULTIVARIATE LOGISTI C REGRES S I ON ANALYS I S Factor (Variable) Pr e-delivery a naemia Parity Ethni c origin Dur a t i on o f l a bour Delivery blood los s Age group occ upa t ion Edu cation Regress ion Coefficient 0.274 - 0 . 233 - 0 .127 0 . 307 - 0 . 001 0.107 0 . 026 - 0 . 029 Standard Error 0. 169 0 .162 0 . 103 0 . 292 0.001 0 .170 0 .064 0 .096 eo eff .J S E 1 . 622 - 1.
158 A Bonf e rroni correction t e s t (ie. P-va1ue x Total no . of variables) also fa i l s t o s up port anaemia as an important predictive factor for UGTI . When the baseli ne characteristics recorded i n t h i s study are co nsidered none s o far ha ve be e n fo un d to be s t a t i sti cally associated with the occurrence of postpartum UGTI in the study population. POSTPARTUM ANAEMIA Compar ing t he socio-demographic characteristics o f a ge . occupation and educational levels for persons who had postpartum anaemia to those who did not have a naemia showed t hese three characteristics teo differ statistically in t he two groups of SUbjects. No difference however was not ed in t heir ethnic origins. sea-sons with anaemia tended to be you nger, and t he mean ages recorded for t hos e with p ostpa r t um anaemia and t hos e wi t h no postpartum anaemia ....as 23 .6 years (SO ± 5.5 yrsl and 25.8 years (SO ± 5 .1 yrs) respe ctivel y (p=O.OOB) . Th i s was d ue most l y to the greater propo r t ion of teenagers in t he an aemi c group. Whor e a r. teenagers were 23.4 %" o f subjects with postpartum anaemia, t he y f or med on l y 11.9% of t he not anaemic group . The RR for postpartum anaemia i n t e e nag e r s as compared to t he o l de r women was 1.66 (el 1. 20 t o 2 .29), a nd t h is risk was s tat istically significant (p",0 . 009). See APPENDI X J .
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A PROSPECTIVE STUDY OF EARLY PUERPE
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dysuria (26%). Nearly 60% of the st
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on l y greatl y enri ch ed the s ub
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5.4 De t e r mi na nt s o f morbidi
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Ta ble 2 .1 1 Di ag nos es in t rea
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CHAPTER 1 IN T RODU CTI ON As mor e
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impair mater nal health [ 13 ] . Th
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Many African countries l ike Ghan a
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Sex ratio (M/F) (1 989) 0 . 98 Rura
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growt h r ate of 2 .5% [ 21] . I t
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Sex ratio (M as a % o f F) Crude bi
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hours in t he h o s p i t ll;l. Nor
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irths ( 19 ) . Although no communit
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It i s ob vious froID. the above in
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The need for adequate puerperal car
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for )0% and 20% respectivel y (33]
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The Za r i a s t ud y ( a}, also re
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embolism coul d be classified a s a
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serious h e alth consequences becau
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o ne known pat hoge n [54] _ Candid
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a de qua t e trr ea tinerrc fo r th
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3 6 Three of the 31 bacteriuric cas
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sinc e direct bladd er s ampling h
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developing world countries have i n
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Unlike t he developed world, breast
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i n t h e puerper ium will occur i
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ED; siotomy wou nd inf ection: I n
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4' The incidence o f deep vein thro
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percent in Bali, Indonesia [37]. Th
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Pos t p a r t um Anaemia: Anaemia i
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study situat ions and ma y be up t
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wome n with caesarean deliveries (-
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deficien t , 50% f o l a t e defici
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days {178, 179] . In a study of pre
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22,774 births s t udied were 6 .1%,
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ca r d i a c failure, a ssoc iated
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of the disease in zaria has been at
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Africa. and the incidence is still
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i ncreased occu rrenC:2 of psychiat
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African studies respectively h a d
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about the i r mari t a l s tat us,
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CHAP TE R 4 M!ill!Q.!2S 4 .1 : THE
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Bearing in mind t he fact t ha t th
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- Fre e medical consultation for ..
