Laboratory-confirmed hospital-acquired infections:An analysis of a hospital's surveillance data in Nigeria

Objective: Hospital-acquired infections (HAI) are a global problem and a major public health concern in hospitals throughout the world. Quantification of HAI is needed in developing countries; hence we describe the results of a 2-year surveillance data in a tertiary hospital in Nigeria. Methodology: This study is a 2-year review using secondary data collected at a tertiary referral center in northwestern Nigeria. The data was collected using surveillance forms modeled based on the Centre for Disease Control (CDC) protocol. Descriptive statistics were used to present results as frequencies and percentages. Result: 518 patients developed HAI out of 8216 patients giving an overall prevalence of 6.3%. The mean age of the patients was 35.98 years (±15.92). Males constituted 281 (54.2%). UTI 223 (43.1%) was the most prevalent HAI. Overall, E. coli 207 (40.0%) was the most frequent isolates followed by P. aerugenosa 80 (15.4%). There was a high prevalence of cloxacillin resistant S. aureus (67.9%) and gram-negative rods resistant to third-generation cephalosporins. Trimethoprim-sulfamethoxazole resistance across the board was more than 90%. Conclusion: There is a high burden of HAI especially UTI in our hospital with resistance to commonly used antibiotics documented. Keywords: Public health, Infectious diseas

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

MODERATING EFFECT OF LEVERAGE ON THE VALUE RELEVANCE OF ACCOUNTING INFORMATION IN THE NIGERIAN LISTED OIL AND GAS FIRMS

The study investigates the moderating effect of leverage on the value relevance of accountinginformation in the Nigerian listed oil and gas firms. The study used correlational research designand the data was extracted from the published annual financial reports of the firms for theindependent variables and the moderator. On the other hand, the data for the dependent variable(share prices) was collected from Nigerian stock exchange website. A sample size of 6 firms wereused for a period of eight years (2011-2018). The data was analysed using multiple regressionanalysis. Findings from the analysis showed that earnings per share, and leverage to be valuerelevant. Additionally, book value per share moderated with leverage was value relevant in additionto earnings per share moderated with leverage as well. Based on the findings, the study recommendsthat listed oil and gas firms in Nigeria should strategize to improve their earnings, Moreover, theyshould also find way of managing their book value, as any unnecessary investment means negativeeffect on share price. Additionally, listed oil and gas firms should maintain an appropriate level ofleverage so that the cheap cost of leverage will reduce the weighted average cost of capital andsubsequently increase value to investors. Finally, the explanatory power of the moderated variablesare more than the ones not moderated

The Effect of Aggregate Types on the Properties of Concrete

Concrete is an extensively used construction material due to its versatility, strength, durability, and ease in making various forms and shapes. The use of substandard materials, deficient quality concrete has been identified in the literature as the leading cause of building collapse in Nigeria. Aggregates strongly affect the concrete’s fresh and hardened properties, mixture proportions, and economy. More than 1/3 of the volume of concrete is occupied by the coarse aggregate, and any changes in rough aggregate type could affect its strength and fracture properties. This study examined the impact of coarse aggregates on the mechanical properties of concrete. Selected aggregates which are granite (igneous rock), schist (metamorphic rock), and sandstone (sedimentary rock), were used in this study. Aggregate Impact value and water absorption test were carried out for each of the aggregates used. A slump test was conducted on the fresh mixture for granite, schist, and coarse sandstone aggregates with river sand (fine aggregate) using a water-cement ratio of 0.50; it was observed that granite has a slump value of 35 mm, schist 28 mm, and sandstone 25 mm. Nominal mix (1:2:4) was adopted, and mix compositions were calculated using the absolute volume method. Twelve cubes (100x100 mm) and twelve cylinders (100x300 mm) were cast for each type of coarse aggregate. The specimens were cured by submersion. Three of the models were tested for 7, 14, 21, and 28 days to determine their compressive and splitting tensile strengths. Granite was found to have the highest average compressive strength of 16.00 N/mm2 with an average density of 2575 kg/m3, compressive strength of schist was 15.17N/mm2 with an average density of 2520 kg/m3, while sandstone has the lowest average compressive strength of 12.33 N/mm2 with an average density of 2500 kg/m3. Granite was found to have the highest moderate splitting tensile strength of 1.31 N/mm2 with an average density of 4266.67 kg/m3, breaking tensile strength of schist was 0.99 N/mm2 with an average density of 4256.67 kg/m3.In contrast, sandstone has the lowest average split tensile strength of 0.67 N/mm2 with an average density of 4241.67 kg/m3. Densities and stability of the individual aggregates accounted for the variation in the concrete forces because of differences in properties and strength. In conclusion, the effect of coarse aggregate on the properties of concrete was identified, which will inform site concrete production of the suitability of aggregate selection in concrete work

