Infertility: an approach to management in a district hospital in Ghana.
Identifieur interne : 000866 ( PubMed/Checkpoint ); précédent : 000865; suivant : 000867Infertility: an approach to management in a district hospital in Ghana.
Auteurs : A. Fiander [Ghana]Source :
- Tropical doctor [ 0049-4755 ] ; 1990.
Descripteurs français
- KwdFr :
- MESH :
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- MESH :
- geographic : Ghana.
- diagnosis : Infertility, Female.
- therapy : Infertility, Female.
- Clinical Protocols, Female, Hospitals, District, Humans, Outpatient Clinics, Hospital.
DOI: 10.1177/004947559002000302
PubMed: 2219439
Affiliations:
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pubmed:2219439Le document en format XML
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Fiander</name><affiliation wicri:level="1"><nlm:affiliation>Bawku Hospital, Upper East Region, Ghana.</nlm:affiliation><country xml:lang="fr">Ghana</country><wicri:regionArea>Bawku Hospital, Upper East Region</wicri:regionArea><wicri:noRegion>Upper East Region</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1990">1990</date><idno type="RBID">pubmed:2219439</idno><idno type="pmid">2219439</idno><idno type="doi">10.1177/004947559002000302</idno><idno type="wicri:Area/PubMed/Corpus">000740</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000740</idno><idno type="wicri:Area/PubMed/Curation">000740</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000740</idno><idno type="wicri:Area/PubMed/Checkpoint">000740</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000740</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Infertility: an approach to management in a district hospital in Ghana.</title><author><name sortKey="Fiander, A" sort="Fiander, A" uniqKey="Fiander A" first="A" last="Fiander">A. Fiander</name><affiliation wicri:level="1"><nlm:affiliation>Bawku Hospital, Upper East Region, Ghana.</nlm:affiliation><country xml:lang="fr">Ghana</country><wicri:regionArea>Bawku Hospital, Upper East Region</wicri:regionArea><wicri:noRegion>Upper East Region</wicri:noRegion></affiliation></author></analytic><series><title level="j">Tropical doctor</title><idno type="ISSN">0049-4755</idno><imprint><date when="1990" type="published">1990</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Clinical Protocols</term><term>Female</term><term>Ghana</term><term>Hospitals, District</term><term>Humans</term><term>Infertility, Female (diagnosis)</term><term>Infertility, Female (therapy)</term><term>Outpatient Clinics, Hospital</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Femelle</term><term>Ghana</term><term>Humains</term><term>Hôpitaux de district (USA)</term><term>Infertilité féminine ()</term><term>Infertilité féminine (diagnostic)</term><term>Protocoles cliniques</term><term>Services de consultations externes des hôpitaux</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Ghana</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Infertility, Female</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infertilité féminine</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Infertility, Female</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Clinical Protocols</term><term>Female</term><term>Hospitals, District</term><term>Humans</term><term>Outpatient Clinics, Hospital</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Femelle</term><term>Ghana</term><term>Humains</term><term>Hôpitaux de district (USA)</term><term>Infertilité féminine</term><term>Protocoles cliniques</term><term>Services de consultations externes des hôpitaux</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Ghana</term></keywords></textClass></profileDesc></teiHeader></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">2219439</PMID><DateCreated><Year>1990</Year><Month>11</Month><Day>16</Day></DateCreated><DateCompleted><Year>1990</Year><Month>11</Month><Day>16</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>14</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0049-4755</ISSN><JournalIssue CitedMedium="Print"><Volume>20</Volume><Issue>3</Issue><PubDate><Year>1990</Year><Month>Jul</Month></PubDate></JournalIssue><Title>Tropical doctor</Title><ISOAbbreviation>Trop Doct</ISOAbbreviation></Journal><ArticleTitle>Infertility: an approach to management in a district hospital in Ghana.</ArticleTitle><Pagination><MedlinePgn>98-100</MedlinePgn></Pagination><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Fiander</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Bawku Hospital, Upper East Region, Ghana.