CHRONIC KIDNEY DISEASE AMONGST SICKLE CELL ANAEMIA PATIENT AT THE UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL, NORTH EASTERN NIGERIA: A STUDY OF PREVALENCE AND RISK FACTORS

ABSTRACT Introduction: Involvement of the kidneys in patient with sickle cell anaemia is a well recognized chronic complication of this disorder. The index study seeks to determine the prevalence of chronic kidney disease in patients with homozygous sickle cell disease (HbSS) and to identify risk factors associated with its development. Methodology: The subjects consisted of adolescents and adults with HbSS recruited sequentially from the adult haematology outpatient clinic and Day care ward of the unit. Clinical variables including age of diagnosis of SCA, frequency of vaso-occlusive crisis and transfusion therapy, as well as laboratory data including haematological profile, renal function test were obtained from routine blood result. The glomerular filtration rate was estimated (eGFR) using the ‘modification of diet in renal disease’ (MDRD) formula.. Results: Two hundred and eighty-four HbSS patients were recruited. The prevalence of CKD amongst them was 38.9%.  Further stratification of the patients based on eGFR showed that sixty-nine (26.8%) had hyperfiltration; 35 (13.6%) stage 1 CKD; 53 (20.6%) stage 2 CKD; 61 (23.7%) stage 3 CKD; 30 (11.7%) stage 4 CKD and 9 (3.5%) had end stage renal disease. There was significant association between eGFR and clinical parameters such as age (r -0.353, p=0.000), SBP (r -0.148, p= 0.021), DBP (r -0.213, p=0.001) and total number of blood received (r -0.276, p=0.000); and laboratory parameters such as  PCV (r 0.371, p=0.000); urea ( r 0.527, p=000 ); creatinine (r 0.625, p=0.000) and uric acid  ( r -0.419, p=0.000). Conclusion The present study has revealed a high prevalence of CKD amongst patients with SCA in this region. Various clinical and laboratory predictors of eGFR were also identified. Monitoring and detection of early stages of these groups of patients may allow for interventions which may delay progression into advance stages and ESRD

EVALUATION OF Cassia sieberiana (DC) AND Vernonia amygdalina (Del.) AGAINST Callosobruchus maculatus (F.) INFESTING STORED BAMBARA GROUNDNUT Vigna subterranea (L.) Verdc.)

The insecticidal activity of Cassia sieberiana (DC) and Vernonia amygdalina (Del.) aqueous extract against Callosobruchus maculatus (F.) in treated bambara groundnut was evaluated under laboratory conditions (25 – 29°C and 56 – 70% r.h.). Seeds were treated separately at four concentrations (2, 4, 6 and 8 ml/100g of seeds) of both plants aqueous extracts. Pirimiphos methyl applied at 8 mg a.i./kg was included as positive control. Data collected were adult mortality, number of adult progeny  (F1 and F2), percentage seed damage, percentage weight loss and germination capacity. Results showed that increasing concentration of both plant extracts and period of exposure to treated seeds significantly (P<0.05) increased adult mortality levels from 16.9±2.9 to 100%. Furthermore, both plant extracts applied at 8 ml/100 g of seeds were comparable to pirimiphos-methyl after 96 h of exposure. The plant extracts significantly (P<0.05) reduced number of adult progeny, percentage seed damage and percentage weight loss, which all progressively declined with increasing concentration from 2 to 8 ml. Both plant aqueous extracts had no effect on germination capacity of treated seeds. For all the parameters measured, the plant extracts tested showed significantly higher biological activity in treated seeds compared to the untreated control. The present results suggest that these plant aqueous extracts have the potential to control C. maculatus populations in stored bambara groundnut

Superiority trial of intermittent treatment with dihydroartemisinin–piperaquine versus sulfadoxine–pyrimethamine for the prevention of malaria during pregnancy

