Socio-demographic and clinico-pathological analysis of cervical cancer patients at a tertiary care centre in South-south Nigeria

Background: Cervical cancer is a significant public health burden in low- and middle-income countries where access to screening and treatment is limited. It is the leading cause of cancer deaths in women in Africa, often due to late presentation and diagnosis. Aim of this study was to determine the socio-demographic and clinical profile of cervical cancer patients and their relationship with tumour related factors. Methods: This was a retrospective review of all cases of histologically confirmed cervical cancer patients managed at the University of Port Harcourt Teaching Hospital, Port Harcourt, over a 5-year period. A data collection form was used to obtain socio-demographic characteristics and clinical profile from the patients’ case records. Results: The mean age of the women was 53.3±8 years, with the highest prevalence in the 55-64 age group 26 (33.3%). Majority 59 (74.4%) of the women were multiparous, and 50 (64.1%) were married. Most 32 (41%) had primary education and about one-third 24 (30.8%) were farmers. The most common clinical features were vaginal bleeding, foul-smelling vaginal discharge, pelvic pain, and weight loss 46 (59%), while squamous cell carcinoma (SCC) was the predominant histological type 56 (71.8%). Only 9 (11.5%) had any form of screening for early detection of cervical cancer. Most 31 (39%) of the patients presented with stage III disease, with a median hemoglobin level of 6.8 (2.3) g/dl before treatment. About two-third 54 (69%) of them had severe anaemia. There was significant association between marital status and histological type (X2 = 42.096, p-value = 0.001).  Use of oral contraceptive pills (X2 = 7.602, p-value =0.04) and menopausal state (X2 = 6828, p-value =0.05), were significantly associated with cancer stage. Conclusions: There is an urgent need to scale up advocacy for regular screening for cervical cancer and vaccination, to ensure increased awareness, early detection, and prevent the progression of early disease.

Culturable fish seeds in Nigerian waters: A research survey (1978-1985)

The desired species identified in this survey include mullets, catfishes, fast growing fish predators, species for control of weeds and grass it, ponds, cichlids and shrimps. Five coastal states: Lagos, Ondo, Bendel, Rivers, and Cross River were covered in the studies. Investigations were also carried into the major rivers and their tributaries. A combination of the estimation methods of Le Cren, (1962) and Pitcher and Mac Donald (1973) was employed in the analysis of data. From the detailed data collected from (1978-1985), the survey indicated that about 100 million fish seeds can be collected annually from Nigerian waters using appropriate gear-seine nets, cast nets, and fish traps. Of this number, 60% is available along the coastal belt of the country while 40% is in the major rivers, their tributaries and swamps. At the present level of fish culture development in Nigeria, this is more than enough, even after allowing for 50% mortality due to handling and transportation stres

EVALUATION OF THE IMPACT OF WASTEWATER GENERATED FROM CATFISH PONDS ON THE QUALITY OF SOIL IN LAGOS, NIGERIA

The study was performed to examine catfish (Clarias gariepinus) effluents on the quality of soil in La-gos State, Nigeria. Five fish farms with highest stock density were selected for evaluation. The soil sampling was collected at 10 metres apart before the effluent discharged site; at the effluent dis-charged site; 10 metres after the effluent discharged site and Non-effluent discharged site (control) denoted as SA, SB, SC and SD respectively. Analysis of the required soil physical and chemical prop-erties were performed at 5 cm depth from 0 – 20 cm. Results showed that the effluents discharged site and Non-effluents discharged site indicated that they contained Temperature (26.5±0.1, 27.5±0.1 oC), pH ( 6.7±0.1, 6.2±0.1), Water Holding Capacity (WHC) (36.4±2.1, 21.4±1.2%), Organic carbon (10.8±0.1, 7.4±0.1 mg/kg), TN (26.4±2.2, 22.4±2.1 mg/kg), TP (7.3±0.1, 6.1±0.1 mg/kg), Potassium (3.4±0.1, 3.1±0.1 mg/kg), Calcium (9.5±0.1, 5.9±0.1 mg/kg), Sodium (1.6±0.1, 0.9±0.1 mg/kg), mag-nesium (8.8±0.1, 7.2±0.1 mg/kg), Zinc (3.3±0.1, 3.0±0.1 mg/kg), Iron (58.7±4.2, 55.8±3.2 mg/kg) and Manganese (23.6±2.3, 21.1±2.2 mg/kg) respectively and were significant different (p≥0.05). Both soil nutrients at the immediate environment of effluents discharged site were within critical range of soil fertility for arable crop production

PERFORMANCE EVALUATION OF A DEVELOPED PADDLE AERATOR ON CATFISH EFFLUENTS IN LAGOS STATE, NIGERIA

Catfish production is one of the largest segments of fish culture in Lagos State, Nigeria. However, catfish effluents, which usually deteriorate the environment, need to be controlled. The effect of paddle-wheel aerator in catfish effluent was evaluated. The volume of catfish effluent was collected into two basins and diluted at given ratios. The paddle-wheel aerator was installed in one basin, while another basin served as control in determining the impact of paddle wheel aerator on catfish effluents. Water qualities such as Total Suspended Solids (TSS), Total Nitrogen (TN), Total Phosphorus (TP), Total Ammonia (TNH3) and Nitrite (NO2-N) and Biochemical oxygen demand (BOD5) examined and ana-lysed. Results indicated that paddle-wheel aerator reduced TSS (24.4±1.5 %), TN2-N (53.3±1.2 %) , TNH3-N (65.2±1.2 %) , NO2-N (97.1±1.1 %) , TP (61.8±1.1 %) and BOD5 (54 ±1.5 %). com-pared with natural purification 33.9±1.6 % of TSS, 22.7±1.4 % of TN2-N, 29.3±1.6 % of TNH3-N, 53.9±1.2 % of NO2-N, 21.6±1.5 % of TP and 15.4±1.6 % of BOD5 at the same dilution ratio There were significant different (P ≤0.05) between paddle wheel aerator and natural purification in concen-trations reduction. The paddle wheel aerator was found to be relevant in the water quality improve-ment and thus recommend for small and medium scale fish farmers in controlling effluents

