Exclusive breastfeeding and its relevance to infant teething

Objective: To determine the relevance of exclusive breast-feeding practice, in the development of healthy oral tissue among teething infants. Method: A cross sectional study design of children aged 6-36 months was carried out in 14 wards of Jos North Local Government Area. A multistage sampling technique was adopted in selecting 1081 mothers who qualified and were interviewed using structured interviewer questionnaire on their knowledge and perception on common complaints during teething in children. The index children were examined for number and type of teeth erupted using mouth mirror under natural light. Result: One thousand and eighty-one mothers and their babies were interviewed and examined; out these 16.5%, 38.7% and 44.8% babies were of age groups 6-12, 13-24 and 25-36 months respectively; 50.2% were female and 49.8% were male. Of the babies examined 62.4% were exclusively breast-fed. There was a significant association between maternal educational status and knowledge of teething complaints. Three hundred and twenty-six (30.1%) babies had cough during their teething period, 349 (32.3%) experienced drooling of saliva, and 352 (32.6%) were observed to bite objects during teething. The high percentage of babies that were exclusively breast-fed but did not experience these symptoms were found to be statistically significant (p = 0.00). Seven hundred and forty-two (68.6%) babies had diarrhoea during teething; out of these 459(42.5%) were exclusively breast-fed and it was however not found to be statistically significant (p = 0.55). Conclusion: This study draws attention to the relatively poor anecdotal evidence related to symptoms associated with the teething process. The result has also demonstrated that exclusive breast-feeding is not only able to reduce the symptoms ascribed to teething, but also promote the development of a healthy oral tissue

Labour and Delivery Practices in Selected Primary Health Centres in Jos Metropolis, Plateau State

Every labour and child delivery activity comes with a collateral vicissitude hence the need to be accurate in its handling toward producing positive outcome. This concern has immensely drawn the attention of the global stakeholders which found its expression in Sustainable Goal Development three (Target 1) aimed at reducing the maternal mortality globally. This study was necessitated by the fact that the level of maternal mortality in Nigeria is unacceptable which invariably makes a lot of practitioners and researchers uncomfortable hence the need to further make an inquiry into how delivery and labour activities are conducted. Evidence abounds that the maternal mortality rate in Jos follows the pattern of that of the nation as a whole. The study was carried out in the selected primary health centres within the two main local government areas that constitute Jos metropolis. The setting of the study was picked as it functions as the operational level of primary health care. The level of care sophistication is relatively low in this setting. The study adopted a descriptive, cross sectional and non-experimental research design. The study population comprised nurses and community health workers working in those primary health centres. Multisampling technique was used in selecting the health centres used in the study. The sample size was one hundred and thirty-five. Convenience sampling technique was adopted in accessing the respondents. A total of one hundred and thirty-three inclined thereby creating a response rate of 98.5%. The ethical injunctions guiding research were observed as the respondents’ informed consent was sought. Assurance was given in the aspects of confidentiality and anonymity. The right to withdraw clause was also emphasized. Data was analyzed using percentages and frequency counts. Results reveal the techniques embedded in labour and delivery as these include assessment of patient’s psychological readiness and foetal readiness for continuous maternal support; and use of partograph. Further, results indicate lack of adequately trained health workers, lack of cordial relationships between mothers and health personnel, inadequate facilities, and financial strain as the factors that affect labour and delivery practices in primary health centres in Jos Metropolis. The import of the findings is that efforts should be strengthened toward upgrading the skills of the health workers, and making adequate provision for needed resources. Keywords: Labour, Delivery, Practices, Primary Health Centres DOI: 10.7176/JHMN/102-04 Publication date:September 30th 202

Posttraumatic stress disorder among internally displaced victims of Boko Haram terrorism in north-eastern Nigeria

