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Spontaneous abortions (miscarriages): Analysis of cases at a tertiary center in North Central Nigeria
Abiodun S Adeniran, Adegboyega A Fawole, Ishaq F Abdul, Kikelomo T Adesina
January-June 2015, 17(1):22-26
Background: Spontaneous abortion (miscarriage) is a source of pregnancy loss globally. Its management, especially in low resource countries remains hampered by inadequate facilities for evaluation. Objectives: To assess the clinical presentation, diagnosis, and treatment of cases of spontaneous abortion at a tertiary hospital in Ilorin, Nigeria. Methodology: A descriptive study of all spontaneous abortions (miscarriages) managed at the University of Ilorin Teaching Hospital, Ilorin, Nigeria between January 1, 2007 and December 31, 2011. The records were retrieved from the medical records department and necessary information retrieved. Results: There were 603 miscarriages with a prevalence of 4.2%; incomplete miscarriage was the most common 254 (42.1%), 356 (59.0%) had no identifiable risk factor; 434 (72%) of the women were <35 years; 361 (59.9%) had first trimester miscarriages, 272 (45.1%) were of low parity (Para 0-1) and 223 (37%) were having a repeat miscarriage. Of the 141 managed for threatened miscarriage, pregnancy was salvaged in 90 (63.8%), 244 (40.5%) had surgical evacuation with 100% success rate while 218 (36.2%) had medical management with 90.8% success rate. The mean duration of admission was shortest with surgical management (2.03 ΁ 1.1 days) and post-abortion infection rate was 11 (2.6%). Histology confirmed product of conception in 98% and molar gestation in 2% of the samples; no mortality was recorded in this study. Conclusion: More than half of women with miscarriages had no identifiable risk factors mainly due to limitation in facilities for evaluation; there is a need to improve facilities for investigating women with spontaneous abortions in developing countries to identify the causes of the losses.
  6,987 775 2
Prevalence, perceptions, consequences, and determinants of induced abortion among students of the Kaduna State University, Northwestern Nigeria
Adegboyega Omoniyi Oyefabi, Awawu G Nmadu, Muhammed S Yusuf
July-December 2016, 18(2):86-92
Background: Induced abortion contributes significantly to maternal mortality in developing countries. Abortion has not been liberalized in Nigeria, and various studies have reported the high prevalence of unsafe abortion in countries where induced abortion has been restricted. The aim of this study was to determine the prevalence, perceptions, determinants, and consequences of induced abortion among the Kaduna State University students. Materials and Methods: This cross-sectional study was conducted among 540 undergraduate students of the University selectedby three faculties from the University main campus through the simple random sampling technique (balloting). Result: The mean age ofthe respondents was 21 ΁ 2 years. Some (14.4%) of the respondents affirmed that abortion should be legalized in every part of the world, while 32.4% believed that a pregnant woman should be free to make decision to have abortion. About 51.7% opined that people should not discriminate against women who chose to have abortion. The prevalence of premarital sex and induced abortion was 8.38% and 6.7%, respectively. There was a signifi cant relationship between the age, religion, faculty, and academic level of the respondents and the incidence of induced abortion (P < 0.05). The most common postabortal complication was vaginal bleeding. Conclusion: This study shows that the respondents had varied perceptions about induced abortion, which influence its prevalence among this population. The demand for pregnant women to be free to make decision to have an abortion without being discriminated against is also high among the respondents. There is a need for improved sexual health education and availability of contraceptive services for the students in this University.
  6,933 581 -
Self-medication among rural residents in Lagos, Nigeria
Modupe B Ayanwale, Ifeoma P Okafor, Oluwakemi O Odukoya
January-June 2017, 19(1):65-71
Background: Self-medication is becoming an increasingly important component of healthcare in both developing and developed countries and has the potential to do good as well as cause harm. The prevalence of irresponsible self-medication is high all over the world. This study aimed to assess self-medication among rural residents in Lagos, Nigeria. Materials and Methods: This cross-sectional study was conducted in Ijede community, Ikorodu Local Government Area of Lagos state, Southwest Nigeria. A multistage sampling method was used to select 337 adult respondents. Data were collected using a structured, interviewer-administered questionnaire. Results: Majority (315, 93.5%) of the respondents had good knowledge about self-medication; 334 (94.1%) had a positive attitude against the use of self-medication; and 311 (92.3%) practiced self-medication. There was no association between the respondents’ overall knowledge and their practice of self-medication. The practice of self-medication was significantly higher among respondents with the highest level of education (odds ratio 4.3, confidence interval 1.3–14.3). Conclusions: Majority of the respondents had good knowledge about self-medication and a positive attitude against the practice. Despite the high level of education and the awareness of side effects, majority of them still practiced self-medication. There should be an increase in awareness and continuous education in the community regarding the importance of professional consultation before drug use, the implications of irresponsible self-medication, and the place of responsible self-medication.
