Seroprevalence and determinants of Helicobacter pylori infection among asymptomatic under-five children at a Tertiary Hospital in the South-Western region of Nigeria

Background: The epidemiology of Helicobacter pylori (H. pylori) infection among under-five children in the South West Nigeria remains largely understudied. There is no data on the subject from the study area.Objectives: This study was conducted to assess the seroprevalence of H. pylori infection among under-five children at a tertiary hospital in the South Western, Nigeria and to determine its associated socio-demographic factors.Methods: Sera of 360 children were analyzed for anti H. pylori Ig G using enzyme linked immunosorbent assay test kit (BQ ELISA Ig G KIT) and H. pylori infection risk factors were determined. Determinants of H. pylori infection was determined using binary logistic regression analysis and p-values < 0.05 were taken as statistically significant.Results: H. pylori infection seroprevalence rate was 32.8% and increased with age. Living in one room accommodation, large families, playing with soil, family history of dyspepsia, practice of premastication, sharing of plates and cutlery, and water closet toilet were associated with H. pylori Ig G seropositivity (p<0.05) on binary regression analysis.Conclusion: The seroprevalence of H. pylori infection in under -five children is high, increasing as the age of the children increased. This may suggest that instituting preventive measures at young age, targeting identified factors may be effective in reducing the burden of H. pylori infection.Keywords: Helicobacter pylori, South-Western Nigeria

Adherence to WHO criteria on drug promotion literature : an exploratory study from a tertiary healthcare facility in South-West Nigeria

INTRODUCTION: In many low and middle-income countries (LMIC), drug promotional literature (DPL) remains one of the main sources of drug information for physicians. Studies conducted in many LMICs showed poor compliance to the WHO guidelines for ethical drug promotion especially in the area of information about excipients, adverse drug reactions, drug-drug interactions and contra-indications. These inadequacies in the information provided may mislead the prescriber with potential adverse consequences among patients using the medicines. Nigeria has a big pharmaceutical sector which is poorly regulated and we hypothesize that such unethical drug promotional practices may exist. This study therefore set out to assess compliance to the WHO ethical drug promotion (using DPL) at the Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, South-West Nigeria. METHODOLOGY: This was a descriptive cross-sectional study conducted in several specialist clinics of EKSUTH, Ado-Ekiti. Printed DPLs (brochures and leaflets) were collected from these clinics, collated using a pre-designed data collection form and analyzed using the WHO ethical criteria for medicinal drug promotion. RESULTS: A total of 234 DPLs were selected after screening to remove duplications. DPLs promoting antibiotics, cardiovascular drugs and vitamins/ nutritional supplements were in the majority (22.2%, 17.1% and 11.5% respectively. Most of the DPLs had the generic (223; 95.3%) and brand (234; 100%) names, active ingredients (209; 89.3%), excipients (149; 63.7%) and indications (232; 99.1%). Information about adverse drug reactions (76; 32.5%), contra-indications (73; 31.2%) and drug interactions (46; 19.7%) was less represented. Only fifty-nine (25.2%) DPLs had references. Fixed-dose combination drugs made up 34.6% of drugs being promoted. CONCLUSION: The DPLs assessed in this study had low adherence to WHO ethical drug promotion criteria especially those related to adverse drug reaction, drug interactions and contra-indications

Seroprevalence and determinants of Helicobacter pylori infection among asymptomatic under-five children at a Tertiary Hospital in the South-Western region of Nigeria

Background: The epidemiology of Helicobacter pylori (H. pylori) infection among under-five children in the South West Nigeria remains largely understudied. There is no data on the subject from the study area. Objectives: This study was conducted to assess the seroprevalence of H. pylori infection among under-five children at a tertiary hospital in the South Western, Nigeria and to determine its associated socio-demographic factors. Methods: Sera of 360 children were analyzed for anti H. pylori Ig G using enzyme linked immunosorbent assay test kit (BQ ELISA Ig G KIT) and H. pylori infection risk factors were determined. Determinants of H. pylori infection was determined using binary logistic regression analysis and p-values < 0.05 were taken as statistically significant. Results: H. pylori infection seroprevalence rate was 32.8% and increased with age. Living in one room accommodation, large families, playing with soil, family history of dyspepsia, practice of premastication, sharing of plates and cutlery, and water closet toilet were associated with H. pylori Ig G seropositivity (p<0.05) on binary regression analysis. Conclusion: The seroprevalence of H. pylori infection in under -five children is high, increasing as the age of the children increased. This may suggest that instituting preventive measures at young age, targeting identified factors may be effective in reducing the burden of H. pylori infection. DOI: https://dx.doi.org/10.4314/ahs.v19i2.32 Cite as: Babatola AO, Akinbami FO, Adeodu OO, Ojo TO, Efere MO, Olatunya OS. Sero-prevalence and determinants of Helicobacter pylori infection among asymptomatic under-five children at a tertiary hospital in the South-Western region of Nigeria. Afri Health Sci.2019;19(2): 2082-2090. https://dx.doi.org/10.4314/ahs.v19i2.3