Background: A large number of youth are often directly involved in armed-conflict, and therefore are at greater risk of developing a wide range of mental disorders including posttraumatic stress disorder (PTSD). However little is known about the prevalence of PTSD among youth who constitute a large work force.Objective: This study was carried out to assess the prevalence of posttraumatic stress disorder among Internally Displaced youth exposed to Boko Haram terrorism in North-Eastern Nigeria. It also assessed the socio-demographic factors associated with PTSD in this population.Method: A cross-sectional study that employed a consecutive sampling technique to select eligible subjects undergoing a Citizenship and leadership training at Citizenship and Leadership training institute Jos, Plateau State. The posttraumatic stress disorder module of Mini International Neuropsychiatric Interview was used to assess for current symptoms of PTSD.Results: The results show that more than two-third of the respondents were unemployed youth with secondary level of education and had low or no stable income. More than 63% of the respondents were diagnosed with PTSD. Educational status (p=0.002), marital status (p=0.001) and income before displacement (p=0.010) were the significant factors associated with PTSD.Conclusions: The results point to the importance of screening and treatment for traumatic armed conflict victims, with particular attention to youth who had low education and low income levels as well as being never married or widowed.Keywords: PTSD, sociodemographic factors, Bokoharam terrorism, North Eastern Nigeri

Electronic structure and surface properties of copper thiocyanate: a promising hole transport material for organic photovoltaic cells

Considering the significance of hexagonal copper thiocyanate (β-CuSCN) in several optoelectronic technologies and applications, it is essential to investigate its electronic structure and surface properties. Herein, we have employed density functional theory (DFT) calculations to characterise the band structure, density of states, and the energy-dependent X-ray photoelectron (XPS) valence band spectra at variable excitation energies of β-CuSCN. The surface properties in the absence and presence of dimethyl sulfoxide (DMSO), a solvent additive for improving perovskite solar cells’ power conversion efficiency, have also been systematically characterised. β-CuSCN is shown to be an indirect band gap material (Eg = 3.68 eV) with the valence band edge demonstrated to change from being dominated by Cu-3d at soft X-ray ionisation photon energies to Cu-3p at hard X-ray ionisation photon energies. The adsorption energy of dimethyl sulfoxide (DMSO) on the (100) and (110) β-CuSCN surfaces is calculated at −1.12 and −0.91 eV, respectively. The presence of DMSO on the surface is shown to have a stabilisation effect, lowering the surface energy and tuning the work function of the β-CuSCN surfaces, which is desirable for organic solar cells to achieve high power conversion efficiencies. View Full-Text Keywords: copper thiocyanate (CuSCN); hole transport layer (HTL); dimethyl sulfoxide (DMSO); electronic structure; XPS valence band spectra; work function; density functional theory (DFT

Drug resistance to sulphadoxine-pyrimethamine in Plasmodium falciparum malaria in Mlimba, Tanzania

BACKGROUND: Sulphadoxine-pyrimethamine (SP) has been and is currently used for treatment of uncomplicated Plasmodium falciparum malaria in many African countries. Nevertheless, the response of parasites to SP treatment has shown significant variation between individuals. METHODS: The genes for dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) were used as markers, to investigate parasite resistance to SP in 141 children aged less than 5 years. Parasite DNA was extracted by Chelex method from blood samples collected and preserved on filter papers. Subsequently, polymerase chain reaction (PCR) and restriction fragment length polymorphism (PCR-RFLP) were applied to detect the SP resistance-associated point mutations on dhfr and dhps. Commonly reported point mutations at codons 51, 59, 108 and 164 in the dhfr and codons 437, 540 and 581 in the dhps domains were examined. RESULTS: Children infected with parasites harbouring a range of single to quintuple dhfr/dhps mutations were erratically cured with SP. However, the quintuple dhfr/dhps mutant genotypes were mostly associated with treatment failures. High proportion of SP resistance-associated point mutations was detected in this study but the adequate clinical response (89.4%) observed clinically at day 14 of follow up reflects the role of semi-immunity protection and parasite clearance in the population. CONCLUSION: In monitoring drug resistance to SP, concurrent studies on possible confounding factors pertaining to development of resistance in falciparum malaria should be considered. The SP resistance potential detected in this study, cautions on its useful therapeutic life as an interim first-line drug against malaria in Tanzania and other malaria-endemic countries

