Background: Tetanus, a disease that is largely preventable, is still a major public health problem in the developing world and is associated with high morbidity and mortality rates. There is a paucity of published literature on tetanus in adults (non-neonatal) in this study area. Materials and Methods: This was a 14-year retrospective study of patients who presented with a clinical diagnosis of tetanus in Ahmadu Bello University Teaching Hospital, Zaria, Northwest Nigeria between January 2001 and December 2014. Data were analyzed using the Statistical Package for the Social Sciences computer software package. Results: A total of 91 cases were reviewed. The median age of patients was 14 years with a male-to-female ratio of 3:1. Majority of the patients (88%) were <40 years. Mean onset period was 19 days, majority of the patients (96.7%) had a generalized tetanus, and the most common presenting signs were spasm (93.4%) and trimus (78.0%). The most common site of injury in 64.8% of the cases was the lower limbs. The complication rate was 71.4%, and the mortality rate was 48.4%. Conclusion: Tetanus is still a major public health problem in our centre and affects people belonging to the younger age group with a high case of fatality rate. The incidence of tetanus can be reduced drastically by an effective and sustained immunization programme.

Background: The fractures of the mandible are common facial injuries, and their consequences have remained a burden in dental and oral surgery practice. To review patients with mandibular fractures at our institution over a 4-year time frame of 10 years apart between 1997–2000 and 2011–2014 and compare the trends in the number of cases. Materials and Methods: The hospital register and case notes of the patients with mandibular fractures were retrospectively reviewed to obtain relevant information concerning the socio-demographic data and clinical characteristics of the fractures. Results: There was a reduction in the number of patients and fractures when the 2011 study (168 patients and 239 fractures) was compared with the 1997 study (358 patients and 474 fractures), and this was significant (P = 0.001). Road traffic accidents were the most common cause of fractures; motorcycle-related traffic accidents were more frequent in the years 1997–2000 (n = 128, 35.7%) than that in the years 2011–2014 (n = 11, 6.6%); vehicular road traffic accidents were more common in the years 2011–2014 (n = 123, 73.2%) than that in the years 1997–2000 (n = 153, 42.7%), and these were significant (P = 0.001). Mandibular fractures were more of isolated fractures and less associated with concomitant injuries in the 2011 study than that in the 1997 study (P = 0.001). There was a significant reduction of complications in the 2011 study (P = 0.001). Conclusion: This study has shown that the frequency of mandibular trauma has changed significantly over the past decade, which may be explained in terms of the ban on the use of motorcycle for public transportation.

Background: Mild head injury (MHI) is the most common type of head trauma, and represents the vast majority of the injuries seen in the trauma unit. Therefore, this study aimed to use the previously identified clinical risk factors to determine which category of patients with MHI does not need to undergo computed tomography (CT). This may save cost to patients and hospitals and thereby reduce radiation dose to patients, personnel, and members of the public. Methodology: This was a retrospective study conducted at the trauma unit of an academic hospital situated in Cape Metropolis. CT scans of 50 patients, 14 years and over who had MHI and underwent CT scan were serially retrieved from the archive. Patients' information, clinical presentation, and resultant CT findings were analyzed. Clinical risk factors were correlated with abnormal and normal CT scan findings. Data were analyzed using Chi-square statistics. Results: Twenty-three (46%) patients had abnormal CT findings, and all presented with one or more of these risk factors, namely, severe headache, skull fracture, scalp injury, loss of consciousness, and intoxication. The results were not statistically significant when compared with the normal CT scans group. Four patients (8%) with no risk factors had normal CT scans. All the patients who presented with the clinical risk factors of nausea and vomiting 6% (n = 50) and seizures 4% (n = 50) had normal CT scan findings. Conclusion: Certain clinical risk factors can be used to suggest the probability of abnormal CT scan in patients with MHI, whereas patients with no risk factors are more likely to have normal CT findings. Hence, the patients do not need to undergo CT scanning. Further studies with larger sample size may be helpful in validating these findings.

Background: Nosocomial infections are among leading causes of morbidity and mortality and are associated with increased antibiotic resistance in Intensive Care Units (ICUs). This prospective study was conducted between March and October 2014 in the ICUs of the University of Maiduguri Teaching Hospital to assess the rate, types, and antibiotic susceptibility pattern of airborne and surface-borne bacterial contamination before and after fumigation. Materials and Methods: Sixty samples were collected and investigated from fomites by surface swabbing and open plate air exposure in the ICUs before and after fumigation using standard microbiological methods. Results: Out of the sixty samples investigated, 38 (63.3%) yielded positive bacterial growth. Twenty-six (68%) were before fumigation of the ICU and 31.5% (n = 12) from postfumigation culture. Coagulase-negative Staphylococci spp.(CoNS) accounted for 39.4% (n = 15) of the positive cultures, Bacillus spp. 15% (n = 9), Klebsiella pneumoniae 13.2% (n = 5), Escherichia coli 10.5% (n = 4), Klebsiella oxytoca 7.9% (n = 3), and Streptococcus pyogenes 5.3% (n = 2). The antibiotic susceptibility test results of the isolates revealed that CoNS were resistant to amoxicillin, ampicillin-cloxacillin, and cefuroxime. K. pneumoniae was also resistance to chloramphenicol, aminoglycosides, and penicillins, whereas E. coli showed resistance to fluoroquinolones, particularly pefloxacin and ofloxacin. Conversely, Bacillus spp., K. oxytoca, and S. pyogenes were susceptibility to all test antibiotics. Conclusion: The high level of bacterial contamination of equipment and inanimate objects in the ICUs and the presence of multidrug resistant bacteria calls for prompt and a holistic infection control interventions.

Background: Injuries pose a significant economic problem to communities in every society. Studies aimed at estimating the costs of management of injuries are very limited in this environment. Materials and Methods: The patients who presented to the emergency unit of the University Teaching Hospital, Ilorin, Nigeria, with traumatic injuries were recruited. The expenses were classified into various groups. Results: Of the 165 patients recruited, majority were young adult men. The mean direct cost per injury was N4061 ($27.1) with the cost of drugs accounting for the largest share of the costs. The costs incurred were higher with the increasing severity of injury. Conclusion: The direct costs of management of injuries from this study represent a significant economic drain to the low-income population of this environment. Extrapolating these cost estimates of medical treatment to the fatal as well as the even larger non-fatal injury burden in Nigeria exposes the immense financial drain to the individual and community.

Background: To assess the patients’ perception of quality of services (PPQS) offered by the haematology laboratory of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. A cross-sectional descriptive study was conducted among 125 outpatients of the haematology laboratory in ABUTH, Zaria. A stratified sampling with subsequent systematic random sampling was utilized. This study was conducted in the haematology laboratory of ABUTH, Zaria, Nigeria from 25^th April to 3^rd August 2016. Participants and Methods: Five-point Likert scales were used to rate 10 categories in addition to overall satisfaction. The most important service categories were also assessed. Percentage satisfaction and scores (on a scale of 1–5) were computed. Data were analyzed using the Statistical Package for the Social Sciences version 20.0 software. Data were presented using tables. Medians and interquartile ranges were used to summarize ordinal data. Mann–Whitney U or Kruskal–Wallis tests were used as applicable. The level of significance was set at P < 0.05. Results: The mean age of participants was 32.04 ± 10.97 years, and females constituted 71 (56.79%). The service category with the highest satisfaction was cleanliness of phlebotomy area (85.60%) followed by information on how to receive results (80.00%). Staff courtesy had the highest satisfaction score (4.25) followed by ease of phlebotomy (3.97). The least was cleanliness of toilets (3.12). Privacy during phlebotomy, ease of phlebotomy and comfort of chairs were the most important categories, with respective scores/values of 26 (20.80%), 23 (18.40%) and 22 (17.60%). Overall satisfaction was 81.60% (score of 3.94). The distribution of overall satisfaction ratings did not differ across socio-economic groups. Conclusion: The PPQS of the haematology laboratory of ABUTH, Zaria reveals a high level of overall satisfaction. Satisfaction with waiting time and cleanliness of toilets are low. All metrics should be considered as opportunities for improvement.

Background: Umbilical cord prolapse remains one of the most common obstetric emergencies associated with high foetal and neonatal morbidity and mortality. Materials and Methods: A descriptive (retrospective) study was conducted on all women who were managed for umbilical cord prolapse over a 4-year period. The medical records of all eligible women were retrieved, and relevant information was extracted. The main outcome measures were perinatal outcome and the need for neonatal intensive care. The results were represented using simple descriptive methods. Results: There were 56 women with umbilical cord prolapse out of the 14,892 deliveries with a prevalence of 0.38%. A single risk factor was present in 39 (72.2%) women, and breech presentation [12 (22.2%)] was the most common risk factor. In addition, 42 (77.8%) women presented with live foetuses with palpable umbilical cord pulsation in the first stage of labour and subsequently had emergency caesarean deliveries. The diagnosis-to-delivery interval for live foetuses was less than 30 min in seven women (16.7%) and between 30 and 60 min in 34 women (80.9%). All women who had foetal death at presentation subsequently had vaginal delivery. A total of 23 (54.8%) neonates were admitted into the neonatal intensive care unit mostly for perinatal asphyxia [16 (69.6%)], whereas 6 (26.1%) suffered early neonatal death. The perinatal mortality rate for the study was 333/1000. Conclusion: Modern antenatal care, early presentation and complication readiness for prompt emergency care by the health facilities will improve perinatal outcome from cord prolapse.

