Prevalence of end-digit preference in recorded blood pressure by nurses: a comparison of measurements taken by mercury and electronic blood pressure-measuring devices

Objectives: When compared with the use of a mercury  sphygmomanometer, the use of a validated digital blood pressure (BP) measuring device eliminates the risk of exposure to mercury. Digital devices are also associated with a lesser degree of end-digit preference (EDP). EDP refers to the occurrence of a particular end digit more frequently than would be expected through chance alone. There have been only a few reports from Africa on the occurrence of EDP in BP measurement. This study examined EDP in BP taken by nurses before and after the introduction of a digital BP-measuring device. Design: The design was a retrospective study. Settings and subjects: We reviewed the BP readings of 58 patients who presented at the dedicated clinic for people living with human immunodeficiency virus/acquired immune deficiency syndrome of Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria, before and after the introduction of the digital BP-measuring device. Outcome measures: The prevalence of end-digit zero of systolic and diastolic BP readings before and after the introduction of the digital device was compared using McNemar’s test. Results: There was a large and significant fall in end-digit zero when BP readings that were taken using the mercury and digital devices were compared (systolic 98.1% vs. 10.9%, p-value < 0.001; diastolic 97.1% vs. 14.9%, p-value < 0.001 (McNemar’s test). Conclusion: There was a significant reduction in the frequency of end-digit zero when BP was taken with the digital devicerather than the mercury device. Regular training and certification of healthcare workers in BP measurement is recommended to ensure a high quality BP measurement standard.Keywords: blood pressure measurement, mercury sphygmomanometer, digital blood pressure-measuring devices, end-digit preferenc

Predictors of Indoor Insecticides spray utilization in the Prevention of Malaria related mosquito bites in Ogun State, Nigeria: A Community based study

BACKGROUND: Modern medicine tends to interpret health in terms of medical interventions and to overemphasize the importance of medical technology. It is important to promote the concept of health as theresult of the interaction of human beings and their total environment.METHODS: This was a descriptive cross-sectional study. A cluster sampling technique was used to select the participants into the study. The study was carried out between January 2012 and February 2012. One participant per household was selected into the study. A semi- structured questionnaire was used to collect relevant information which was collated and analyzedusing SPSS 15 statistical software.RESULTS: A total of 400 households were recruited into the study. The prevalence of insecticide spray utilization in the last 6months was 18.5%. Source of information on the use of insecticides included the radio/TV 174 (43.5%), Relatives 78 (19.5%), Health workers 54 (13.5%), friends 68 (17.0%) and others 26 (6.5%). Reasons for not using insecticides includedbeing expensive (cost) 94 (23.5%), fear of side effect 16 (4.0%), Inconvenience 38 (9.5%) and un-availability 74 (18.5%). Predictors of utilization of insecticide spray were young age (<30 yrs) of heads of household (O.R=5.10, C.I=1.06-21.7), tertiary education (OR= 9.14C.I=1.13-53.08), Nuclear family structure (OR=2.45 C.I=1.13-3.74) and availability of insecticide spray (OR=2.21 C.I=1.24-4.05).CONCLUSION: The study shows that households with heads that are young and educated are more likely to use insecticide spray. The study indicates that programs that will be geared towards increasing the knowledge and awareness of indoor insecticide spray in the prevention of Malaria should be introduced at the community level

Profile of clinically-diagnosed dementias in a neuropsychiatric practice in Abeokuta, South-Western Nigeria

Objective: Many subjects with dementia present primarily to neuropsychiatric practices because of behavioural and psychological symptoms (BPSD). This study reviewed the profile of clinically-diagnosed dementias and BPSD seen in a pioneer neuropsychiatric practice in Abeokuta, southwestern Nigeria over a ten year period (January1998 – December 2007). Methods: A review of hospital records of all patients with diagnoses of dementia or dementing illness using the ICD-10 criteria as well as specific diagnostic criteria for different dementia phenotypes. Associated BPSD, co-morbidities and treatments were also reviewed. Results: Out of a total of 240,294 patients seen over the study period, 108 subjects met clinical diagnostic criteria for probable dementia giving a hospital frequency of 45 per 100,000. Alzheimer’s disease (AD) and Vascular dementia (VaD) were the predominant phenotypes seen in 62 (57.4%) and 18 (16.7%) subjects respectively. Others include mixed dementia (4 cases), frontotemporal dementia (4 cases), Lewy body dementia (3 cases), alcohol-related dementia (3 cases), PD dementia (1 case) and unclassifiable (13 cases). Apathy, night time behaviour, aberrant motor behaviour, agitation and irritability were the most common BPSD features, while hypertension was the most common co-morbidity. Neuroleptics, anticholinergics and anti-hypertensives were most commonly prescribed. Anticholinesterase inhibitors were sparingly used. Conclusion: Probable AD was the most prevalent dementia phenotype seen in this practice. Increased awareness of dementia and better utilization of specific treatments are needed among psychiatrists and primary care practitioners in Nigeria.Keywords: Dementia phenotypes; BPSD; Neuropsychiatric practice; Nigeria; Afric

