Research Articles in Medicine & Surgery

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Phaeochromocytoma in a 4-year old girl
(Nigerian Journal of Surgical Research, 2004-02-02) Gali Bata Mtaku; Madziga A G; Nggada H A; Hamid A U
This is a report of a 4-year old female Nigerian patient with phaeochromocytoma, a rare surgically correctable cause of hypertension, highlighting the problems in diagnosis and management in our sub region with review of the literature.
Pyomyositis in north - eastern Nigeria
(Nigerian Journal of Surgical Research, 2004-02-02) Madziga A G; Na’aya U H; Gali Bata Mtaku
Background: Pyomyositis is a suppurative disease of skeletal Muscle and a well-known disease with frequent occurrence in the tropics and subtropics, which continues to cause significant morbidity. Despite several studies of the disease in various regions of the tropics, there has been none from the northeast region of Nigeria, consisting of a largely rural population where the climate is hot and dry with little annual rainfall.Methods: A retrospective study of all patients seen and treated for pyomyositis in the University of Maiduguri Teaching Hospital from April 1990 to April 2000 was undertaken.Results: Fifty four patients with pyomyositis were seen and managed comprising 36 Males and 18 Females (M: F ratio 2:1). Two peak age incidences of 6-10 years and 31-40 years were noted. Most were from a labouring population and presented with a fully evolved disease affecting the large and powerful muscles of the thigh and calf in 59.7% of cases, the glutei in 12.9% and the trunk in 9.7%. The smaller muscles of the arm and forearm and head and neck were rarely affected. 8 patients had multiple lesions. Staphylococcus aureus was cultured in 91.8% of cases sensitive to cloxacillin, augmentin, chloramphenicol and erythromycin in that order.Conclusion: Prompt diagnosis, appropriate supportive therapy, effective antibiotic therapy and early drainage of abscesses have resulted in minimal mortality despite late presentation although hospital stay was prolonged.
Incidence of Renal Insufficiency in Cancer Patients
(Health Communications Inc, 2005-02-02) Dogan Ekrem; Izmirli Mustafa; Ceylan Kadir; Erkoc Reha; Sayarlioglu Hayriye; Begenik Huseyin; Alici Suleyman; Yil Yuzuncu
The frequency of chronic renal insufficiency among cancer patients is unclear. The aim of this study was to determine the frequency of impaired renal function within a population of cancer patients. One thousand two hundred seventeen patients (563 women, 654 men) with cancer underwent serum creatinine concentration and glomerular filtration rate (GFR) evaluations. The Cockcroft-Gault formula was used to estimate the GFR from the creatinine clearance (Clcr). Renal insufficiency was defined as a GFR ≤90 mL/min. Among this population, 72 (5.9%) demonstrated an abnormal serum creatinine concentration (>1.2 mg/dL). According to the Cockcroft-Gault formula evaluations, however, 330 (27.1%) of the patients had an estimated GFR <90 mL/min. Among these, the Clcrwas between 60 and 89 mL/min in 241 patients (19.8%); 30 and 59 mL/min in 75 patients (6.2%); and 15 and 29 mL/min in 7 patients (0.6%); 7 patients (6%) had a Clcr <15 mL/min. As a result, 21.2% of patients demonstrating a normal serum creatinine level had abnormal renal function. Renal function should be evaluated in all cancer patients, regardless of their serum creatinine level, before any drug regimen is administered. The Cockcroft-Gault formula appears to be more accurate than serum creatinine concentration for diagnosing renal insufficiency in patients with cancer, but more prospective studies in this population will be necessary to confirm this finding.
