Commercial Laboratory IgM Testing for Toxoplasma gondii in Pregnancy: A 20-Year Experience

Objective. This study was performed to review the clinical utility of commercial laboratory Toxoplasmosis-specific IgM testing during pregnancy and outcomes of the gestation at our institution

COVID-19 Vaccine Uptake and Hesitancy amongst University Students in a Tertiary Institution in Edo State, Nigeria

Hesitancy among various population groups, including young university students, is a significant challenge to maximising vaccination benefits, including the promotion of educational activities. However, there is a paucity of epidemiological evidence on COVID-19 hesitancy among this young population. Therefore, the objective of this paper is to describe the COVID-19 vaccine uptake and hesitancy amongst University students in a Tertiary Institution in Edo State, Nigeria, using appropriate standard methods with 677 students participating in this study from December 2021 to January 2023. Students aged 18-22 accounted for the highest proportion of the study participants at 71.1%, and the proportion of male students was slightly higher than that of female students (52.4% vs 47.6%). Only 9.2% of the 677 students had ever taken the COVID-19 vaccine prior to the study. However, 615 responded to whether they would be willing to take the COVID-19 vaccine if made available, of which 68.3% (420/615) reported hesitancy. The common reasons cited by hesitant students (n=420) were the ineffectiveness of the vaccine against severe clinical outcomes (46.0%; 193/420), unavailability of the vaccine (29.5%; 124/420), and other reasons such as fear and rumoured side effects (14.5; 61/420). In conclusion, COVID-19 vaccine uptake and hesitancy among students in the study population were low and high, respectively, underlining the need for context-specific COVID-19 vaccination campaigns

A comparison of meningococcal carriage by pregnancy status

Neisseria meningitidis is the second leading cause of invasive meningitis. A prerequisite for infection is colonization of the nasopharynx, and asymptomatic carrier rates are widely reported in the range of 10-15%. Recent reports have indicated an increased likelihood that a pediatric admission for Neisseria meningitidis will have a mother who is pregnant in the home. We hypothesized that this association may relate to immunologic changes in pregnancy leading to higher carrier rates

Abdominoplasty Combined with Liposuction and Abdominal Herniorraphy as a Single Procedure for Ventral Hernia Repair- A Review of 6 Patients

Abdominoplasty is a commonly performed aesthetic procedure. Indications for this procedure include: fascial laxity or diastasis of the abdominal wall, abdominal wall hernias and aesthetic concerns of patient. Ventral hernias may be diagnosed clinically or intraoperatively during abdominoplasty. Hence, the objective of this paper is to review six (6) patients who had abdomiinoplasty combined with liposuction and abdominal herniorraphy as a single procedure for ventral hernia repair. Indication for surgery was purely cosmetic in 33.3% (n=2) while the other patients had co-existing hernia. One patient had umbilical hernia, 2 patients had epigastric hernia and one of the patients had combined paraumblical and epigastric hernia. All the patients had diastasis of the rectus. The abdominal hernias were diagnosed pre- operatively. All patients had liposuction from the trunk and the upper abdomen prior to abdominoplasty on same sitting. The procedures were done under general anesthesia with endotracheal intubation .The liposuction was done using the tumescence technique after which the traditional abdominoplasty was done. Herniorrhaphy was done along with rectal plication. Wound was closed in two layers.One patient had peri- umbilical abscess which resolved with drainage. All the patients had good outcome and expressed satisfaction with the procedure. Abdomiinoplasty combined with liposuction and abdominal herniorraphy as a single procedure is safe

What are the drivers of recurrent cholera transmission in Nigeria? Evidence from a scoping review

Background: The 2018 cholera outbreak in Nigeria affected over half of the states in the country, and was characterised by high attack and case fatality rates. The country continues to record cholera cases and related deaths to date. However, there is a dearth of evidence on context-specific drivers and their operational mechanisms in mediating recurrent cholera transmission in Nigeria. This study therefore aimed to fill this important research gap, with a view to informing the design and implementation of appropriate preventive and control measures. / Methods: Four bibliographic literature sources (CINAHL (Plus with full text), Web of Science, Google Scholar and PubMed), and one journal (African Journals Online) were searched to retrieve documents relating to cholera transmission in Nigeria. Titles and abstracts of the identified documents were screened according to a predefined study protocol. Data extraction and bibliometric analysis of all eligible documents were conducted, which was followed by thematic and systematic analyses. / Results: Forty-five documents met the inclusion criteria and were included in the final analysis. The majority of the documents were peer-reviewed journal articles (89%) and conducted predominantly in the context of cholera epidemics (64%). The narrative analysis indicates that social, biological, environmental and climatic, health systems, and a combination of two or more factors appear to drive cholera transmission in Nigeria. Regarding operational dynamics, a substantial number of the identified drivers appear to be functionally interdependent of each other. / Conclusion: The drivers of recurring cholera transmission in Nigeria are diverse but functionally interdependent; thus, underlining the importance of adopting a multi-sectoral approach for cholera prevention and control

Descriptive epidemiology of cholera outbreak in Nigeria, January-November, 2018: implications for the global roadmap strategy

