Yellow fever childhood immunization coverage in Jos North Local Government Area, North Central Nigeria: 2015 – 2017

Background: The transmission of Yellow fever,a viral hemorrhagic feveris facilitated in countries which have close proximity to the mosquito vectors and large number of unvaccinated population. Globally, mass vaccination campaigns have significantlyreduced the incidence of this disease, but recent reports from the World Health Organization (WHO), indicates an increase in the rate of transmission, especially in Sub-Saharan Africa. Between 2017 and 2018,some Nigerian states including Plateau state reported confirmed cases of yellow fever. In this study, we assessed the yellow fever immunization coverage in Jos North Local Government area (LGA) of Plateau state.Methodology: A retrospective cross-sectional study was carried out to assess yellow fever immunization coverage in Jos North LGA over a 3-year period from January 2015 to December 2017, with data obtained from the Local Government Area office. This included both data from routine and supplemental immunization activities. The number of children immunized was then compared to the target population to assess coverage for each year.Results: Overall, 71, 734 children were immunized. This comprised of  infants 9-11 months 69,344(96.7%) and 1 -5 year old infants 2390(3.3%). The overall average immunization coverage was (21,514/92,652) 23.2% in 2015, (24,977/93,569) 26.6% in 2016, and (25,243/94,495) 26.7% in 2017, with a mean coverage of 25.5% over the 3 year period.Conclusion: Yellow fever immunization coverage in this LGA is low. Urgent work needs to be done to increase immunization coverage across the local government, and by extension the state and country, especially in view of the recent outbreak of yellow fever in some states.Key words: Yellow fever, Immunization, North-Central Nigeria

The Effect of Varied Doses of Nicotine on Some Morphometric Parameters of the Testis in Albino Wistar Rats

Background: This study is aimed at determining the effect of nicotine on male fertility by evaluating some morphometric parameters of male Wistar rat such as testicular weight, seminiferous tubule diameter, height of epithelium, sertoli-germ cell ratio and Johnsen’s score  in order to assess the spermatogic  index. Methods: 20 adult male rats were randomly divided into four groups, the test groups were administered with 0.2mg/100g, 0.4/100g and 0.6/100g body weight of nicotine base daily for 30 days using a polythene catheter orally , while the control were administered with 2mls 0.9%physiological saline. Histological slides of the testis were made and data obtained from the slides. Results: nicotine caused a significant reduction (P < 0.05) and (P< 0.01) in the mean values of the morphometric parameters of the test group compared with control. The Johnsen’s Score results were 5.4 ± 0.51*, 5.2 ± 0.37* for groups 2 and 3 respectively. For seminiferous tubule diameter the significant values were 208.0±4.22**, 184.5±11.31**in groups 2 and 3, whilst the height of epithelium showed a significant reduction of 153.9± 13.58*, 101.6 ± 1.35**, 76.6 ± 6.65** for groups 1, 2 and 3 respectively. Sertoli-germ cell ratio showed a significant reduction in groups 2 and 3 with values of 3.6 ± 0.77 ** , 1.5 ±  0.16**for groups 2, and 3 respectively, testicular weight showed significant reduction of 1.2±0.05**,1.1±0.05** for group 2 and 3.The results stated are only those that showed a significant reduction at 95% confidence level when compared with the control. Conclusion:  It was concluded that nicotine exerted an adverse effects on the spermatogenic index with concomitant reduction in reproductive potentials of the male rat. Nicotine and nicotine- based products should therefore be taken with caution in cases of infertility in man and animal. Key words: Morphometric parameters ,Johnsen’s Score,Spermatogenic index , fertilit