Incidence of retro-aortic left renal vein and its relationship with varicocele
(Urogenital European Radiology, 2005-02-23) Arslan Halil; Etlik Ömer; Ceylan Kadir; Temizoz Osman; Kavan Mustafa; Ceylan, K
The retro-aortic left renal vein (RLRV) is a malformation characterized by the presence of a vessel that drains the left renal blood up to the inferior vena cava crossing behind the aortic artery. Varicocele is defined as venous dilation of the pampiniform plexus, and the left side is the most commonly affected. Several theories concerning the possible aetiology of varicocele are reviewed in the literature, but RLRV was not mentioned as an aetiologic factor of varicocele. in this study we investigated the percentage of RLRVs and their relation with varicocele. A total of 1,125 contrast-enhanced abdominal CT scans was examined to identify RLRVs. RLRVs were found in nine women (1.6%) and ten men (1.7%). We performed scrotal Doppler ultrasonography (US) for all affected men except one. Varicocele of varying degrees was found in seven of the nine male patients with RLRV (77%). RLRV could be one of the aetiological factors in the development of varicocele, and the cases with RLRV should be examined by scrotal Doppler US for the presence of varicocele.
Sero-prevalence of hepatitis B surface antigen among primary school pupils in rural Hawal valley, Borno State, Nigeria
(Journal of Community Medicine and Primary Health Care, 2005-06-09) DN Bukbuk; Bassi Amos Paul; ZM Mangoro
Background and objective: Hepatitis B virus infection is a major public health problem worldwide and in Africa. In the northeastern part of Nigeria. Information on the prevalence of HBV infection in rural communities is scarce. This study was carried out to determine the sero-prevalence of hepatitis B surface antigen amongst primary school pupils in a rural setting in northeastern Nigeria. Methods: Hepatitis B surface antigen was tested for in 150 apparently healthy children in two primary schools in two rural communities situated in the Hawal valley area in Borno State, North East zone of Nigeria using an Enzyme Linked Immunosorbent Assay technique. Results: The overall sero-positivity of Hepatitis B surface antigen (HBsAg) in the pupils was 44.7% (95% C.I: 36.6 53.0). The prevalence of HBsAg was found to increase with age, rising from 40.6% in children aged 10-11 years to 75% in children aged above 13 years. The sero-prevalence is (47.2%, (95% C.I: 37.5 57.1) among males while among the females it was slightly lower 38.1 % (95 C.I: 23.6 54.4%). The differences in the HbsAg sero-prevalence by age, sex and location were not statistically significant. Conclusion: The high prevalence of HBsAg in the two primary school children provides evidence for an urgent mass immunization for children on entry to the schools.Keywords: HBs Antigenaemia, primary school pupils, rural hawal river valley, northeastern NigeriaJournal of Community Medicine and Primary Health Care 2005, 17(1): 20-23
A Clinicopathological Pattern Of Tumoral Calcinosis In Maiduguri, North Eastern Nigeria
(The Internet Journal of Third World Medicine, 2005-06-28) Gali Bata Mtaku; Nggada H; Mshelia D
Background: Tumoral calcinosis is a rare disease reported mainly among blacks of African descent with paucity literature in Africa. Aims and Objective: This study aims at reviewing the clinicopathological pattern of Tumoral calcinosis in Maiduguri Northeastern Nigeria. Methods: All histologically diagnosed cases of Tumoral calcinosis were retrieved and reviewed at the University of Maiduguri Teaching Hospital between January 1994 and December 2003. Results: There were twelve diagnosed cases of Tumoral calcinosis. All age groups were affected except the pediatrics age group. The age ranges between 15 and 70 years with a mean age of 38.5 years. There was no sex predilection. Multiple sites occurred in three patients with two recurrences. The commonest site is the hip joint and one unusual site, which is the scrotum. Surgical excision was performed on all patients with recurrences. Conclusions: Tumoral calcinosis is a rare benign lesion and most of the lesions are asymptomatic. However, morbidity may be related to the size, location and secondary infection. Early and adequate wide surgical excision is essential to avoid the morbidity and recurrence.
