Background: Birth registration is both a fundamental human right and an essential means of protecting a child's right to identity. Objective: The aim was to assess the awareness, knowledge and practice of birth registration by mothers and the socio-demographic determinants of birth registration in an urban community in southern Nigeria. Methodology: A community-based descriptive cross-sectional study was carried out among mothers in an urban community in Ovia North East local government area of Edo State, Nigeria. A structured interviewer administered questionnaire was used for data collection. Data were analyzed using SPSS version 20. Results: Awareness of birth registration was high (69.6%) with mass media as the major source of information (60.5%), but the composite knowledge of it was poor. Awareness of the agency responsible for birth registration was poor. Only 44.2% of the respondents registered the births of their children, two-thirds of those who registered births possess a birth certificate. Marital status and level of education were significantly associated with the knowledge of birth registration. Age, level of education, marital status, occupation, and place of delivery were the determinants of the practice of birth registration. Conclusion: There is a need for a change of strategy in the campaign for birth registration so that awareness can translate into better knowledge and practice. We advocate the establishment of community-based birth registration centers to improve accessibility and practice of birth registration.

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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.

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Background: Hand washing is a cheap and effective method of limiting the spread of health care associated infections, but compliance has been reported to be low worldwide, especially in developing countries. Objective: To determine the knowledge and practice of hand hygiene among doctors in a tertiary health facility in southern Nigeria. Materials and Methods: This cross-sectional, descriptive study was carried out among all cadres of doctors employed by the hospital. Data were collected using a pretested, semistructured, self-administered questionnaire as well as by direct observation of a subsample of the doctors using an observational checklist. Data analysis was done using the SPSS version 16.0 statistical package and level of significance was set at P < 0.05. Results: A total of 326 doctors participated in the study and one third of these (108) were directly observed. Less than half of the respondents had good knowledge (43.9%) and good practice (48.2%) of hand hygiene. However, on direct observation, the overall compliance rate was 16.7%. Sex and specialty of the respondents were significantly associated with knowledge but not with practice of hand hygiene. The reasons mentioned for noncompliance included: Lack of hand hygiene materials like soap and water (65.0%), forgetfulness (35.0%), too busy/insufficient time (19.3%), inconvenient location of sinks (16.9%), the use of gloves (7.1%), and skin irritation from washing agents (4.6%). Conclusion: This study revealed a very low hand hygiene compliance rate among doctors in a tertiary health facility in the southern part of Nigeria and also highlighted some of the contributory factors. It is recommended that an institution-wide hand hygiene promotion campaign be embarked upon.

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Background/Purpose: Neonatal morbidity and mortality contributes significantly to under-five morbidity and mortality in sub-Saharan Africa accounting for 40% of under-five mortality. A substantial reduction in neonatal mortality is therefore necessary to achieve the Millennium Development Goal (MDG) 4 target by 2015. The aim of the study was to assess the pattern of neonatal morbidity and mortality in our environment which will help to identify interventions for better neonatal outcome. Materials and Methods: The study is a review of cases admitted into the neonatal unit of the Jos University Teaching Hospital situated in the North Central part of Nigeria. The unit started operating from the permanent site of the hospital on 1 March 2010 after the relocation of the hospital from the previous site. Data on all neonates admitted into the neonatal unit from 1 March 2010 to 28 February 2011 were obtained from the various registers/records and analyzed. Data extracted included biodata, gestational age, birth weight, main diagnosis, duration of admission, etc., In addition, the outcomes (discharged/died) were documented. All statistical analyses were performed using two-sided tests. A P < 0.05 was considered statistically significant. Results: A total of 572 neonates were admitted, accounting for 54.6% of the 1047 pediatric medical admissions into the hospital. The main causes of admission were neonatal infections (37.1%), prematurity (20.1%), and birth asphyxia (11.5%). Out of the 572 neonates, 111 (19.4%) died. About three quarters (76.5%) of the mortalities occurred in the first week of life with 46.4% of these occurring in the first 24 hours (χ² -20.2, P < 0.001). The common causes of mortality were prematurity (43.2%), , birth asphyxia (18.0%) and neonatal infections (17.1%) Conclusion: There is a high burden for neonatal care at the institution. The three main causes of morbidity and mortality are prematurity, infections, and birth asphyxia. Hence, neonatal care/facilities need to be improved especially to care for the high risk neonate. Also, the importance of infection control cannot be overemphasized.

