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  Citation statistics : Table of Contents
   2016| July-December  | Volume 18 | Issue 2  
    Online since October 13, 2016

 
 
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ORIGINAL ARTICLES
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
DOI:10.4103/2276-7096.192237  
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.
  4 3,896 353
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
DOI:10.4103/2276-7096.192212  
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.
  2 5,643 1,596
Occupational exposure to blood and body fluids among primary health-care workers in Kaduna State, Nigeria
Awawu Grace Nmadu, Kabir Sabitu, Istifanus Anekoson Joshua
July-December 2016, 18(2):79-85
DOI:10.4103/2276-7096.192223  
Background: Primary Health-Care Workers (PHCWs) are at a high risk of contracting blood-borne infections due to their occupational exposure to blood and body fluids (BBFs). The aim of this study is to determine the frequency of occupational exposures and associated factors contributing to the exposure to BBFs. We also evaluated the post-exposure practices among PHCWs in Kaduna State. Materials and Methods: A cross-sectional study was carried out from September 26 to October 7, 2011. One hundred and seventy-two PHCWs were included in the study using a multistage sampling technique. A structured questionnaire was used to obtain the data on sociodemographic characteristics, occupational exposures to BBFs and post-exposure practices of PHCWs. Data were analyzed using SPSS version 20.0 statistical software, and descriptive, bivariate, and multiple logistic regression analyses were performed. The level of significance was set at P ≤ 0.05. Results: One hundred and seventeen (68%) PHCWs had been exposed to BBF during their professional practice, of which 53.5% and 38.4% were needlestick and blood splash exposures, respectively. Needlestick and blood splash exposures 3 months prior to the survey occurred in 27.2% and 53.0% of them, respectively. The most common causes of needlestick injuries were during disposal of needles (44.0%) and administration of injections (28.0%). The majority of the respondents (79.8%) failed to report the exposure incidents. Only 8% of the respondents preformed the desirable post-exposure action of washing the exposure site immediately with soap and water. Primary health care workers < 40 years of age had significantly lesser odds of exposure compared to those aged 40 years and above (adjusted odds ratio = 0.18, P = 0.02). Conclusion: The high rate of occupational exposure to BBFs among health-care workers reveals an urgent need to raise awareness and to provide periodic training in infection prevention.
  1 2,256 284
Retrospective evaluation of prospective blood donor deferral in a tertiary hospital-based blood bank in South-East Nigeria
C John Aneke, U Theodora Ezeh, A Gloria Nwosu, E Chika Anumba
July-December 2016, 18(2):103-107
DOI:10.4103/2276-7096.192241  
Background: Blood transfusion safety is vital to improving the quality of health-care delivery, particularly in developing countries. An efficient donor deferral system is critical to blood transfusion service because it ensures the safety of both prospective donors and recipients. Objective: We sought to determine the pattern of prospective blood donor deferral with a view to understanding the dynamics of blood donor sourcing in a tertiary hospital-based blood bank in South-Eastern Nigeria in this study. Subjects and Methods: The blood donor records from the blood transfusion unit of our hospital from April 2014 to September 2015 were analyzed in retrospect. Screening results for transfusion transmissible infections, hemoglobin concentration, and information on the donor selection of the blood bank were retrieved from the blood bank records. Data were analyzed using the Statistical Package for Social Sciences version 20.0 (SPSS Inc., Chicago, IL, USA) computer software. Descriptive statistics were employed to represent the distribution of donor characteristics as means (΁ standard deviation) and percentages. Results: A total of 5249 individuals presented for donation within the study period with an overall donor deferral rate of 32.50%; out of which 29.24% were temporarily deferred while 3.26% were deferred permanently. The most common reason for temporal deferral was low hemoglobin concentration (25.30%), while positivity for hepatitis B virus (1.71%) was the most common reason for permanent deferral. Conclusion: Low hemoglobin concentration is responsible for the majority of prospective donor deferral in our population which may reflect the burden of anemia in the general population.
  1 1,224 160
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
DOI:10.4103/2276-7096.188533  
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.