Virtual computed tomography cystoscopy in bladder pathologies
(International Braz J Urol, 2006-04-02) Arslan Halil; Ceylan Kadir; Harman Mustafa; Yilmaz Yuksel; Temizoz Osman; Can Saban
Assessed the usefulness of virtual cystoscopy performed with multidetector computed tomography (CT) in patients with different urinary bladder pathologies compared to the conventional cystoscopy.Eighteen patients with different bladder pathologies, which consisted of 11 tumors, 3 diverticula, 2 trabecular changes and 2 stones, were assessed with conventional cystoscopy and virtual CT cystoscopy. The results of virtual CT cystoscopy were compared with the findings of conventional cystoscopy. We determined the detection rate and positive predictive value of CT imaging based virtual cystoscopy in the diagnosis of urinary bladder lesions.CT scanning was well tolerated by all patients, and no complications occurred. Images in 16 (88%) of the 18 virtual cystoscopic examinations were either of excellent or good quality. All tumors except one, 2 trabecular changes and 2 stones were characterized with similar findings in the both of methods. The masses ranged from 0.4 to 7.0 cm in diameter. While conventional cystoscopy could not evaluate interior part of the diverticulum, virtual CT cystoscopy could demonstrate clearly within it. There were no false-positive findings in our series.Virtual CT cystoscopy is a promising technique to be used in the detection of bladder lesions. It should be considered especially at the evaluation of bladder diverticula. In the future, it may be possible or even advantageous to incorporate into the imaging algorithm for evaluation of bladder lesion.
Communities’ Awareness, Perception and Participation in the Community-Based Medical Education of the University of Maiduguri
(Taylor and Francis, 2006-07-02) Omotara, B. A.; Yahya, S. J.; Shehu, U.; Bello, H. S.; Bassi Amos Paul
Background: Community-based medical education (CBME) is no longer a new innovation in medical education since the establishment of The Network: Towards Unity for Health (The Network: TUFH) 25 years ago. The CBME of the University of Maiduguri medical college is 14 years old and has never been assessed in terms of the population it serves. The study was conducted to determine the level of awareness, perception, and participation of the communities in CBME. Methods: A cross-sectional survey was carried out in 11 village units of three Local Government Areas (LGAs) using a 14-item structured questionnaire administered to adults in randomly selected households. The questionnaire was based on guide questions used for focus group discussions held earlier with community leaders. Results: Awareness of students’ visits among respondents was 73.7%. Knowledge of the frequency of presence of the students in the communities was 72.2%. ‘‘To examine and treat’’ (33.6%) and ‘‘to ask questions’’ (16.6%) were the most prominent reasons given for the visits. The majority of respondents perceived the visits as beneficial (72.2%). More frequent visits were requested by 54.4% of the respondents. The communities were willing to be more accessible and felt that the LGAs should provide more logistic support to the program. Discussion: This study revealed that communities were aware of students’ visits and knew reasons for the visits, thought visits were beneficial, and were willing to provide more support for these visits.
Tuberculous ileal perforation in a HIV positive patient: a case report and review of literature.
(Nigerian Journal of Clinical Practice, 2008-12-02) Dogo D; Bakari AA; Gali Bata Mtaku; Ibrahim AG
Tuberculosis is prevalent worldwide. Even in developed countries there is a resurgence of tuberculosis mainly due to increasing HIV infection. Tuberculous ileal perforation is uncommon. It is, however, a potentially fatal complication of intestinal tuberculosis especially in HIV/AIDS patient.To highlight tuberculous ileal perforation as an underestimated complication of intestinal tuberculosis in an HIV patient presenting with acute abdomen.A 42-year-old HIV positive long distance truck driver with tuberculous ileal perforation is presented and related literatures reviewed.Intestinal perforation due to abdominal tuberculosis is an aetiological factor in acute HIV abdomen. High index of suspicion remains the key to diagnosis.
Perceptions of working conditions amongst health workers in state-owned facilities in northeastern Nigeria
(Annals of African Medicine, 2009-01-01) Chirdan, Oluwabunmi O; Akosu, Joeseph T.; Ejembi, Clara L.; Bassi Amos Paul; Zoakah, Ayuba I.