Epidemiologic review of Zika virus disease

Zika virus disease has resonated great concern globally. The World Health Organization declared it “a public health emergency of International concern” on 1st February, 2016. The recent outbreaks have become a major challenge due to a drift from its earlier known benign exanthematous spectrum to a causal link to microcephaly. Historically, the name Zika virus comes from the Zika Forest of Uganda. It was first identified in 1947 among Rhesus Macaque sub-population. Two genetically distinct isolates have been well characterized; the Asian and African strains. This virus is spread by bites of day-time-active Aedes mosquitoes; the Aedes aegypti and Aedes albopictus. Zika Virus appears to spread along a narrow equatorial belt of Africa to Asia through the Pacific Ocean to French Polynesia, New Caledonia (southwest Pacific Ocean), the Cook Islands (south Pacific), and Easter Island (a Chilean territory in Polynesia), and most recently to Mexico, Central America, the Caribbean, and South America, where today has assumed a pandemic proportion.Up to eighty percent of infections are asymptomatic. Symptomatic infections are characterized by a self-limiting febrile illness and maculopapular rash, arthralgia, conjunctivitis, back pain and mild headaches. Maternal Zika viral load is thought to be a significant risk factor to fetal infection leading to invasion of either trophoblasts or placental cells or both through maternal decidua. Zika viral RNA proteins and associated extensive selective tissue injuries have been demonstrated in the brains and spinal cords of abortuses. Diagnosis of Zika virus is essentially based on viral RNA detection from clinical specimens. Currently, licensed preventive medicines or vaccines are unavailable. With the wide spate of recent outbreaks and consequent neurologic morbidity and mortality, there is need for deployment of point-of-care equipment for screening of pregnant women in our environment. This is an ambitious call for advocacy by all relevant health care providers.Keywords: Zika Virus, disease outbreaks, microcephaly, Aedes mosquitoe

Evaluation of andrological indices and testicular histology following administration of varied doses of nicotine

This study is aimed at determining the effect of Nicotine on male fertility by evaluating some andrological parameters of male Wistar rat such as sperm parameters (spermatozoa count and motility), serum concentration of testosterone and testicular weight. Histopathology of the testis was also carried out on the effect of nicotine on testicular microstructure. 20 adult male rats were randomly divided into four groups, the test groups were administered with 0.2mg/100g, 0.4/100g and 0.6/100g body weight daily for 30 days while the control were administered with 2mls 0.9% physiological saline. Nicotine caused a significant reduction (P < 0.05) and (P< 0.01) in the mean values of sperm count, serum testosterone concentration and testicular weight in the test when compared with the control. Also, in the test group, the deleterious effect of nicotine on the sperm parameters and testosterone concentration was corroborated by histopathology which revealed a marked degeneration of germ cell layers in the seminiferous tubule and disruption of interstitial cells of the testis thereby interfering with spermatogenesis and testosterone secretion while there was no visible change in the control group. It was concluded that nicotine exerted toxic effect on the germ cell layers in seminiferous tubule with concomitant reduction in reproductive potentials of the male rat whilst showing no significant change in sperm motility. Nicotine and nicotine based products should therefore be taken with caution in cases of infertility. Key words: germ cells, testes, testosterone, fertility, spermatogenesis

Pain management in medical wards: A single centre experience in Nigeria

Background: Pain is the commonest reason for hospital presentation worldwide. Its prevalence, distribution and severity are similar across different wards. However, the management of pain in medical wards is sub-optimal. The study was aimed at the determination of patients' perception of adequacy of pain management in medical wards.Methods: A cross sectional hospital based study of patients admitted into the medical wards of Federal Medical Centre, Makurdi over a two year period using a validated questionnaire purposively administered to consecutive patients who had diagnoses with pain as a major component (e.g. Sickle Cell Crisis, Painful Neuropathies) to capture socio - demographic and clinical parameters, diagnoses and analgesics (type, dose, escalation frequency).Results: There were 1,986 patients made up of 1,019 females and 967 males with mean age 53±18 years. Up to 31.1% were in their seventh decade with majority (59.3%) living in urban areas. Respondents were admitted with various painful conditions (e.g. neuropathies from diabetes and chronic kidney diseases constitute 42%). They were on appropriate analgesics at rather low doses or one off doses. Up to 62% had used bioceuticals. Majority (95.2%) of respondents felt that pain management in the medical wards was inadequate.Conclusion: Most (95.2%) patients felt pain management while they were on admission was not adequate. Analgesia was based on patient's complaint and the judgment of the physician. Key Words: Pain, analgesics, medical wards, bioceutical