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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.

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Background: Food is an important basic necessity, its procurement, preparation and consumption are vital for the sustenance of life. Food handlers have been found to play prominent roles in the transmission of food borne diseases, therefore training of food handlers on food safety and hygiene is crucial to the prevention of food borne diseases. Methodology: A quasi-experimental study carried out among food handlers in boarding secondary schools in Jos North Local Government Area to determine the effect of training on the knowledge and practice of food safety and hygiene. EPI info statistical software version 3.5.4 was used for data analysis and 95% confidence interval was used in this study with a P ≤ 0.05 considered statistically significant. Result: The mean age of the food handlers in the study was 42.07 ± 8.71 years with the mean years of work experience as 11.59 ± 8.05 years. The level of knowledge of food safety and hygiene improved significantly after the training ( P < 0.001). Majority (98.5%) of the food handlers had good practice of food safety and hygiene after the training as against 51.5% who had same before the training (χ² = 76.6; P < 0.001). Conclusion: This study has demonstrated the effectiveness of training in improving the knowledge and practice of food safety and hygiene among food handlers.

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Background: Psychoactive substance use by vehicle drivers is a global problem. The identification of factors associated with their use among long-distance commercial drivers will provide information valuable to the interventions aimed at the control of this pattern of behavior. Objective: To determine the sociodemographic factors associated with the use of psychoactive substances among long distance commercial vehicle drivers in Kaduna, a city in Northwest Nigeria. Materials and Methods: Long distance drivers from selected motor parks in Kaduna metropolis were recruited. They were interviewed using a sociodemographic and a brief drug use questionnaire, two screening instruments which included the Alcohol Use Disorder Identification Test and the Drug Abuse Screening Test. Results: All 274 subjects were males, with a mean age of 43.4 ± 10.2 years. 94.9% of the subjects were married, 78.5% of them were Muslims, and 67.5% had received a formal education of at least primary school level. Younger drivers were more likely to use cannabis, P < 0.0001, and tobacco P < 0.028, while those who had no spouse used more cannabis. A significant proportion of alcohol users was Christians with formal education, while Muslims were more likely to use cannabis and caffeinated substances. Significant predictors of alcohol use were being a Christian, odds ratio (OR) = 30.6, P < 0.0001 and above 45 years of age, OR = 3.3, P = 0.007, while significant predictors of cannabis use were not having a spouse, OR = 6.6, P = 0.004, and below 45 years of age, OR = 5.5, P = 0.03. Conclusion: Sociodemographic factors influence substance use among long distance drivers, and these characteristics can be explored as the focus in directing drug use control intervention.

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Background: Knee osteoarthritis is a chronic medical condition of public health importance in this setting. It is mostly diagnosed when preventive measures are no longer practicable due to reliance on the radiological diagnosis. Objectives: To determine the magnitude and risk factors associated with knee osteoarthritis among adult patients presenting at the University College Hospital, Ibadan, Nigeria. Materials and Methods: This cross-sectional study used a semi-structured questionnaire to interview 400 respondents. Knee osteoarthritis was diagnosed clinically using the American College of Rheumatology (ACR) criteria. Results: The point prevalence of knee osteoarthritis was 11.5%. Increasing age, female gender, marital status, low educational status, financial dependency, poor income, obesity, previous knee injury, epigastric pain, peptic ulcer disease, varus deformity of the knee, and poor health status were significantly associated with knee osteoarthritis. Logistic regression analysis showed increasing age (OR = 2. 874, CI = 1. 294-6.381), history of epigastric pain (OR = 57. 044, CI = 1. 693-192.24) and varus deformity of the left knee (OR = 3. 012, CI = 1. 063-8.547) to be the most significant factors associated with knee osteoarthritis. Conclusion: The magnitude of clinical knee osteoarthritis is high among respondents in this hospital-based study. Doctors in primary care should screen patients at first-contact to detect osteoarthritis early and manage appropriately.

