Referral System: An Assessment of Primary Health Care Centres in Plateau State, North Central Nigeria

Background: An effective referral system ensures a close relationship between all levels of the health system and helps to ensure patients receive the best possible care close to home. There appears to be a weak link of referral system in chain of continuity of care across the levels of health care in Nigeria placing huge demands on secondary and tertiary levels of care for health care service provision. In view of this, this study was conducted to assess the level of practice of referral and factors influencing it among health workers in PHCs in Plateau state North central Nigeria. Methodology: This was a cross sectional study conducted among 228 frontline health care workers in PHCs. SPSSS version 20 was used for data analysis, adjusted odds ratio as well as 95% confidence interval were used in this study with a p-value of le 0.05 considered statistically significant. Results: The respondentsrsquo mean age was 38.0 plusmn 9 years with slight above half 116 (54.2%) having good understanding of the concept of referral and mostnbsp 77.6% had referred at least a case within the last one month. nbspFactors such as good understanding of the concept of referral (AOR = 6.2 95% Cl = 1.4556 ndash 8.7991) and availability of referral system (AOR = 8.4 95% Cl = 2.1168 ndash 15.5450) were predictors of the practice of referral. Conclusion: This study has demonstrated the level of practice of referral among cadres of health care workers at PHCs level with significant need for improvement

Miscarriage rates after dehydroepiandrosterone (DHEA) supplementation in women with diminished ovarian reserve: a case control study

<p>Abstract</p> <p>Background</p> <p>Dehydroepinadrosterone (DHEA) supplementation improves pregnancy chances in women with diminished ovarian reserve (DOR), by possibly reducing aneuploidy. Since a large majority of spontaneous miscarriages are associated with aneuploidy, one can speculate that DHEA supplementation may also reduce miscarriage rates.</p> <p>Methods</p> <p>We retroactively compared, utilizing two independent statistical models, miscarriage rates in 73 DHEA supplemented pregnancies at two independent North American infertility centers, age-stratified, to miscarriages reported in a national U.S. in vitro fertilization (IVF) data base.</p> <p>Results</p> <p>After DHEA supplementation the miscarriage rate at both centers was 15.1% (15.0% and 15.2%, respectively). For DHEA supplementation Mantel-Hänszel common odds ratio (and 95% confidence interval), stratified by age, was significantly lower, relative to odds of miscarriage in the general IVF control population [0.49 (0.25-0.94; p = 0.04)]. Miscarriage rates after DHEA were significantly lower at all ages but most pronounced above age 35 years.</p> <p>Discussion</p> <p>Since DOR patients in the literature are reported to experience significantly higher miscarriage rates than average IVF patients, the here observed reduction in miscarriages after DHEA supplementation exceeds, however, all expectations. Miscarriage rates after DHEA not only were lower than in an average national IVF population but were comparable to rates reported in normally fertile populations. Low miscarriage rates, comparable to those of normal fertile women, are statistically impossible to achieve in DOR patients without assumption of a DHEA effect on embryo ploidy. Beyond further investigations in infertile populations, these data, therefore, also suggest the investigations of pre-conception DHEA supplementation in normal fertile populations above age 35 years.</p

Baboons as potential reservoirs of zoonotic gastrointestinal parasite infections at Yankari National Park, Nigeria

Background: Zoonoses pose a risk to public health.Objective: To carry out the investigation of the prevalence of  gastrointestinal parasites of baboons, Papio anubis, frequenting the Wikki base Camp in Yankari National Park, NigeriaMethod: Formol-ether concentration technique was used to isolate parasite eggs and cysts from faecal samples.Results: Parasites recovered were Ascaris lumbricoides, Ancylostoma duodenale, Strongyloides stercoralis, Fasciola sp, Schistosoma mansoni, Hymenolepis nana, and Trichostrongylus sp, and cysts of protozoan  parasites Entomoeba histolytica, E. coli, and Iodamoeba butschii.Conclusion: Most of the parasites identified are known to have high pathologic involvement in humans, implicating the baboons as potential source and reservoirs for human zoonotic parasitic infections although further molecular work would be necessary to ascertain if these  gastrointestinal parasites are the same strains that infect humansKeywords: Papio anubis, gastrointestinal parasites, zoonoses, Yankar

