Prevalence of anemia and its associated factors among married women in 19 sub-Saharan African countries.

BACKGROUND: Sub-Saharan Africa (SSA) remains the region with the highest burden of anemia globally. Since anemia has both health and non-health-related consequences, its reduction is one of the Sustainable Development Goals. Therefore, this study aimed to examine the prevalence of anemia and its associated factors among married women in SSA. METHODS: Using Stata version-14 software, the analysis was done on 89,029 married women from the Demographic and Health Surveys of 19 countries in SSA. Pearson Chi-Square test and Binary logistic regression analyses were used to examine the factors associated with anemia. The results were presented using adjusted Odds Ratio (aOR) at a 95% Confidence Interval (CI). A p-value less than or equal to 0.05 (p ≤ 0.05) was considered statistically significant. RESULTS: The pooled analysis showed that 49.7% of married women were anemic. Of these, 1.04% and 15.05% were severely and moderately anemic respectively, and the rest 33.61% were mildly anemic. Husband education (primary school-aOR = 0.84, 95% CI; 0.71-0.99), wealth index (middle-aOR = 0.81, 95% CI; 0.68-0.96, richer-aOR = 0.69, 95% CI; 0.57-0.84, richest-aOR = 0.68, 95% CI; 0.51-0.91), modern contraceptive use (yes-aOR = 0.68, 95% CI; 0.56-0.81) and religion (Muslim-aOR = 1.27, 95% CI; 1.11-1.46, others-aOR = 0.73, 95% CI; 0.59-0.90) were factors associated with anemia among married women. CONCLUSION: The findings show that nearly half of the married women are affected by anemia. Enhancing partners' educational levels, and economic empowerment of women, strengthening family planning services, and working with religious leaders to reduce the perception and religious beliefs related to food restrictions can be the main focus to reduce the burden of anemia among married women in SSA

Duration of Hospital Stay and Mortality in the Medical Wards of Ahmadu Bello University Teaching Hospital, Kaduna

Background: Many factors affect mortality among hospitalized patients. These include: - age, sex, diagnosis, types and complexity of co-morbidities, social and economic conditions of the patient and duration of hospital stay. Duration of hospital stay as it affects mortality is studied on our medical wards. Methods: A two year review of admissions into our medical wards between June 1999 and June 2001 was carried out. Medical records of patients as well as the discharge/death register were used. The SPSS version 10 was used to analyse the data Results: A total of 179 patients with age range of 12-85 years, mean age of 44.46 years were studied. Twenty (11.2%) of them died. Sixty-five percent of all deaths had occurred by the fifth day of admission, only 15% of all deaths occurred after the 10th day of admission. The mean duration of hospital stay for those who died was significantly shorter (P<0.01) than that for those who were discharged (4.95 days vs. 12.5days). Conclusion: The results suggest that duration of hospital stay is strongly linked with the likelihood of death among other factors. Death occurring mostly within the first few days of admission. Improved public health and education, raising the socio-economic status of people and improving the standards of our healthcare facilities and personnel would prevent a large proportion of deaths on our medical wards

Responsiveness of primary health care services in Nigeria: The patients’ perspective

Health system responsiveness reflects the extent national health systems meet the legitimate expectations of patients. This study assessed the responsiveness of primary health care services in Nigeria from the clients’ perspective. A cross-sectional survey of 379 participants were randomly selected from 7 centers from a sample frame of 20 primary healthcare centers. Descriptive results were presented in frequencies and percentages. The associations between the importance and performance ranking were examined using the Spearman’s ranked correlation coefficient. Multivariate logistic regression was used to identify predictors of responsiveness with p-values ≤ 0.05 considered statistically significant. There were equal proportion of respondents aged≥30 years but more were female (95%), had attained less than the tertiary level of schooling (60.9%), and currently married (92.3%). The highest proportion of patients reported good responsiveness for dignity (81.8%) and least proportion for the choice of care provider (53.8%). Patient-level predictors of good responsiveness in relation to autonomy were younger age (p = 0.003) attainment of tertiary level of education (p = 0.001); tertiary education was associated with confidentiality (p = 0.009) and those who are not married with prompt attention (p = 0.027). Dignity, confidentiality, and prompt attention were identified as priority areas to focus in improving the responsiveness of primary healthcare services in Rivers State. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens

Petrography and depositional environments of the sandstones in areas around Abuul, in Ushongo, southern Benue trough, Nigeria

The study focuses on the petrography and depositional setting of the sandstones in areas around Abuul, Ushongo; lower Benue Trough. The integration of outcrop,  textural and petrographic studies aided the inference of the depositional framework of the sandstones in the area. Indurated sandstone samples were cut into thin  sections for petrographic analysis while a total of 100 pebbles from OAM/1/Abuul were subjected to morphometric analysis. The thin section studies involved the determination of the texture and mineral/framework element compositions of the sandstones through point counting of about 100 constituent grains. The geologic mapping indicates that the sandstones are deposited proximal to the Basement Complex rocks. Thin section results show that the sandstones are coarse-grained and poorly sorted lithic arkoses, predominantly comprising of angular framework elements, with low textural and chemical maturity, possibly deposited in a fluvial setting. The result from pebble morphometry analysis also confirmed that the sands are fluvial. The bivariate plots of the pebble studies indicate a dominating population of fluvial-influenced pebbles in association with a subordinate population of beach influenced pebbles. However, minor grain compression is evident through the  observed sediment compaction, stretched grains and presence of quartz  overgrowths in some of the sandstones. This study has shown that the sandstones in the area are deposited by fluvial dominated processes, with the interaction of beach processes, though to a lesser degree.Keywords: textural analysis, sandstone petrography, depositional settin

The use of cross-plots in lithology delineation and petrophysical evaluation of some wells in the western Coastal Swamp, Niger Delta

Abstract The inaccurate delineation of the sand intervals in well logs can significantly affect the porosity, permeability, pore-size geometry and net-to-gross ratio of the reservoir units. This study utilized well log cross-plots to accurately delineate the lithologic units and also used petrophysical evaluation methods to determine the reservoir properties of the sandstone intervals in three wells (L, M, N wells) of the Daura field, Niger Delta. The cross-plots of the gamma ray with density, gamma ray with sonic and gamma ray with depth were generated using the Hampson Russel software. The result of the cross-plot clusters shows two major lithologies of sandstone and shale with occasional intercalation of sand and shale units. Fluid detection analysis shows that reservoirs L3 (well L), M4–M5 (well M), and N2–N3 (well N) were found to contain oil, while reservoir M2 (well M) contains gas. The rest of the reservoir intervals in the three wells contain water, and the average porosity ranges from 14.23 to 28.01%. This study has shown that the cross-plots approach can be used to accurately delineate reservoirs for further formation evaluation. It therefore means that an outright estimation of petrophysical properties on wrongly delineated reservoirs can significantly affect the porosity, permeability, pore-size geometry and net-to-gross ratio of the reservoir units

Women's decision-making capacity and its association with comprehensive knowledge of HIV/AIDS in 23 sub-Saharan African countries.

