Awareness and Usage of the Baobab in Rural Communities in Kwara State, Nigeria

The study investigated awareness and usage of the Baobab plant in rural communities in Kwara State, Nigeria. It examined the determinants of the plant’s usage as well as constraints to its usage in the State. A three stage random sampling procedure produced the 200 respondents from which primary data used for the study was collected using a well structured questionnaire. Descriptive statistics including frequency counts, percentages and means was employed in presenting the findings of the study. The logit regression model was used in the determination of the factors of usage among the respondents. The study revealed that the level of awareness of the uses and benefits of the plant as well as its usage in the state is poor. Level of awareness at p<0.05 and income at p< 0.1 were found to be the determinants of usage of the baobab in the State. The strong negative socio-cultural belief held about the plant, poor level of awareness about its benefits and the poor knowledge of its processing were the major constraints against its use in the State. The study recommends the need to increase awareness of the benefits of the plant and also to provide information on the processing methods applicable to the baobab. The various agricultural extension agencies in the State in collaboration with agricultural research institution in the State can go a long way in ensuring that the potentials of the baobab plant is optimized among rural communities in the State.Keywords: Baobab (Adansonia digitata L.), Awareness, Usage, Logit Regression Model, Kwara State

Incidental finding of dextrocardia with situs inversus totalis in a day old neonate: Case report and review of the literature

Dextrocardia with situs inversus are rare congenital anomalies which can be asymptomatic and compatible with normal life. They are characterized by mirror images of all intra-thoracic and intra-abdominal viscera. Our aim isto report an incidental finding of dextrocardia with situs inversus in a neonate with neonatal sepsis. A day-old male term neonate presented with features of infection. Physical examination revealed cardiac apex on the 4th right   intercostal space, along the mid-clavicular line. Chest radiograph and  abdominal ultrasound confirmed the diagnosis of dextrocardia with situs inversus. Bilateral cervical ribs were also seen on chest radiograph. He was managed with antibiotics  and  discharged . Newborn babies should have a thorough physical examination after delivery before discharge to enable early diagnosis of congenital anomalies for appropriate referral.Key words: Dextrocardia, neonate, neonatal sepsis

Antibiogram of pharyngeal isolates of children with pharyngotonsillitis in a specialist hospital in Gusau, North-Western Nigeria

Pharyngotonsillitis is one of the common childhood infections caused by bacteria in 30 to 40% of cases. Bacterial causes are important due to the non suppurative sequalae caused by Streptococcus pyogenes and also associated complications. These microorganisms undergo constant changes and antibiotic resistance have been reported. Objective: To document organisms isolated from throat swab microscopy and culture with their antibiotic susceptibility pattern in children diagnosed with pharyngotonsillitis. Methodology: This was a retrospective analysis of throat swabs microscopy, culture and sensitivity results of children aged 0-13 years with a diagnosis of pharyngotonsillitis over a four-year period. Results: Of the 144 results reviewed; 120 samples yielded 122 isolates, giving a culture positive yield of 83.3%. Males were 81 (56.2%) with a M:F ratio of 1.3:1. Majority of the children were under fives (58.3%). Gram positive organisms were 118 (96.7%), with Streptococcus pyogenes being the commonest organism isolated (79.5%), followed by Staphylococcus aureus (13.9%). Gentamicin (85.0%), Ofloxacin (64.2%) and Augmentin (51.7%) had the highest susceptibility rate, while the least was seen with Cefixime, Tetracycline, Levofloxacin and Netillin. Streptococcus pyogenes and Staphylococcus aureuswere susceptible to Gentamicin and Ofloxacin, while all the Streptococcus pneumoniae were susceptible to Gentamicin. Multi drug resistance was seen with Providencia spp and Serratia marcescens. Conclusion: Streptococcus pyogenes was the commonest organism and Gentamicin, Ofloxacin and Augmentin were the antibiotics with the highest susceptibility. Gram negative organisms display high rate of multidrug resistance. Gentamicin could be considered as an option or an adjunct in the treatment of pharyngotonsilliti

Hepatitis b, c and hiv serological markers in children with sickle cell anaemia in a tertiary hospital, Gusau, North-Western Nigeria

Sickle Cell Anaemia patients are considered to be among the high-risk groups for hepatitis B and C viral infections. These viruses and HIV share common routes of transmission and similar risk factors and their infections coexist. Objective: This study was aimed at determining the seroprevalence of hepatitis B, C and HIV viral markers of infections in children with SCA. Methodology: A cross sectional Hospital based study conducted on 89 confirmed SCA Children aged 6 months – 13 years in steady state attending Haematology Clinic in a Specialist Hospital Gusau from July 2017 to March 2018. Approval for the study was obtained from the Research and Ethics Committee of the Hospital. The age, gender, history of blood transfusion, traditional scarification, uvulectomy, circumcision and immunization of the subjects were recorded. Serological test was carried out to determine the prevalence of hepatitis B, C and HIV using the viral markers and HIV 1& 2 rapid test kits. Results: Eighty-nine subjects were recruited with 46(51.7%) males and 43(48.3%) females. The mean age was 5.06 ±3.4 years. The seroprevalence of HBsAg, HBsAb, HBcAb, HBeAg, HBeAb, AntiHCV and HIV 1& 2 were 3(3.4%), 3(3.4%), 5(5.7%), 1(1.1%), 6(6.9%) and 0% respectively. No co-infection among the studied subjects. There is no significant difference in the age or gender distribution and seroprevalence of the viruses among SCA children. p = > 0.05 Conclusion: Hepatitis C infection is found to be high as opposed to Hepatitis B which is lower among SCA Children in this community

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017—and more than 80% in some low- and middle-income regions—was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing—and in some countries reversal—of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions