Substitution of Maize with Cassava and Sweet Potato Meal as the Energy Source in the Rations of Layer Birds

Three hundred and sixty layer hens (36 weeks old Isa Brown) were fed a maize based diet in which sweet potato meal and cassava meal replaced maize in the basal diet during a 12-week trial period. Hen-day egg production was significantly (P< 0.05) depressed lJy cassava meal while birds fed diets with maize and sweet potato meal were not significantly different from each other in hen-day eeg production. Cassava meal significantly reduced (P< O. 05) metabolizable energy intake while there was no significant difference in the crude protein intake of birds fed sweet potato and cassava meal. There was, however, no significant effect from replacing maize with sweet potato or cassava meal on egg, weight, feed intake, shell thickness, Haugh unit, feed/dozen eggs or feed/kg egg (p<0.05). The maize control diet was superior (P< O. 05) in the digestibility of crude protein while energy digestibility was depressed (P< 0.05) with the cassava diet

Adherence to WHO criteria on drug promotion literature : an exploratory study from a tertiary healthcare facility in South-West Nigeria

INTRODUCTION: In many low and middle-income countries (LMIC), drug promotional literature (DPL) remains one of the main sources of drug information for physicians. Studies conducted in many LMICs showed poor compliance to the WHO guidelines for ethical drug promotion especially in the area of information about excipients, adverse drug reactions, drug-drug interactions and contra-indications. These inadequacies in the information provided may mislead the prescriber with potential adverse consequences among patients using the medicines. Nigeria has a big pharmaceutical sector which is poorly regulated and we hypothesize that such unethical drug promotional practices may exist. This study therefore set out to assess compliance to the WHO ethical drug promotion (using DPL) at the Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, South-West Nigeria. METHODOLOGY: This was a descriptive cross-sectional study conducted in several specialist clinics of EKSUTH, Ado-Ekiti. Printed DPLs (brochures and leaflets) were collected from these clinics, collated using a pre-designed data collection form and analyzed using the WHO ethical criteria for medicinal drug promotion. RESULTS: A total of 234 DPLs were selected after screening to remove duplications. DPLs promoting antibiotics, cardiovascular drugs and vitamins/ nutritional supplements were in the majority (22.2%, 17.1% and 11.5% respectively. Most of the DPLs had the generic (223; 95.3%) and brand (234; 100%) names, active ingredients (209; 89.3%), excipients (149; 63.7%) and indications (232; 99.1%). Information about adverse drug reactions (76; 32.5%), contra-indications (73; 31.2%) and drug interactions (46; 19.7%) was less represented. Only fifty-nine (25.2%) DPLs had references. Fixed-dose combination drugs made up 34.6% of drugs being promoted. CONCLUSION: The DPLs assessed in this study had low adherence to WHO ethical drug promotion criteria especially those related to adverse drug reaction, drug interactions and contra-indications

Non-mental health workers’ attitudes and social distance towards people with mental illness in a Nigerian teaching hospital

Background: Studies on attitudes towards mental health in Nigeria have been mainly community-based surveys. Objective: To determine the knowledge and attitudes towards mental illness (MI) of health workers in a Nigerian Teaching Hospital. Methods: A stratified sample of 256 health workers completed an Attitude to Mental Illness Questionnaire (AMIQ) designed for this study. Results: Most participants (62.1% to 80.9%) identified scientific factors such as genetic inheritance as causes of MI; 24.8% identified spiritual factors as potential causes. Effective methods of treatment identified by respondents include orthodox methods (84.6%) and a combination of traditional and orthodox management (37.8%). There were varying shades of negative attitudes towards mentally ill persons (MIPs). Conclusion: The health workers showed some degree of social distance to MIPs, and there is need for psycho-education to improve their knowledge in mental health

Children with neurodevelopmental disorders: The burden and psychological effects on caregivers in Lagos, Nigeria

