Assessment of Background Radiation Levels at the Radiology Department of a Tertiary Hospital in North-central Nigeria

Background: Background radiation has over the years become a public health concern. It is therefore, imperative to ascertain its levels within strategic areas in our radiology facility for monitoring and compliance with international standards.Objectives: To determine the background radiation levels in the Radiology Department of Federal Medical Centre (FMC), Keffi, Nigeria.Methodology: The design was prospective and cross-sectional and involved the measurement of background radiation levels at various locations in the radiology department. Calibrated thermo Scientific RadEye TM B20 / B20-ER survey meter, an associated scalar counter, and a stopwatch, were used for measurements at each point, based on standard guidelines recommended by the International Atomic Energy Agency (IAEA).Results: The least mean radiation (0.11µSv/hr) was detected in the computed tomography (CT) suite while the maximum value (0.13µSv/hr) emanated from the radiographers' common room. The coefficient of variation for the Chief Radiographers office, Head of Department's office and the Radiologist’s office were similar 8.3%. The radiographers’ common room was slightly higher (10.9%). The main diagnostic room and seminar room had 16.7%, while it was 9.09% for the CT suite. The standard error ranged between 0.002 and 0.004. There was statistically significant difference in all test values at a level of significance of 5% (p < 0.05). Conclusion: Background radiation values obtained were within recommended standards. However, there is need for regular radiation monitoring as part of radiation safety culture in our radiology facility

Mentorship in Radiography: an Indispensable Tool for Sustainable Healthcare Transformation

  Background: The concept of mentorship has gained widespread popularity in literature across different walks of life owing to the significant benefits attached to it. Purpose: This paper intends to discuss the need for mentorship in radiography, as an indispensable tool for a sustainable healthcare transformation, taking clues from other health science disciplines and medicine. Method: Authors reviewed relevant literature on the subject to have an in-depth and updated knowledge both in the health sciences as well as in other disciplines. Search engines such as Google Scholar, My Websearch, and data base such as Science Direct, Hinari, Taylor and Francis and Medknow were consulted. Several articles that discussed mentorship across various disciplines were reviewed. Those with ideas and concepts that fit into the purpose of the study were included. Results: Several definitions and types of mentorship exist across different walks of life based on literature. However, we decided to adopt the definition of mentorship and types of mentorship by Feldman, who defined mentorship as a dynamic, reciprocal relationship in a work environment between an advanced career incumbent and a beginner, aimed at promoting the development of both. The uniform agreement across various disciplines is that mentoring is a crucial component of success. However, its application in radiography is inadequate. Conclusion: In view of the apparent benefits accruable to mentorship globally, stakeholders in radiography should make mentorship a priority, if we must maintain our role in a sustainable healthcare transformation.             &nbsp

Choice of contraception after previous operative delivery at a family planning clinic in Northern Nigeria

Context: Effective contraceptive use is important after a caesarean or operative delivery because of the possible risks a woman may face in subsequent pregnancies.Objectives: The objective of the present study was to determine the uptake and choices of contraception among women with previous operative delivery.Materials and Methods: A retrospective study was conducted at the Barau Dikko Teaching Hospital from 1st January, 2000 to 31st March, 2014. Family planning cards were retrieved, and relevant information was collected and analyzed using the Statistical Package for Social Sciences version 15. Chi‑square test was used as a test of association, with significance level established at a P value of < 0.05.Results: Of the 5992 cards retrieved, 164 (2.7%) had previous operative delivery; 152 caesarean sections and 12 laparotomies for ruptured uterus. Only 17.7% initiated contraception within 6 months. More women were spacers (86.6%) rather than limiters (13.4%). Age, education, religion, parity, prior contraception, and interval from the last delivery were significantly associated with the current choice of contraception (P < 0.05), whereas breast feeding status was not (P > 0.05). Overall, when comparing the pattern among those with a previous operative delivery and those without, there was no significant difference between both the groups; injectables was the most popular method chosen followed by intrauterine devices, oral contraceptive pills, and implants.Conclusion: Most women with a previous operative delivery were at risk of unwanted pregnancies because they did not initiate contraception within 6 months of their last delivery. Their preferred forms of contraception were injectables and intrauterine devices, which was not significantly different from the methods chosen by other women.Keywords: Contraception; family planning; northern Nigeria; previous caesarean; previous operative deliver

What is next in African neuroscience?