Evaluation of four apicultural products for hive colonization by honey bees (Apis mellifera adansonii) (Hymenoptera: apidae) and pre-colonization pests

Four apicultural products (honey, bee wax, slum gum and propolis) were evaluated for their potentials to attract the African honey bee (Apis mellifera adansonii) colony into artificial hives and their effect on infestation by apicultural insect pests. Ten grammes each of propolis, bee wax and slum gum and 10 ml of honey were applied at the flight entrance, walls of the hives and on the top bars. Data were collected on type and number of pre-colonization pests, hive colonization, colony weight gain, weight of matured harvested combs and weight of extracted honey from the harvested combs. Statistical analysis of the data was carried out using analysis of variance and means were separated with Tukeys’ HSD at 5% level of probability. Slum gum-baited hives were the first to be colonized (10 days post hive installation) (DPI), followed by bee wax (26.5 DPI). Bee wax however had the highest percentage hive colonization (66.67%) which was not significantly (P>0.05) different from 33.33% observed in other apicultural products. Weight gain on weekly basis did not follow a regular pattern for 2-10 weeks after colonization (WAC); but at 12-16 WAC, hives baited with bee wax had the highest weekly weight gain. In terms of total harvest, the performance of the different baiting materials was as follows: slum gum > bee wax > honey > propolis. However, percentage honey yield was highest in hives baited with bee wax and lowest in propolis-baited hives. The two pests encountered at the pre-colonization stage were waiver ant (Oecophylla longinuda) and sugar ant (Camponotus consobrinus). O. longinuda was significantly (P<0.05) highest (17.33) in honey baited hives than any other baiting material at 2 DPI. Slum gum and honey attracted more sugar ants at 2-4 DPI than bee wax. At 3 DPI, O. longinuda was significantly (P<0.05) higher in slum gum than bee wax; but the later performed better with significantly lower level of pre-colonization pest infestation.Keywords: pest, wax, honey, propolis, slum-gu

Effect of industrial effluents on the growth and anatomical structures of Abelmoschus esculentus (okra)

The authors investigated the impact of industrial effluents from 5 different industrial concerns in Lagos, Nigeria on Okra (Abelmoschus esculentus). During the study, it was observed that these effluentsinduced detrimental effects on the flowering, fruiting, stem length, leaf width and leaf length of okra. Other parameters analysed were pH, electrical conductivity, total dissolved solids, chemical oxygendemand (COD), biological oxygen demand (BOD) and oil level. Results obtained show that the main drain (MD) had the highest electrical conductivity (1961 ìs, pH 10.43), as well as total dissolved solids(TDS, 977 mg/l). Effluent from toiletries had the highest concentration of oil (0.121) and the lowest pH (2.75). All effluents affected the time of flowering and fruiting of okra when compared with the control.The mean number and mean weight of fruits produced were also affected, although the extent varies from effluent to effluent. The effect was more pronounced in toiletries and plastic effluents where themean values for fruit numbers was 3 and mean weight of 17.4 g. However, the mean weight for paint was higher than toiletries. Cross-sections of the experimental okra plants showed that the effluentaffected the anatomical structures of the plant; the effect being more pronounced on okra grown on MD. The anatomy of the control grown okra was not affected. The leaves of okra grown on toiletrieseffluent had a less mean leaf length than those grown on the rest effluents. The same trend was recorded for the mean leaf width. The stem length of okra grown on paint effluent had the least meanvalue and hence most affected. The highest value for all parameters studied was recorded for the control. There was a significant difference between the means of length of leaf, stem and leaf width andthose of the control, signifying the effects which industrial effluents could have on the growth and productivity of plants

Exploiting thrips aggregation pheromones to develop a lure-and-kill strategy for the management of the bean flower thrips