The health care sector depends to a large extent on human labor. Poor worker motivation can greatly affect health outcomes and patient safety. There is little information on the health workers' perceptions of working conditions in resource-poor settings.Three state-owned facilities in each state were selected by simple random sampling technique. The selected facilities were visited on weekdays between 9 and 10 a.m. A self-administered structured questionnaire was given to all health care workers on duty in the facility at the time of visit.A total of 299 questionnaires were returned. The response rate was 85.43%. Two hundred four (68.2%) workers experienced general satisfaction with their current jobs. The relationships between general job satisfaction and presence of conflict at work (P = 0.001), freedom of expression (P > 0.001), managerial support for staff welfare (P > 0.001), managerial support for staff career development (P > 0.001), availability of tools and consumables in the workplace (P > 0.001) and progress towards personal professional goals (P = 0.001) were statistically significant.The level of general job satisfaction was high. Though salaries were important, presence of conflict at work, freedom of expression, managerial support for staff welfare, managerial support for staff career development, availability of tools and consumables in the workplace and progress towards personal professional goals appear to play a role in worker motivation.
Congenital aganglionic megacolon in Nigerian adults
(Nigerian Journal of Clinical Practice, 2011-06-02) Bakari AA; Gali Bata Mtaku; Ibrahim AG; Nggada HA; Ali N; Dogo D; Abubakar AM
Congenital aganglionic mega colon (Hirschsprung’s disease) is a motor disorder in the gut, due to a defect in the craniocaudal migration of the neuroblast originating from the neural crest that occurs during the first twelve weeks of gestation, causing a functional intestinal obstruction, with its attendant complications, in infants. Despite modern pediatric practice, with emphasis on early diagnosis, Hirschsprung’s disease is seen in adults in regions where perinatal care is limited. We report two cases of Nigerian adults with longstanding, recurrent constipation, getting relieved by laxatives and herbal enemata, and then presented to our Emergency Department with a history of progressive abdominal distention, colicky pain, occasional vomiting, and weight loss. Per rectal examination revealed a gripping sensation in the rectum, 10cm from the anal verge, with rectal fecal load. Barium enema showed a grossly distended proximal large colon, with high fecal retention, with the transition zone at the middle one-third of the rectum. Due to difficulty in bowel preparation of these patients, emergency laparotomy was done. The first case had a diverting sigmoid colostomy and later had a low anterior resection. The second case had a one-stage procedure. Histology of both the cases showed aganglionosis of the stenotic segment and a normal distal rectum. Both patients had complete resolution of the symptoms, without complications, in a three-year follow-up. The related literatures were reviewed. Hirschsprung’s disease should be considered in adults patient presenting with chronic constipation. Low anterior resection of the rectum would be a surgical option for the treatment of short and zonal segment of adult Hirschsprung’s disease.
Outcome of surgery for toxic goitres in maiduguri
(Nigerian Journal of Clinical Practice, 2012-10-02) Ali N; Madziga AG; Dogo D; Gali Bata Mtaku; Gadzama AA
Background: Thyrotoxicosis a common endocrine disorder of the thyroid gland in Nigeria is commonly treated surgically. The outcome of thyroidectomy for toxic goiters in Maiduguri Nigeria is evaluated. Materials and Methods: Over the last 5 years (Jan 2005-July 2010), in a prospective review, the demographic, and clinical data of patients operated for toxic goiters in our department was entered, into a predesigned proforma and analyzed. The objective of the study is to review our experience with subtotal and near-total thyroidectomy as treatment for benign toxic goiters. Results: Seventy-eight patients, 11 males (14.1%) and 67 females (85.9%), with male: female ratio of 1:6.1 and the mean age of 30 ± 10.9 (range, 17-65 years), underwent thyroidectomy for toxic goiters. The mean duration of symptoms was 41.9 (range 3-126 months). There were 53 patients with toxic diffuse goiters (Grave’s disease) with their mean age of 27.6 ± 6.93 (range 17-38 years), 23 with toxic multinodular goiters, the mean age of 43.7 ± 15.68 (range 17-65 years) and two with toxic nodule. There was no case of permanent recurrent laryngeal nerve palsy or permanent hypocalcemia. Transient hypocalcemia occurred in 9 (11.5%) patients and hemorrhage with hematoma, requiring exploration in 4 (5.1%). There were two cases of wound infection and no postoperative mortality. The mean hospital stay was 7.6 ± 2.34 (range 5-15 days). There was no disease recurrence over a mean follow-up of 20.7 (range 2-48) months. Conclusion: Subtotal thyroidectomy is an effective procedure for the treatment of thyrotoxicosis with few postoperative complications and majority of patients being euthyroid after long follow-up.
