Determinants and Differentials of Maternal Reproductive Health Outcomes in Nigeria: A Review of National Demographic Health Survey Data from 1999 to 2013

Women in Sub-Saharan Africa face significant clinical and socio-demographic challenges that translate to poor health outcomes including high maternal morbidity and mortality. Nigeria being the most populous nation in Africa bears a significant burden of both communicable and non-communicable diseases. This study aimed to determine the trends and differentials in indices fuelling poor health outcomes in Nigeria. The study was a review and trend analysis of maternal reproductive health indicators obtained from the Nigeria National Demographic and Health Survey (NDHS) data from 1990 to 2013 including secondary data from WHO, UNICEF and the World Bank. The life expectancy at birth was 54.5 years with an estimated infant mortality rate of 75 per 1000 live births, child mortality rate of 88 per 1,000 live births, under-5 mortality rate of 157 per 1,000 live births and a maternal mortality ratio (MMR) of 545 per 100,000 live births. Contraceptive prevalence was 22% among women in the wealthiest quintile and 3% among those in the poorest quintile.  Only 3% of women with no education used modern contraception as compared to 24% of women with tertiary education. Most of the maternal deaths were due to preventable causes which were largely related to poverty, inimical socio-cultural beliefs and practices as well as clinical factors like haemorrage, hypertension, and indirect causes like inadequate human resource for health, user charges, cultural pregnancy/childbirth beliefs and myths. A community-based participatory research using both qualitative and quantitative methods may shed more light on the non-clinical factors fueling high MMR in Nigeria. Keywords: Maternal and Child Health, maternal mortality, contraceptio

Is differential cleaning needed for SARS-CoV-2 beyond standard procedures? A systematic review.

BACKGROUND: There is a substantial risk of indirect transmission of SARS-CoV-2 from contaminated surfaces and objects in healthcare settings. AIM: To evaluate the effectiveness of enhanced cleaning protocols for high-touch surfaces during COVID-19, focusing on cleaning products, concentrations, contact time, and recommended frequency. SETTING: We focused on research conducted in healthcare settings or where samples were obtained from healthcare environments. METHOD: We assessed studies that compared different cleaning, disinfection, sterilisation, or decontamination procedures and cleaning frequency with standard or routine procedures. We prioritised randomised trials, non-randomised controlled trials, controlled before-and-after studies, and interrupted time series analyses carried out between 01 January 2020 and 31 August 2022. RESULTS: Three studies met our criteria from 2139 references searched. These studies, which took place in Iran, China and the United States, found that routine terminal cleaning and enhanced terminal cleaning with different cleaning enhancements significantly reduced SARS-CoV-2 surface contamination. One of the studies tested residual SARS-CoV-2 levels after routine and terminal cleaning with varying strengths of disinfectant and evaluated the efficacy of two common types of disinfectants in inactivating SARS-CoV-2 on inanimate surfaces in different hospital wards. CONCLUSION: Limited evidence supports cleaning strategies that can reduce the transmission of SARS-CoV-2 from surfaces in healthcare settings. Combining various cleaning methods and using multiple disinfectants can effectively reduce surface contamination. CONTRIBUTION: Randomised controlled trials are crucial for evaluating cleaning effectiveness. They must outline cleaning protocols, detailing frequency, product concentration and volume, application methods, soil and surface types, and environmental conditions, to provide strong evidence

Soap and water cleaning versus bleach-based cleaners for eliminating SARS-CoV-2 infection

Background: Households and community settings are important hubs for the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As understanding ofviral transmission improves, infection prevention and control (IPC) policies need to beupdated. Aim: To compare the effectiveness of soap and water alone to bleach-based cleaners in eliminating SARS-CoV-2 infection in households and community settings. Setting: We conducted a virtual search through the Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane database of systematic reviews, PubMed, EMBASE, and Effective Practice and Organisation of Care (EPOC). Methods: We assessed studies which compared the effect of soap and water cleaning on SARS-CoV-2 among humans to that of bleach-based cleaning, both in households and communities. We prioritised systematic reviews and randomised studies and only included other study designs, such as laboratory studies, which had interventions of relevant interest. Results: We retrieved 1192 articles from the search. We summarised evidence from three laboratory studies as there were no randomised controlled trials (RCTs) or comparative effectiveness studies that met our inclusion criteria. Indirect evidence suggests that soap and bleach-based cleaners were effective at different concentrations. Substantial heterogeneity between the cited studies precludes any inference on effectiveness in reducing risk of SARS-CoV-2 infection in humans. Both interventions remain important components of IPC measures. Conclusion: There was no evidence for comparison of soap and water versus bleach-based cleaners against SARS-CoV-2 in humans in household and community settings. Indirect evidence shows both interventions to be effective against the virus