COVID‐19 vaccine wastage: A challenge to achieving herd immunity in Nigeria

Abstract The emergence of the COVID‐19 pandemic has overburdened many health‐care systems in the world, particularly in Nigeria and other African countries with fragile public health system. Since the emergence of the pandemic, Nigeria has been struggling to restore the impact on its health‐care system as the country keeps recording a growing number of cases and deaths. Vaccination has been the most efficient strategy towards curbing the COVID‐19 pandemic, particularly in countries like Nigeria where preventive measures were poorly strategised or implemented. The country was able to secure some doses of the COVID‐19 vaccine through donations, but concerns have been raised as up to 1 million doses of the vaccine were wasted due to delays in importations and poor cold chain management system. This wastage can pose a challenge to achieving COVID‐19 herd immunity in Nigeria. The causative factors of the vaccine wastage in Nigeria must therefore be tackled in order to effectively curb the COVID‐19 outbreak and consequently achieve herd immunity through massive vaccination. The government in collaboration with World Health Organisation and Africa Centre for Disease Control should facilitate and fast track the safe delivery of the vaccines to Nigeria. Misconceptions about COVID‐19 and its vaccine should be tackled to encourage the vaccine acceptance. The challenges faced by the vaccine supply chain system should be properly addressed by providing adequate funding and security, improved power supply, good vaccine infrastructure and improved vaccine data management in order to facilitate the safe and timely distribution of adequate vaccines across the country

The challenges of addressing the cholera outbreak in Cameroon

Cholera is an enteric disease caused by the ingestion of food or water contaminated by the toxins of the bacteria - Vibrio Cholerae. Its transmission is exacerbated by poor sanitary conditions and poor hygiene practices. Affected individuals may present with severe symptoms such as watery diarrhoea and vomiting that can lead to death within few hours. Cameroon is experiencing its worst cholera outbreak in decades. The outbreak is severest in the South-West and the Littoral regions. As of the time of writing, in six regions of the country, 6652 suspected cases of cholera including 134 deaths (CFR 2%) have been reported and the number is rising. Shortage of safe drinking water and contamination of rivers has exacerbated the outbreak, especially in the rural and hard to reach communities. The trans-border movement at the South-West region, defecation in the open and on rivers, and overcrowding at the Littoral region have been particularly challenging towards curbing the outbreak. Despite the challenges, Cameroon's health authorities have been working to bring the situation under control by engaging in community sensitization on good hygiene habits, disinfection of houses and vaccination campaigns. In the light of these, it is recommended that Cameroon should improve and strengthen its vaccination campaign across the country. Adequate health systems should be established at the point of entry to prevent cross-border cholera transmission and retransmission. Access to hard to reach communities should be improved so that vaccines and basic health care and sanitation services such as provision of safe drinking water can be provided

Understanding rural women's preferences for telephone call engagement with primary health care providers in Nigeria: a discrete choice experiment

