The use of folic acid in the prevention of spinal bifida: Knowledge, attitude, and practice of women of childbearing age in low income rural communities

Background. Spinal Bifida is a congenital malformation of the spine that typified defect of the neural tube with devastating neurological, psychosocial and developmental burden to the growing child with associated huge financial burden to the parents, community and the country. Past and present studies have shown strong evidence to indicate that folic acid supplementation during the periconceptional period reduces the occurrence of spinal bifida in children.Aim. To assess the knowledge, attitude, and practice of use of folic acid during the periconceptional period among women of childbearing age in two rural communities in Edo State, Nigeria.Materials and methods. A prospective cross-sectional study of 170 women between the ages of 15 and 49 years recruited through a multi-stage sampling technique. The survey instrument was a structured interviewer-administered questionnaire. The data was analysed using Statistical Package for Social Sciences (SPSS) version 21 and presented as charts, tables, and associations tested with Chi-square at a statistical level of significance set at p<0.05.Results. One hundred and twenty-two (71.8%) of the respondents showed good knowledge, 147(86.5%) had a positive attitude, and 106 (62.4%) had a good practice of use of folic acid. There was a statistically significant association between respondents’ age, marital status, level of education, occupation, and their knowledge of the use of folic acid as well as with their attitude towards the use of folic acid. However, the practice was mainly associated with the socio-demographic variable of each household.Conclusion. The use of folic acid during the perinatal period for the prevention of spinal bifida is found to be absent in about two-fifths of the study population, a number found to be alarming despite the high level of good knowledge and attitude towards the use of folic acid. There is, therefore, an urgent need to step up more advocacy and health education to women of childbearing age to increase the uptake of folic acid for effective reduction of the incidence of spinal bifida

Prevalence of Lassa Virus Disease (LVD) in Nigerian children with fever or fever and convulsions in an endemic area

Background: Convulsions with fever in children are a common neurologic emergency in the tropics, and determining the contribution of endemic viral infections can be challenging. In particular, there is a dearth of data on the prevalence and clinical differentiation of Lassa virus disease (LVD) in febrile children in endemic areas of Nigeria, which has multiple lineages of the virus. The aim of this study was to determine the prevalence and presentation of LVD in febrile children with and without convulsions. Methodology/Principal findings This was a prospective study of consecutive febrile children aged ≥1 month– 15 years admitted to the Children’s Emergency Room of Irrua Specialist Teaching Hospital over a period of 1 year. Febrile children with convulsions (Cases) were compared with those without convulsions (Controls). LVD was defined by the presence of a positive Lassa virus RT-PCR test. Rates were compared between groups using χ2 or Fisher’s exact tests and p <0.05 taken as significant. 373 (40.9%) of 913 admissions had fever. Of these, 108/373 (29%) presented with convulsions. The overall prevalence of LVD was 13/373 (3.5%; 95% CI = 1.9%, 5.7%) in febrile admissions, 3/108 (2.8%) in Cases and 10/265 (3.8%) in Controls [(Odds Ratio (95% Confidence Interval) (OR (95% CI)) of LVD in Cases versus Controls = 0.73 (0.2, 2.7)]. Only vomiting (OR (95% CI) = 0.09 (0.01, 0.70)) and bleeding (OR (95% CI) = 39.56 (8.52, 183.7)) were significantly associated with an increased prevalence of LVD. Conclusions/Significance: LVD is an important cause of fever, including undifferentiated fever in children in endemic areas, but it is not significantly associated with convulsions associated with fever. Its prevalence, and lack of clinical differentiation on presentation, underscores the importance of a high index of suspicion in diagnosis. Screening of febrile children with undifferentiated fever in endemic areas for LVD could be an important medical and public health control measure

Pattern of infections in children with undifferentiated fever.

<p>Pattern of infections in children with undifferentiated fever.</p

Seasonality, age, gender and general clinical and laboratory profile of Cases and Controls.

<p>Seasonality, age, gender and general clinical and laboratory profile of Cases and Controls.</p

Pattern of illnesses in febrile children with differentiated fever.

<p>Pattern of illnesses in febrile children with differentiated fever.</p

Presenting features in children with LVD versus children with other infections.

<p>Presenting features in children with LVD versus children with other infections.</p

Association between the prevalence of LVD and age, gender, season, and clinical status on presentation.

<p>Association between the prevalence of LVD and age, gender, season, and clinical status on presentation.</p

Prevalence of undifferentiated fever and contribution of LVD and malaria parasitaemia to undifferentiated fever in Cases with febrile versus non-febrile convulsions.

<p>Prevalence of undifferentiated fever and contribution of LVD and malaria parasitaemia to undifferentiated fever in Cases with febrile versus non-febrile convulsions.</p

Phylogeography of Lassa Virus in Nigeria

ABSTRACT Lassa virus is genetically diverse with several lineages circulating in West Africa. This study aimed at describing the sequence variability of Lassa virus across Nigeria and inferring its spatiotemporal evolution. We sequenced and isolated 77 Lassa virus strains from 16 Nigerian states. The final data set, including previous works, comprised metadata and sequences of 219 unique strains sampled between 1969 and 2018 in 22 states. Most of this data originated from Lassa fever patients diagnosed at Irrua Specialist Teaching Hospital, Edo State, Nigeria. The majority of sequences clustered with the main Nigerian lineages II and III, while a few sequences formed a new cluster related to Lassa virus strains from Hylomyscus pamfi .Within lineages II and III, seven and five sublineages, respectively, were distinguishable. Phylogeographic analysis suggests an origin of lineage II in the southeastern part of the country around Ebonyi State and a main vector of dispersal toward the west across the Niger River, through Anambra, Kogi, Delta, and Edo into Ondo State. The frontline of virus dispersal appears to be in Ondo. Minor vectors are directed northeast toward Taraba and Adamawa and south toward Imo and Rivers. Lineage III might have spread from northern Plateau State into Kaduna, Nasarawa, Federal Capital Territory, and Bauchi. One sublineage moved south and crossed the Benue River into Benue State. This study provides a geographic mapping of lineages and phylogenetic clusters in Nigeria at a higher resolution. In addition, we estimated the direction and time frame of virus dispersal in the country. IMPORTANCE Lassa virus is the causative agent of Lassa fever, a viral hemorrhagic fever with a case fatality rate of approximately 30% in Africa. Previous studies disclosed a geographical pattern in the distribution of Lassa virus strains and a westward movement of the virus across West Africa during evolution. Our study provides a deeper understanding of the geography of genetic lineages and sublineages of the virus in Nigeria. In addition, we modeled how the virus spread in the country. This knowledge allows us to predict into which geographical areas the virus might spread in the future and prioritize areas for Lassa fever surveillance. Our study not only aimed to generate Lassa virus sequences from across Nigeria but also to isolate and conserve the respective viruses for future research. Both isolates and sequences are important for the development and evaluation of medical countermeasures to treat and prevent Lassa fever, such as diagnostics, therapeutics, and vaccines.info:eu-repo/semantics/publishe