The potential of semiochemicals to lure insect pests to a trap where they can be killed with biopesticides has been demonstrated as an eco-friendly pest management alternative. In this study, we tested two recently characterized male-produced aggregation pheromones of the bean flower thrips Megalurothrips sjostedti (Trybom), namely (R)-lavandulyl 3-methylbutanoate (major) and (R)-lavandulol (minor), for their field efficacy. Moreover, compatibility of these pheromones and two other thrips attractants, Lurem-TR and neryl (S)-2-methylbutanoate, with the entomopathogenic fungus (EPF) Metarhizium anisopliae ICIPE 69 has been determined. Our study revealed that the M. sjostedti aggregation pheromones have dose-dependent antifungal effects on the EPF viability, but showed no fungistatic effect at a field-realistic dose for attraction of thrips. (R)-lavandulyl 3-methylbutanoate had similar antifungal effects as neryl (S)-2-methylbutanoate 8 days after exposure; whereas, Lurem-TR had a stronger antifungal effect than other thrips attractants. In the semi-field experiments, all autoinoculation devices maintained at least 86% viability of M. anisopliae conidia after 12 days of exposure. Field trials demonstrated for the first time that (R)-lavandulyl 3-methylbutanoate increases trap catches. Our findings pave a way for designing a lure-and-kill thrips management strategy to control bean flower thrips using autoinoculation devices or spot spray application

Social factors affecting seasonal variation in bovine trypanosomiasis on the Jos Plateau, Nigeria

BACKGROUND: African Animal Trypanosomiasis (AAT) is a widespread disease of livestock in Nigeria and presents a major constraint to rural economic development. The Jos Plateau was considered free from tsetse flies and the trypanosomes they transmit due to its high altitude and this trypanosomiasis free status attracted large numbers of cattle-keeping pastoralists to the area. The Jos Plateau now plays a major role in the national cattle industry in Nigeria, accommodating approximately 7% of the national herd, supporting 300,000 pastoralists and over one million cattle. During the past two decades tsetse flies have invaded the Jos Plateau and animal trypanosomiasis has become a significant problem for livestock keepers. Here we investigate the epidemiology of trypanosomiasis as a re-emerging disease on the Plateau, examining the social factors that influence prevalence and seasonal variation of bovine trypanosomiasis. METHODS: In 2008 a longitudinal two-stage cluster survey was undertaken on the Jos Plateau. Cattle were sampled in the dry, early wet and late wet seasons. Parasite identification was undertaken using species-specific polymerase chain reactions to determine the prevalence and distribution of bovine trypanosomiasis. Participatory rural appraisal was also conducted to determine knowledge, attitudes and practices concerning animal husbandry and disease control. RESULTS: Significant seasonal variation between the dry season and late wet season was recorded across the Jos Plateau, consistent with expected variation in tsetse populations. However, marked seasonal variations were also observed at village level to create 3 distinct groups: Group 1 in which 50% of villages followed the general pattern of low prevalence in the dry season and high prevalence in the wet season; Group 2 in which 16.7% of villages showed no seasonal variation and Group 3 in which 33.3% of villages showed greater disease prevalence in the dry season than in the wet season. CONCLUSIONS: There was high seasonal variation at the village level determined by management as well as climatic factors. The growing influence of management factors on the epidemiology of trypanosomiasis highlights the impact of recent changes in land use and natural resource competition on animal husbandry decisions in the extensive pastoral production system

Characterisation of heart failure with normal ejection fraction in a tertiary hospital in Nigeria

<p>Abstract</p> <p>Background</p> <p>The study aimed to determine the frequency and characteristics of heart failure with normal EF in a native African population with heart failure.</p> <p>Methods</p> <p>It was a hospital cohort study. Subjects were 177 consecutive individuals with heart failure and ninety apparently normal control subjects. All the subjects underwent transthoracic echocardiography. The group with heart failure was further subdivided into heart failure with normal EF (EF ≥ 50) (HFNEF) and heart failure with low EF(EF <50)(HFLEF).</p> <p>Results</p> <p>The subjects with heart failure have a mean age of 52.3 ± 16.64 years vs 52.1 ± 11.84 years in the control subjects; p = 0.914. Other baseline characteristics except blood pressure parameters and height were comparable between the group with heart failure and the control subjects. The frequency of HFNEF was 39.5%. Compared with the HFLEF group, the HFNEF group have a smaller left ventricular diameter (in diastole and systole): (5.2 ± 1.22 cm vs 6.2 ± 1.39 cm; p < 0.0001 and 3.6 ± 1.24 cm vs 5.4 ± 1.35 cm;p < 0.0001) respectively, a higher relative wall thickness and deceleration time of the early mitral inflow velocity: (0.4 ± 0.12 vs 0.3 ± 0.14 p < 0.0001 and 149.6 ± 72.35 vs 110.9 ± 63.40 p = 0.001) respectively.</p> <p>The two groups with heart failure differed significantly from the control subjects in virtually all echocardiographic measurements except aortic root diameter, LV posterior wall thickness(HFLEF), and late mitral inflow velocity(HFNEF). HFNEF accounted for 70(39.5%) of cases of heart failure in this study.</p> <p>Hypertension is the underlying cardiovascular disease in 134(75.7%) of the combined heart failure population, 58 (82.9%) of the subjects with HFNEF group and 76(71%) of the HFLEF group. Females accounted for 44 (62.9%) of the subjects with HFNEF against 42(39.3%) in the HFLEF group (p = 0.002).</p> <p>Conclusion</p> <p>The frequency of heart failure with normal EF in this native African cohort with heart failure is comparable with the frequency in other populations. These groups of patients are more likely female, hypertensive with concentric pattern of left ventricular hypertrophy.</p