Background: The youths in the areas of developing nations such as Nigeria have been found to exhibit varying degrees of vulnerability towards sexually transmitted infections (STIs). Most cases of human immunodeficiency virus infection, other STIs and unintended pregnancy occur through unprotected sex. This study, therefore, sought to determine the risky sexual practices and the use of contraceptives among rural youths in two communities in Southwest Nigeria. Materials and Methods: A cross-sectional study design was used; a semi-structured questionnaire was administered to 640 youths (320 in two separate communities) in 2013. Risky sexual behaviour was measured using five items, namely age at first sexual experience, the use of condom at first sexual intercourse, consistent condom use among youths who had sexual intercourse in the 3 months preceding the study, the number of sex partners 3 months preceding the study and the history of transactional sex. Systematic random sampling technique was used to select one respondent per house. Chi-square at P < 0.05 was used to demonstrate the association between categorical variables. Multivariate logistic regression was used to identify the predictors of risky sexual behaviour and contraceptive use. Results: The mean age was 19.51 ± 2.62 years, whereas the mean age at first sex was 17.33 ± 2.56 years. About 10% of the respondents had engaged in transactional sex. Among respondents who had previously used condom, 31.2% used it at first sexual act, and this was significantly common (P = 0.032) among the males (55.8%) compared to the females (39.7%). About half of the sexually active respondents used condom consistently, and about a quarter (28.6%) had multiple sexual partners. The most popular modern contraceptive methods were male condoms (49.8%) followed by injectables (46.0%) and the pill (30.1%). Male respondents (90.0%) were more likely to know where to procure family planning services (P = 0.001). All sexually active respondents using contraceptives used the male condom, and <5% used hormonal contraceptive namely the pill. Only 22.1% of the sexually active respondents expressed willingness to use contraceptives; within this group, females (29.5%) outscored the males (15.7%) (P = 0.005). More than a quarter (27.9%) reported a past incidence of unintended pregnancy. Conclusion: A high proportion of respondents were observed to engage in risky sexual behaviour. There is an urgent need for community-based sexuality education and contraceptive use to promote behaviour change and a qualitative study to explore reasons why youths are not using contraceptives.

Background: Parasitic infection is a cause of maternal and neonatal morbidity and mortality. This study was conducted to determine the co-infection of Plasmodium falciparum and intestinal parasites among the pregnant women in Edo State, Nigeria. Materials and Methods: A total of 601 participants, consisting of 401 pregnant women attending antenatal clinics and 200 non-pregnant controls, were recruited in this study. The blood and stool specimens were collected from each participant. P. falciparum and intestinal parasites were diagnosed using standard techniques. Results: An overall prevalence of 43.1% of co-infection of P. falciparum and intestinal parasites was observed among the pregnant women. P. falciparum parasitaemia prevalence was 24.9%, whereas the prevalence of intestinal parasites was 18.2%. The most common co-infections among the pregnant women were either P. falciparum/Entamoeba histolytica (16.7%) or P. falciparum/Ascaris lumbricoides (16.7%). Pregnancy status, gestational age and anaemia correlated with the co-infection of P. falciparum/intestinal parasites. Conclusion: Measures to reduce P. falciparum/intestinal parasite co-infection and their effect on pregnant women are advocated.

Background: Adolescents form a part of the productive age group in Nigeria, and giving attention to their needs is essential in the development of the nation. Assessing the nutritional status of boarders in secondary schools could provide evidence-based information, which could be used for future nutritional interventions. This study compared the nutritional status of the adolescents in private and public boarding secondary schools in Ibadan, South Western Nigeria. Materials and Methods: This was a descriptive cross-sectional study of 239 and 251 participants from both private and public boarding secondary schools, respectively, selected by multistage sampling technique. Socio-demographic characteristics and anthropometric measurements were analysed using Epi info version 3.5.1 software and the Statistical Package for the Social Sciences version 20 software. Results: The mean age of the students in the private and public schools was 12.9 ± 2.05 years and 14.0 ± 1.49 years, respectively. The prevalence of stunting, underweight, normal weight, overweight and obesity among private school participants was 2.5, 39.3, 51.9, 8.0 and 0.8% respectively, whereas that of public school participants was 8.4, 37.1, 60.6, 2.4 and 0.0, respectively. These differences in the stunting and body mass index categories were statistically significant (P < 0.05). Higher proportion of the younger adolescents in both private and public schools were underweight (P < 0.001). In private schools, a higher proportion of male students were underweight (P = 0.001), whereas a higher proportion of the older adolescents were overweight (P = 0.033). Conclusion: More private school boarders were underweight and overweight, whereas more public school boarders were stunted. Students, school administrators and parents should be enlightened on the nutrition problems of adolescents and their potential danger.