  6,438 354 -
Lassa fever in Nigeria: Insights into seroprevalence and risk factors in rural Edo State: A pilot study
Ekaete Alice Tobin, Danny Asogun, Nosa Akpede, Donatus Adomeh, Ikponwonsa Odia, Stephan Gunther
July-December 2015, 17(2):51-55
Background: The study aimed to assess the prevalence of risk factors and Lassa seroprevalence in Esan West local government area of Edo State. Methodology: One hundred and sixty-six respondents from 50 households were interviewed using structured questionnaires on prevalence of risk factors for Lassa virus exposure, household heads provided information on household risk factors. Determination of Lassa virus specific antibodies immunoglobulin (Ig) in the blood was by an Enzyme-linked immunosorbent assay technique. Analysis was performed with Statistical Package for Social Sciences (SPSS) version 16. (SPSS Inc, Chicago, IL, USA). Results: Rodents were seen in 49 (96.1%) houses in the previous 6 months, garri was eaten as a soaked meal by 97 (58.4%) respondents. IgM was found in 2 (1.3%) samples, and IgG, in 103 (58.2%). Negative IgG sero status was significantly associated with age <20 years (P < 0.00) and marital status as single (P < 0.00). Conclusion: There is a need for health education to improve food hygiene practices and reduce practices that promote rodent contact with humans.
  3,007 3,698 2
Does docosahexaenoic acid play a role in infant malnutrition in the children of Fulani nomads in Northern Nigeria?
Robert H Glew, Dorothy J VanderJagt
July-December 2013, 15(2):69-75
Malnutrition is a major contributor to the death of children under 5 years of age in sub-Saharan Africa. Furthermore, poor nutrition causes stunting and underweight in infants and children while at the same time putting at risk normal neurologic and cognitive development. A recent study of rural Fulani infants up to age 2 years in northern Nigeria found that more than one-quarter were stunted and underweight. The nutritional status of these infants was relatively sound at birth but progressively declined over the following 2 years. While insufficient dietary macronutrients such as protein and carbohydrate and micronutrients such as iodine, zinc, vitamin A and iron may well have contributed to their post-natal growth retardation, in this report we raise the possibility that inadequate intake of essential long-chain ω-3 fatty acids, docosahexaenoic acid (DHA) in particular, by infants during the first few years of life may play a role in childhood malnutrition in this part of the world, especially in populations like the Fulani pastoralists who live far-removed from the ocean which would otherwise provide access to DHA-rich seafood. We conclude this piece by suggesting several approaches for improving the DHA status of pregnant and lactating Fulani women and their offspring in Nigeria.
  3,042 3,233 4
Prevalence and correlates of obesity and overweight in healthcare workers at a tertiary hospital
Musa Dankyau, Joy Adeyinka Shu'aibu, Ayodele Emmanuel Oyebanji, Oluwatobi Victoria Mamven
July-December 2016, 18(2):55-59
Background: Obesity and overweight are increasing consequences for the health system. Previous studies suggest that prevalence and correlates might be different in health workers compared to the general population. This study aims to determine prevalence and correlates of obesity and overweight. Subjects and Methods: A cross-sectional study involving health workers at a 250-bed, urban, faith-based tertiary hospital in North-Central Nigeria consisting of 320 eligible full-time employees. Results: Response rate was 68.8%. Most respondents were female (66.4%), young (mean age 41.6 ± 9.88), and married (70.5%); had tertiary education (61.8%), mean duration of employment 11.3 ± 9.79 years, and median duration of employment 7.0 years (range 0-37); and were mainly (55.9%) health service providers. Mean body mass index (BMI) was 26.6 ± 4.85 kg/m 2 . Males had lower BMI compared to females (23.8 ± 3.43 kg/m 2 vs. 28.1 ± 4.83 kg/m 2 , P < 0.0001, odds ratio [OR] 4.3, 95% confidence interval [CI] 3.1-5.6). Overall, 63.4% (23.2% obese, 31.4% overweight) were overweight or obese and 60% had abdominal obesity. Females had higher mean waist circumference than males (92.1 ± 11.8 cm vs. 83.0 ± 9.8 cm, P = 0.016, OR 9.1, 95% CI 6.0-12.3). Female staff (OR 4.9, 95% CI 2.6-9.2) and married staff (OR 2.5, 95% CI 1.3-4.9) were more likely to be obese or overweight. Conclusions: The prevalence of obesity, overweight, and abdominal obesity was high. Females and married status were associated with overweight and obesity. This calls for workplace interventions to address causes of overweight and obesity in health workers.