Isolated gallbladder rupture following blunt abdominal trauma
(Nigerian Journal of Clinical Practice, 2013-06-14) Gali Bata Mtaku; Ali N; Bakari AA; Suleiman IE
The gallbladder is a relatively well-protected organ; consequently its rupture following blunt abdominal injury is rare and usually associated with other visceral injuries. Isolated gallbladder rupture is extremely rare. We report a healthy Nigerian adult male who sustained isolated gallbladder rupture following blunt abdominal injury from riding a motor cycle (Okada). A high index of suspicion with positive bile aspirate might lead to early diagnosis. Open cholecystectomy is a safe option of treatment in a resource poor centre especially in delayed presentation and has a good outcome.
Patterns and predictors of malaria care-seeking, diagnostic testing, and artemisinin-based combination therapy for children under five with fever in Northern Nigeria
(BioMed Central, 2014-11-21) Eugenie H Coakley; Bassi Amos Paul; Kathryn R Millar; Zainab Mohammed; Jennifer McCutcheon; Mohammed Auwal Ibrahim; William R. Brieger; William Sambisa
Despite recent improvements in malaria prevention strategies, malaria case management remains a weakness in Northern Nigeria, which is underserved and suffers the country's highest rates of under-five child mortality. Understanding malaria care-seeking patterns and comparing case management outcomes to World Health Organization (WHO) and Nigeria's National Malaria Control Programme (NMCP) guidelines are necessary to identify where policy and programmatic strategies should focus to prevent malaria mortality and morbidity.A cross-sectional survey based on lot quality assurance sampling was used to collect data on malaria care-seeking for children under five with fever in the last two weeks throughout Sokoto and Bauchi States. The survey assessed if the child received NMCP/WHO recommended case management: prompt treatment, a diagnostic blood test, and artemisinin-based combination therapy (ACT). Deviations from this pathway and location of treatment were also assessed. Lastly, logistic regression was used to assess predictors of seeking treatment.Overall, 76.7% of children were brought to treatment-45.5% to a patent medicine vendor and 43.8% to a health facility. Of children brought to treatment, 61.5% sought treatment promptly, but only 9.8% received a diagnostic blood test and 7.2% received a prompt ACT. When assessing adherence to the complete case management pathway, only 1.0% of children received NMCP/WHO recommended treatment. When compared to other treatment locations, health facilities provided the greatest proportion of children with NMCP/WHO recommended treatment. Lastly, children 7-59 months old were at 1.74 (p = 0.003) greater odds of receiving treatment than children ≤6 months.Northern Nigeria's coverage rates of NMCP/WHO standard malaria case management for children under five with fever fall short of the NMCP goal of 80% coverage by 2010 and universal coverage thereafter. Given the ability to treat a child with malaria differs greatly between treatment locations, policy and logistics planning should address the shortages of essential malaria supplies in recommended and frequently accessed treatment locations. Particular emphasis should be placed on integrating the private sector into standardized care and educating caregivers on the necessity for testing before treatment and the availability of free ACT in public health facilities for uncomplicated malaria.