BACKGROUND: Globally, Human Immunodeficiency Virus (HIV) that causes Acquired Immunodeficiency Syndrome (AIDS) remains a public health problem with a higher burden in sub-Saharan African countries. Though the coverage is low in sub-Saharan Africa (SSA), comprehensive knowledge about HIV is vital for preventing and controlling the transmission of the virus. Women's decision-making power is significantly linked with the knowledge and use of healthcare services. However, there is no available evidence on women's decision-making capacity and comprehensive knowledge of HIV. Therefore, this study investigated the association between women's decision-making capacity within households and comprehensive knowledge of HIV/AIDS in SSA. METHODS: We derived data from the 2010 to 2020 Demographic and Health Surveys of 23 sub-Saharan African countries for the analysis. Using Stata version 14, both bivariate logistic regression and multivariate multilevel logistic regression analyses were used to examine the association between women's decision-making capacity and comprehensive knowledge of HIV/AIDS at p ≤ 0.05. Results were reported using adjusted odds ratios (aOR) with their respective 95% confidence interval (CI). RESULTS: The pooled results show that comprehensive HIV/AIDS knowledge among married women in the studied countries was 35.5%, from 18.3% in Chad to 77.1% in Rwanda. Regarding sub-regional distribution, comprehensive knowledge of HIV/AIDS in Southern Africa was 73.2%, followed by East Africa (52.4%), West Africa (43.6%), and Central Africa (35.5%). The study showed higher odds of comprehensive knowledge of HIV/AIDS among married women who had decision making power (yes-aOR = 1.20, 95% CI; 1.16-1.25) compared to those who had no decision-making power. Age, women and partner's level of education, place of residence, exposure to media, HIV testing status, community socio-economic status, parity, religion, and distance to health facilities also had significant association with comprehensive HIV/AIDS knowledge. CONCLUSIONS: Comprehensive knowledge of HIV/AIDS in SSA is low but varies per country. Married women with decision-making capacity were more likely to have comprehensive knowledge of HIV compared to those with no decision-making capacity. Therefore, comprehensive knowledge of HIV/AIDS can be increased through enhancing women's decision-making capacities, strengthening employment opportunities, socioeconomic capacities and creating awareness through media. Moreover, improving access to health care facilities working closely with religious leaders, can be considered to increase coverage of comprehensive knowledge of HIV among married women in SSA

Clay mineral formation and transformation in non-marine environments and implications for Early Cretaceous palaeoclimatic evolution: The Weald Basin, Southeast England

Availability of data and materials: Supplementary data are available as Appendix 1. The corresponding author can be contacted for queries or clarifications.Analyses of clay minerals within the Early Cretaceous Weald Basin, Southeast England reveal kaolinite, illite and chlorite as the main detrital clay minerals while glauconite and smectite are subordinates. A kaolinite-rich assemblage which characterized the sand-dominated Ashdown and Tunbridge Wells Sand formations and an illite-dominated assemblage associated mostly with the Wadhurst Clay and Weald Clay formations are recognized. Kaolinite was enriched in the Ashdown and Tunbridge Wells Sand formations during warm and humid climate with high precipitation that encouraged chemical weathering and leaching, while cold and dry conditions favoured the concentration of illite in the Wadhurst Clay and Weald Clay formations. Rainfall patterns associated with warm climate were drastically reduced during the drier climatic conditions. Most clay minerals are detrital in origin, with chlorite being more prominent than previously recognized. Contrary to previous studies and assumptions, this study revealed that authigenic clay minerals are present in the Hastings Beds, with vermiform and mica-replacive kaolinite being the most common, consistent with humid depositional environments. Isolated authigenic illite is also present, along with a chloritized grain, providing evidence for mesodiagenesis. The absence of dickite and occurrence of kaolinite, suggest that authigenic illite formed in relatively shallow burial conditions, indicating a maximum burial depth of 2500 m–3000 m, about 1000 m deeper than previous estimates of 1500 m–2000 m. Authigenic clay minerals are absent in the Weald Clay Formation possibly because of hindered flow of meteoric water and limited growth space for authigenic minerals. This study is significant in: 1) reinforcing multiple methods to facilitate a robust and balanced knowledge of formation and transformation of clay minerals; 2) investigating detrital and authigenic clay mineral assemblages when assessing the palaeoenvironments of sedimentary basins.CGG Robertson provided collaborative funding by conducting QEMSCAN®, SEM and thin section analyses for the project

Increased incidences of Salmonella, Plasmodium falciparum and hepatitis C viral specific circulating immune complexes in participants from malaria endemic and HIV prevalent area of Nigeria