  1 3,195 3,302
A comparison of referrals among primary health-care workers in urban and rural local government areas in North-Western Nigeria
Sunday Asuke, Muhammed Sani Ibrahim, Kabir Sabitu, Agnes Uregwu Asuke, Isaac Ileren Igbaver, Sunday Joseph
July-December 2016, 18(2):93-97
DOI:10.4103/2276-7096.192233  
Introduction: In Nigeria, the three tiers of health-care service are linked through the referral system and primary health care (PHCs) are an entry point into this health-care service. Effectiveness of referral system is a strong determinant of the strength of health-care service delivery. This study was conducted to assess and compare knowledge and practice of referral among PHC workers in urban and rural health facilities in two local government areas (LGAs) in Kaduna State. Methodology: The study was comparative cross-sectional. It enrolled all eligible PHC workers in the study areas; seventy in urban and 69 in rural LGAs. Data were collected using a structured interviewer-administered questionnaire containing close-ended questions. Results: Majority of the health workers in both LGAs were in the age range 25-34 years. Only 16 (22.9%) of those in urban and 13 (21.0%) in rural PHCs had good knowledge of referral (P = 0.594). In addition, only 9 (12.9%) in urban and 7 (11.3%) in rural PHCs had good practice of referral (P = 0.595). Conclusion: Knowledge and practice of referral were poor in both urban and rural PHCs. There is an urgent need for training on referral and other forms of intervention such as instituting a referral focal person to improve practice of referral among the health workers in both rural and urban PHCs.
  1 3,373 243
CASE REPORTS
Is this eosinophilic meningitis in a Nigerian child?
Rasheedat Mobolaji Ibraheem, Damilola Modupe Oladele, Salihu Sheni Mohammed, Aishat Ahmed Gobir
July-December 2016, 18(2):113-115
DOI:10.4103/2276-7096.192245  
Meningitis is a dreaded disease entity with a clinical course and prognosis that is dependent on its etiology, which is an important source of concern in ensuring proper management. The frequently implicated etiologic agents are bacterial and less often viral; however, rare causes requiring a different management approach may also masquerade as these common causes as is seen in eosinophilic meningitis (EoM). Against this background, the case of a Nigerian male child with suspected helminth-induced EoM, management approach, and outcome is described.
  - 831 85
Iatrogenic femoral artery pseudoaneurysm complicating vascular access for haemodialysis in a patient with end-stage renal disease; unexpected occurrence after a common procedure
Chimezie Godswill Okwuonu, Odigie Ojeh-Oziegbe, Oluwaseyi Adejumo, Ikponmwosa Iyawe
July-December 2016, 18(2):116-118
DOI:10.4103/2276-7096.192246  
Pseudoaneurysm is a collection of blood formed as a result of a vascular injury and retained in the tissues surrounding the vessel breached. There is a complete rupture through the three walls of the artery: The intima, media, and adventitia are compromised. In the femoral region, the escaping blood pools as a well-circumscribed mass and is constrained by the surrounding soft tissues. Pseudoaneurysms can develop following penetrating trauma or arterial catheterization. It can uncommonly complicate procedures in the femoral region. Ultrasound-guided compression repair, minimally invasive percutaneous treatments, and surgical repair are the three therapeutic options. We present a 58-year-old woman with end-stage renal disease who developed a pseudoaneurysm of the femoral artery caused by inadvertent puncture of the artery in an attempt to catheterize the femoral vein for an emergency hemodialysis. The pseudoaneurysm was treated by ultrasound-guided compression. It is important to recognize the indications for surgery to avoid delay in the management of this potentially limb- or life-threatening condition.
  - 1,073 117
ORIGINAL ARTICLES
Cancellations of elective surgical procedures performed at a Teaching Hospital in North-West Nigeria
Auwal Umar Gajida, Idris Usman Takai, Yahaya Nadiya Nuhu
July-December 2016, 18(2):108-112
DOI:10.4103/2276-7096.192244  
Background: Cancellation of cases on the scheduled day of surgery leads to inefficient utilization of operating theater space, waste of valuable workforce, and scarce resources for patients and hospitals. Objectives: The objective of this study is to determine the prevalence and reasons for cancellations of elective surgical procedures done at Aminu Kano Teaching Hospital, Kano. Materials and Methods: A retrospective cross-sectional descriptive study was undertaken by reviewing the list of all patients whose names appeared on the routine elective surgical operation lists in the Surgical Departments of the hospital, from January to September 2012. The list of those whose surgeries were cancelled was compiled. A sample of 200 cases (determined using appropriate formula, n = z 2 pq/d 2 ) were selected by stratified sampling technique with proportionate allocation. The demographic data, diagnosis, specialty of surgery, proposed surgery, and reasons for cancellation were extracted and analyzed. Results: A total of 2355 cases were booked for elective surgeries during the study. Out the 200 sample selected for the study, 97 were cancelled for various reasons giving a cancellation rate of 48.5%. Overall, Obstetrics and Gynecology accounted for the highest number of cases booked 27.5% (55 out of 200) and cancelled 27.8% (27 out of 97); and had the highest cancellation rate of 49.1% (27 out of 55). The most common reason for the cancellation was a patient factor (60.8%) arising from patient absconding from surgery for personal reasons not communicated to the surgeons, and lack of funds to pay for surgery. Conclusion: The prevalence of cancellation of elective cases on the scheduled day of surgery is still high in our hospital. Most of the causes of the cancellations are due to patient-related factors which are preventable and avoidable. Avoidance of unnecessary cancellations of cases is an important way of ensuring efficient utilization of scarce resources. Adequate counseling before, during, and after elective surgical procedures in our setting is highly recommended.