Background: Children with neurodevelopmental disorders (CNDs) are a group requiring more attention as their care is often challenging, particularly for parents with primary caregiving roles in resource-restricted settings. This study had set out to investigate the burden and psychological distress among caregivers of children with neurodevelopmental delays. Materials and Methods: A total of 68 caregivers were recruited during the 2013 annual autism health program organized by the College of Medicine, University of Lagos in collaboration with Guaranty Trust Bank, Nigeria and Blazing Trails, USA. Of these caregivers, 60 respondents (caregivers and children) were included in the final analyses due to poorly completed questionnaires. The Zarit Caregivers Burden Scale (ZCBS) and General Health Questionnaire version 12 (GHQ-12) were administered to elicit caregivers' experience with respect to burden and psychological distress, respectively. Results: Of the 60 participants included in the final analyses, the majority constituted parents (96.3%) with mothers accounting for 71.7%; 28 (46.7%) participants were government workers and 3 (5%) were full-time housewives. The mean age of CNDs was 6.8 (±3.2) years, and 33 (55.0%) were males. Delivery by cesarian section was reported in 19 (31.8%). The common presenting complaints by caregivers were inability to walk (32.7%), repetitive behavior (25.5%), difficulty with verbal communication (10.9%), nonsocialization (9.1%), seizures (9.1%), and hyperactivity (3.6%). Problems were noticed at ≤ 1 year in 46.7% while they were noticed after 2 years in more than half the children, and a little above one-eighth (14%) had siblings with similar problems. On the ZCBS, nine (15.0%) caregivers reported a significant burden. In addition, 23 (38.3%) caregivers had psychological distress. Caregivers' burden was significantly related to the report of psychological distress in caregivers (P < 0.001) and there was a trend toward the presence of psychological distress in almost all caregivers with children experiencing seizures. Conclusions: The findings in this study underscore the need for counseling and psychosocial support for caregivers of CNDs. Further research on the emotional experience of caregivers is also warranted

Autism spectrum disorder in a community-based sample with neurodevelopmental problems in Lagos, Nigeria

Autism Spectrum Disorder (ASD) is a globally prevalent neurodevelopmental disorder for which early diagnosis and intervention is the mainstay of management. In the African continent, limited data is available regarding the non-clinic based samples. Lack of information available to caregivers and inadequate skilled manpower often limit early detection and access to the few available though under resourced services in the community. Community based screening can be an important drive to create awareness and improve information dissemination regarding services available for those living with this disorder. This is a descriptive cross-sectional study utilizing data obtained from participants of a community-based autism screening exercise. The surveillance exercise was part of the annual Orange Ribbon initiative for autism awareness and screening held in 2014. Data was obtained from 85 participants involved in the Autism Surveillance screening exercise within the Lagos community. Community public service radio announcements state wide and word of mouth were used to invite and enroll eligible participants to the screening and consultation exercise. A second stage screening and a brief sociodemographic questionnaire followed by a third stage clinical interview and evaluation using the Diagnostic and Statistical Manual of Mental Disorders - 5 Edition (DSM 5) were used. Appropriate consultation and referrals to services in the community were given. Participants had a mean age of 7.53 years (SD 4.35). Twenty-nine (34.5%) met the diagnosis of ASD. Other diagnosis included attention deficit hyperactivity disorder (ADHD), language and speech disorder, intellectual disability (8.3%) and learning disorders (9.5%). Main health concerns to caregivers were poor language development in all (100%), of which 11 (40.7%) were non-verbal; gaze avoidance was seen in 14 (48.3%) and challenging behavior in 12 (42.9%). Comorbidities included seizure disorders (3.4%) and ADHD (6.9%). Persons with autism had history of ASD behavior more often when compared to the other neurodevelopmental disorders and these findings were statistically significant. Referrals were given to caregivers to engage in services within the community. As seen in this study, community understanding of ASD is poor in such locations, in which many persons with other neurodevelopmental disorders are often presented as having autism. Caregivers in the study location are distressed by many symptoms associated with autism and their comorbid conditions. Currently there is an evident role for frequent large scale community based screening and autism awareness exercises possibly using inter-sectoral collaboration as a strategy

Challenges and opportunities for implementing hypofractionated radiotherapy in Africa: lessons from the HypoAfrica clinical trial

The rising cancer incidence and mortality in sub-Saharan Africa (SSA) warrants an increased focus on adopting or developing approaches that can significantly increase access to treatment in the region. One such approach recommended by the recent Lancet Oncology Commission for sub-Saharan Africa is hypofractionated radiotherapy (HFRT), which can substantially increase access to radiotherapy by reducing the overall duration of time (in days) each person spends being treated. Here we highlight challenges in adopting such an approach identified during the implementation of the HypoAfrica clinical trial. The HypoAfrica clinical trial is a longitudinal, multicentre study exploring the feasibility of applying HFRT for prostate cancer in SSA. This study has presented an opportunity for a pragmatic assessment of potential barriers and facilitators to adopting HFRT. Our results highlight three key challenges: quality assurance, study harmonisation and machine maintenance. We describe solutions employed to resolve these challenges and opportunities for longer term solutions that can facilitate scaling-up use of HFRT in SSA in clinical care and multicentre clinical trials. This report provides a valuable reference for the utilisation of radiotherapy approaches that increase access to treatment and the conduct of high-quality large-scale/multi-centre clinical trials involving radiotherapy