Working in Africa provides neuroscientists with opportunities that are not available in other continents. Populations in this region exhibit the greatest genetic diversity; they live in ecosystems with diverse flora and fauna; and they face unique stresses to brain health, including child brain health and development, due to high levels of traumatic brain injury and diseases endemic to the region. However, the neuroscience community in Africa has yet to reach its full potential. In this article we report the outcomes from a series of meetings at which the African neuroscience community came together to identify barriers and opportunities, and to discuss ways forward. This exercise resulted in the identification of six domains of distinction in African neuroscience: the diverse DNA of African populations; diverse flora, fauna and ecosystems for comparative research; child brain health and development; the impact of climate change on mental and neurological health; access to clinical populations with important conditions less prevalent in the global North; and resourcefulness in the reuse and adaption of existing technologies and resources to answer new questions. The article also outlines plans to advance the field of neuroscience in Africa in order to unlock the potential of African neuroscientists to address regional and global mental health and neurological problems

Implementing electronic health system in Nigeria: perspective assessment in a specialist hospital

Background: Perspectives on the pioneering work of Electronic Health Recording (EHR) system in Nigeria was studied Objectives: To determine health workers perception, challenges, motivation and satisfaction with EHR. Methodology: This was a descriptive cross sectional study using structured questionnaire to assess health workers perspective on EHR system at Kogi State Specialist Hospital. Results: A total of 35 consenting health workers with an mean age of 39.4(\ub1 7.6) years using EHR were assessed. The mean daily work hour was 8.0(\ub1 2.4 hours) and median client load per participant was 20 daily. On perceptions, 74.3%, 52.9%, 45.5% and 60.0% were comfortable, well-motivated, satisfied and competent with EHR. The advantages were reduction in transcription cost (88.5%), Paper work (97.1%), administrative cost (91.4%), errors (82.9%) and it captures, provides more services including timely access and ease research in 94.3%, 74.3%, 94.3% and 82.9% respectively. Challenges were threat to patient privacy, poor internet, information overload, power outages, incomplete and inaccurate information in 17.0%, 65.7%, 31.5%, 62.9%, 37.1% and 22.9% respectively. Conclusion: Health workers were comfortable and satisfied with EHR and it eased their work.Scaling up EHR would reduce administrative cost, transcription errors and paper works to mitigate poor quality data from Nigeria a great contributor to global morbidities/mortalitie

Drug-resistance mechanisms and tuberculosis drugs.

This publication presents independent research supported by the Health Innovation Challenge Fund (HICF-T5-342 and WT098600), a parallel funding partnership between the UK Department of Health and Wellcome Trust.This is the final version of the article. It first appeared at http://dx.doi.org/10.1016/S0140-6736(14)62450-8

Evaluation of Host Protein Biomarkers by ELISA From Whole Lysed Peripheral Blood for Development of Diagnostic Tests for Active Tuberculosis

Tuberculosis (TB) remains a significant global health crisis and the number one cause of death for an infectious disease. The health consequences in high-burden countries are significant. Barriers to TB control and eradication are in part caused by difficulties in diagnosis. Improvements in diagnosis are required for organisations like the World Health Organisation (WHO) to meet their ambitious target of reducing the incidence of TB by 50% by the year 2025, which has become hard to reach due to the COVID-19 pandemic. Development of new tests for TB are key priorities of the WHO, as defined in their 2014 report for target product profiles (TPPs). Rapid triage and biomarker-based confirmatory tests would greatly enhance the diagnostic capability for identifying and diagnosing TB-infected individuals. Protein-based test methods e.g. lateral flow devices (LFDs) have a significant advantage over other technologies with regard to assay turnaround time (minutes as opposed to hours) field-ability, ease of use by relatively untrained staff and without the need for supporting laboratory infrastructure. Here we evaluate the diagnostic performance of nine biomarkers from our previously published biomarker qPCR validation study; CALCOCO2, CD274, CD52, GBP1, IFIT3, IFITM3, SAMD9L, SNX10 and TMEM49, as protein targets assayed by ELISA. This preliminary evaluation study was conducted to quantify the level of biomarker protein expression across latent, extra-pulmonary or pulmonary TB groups and negative controls, collected across the UK and India, in whole lysed blood samples (WLB). We also investigated associative correlations between the biomarkers and assessed their suitability for ongoing diagnostic test development, using receiver operating characteristic/area under the curve (ROC) analyses, singly and in panel combinations. The top performing single biomarkers for pulmonary TB versus controls were CALCOCO2, SAMD9L, GBP1, IFITM3, IFIT3 and SNX10. TMEM49 was also significantly differentially expressed but downregulated in TB groups. CD52 expression was not highly differentially expressed across most of the groups but may provide additional patient stratification information and some limited use for incipient latent TB infection. These show therefore great potential for diagnostic test development either in minimal configuration panels for rapid triage or more complex formulations to capture the diversity of disease presentations

