Uterovaginal prolapse: the sociodemographic profile and reproductive health service uptake in a low resource setting, Calabar, Nigeria

Background: Uterovaginal prolapse is a common gynaecological condition in low resource countries because of high prevalence of grand multiparity, low skilled attendant at delivery and low contraceptive usage. Objective of this study was to determine the prevalence, sociodemographic profiles, utilization of reproductive health services and delay in seeking medical care of patient with uterovaginal prolapse in Calabar, Nigeria.Methods: This was a retrospective study of women who presented with uterovaginal prolapse at University of Calabar Teaching Hospital, Calabar, Nigeria between 1st May 2009 and 1st June 2019. Patients case records were retrieved and analyzed. Statistical analysis was done using SPSS version 22.Results: The prevalence of genital prolapse was 0.3%. The mean age and parity were 60.19±8.71 years and 6.31±2.80, respectively. The mean duration of symptoms before presentation was 3.19±2.16 years. Genital prolapse was commonest among age group 60-79 years (52.8%), parity 5-9 (66.7%), post-menopausal (97.2%), primary education (55.6%) and farmers (47.2%). Grade 3 uterovaginal prolapse was the commonest grade (58.3%). Most patients (86.1%) had symptoms of genital prolapse for less than 5 years before seeking medical treatment. The majority of patients had no antenatal care during their pregnancies (80.6%), no skilled attendant at deliveries (86.1%) and no contraceptive use during their reproductive years (77.8%). Participants with lower parity (1-4) (p=0.03), higher educational level (p˂0.001) and teachers/civil servants (p=0.043) presented earlier (less than 1 year) to the hospital.Conclusions: There is poor utilization of reproductive health services among women who develop uterovaginal prolapse in study environment. Women with higher social status sought for help earlier. Increasing awareness of this condition and providing antenatal care, skilled birth attendants and contraceptive services will reduce the burden of this condition.

Community Livelihood and Agricultural Techniques in Peri-Urban Farming in Cameroon

Agriculture is the bedrock of Cameroon’s economy as it contributes significantly to food, income and employment. However, the country’s agriculture is confronted by a myriad of challenges which include inter-alia issues of land tenure, inadequate finance, weak market information system and use of simple technology. The unprecedented growth in Cameroon’s urban population has given rise to peri-urban agriculture. Using survey data of 150 randomly sampled farmers, we assess the socio-economic contributions of peri-urban farming to livelihoods and the constraints faced by farmers in study area, at the periphery of Buea in the South West Region of Cameroon. The study identified some of the agricultural techniques being practiced to include slash and burn, shifting cultivation, crop rotation, farming without ridges, monoculture, and livestock farming. The commonest crops and livestock are tubers, grains, horticultural products, oil palm, poultry, goats and pigs. We found that peri-urban agriculture contributes significantly to household food security and nutrition, income, and employment of farmers. These findings have important policy implications for urban food security and nutrition, and sustainable development. Keywords: Cameroon, Peri-urban farming, Agricultural techniques, Community livelihood

The impact of an enlightenment program on community perception towards children with epilepsy

Background: Epilepsy is associated with social stigma and discrimination which is often harmful and devastating. Lack of knowledge and misconception is responsible for these negative attitudes. Public awareness and education are known to improve perception towards epileptics.Methods: A sensitization workshop among community leaders on epilepsy was carried out in a rural community in Cross River State, Nigeria. A pretest questionnaire was administered to participants based on items related to knowledge and perception towards epileptics. The respondents were offered a 2-hour workshop on the causes, types, cure and myths about epilepsy. The same questionnaire was again applied after the workshop. The responses before and after intervention were compared using the McNemar test statistic, with a significance level at p<0.05.Results: Seventy-two respondents participated in the study comprising of 42 (58.3%) males and 30 (41.7%) females. Twenty-eight (38.9%) had primary education and the same number had tertiary education. There was a positive correlation between level of education and performances in the perception towards various domains of epilepsy. Statistical significant differences were found in perceptions regarding cure, mode of contracting epilepsy and potentials of epileptics. However, no statistical difference in perception after the intervention regarding marriage to epileptics.Conclusions: Respondents with higher level of education demonstrated significantly better awareness and attitude towards epileptics compared to those with lower levels the intervention package produced a significant improvement in most domains of perception about epilepsy. Public enlightenment is effective in reducing social stigma and discrimination. It should be encouraged to curtail the negative attitude and perception towards epileptics

