Worldwide, there is a general lack of knowledge about medication safety during pregnancy. This problem is even greater in developing countries such as Cameroon with no epidemiological data. This PhD thesis provides data on the two arms of pharmacoepidemiological safety studies - use and risk - for anti-infectives in pregnancy. Between February and August 2015, 795 pregnant women attending 23 hospitals in SW Cameroon for antenatal (ANC) or other care were interviewed on first trimester medication use using structured questionnaires. Findings indicated that use of orthodox (73.1%) or traditional (36.9%) medications were common, with a proportion of women (28.7%) combining both. Antimalarials (33.6%) and antibiotics (20.8%) were the 3rd and 4th most commonly consumed group of orthodox medication. Sulfadoxine/pyrimethamine, contraindicated in the first trimester of pregnancy, was the most commonly used antimalarial (13%). Health unit and gestational age at ANC booking were consistent statistically significant predictors of use of different medications. In the second study, 30 congenital anomaly (CA) signals related to antibiotics use identified from the literature were tested in a case-malformed control study using the European Surveillance of Congenital Anomaly (EUROCAT) database covering 8 million births and records for 155,630 livebirths, stillbirths and terminations of pregnancy with CA. Cases were babies/fetus with CAs identified in the 30 signals, and controls were all other malformed babies/fetus. Binary logistic regression results confirmed two signals: congenital glaucoma related to general antibiotics intake (AOR2.11; CI: 1.05, 4.23); and atrioventricular septal defect related to intake of macrolides (AO2.97; CI: 1.47, 5.98). Eight new signals were generated requiring independent confirmation. The last part of this thesis combines the results from both studies to estimate the burden of CAs associated with first trimester use of antibiotics in SW Cameroon and recommends public health measures for safer use of medication in pregnancy in Cameroon.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:716360 |
| Date | January 2017 |
| Creators | Leke, Aminkeng Z. |
| Publisher | Ulster University |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
Page generated in 0.03 seconds