The present study used dissociated circulating immune complexes (CIC) to identity the burden of exposure to certain infectious agents. The participants were divided into HIV seropositive group (n=100) and HIV seronegative group (n=100). Polyethylene glycol (PEG) 6000 and phosphate buffer techniques were used for precipitation and dissociation of CIC in sera. The dissociated CIC were tested for Salmonella typhi antibody, Plasmodium falciparum histidine rich protein (Pf-hrp)-2 antigen and HCV antibody using commercially available kits. Result showed that Salmonella typhi antibody was detected in 76 (76%) of the HIV seropositive participants; Plasmodium falciparum histidine rich protein-2 (Pf-hrp-2) antigen was detected in 48 (48%) of HIV seropositive participants while Hepatitis C viral antibodies was detected in 20 (20%) of the HIV seropositive participants. Similarly, Salmonella typhi antibody was detected in 24(24%) of the HIV seronegative participants, Pf-hrp-2 antigen was detected in 47(47%) of the participants while Hepatitis C viral antibody was detected in 5(5%) of the HIV seronegative participants. There were significant differences between the number of HIV seropositive and seronegative participants with positive Salmonella typhi (P<0.05) and HCV antibody (P<0.05). The rates of homogeniuty and heterogeniuty of CIC in HIV seropositive participants was; 26 (34%) and 50 (66%) for Salmonella typhi antibody, 3 (6%) and 45 (94%) for Pf-hrp-2 antigen and 0 (0%) and 20 (100%) for HCV antibody, respectively. While the rates of homogeniuty and heterogeniuty of CIC in HIV seronegative participants was 1 (4.2%) and 23 (95.8%) for Salmonella typhi antibody; 25 (53%) and 22 (47%) for Pf-hrp-2 antigen and 3 (60%) and 2 (40%) for HCV antibody respectively in all cases. The finding of the present study suggest that HIV infection may enhance susceptibilty to both salmonella typhi and HCV infection but not Plasmodium falciparum. The study thus revealed that Salmonella and HCV infections may constitute the major secondary infection in HIV infected patients and could be a cause for concern as HIV progressed to AIDS

Combined GLP-1, oxyntomodulin, and peptide YY improves body weight and glycemia in obesity and prediabetes/type 2 diabetes: a randomized single-blinded placebo controlled study

OBJECTIVE: Roux-en-Y gastric bypass (RYGB) augments postprandial secretion of glucagon-like peptide 1 (GLP-1), oxyntomodulin (OXM), and peptide YY (PYY). Subcutaneous infusion of these hormones ("GOP"), mimicking postprandial levels, reduces energy intake. Our objective was to study the effects of GOP on glycemia and body weight when given for 4 weeks to patients with diabetes and obesity. RESEARCH DESIGN AND METHODS: In this single-blinded mechanistic study, obese patients with prediabetes/diabetes were randomized to GOP (n = 15) or saline (n = 11) infusion for 4 weeks. We also studied 21 patients who had undergone RYGB and 22 patients who followed a very low-calorie diet (VLCD) as unblinded comparators. Outcomes measured were 1) body weight, 2) fructosamine levels, 3) glucose and insulin during a mixed meal test (MMT), 4) energy expenditure (EE), 5) energy intake (EI), and 6) mean glucose and measures of glucose variability during continuous glucose monitoring. RESULTS: GOP infusion was well tolerated over the 4-week period. There was a greater weight loss (P = 0.025) with GOP (mean change -4.4 [95% CI -5.3, -3.5] kg) versus saline (-2.5 [-4.1, -0.9] kg). GOP led to a greater improvement (P = 0.0026) in fructosamine (-44.1 [-62.7, -25.5] µmol/L) versus saline (-11.7 [-18.9, -4.5] µmol/L). Despite a smaller weight loss compared with RYGB and VLCD, GOP led to superior glucose tolerance after a mixed-meal stimulus and reduced glycemic variability compared with RYGB and VLCD. CONCLUSIONS: GOP infusion improves glycemia and reduces body weight. It achieves superior glucose tolerance and reduced glucose variability compared with RYGB and VLCD. GOP is a viable alternative for the treatment of diabetes with favorable effects on body weight

A follow-up study of the prevalence of valvular heart abnormalities in hyperprolactinemic patients treated with cabergoline.

CONTEXT Uncertainty exists whether the long-term use of ergot-derived dopamine agonist (DA) drugs for the treatment of hyperprolactinemia may be associated with clinically significant valvular heart disease; and whether current regulatory authority guidelines for echocardiographic screening are clinically appropriate