  2,875 2,997 1
Sexual behavior and risk factors for HIV infection among young people aged 15-24 years in North-Central Nigeria
Patricia Aladi Agaba, Rahila Makai, Clement T Bankat, Phillipe R Chebu, Temi Apena, Ochanya Iyaji-Paul, John A Idoko
July-December 2016, 18(2):60-67
Background: Young people continue to account for the majority of new HIV infections in Sub-Saharan Africa, yet a few studies focus on this group. We assessed sexual behavior, determined HIV prevalence infection, and explored risk factors for infection among young persons in Jos, Nigeria. Methodology: This cross-sectional survey involved young people aged 15-24 years in Plateau State, Nigeria. Sociodemographic and sexual history was obtained. HIV counseling and testing was provided in accordance with national guidelines. Logistic regression was used to assess independent risk factors for HIV infection. Results: Out of 4302 participants, 2032 (47.7%) were females, with a mean age of 19 ± 2 years, with males being older than females (P < 0.001). The mean age at sexual debut was 17 ± 2 years for females and 16 ± 3 years for males (P = 0.03). Three hundred and twelve (14%) males and 132 (6.5%) females had multiple sexual partners (P < 0.001). Majority (74.0%) had unprotected sex at their most recent sexual encounter. Seventy-eight (1.8%) participants were HIV-positive, out of which 75 were females (96.1%). Risk factors for HIV infection were female sex (adjusted odds ratio [aOR]: 53.47, confidence interval [CI]: 12.94-220.88), older age group (aOR: 5.37, CI: 2.68-10.77), residence in an urban area (aOR: 2.40, CI: 1.31-4.41), multiple sexual partners (aOR: 2.38, CI: 1.24-4.54), and being in a polygamous marriage (aOR: 3.31, CI: 1.17-9.32). Conclusion: HIV prevention efforts in Nigeria need to focus on girls in the late adolescence who reside in urban areas and have multiple sexual partners, either by choice or in marriage setting, and equip them with skills to negotiate safe sex with their partners.
  4,406 1,373 2
Factors related to the uptake of contraceptive in a rural community in Plateau State Nigeria: A cross-sectional community study
Hadiza Abigail Agbo, Chikaike Ogbonna, Basil N Okeahialam
July-December 2013, 15(2):107-112
Background: Contraceptive widely known in most rural setting as family planning is the planning of when to have children and the use of birth control and other techniques to implement such plans. Socio-cultural status is a determinant of health; it also has an influence on women's knowledge and uptake of contraceptive, the study therefore assessed the family planning uptake rate, prevalence of family planning method and the relationship between the social status and the method used. Methodology: A cross-sectional community survey was conducted among women of reproductive age residing in the community. Epi info version 3.4.3 and statistical package for the social sciences version 16.0 were used for the data entry and analysis respectively. Results: Out of the 362 females studied, (85.4%) were married and (46.4%) had no formal education. Farming was their predominant occupation. Out of all the females respondents; (86.7%) have had deliveries out of which (42.2%) are multiparous and (44.6%) grand multiparous. Contraceptive use was found to be (18.0%); and the most used was injectables (58.5%). A statistically significant association (P = 0.001) was established between contraceptive use and age, religion and marital status. Conclusion: Although contraception use was generally poor among the rural women in the studied community; married women, Christians and younger women were more likely to use a method compared to singles, Muslims and the older women respectively.
  5,166 497 3
Knowledge, Sources of information, and Risk Factors for Sexually Transmitted Infections among Secondary School Youth in Zaria, Northern Nigeria
Alhaji A Aliyu, Tukur Dahiru, Awwal M Ladan, Adamu U Shehu, Aisha A Abubakar, Adegboyega M Oyefabi, Shamsudeen S Yahaya
July-December 2013, 15(2):102-106
Background: Sexually transmitted infections (STIs) are responsible for a variety of health problems especially among the youth who engage in risky sexual behavior. There are few studies that describe STIs among the youths in Northern Nigeria. The objective of the study was to assess knowledge of STIs and risk factors among secondary school youth. Materials and Methods: This was a cross-sectional study in which structured, self-administered questionnaire was used to collect data on socio-demographics, knowledge on STIs, and risk factors. Three senior secondary schools were purposively selected for the study. Results: A total of 1765 youths aged 10-30 years with mean age of 16.9 ± 2.0 years participated in the study. 1371 (77.7%) and 394 (22.3%) were respectively Muslim and Christian. Mean age at first sexual intercourse was 16.7 ± 2.0 years. A majority (67.6%) of them heard about STIs; sources of information of STIs were school lessons 23.6%, mass media 23.3%, and health magazines 19.2%, respectively. Generally, knowledge on STIs was good as 75.4% of respondents knew how the disease is transmitted. This knowledge was significantly associated with class of student, place of treatment, and religious teaching (χ2 = 9.6, P = 0.047, χ2 = 22.1, P = 0.035 and 42.6, P = 0.001, respectively). Mean knowledge score was 0.698 ± 0.01. A majority of respondents were engaged in risky sexual behavior as only 16.2% use condom as a preventive measure. Eleven percent reported ever having an STI in the past and majority (52.8%) go to government hospital for treatment of acquired STI. 56% of the youth had two or more boy/girl friends and 30% had sexual relationships. Conclusion: It was concluded that secondary school youth had good knowledge about STIs; however, the opposite is true when it comes to preventive practice (use of condom). Interventions such as periodic publicity awareness and school seminars focusing on STI preventions are needed to control the disease among the youth.