Background: The cholera outbreak in 2018 in Nigeria reaffirms its public health threat to the country. Evidence on the current epidemiology of cholera required for the design and implementation of appropriate interventions towards attaining the global roadmap strategic goals for cholera elimination however seems lacking. Thus, this study aimed at addressing this gap by describing the epidemiology of the 2018 cholera outbreak in Nigeria. Methods: This was a retrospective analysis of surveillance data collected between January 1st and November 19th, 2018. A cholera case was defined as an individual aged 2 years or older presenting with acute watery diarrhoea and severe dehydration or dying from acute watery diarrhoea. Descriptive analyses were performed and presented with respect to person, time and place using appropriate statistics. Results: There were 43,996 cholera cases and 836 cholera deaths across 20 states in Nigeria during the outbreak period, with an attack rate (AR) of 127.43/100,000 population and a case fatality rate (CFR) of 1.90%. Individuals aged 15 years or older (47.76%) were the most affected age group, but the proportion of affected males and females was about the same (49.00 and 51.00% respectively). The outbreak was characterised by four distinct epidemic waves, with higher number of deaths recorded in the third and fourth waves. States from the north-west and north-east regions of the country recorded the highest ARs while those from the north-central recorded the highest CFRs. Conclusion: The severity and wide-geographical distribution of cholera cases and deaths during the 2018 outbreak are indicative of an elevated burden, which was more notable in the northern region of the country. Overall, the findings reaffirm the strategic role of a multi-sectoral approach in the design and implementation of public health interventions aimed at preventing and controlling cholera in Nigeri

Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: retrospective cohort study

Objective: Despite the increasing disease burden, there is a dearth of context-specific evidence on the risk factors for COVID-19 positivity and subsequent death in Nigeria. Thus, the study objective was to identify context-specific factors associated with testing positive for COVID-19 and fatality in Nigeria. Design Retrospective cohort study. Setting: COVID-19 surveillance and laboratory centres in 36 states and the Federal Capital Territory reporting data to the Nigeria Centre for Disease Control. Participants: Individuals who were investigated for SARSCoV-2 using real-time PCR testing during the study period 27 February–8 June 2020. Methods: COVID-19 positivity and subsequent mortality. Multivariable logistic regression analyses were performed to identify factors independently associated with both outcome variables, and findings are presented as adjusted ORs (aORs) and 95% CIs. Results: A total of 36 496 patients were tested for COVID-19, with 10 517 confirmed cases. Of 3215 confirmed cases with available clinical outcomes, 295 died. Factors independently associated with COVID-19 positivity were older age (p value for trend<0.0001), male sex (aOR 1.11, 95%CI 1.04 to 1.18) and the following presenting symptoms: cough (aOR 1.23, 95% CI 1.13 to 1.32), fever (aOR 1.45, 95% CI 1.45 to 1.71), loss of smell (aOR 7.78, 95% CI 5.19 to 11.66) and loss of taste (aOR 2.50, 95% CI 1.60 to 3.90). An increased risk of mortality following COVID-19 was observed in those aged ≥51 years, patients in farming occupation (aOR 7.56, 95% CI 1.70 to 33.53) and those presenting with cough (aOR 2.06, 95% CI 1.41 to 3.01), breathing difficulties (aOR 5.68, 95% CI 3.77 to 8.58) and vomiting (aOR 2.54, 95% CI 1.33 to 4.84). Conclusion: The significant risk factors associated with COVID-19 positivity and subsequent mortality in the Nigerian population are similar to those reported in studies from other countries and should guide clinical decisions for COVID-19 testing and specialist care referrals

Foetal haemoglobin, blood transfusion, and retinopathy of prematurity in very preterm infants:A pilot prospective cohort study

Purpose To identify if there is an association between foetal haemoglobin (HbF) concentration and retinopathy of prematurity (ROP) in very preterm infants. Patients and methods Prospective cohort study. Infants born <32 weeks’ gestational age or <1501 g in two tertiary neonatal units between January 2012 and May 2013 (n=42) were enrolled. HbF and adult haemoglobin (HbA) concentrations were measured using high-pressure liquid chromatography from blood samples sent as part of routine neonatal care once routinely requested laboratory tests had been performed. Clinical data were obtained from case notes. We calculated odds ratios (ORs) (95% confidence intervals (CIs)) to quantify the relationship between initial and mean %HbF with ROP severity (none, stages 1–3). Results A total of 42 infants were recruited: mean gestation 28.0 weeks (SD 1.91); mean birth weight 1042 g (SD 264). Six infants died before ROP screening; 14/36 developed ROP (39%); and 22/36 (61%) did not. Infants who developed ROP had similar initial %HbF (83.3 vs 92.3%, P=0.06), but significantly lower mean %HbF (61.75 vs 91.9%, P=0.0001) during their inpatient stay than those who did not develop ROP. In ordinal logistic regression models adjusted for birth weight, gestation and transfusion volume, mean post-natal %HbF was negatively associated with ROP severity: adjusted OR 0.94 (0.90–0.99), while initial %HbF at birth was not: adjusted OR 1.05 (0.97–1.16). Conclusion Replacing HbF by HbA during transfusion may promote ROP development by rapidly increasing oxygen availability to the retina. Conversely, maintaining a higher %HbF may be a protective factor against ROP