  - 1,317 134
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
DOI:10.4103/2276-7096.192230  
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.
  - 8,801 648
Safety of subarachnoid block for elective cesarean delivery in women with major degree placenta previa
Bassey E Edem, Ajen S Anzaku, Stephen D Ngwan, Michael E Efu, Ada J Opita
July-December 2016, 18(2):68-72
DOI:10.4103/2276-7096.188532  
Background: Placenta previa is a serious complication of pregnancy, often causing antepartum hemorrhage with significant fetomaternal morbidity and mortality. The ideal anesthetic technique for cesarean section is controversial because of associated complications. The study aimed at ascertaining the safety of subarachnoid block among women with major degree placenta delivered by elective cesarean section. Materials and Methods: This was a prospective analysis of 11 parturients of the American Society of Anesthesiologists Class I/II with major degree placenta previa billed for elective cesarean section, who desired and consented for spinal anesthesia over a 32-month period. Spinal anesthesia was induced with 10 mg heavy bupivacaine plus 0.5 mg morphine sulfate after a 2-L infusion of normal saline. The surgeon incised the uterus only after 10 IU of intravenous oxytocin was given. Data collected included pre- and post-operative packed cell volume (PCV), mean arterial pressure (MAP), pulse rate, peripheral oxygen saturation, estimated blood loss (EBL), and Apgar scores. The data were analyzed using SPSS version 21 for Windows; with statistical significance set at P < 0.05. Results: The mean preoperative PCV was 33.6 ± 3.5% and pulse rate was 99.3 ± 8.5/min while MAP was 97.9 ± 9.9 mmHg. Mean EBL was 918.2 ± 499.6 ml. Apgar scores at 1 and 5 min were 8.8 ± 1.2 and 10.00, respectively. There was no statistical significance between pre- and post-operative parameters: Pulse rate 95.71 ± 14.07/min (P = 0.96), MAP 95.7 ± 12.13 (P = 0.70), and PCV 30.3 ± 3.9 (P = 0.32). Ten parturients (90.9%) had spinal hypotension. There was no maternal or fetal death. Conclusion: Subarachnoid block is safe in women undergoing cesarean delivery for major degree placenta previa, but anticipation for hypotension is important.
  - 2,603 199
Severe maternal insulin resistance in pregnancy: An independent predictor of fetal macrosomia
Lucius Chidiebere Imoh, Obasola O Ogunkeye, Christian O Isichei, Amos A Gadzama, Collins John, Amaka Ngozi Ocheke
July-December 2016, 18(2):73-78
DOI:10.4103/2276-7096.188531  
Objective: Macrosomia is associated with increased maternal and fetal complications in obstetric practice. Gestational diabetes mellitus (GDM), maternal obesity, insulin resistance (IR), and other variables such as maternal age and gestational age at delivery may influence neonatal birth weight. It is not clear if a severe degree of IR in pregnancy is an independent risk factor for macrosomia. We therefore investigated the association between IR and macrosomia independent of GDM and other confounding factors. Materials and Methods: We measured the insulin sensitivity index (Matsuda index) in 118 pregnant women during a 75-g oral glucose tolerance test at 24-32 weeks of gestation. The birth weights of their neonates were measured at delivery. Multiple logistic regression was use to assess the association between IR and macrosomia after controlling for confounders GDM and other confounding factors. Results: Twenty-four women (20.3%) were classified under IR, 20 women (16.9%) and 62 women (52.5%) had GDM and obesity, respectively. Eleven women (9.3%) had macrosomic babies. Although the fasting insulin and 2-h insulin were higher in women with macrosomic babies compared to the normal weight babies, the observed difference was not significant (P > 0.05). The Matsuda index was significantly lower among women with macrosomic babies. Severe IR (odds ratio [OR] [95% confidence interval (CI)] = 9.3 [2.4-35.1]) and GDM (OR [95% CI] = 12.7 [3.3-49.2]) were significantly associated with macrosomia. After adjusting for the confounding variables, IR remained significantly associated with macrosomia (adjusted OR [95% CI] = 10.0 [1.6-64.4]). Conclusion: IR is an independent risk factor for macrosomia, and its assessment during pregnancy should form a basis for categorizing women at risk of macrosomia.
  - 2,048 155
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