Baboons as potential reservoirs of zoonotic gastrointestinal parasite infections at Yankari National Park, Nigeria

Background: Zoonoses pose a risk to public health. Objective: To carry out the investigation of the prevalence of gastrointestinal parasites of baboons, Papio anubis , frequenting the Wikki base Camp in Yankari National Park, Nigeria Method: Formol-ether concentration technique was used to isolate parasite eggs and cysts from faecal samples. Results: Parasites recovered were Ascaris lumbricoides , Ancylostoma duodenale , Strongyloides stercoralis , Fasciola sp, Schistosoma mansoni , Hymenolepis nana , and Trichostrongylus sp, and cysts of protozoan parasites Entomoeba histolytica , E. coli , and Iodamoeba butschii . Conclusion: Most of the parasites identified are known to have high pathologic involvement in humans, implicating the baboons as potential source and reservoirs for human zoonotic parasitic infections although further molecular work would be necessary to ascertain if these gastrointestinal parasites are the same strains that infect human

Evaluation of parasitic contamination of local potable water sources in Doma Local Government Area of Nasarawa State, Nigeria

The health and well-being of individuals in a nation absolutely depends on the quality of water available for consumption. Therefore, this study evaluated parasitic contaminants of drinking water sources in Doma Local Government Area of Nasarawa State, Nigeria. A total of 48 water samples were collected from different sources (boreholes, wells and streams) from March to July 2017. The water samples were analyzed using the Calcium Carbonate (CaCO3) floatation method and the samples were examined microscopically for the presences of parasites. A total of 32 (66.67%) water samples were parasitized by a trematode (Fasciola hepatica), two protozoans (Entamoeba histolytica, and Giardia lamblia) and three nematodes (Trichuris trichiuria, Ascaris lumbricoides and Hookworm). The nematode group had the highest contamination rate 19 (59.38%) followed by the protozoan group 12 (37.50%) while trematode was the least with 1(3.13%). The stream source was the most contaminated in late dry and early wet seasons having 69.23% and 94.74% respectively, followed by wells which had 30.77% and 5.26% in late dry and early wet seasons respectively while boreholes had 0% contamination in both seasons. Therefore, prevalence of parasites in relation to sources of water showed a very high significant association (X2= 49.741, df = 2, P &lt; 0.0001), while there was no significant association with seasons (X2 = 2.3438, df = 1, P = 0.1258).Result indicated high rate of parasitic contamination of drinking water sources in the study area. Hence, the need for advocacy and enlightenment of the inhabitants of the area on the importance of proper treatment of potable water.Key words: Parasites, potable water sources, season

Prevalence and spectrum of cervical cytological abnormalities among brothel based sex workers in Jos, Nigeria

Background: Cervical cancer is the second most common cause of cancer-related death among women in sub-Saharan Africa. Female sex workers being high-risk group are more susceptible to infections with the Human Papillomavirus and thus, the development of the premalignant and malignant disease of the cervix. We therefore sought to determine the prevalence and spectrum of cervical cytological abnormalities among female sex workers in Jos, Nigeria. Methods: A cross-sectional study was conducted among Brothel based sex workers (BBSW) aged 18years and above in Jos, Nigeria between March 2018-February 2019. Papanicolaou test technique was the screening method used to detect premalignant lesions. Data were entered and analyzed using STATA version 15.1 software. Results: A total of 201 participants were recruited for the study. One hundred and ninety-four (194) had adequate smears and were included in the analysis. Of this 80.4% were negative for intraepithelial malignancy, while 19.6% were positive for intraepithelial malignancy and this included ASCUS (10.3%), LSIL (4.6%), HSIL (3.6%), AGUS (0.5%) and ASC-H (0.5%). Abnormal cervical cytology was seen more in participants that were single, between the ages of 24-34years, multiparous, with a previous history of sexually transmitted disease, and have greater than 2 clients/day, but all these were not statistically significant. Conclusion: Due to the high prevalence of abnormal cervical cytology among BBSW, there is a need for them to have regular screening, follow-up, and treatment of premalignant lesions to prevent progression to frank cervical cancer