Assessment of Catfish Effluents Management in Lagos State, Nigeria

Catfish is one of the major sources of dietary protein in Nigeria. Lagos State is one of culturing areas with abundant fresh water and marine environments. The aim of this study was to evaluate the catfish rearing industry and its effluents management and make appropriate recommendations. Forty fish farms were randomly selected in Lagos State for the study. Questionnaire and in-depth interview were used for data collection on water sources, equipment operations, and waste management. Data collected were analyzed using descriptive statistics. Results indicated that over 80% of water for fish rearing was from shallow wells and 95% of the waste water generated was not treated before disposal into the environment. Effluents disposals employed were open pit (12.5%), drainage canal (32.5%), bare-land (20.0%), stream (22.5%) and re-used on farm (12.5%) and these methods of disposal were not significantly different (p ≤ 0.05). Only a few farmers carried out simple treatment before disposal namely; infiltration (2.5%) and sedimentation (2.5%). If the effluent management conditions were not improved, it could pose a threat to the environment in the study areas. Pond effluent must be treated before being disposed into the environment and waste water from fish pond effluent should be reused as irrigation water

The building blocks of community health systems: a systems framework for the design, implementation and evaluation of iCCM programs and community-based interventions

INTRODUCTION: Almost all sub-Saharan African countries have adopted some form of integrated community case management (iCCM) to reduce child mortality, a strategy targeting common childhood diseases in hard-to-reach communities. These programs are complex, maintain diverse implementation typologies and involve many components that can influence the potential success of a program or its ability to effectively perform at scale. While tools and methods exist to support the design and implementation of iCCM and measure its progress, these may not holistically consider some of its key components, which can include program structure, setting context and the interplay between community, human resources, program inputs and health system processes. METHODS: We propose a Global South-driven, systems-based framework that aims to capture these different elements and expand on the fundamental domains of iCCM program implementation. We conducted a content analysis developing a code frame based on iCCM literature, a review of policy documents and discussions with key informants. The framework development was guided by a combination of health systems conceptual frameworks and iCCM indices. RESULTS: The resulting framework yielded 10 thematic domains comprising 106 categories. These are complemented by a catalogue of critical questions that program designers, implementers and evaluators can ask at various stages of program development to stimulate meaningful discussion and explore the potential implications of implementation in decentralised settings. CONCLUSION: The iCCM Systems Framework proposed here aims to complement existing intervention benchmarks and indicators by expanding the scope and depth of the thematic components that comprise it. Its elements can also be adapted for other complex community interventions. While not exhaustive, the framework is intended to highlight the many forces involved in iCCM to help managers better harmonise the organisation and evaluation of their programs and examine their interactions within the larger health system

Efficacy of insect larval meal to replace fish meal in juvenile barramundi, Lates calcarifer reared in freshwater

The present experiment was conducted to evaluate the efficacy of dietary protein from black soldier fly, Hermetia illucens, larval meal (BSFL) to replace fish meal (FM) protein in juvenile barramundi, Lates calcarifer. Larvae of black soldier fly were fed with the underutilised crop, sesbania, Sesbania grandiflora. Five isonitrogenous (44% crude protein) and isocaloric (16.0 kJ available energy/g) experimental diets were formulated to replace FM using processed BSFL meal at 0 (control), 25% (BSFL25), 50% (BSFL50), 75% (BSFL75) and 100% (BSFL100). Data for proximate and amino acid analysis suggested BSFL meal as an inferior protein ingredient than FM, but parallel to soybean meal. At the end of 8 weeks of fish feeding trial, there were no significant differences in the average weight gain (WG) and specific growth rate among the group of fish-fed control, BSFL25 and BSFL50 diets (P < 0.05). Although numerical differences were recorded in the fish whole-body proximate composition, crude protein and moisture content were not much affected by the different dietary treatments. Essential amino acids including arginine, histidine, lysine and methionine were found to be higher in the whole body of fish-fed BSFL100 diet. Broken line regression analysis of average WG showed an optimum FM replacement level of 28.4% with BSFL meal. Therefore, the present experiment clearly demonstrates that the maximal dietary inclusion level of BSFL meal as FM protein replacer for the optimum growth of juvenile barramundi reared in freshwater could be greater than 28.4% but less than 50%, without any adverse effects on the fish whole-body proximate and amino acid composition

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Monetization in the Nigerian public service: issues, challenges and the way forward

This study evaluates the introduction of monetization of fringe benefits enshrined by government in 2003 as a panacea to enhance efficiency and effectiveness in the Nigerian public sector. The twin issue of efficiency and effectiveness has been a growing concern in the Nigerian public service which has led to monetization. The work is carried out using a qualitative approach through the use of secondary data. Elite theory is used to underpin the study because the philosophical disposition of the policy is elitist in nature. The paper revealed that monetization has reduced the running cost of government and also increased workers‘ social status and national productivity. Conversely, the policy is skewed to favour the ruling aristocrats. There are observed some unplanned consequences due to the reversal of some aspects during implementation and also inconsistency of the policy is evident. It is recommended that monetization should be implemented across board and to affect all interest groups. Arrangements should be made to cushion the effect of workers who were dismissed from the service occasioned by the policy.Keywords: Monetization, Efficiency, Effectiveness, Performance, Fringe benefits