Availability of Essential Medicines in Healthcare Facilities Offering Maternal and Reproductive Healthcare Services in Nigeria

Background: The availability of essential medicines is important in preventing maternal and child deaths. This study assessed the availability of essential medicines in healthcare facilities offering maternal and reproductive healthcare services in Nigeria. Method: This study was cross-sectionally designed using structured interviewer-administered survey questions and site inspections. The study was conducted across all States in Nigeria except three states (Borno, Adamawa, and Yobe) that had security challenges. The survey was carried out between May and July 2019. The data were analysed with IBM-SPSS version 25.0. Results: The mean availability of 17 essential medicines was 58.8%. South-East has a very low availability of 49.1%, North East, South West, and South-South had availability below 60% whereas North-West (71.8%) and North-central (60.2%) had higher availability (

Alleviating the Material and Health Challenges of Young Internally Displaced People in North-East Nigeria

The increasing rate of attack in the North-Eastern parts of Nigeria has caused the deaths of thousands and thereby forcing many of the residents, including children to abandon their comforts zones. This study assessed the material and health challenges of young IDPs and the impacts of sexual and reproductive health programs in improving the conditions of these young ones. The study was conducted in sixteen local governments of three states (Borno, Adamawa and Yobe) in the North-East of Nigeria using mixed methods. The quantitative data were obtained by the administration of a structured questionnaire to the young IDPs in the three states. The quantitative data were analysed and were complemented by the qualitative data {Focus Group Discussions (FGDs)} that were obtained from the young IDPs. Data were analysed using SPSS version 20. The majority (78.5%) of the young internally displace persons (IDPs) were within the age group of 10-14 years with 51.8% males and 59.1% have attained primary. The major material challenges facing the young IDPs include lack of food (31.6%), clothing (28.7%), Soap/cream (19.8%) and medicine (13.1%). The most common health problems include Malaria (28.9%), cough 23.1%, diarrhoea (18.3%) and cholera (13.1%). The IDPs confirmed that they were fully protected in the camp with no experience of rape. They affirmed that their needs were met by the intervention programs provided for them; 71.7% affirmed that their situation was “Good” since they came to the camps and more than half (55.2%) confirmed a better situation. The training in the IPD camps was mostly artisan related while only 31.7% were schooling. This study found that young IDPs are being faced with material and health-related challenges as well as the lack of proper training and education. However, the outcome of the SRH project is a manifestation of the efficient utilization of the resources of the project. More intervention programs to alleviate the challenges of IDPs are advocated

In vitro antidiabetic, anti-inflammatory and antioxidant potential of the ethanol extract of Uromastyx hardwickii skin

Purpose: To evaluate the in vitro antidiabetic, anti-inflammatory and antioxidant potential of the ethanol extract of Uromastyx hardwickii Skin (UHSEE). Methods: The in vitro effects of UHSEE at various concentrations (10 - 250 µg/mL) on the activities of ߙ-amylase, ߙ-glucosidase and glucose uptake by yeast cells were used to evaluate its antidiabetic potential. Nitric oxide (NO), 2,2-diphenyl-1-picrylhydrazyl (DPPH) and hydrogen peroxide inhibitory assay were employed to determine its antioxidant effects, while the anti-inflammatory effects were evaluated using human red blood cell (HRBC) membrane stabilization assay. Results: UHSEE inhibited ߙ-amylase and ߙ-glucosidase enzymes but increased glucose uptake by yeast cells in a concentration-dependent manner (p < 0.05). It also inhibited NO, DPPH, hydrogen peroxide and HRBC hemolysis in a concentration-dependent manner (p < 0.05). Conclusion: Uromastyx hardwickii skin exhibits promising good antidiabetic, antioxidant and antiinflammatory properties in vitro. However, its true potentials in this regard needs to be evaluted in vivo

Predictive Modeling of Antibiotic Susceptibility in E. Coli Strains Using the U-Net Network and One-Class Classification