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Examination : SUbjects wer e examin
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•• Lowe r genita l t ract i nte
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" c linica l assessment and lIlanaq
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sample cJ9scr ipt i on ; The charac
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Further mUltivariate logistic regre
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discharge s i n c e they were aa s
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104 ETHNIC ORIGINS: The majority of
Page 121: 106 ap prenticeship- trained occupa
Page 124: YES 1l6'l\ FIG. 1.4 ANTENATAL CARE
Page 129 and 130: Labour e ve nts , c omplications a
Page 131 and 132: n . OTHER IMMEDI ATE COMPL.ICATIONS
Page 133: 5 .2 : FOLLOW-UP AND MORBIDI'I'Y FI
Page 136: 5 .2 . 1 Comparinq clinic a t t e n
Page 140 and 141: 200 ,eo 100 FIG. 2.1 :HOW SUBJECTS
Page 142 and 143: FIG.2.3: THE DAY OF FEVER ONSET REP
Page 145: 13 . I n a l l 21 2 ( 59 . 1\> s Ub
Page 148 and 149: 133 sUbjects said they did. A wide
Page 151: 136 Diastolic blood pressure readin
Page 156 and 157: 141 OTHER PATHOLOGI CAL FI NDI NGS
Page 159 and 160: 144 FOLLOW-UP OUTCOMES: At the end
Page 161: 5. 3 : I NCI DENCE OF MORBI DITY 5
Page 165 and 166: 150 LOWER GENITAL TRACT I NFECTIO N
Page 167 and 168: 152 ACUTE URIN ARY TRACT I NFECTION
Page 169: 154 !i\!m.!!!Ari. : The occurrence
Page 174 and 175: 15. The s tat i stically significan
Page 176 and 177: 161 s t atistically !li gnifica nt
Page 178 and 179: 16 3 t.o de t ermi ne t hose wi th
Page 180 and 181: 165 was 280 nr (SO ± 166 ml.) and
Page 182 and 183: 1 6 7 The results o f multiva riate
Page 184 and 185: 169 The s atur a t ed rnode I of th
Page 188 and 189: CHAPTER 6 !l!SQJ.SSI ON AND RECOMME
Page 190 and 191: 175 higher ed ucation levels a nd l
Page 192: 177 a bout half of t he women who h
Page 195 and 196: 180 ranked t he i r health as satis
Page 197: 1 8 2 I nformal i nf ormat ion obta
Page 201: 1 8 6 bact eriur ia r ates often r-
Page 205 and 206: 190 lacerations or i ncisions which
Page 207 and 208: The non-infectiolIs morbid!ties : P
Page 209 and 210: 194 About 60 % of the su b j ec t.s
Page 212 and 213: 197 for preventing postpartum infec
Page 214 and 215: '" comparable to t h e high 57% rep
Page 216 and 217: 201 p ostpartum pe r Lcd and also f
Page 218 and 219: 203 bcv ev e r , a bou t 3 to 10 t
Page 220: 205 The ve ry small number of patie
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210 i n f orm ation on t he ea rly
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212 depend o n the type of mo r b i
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one d id not fUlly escape t he l i
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3 . What i s the ex tent o f pos t
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2 21 38 . Kah n AR, Jahan FA ( 1 98
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225 85 . Ph ill i p s I , ' Ba s s
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22. 122. Thacker 58, Banta HD (1982
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232 17 1. Hype r tensive di s o rde
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234 191. Cox ML ( J.963) . Incidenc
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'" 223 . Pugb TF , J erat h BK, Sch
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APPENDIZ A MAP OF GHANA AND STUDY "
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STUDY FORM A: Pa g e 2. PREGNANCY/l
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STUD Y FORM B : Page 2 IF YES, Did
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STUDY FORM B: Page 5 Bima nual Pa l
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3) Gaped wound/Delayed wound healin
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APPENDI X F R.ESULTS OF MUTI VARI A
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APPENDI X r II THE PREDICTORS OF PO
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APPENDIX L DETERMINANTS or POSTPART
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