Background The COVID-19 pandemic has accelerated the use of mobile phones to provide primary health care services and maintain continuity of care. This study aims to understand rural women’s preferences for telephone call engagement with primary health care providers in Nigeria.Methods A discrete choice experiment was conducted alongside an action research project that empowered primary health care workers to develop and implement a telephone call intervention to assess and enhance experiences with facility childbirth care. Between January and March 2022, 30 providers from 10 primary health care facilities implemented the choice experiment among rural women who had institutional childbirth to elicit service user preferences for telephone call engagement. The women were asked to express their preferred scenario for telephone call engagement with their primary health care providers. Generalised linear mixed models were used to estimate women’s preferences.Results Data for 460 women were available for the discrete choice experiment. The study showed that rural women have preferences for telephone call engagement with primary health care providers. Specifically, women preferred engaging with female to male callers (β=1.665 (95% CI 1.41, 1.93), SE=0.13, p<0.001), preferred call duration under 15 min (β=1.287 (95% CI 0.61, 1.96), SE=0.34, p<0.001) and preferred being notified before the telephone engagement (warm calling) (β=1.828 (95% CI 1.10, 2.56), SE=0.37, p<0.001). Phone credit incentive was also a statistically significant predictor of women’s preferences for engagement. However, neither the availability of scheduling options, the period of the day or the day of the week predicts women’s preferences.Conclusions The study highlights the importance of understanding rural women’s preferences for telephone call engagement with healthcare providers in low-income and middle-income countries. These findings can inform the development of mobile phone-based interventions and improve acceptability and broader adoption

DataSheet_1_Erythromycin, retapamulin, pyridoxine, folic acid, and ivermectin inhibit cytopathic effect, papain-like protease, and MPRO enzymes of SARS-CoV-2.pdf

BackgroundAlthough tremendous success has been achieved in the development and deployment of effective COVID-19 vaccines, developing effective therapeutics for the treatment of those who do come down with the disease has been with limited success. To repurpose existing drugs for COVID-19, we previously showed, qualitatively, that erythromycin, retapamulin, pyridoxine, folic acid, and ivermectin inhibit SARS-COV-2-induced cytopathic effect (CPE) in Vero cells.AimThis study aimed to quantitatively explore the inhibition of SARS-CoV-2-induced CPE by erythromycin, retapamulin, pyridoxine, folic acid, and ivermectin and to determine the effect of these drugs on SARS-CoV-2 papain-like protease and 3CL protease (MPRO) enzymes.MethodsNeutral red (3-amino-7-dimethylamino-2-methyl-phenazine hydrochloride) cell viability assay was used to quantify CPE after infecting pre-treated Vero cells with clinical SARS-Cov-2 isolates. Furthermore, SensoLyte® 520 SARS-CoV-2 papain-like protease and SensoLyte® 520 SARS-CoV-2 MPRO activity assay kits were used to evaluate the inhibitory activity of the drugs on the respective enzymes.ResultsErythromycin, retapamulin, pyridoxine, folic acid, and ivermectin dose-dependently inhibit SARS-CoV-2-induced CPE in Vero cells, with inhibitory concentration-50 (IC50) values of 3.27 µM, 4.23 µM, 9.29 µM, 3.19 µM, and 84.31 µM, respectively. Furthermore, erythromycin, retapamulin, pyridoxine, folic acid, and ivermectin dose-dependently inhibited SARS-CoV-2 papain-like protease with IC50 values of 0.94 µM, 0.88 µM, 1.14 µM, 1.07 µM, and 1.51 µM, respectively, and inhibited the main protease (MPRO) with IC50 values of 1.35 µM, 1.25 µM, 7.36 µM, 1.15 µM, and 2.44 µM, respectively.ConclusionThe IC50 for all the drugs, except ivermectin, was at the clinically achievable plasma concentration in humans, which supports a possible role for the drugs in the management of COVID-19. The lack of inhibition of CPE by ivermectin at clinical concentrations could be part of the explanation for its lack of effectiveness in clinical trials.</p