The challenges of curtailing the outbreak and spread of Lassa fever in Nigeria

In Nigeria, the Lassa Fever outbreak of 2015 had been persistent up till the present (end of 2019), with significant mortality and morbidity. The epidemiology of Lassa Fever is gradually changing towards assuming an endemic dimension despite several evidence-based efforts taken by stakeholders towards disease control. Several challenges militate against prevention and control efforts. These are related to environmental and climatic factors, poor knowledge risk perception and preventive practices among community members and health care workers, poor diagnosis and treatments of the disease. It is doubtful that Nigeria could successfully win the war against Lassa Fever without surmounting the challenges identified in this review article. The efforts to curtail Lassa Fever would yield significant reduction in prevalence if these challenges militating against prevention and control are removed. This would require collaborative efforts among all stakeholders that are relevant to this task, and Governments creating an enabling environment for prevention and control efforts to thrive.peer-reviewe

Practice of Safety Measures among Inter-City Commercial Vehicle Drivers in Kwara State, Nigeria

Background: The incidence of Road Traffic Crashes (RTC) is rising world-wide, with 1.24 million people killed on the world’s roads in 2010 due to non-compliance with safety measures.The objectives of the study was to determine the practice of safety measures and prevalence of road crashes among inter-city commercial vehicle drivers in Kwara State, Nigeria.Materials and Methods: It was a descriptive cross-sectional study done by interviewer administered questionnaire and blood alcohol concentration of respondents was determined using Breathalyzers. A total of 410 respondents were involved by multi-stage sampling technique and data analysis was done using EPI INFO version 3.5.1 software package. An appropriate test of significance were used and the level of significance was < 0.05 at 95% confidence level.Results: There was statistically significant p = 0.057 relationship in good safety practices among drivers in the age group 26-55 years compared with those ≤ 25 years and > 55 years. More respondents who practiced safety measures carried out driving test before issuance of license compared with those who did not (p = 0.001). Some respondents tested positive for alcohol and the mean blood alcohol concentration was 23.28± 23.32µg/dl. About a third of the respondents had experienced road traffic crashes in the past.Conclusion: The middle age respondents had good safety practices compared with others. Safety practices were influenced by driving test before issuance of license and alcohol intake was a factor in RTC. Orientation of drivers and enforcement of laws are critical in road safety

Knowledge and use of emergency contraception among students of public secondary schools in Ilorin, Nigeria

Introduction: Unintended pregnancy and unsafe abortion pose a major reproductive health challenge to adolescents. Emergency contraception is safe and effective in preventing unplanned pregnancy. The objective of this study was to assess the student's knowledge and use of emergency contraception. Methods: This cross-sectional study was carried out in Ilorin, Nigeria, using multi-stage sampling method. Data was collected using pre-tested semi-structured self-administered questionnaire. Knowledge was scored and analysed. SPSS version 21.0 was used for data analysis. A p-value <0.05 was considered statistically significant. Results: 27.8% of the respondents had good knowledge of emergency contraception. Majority of respondents (87.2%) had never used emergency contraception. Majority of those who had ever used emergency contraception (85.7%) used it incorrectly, using it more than 72 hours after sexual intercourse (p=0.928). Conclusion: Knowledge about Emergency contraception and prevalence of use were low. Contraceptive education should be introduced early in the school curriculum for adolescents.Pan African Medical Journal 2016; 2

Pattern of utilization of ante-natal and delivery services in a semi-urban community of North-Central Nigeria.

Background: Nigeria accounts for only 2% of the world\u2019s population, but contributes up to 10 % of the global estimates of maternal deaths. The study assesses the utilization of antenatal and delivery services by women of reproductive age in Afon community. Methodology: It was a descriptive cross-sectional study that collected both quantitative and qualitative data using semi-structured interviewer administered questionnaire and focus group discussions (FGD). Interviews were house-hold based. FGD had two homogenous groups. Data was analysed using Epi-info version 3.5.1 software package. Level of statistical significance was set at p <0.05. Results: There was a high level of utilization of antenatal/delivery services in the community. Barriers to utilization of ANC/ delivery services include lack of money, distance from health facility, long waiting time, poor attitude of health workers and no permission from husbands. Level of education and employment status were significantly associated with utilization of ANC/ delivery services. Conclusion: Girl- child education and women empowerment are required to improve utilization of services. Ante-natal care providers need to be trained to improve quality of care in the discharge of their duties

Determination of Normal and Variant Hemoglobin using Capillary Electrophoresis among Voluntary Blood Donors in North Central Nigeria: Implications on Blood Transfusion Services

Background: Voluntary non-remunerated blood donation is a strategy adopted by World Health Organization aimed at ensuring safety and adequacy of blood supply. Sub-Saharan Africa has a high prevalence of hemoglobin disorders and therefore needs to adopt stringent measures in donor selection to ensure safety for the recipient of blood transfusion. This study aimed to analyze normal and variant hemoglobin among voluntary blood donors. Methods: In this descriptive cross-sectional study, 100 prospective blood donors including 55 (55%) males and 45 (45%) females, aged 18–34 years were recruited. Capillary electrophoresis using the Minicap system was used for determining the hemoglobin variants in alkaline buffer (PH 9.4). Data analysis was done using SPSS version 20 and p-value < 0.05 was considered as the level of significance Results: The mean age of the participants was 22.23 ± 3.3 SD years. The proportion of participants with genotype AA was 67 (67%), those with AS were 17 (22 %), while those with AC were 11 (11 %). While Hb A ≥ 90% was noted in 67 (67%) blood donors, Hb S was seen in 22 (22%) and Hb A2 > 3.5% in 57 (57%). Hb F > 2% was observed in 3% of the studied participants Conclusion: Variant hemoglobin is common among blood donors and this should be taken into consideration whenever blood is being crossmatched for recipients of blood transfusion. Data from this study will be useful in raising awareness and genetic counseling. Keywords: prevalence, hemoglobin variants, capillary electrophoresi