  5,171 486 2
Pattern of neonatal admissions and outcome in a tertiary institution in north central Nigeria
Bose O Toma, Olukemi O Ige, Ibrahim I Abok, Carol Onwuanaku, Rose O Abah, Amina Donli
July-December 2013, 15(2):121-125
Background/Purpose: Neonatal morbidity and mortality contributes significantly to under-five morbidity and mortality in sub-Saharan Africa accounting for 40% of under-five mortality. A substantial reduction in neonatal mortality is therefore necessary to achieve the Millennium Development Goal (MDG) 4 target by 2015. The aim of the study was to assess the pattern of neonatal morbidity and mortality in our environment which will help to identify interventions for better neonatal outcome. Materials and Methods: The study is a review of cases admitted into the neonatal unit of the Jos University Teaching Hospital situated in the North Central part of Nigeria. The unit started operating from the permanent site of the hospital on 1 March 2010 after the relocation of the hospital from the previous site. Data on all neonates admitted into the neonatal unit from 1 March 2010 to 28 February 2011 were obtained from the various registers/records and analyzed. Data extracted included biodata, gestational age, birth weight, main diagnosis, duration of admission, etc., In addition, the outcomes (discharged/died) were documented. All statistical analyses were performed using two-sided tests. A P < 0.05 was considered statistically significant. Results: A total of 572 neonates were admitted, accounting for 54.6% of the 1047 pediatric medical admissions into the hospital. The main causes of admission were neonatal infections (37.1%), prematurity (20.1%), and birth asphyxia (11.5%). Out of the 572 neonates, 111 (19.4%) died. About three quarters (76.5%) of the mortalities occurred in the first week of life with 46.4% of these occurring in the first 24 hours (χ2 -20.2, P < 0.001). The common causes of mortality were prematurity (43.2%), , birth asphyxia (18.0%) and neonatal infections (17.1%) Conclusion: There is a high burden for neonatal care at the institution. The three main causes of morbidity and mortality are prematurity, infections, and birth asphyxia. Hence, neonatal care/facilities need to be improved especially to care for the high risk neonate. Also, the importance of infection control cannot be overemphasized.
  5,222 385 1
Cardiothoracic ratio and body mass index in normal young adult Nigerians
John E Ekedigwe, Stephen D Pam, Peter O Binitie, Anil U Sirisena, Mohammed Hameed, Emmanuel O Adegbe
July-December 2014, 16(2):47-51
Background: Interest is growing in the value of the cardiothoracic ratio in clinical evaluation of patients, and the factors that influence its relevance. This study attempts to explore the normal values of the cardiothoracic ratio and asses its relation to the body mass index (BMI), height weight and age, of normal young Nigerians in a highland plateau area of Nigeria. Methodology: In this prospective study, a total of 100, standard posterior-anterior chest radiographs taken from normal adult Nigerians (41 females and 59 males) in Jos environment were reviewed. From the Chest radiographs, the cardiac diameters (CDs) were measured at the widest point of the cardiac silhouette. The thoracic diameter (TD) was taken at the costophrenic insertion of the diaphragm. Using these data the cardiothoracic ratio (CTR) was computed. Body index was calculated based on the formula Weight (Kg)/Height 2 (m 2 (Kgm -²) while CTR was determined by dividing the CD by the TD. Degree of correlation was assessed for all the parameters and analysis was made for regression and correlation coefficients using SPSS statistical package. Results: The age range of all subjects was from 17 years to 44 years with a mean age of 24.93 ± 7.42 years. The mean age for the males was 25.59 ± 7.04 years and for the females 23.98 ± 7.92 years. The average cardiothoracic ratio in males was 0.46 ± 0.04 while in females it was 0.457 ± 0.042 showing a slightly higher but not significant CTR in males at the P = 0.05 significance level. The mean BMI for males and females were 26.94 ± 3.97 (Kgm -²) and 28.94 ± 5.26 (Kgm -²) respectively. The averageCD, TD, for males and females were 1.7 ± 0.039 m, 12.86 ± 1.22 cm, 27.88 ± 1.82 cm, and 1.5 ± 0.057 cm, 11.7 ± 1.19 cm, 25.65 ± 1.85, respectively. Conclusion: The CTR did not correlate strongly with the BMI.
  2,817 2,731 1
Giant lipoma of the right gluteal region
Olakulehin Olawale Adebayo, Babalola Oladimeji Ranti, Akanbi Olusola Olateju
July-December 2013, 15(2):168-170
Lipomas are the most common benign mesenchymal tumors and can arise in any location where fat is found. They could present as a tiny swelling or as an enormous mass in a body region. When they are more than 10 cm in their widest dimension or greater than 1 kg in weight, they are called giant lipomas. Giant lipomas have been described in the thigh, shoulder and trunk. We present a case of a giant gluteal lipoma in a 62-year-old woman seen in our out-patient clinic.
