Social Meaning and Consequences of Infertility in Ogbomoso, Nigeria

Background: This study examined the meaning of infertility from layman's perspective, and experiences of women suffering from infertility among reproductive age women seeking care at the gynaecology unit of the Bowen University Teaching Hospital, Ogbomoso, Nigeria.Materials and Methods: It was a cross-sectional study. Quantitative and qualitative data collection methods were employed. Quantitative data collection was by the aid of a structured interviewer-administered questionnaire among 200 women seeking care for infertility at the hospital. Qualitative data collection was by Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs).Result: Approximately 40% and 60% of the respondents seeking care for infertility were suffering from primary and secondary infertility respectively. Perceived meaning and   etiologies of childlessness were multidimensional, but 33% of the respondents not sure of the causal factor. Seventy-nine percent   were under pressure to become pregnant. The high premium placed on fertility within marriage has placed   a larger proportion of them under pressure from their husbands (25%), their mother-in-laws (40%), and the community (14%).Conclusion: This study concluded that women regard infertility to be caused by multiplicity of factors. Most of these etiologies were unscientific and unverifiable. Fruitful expectations also put enormous burden on those women suffering from infertility including adverse psychosexual effects. The unceasing pressure due to infertility   in this group of patients calls for urgent intervention as most of these women become susceptible to high risk sexual behavior, depression and other severe consequences

Determinants of utilisation of traditional birth attendant services by pregnant women in Ogbomoso, Nigeria

Background: This study was designed to assess the determinants of utilization of Traditional Birth Attendants (TBAs) services by pregnant women in different communities in Ogbomoso, Nigeria.Methods: This was a community- based cross-sectional study. Fisher's formula was used to calculate the sample size and a total of 270 eligible pregnant women were enrolled for the study using multistage sampling technique. Data was collected using pretested structured interviewer-administered questionnaire. Data analysis was done using SPSS version 20 and results were presented in frequencies and percentages.Results: Factors found to have a significant influence on the utilization of TBA services in this study include: low educational status (p <0.001), lower socioeconomic status (p <0.001), and compassionate care given by the TBAs (p=0.004). Other factors include service proximity and lower cost of TBA services.Conclusions: The impact of TBAs and their services cannot be overemphasized in the present state of maternal and child health in Nigeria.  Lower educational status among others has been found to be a strong predictor of utilization of TBA services. There is, therefore, the need to improve the educational and socioeconomic status of women in order to allow them to access quality health care services that will safeguard their well-being. Inculcating compassionate care into orthodox healthcare delivery will go a long way to improve patronage and discourage TBA utilization

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children &lt;18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p&lt;0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p&lt;0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p&lt;0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Emergence and spread of two SARS-CoV-2 variants of interest in Nigeria.

Identifying the dissemination patterns and impacts of a virus of economic or health importance during a pandemic is crucial, as it informs the public on policies for containment in order to reduce the spread of the virus. In this study, we integrated genomic and travel data to investigate the emergence and spread of the SARS-CoV-2 B.1.1.318 and B.1.525 (Eta) variants of interest in Nigeria and the wider Africa region. By integrating travel data and phylogeographic reconstructions, we find that these two variants that arose during the second wave in Nigeria emerged from within Africa, with the B.1.525 from Nigeria, and then spread to other parts of the world. Data from this study show how regional connectivity of Nigeria drove the spread of these variants of interest to surrounding countries and those connected by air-traffic. Our findings demonstrate the power of genomic analysis when combined with mobility and epidemiological data to identify the drivers of transmission, as bidirectional transmission within and between African nations are grossly underestimated as seen in our import risk index estimates

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Full Length Research Article - PROFILE OF CHLOROQUINE – INDUCED PRURITUS IN NIGERIAN CHILDREN RESIDENT IN IBADAN, NIGERIA

Chloroquine is still the first-line drug in the treatment of malaria in Nigeria and West-Africa sub-region. A major drawback to the use of chloroquine is pruritus. We studied a total of 175 children aged 1–15 years with a view to assessing some factors that may influence chloroquine induced pruritus and the possible impact on therapy with this drug. The mean age was 5.2+4.0 and there were 87 females and 88 males. Chloroquine-induced pruritus was found in 43/175 (24.6%). All the subjects experienced the itching within 24 hours of ingestion of the drug and median duration of the itching was 2 days. Majority of those who itched still used chloroquine to treat malaria for various reasons. There was positive family history in 34/43 (79%) of those who itched and 57/132 (43%) of those who did not itch to chloroquine. Those who had chloroquine-induced pruritus were relatively older (mean age 6.90+3.68 years versus 4.64+4.00; p< 0.05) and mean age onset of chloroquine-induced pruritus was positively associated with mean age of the children r = 0.91; 95% confidence limits: 0.71< r < 0.91. We concluded that chloroquine-induced pruritus in this group of children evolved with increasing age and was associated with positive family history

Effects of antifolates – co-trimoxazole and pyrimethaminesulfadoxine – on gametocytes in children with acute, symptomatic, uncomplicated, Plasmodium falciparum malaria

Antimalarial drugs including the antifolate, pyrimethamine-sulfadoxine (PS), can modulate the prevalence and intensities of gametocytaemia following treatment of acute malaria infections. They may also directly influence the transmission and spread of drug insensitivity. Little is known of the effects of co-trimoxazole (Co-T), another antifolate antimalarial, on gametocytes in children with acute malaria infections. We compared the effects of Co-T and PS on the prevalence and intensities of gametocytaemia and gametocyte sex ratios in 102 children aged 0.5-12 years presenting with acute and uncomplicated falciparum malaria. Compared to pre-treatment, both drugs significantly increased gametocyte carriage post-initiation of treatment. However, gametocyte carriage was significantly lower on day 14 in those treated with Co-T than PS. Significant increase in gametocytaemia with time occurred in PS - but not Co-T-treated children. Kaplan-Meier survival curve of the cumulative probability of remaining gametocyte-free in children who were agametocytaemic at enrolment showed that by day 7 of follow up, children treated with PS had a significantly higher propensity to have developed gametocytes than in Co-T-treated children (Log-rank statistic 5.35, df = 1, P = 0.02). Gametocyte sex ratio changes were similar following treatment with both drugs. PS and Co-T treatment of acute malaria infections in children from this endemic area is associated with significant increases in prevalence and intensities of gametocytaemia but these effects are more marked in those treated with PS than Co-T