Haematological and immunological effect of coadministration of extracts of Vernonia amygdalina and Azadirachta indica on normal and diabetic rats

This study evaluated the effect of co-administration of extracts of Vernonia amygdalina Del. (VA) and Azadirachta indica Linn.(AI) on haemapoietic and immunological indices of normal and diabetic rats. White blood cells which were non-significantly decreased (p&gt;0.05) in diabetic control rats relative to the normal control, respectively increased and decreased non-significantly (p&gt;0.05) upon administration of the combined extracts of VA and AI to diabetic and non-diabetic test rats. Packed cell volume, haemoglobin content and red cell count as well as its derived factors (mean cell volume, mean cell haemoglobin and mean cell haemoglobin concentration) of both diabetic and non-diabetic rats were not affected by the treatment, relative to their respective controls. As compared to insulin treatment, the combined extracts significantly increased (p&lt;0.05) mean cell haemoglobin concentration (MCHC) of diabetic rats. Platelets number which was non-significantly lower (p&gt;0.05) in diabetic control rats as compared to non-diabetic control was further decreased non-significantly (p&gt;0.05) upon administration of the combined extracts and insulin. Diabetes induction significantly increased CD4+ count (p&lt;0.05) as compared to the normal control. This was however decreased significantly (p&lt;0.05) upon treatment with the combined extracts and insulin. The combined extract similarly decreased CD4+ counts in normal test rats as compared to the normal control. Combined extracts of VA and AI is non-haematotoxic and may possess some anti-inflammatory properties when used as a management against diabetes mellitus.Key words: Diabetes, haematological and immunological indices, Vernonia amygdalina, Azadirachta indica

Helminthic Infestation in Children Aged 6 to 59 Months with Diarrhea in Calabar

Background: Helminthic infections and diarrheal diseases have remained public health problem worldwide, especially in developing countries. Children below five years of age are at a higher risk. This study therefore aims to determine the prevalence, and intensity of intestinal helminths in children with and without the diarrheal disease. Materials and Methods: This was a cross‑sectional analytical study of 130 children aged 6 to 59 months, carried out in the Children Emergency Room and the Diarrhea Treatment and Training Unit of the University of Calabar Teaching Hospital (U. C. T. H), Calabar, Nigeria. Those admitted with and without diarrhoea were consecutively recruited. Data were obtained by administration of questionnaires to parents/caregivers whose children met the inclusion criteria. Clinical examinations including anthropometric parameters (weight and length/height) were carried out on all the children recruited for the study while mid‑upper arm circumference was done for children aged 12–59 months. Stool samples were collected from each child into a wide mouth universal, clean, dry, leak‑proof, container, with the help of their parents/guardians. Microscopy was carried out on the stool&nbsp; samples collected within 1 h in the microbiology laboratory for the presence of ova, larva, or worm segment using direct microscopy with saline and iodine wet preparation and formol ether concentration. Ova were identified and quantified. The type of worm and intensity were recorded. Results: Out of the 130 children, 65 (50%) had diarrhea while the other 65 (50%) were without diarrhoea. The mean age of subjects with diarrhea was 16.86 ± 11.7 months and 17.60 ± 9.9 months for those without diarrhoea. There was no significant difference in sex distribution between the age groups (P = 0.86). The overall prevalence of intestinal helminthic infection in the study population was 1.5%. The prevalence of intestinal helminths in those with diarrhea and those without diarrhea was 3.1% and 0.0%, respectively, (P = 0.496). Only Ancylostoma duodenale (hookworm) was isolated in those with diarrhea and it was of light intensity. There was no significant&nbsp; difference in the method of disposal and source of water, comparing subjects having diarrhea and those not having diarrhea (P &gt; 0.05). The proportions of subjects that usually played in the sand, go on footwear outside home, and go on footwear at home, were not&nbsp; significantly different comparing those having diarrhea and those not having diarrhea (P &gt; 0.05). Conclusions: The prevalence rate of intestinal helminths in children with and without diarrhoea was low. There was general&nbsp; environmental cleanliness and personal hygiene in the study population which were likely responsible for the low helminthic infection thus emphasizing the need for maintenance of good hygiene, access to good water supply and periodic intake of anti-helminthic drugs in view of the public health importance of helminthic infection and diarrhoea