  4,873 217 1
A survey of commercial drivers' perception on the causes of road traffic accidents in Nigeria
Nwashindi Arthur
January-June 2015, 17(1):12-15
Background: Road traffic accident is a multifactorial phenomenon that affects victims to different degrees depending on the type of accident. The aim of this study was to study commercial driver's attitude and their perceived causes of accidents on Nigerian roads. Methodology: A cross-sectional study of commercial drivers from various motor parks in a Nigerian urban city was carried out using questionnaires. Every volunteer was asked to complete a questionnaire that revealed patient demographics, age, education level, time of accident and perceived cause(s) of the accident. All participants were males and licensed drivers. Results : Drivers in the age range of 38 - 47 years (n = 174; 46.77%) were mostly involved in road traffic accidents. Road accidents were much more prevalent on rural roads than on urban roads. Majority of the drivers (n = 198; 53%) had secondary level of education, while 112 drivers (30%) had primary level of education. One hundred and eight drivers (29.03%) believed the accidents were as a result of the road. 21.24% (79) stated that the time of the day, which could be in the daylight, dusk or at night, could influence road traffic accidents. Conclusions : The drivers perceived that the nature of the road, time and weather are some of the major contributory factors to road accidents. However, it was deduced from the study  that behavioral patterns on the road, violation of traffic rules and driving under the influence of alcohol were the major contributory factors in commercial drivers' involvement in vehicular accidents.
  4,527 490 -
Distribution of ABO, Rh D blood groups and hemoglobin phenotypes among pregnant women attending a Tertiary Hospital in Yola, Nigeria
Jessy Thomas Medugu, Usman Abjah, Idris Abdullahi Nasir, Simeon Adegoke, Emmanuel Etim Asuquo
January-June 2016, 18(1):38-42
Background: Attempts being made to unravel the relationship between blood antigens, hemoglobin (Hb) genotypes and increased susceptibility to certain diseases are ongoing. Objective: The study was carried out to provide data on the distribution of ABO, Rh D, and Hb variants among pregnant women receiving antenatal care at Federal Medical Centre, Yola, Nigeria. Materials and Methods: Medical records of these subjects (n = 2226) were sorted out and analyzed according to their ABO blood group phenotypes and Hb variants. Results: Blood group O was the most prevalent (47.7%) among our subjects, followed by A (26.6%), B (22.2%), and AB (3.5%). The Rh D antigen was positive in 97.1% and negative in 2.9% of the study population. There were five Hb genotypes AA (81.94%), AC (0.34%), AS (17.57%), SC (0.05%), and SS (0.14%). The occurrence of different ABO, Rh D blood groups and Hb variants varied significantly (P < 0.05) among pregnant women studied. Conclusion: The frequency of ABO and Rh D blood groups will assist in the formulation of genetic counseling policies.
  4,233 277 -
Evaluating the knowledge of sickle cell disease and hemoglobin electrophoretic pattern among people living in Sekondi-Takoradi Metropolis, Ghana
Verner N Orish, Onyekachi S Onyeabor, Adekunle O Sanyaolu, Nnaemeka C Iriemenam
July-December 2014, 16(2):56-60
Background: Sickle cell disease (SCD) is an inherited lifelong hemolytic disorder affecting many children in sub-Saharan Africa, especially in West and Central Africa. There is a limited public health education on SCD in Ghana with only two information centers in Accra and Kumasi, respectively. Methodology: This cross-sectional study evaluated the knowledge of SCD among people living in Sekondi-Takoradi metropolis. Churches, saloons, internet cafes and bus stations were randomly selected in the center of the city with proximity to the central market. Results: A total of 621 individuals were recruited, 52.5% (326) had knowledge of their hemoglobin (Hb) electrophoretic pattern while 47.5% (295) had none. In addition, 93.4% individuals had knowledge of SCD while 6.6% had no knowledge of SCD. Older individuals exhibited better knowledge of their Hb electrophoretic pattern than the younger ones (P = 0.019). Individuals with tertiary education and married couples exhibited higher knowledge of SCD when compared to their counterparts (P < 0.001). Conclusion: Despite the relatively high knowledge of SCD and Hb electrophoretic pattern observed in this study, it is very important to increase neonatal screenings and health care services to the region. In addition, more emphasis is needed to increase public awareness of SCD especially in schools, churches, hospitals and the media.
  3,640 817 1
How relevant is pre-gastrointestinal endoscopy screening for HBV and HIV infections?