Malariometric indices among Nigerian children in a rural setting

Malaria contributes to high childhood morbidity and mortality in Nigeria. To determine its endemicity in a rural farming community in the south-south of Nigeria, the following malariometric indices, namely, malaria parasitaemia, spleen rates, and anaemia were evaluated in children aged 2-10 years. This was a descriptive cross-sectional survey among school-age children residing in a rubber plantation settlement. The children were selected from six primary schools using a multistaged stratified cluster sampling technique. They were all examined for pallor, enlarged spleen, or liver among other clinical parameters and had blood films for malaria parasites. Of the 461 children recruited, 329 (71.4%) had malaria parasites. The prevalence of malaria parasitaemia was slightly higher in the under fives than that of those ≥5 years, 76.2% and 70.3%, respectively. Splenic enlargement was present in 133 children (28.9%). The overall prevalence of anaemia was 35.7%. Anaemia was more common in the under-fives (48.8%) than in those ≥5 years (32.8%). The odds of anaemia in the under fives were significantly higher than the odds of those ≥5 years (OR = 1.95 [1.19-3.18]). Malaria is highly endemic in this farming community and calls for intensification of control interventions in the area with special attention to school-age children

Respiratory symptoms, lung function testing, and PPE use among flour mill workers in Calabar, Nigeria

Abstract This study aimed to investigate the prevalence of respiratory symptoms, the use of personal protective equipment (PPE), and lung function parameters among flour mill workers in Calabar, Nigeria. A cross-sectional study was employed to sample 222 flour mill workers. Data were collected using structured questionnaires and spirometry tests. Statistical analyses, including descriptive statistics and inferential tests, were conducted to test: (1) the association between the level of exposure to flour dust and respiratory symptoms and lung function parameters; (2) the difference in respiratory symptoms and lung function between workers who use PPE and those who do not. From this study, 39.2% of workers reported experiencing occasional cough, 9.9% reported coughing with shortness of breath, and 5.0% experienced cough and wheezing. Most respondents, 57.7% had normal FVC values, and 24.8% experienced mild reductions. 9.9% exhibited moderate reductions, and 7.7% had severe reductions. The majority of the respondents, 60.8% had normal FEV1 values, 19.8% exhibited mild reductions, 8.6% had moderate reductions, and 10.8% had severe reductions. 85.6% of respondents had a normal FEV1/FVC ratio, 7.2% exhibited mild obstruction, 3.2% experienced moderate obstruction, and 4.1% had severe obstruction. Respiratory symptoms were significantly (χ 2 = 68.162, p < 0.001) higher among exposed workers. There was a significant difference in lung function parameters between directly exposed subjects and those who were indirectly exposed or unexposed (χ 2 = 20.421, p < 0.001). The prevalence of respiratory symptoms in non-PPE users was significantly higher (χ 2 = 12.886, p < 0.001)) and lung function parameters also showed a significant difference (χ 2 = 24.857), p < 0.001). This study confirms that flour mill workers in Calabar are at increased risk of respiratory health problems due to flour dust exposure. Effective use of PPE and reducing dust exposure are essential in mitigating these risks

Epidemiological trends of Lassa fever in Nigeria, 2018–2021

Background Lassa fever is a viral haemorrhagic fever endemic in Nigeria. Improved surveillance and testing capacity have revealed in an increased number of reported cases and apparent geographic spread of Lassa fever in Nigeria. We described the recent four-year trend of Lassa fever in Nigeria to improve understanding of its epidemiology and inform the design of appropriate interventions. Methods We analysed the national surveillance data on Lassa fever maintained by the Nigeria Centre for Diseases Control (NCDC) and described trends, sociodemographic, geographic distribution, and clinical outcomes. We compared cases, positivity, and clinical outcomes in the period January 2018 to December 2021. Results We found Lassa fever to be reported throughout the year with more than half the cases reported within the first quarter of the year, a recent increase in numbers and geographic spread of the virus, and male and adult (&gt;18 years) preponderance. Case fatality rates were worse in males, the under-five and elderly, during off-peak periods, and among low reporting states. Conclusion Lassa fever is endemic in Nigeria with a recent increase in numbers and geographical distribution. Sustaining improved surveillance, enhanced laboratory diagnosis and improved case management capacity during off-peak periods should remain a priority. Attention should be paid to the very young and elderly during outbreaks. Further research efforts should identify and address specific factors that determine poor clinical outcomes. </jats:sec

Epidemiological trends of Lassa fever in Nigeria, 2018-2021.

BackgroundLassa fever is a viral haemorrhagic fever endemic in Nigeria. Improved surveillance and testing capacity have revealed in an increased number of reported cases and apparent geographic spread of Lassa fever in Nigeria. We described the recent four-year trend of Lassa fever in Nigeria to improve understanding of its epidemiology and inform the design of appropriate interventions.MethodsWe analysed the national surveillance data on Lassa fever maintained by the Nigeria Centre for Diseases Control (NCDC) and described trends, sociodemographic, geographic distribution, and clinical outcomes. We compared cases, positivity, and clinical outcomes in the period January 2018 to December 2021.ResultsWe found Lassa fever to be reported throughout the year with more than half the cases reported within the first quarter of the year, a recent increase in numbers and geographic spread of the virus, and male and adult (>18 years) preponderance. Case fatality rates were worse in males, the under-five and elderly, during off-peak periods, and among low reporting states.ConclusionLassa fever is endemic in Nigeria with a recent increase in numbers and geographical distribution. Sustaining improved surveillance, enhanced laboratory diagnosis and improved case management capacity during off-peak periods should remain a priority. Attention should be paid to the very young and elderly during outbreaks. Further research efforts should identify and address specific factors that determine poor clinical outcomes