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Background: The contribution of obesity to obstructive sleep apnea (OSA) is poorly described in Nigeria. We aimed to compare OSA risk between obese and nonobese adults in urban Nigeria. Materials and Methods: An analytic cross-sectional study was conducted. Participants were interviewed using the World Health Organization Non-Communicable Disease questionnaire. OSA risk assessment was performed using the STOP-BANG questionnaire. A total score of ≥3 on the STOP-BANG questionnaire indicated OSA risk, whereas a score ≥5 indicated high OSA risk. Obesity was defined as body mass index (BMI) >30 kg/m². Relationship between obesity and OSA was tested using chi-square and logistic regression models used to control for confounding factors. Results: There were 744 respondents, with a mean age of 44 (standard deviation 10) years. A total of 206 [27.7%, 95% confidence interval (CI) 24.46–30.9] respondents were obese (BMI ≥30 kg/m²). A total of 307 (41.3%, 95% CI 37.7–44.9) respondents scored ≥3 on the STOP-BANG questionnaire, whereas 37 (4.9%, 95% CI 3.6–6.7) scored ≥5. More number of obese than nonobese [57.8% (119/206) versus 34.9% (188/538)] respondents met the criteria for OSA risk (P < 0.001). Similarly, more obese persons [10.3% (21/206)] met the criteria for high-risk OSA compared to the nonobese [3% (16/538)]; P < 0.001. In logistic regression models adjusted for cigarette smoking and alcohol consumption, the odds for OSA risk was 15.76 (95% CI 7.44–33.9) in persons with BMI >35 kg/m² compared to those with a BMI range of 18.5–24.99. Conclusion: Obesity and OSA may be more prevalent in Nigeria than previously predicted. Obesity independently increased OSA risk in this population.

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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.

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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.

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Background: Hematologic malignancies cause significant morbidity and mortality and are not uncommon in resource-limited low-income countries. However, the types, pattern of presentation, and treatment outcomes vary across regions. We assessed the presentation and overall survival (OS) over an 11-year period in adult patients with hematologic cancers in Jos, North Central Nigeria. Materials: and Methods This retrospective outcome study evaluated patients who presented with hematologic malignancies between 2005 and 2015 at the Jos University Teaching Hospital, Jos. Variables of interest were abstracted through chart reviews. Descriptive statistics were used to evaluate baseline and follow-up parameters. OS was assessed by using Kaplan–Meier method. Results: Sixty patients, contributing 25,994 person-days of follow-up were evaluated. The mean age was 43 ± 17 years and 61.7% were males. Thirty-one patients (51.7%) presented with leukemia, 45.0% with lymphoma, and 3.3% with multiple myeloma. Forty-two (70.0%) presented with advanced disease, 5 (5.2%) were human immunodeficiency virus positive and 4 (6.7%) had died at the end of follow-up. OS was 84.3% (95% confidence interval: 58.1–94.7). Survival differed by disease group (P = 0.01) and having fever at presentation (P = 0.02). Conclusion: We found long-term OS to be impacted by disease type and status of fever at presentation. Disease-specific strategies to improve early diagnosis and therapies are needed to ensure optimal outcomes in Nigerian patients.

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Background: The study aimed to assess the prevalence of risk factors and Lassa seroprevalence in Esan West local government area of Edo State. Methodology: One hundred and sixty-six respondents from 50 households were interviewed using structured questionnaires on prevalence of risk factors for Lassa virus exposure, household heads provided information on household risk factors. Determination of Lassa virus specific antibodies immunoglobulin (Ig) in the blood was by an Enzyme-linked immunosorbent assay technique. Analysis was performed with Statistical Package for Social Sciences (SPSS) version 16. (SPSS Inc, Chicago, IL, USA). Results: Rodents were seen in 49 (96.1%) houses in the previous 6 months, garri was eaten as a soaked meal by 97 (58.4%) respondents. IgM was found in 2 (1.3%) samples, and IgG, in 103 (58.2%). Negative IgG sero status was significantly associated with age <20 years (P < 0.00) and marital status as single (P < 0.00). Conclusion: There is a need for health education to improve food hygiene practices and reduce practices that promote rodent contact with humans.