Adegboyega Akere, Jesse A Otegbayo, Samuel O Ola
January-June 2015, 17(1):1-3
Aim: To determine the prevalence of HBV and HIV infections among patients referred for gastrointestinal (GI) endoscopy and evaluate the need for prescreening of patients prior to this procedure. Settings and Design: Retrospective study carried out in a teaching hospital. Methodology: The data of 772 patients referred for GI endoscopy were retrospectively reviewed, but the screening results of only 711 patients were available for review. Statistical Analysis Used: SPSS version 7. Results: The 772 patients, consisted of 420 (54.4%) males and 352 (45.6%) females with a mean age of 50.4 ± 16.5 years (range 10-100). Of the 711 patients with screening results, 574 (80.7%) had UGI endoscopy, while 137 (19.3%) had Colonoscopy. It showed that 82 (11.5%) had HBV and 26 (3.7%) had HIV, while 8 (1.1%) patients had co-infection. Conclusion: The high prevalence of HBV and HIV infections observed calls for high level precaution to prevent transmission of these infections to other patients and health care personnel.
  3,641 224 -
Effect of primary health care workers training on the knowledge and utilization of intermittent preventive therapy for malaria in pregnancy in Zaria, Nigeria
Adegboyega M Oyefabi, Mohammed N Sambo, Kabir Sabitu
January-June 2015, 17(1):4-11
Introduction: Malaria in pregnancy (MIP) is one of the leading causes of maternal deaths and adverse pregnancy outcomes in Nigeria. All pregnant women in the country are at risk of MIP. Since 2001, intermittent preventive therapy (IPTp) using pyrimethamine sulfadoxinewas recommended by the World Health Organization as a strategy for prevention of MIP. Nigeria adopted this policy in 2005. This study was carried out to determine the effects of training primary health care workers on the utilization of IPTp among pregnant women who attend antenatal clinics in Sabon-Gari local government area (LGA) of Kaduna State, Nigeria. Methodology: Using quasi-experimental pre and post study design. Two LGAs were sampled, SabonGari the intervention LGA and Zaria LGA as the control. One hundred and seventy clients each from the 6 Primary Health Care Centers (PHCs) in Sabon-Gari, the study and 5 PHCs in Zaria LGA, the control were selected. Semi-structured, Pre-tested questionnaires and focused group discussion (FGD) guides were used as an instrument of data collection from the clients' pre- and post-intervention. Data were analyzed with SPSS 17 and STATA 12SE. Relationships between variables were tested using χ2 at P < 0.05 level of significance. Results: Majority of the clients aged 20-24 years, were married, Hausa Muslims Intermittent preventive therapy had mainly primary education, and earn < 5000/month. During the baseline assessment at the PHCs in Sabon-Gari LGAs, only 20 (11.8%) of the clients had good knowledge of the IPTp. This however increased significantly to 144 (87.4%) clients post intervention (mks 11.12 ± 1.99 P < 0.001). A significant majority of the clients in Zaria still had poor knowledge of the IPTp post study (mean knowledge score = 3.86 ± 2.50, P < 0.001). The poor practice in Zaria also persisted even after the study period, but with a significant decrease from 160 (94.12%) to 142 clients (83.53%), with the mean practice score in Zaria being 2.62 ± 1.72, P < 0.001). More clients (68%) use IPTp - sulfadoxine pyrimethamine at the study LGA postintervention. Conclusion: This research has demonstrated significant improvement in the knowledge and utilization of the IPTp by the clients in the study LGA when the health care workers were trained compared with where such training was not conducted, in the control LGA.
  3,545 309 -
A case of severe falciparum malaria presenting with hyperglycemia
Yatendra Singh, Subhash C. Joshi, Vivekanand Satyawali, Abhisek Gupta
January-June 2014, 16(1):39-41
Malaria remains a major cause of morbidity and mortality world-wide. World-wide more than 100 countries are endemic, but mainly in African and south East Asian region. We report a case of an uncommon presentation of Plasmodium falciparum infection in a 50-year-old male patient who presented with hyperglycemia and multiple organ dysfunction syndrome. Reports of unusual presentations of malaria are few and cases of severe malaria with hyperglycemia are rarely described. As hyperglycemia is associated to most severe malaria and high mortality, our aim is to draw the attention of the physicians on this entity.
  3,497 265 -
Reference values of CD4 T-lymphocytes in human immunodeficiency virus-exposed uninfected infants in Kano-Nigeria
Isyaku Umar Yarube, Mudassar Ahmad, Umar Muhammad Lawan
July-December 2013, 15(2):86-90
Background: CD4 T-lymphocyte count has been known to be affected by several factors including ethnic group, region, age, sex and physiological conditions. Studies to evaluate CD4 count in vertically exposed, but human immunodeficiency virus (HIV) negative infants from this region have not been done previously. The aim of this study was to determine the reference values of CD4 counts, percentages and temporal profile in vertically exposed HIV negative infants residing in this environment. Methodology: Blood samples were auto-analyzed using hematology machine made by Point Care Technologies, Inc. (Marlborough, MA, USA). All data were analyzed using statistical package for the social sciences 15.0 for Windows™. Median and 10 th and 90 th percentiles of CD4 cells were determined and analyzed using Mann-Whitney U test and Kendall's non-parametric correlations. P ≤0.05 values were considered to be significant. Results: The values of CD4 counts in the infants studied were higher compared with adults. The values of CD4 count, %CD4 and their normal ranges were statistically the same for male and female sexes and within all age categories under 1 year. Although absolute CD4 cell count remained fairly constant from birth to the age of 1 year, %CD4 decreased gradually from birth toward the age of one. Conclusions: For the first time in this environment, our study has reported absolute and percentage CD4 count, which were similar to those reported from other African studies. The results support the use of the same reference values for resident male and female infants for clinical decision making.