Female factors infertility: Laparoscopic evaluation at a public health facility in Ilorin, Nigeria

Background: Infertility is a problem of global proportions, the majority being the residents of developing countries. The contribution of female factor is assuming a tremendous proportion. Laparoscopy remains an indispensable tool in the evaluation of the fertility potential of these female partners. Aims: This study was aimed at determining the various causes of female factor infertility among female partners of infertile couple in a tertiary health facility. Methods: A cross-sectional observational study of ninety seven (97) eligible infertile women who underwent diagnostic laparoscopy between 1st January 2012 and 31st December 2015 were enrolled for the study. The data were analyzed using SPSS/PC version 16.0 and p value was preset at <0.05. Results: The patients aged 21-50 years with a mean age of 33.2 ± 6.6 years. Majority (79.4%) were nulliparous. Fifty (51.5%) had primary infertility. Their duration of infertility ranged from 1to 33years (5.7 ± 5.5 years). Most (63.9%) belong to middle social class and their spouse age ranges between 28-60 years (39.0 ± 7.5). More than a quarter had clomiphene resistant Polycystic Ovarian Syndrome, 19 (19.6%) tubal blockage, 13 (13.4%) uterine fibroid and 10 (10.3%) each had endometriosis, peritubal and ovarian adhesions, ovarian cyst and normal findings respectively. There was significant association between patients' age, intra-operative findings and tubal patency evaluation on laparoscopy (P < 0.05). Conclusion: Laparoscopic procedures are less invasive, more convenient and more precise for diagnosis of infertility in women. The common causes responsible for infertility were polycystic ovarian syndrome, tubal occlusion, uterine fibroid, endometriosis, peri-tubovarian adhesions and ovarian cyst

Socio-demographic profiles and outcome of motorcycle related head injury in a Nigerian Tertiary Health Institution

Background: Motorcycle increasingly has been used for commercial transportation in many Nigerian cities with attendance increase in the rate of motorcycle crashes. Head injury is responsible for high morbidity and most mortality following such crashes. The aim of this study is to determine the socio-demographic characteristics of head injured victims of motorcycle crashes, severity of head injury and management outcome. Materials and Methods: A 1 year prospective study of head injured motorcyclists and pedestrians knocked down by motorcycle were carried out at University of Ilorin Teaching Hospital using a pre-designed proforma. Information collected included the age, gender, literacy level, alcohol consumption, license status, crash helmet use, Glasgow coma score and Glasgow outcome score. The IBM statistical package for social sciences (version 15.0) statistical package was used for statistical analysis. Results: A total of140 patients with the median age of 30 years (ranged 3-90 years) were studied. They comprised 115 (82%) males and 25 (18%) females. Most patients (66%) had at least secondary education. People of varying occupations were involved in a motorcycle crash. All riders were males and most (71.8%) were unlicensed. Only 5.8% of riders wore crash helmets at the time of the crash and they all had a favorable outcome. At both extremes of age (70 years) more patients were involved as pedestrians. The only socio-demographic variable that influence outcome of head injury was the patient age. Outcome was better in younger age group (P = 0.004). There was 26.4% mortality. Most, 23 (88.4%), of patients with severe head injury died and none of them had good recovery (P < 0.0001). Conclusion: Our findings demonstrated high mortality among non-crash helmet wearing motorcyclists with motor cycle related head injury. The outcome was significantly influenced by age and head injury severity

Assisted reproduction technology: Comparison of clinical outcomes between day 3 and day 5 embryo transfers

BACKGROUND: Embryo transfer (ET) is a critical step in in vitro fertilization (IVF). Selecting the day of transfer for achieving the desired outcomes has been a great challenge. AIMS AND OBJECTIVES: The aim of this study was to compare the pregnancy rates of day 3 and day 5 ET in assisted conception. MATERIALS AND METHODS: This is a longitudinal prospective study of 122 eligible patients that underwent assisted reproduction program in our facility. All patients had controlled ovarian hyperstimulation using antagonist protocol. Patients with four or more zygotes were randomly allocated on day 1 to either day 3 or 5 transfers (58 vs. 64 patients). Fertilization was achieved through conventional IVF. Zygotes were kept in a single-step medium (Global total ®) for day 3 and 5 transfers, respectively. The morphologically best two or three embryos or blastocysts were chosen for transfer in both groups. RESULTS: The overall clinical pregnancy and live birth rates for both groups were 40.2% and 33.6%. There was no statistically significant difference between day 3 and day 5 transfer regarding clinical pregnancy rates (36.2% vs. 43.8% [P = 0.51]), live birth rates (27.6% vs. 9.1% [P = 1.0]), twinning rates (18.8% vs. 20% [P = 1.0]), and rates of early pregnancy loss (8.6% versus 4.7% P = [0.2]). CONCLUSION: In this study, the clinical outcomes of blastocyst transfer are similar to day 3 ET. This underscores the need for patient selection for the choice of days of ET. Further controlled randomized prospective studies with larger sample sizes are recommended