Abstract Background Malaria in pregnancy is responsible for various adverse maternal and birth outcomes. The emerging resistance to sulfadoxine–pyrimethamine (SP) raises important concerns about its use for intermittent preventive treatment in pregnancy (IPTp) in Africa. This trial aimed to assess the efficacy and safety of IPTp with dihydroartemisinin–piperaquine (DP) as an alternative to IPTp with SP. Results The double-blind, randomized, and controlled superiority trial was conducted between July 2020 and June 2021. A total of 250 women were enrolled and randomly assigned to receive SP (n = 125) or DP (n = 125). Two hundred and six (82.4%) participants that contributed to the outcomes were included in the modified intention-to-treat (ITT) analysis, while 84 participants that completed the three courses of the study drugs were included in the per protocol (PP) analysis. The ITT analysis results showed that the incidence of histopathologically confirmed placental malaria was nonsignificantly higher in the DP group compared with the SP group (62.5% vs. 51.1%, P = 0.098). After adjusting for confounders, the risk of histopathologically confirmed placental malaria was also nonsignificantly higher in the DP group (Adjusted Relative Risk [RR] = 1.27, 95% CI 0.94–1.71) compared with the SP group. In contrast, the risk of a low APGAR score was significantly lower in the DP group (RR = 0.45, 95% CI 0.38–0.52) compared with the SP group. Also, the risk of a composite adverse birth outcome (low birth weight or preterm delivery or neonates small for the gestational age) was nonsignificantly lower in the DP group (Adjusted RR = 0.82, 95% CI 0.55–1.21) compared with the SP group. Both drugs were well tolerated, although nausea and vomiting occurred in a significant number of participants in the SP group. Conclusions A three-course IPTp with DP was safe and was not found to be superior to IPTp with SP in the prevention of placental malaria. Although IPTp with DP was associated with a significant lower risk of low APGAR score and nonsignificant lower risks of other adverse birth outcomes compared with IPTp with SP. Trial registration PACTR, PACTR202002644579177. Registered 20 February 2020, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9753

ASSESSING THE EFFECTIVENESS OF MANAGERS OF TECHNICAL COLLEGE WORKSHOPS: A CASE OF NORTH CENTRAL NIGERIA

This study assesses&nbsp;the effectiveness of managers of technical college workshops from the perspective of stakeholders in North Central Nigeria. A descriptive survey design was employed. Three research questions and two hypotheses were formulated to guide the study. A 35-item questionnaire developed by the researchers and validated by three experts was used to collect data from 101 administrators, 140 teachers, and 24 workshop personnel randomly sampled and stratified along trades in technical colleges. Mean was employed to answer the research questions while one way analysis of variance (ANOVA) was employed to test the hypotheses using Statistical Package for Social Sciences (SPSS) for data analysis. Result revealed that respondent shared similar opinions on the management of technical college workshops. It was therefore recommended that: The managers of the workshops should use alternative approaches in the management of workshop instead of waiting for government to provide everything; maintenance of tools should be a regular practice in the workshops; administrators should recommend teachers and workshop personnel to attend seminars regularly in order to update their knowledge on current practices in the management of technical college workshops among others

Sonographic evaluation of some abdominal organs in sickle cell disease patients in a tertiary health institution in Northeastern Nigeria

Background: Sonographic evaluation of abdominal organs is an important work up in managing sickle cell disease (SCD) patients. This study aimed at evaluating abdominal organs by sonography among SCD patients. Methodology: A cross-sectional study was carried out in Maiduguri, Nigeria from April 2014 to July 2015. Two hundred and fifty-two patients participated in the study, with 126 controls and 126 SCD patients. There were 131 (52%) males, and 121 (48%) females, with age range 3–38 years. Measurements were done using ultrasound machine with probe frequencies ranging from 1–4MHz and 4–9MHz in supine, right and left oblique positions for optimum visualization of the abdominal organs. Results: Participants within the age range of 10–15 years had the highest frequency with 88 (34.9%), followed by those within the age group of 17–23 years with 86 (34.1%), and the least were those within the age group of 30 years and above with 8 (3.2%). Hepatomegaly was found in 53 (75.7%), and increased echogenicity of the liver was found in 50 (94.3%) of the SCD patients, P = 0.000. Gallstones were found in 45 (17.9%), gallbladder sludge was found in 51 (21.4%) and thickened gallbladder wall was found in 84 (33.3%) of the SCD patients, P = 0.000. Autosplenectomy was found in 45 (17.9%), splenomegaly in 63 (24.9%), and calcified spleen in 18 (8.7%) of the SCD patients, P = 0.000. Enlarged kidneys in SCD patients were found in 61 (98.4%) and 63 (98.4%) on the right and left kidneys, respectively. Shrunken kidneys were found in 5 (2.0%) and 4 (1.6%) of the SCD patients on the right and left kidneys, respectively, P = 0.000. Conclusion: Abdominal sonography in SCD patients revealed varied remarkable changes in the size, echotexture, intraluminal deposits and wall thickness in the liver, gallbladder, kidneys, and spleen