Benign prostatic hyperplasia and prostate cancer differentiation via platelet to lymphocyte ratio
(IOS Press, 2015-02-02) Kaynar Mehmet; Yildirim Mehmet Erol; Gul Murat; Kilic Ozcan; Ceylan Kadir; Goktas Serdar
The aim of the current study is to evaluate NLR and PLR inflammation markers in PCa and BPH.Clinical and pathological data such as age, prostate volume, PSA, NLR, and PLR levels of 201 patients were retrospectively reviewed. Pathological sample results of these patients were categorized either as benign or malign. The benign group consisted of chronic prostatitis and BPH and the malign group of PCa. The PSA levels were divided into three categories as PSA: 0-4 ng/ml, PSA: 4-10 ng/ml, and 10 ng/ml and above.In the benign category, the mean PLR values for PSA: 0-4 ng/ml is 131.8 ± 31.2, for PSA: 4-10 ng/ml 124.7 ± 83.9 and 10 ng/ml and above 124 ± 53 in chronic prostatitis group and in the BPH group for PSA: 4-10 ng/ml 120.3 ± 45.1, for PSA: 4-10 ng/ml 126 ± 54.2, and 10 ng/ml and above 191.4 ± 176.1. In the malign category, the mean PLR values of PCa patients is for PSA: 0-4 ng/ml 122.8 ± 43.8, for PSA: 4-10 ng/ml 123 ± 43.8, and above 10 ng/ml 179.1 ± 94. Related to the variables of age, NLR, and mean prostate volume, there were no statistically significant differences. Statistically significant differences were observed in the mean PLR values only if the PSA level was 10 ng/ml and above (p: 0.044) in the BPH and PCa groups. The correlation of the PCa Gleason score and PSA, NLR and PLR parameters in the malign category revealed no statistically significant differences (P > 0.05).Effective malign and benign differentiation of prostate pathologies based on noninvasive inflammation biomarkers such NLR and PLR necessitate clinical studies with larger patient series.
Comparison of the efficacy of diclofenac, acupuncture, and acetaminophen in the treatment of renal colic
(Elsevier Inc, 2015-02-19) Kaynar Mehmet; Koyuncu Ferudun; Buldu Ibrahim; Tekinarslan Erdem; Tepeler Abdulkadir; Karatağ Tuna; İstanbulluoğlu Mustafa Okan; Ceylan, Kadir
The objective is to compare the analgesic effects of diclofenac, acetaminophen, and acupuncture in urolithiasis-driven renal colic pain relief.Renal colic patients were divided randomly into 3 groups. Patients in group I (n = 40) were treated with intravenous acetaminophen, those in group II (n = 41) with acupuncture, and those in group III (n = 40) with a 75-mg intramuscular injection diclofenac sodium. Visual analogue scale (VAS) and verbal rating scale (VRS) were used to assess pain intensity after 10, 30, 60, and 120 minutes.No significant differences in baseline VAS or VRS were found with regard to age or sex. After 10 minutes, all 3 groups experienced a significant decrease in VAS and VRS scores, with the most drastic decrease occurring in group II. After 30 minutes, there was a significantly higher decrease in group III than in group I (P = .001). After 60 minutes, mean VAS scores of groups I and III (P = .753) were similar. The mean VAS score of group III was lower than that of group II (P = .013). After 120 minutes, the difference in the VAS scores was (P = .000) between groups I and II and between groups II and III. Yet, the VAS evaluation made after 120 minutes revealed statistically similar outcomes for groups I and III (P = .488). The statistical findings for VRS evaluations made after 10, 30, 60, and 120 were similar to those for VAS.In renal colic patients with a possible nonsteroidal anti-inflammatory drug and acetaminophen side effect risk, acupuncture emerges as an alternative treatment modality.