The antibiotic resistance of bacterial pathogens has become one of the most serious global health issues due to misusing and overusing of antibiotics. Recently, different technologies were developed to determine bacteria susceptibility towards antibiotics; however, each of these technologies has its advantages and limitations in clinical applications. In this contribution, we aim to assess and automate the detection of bacterial susceptibilities towards three antibiotics; i.e. ciprofloxacin, cefotaxime and piperacillin using a combination of image processing and machine learning algorithms. Therein, microscopic images were collected from different E. coli strains, then the convolutional neural network U-Net was implemented to segment the areas showing bacteria. Subsequently, the encoder part of the trained U-Net was utilized as a feature extractor, and the U-Net bottleneck features were utilized to predict the antibiotic susceptibility of E. coli strains using a one-class support vector machine (OCSVM). This one-class model was always trained on images of untreated controls of each bacterial strain while the image labels of treated bacteria were predicted as control or non-control images. If an image of treated bacteria is predicted as control, we assume that these bacteria resist this antibiotic. In contrast, the sensitive bacteria show different morphology of the control bacteria; therefore, images collected from these treated bacteria are expected to be classified as non-control. Our results showed 83% area under the receiver operating characteristic (ROC) curve when OCSVM models were built using the U-Net bottleneck features of control bacteria images only. Additionally, the mean sensitivities of these one-class models are 91.67% and 86.61% for cefotaxime and piperacillin; respectively. The mean sensitivity for the prediction of ciprofloxacin is only 59.72% as the bacteria morphology was not fully detected by the proposed method

A qualitative look at bed net access and use in Burkina Faso, Mozambique, Nigeria, and Rwanda following piloted distributions of dual-active ingredient insecticide-treated nets

Background: Universal coverage with insecticide-treated nets (ITNs) is important for malaria control and elimination. The emergence and intensification of insecticide resistance threatens progress made through the deployment of these interventions and has required the development of newer, more expensive ITN types. Understanding malaria prevention behaviour, including barriers and facilitators to net access and use, can support effective decision-making for the promotion and distribution of ITNs. Methods: In-depth interviews and focus group discussions were conducted in 3 to 4 villages per district, in 13 districts across Burkina Faso, Mozambique, Nigeria and Rwanda from 2019 to 2022. Interviews were conducted in the local language, translated and transcribed in English, French or Portuguese. Transcripts were coded and analysed using Nvivo and ATLAS.ti. Results: ITNs were obtained from mass distribution campaigns, antenatal care and immunization visits, and purchased on the private market in some locations. While there were divergent perspectives in whether the number of distributed nets were adequate, participants consistently expressed concerns of bias, discrimination, and a lack of transparency with the distribution process. ITNs were frequently used alongside other malaria prevention methods. The primary motivation for use was malaria prevention. While some participants reported using nets nightly throughout the year, other participants reported seasonal use, both due to the perceived higher density of mosquitoes and discomfort of sleeping under a net in the increased heat. Other barriers to consistent net use included activities that take place away from the home, sleeping patterns and arrangements, and sensitivity to the insecticides on the nets. Conclusions: ITNs remain an important malaria control intervention. To ensure adequate and increased net access, distribution campaigns should consider family structures, available sleeping spaces, and other bed sharing preferences when identifying the number of nets needed for distribution. In addition, campaigns should allow for multiple options for net distribution points and timing to accommodate households remote to health services. Continuous distribution channels and complimentary distribution through the private sector could help fill gaps in coverage. Solutions are needed for outdoor malaria transmission, including alternative designs for ITNs, and improving access to complementary personal protective measures

Design and methods for a quasi-experimental pilot study to evaluate the impact of dual active ingredient insecticide-treated nets on malaria burden in five regions in sub-Saharan Africa

Background:Vector control tools have contributed significantly to a reduction in malaria burden since 2000, primar‑ily through insecticidal‑treated bed nets (ITNs) and indoor residual spraying. In the face of increasing insecticide resist‑ance in key malaria vector species, global progress in malaria control has stalled. Innovative tools, such as dual active ingredient (dual‑AI) ITNs that are effective at killing insecticide‑resistant mosquitoes have recently been introduced. However, large‑scale uptake has been slow for several reasons, including higher costs and limited evidence on their incremental effectiveness and cost‑effectiveness. The present report describes the design of several observational studies aimed to determine the effectiveness and cost‑effectiveness of dual‑AI ITNs, compared to standard pyre‑throid‑only ITNs, at reducing malaria transmission across a variety of transmission settings.Methods:Observational pilot studies are ongoing in Burkina Faso, Mozambique, Nigeria, and Rwanda, leveraging dual‑AI ITN rollouts nested within the 2019 and 2020 mass distribution campaigns in each country. Enhanced surveil‑lance occurring in select study districts include annual cross‑sectional surveys during peak transmission seasons, monthly entomological surveillance, passive case detection using routine health facility surveillance systems, and studies on human behaviour and ITN use patterns. Data will compare changes in malaria transmission and disease burden in districts receiving dual‑AI ITNs to similar districts receiving standard pyrethroid‑only ITNs over three years. The costs of net distribution will be calculated using the provider perspective including financial and economic costs, and a cost‑effectiveness analysis will assess incremental cost‑effectiveness ratios for Interceptor® G2, Royal Guard®, and piperonyl butoxide ITNs in comparison to standard pyrethroid‑only ITNs, based on incidence rate ratios calcu‑lated from routine data.Conclusions:Evidence of the effectiveness and cost‑effectiveness of the dual‑AI ITNs from these pilot studies will complement evidence from two contemporary cluster randomized control trials, one in Benin and one in Tanzania, to provide key information to malaria control programmes, policymakers, and donors to help guide decision‑making and planning for local malaria control and elimination strategies. Understanding the breadth of contexts where these dual‑AI ITNs are most effective and collecting robust information on factors influencing comparative effectiveness could improve uptake and availability and help maximize their impact