Background: Most nutritional surveys either focus on under-five children or adolescents aged 10–19 years. Few works have been reported among school-aged children of 6–12 years. In Nigeria, a recent demographic health survey only focused on under-five children. Thus, not much is discussed as regards the nutritional state of children aged 6–12 years. Objective: To determine the prevalence and pattern of malnutrition among school-aged children in Jos East Local Government Area of Plateau State using the 2007 World Health Organization (WHO) standards for schoolchildren and adolescents. Subjects and Methods: A cross-sectional descriptive study was conducted on schoolchildren aged 6–12 years from 10 schools. Sociodemographic data were collected using an interviewer-administered questionnaire. Height and weight were measured according to standard procedures. The height-for-age Z-score and the body mass index-for-age Z-score were generated from the WHO software Anthroplus^®. Statistical Package for the Social Sciences version 17.0 software was used for data analysis. Results: The mean age of the participants was 9.5 ± 1.8 years, and the male:female ratio was 1.1:1. The mean weight and height were 25.06 ± 4.56 kg and 128.07 ± 10.01 cm, respectively. The prevalence of stunting was 10.34%, overweight/obesity 4.47%, and thinness 1.39%. The adolescent age group (10–12 years) had a significantly higher (15.98%) prevalence of stunting than that of the preadolescent age group (3.66%). Conclusion: Chronic undernutrition is a problem among the schoolchildren considered in this study with the adolescent age group bearing the greater burden.

Background: The deployed artemether–lumefantrine (AL) and artesunate–amodiaquine (AA) medicines are known to be gametocytocidal. Continuous monitoring of their efficacies is imperative for malaria elimination interventions. To compare gametocytocidal clearance by AL versus AA. Materials and Methods: Data on demographics, anthropometry measures and gametocytes densities of 111 of 114 Human Immunodeficiency Virus (HIV) sero-negative children aged 6–59 months with uncomplicated Plasmodium falciparum malaria mono-infection, who participated in a drug therapeutic efficacy testing, were extracted. Patients who had severe malnutrition, other causes of common childhood fevers and use of antimalarial medicines in the preceding 1 week were excluded from the study. Study participants who met the enrolment criteria and gave written informed parental consent were randomized to receive AL or AA according to the manufacturer’s instructions. Clinical and parasitological evaluations were performed on D0, D1, D2, D3, D7, D14, D21 and D28. Analysis was restricted to 111 participants who completed the study. Results: Twelve (10.8%) patients had gametocytes on D0. Six (5.4%) study participants were in the AL treatment arm and 6 (5.4%) participants were in the AA treatment arm (P = 0.32). Gametocyte clearance time (GCT)_AL was 104 h and (GCT)_AA was 152 h (P = 0.44). Conclusion: AL and AA demonstrated comparable gametocytocidal activity in North-Central Nigeria. There is a need for continuous monitoring of the efficacies of these artemisinin-based combination therapies to keep track with the emergence of resistant Plasmodium gametocyte isolates in Nigeria.

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.

Background: To describe the computed tomographic findings in pedestrians, who presented with head trauma at the University of Benin Teaching Hospital (UBTH). Materials and Methods: This was a descriptive, retrospective study conducted at the UBTH from January 2011 to January 2014 involving 103 pedestrians with suspected intracranial injury following head trauma, who presented for computed tomography (CT). The CT findings, Glasgow coma scale (GCS) score as well as the demographic details of the patients were analysed using the Statistical Package for the Social Sciences version 16 software. Results: A total of 103 patients were reviewed, which comprised 69 males (67.0%) and 34 females (33.0%) with a male-to-female ratio of 2:1. Patients 10 years and below had the highest incidence, whereas the least incidence was recorded in those above 80 years. The mean age was 30.59 ± 2.07 years and 38.55 ± 2.93 years for males and females, respectively. Motor car collision (60.2%) was the most common mode of injury. The findings on computed tomographic scan were intracerebral haemorrhage 23.8%, cerebral contusion 18.0%, subdural haematoma 10.5%, subarachnoid haematoma 7.6% and extradural haematoma 2.9%. Others were calvarial fracture 15.1%, facial fractures 6.4% and base of skull fracture 4.7%. Only one case of diffuse axonal injury was reported. On the basis of the admission GCS, 33 patients had severe head injury, 30 patients had moderate head injury while mild head injury was observed in 15 patients. Normal GCS was observed in 25 patients. Conclusion: CT is a useful tool in the management of pedestrians with head trauma in the acute setting.

Fall from height is a common cause of penetrating abdomino-thoracic injuries. These often require thoracotomies to treat. Thoracotomy requires lung isolation technique. Specialized endobronchial tubes and endobronchial blockers are ideally used in the technique. However, in resource-poor settings, these specialized tubes are often unavailable. We report how a conventional single-lumen endotracheal tube was used to carry out one-lung anesthesia for thoracotomy to repair an impalement thoraco-abdominal injury following a fall from height with good results.