Correlates of undiagnosed hypertension among health care workers in a secondary health care facility in north central Nigeria

Background: Hypertension is a major risk factor for cardiovascular disease, yet many health care workers rarely check their blood pressure. The  detection of hypertension among health care workers is key to prevention of hypertension, its attendant complications in the community and a strategy for health care workers retention.Objective: To determine the prevalence and correlates of undiagnosed hypertension among health care workers in a secondary health care facility.Methods: Using a structured questionnaire, sociodemographic variables and risk factors for hypertension were obtained. Measurements of blood  pressure, weight, height and waist circumference were carried out and body mass index calculated.Results: The prevalence of hypertension was 41.9%. The prevalence of undiagnosed hypertension was 35.1%. Multivariate analysis showed that age greater than 42 years (OR=0.24; 95%CI: 0.10-0.72) is a significant  correlate of undiagnosed hypertension. Those who self-reported that theyhad been diagnosed to have hypertension were 15.5% of the study population. Among those who had self-reported hypertension, 79.1% were found to have hypertension by the researchers while among those who had no history of hypertension, 35.1% were hypertensive. When a history ofhypertension is used as a screening test for the diagnosis of hypertension, it gave a sensitivity of 29.2%, a specificity of 94.4%, a positive predictive value of 79.1%, a negative predictive value of 64.9% and an accuracy of 67.1%.Conclusion: One in three persons had undiagnosed hypertension and those who were over 42 years are at risk for undiagnosed hypertension. This calls for urgent workplace strategies to create more awareness as a prevention and control strategy for the facility and the general population.Key words

Prevalence and correlates of hepatitis B and C seropositivity among health care workers in a semi urban setting in North Central Nigeria

Background: Health care workers are at risk of acquiring hepatitis B and C infections from patients in the course of providing care to them. The study is thus aimed at determining the prevalence and correlates of hepatitis B and C amongst health care workers of a secondary health care facility in northcentral Nigeria as a means of disease prevention.Methods: This was a cross sectional study and recruitment was on the basis of arrival at the study venue, without any random selection. A structured questionnaire was used to determine relevant socio-demographic variables and risk factors forhepatitis B and C. Antibodies to HCV and Hepatitis B surface antigen were detected using enzyme linked immuno-absorbant assay (ELISA).Results: The complete (three doses) hepatitis B vaccine uptake was 21.3%. The seroprevalence of hepatitis B and C were 8.4% and 6.5% respectively. Co-infection was found in 1.3% of workers. Staff who were married or had ever been married wereless likely to have hepatitis B compared to those who were single (OR =0.07: 95% CI 0.01 – 0.69), and those who did not have a personal clipper for barbing had a fivefold likelihood of being hepatitis B seropositive compared to those who had a clipper (OR= 5.24; 95% CI 1.18 – 23.23).Conclusion: There is a high sero-prevalence of hepatitis B and C and a low prevalence of Co-infection amongst workers.Keywords: Prevalence, Correlates, Hepatitis B, Hepatitis C, Health care worker

Monthly sulphadoxine-pyrimethamine combination versus daily proguanil for malaria chemoprophylaxis in sickle cell disease: a randomized controlled study at the Jos University Teaching Hospital