Countdown to 2015: Tracking Maternal and Child Health Intervention Targets Using Lot Quality Assurance Sampling in Bauchi State Nigeria
(PLoS ONE, 2015-06-18) Dele Abegunde; Nosa Orobaton; Habib Sadauki; Bassi Amos Paul; Ibrahim A. Kabo; Masduq Abdulkarim
Improving maternal and child health remains a top priority in Nigeria's Bauchi State in the northeastern region where the maternal mortality ratio (MMR) and infant mortality rate (IMR) are as high as 1540 per 100,000 live births and 78 per 1,000 live births respectively. In this study, we used the framework of the continuum of maternal and child care to evaluate the impact of interventions in Bauchi State focused on improved maternal and child health, and to ascertain progress towards the achievement of Millennium Development Goals (MDGs) 4 and 5.At baseline (2012) and then at follow-up (2013), we randomly sampled 340 households from 19 random locations in each of the 20 Local Government Areas (LGA) of Bauchi State in Northern Nigeria, using the Lot Quality Assurance Sampling (LQAS) technique. Women residents in the households were interviewed about their own health and that of their children. Estimated LGA coverage of maternal and child health indicators were aggregated across the State. These values were then compared to the national figures, and the differences from 2012 to 2014 were calculated.For several of the indicators, a modest improvement from baseline was found. However, the indicators in the continuum of care neither reached the national average nor attained the 90% globally recommended coverage level. The majority of the LGA surveyed were classifiable as high priority, thus requiring intensified efforts and programmatic scale up.Intensive scale-up of programs and interventions is needed in Bauchi State, Northern Nigeria, to accelerate, consolidate and sustain the modest but significant achievements in the continuum of care, if MDGs 4 and 5 are to be achieved by the end of 2015. The intentional focus of LGAs as the unit of intervention ought to be considered a condition precedent for future investments. Priority should be given to the re-allocating resources to program areas and regions where coverage has been low. Finally, systematic considerations need to be given to the design of strategies that address the demand for health services.
The Impact of Integrated Community Case Management of Childhood Diseases Interventions to Prevent Malaria Fever in Children Less than Five Years Old in Bauchi State of Nigeria
(PLoS ONE, 2016-02-04) Dele Abegunde; Nosa Orobaton; Bassi Amos Paul; Olugbenga Oguntunde; Moyosola Bamidele; Masduq Abdulkrim; Ezenwa Nwizugbe
Malaria accounts for about 300,000 childhood deaths and 30% of under-five year old mortality in Nigeria annually. We assessed the impact of intervention strategies that integrated Patent Medicines Vendors into community case management of childhood-diseases, improved access to artemisinin combination therapy (ACT) and distributed bed nets to households. We explored the influence of household socioeconomic characteristics on the impact of the interventions on fever in the under-five year olds in Bauchi State Nigeria.A cross-sectional case-controlled, interventional study, which sampled 3077 and 2737 under-5 year olds from 1,588 and 1601 households in pre- and post-intervention periods respectively, was conducted from 2013 to 2015. Difference-in-differences and logistic regression analyses were performed to estimate the impact attributable to the interventions: integrated community case management of childhood illness which introduced trained public and private sector health providers and the possession of nets on the prevalence of fever.Two-week prevalence of fever among under-fives declined from 56.6% at pre-intervention to 42.5% at post-intervention. Fever-prevention fraction attributable to nets was statistically significant (OR = 0.217, 95% CI: 0.08-0.33). Children in the intervention group had significantly fewer incidence of fever than children in the control group had (OR = 0.765, 95% CI: 0.67-0.87). Although being in the intervention group significantly provided 23.5% protection against fever (95% CI: 0.13-0.33), the post-intervention likelihood of fever was also significantly less than at pre-intervention (OR = 0.57, 95% CI: 0.50-0.65). The intervention protection fraction against fever was statistically significant at 43.4% (OR = 0.434, 95% CI: 0.36-0.50). Logistic regression showed that the odds of fever were lower in households with nets (OR = 0.72, 95% CI: 0.60-0.88), among children whose mothers had higher education, in the post-intervention period (OR = 0.39, 95% CI: 0.33-0.46) and in the intervention group (OR = 0.52, 95% CI: 0.48-0.66). The odds of fever increased with higher socio-economic status of households (17.9%-19.5%). Difference-in-differences showed that the interventions significantly reduced occurrence of fever in the intervention group (OR = 1.70, 95% CI: 1.36-2.14).The interventions were effective in reducing the prevalence and the likelihood of childhood malaria fever. Taken to scale, these can significantly reduce the burden of malaria fever in the under-five year old children.