  3,478 273 -
Hand hygiene practices among doctors in a tertiary health facility in southern Nigeria
Vivian Ossaidiom Omuemu, Esohe O Ogboghodo, Rosemary A Opene, Phebe Oriarewo, Orezimena Onibere
July-December 2013, 15(2):96-101
Background: Hand washing is a cheap and effective method of limiting the spread of health care associated infections, but compliance has been reported to be low worldwide, especially in developing countries. Objective: To determine the knowledge and practice of hand hygiene among doctors in a tertiary health facility in southern Nigeria. Materials and Methods: This cross-sectional, descriptive study was carried out among all cadres of doctors employed by the hospital. Data were collected using a pretested, semistructured, self-administered questionnaire as well as by direct observation of a subsample of the doctors using an observational checklist. Data analysis was done using the SPSS version 16.0 statistical package and level of significance was set at P < 0.05. Results: A total of 326 doctors participated in the study and one third of these (108) were directly observed. Less than half of the respondents had good knowledge (43.9%) and good practice (48.2%) of hand hygiene. However, on direct observation, the overall compliance rate was 16.7%. Sex and specialty of the respondents were significantly associated with knowledge but not with practice of hand hygiene. The reasons mentioned for noncompliance included: Lack of hand hygiene materials like soap and water (65.0%), forgetfulness (35.0%), too busy/insufficient time (19.3%), inconvenient location of sinks (16.9%), the use of gloves (7.1%), and skin irritation from washing agents (4.6%). Conclusion: This study revealed a very low hand hygiene compliance rate among doctors in a tertiary health facility in the southern part of Nigeria and also highlighted some of the contributory factors. It is recommended that an institution-wide hand hygiene promotion campaign be embarked upon.
  3,342 383 2
Harmful effects of ascorbic acid and α-tocopherol on male reproductive organs of rats chronically exposed to sodium nitrate
Isyaku U. Yarube, Joseph O. Ayo, Muhammad Y. Fatihu
January-June 2014, 16(1):5-8
Background: Humans and animals are exposed to sodium nitrate through the air, food and drinking water. Because nitrates induce oxidative stress, the effects of antioxidant vitamins ascorbic acid and α-tocopherol on oxidative damage induced by sodium nitrate on reproductive organs of male Wistar rats were studied. Methodology: Five rats each in four groups were treated for 60 days. They received distilled water (Group I), 3 mg/100 g body weight NaNO 3 (Group II), 3 mg/100 g body weight NaNO 3 + 50 mg/100 g body weight ascorbic acid (Group III) and 3 mg/100 g body weight NaNO 3 + 30 mg/100 g body weight α-tocopherol (Group IV). Live weights of the animals were obtained at the beginning of the experiment and every 2 weeks subsequently. At the end of the study, the left testis, epididymis and seminal vesicle of each rat was carefully removed and weighed. These organs were also examined for histopathological lesions. Results: Testis:body weight ratio and seminal vesicle:body weight ratio of Group II animals were less than (P < 0.05) those of the control. Epididymis:body weight and seminal vesicle:body weight ratios of Group III animals were significantly lower than those of Group II. Testis:body weight ratio of Group IV animals was significantly less than that of Group II. There was testicular degeneration with absence of spermatids and spermatogenic cells in the semeniferous tubules and absence of epididymal sperm reserve in Group IV animals. Conclusions: The results indicate that intake of ascorbic acid and α-tocopherol may enhance oxidative damage in the testis, epididymis and seminal vesicle during chronic sodium nitrate exposure.