A longitudinal survey of African animal trypanosomiasis in domestic cattle on the Jos Plateau, Nigeria:prevalence, distribution and risk factors

BACKGROUND: Trypanosomiasis is a widespread disease of livestock in Nigeria and a major constraint to the rural economy. The Jos Plateau, Nigeria was free from tsetse flies and the trypanosomes they transmit due to its high altitude and the absence of animal trypanosomiasis attracted large numbers of cattle-keeping pastoralists to inhabit the plateau. The Jos Plateau now plays a significant role in the national cattle industry, accommodating approximately 7% of the national herd and supporting 300,000 pastoralists and over one million cattle. However, during the past two decades tsetse flies have invaded the Jos Plateau and animal trypanosomiasis has become a significant problem for livestock keepers. METHODS: In 2008 a longitudinal two-stage cluster survey on the Jos Plateau. Cattle were sampled in the dry, early wet and late wet seasons. Parasite identification was undertaken using species-specific polymerase chain reactions to determine the prevalence and distribution bovine trypanosomiasis. Logistic regression was performed to determine risk factors for disease. RESULTS: The prevalence of bovine trypanosomiasis (Trypanosoma brucei brucei, Trypanosoma congolense savannah, Trypanosoma vivax) across the Jos Plateau was found to be high at 46.8% (39.0 – 54.5%) and significant, seasonal variation was observed between the dry season and the end of the wet season. T. b. brucei was observed at a prevalence of 3.2% (1% – 5.5%); T. congolense at 27.7% (21.8% - 33.6%) and T. vivax at 26.7% (18.2% - 35.3%). High individual variation was observed in trypanosomiasis prevalence between individual villages on the Plateau, ranging from 8.8% to 95.6%. Altitude was found to be a significant risk factor for trypanosomiasis whilst migration also influenced risk for animal trypanosomiasis. CONCLUSIONS: Trypanosomiasis is now endemic on the Jos Plateau showing high prevalence in cattle and is influenced by seasonality, altitude and migration practices. Attempts to successfully control animal trypanosomiasis on the Plateau will need to take into account the large variability in trypanosomiasis infection rates between villages, the influence of land use, and husbandry and management practices of the pastoralists, all of which affect the epidemiology of the disease

Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3

Background: Sustainable Development Goal (SDG) 3 aims to “ensure healthy lives and promote well-being for all at all ages”. While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available. Methods: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in 106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from 1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until 2030. We report all spending estimates in inflation-adjusted 2019 US$, unless otherwise stated. Findings: Since the development and implementation of the SDGs in 2015, global health spending has increased, reaching$7·9 trillion (95% uncertainty interval 7·8–8·0) in 2017 and is expected to increase to $11·0 trillion (10·7–11·2) by 2030. In 2017, in low-income and middle-income countries spending on HIV/AIDS was$20·2 billion (17·0–25·0) and on tuberculosis it was $10·9 billion (10·3–11·8), and in malaria-endemic countries spending on malaria was$5·1 billion (4·9–5·4). Development assistance for health was $40·6 billion in 2019 and HIV/AIDS has been the health focus area to receive the highest contribution since 2004. In 2019,$374 million of DAH was provided for pandemic preparedness, less than 1% of DAH. Although spending has increased across HIV/AIDS, tuberculosis, and malaria since 2015, spending has not increased in all countries, and outcomes in terms of prevalence, incidence, and per-capita spending have been mixed. The proportion of health spending from pooled sources is expected to increase from 81·6% (81·6–81·7) in 2015 to 83·1% (82·8–83·3) in 2030. Interpretation: Health spending on SDG3 priority areas has increased, but not in all countries, and progress towards meeting the SDG3 targets has been mixed and has varied by country and by target. The evidence on the scale-up of spending and improvements in health outcomes suggest a nuanced relationship, such that increases in spending do not always results in improvements in outcomes. Although countries will probably need more resources to achieve SDG3, other constraints in the broader health system such as inefficient allocation of resources across interventions and populations, weak governance systems, human resource shortages, and drug shortages, will also need to be addressed. Funding: The Bill & Melinda Gates Foundatio