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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.

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Background: The pattern of congenital heart diseases (CHD) varies from region to region even in the same country. Echocardiography has been available in Aminu Kano Teaching Hospitalfor about 10 years now but problems then were non-available of appropriate probes for children making it difficult to make some specific diagnosis. This study was undertaken to determine the types and the relative frequencies of congenital heart defects seen among children at the Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods: This is a retrospective study of the echocardiographic data collected over 24 month's period, between October 2009 and September 2011. Information obtained from the records included age, gender, clinical diagnosis, and echocardiographic findings. Data was analyzed and expressed in frequency tables and percentages. Results: A total of 506 children were seen. The age range was between 5 days and 15 years with a mean age of 3.29 ΁ 2.56. A total of 173 (34.2%) had CHD. There were 104 boys and 69 girls giving a M: F ratio of 3:2. 48.6% of the children were 1 year and younger. In order of frequencies, the common CHD are ventricular septal defect (30.6%), tetralogy of fallot (16.7%), atrial septal defect (12.1%), patent ductus arteriosus (10.9%), endocardial cushion defect (8.8%), tricuspid atresia (4.6%) and truncus arteriosus (2.3%). Conclusions: Echocardiographic screening of the children revealed a wide variety of CHDs. VSD and TOF are the most common, accounting for about half of the cases with CHDs. There is an urgent need for government and non-government organizations to establish well-equipped cardiothoracic surgical centes across the country to cater for children with CHDs.

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Background: Contraceptive widely known in most rural setting as family planning is the planning of when to have children and the use of birth control and other techniques to implement such plans. Socio-cultural status is a determinant of health; it also has an influence on women's knowledge and uptake of contraceptive, the study therefore assessed the family planning uptake rate, prevalence of family planning method and the relationship between the social status and the method used. Methodology: A cross-sectional community survey was conducted among women of reproductive age residing in the community. Epi info version 3.4.3 and statistical package for the social sciences version 16.0 were used for the data entry and analysis respectively. Results: Out of the 362 females studied, (85.4%) were married and (46.4%) had no formal education. Farming was their predominant occupation. Out of all the females respondents; (86.7%) have had deliveries out of which (42.2%) are multiparous and (44.6%) grand multiparous. Contraceptive use was found to be (18.0%); and the most used was injectables (58.5%). A statistically significant association (P = 0.001) was established between contraceptive use and age, religion and marital status. Conclusion: Although contraception use was generally poor among the rural women in the studied community; married women, Christians and younger women were more likely to use a method compared to singles, Muslims and the older women respectively.

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Background: Sexually transmitted infections (STIs) are responsible for a variety of health problems especially among the youth who engage in risky sexual behavior. There are few studies that describe STIs among the youths in Northern Nigeria. The objective of the study was to assess knowledge of STIs and risk factors among secondary school youth. Materials and Methods: This was a cross-sectional study in which structured, self-administered questionnaire was used to collect data on socio-demographics, knowledge on STIs, and risk factors. Three senior secondary schools were purposively selected for the study. Results: A total of 1765 youths aged 10-30 years with mean age of 16.9 ± 2.0 years participated in the study. 1371 (77.7%) and 394 (22.3%) were respectively Muslim and Christian. Mean age at first sexual intercourse was 16.7 ± 2.0 years. A majority (67.6%) of them heard about STIs; sources of information of STIs were school lessons 23.6%, mass media 23.3%, and health magazines 19.2%, respectively. Generally, knowledge on STIs was good as 75.4% of respondents knew how the disease is transmitted. This knowledge was significantly associated with class of student, place of treatment, and religious teaching (χ² = 9.6, P = 0.047, χ² = 22.1, P = 0.035 and 42.6, P = 0.001, respectively). Mean knowledge score was 0.698 ± 0.01. A majority of respondents were engaged in risky sexual behavior as only 16.2% use condom as a preventive measure. Eleven percent reported ever having an STI in the past and majority (52.8%) go to government hospital for treatment of acquired STI. 56% of the youth had two or more boy/girl friends and 30% had sexual relationships. Conclusion: It was concluded that secondary school youth had good knowledge about STIs; however, the opposite is true when it comes to preventive practice (use of condom). Interventions such as periodic publicity awareness and school seminars focusing on STI preventions are needed to control the disease among the youth.