  3,425 233 -
Pattern of cervical dysplasia among women of reproductive age in Zaria, Northern Nigeria
Solomon Avidime, Saad A Ahmed, Adekunle Oguntayo, Teni O Abu, James A Ndako
July-December 2014, 16(2):52-55
Background : Cervical cancer is a preventable and the most common female genital tract cancer despite the availability of screening services for precancerous lesions of the cervix. This study aims to determine the prevalence of cervical dysplasia in women of reproductive age in Zaria. Methodology: A prospective study of 131 women of child bearing age attending the family planning and Gynaecology clinics in Ahmadu Bello University Teaching Hospital, Zaria - Nigeria were recruited for the study after obtaining their consent. Cervical samples were collected and subjected to pap staining and cytological examination by a pathologist and classified using the Bethesda System. The data were processed using Statistical Package for the Social Sciences (SPSS) version 17. Bivariate analysis was done and the level of significance was set at a P < 0.05. Results: Cervical dysplasia prevalence of 7.0% was found out of which High Grade Squamous Intraepithelial Lesion (HSIL) was 2.3% (n = 3), Low Grade Squamous Intraepithelial Lesion (LSIL) was 3.1% (n = 4) and Atypical Squamous Cells of Undetermined Significance (ASC-US) was 1.6% (n = 2). There were 13% (n = 17) inflammatory features. Normal cytological features for Pap smear testing was present in 77.1% (n = 101). Conclusion: These findings underscore the importance of routine screening and early treatment of cervical dysplasia in order to reduce morbidity and mortality associated with cervical cancer.
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Management of Graves' disease during pregnancy in developing countries: A report of two cases and a review of the literature
Kennedy I. Akhuemokhan, Reuben A. Eifediyi
January-June 2014, 16(1):35-38
Grave's disease account for about 85% of hyperthyroidism during pregnancy. If not properly managed, it can result in severe maternal, fetal and neonatal morbidity and mortality. Anti-thyroid drugs are the main treatment for Grave's disease during pregnancy. The lowest possible dose should be used to maintain maternal free thyroxine levels at or just above the upper limit of the normal non-pregnant normal range. Fetal thyroid function depends on the balance between the trans-placental passage of thyroid-stimulating maternal antibodies and thyroid-inhibiting anti-thyroid drugs. In developing countries where propylthiouracil is either expensive or not available the use of carbimazole at lower doses is safe. Two cases are here presented to buttress this view.
  3,203 271 -
Socio-demographic determinants of birth registration among mothers in an urban community in southern Nigeria
Alphonsus R Isara, Antony O Atimati
January-June 2015, 17(1):16-21
Background: Birth registration is both a fundamental human right and an essential means of protecting a child's right to identity. Objective: The aim was to assess the awareness, knowledge and practice of birth registration by mothers and the socio-demographic determinants of birth registration in an urban community in southern Nigeria. Methodology: A community-based descriptive cross-sectional study was carried out among mothers in an urban community in Ovia North East local government area of Edo State, Nigeria. A structured interviewer administered questionnaire was used for data collection. Data were analyzed using SPSS version 20. Results: Awareness of birth registration was high (69.6%) with mass media as the major source of information (60.5%), but the composite knowledge of it was poor. Awareness of the agency responsible for birth registration was poor. Only 44.2% of the respondents registered the births of their children, two-thirds of those who registered births possess a birth certificate. Marital status and level of education were significantly associated with the knowledge of birth registration. Age, level of education, marital status, occupation, and place of delivery were the determinants of the practice of birth registration. Conclusion: There is a need for a change of strategy in the campaign for birth registration so that awareness can translate into better knowledge and practice. We advocate the establishment of community-based birth registration centers to improve accessibility and practice of birth registration.
  2,945 460 4
Isolation and polymerase chain reaction detection of virulence invA gene in Salmonella spp. from poultry farms in Jos, Nigeria
Joseph Aje Anejo-Okopi, Samson Ejiji Isa, Onyemocho Audu, Idowu O Fagbamila, Jacob Chire Iornenge, Ifeanyi Stella Smith
July-December 2016, 18(2):98-102
Background: Salmonella serovars are one of the most common food-borne pathogens, and poultry consumption is responsible for the majority of routes of infection worldwide. There is a paucity of documented data regarding the prevalence of virulence determinant genes in Salmonella serovars in Nigeria. The aim of the study was to isolate Salmonella spp. in selected poultry farms in Jos Metropolis, Plateau State, Nigeria. Methodology: A total of eighty samples were conveniently collected from 18 commercial poultry. The samples were from poultry droppings, egg shells, workers' hands, and feeds. The samples were examined for the presence of Salmonella by standard microbiological techniques. The isolates were phenotypically confirmed using biochemical characterization and virulence gene determined by polymerase chain reaction (PCR). Results: The overall isolation percentage of Salmonella species was 28.75% (23/80). DNA extraction was carried out on the isolated 23 Salmonella isolates and 11 successfully quantified. Of the 11 isolates, ten (91.0%) successfully amplified using the invA gene-specific primers by PCR method. The result indicates the presence of Salmonella in poultry farms, and this posed a major concern for public health. Conclusion: The result showed that the use of PCR amplification of virulence genes in suspected Salmonella spp. from poultry farms proved to be efficient and could serve as an alternative rapid tool for the detection of Salmonella spp. Further large studies with the use of more virulence genes are needed to understand the Salmonella epidemiology in poultry farms that serves as a major protein source of the nation.
  3,093 309 4