Effectiveness of a 6-dose regimen of Artemether-Lumefantrine for unsupervised treatment of uncomplicated childhood malaria in Calabar, Nigeria

Background: The six dose regimen of Artemether- Lumefantrine (AL), has high efficacy in clinical trials and is the first -line drug for treating uncomplicated malaria in Nigeria. The complex dosage schedule could militate against its effectiveness.Objective: To assess the effectiveness of AL prescribed under routineoutpatient conditions in the treatment of uncomplicated malaria.Methods: An open label, noncomparative trial to assess the effectivenessof AL in children 6 to 59 months with uncomplicated P. falciparum and parasite density between 1,000 and 250,000/ìL. Enrolled children received 6-dose course of AL (20/120mg tablets). The first dose was administered in the health facility and caregivers were instructed on how to administerthe remaining five doses at home.Results: Of the 1035 screened, 215 eligible children were enrolled and193 completed the study. Twenty two (22) patients withdrew from thestudy (18 were lost to follow-up, 3 violated protocol and 1 withdrewconsent). Adequate clinical and parasitological response (ACPR) was observed in 90.7%; late clinical failure in 7 (3.6%) and late parasitologicalfailure in 11 (5.7%).Conclusion: This study showed high efficacy of AL in treating uncomplicatedP. falciparum malaria in under-fives in Nigeria. Adherence by caregivers to the treatment regimen was quite good and so, should continue to be used in the home setting.Key words: Artemetherlumefantrine, effectiveness, adherence, uncomplicated malaria

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

Performance and usefulness of the Hexagon rapid diagnostic test in children with asymptomatic malaria living in the Mount Cameroon region

<p>Abstract</p> <p>Background</p> <p>Rapid and correct diagnosis of malaria is considered an important strategy in the control of the disease. However, it remains to be determined how well these tests can perform in those who harbour the parasite, but are asymptomatic, so that rapid diagnostic tests (RDTs) could be used in rapid mass surveillance in malaria control programmes.</p> <p>Methods</p> <p>Microscopic and immunochromatographic diagnosis of malaria were performed on blood samples from the hyperendemic Mount Cameroon region. Thin and thick blood films were stained with Giemsa and examined under light microscopy for malaria parasites. The RDT was performed on the blood samples for the detection of <it>Plasmodium </it>species. In addition, the performance characteristics of the test were determined using microscopy as gold standard.</p> <p>Results</p> <p>Results revealed 40.32% to be positive for microscopy and 34.41% to be positive for the RDT. Parasites were detected in a greater proportion of samples as the parasite density increase. <it>Plasmodium falciparum </it>was the predominant <it>Plasmodium </it>species detected in the study population either by microscopy or by the RDT. Overall, the test recorded a sensitivity and specificity of 85.33% and 95.05% respectively, and an accuracy of 91.40%. The sensitivity and specificity of the RDT increased as parasite densities increased.</p> <p>Conclusion</p> <p>The Hexagon Malaria Combi™ test showed a high sensitivity and specificity in diagnosing malaria in asymptomatic subjects and so could be suitable for use in mass surveillance programmes for the management and control of malaria.</p