Research Articles in Medicine & Surgery

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    Ebola Virus
    (NUMSA International Journal of Medicine and Health Education, 2025-02-02) Lawal, Sakinatu; Oranwusi, Emmanuel; Ibrahim, Abdul-Azeez O.
    Ebola Virus Disease (EVD) is a highly lethal infectious disease caused by the Ebola virus, with mortality rates ranging from 25% to 90%. First identified in 1976, EVD has emerged as a major public health threat, particularly in sub-Saharan Africa. The disease is transmitted through contact with infected animals and humans, with outbreaks often exacerbated by limited healthcare infrastructure. Nigeria experienced a notable outbreak in 2014, which highlighted the challenges of diagnosis, treatment, and prevention in resource limited settings. This review explores the pathophysiology, clinical presentation, diagnosis, treatment, and prevention of EVD, emphasizing Nigeria’s experience and response. It underscores the importance of surveillance, public awareness, supportive care, vaccination, and international collaboration in mitigating the impact of future outbreaks.
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    A Review of Human Immunodeficiency Virus (HIV) in Nigeria
    (NUMSA International Journal of Medicine and Health Education, 2025-02-02) Oranwusi, Emmanuel; Ibrahim, Abdul-Azeez O.
    Human Immunodeficiency Virus (HIV) remains a critical global health challenge, with Nigeria bearing one of the heaviest burdens in sub-Saharan Africa. Despite advances in antiretroviral therapy (ART) and prevention strategies, approximately 1.9 million people in Nigeria are living with HIV as of 2020. The virus, transmitted primarily through unprotected sexual contact, mother-to-child transmission, and contaminated needles, progressively impairs the immune system, leading to acquired immunodeficiency syndrome (AIDS) if untreated. This review examines the pathophysiology, clinical presentation, diagnosis, treatment, and prevention of HIV, with a particular focus on its impact in Nigeria. Persistent challenges such as stigma, limited access to ART, inadequate healthcare infrastructure, and socioeconomic barriers continue to undermine effective control. Strengthening surveillance, expanding ART access, promoting public education, and achieving UNAIDS 95-95-95 targets are essential to mitigating the epidemic’s impact and advancing toward ending AIDS as a public health threat.
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    Cholera
    (NUMSA International Journal of Medicine and Health Education, 2025-02-02) Rakiya, Sule Alhassan; Eniola, Adejumo; Bassey, Imaobong; Agan, Grace Ripeh
    Cholera is an acute diarrheal disease caused by Vibrio cholerae, transmitted primarily through contaminated water and food. This review provides a comprehensive overview of cholera, tracing its historical pandemics, epidemiology, pathophysiology, and clinical manifestations. It highlights the global and local burden of cholera, with emphasis on recurrent outbreaks in Nigeria, where poor sanitation, flooding, and limited healthcare infrastructure exacerbate transmission and mortality. The discussion explores diagnostic methods, treatment strategies such as oral rehydration therapy, intravenous fluids, and antibiotics, alongside preventive measures including vaccination, improved water, sanitation, and hygiene practices. The paper further examines global efforts to combat cholera, notably the WHO’s “Ending Cholera: A Global Roadmap to 2030,” and outlines challenges such as climate change, vaccine shortages, and weak healthcare systems. Despite advances in treatment and prevention, cholera remains a major public health threat, necessitating coordinated interventions, strengthened surveillance, and sustained global commitment to reduce mortality and achieve long-term control.
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    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.
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    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.
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    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.
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    Seroprevalence of Transfusion Infections Among Prospective Blood Donors in a District Hospital in Abuja, Nigeria
    (Nile University of Nigeria, 2025-01-02) Nwankwo Chizoba Gloria; Sanni Emmanuel Oladipo; Okudo Adaora Chinwendu; Eseigbe, P.; Ezike Kevin Nwabueze
    Background: Blood transfusion plays a crucial role in medical practices. However, blood transfusion safety remains a public health concern in developing countries due to the high prevalence of Transfusion Transmissible Infections (TTIs) among blood donors. Methods: This was a retrospective cross-sectional study involving data obtained from prospective blood donors’ records at the blood bank of Asokoro District Hospital (ADH), Abuja, Nigeria, from 01 January 2021 to 31 December 2021. The records comprised results of screening for TTIs, namely Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV), Hepatitis C virus (HCV), and syphilis. Screening was performed using rapid test kits. Data was analyzed with the SPSS 23.0 statistical software. Results: A total of 1,507 blood donor data were analyzed. The age range of the donors was 17 to 67 years. TTIs amongst donors in ADH, Abuja was HCV 4.2%, HBV 4.1%, Syphilis 1.0%, and HIV 0.9% respectively. Conclusion: There is a need for counselling amongst positive patients after blood transfusion screening, and referral to the relevant clinics for management. There is also a need to create effective public health interventions towards HCV infection which had the highest prevalence among blood donors.