Addressing antimicrobial resistance in Nigerian hospitals : exploring physicians prescribing behavior, knowledge, and perception of antimicrobial resistance and stewardship programs

Introduction: We assessed the knowledge of, attitude toward antimicrobial resistance (AMR) and practice of antimicrobial stewardship (AMS) among physicians in Nigeria to provide future guidance to the Nigerian National Action Plan for AMR. Methods: A descriptive cross-sectional questionnaire-based study explored the physicians’ self-reported practice of antibiotic prescribing, knowledge, attitude, and practice of AMR and components of ASPs. Results: The majority (217; 67.2%) of respondents prescribed antibiotics daily in their clinical practice AMR was recognized as a global and local problem by 308 (95.4%) and 262 (81.1%) respondents, respectively. Only 91 (28.2%) of respondents have ever heard of antibiotic stewardship. The median AMR knowledge score was 40 (19–45)out of 45while that for ASP was 46.0(32–57) out of 60. There was significant statistical difference between the ASP median scores among the medical specialties category (P value <0.0001) More respondents had good knowledge of AMR than ASPs (82.7% versus 36.5%; p < 0.0001). Conclusion: Respondents in this study were more knowledgeable about AMR than AMS and its core components

Paediatric brought-in-dead at a tertiary health facility in South western Nigeria: Patterns and drivers

Background: ‘Brought- in-dead’ (BID) refers to the demise of an individual before presentation to a health facility. This study assessed the pattern of paediatric BID cases seen at a tertiary health facility in southwest Nigeria. Method: A cross-sectional, descriptive study was done at the Children Emergency Ward (CEW) of the hospital between January 2014 and December 2018. The patterns of BID cases and presumed causes of death were determined using a standardized checklist adapted from the WHO verbal autopsy instrument. Results: Ninety-eight BID cases were seen during the study, constituting 2.5% of total patients seen during the period. The median (IQR) age of cases was 24.0 (8.75 – 63.0) months and 72.4% were under-fives. Most had symptoms related to the haematologic (36.7%), respiratory (24.5%) or digestive (20.4%) systems. Severe anaemia 31(31.6%), gastroenteritis 19 (19.4) and aspiration 17 (17.3%) were the most common causes of death. The median (IQR) duration of illness before presentation was 3.0 (1.0 – 7.0) days but most presented from 4 – 7 days of illness. A significant relationship was found between the duration of illness and whether or not pre-hospital treatment was received (p &lt; 0.0001). Unprescribed drugs purchased over the counter were the most commonly used treatment in 79.1% of cases (p &lt; 0.0001). Conclusion: This study has highlighted the prevalence and pattern of paediatric BID in a tertiary health facility in southwest Nigeria and the factors that were associated with it. More efforts need to be geared towards community sensitization and pediatric health care to prevent factors drivingits menace

Pattern of admissions and outcome in the children emergency department of a tertiary health institution in Southwestern Nigeria: A four-year review

Introduction: Pediatrics and adolescents are susceptible to illnesses that often necessitate emergency attention. Morbidity and mortality from illnesses in these ages have attracted much interest globally, particularly in Africa. Knowledge of pattern and outcomes of admissions may guide policy and interventions especially in resource constrained settings. The study aimed to determine the pattern of admissions, outcomes and seasonal variations of conditions that presented at the children emergency of a tertiary health institution over a four-year period. Methods: A retrospective descriptive study of children emergency admissions from January 2016 to December 2019. Information obtained included age, diagnosis, month and year of admission, and outcome. Descriptive statistics were used to describe the demographic characteristics and Chi-squared test to assess their associations with the diagnoses made. Results: There were 3,223 admissions. There were more males (1866; 57.9%) and more toddlers (1181; 36.6%). The highest number of admissions were observed in the year 2018 (951; 29.6%) and during the wet season (1962; 60.9%). There was an overall mortality rate of 7%; complicated malaria, gastroenteritis and meningitis were the leading causes of death. Malaria (χ2 = 135.522, p value < 0.001), and gastroenteritis (χ2 = 130.883, p value < 0.001) were predominant among the toddlers while sepsis (χ2 = 71.530, p value < 0.001) and pneumonia (χ2 = 133.739, p value < 0.001) were more among the infants. Typhoid enteritis (χ2 = 26.629, p value < 0.001) and HIV (χ2 = 16.419, p value = 0.012) were commoner among the early adolescents. Conclusion: The major causes of death in the study area are preventable with more of these amongst the children under the age of 5 years. There are seasonal and age-related patterns to admissions and the need for policy formulations and emergency preparations to be tailored towards these observed patterns through the year