COMPARISON OF CARDIOVASCULAR DISEASE RISK ASSOCIATED WITH THE USE OF IMPLANON AND JADELLE CONTRACEPTIVES IMPLANTS AT A TERTIARY HEALTH INSTITUTION OF NORTH WESTERN NIGERIA

*Tunau Karima Abubakar, Umar Muhammad, Nwobodo Emmanuel Ikechukwu, Panti Abubakar Abubakar, Sulaiman Bilal and Shuaibu Yusuf

ABSTRACT

Background: Cardiovascular diseases are the leading cause of adult mortality. Abnormal lipid profiles have been associated with a major risk factor for cardiovascular disease (CVD) which is one of the most dominant causes of death in the world. Dyslipidemia contributes to the development of arthrosclerosis. Objectives: The purpose of this study is to determine baseline Castelli index in women who use Implanon and those who use Jadelle contraceptive implants. Compare the extent of cardiovascular atherosclerotic risk associated with the lipid metabolism in women using Implanon and Jadelle subdermal implants over 3 and 6 month of use and evaluate changes in Castelli 1 and 2 indices over 3 and 6 months of use in each group. Methodology: This was a prospective study of clients who desired contraception and chose any of the two subdermal implants (Implanon and Jadelle) as the method of contraception from 1st November 2015 to 30th June 2016. Venous blood samples (fasting) were taken before insertion of the implant (baseline) and at third and sixth month of insertion from each participant. The serum was analysed for lipid profile. Castelli indices I & II were calculated to determine the CVD risk. All the results were entered in to SPSS version 20 and analysed. Results: A total of 100 clients were enrolled for this study. Eighty-seven clients completed the study, 42 for Implanon and 45 for Jadelle with an overall response rate of 87%. The baseline Castelli1 indices were 4.1 mg/dl ±1.0 and 3.8 mg/dl ±0.9, Castelli2 indices were 2.6.1 mg/dl ±1.0 and 2.4 mg/dl ±0.8 for Implanon and Jadelle respectively. These values did not change to a statistically significant level over 3 and 6 months of use when compared between the two implants except in the value of castelli 2 index at 6 month of use p = 0.038. There was statistically significant increase in Castelli 2 index among the Jadelle group at 3 month of use and also at sixth month when compared with baseline ( p<0.05). The other indices were not statistically significant (p>0.05). Conclusion: The cardiovascular risk associated with the use of Implanon and Jadelle appears low, however clients on long term contraceptive implants may require close monitoring of serum lipid profile to checkmate possible occurance of cardiovascular disease risk.

Keywords: Castelli, sokoto, jadelle, implanon, contraception.