Medicinal plants in traumatic brain injury: Neuroprotective mechanisms revisited

Traumatic brain injury (TBI) is the most prevalent health problem affecting all age groups, and leads to many secondary problems in other organs especially kidneys, gastrointestinal tract, and heart function. In this review, the search terms were TBI, fluid percussion injury, cold injury, weight drop impact acceleration injury, lateral fluid percussion, cortical impact injury, and blast injury. Studies with Actaea racemosa, Artemisia annua, Aframomum melegueta, Carthamus tinctorius, Cinnamomum zeylanicum, Crocus sativus, Cnidium monnieri, Curcuma longa, Gastrodia elata, Malva sylvestris, Da Chuanxiong Formula, Erigeron breviscapus, Panax ginseng, Salvia tomentosa, Satureja khuzistanica, Nigella sativa, Drynaria fortune, Dracaena cochinchinensis, Polygonum cuspidatum, Rosmarinus officinalis, Rheum tanguticum, Centella asiatica, and Curcuma zedoaria show a significant decrease in neuronal injury by different mechanisms such as increasing superoxide dismutase and catalase activities, suppressing nuclear factor kappa B (NF‐κB), interleukin 1 (IL‐1), glial fibrillary acidic protein, and IL‐6 expression. The aim of this study was to evaluate the neuroprotective effects of medicinal plants in central nervous system pathologies by reviewing the available literature

Comparative analysis of family planning services in urban and rural health facilities in Nigeria

Aim: This study aimed to compare family planning (FP) services in urban and rural health facilities in Nigeria. Materials and Methods: The study is a cross-sectional study conducted in 204 rural and 198 urban health facilities comprising 182 primary and 216 secondary facilities in Nigeria. A FP client was randomly selected from each of the facilities, and structure questionnaires were used to collect information from them. Data collected include the various types of contraception available, waiting time, and satisfaction with services. Data were analyzed with IBM-SPSS Statistics Version 25.0. Results: The most requested contraceptives methods were injectables (48.2%) and oral contraceptives (22.6%). Most clients in both the rural (76.0%) and urban (76.3%) waited 0.05). Conclusion: There is a need for an improvement in waiting time and quality of services offered in health facilities. Policymakers should to carry out regular supervision of health facilities and ensure availability of contraceptives in the health facilities at affordable prices in order to improve FP uptake in Nigeria

Baseline and post-intervention surveys of the prevalence of HIV in an African Rural population and women in the brothel

Backgrounds: HIV remains a major global public health challenge despite all efforts to end the endemic since the 1980s. This study is aimed to determine the baseline and postintervention HIV prevalence among female sex workers (FSW) and in the population of Bonny Island. Materials and Methods: The study is a quantitative study involving the general population of the Bonny Kingdom and the FSW in baseline and postintervention surveys. Blood samples were collected and tested for HIV. Data were analyzed with SPSS version 25. Results: A total of 1104 blood samples were tested for HIV in both surveys. The baseline HIV prevalence was 4.5% and 1.8% in the postintervention. The prevalence ratio of baseline/postintervention was 2.5 (confidence interval [CI] 1.2–5.8; P = 0.011). HIV prevalence was 4.5% in both males and females in the baseline survey as compared to 1.9% and 3.8% in postintervention. The HIV prevalence ratio in females was 3.8 (CI: 1.0–21.1, P = 0.025), but no significant difference was observed among males. Baseline HIV prevalence was 7.0 among age 25–34 years and 0.5% in postintervention with a prevalence ratio of 12.9 (CI: 2.0–54.9; P < 0.001). The highest prevalence in the baseline survey was observed among FSW (14.0%) and 1.2% in the postintervention with a prevalence ratio of 14.3 (CI: 2.2–60.3; P < 0.001). HIV prevalence was significantly higher among FSWs aged 25 or more, full time, had more than one client and have spent over a year in sex work (P < 0.05). Conclusion: The reduction in the prevalence of HIV seen at the postintervention survey could be attributed to the 3 years of interventions. However, the intervention programs should be sustained and ever scaled up to prevent, control of HIV