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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.

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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.

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Introduction: Tuberculosis (TB) kills, worldwide, about 1.5 million people infected by the disease per year according to the 2015 World Health Organization (WHO) Global TB report. In sub-Saharan Africa, Nigeria accounts for the highest absolute number of TB morbidity and the 4th among the six high-TB burden countries, which account for about 60% of all TB cases globally. Materials and Methods: This study is a retrospective, descriptive cross-sectional review of the facility TB registers of 4054 patients who accessed TB healthcare services at the 25 directly observed treatment short course (DOTS) Primary Health Care facilities in Zaria, Northwestern Nigeria, between January 1, 2007 and December 31, 2015. Results: Majority of the patients were males (2601; 64.2%), belonging to the age group <40 years (2837; 70%) The patients presented mainly with pulmonary TB (3591; 88.6%). Only half the number of patients (50.3%) had smear-positive results before the commencement of short-course chemotherapy with either 2RHZE/6EH or 2SRHZE/IRHZE/5RHE (1, 2 = 1 or 2 months intensive phase, 5 = 5 months continuation phase, R = rifampicin, H = isoniazid, Z= pyrazinamide, E = ethambutol, S = streptomycin). Human immunodeficiency virus (HIV) coinfection was reported in 774 (19.1%) patients. The treatment success rate was 80.2% (3253 patients); 278 (6.9%) of the patients were lost to follow-up, 176 (4.3%) were transferred out, and 235 (5.8%) died. The determinants of the unsuccessful treatment outcome were being a male, aged >40 years, TB and HIV coinfection, a greater degree of sputum smear positivity before treatment, located at far distances from DOTS centers, and being on retreatment or second-line regimen. Conclusion: The treatment success rate falls below the recommended 85% by the WHO. Recommendations: There is a need for the Nigeria government in collaboration with international agencies to intensify effort at TB surveillance, monitoring, and control activities in Nigeria. Effort should be directed at promoting TB/HIV awareness, the early recognition and diagnosis of TB, and strategies to expand and improve DOTS service at community level.

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Introduction: Head injury (HI) is defined as physical damage to the brain or skull caused by external forces. The aim of this study was to examine the epidemiology of HI-related emergency department visits in our institution. Materials and Methods: This was a retrospective study of all patients with HI presenting at the accident and emergency department (AED) of the University of Port Harcourt Teaching Hospital from January 2013 to December 2014. The variables extracted for the study included patients’ age, gender, etiology, the severity of injury, the period of presentation, and the outcome of the management of HI by the AED. Results: HI occurred in 415 (30.9%) of the patients with trauma (1344) and 3.6% of all AED admissions (11,393). Of the patients with HI, 319 (76.9%) were males, and 96 (23.1%) were females. The male/female ratio was 3.3:1. The median age was 27 years (range − 1 month to 100 years). The highest frequency of 133 (32.0%) was in the age range of 21–30 years followed by 98 (23.6%) in the age range of 31–40 years. The most common etiologic factor was road traffic accident (RTA) [260 (62.6%)]. Most of the HIs were mild [162 (39.0%)]. More patients presented at night [161 (38.8%)]. There were 94 deaths, giving a case fatality rate of 22.6%. Conclusion: The 21–40 years age bracket was more affected by HI. RTA was the major cause of HI in our environment. The evening and night periods recorded the highest HI visits to the AED.

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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.