Bacterial and antibiotic susceptibility pattern of urinary tract infection isolated from asymptomatic and symptomatic diabetic patients attending tertiary hospital in Jos, Nigeria
(Trends in Medicine, 2017-11-23) Panshak Barnabas Bakwet; Seljul Mamzhi-Crown Ramyil; Joseph Anejo-Okopi; Bassi Amos Paul; Godwin Agada; Segun David Adeniyi; Juliet Okechalu; Ocheme Julius Okojokwu
Urinary tract infection (UTI) is an infection caused by the presence and growth of microorganisms in the urinary tract. In most cases empirical antimicrobial treatment is usually initiated before the laboratory results are made available; hence the need for antibiotic susceptibility test to enhance management of UTI. The study was designed to determine the bacterial profile and antibiotic susceptibility pattern of urinary tract bacteria isolated from symptomatic and asymptomatic diabetic patients at Bingham University Teaching Hospital Jos. 100 mid-stream urine samples (app. 20 mls) were aseptically collected into sterile containers after informed consent of diabetic patients of ages 20 years and above were analyzed at Central Diagnostic Laboratory NVRI Vom. The isolates were identified using standard bacteriological techniques after been cultured on MacConkey and CLED agars. Antibiotic sensitivity testing was done in accordance with NCCLS disc diffusion methods. The results were then analyzed using chi square test. Of the 100 urine samples, different bacterial uropathogens were isolated, with a prevalence of 40%. The bacteria isolates were; Coagulase negative Staphylococci (CNS) (37.5%), Escherichia coli (24%), Klebsiella pneumoniae (12.5%), Staphylococcus aureus (15%) and Streptococcus spp (10%). Esherichia coli and Klebsiella pneumoniae were highly resistant to most antibiotics used, while coagulase negative staphylococci, Staphylococcus aureus and Streptococcus spp were highly sensitive to most antibiotics used in this study. Self-medication including antibiotics is clearly a major culprit. Behavioral Change Communication to all stake holders is increased to cover all radio and TV stations in the state. In addition, investigations (routine microscopy, culture and sensitivity of urine) be completed before treatment is commenced in order to mitigate acquisition and spread of drug resistance by bacteria.
Cord care among mothers of sub-urban Lewllem community of Jos South LGA, Plateau State, Nigeria
(African Journal of Pharmaceutical Research & Development, 2018-02-02) Isah, H.O.; Bassi Amos Paul; Chima, G.
Care of the cord is a known determinant of an infant’s well-being in neonatal life period, and when not according to standard frequently results in high prevalence of neonatal infections and complications, some fatal. This study sought to determine the practice of cord care among mothers of Lewllem Community of Jos South LGA, Plateau State, Nigeria. This was a community-based descriptive cross-sectional study among 300 women of reproductive age group 15-49 years with children less than 5 years of age. Substances commonly applied to cord of babies, reasons for cord care, respondents’ age, educational status and ANC attendance were determined. Along with tables and proportions, associations between respondents’ educational and age status and type of substances, reasons for cord care and duration for cord care with significant level at pV < 0.05 were determined. Methylated spirit (57.60%), Vaseline (39.22%), warm water salt solution (16.61%), plain warm water (9.54%) and herbs/native preparation (1.77%) were found in use with achieving the shrivel (drying) of the cord (50.33%), prevention of cord infection (28.33%), timely detachment of the cord (22.67%) and prevention of development of bad odor by cord (2.33%) as reasons for cord care. There was no statistical significant association between educational attainment and choice of the substances (pV = 0.1656), respondents’ age and reasons for cord care (pV = 0.9226), educational attainment and reasons for cord care (pV = 0.3006) and educational attainment and duration of cord care (pV = 1.0000). Presence of a health facility within study setting and 95.5% ANC attendance rate did not impact on respondents’ choices of appropriate substances and informed reasons for cord care. Quality of MCH services made available to pregnant mothers by the health facility, and skills of service providers will require review for remedial measures.