Background: Malaria carries a high case fatality among patients with sickle cell disease. In Jos University Teaching Hospital, at the time of this study, the use of Proguanil was the acceptable mode of chemoprophylaxis for preventing malaria in these patients. Intermittent Preventive Treatment (IPT) with Sulphadoxine-Pyrimethamine [SP] has shown great potential for reducing the prevalence of malaria and anaemia among pregnant women, infants and travellers. We hypothesised that monthly SP was superior to daily Proguanil in reducing malaria parasitaemia, clinical malaria attacks and sickle cell crises in such patients.Objective: To assess the efficacy and affordability of monthly SP versus daily Proguanil for malaria chemoprophylaxis in patients attending Sickle Cell Clinic at Jos University Teaching Hospital, Plateau State, Nigeria.Methods: One hundred and fifty four patients [114 children and 40 adults] with Sickle Cell Disease in their steady state were randomized to monthly SP or daily Proguanil for malaria chemoprophylaxis. Active detection of malaria parasite in the peripheral blood and packed cell volumes were done at each monthly visit to the clinic over a period of three months. The primary outcome measure was the proportion of patients with malaria parasite in the peripheral blood at the end of 3 months. The secondary outcome measures included episodes of clinical malaria attacks, frequency and type of sickle cell crises and adverse effects of the medication.Results: Ninety four percent [72/77] of patients in the SP group and 91% [70/77] in the Proguanil group respectively completed three months of follow up. SP reduced the prevalence of malaria parasitaemia by 25% [(14%) 10/72] compared to 6.4% [(30%) 21/70] in the proguanil group. [X2 54; p = 0.01]. Seventeen percent [12/72] of the patients receiving monthly SP had malaria attacks compared to 57% [40/70] on prophylaxis with Proguanil. [X2 =25; p< 0.0003]. Thirty three percent [24/72] of the patients receiving SP had at least an episode of bone pain crises compared to 69% [48/70] of the patients receiving Proguanil. [X2 =17.6; p<0.0001]. SP was 8 times cheaper than Proguanil.Conclusion:  Monthly chemoprophylaxis with SP was more efficacious than daily Proguanil in reducing the prevalence of asymptomatic malaria parasitaemia, clinical malaria attack and sickle cell crises in patients with sickle cell disease. SP was 8 times cheaper than Proguanil. No significant side effect was recorded in both groups. The current practice of routinely prescribing daily Proguanil to SCD patients for malaria chemoprophylaxis needs to be reviewed.Keywords: Sickle Cell Disease, Malaria Chemoprophylaxis, sickle cell crisi

Is Simple Microscopy Useful in the Diagnosis of Asymptomatic Bacteriuria in Pregnancy in Primary Care Settings?

Background: Booked antenatal care patients are often seen with routine urine microscopy result, but there are no locally defined guidelines for the primary care physician on how to use those results. The objective of the study was to establish whether the current practice of the diagnosis of ASB in pregnancy by urine microscopy among booked women at ECWA Evangel Hospital Jos was adequate, using urine culture as a gold standard.Methods: A descriptive, cross sectional, facility-based study was carried out using a structured questionnaire administered to 184 patients between the ages of 17-42 years who gave informed consent. They had their socio-demographic data and relevant current and past medical history recorded. A physical examination was done measuring their temperature, eliciting for lower abdominal tenderness, renal angle tenderness and noting findings on speculum examination. Urine samples for urinalysis and urine culture were obtained using the clean catch mid urine technique. A white blood cell count per high power field of 2 or more seen under the microscope was considered significant for urinalysis and a single colony count of 105 was considered significant for urine culture.Results: The prevalence of ASB by urine culture was 4.9%. The correlation between urine culture and urine microscopy was 8.5%. A WBC/HPF of > 3 was found to be the most significant urine microscopy value that predicted a positive colony count. Using urine culture as a gold standard, microscopy > 2 WBC/HPF (current practice) gave a prevalence of 20.1%; sensitivity, 66.7%; specificity, 82.3%; PPV, 16.2%; NPV, 98.0%; and accuracy, 82.0%. Using > 3 WBC/HPF (proposed practice) however gave prevalence, 5.9%; sensitivity, 33.3%; specificity, 95.4%; PPV,27.3%; NPV, 96.5%; and accuracy, 92.4%.Conclusion: In a setting where urine culture is not available, the use of microscopic urinalysis > 3WBC/HPF is an alternative in detecting ASB. However, in settings where urine culture is available, patients with > 2WBC/HPF should be requested to have a urine culture.Keywords: Simple Microscopy, Useful, Diagnosis, Asymptomatic Bacteriuria, Pregnancy, Primary Car