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Background: Sickle cell disease (SCD) is an inherited lifelong hemolytic disorder affecting many children in sub-Saharan Africa, especially in West and Central Africa. There is a limited public health education on SCD in Ghana with only two information centers in Accra and Kumasi, respectively. Methodology: This cross-sectional study evaluated the knowledge of SCD among people living in Sekondi-Takoradi metropolis. Churches, saloons, internet cafes and bus stations were randomly selected in the center of the city with proximity to the central market. Results: A total of 621 individuals were recruited, 52.5% (326) had knowledge of their hemoglobin (Hb) electrophoretic pattern while 47.5% (295) had none. In addition, 93.4% individuals had knowledge of SCD while 6.6% had no knowledge of SCD. Older individuals exhibited better knowledge of their Hb electrophoretic pattern than the younger ones (P = 0.019). Individuals with tertiary education and married couples exhibited higher knowledge of SCD when compared to their counterparts (P < 0.001). Conclusion: Despite the relatively high knowledge of SCD and Hb electrophoretic pattern observed in this study, it is very important to increase neonatal screenings and health care services to the region. In addition, more emphasis is needed to increase public awareness of SCD especially in schools, churches, hospitals and the media.

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Introduction: The human immunodeficiency virus (HIV) and drugs taken for this infection are known to cause QTc interval prolongation which in turn can lead to severe arrhythmias. The prevalence and associated factors of prolonged QTc in HIV-positive children in sub- Saharan Africa have not been described. Objectives: To compare the mean QTc interval and prevalence of QTc prolongation in HIV-positive children and HIV-negative controls, and to determine the factors associated with prolonged QTc in HIV-positive children. Methodology: In a cross-sectional comparative study, the corrected QT intervals (QTc) of 100 HIV-positive children were compared with those of age- and sex-matched HIV-negative healthy controls. QTc > 0.46 seconds was regarded as prolonged. Results: Subjects were aged 9 months to 14 years. Mean QTc was significantly longer-43.31 (95% CI 43.30, 43.32) seconds in HIV-positive children (62% of whom were on anti-retroviral therapy) compared with controls-41.43 (41.42, 41.44) seconds (P < 0.0001). Mean QTc was also significantly longer in subjects receiving zidovudine (ZDV) - [0.46 (0.45, 0.47) versus 0.43 (0.42, 0.44) seconds] - P = 0.007 and efavirnez (EFV) - [0.45 (0.43, 0.47) versus 0.43 (0.42, 0.44) seconds] - P = 0.047 in subjects not on these drugs. Prolonged QTc was significantly more frequent in HIV-positive children (18.0%) compared with controls (0%) - P = 0.0001. There was no significant relationship between either the mean QTc or the frequency of prolonged QTc, and the subjects' mean age, sex, clinical or immunological stage of disease. Conclusion: Mean QTc is significantly longer in HIV-positive children (especially those receiving ZDV or EFV), compared with controls. Prolonged QTc is also significantly more frequent in subjects. Baseline and periodic ECG screening of HIV-positive children may facilitate early detection of QTc prolongation and help prevent fatal arrhythmias.

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Malnutrition is a major contributor to the death of children under 5 years of age in sub-Saharan Africa. Furthermore, poor nutrition causes stunting and underweight in infants and children while at the same time putting at risk normal neurologic and cognitive development. A recent study of rural Fulani infants up to age 2 years in northern Nigeria found that more than one-quarter were stunted and underweight. The nutritional status of these infants was relatively sound at birth but progressively declined over the following 2 years. While insufficient dietary macronutrients such as protein and carbohydrate and micronutrients such as iodine, zinc, vitamin A and iron may well have contributed to their post-natal growth retardation, in this report we raise the possibility that inadequate intake of essential long-chain ω-3 fatty acids, docosahexaenoic acid (DHA) in particular, by infants during the first few years of life may play a role in childhood malnutrition in this part of the world, especially in populations like the Fulani pastoralists who live far-removed from the ocean which would otherwise provide access to DHA-rich seafood. We conclude this piece by suggesting several approaches for improving the DHA status of pregnant and lactating Fulani women and their offspring in Nigeria.

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