Prevalence and predictors of obstructive sleep apnea syndrome in a sample of patients with type 2 Diabetes Mellitus in Nigeria

Introduction: Obstructive sleep apnea (OSA) and Diabetes Mellitus (DM) are growing health challenges worldwide. However, the relation of OSA with type 2 diabetes is not well understood in developing countries. This study described the prevalence and predictors of OSA in type 2 DM patients using a screening questionnaire. Materials and Methods: Patients aged 40years and above with type 2 diabetes mellitus were recruited into the study consecutively from the outpatient clinics of a university hospital. They were all administered the Berlin questionnaire and the Epworth sleepiness scale (ESS) to assess the risk of OSA and the tendency to doze off, respectively. Anthropometric details like height, weight and body mass index (BMI) were measured and short-term glycaemic control was determined using fasting blood glucose. Results: A total of 117 patients with type 2 diabetes mellitus were recruited into the study. The mean (SD) age, height and BMI was 63 years (11), 160 cm (9) and 27.5 kg/m2 (5.7), respectively. Twenty-seven percent of the respondents had a high risk for OSA and 22% had excessive daytime sleepiness denoted by ESS score above 10. In addition, the regression model showed that for every 1 cm increase in neck circumference, there is a 56% independent increase in the likelihood of high risk of OSA after adjusting for age, sex, BMI, waist, hip circumferences and blood glucose. Conclusion: Our study shows a substantial proportion of patients with type 2 diabetes may have OSA, the key predictor being neck circumference after controlling for obesity.Keywords: Diabetes, obstructive sleep apnea, slee

Hypertension in treated and untreated HIV infected patients - a study from 2011 to 2013 at the Jos University Teaching Hospital, Nigeria

Background: HIV infected individuals, especially those on antiretroviral therapy (ART), may have increased risk of hypertension. We investigated the prevalence of hypertension at enrolment and 12 months after commencing ART in a Nigerian HIV clinic. Methods: Data from patients enrolled for ART from 2011 to 2013 was analysed, including 2310 patients at enrolment and 1524 re-evaluated after 12 months of ART. The presence of hypertension, demographic, clinical and biochemical data were retrieved from standardized databases. Bivariate and logistic regressions were used to identify baseline risk factors for hypertension. Results: Prevalence of hypertension at enrolment was 19.3% (95%CI: 17.6% – 20.9%), and age (p<0.001), male sex (p=0.004) and body mass index (BMI) (p<0.001) were independent risk factors for hypertension. Twelve months after initiating ART, a further 31% (95%CI: 17.6% – 20.9%) had developed hypertension. Total prevalence at that point in time was 50.2%. Hypertension among those on ART was associated with age (p=0.009) and BMI (p=0.008), but not with sex. There were no independently significant associations between hypertension and CD4+ counts, viral load or type of ART. Conclusions: Hypertension is common in HIV infected individuals attending the HIV clinic. Patients initiating ART have a high risk of developing hypertension in the first year of ART. Since BMI is modifiable, life-style advice aimed at weight reduction is strongly advisable

Assessment of hand hygiene facilities and staff compliance in a large tertiary health care facility in northern Nigeria: a cross sectional study

The burden of healthcare-associated infection (HAI) is 2 to 18 times higher in developing countries. However, few data are available regarding infection prevention and control (IPC) process indicators in these countries. We evaluated hand hygiene (HH) facilities and compliance amongst healthcare workers (HCW) in a 600-bed healthcare facility in Northcentral Nigeria providing tertiary care service for a catchment population of about 20 million