Non-falciparum malaria infections in pregnant women in West Africa

BACKGROUND: Non-Plasmodium falciparum malaria infections are found in many parts of sub-Saharan Africa but little is known about their importance in pregnancy. METHODS: Blood samples were collected at first antenatal clinic attendance from 2526 women enrolled in a trial of intermittent screening and treatment of malaria in pregnancy (ISTp) versus intermittent preventive treatment (IPTp) conducted in Burkina Faso, The Gambia, Ghana and Mali. DNA was extracted from blood spots and tested for P. falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale using a nested PCR test. Risk factors for a non-falciparum malaria infection were investigated and the influence of these infections on the outcome of pregnancy was determined. RESULTS: P. falciparum infection was detected frequently (overall prevalence by PCR: 38.8 %, [95 % CI 37.0, 40.8]), with a prevalence ranging from 10.8 % in The Gambia to 56.1 % in Ghana. Non-falciparum malaria infections were found only rarely (overall prevalence 1.39 % [95 % CI 1.00, 1.92]), ranging from 0.17 % in the Gambia to 3.81 % in Mali. Ten non-falciparum mono-infections and 25 mixed falciparum and non-falciparum infections were found. P. malariae was the most frequent non-falciparum infection identified; P. vivax was detected only in Mali. Only four of the non-falciparum mono-infections were detected by microscopy or rapid diagnostic test. Recruitment during the late rainy season and low socio-economic status were associated with an increased risk of non-falciparum malaria as well as falciparum malaria. The outcome of pregnancy did not differ between women with a non-falciparum malaria infection and those who were not infected with malaria at first ANC attendance. CONCLUSIONS: Non-falciparum infections were infrequent in the populations studied, rarely detected when present as a mono-infection and unlikely to have had an important impact on the outcome of pregnancy in the communities studied due to the small number of women infected with non-falciparum parasites

Tuberculosis diagnostics and biomarkers: needs, challenges, recent advances, and opportunities

Tuberculosis is unique among the major infectious diseases in that it lacks accurate rapid point-of-care diagnostic tests. Failure to control the spread of tuberculosis is largely due to our inability to detect and treat all infectious cases of pulmonary tuberculosis in a timely fashion, allowing continued Mycobacterium tuberculosis transmission within communities. Currently recommended gold-standard diagnostic tests for tuberculosis are laboratory based, and multiple investigations may be necessary over a period of weeks or months before a diagnosis is made. Several new diagnostic tests have recently become available for detecting active tuberculosis disease, screening for latent M. tuberculosis infection, and identifying drug-resistant strains of M. tuberculosis. However, progress toward a robust point-of-care test has been limited, and novel biomarker discovery remains challenging. In the absence of effective prevention strategies, high rates of early case detection and subsequent cure are required for global tuberculosis control. Early case detection is dependent on test accuracy, accessibility, cost, and complexity, but also depends on the political will and funder investment to deliver optimal, sustainable care to those worst affected by the tuberculosis and human immunodeficiency virus epidemics. This review highlights unanswered questions, challenges, recent advances, unresolved operational and technical issues, needs, and opportunities related to tuberculosis diagnostics

Non-falciparum malaria infections in pregnant women in West Africa.

BACKGROUND: Non-Plasmodium falciparum malaria infections are found in many parts of sub-Saharan Africa but little is known about their importance in pregnancy. METHODS: Blood samples were collected at first antenatal clinic attendance from 2526 women enrolled in a trial of intermittent screening and treatment of malaria in pregnancy (ISTp) versus intermittent preventive treatment (IPTp) conducted in Burkina Faso, The Gambia, Ghana and Mali. DNA was extracted from blood spots and tested for P. falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale using a nested PCR test. Risk factors for a non-falciparum malaria infection were investigated and the influence of these infections on the outcome of pregnancy was determined. RESULTS: P. falciparum infection was detected frequently (overall prevalence by PCR: 38.8 %, [95 % CI 37.0, 40.8]), with a prevalence ranging from 10.8 % in The Gambia to 56.1 % in Ghana. Non-falciparum malaria infections were found only rarely (overall prevalence 1.39 % [95 % CI 1.00, 1.92]), ranging from 0.17 % in the Gambia to 3.81 % in Mali. Ten non-falciparum mono-infections and 25 mixed falciparum and non-falciparum infections were found. P. malariae was the most frequent non-falciparum infection identified; P. vivax was detected only in Mali. Only four of the non-falciparum mono-infections were detected by microscopy or rapid diagnostic test. Recruitment during the late rainy season and low socio-economic status were associated with an increased risk of non-falciparum malaria as well as falciparum malaria. The outcome of pregnancy did not differ between women with a non-falciparum malaria infection and those who were not infected with malaria at first ANC attendance. CONCLUSIONS: Non-falciparum infections were infrequent in the populations studied, rarely detected when present as a mono-infection and unlikely to have had an important impact on the outcome of pregnancy in the communities studied due to the small number of women infected with non-falciparum parasites