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Trop Doct</MedlineTA><NlmUniqueID>1301706</NlmUniqueID><ISSNLinking>0049-4755</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CitationSubset>J</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Trop Doct. 1991 Jan;21(1):36-7</RefSource><PMID Version="1">1750865</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D002985" MajorTopicYN="N">Clinical Protocols</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005869" MajorTopicYN="N" Type="Geographic">Ghana</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006767" MajorTopicYN="N">Hospitals, District</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007247" MajorTopicYN="N">Infertility, Female</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010044" MajorTopicYN="N">Outpatient Clinics, Hospital</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="CPFH">27180cr990</OtherID><OtherID Source="POP">00195546</OtherID><OtherAbstract Type="PIP" Language="eng"><AbstractText>Up to 1/3 of women of child bearing age are infertile in certain African areas. Over 1000 patients registered at Bawku Hospital, Upper East Region, Ghana during an 18-month period, where a scheme for the investigation and treatment of infertile patients was established. The 5 main causes of infertility are: 1) tubal damage; 2) male factor; 3) anovulation; 4) uterine factor; and 5) unexplained. Special clinics are set up for infertility; outpatient staff are recruited. A preprinted questionnaire should be used for a uniform approach. The one used in Bawku is shown in the appendix. Health talks should be given. They should use the local language be at the right level, and use visual aids. In large clinics, numbers should be used to insure a 1st come, 1st served basis. A treatment protocol is important. When the patient 1st walks in, the infertility form is completed; appropriate investigations are done--hemoglobin, VDRL, seminal analysis, and cervical or high vagina swabs, and others--and the results are reviewed. The patient is encouraged to keep a menstrual calendar for 3 months. At the 2nd visit, the menstrual calendar is reviewed. A pelvic examination and a tubal patency test (TPT) are done. At the 3rd visit, abdominal and pelvic examinations are done and a TPT. Then patients can be diagnosed and counselled accordingly. At the last visit, further explanation is given, further TPTs are done if necessary, and anovulation is treated with clomiphene. The visits are spread out over 6 months. In unexplained fertility cases, the couple is told there is nothing wrong, they should keep trying. The idea that the man may be causing the infertility is foreign to many communities. This needs changing. 20% of infertility is due to male factor in Bawku. Male infertility is hard to cure. Cultural considerations prevent the clinician from telling the patient that her partner is infertile. They will tell her that there is nothing wrong with her. Approximately 15% become pregnant. The clinic has a strong psychological component.</AbstractText></OtherAbstract><KeywordList Owner="PIP"><Keyword MajorTopicYN="N">Africa</Keyword><Keyword MajorTopicYN="N">Africa South Of The Sahara</Keyword><Keyword MajorTopicYN="Y">Anovulation--complications</Keyword><Keyword MajorTopicYN="Y">Attitude--men</Keyword><Keyword MajorTopicYN="N">Behavior</Keyword><Keyword MajorTopicYN="N">Biology</Keyword><Keyword MajorTopicYN="N">Clinic Activities</Keyword><Keyword MajorTopicYN="Y">Clomiphene--therapeutic use</Keyword><Keyword MajorTopicYN="Y">Counseling</Keyword><Keyword MajorTopicYN="N">Delivery Of Health Care</Keyword><Keyword MajorTopicYN="N">Developing Countries</Keyword><Keyword MajorTopicYN="N">English Speaking Africa</Keyword><Keyword MajorTopicYN="N">Fallopian Tubes</Keyword><Keyword MajorTopicYN="N">Family Planning</Keyword><Keyword MajorTopicYN="N">Fertility Agents</Keyword><Keyword MajorTopicYN="N">Genitalia</Keyword><Keyword MajorTopicYN="N">Genitalia, Female</Keyword><Keyword MajorTopicYN="N">Ghana</Keyword><Keyword MajorTopicYN="N">Health</Keyword><Keyword MajorTopicYN="N">Health Facilities</Keyword><Keyword MajorTopicYN="Y">Hospitals</Keyword><Keyword MajorTopicYN="Y">Infertility--etiology</Keyword><Keyword MajorTopicYN="Y">Male Role</Keyword><Keyword MajorTopicYN="N">Organization And Administration</Keyword><Keyword MajorTopicYN="Y">Outpatient Clinic</Keyword><Keyword MajorTopicYN="N">Ovarian Effects</Keyword><Keyword MajorTopicYN="N">Ovary</Keyword><Keyword MajorTopicYN="N">Physiology</Keyword><Keyword MajorTopicYN="N">Program Activities</Keyword><Keyword MajorTopicYN="N">Programs</Keyword><Keyword MajorTopicYN="Y">Psychological Factors</Keyword><Keyword MajorTopicYN="N">Reproduction</Keyword><Keyword MajorTopicYN="N">Reproductive Control Agents</Keyword><Keyword MajorTopicYN="N">Social Behavior</Keyword><Keyword MajorTopicYN="Y">Summary Report</Keyword><Keyword MajorTopicYN="Y">Treatment</Keyword><Keyword MajorTopicYN="Y">Tubal Effects--complications</Keyword><Keyword MajorTopicYN="N">Urogenital System</Keyword><Keyword MajorTopicYN="Y">Uterine Effects--complications</Keyword><Keyword MajorTopicYN="N">Uterus</Keyword><Keyword MajorTopicYN="N">Western Africa</Keyword></KeywordList><GeneralNote Owner="PIP">TJ: TROPICAL DOCTOR.</GeneralNote></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1990</Year><Month>7</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1990</Year><Month>7</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1990</Year><Month>7</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">2219439</ArticleId><ArticleId IdType="doi">10.1177/004947559002000302</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Ghana</li></country></list><tree><country name="Ghana"><noRegion><name sortKey="Fiander, A" sort="Fiander, A" uniqKey="Fiander A" first="A" last="Fiander">A. 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