Worm Infestation And Anaemia Among Pre-school Children Of Peasant Farmers In Calabar, Nigeria.

Background: Worm infection and anaemia are common childhood conditions in Nigeria. We assessed the status of helminthiasis and associated anaemia among pre school children of peasant farmers aged 1-5 years living in a rubber plantation near Calabar, Nigeria. Design: Cross sectional. Method: Three hundred and fifty children were selected by multi-stage cluster sampling technique. Freshly passed stool was examined using Kato-Katz method while anaemia was estimated using haematocrit technique. Result: Of the 350 children, 174 (49.7%) had intestinal helminths: Ascaris lumbricoides 64.4%, hookworms 10.9% and Trichuris trichuria 1.1%. There were 41(23.6%) children with polyparasitism, 33 of them were due to Ascaris lumbricoides and hookworms. The worm load was generally light in intensity with egg per gram of stool ranging from 24-60,960. Males (28.9%) were infected more than females (20.8%). The frequency of infection increases with age. The prevalence of anaemia among the entire study population and in those infected with worms was 56.6% and 56.9% respectively. With polyparasitism there was a relative increase in the frequency of anaemia females > males. Conclusion: Worm infections and anaemia are common in our children. A comprehensive control strategy involving good sanitation, sinking of bore hole for clean water supply and regular deworming exercises are recommended. Nigerian Journal of Clinical Practice Vol. 11 (3) 2008: pp. 220-22

Exposure of Petrol Station Attendants and Auto Mechanics to Premium Motor Sprit Fumes in Calabar, Nigeria

A population-based-cross-sectional survey was carried out to investigate the potential risk of exposure to premium motor spirit (PMS) fumes in Calabar, Nigeria, among Automobile Mechanics (AM), Petrol Station Attendants (PSA) and the general population. Structured questionnaire was administered on the randomly chosen subjects to elicit information on their exposure to PMS. Duration of exposure was taken as the length of work in their various occupations. Venous blood was taken for methaemoglobin (MetHb) and packed cells volume (PCV). Mean MetHb value was higher in AM (7.3%) and PSA (5.8%) than in the subjects from the general population (2.7%). PCV was lower in PSA (30.8%), than AM (33.3%) and the subjects from the general population (40.8%). MetHb level was directly proportional, and PCV inversely related, to the duration of exposure. The study suggested increased exposure to petrol fumes among AM, PSA, and MetHb as a useful biomarker in determining the level of exposure to benzene in petrol vapour

A study of the M235T variant of the angiotensinogen gene and hypertension in a sample population of Calabar and Uyo, Nigeria

AbstractA common molecular variant of the angiotensinogen gene had been reported to predispose some ethnic groups to hypertension. This case–control study was designed to determine the frequency and association of the angiotensinogen M235T allele with hypertension in residents of Calabar and Uyo cities, south–south Nigeria.The study involved 1308 subjects, 612 patients and 696 controls. The M235T variant was investigated using an allele specific polymerase chain reaction and enzymatic digestion to determine allele frequencies. Hypertensinogenic factors such as dietary habits, physical activity, smoking and drinking habits were assessed using questionnaires. Descriptive statistics, chi-square and multiple regression analysis were used to analyze the data obtained.The M235T allele frequency was high (0.94 for hypertensives and 0.96 for controls) though it was not associated with hypertension status. The odds ratio for hypertension was 0.64 (95% confidence interval: 0.39–1.06) there were no significant differences between the genotype frequency of hypertensives and controls. By multiple regression, Hypertension was observed to be associated with age and was a predictor for systolic blood pressure in both patient r2=0.359; p<0.05 and control groups r2=0.26.Age and body mass index were predictors for diastolic blood pressure in the control group, r2=0.28.Although the frequency of the M235T variant was high, it was not a significant risk factor for hypertension in the study population

Snake bites in Nigeria: A study of the prevalence and treatment in Benin City

Purpose: Although snake bites occur frequently in Benin City, the prevalence has not been documented. This study was therefore done to determine the prevalence, morbidity, mortality, and the orthodox treatment of victims. Methods: The study was retrospective and data on victims of snake bite covering a period of twenty years were obtained from the records as contained in the individual patients\' case files available at the University of Benin Teaching Hospital and Central Hospital, Benin City. Results: Males were twice more often bitten than females, and teenagers and youths in their early twenties constituted the peak age range of victims. Most victims (59.5%) were bitten in the bush or farm. The limbs were the commonest sites of bite with the feet (73.5%) and arms (20.9%) more frequently bitten; both the upper and lower right limbs were also more frequently bitten than the corresponding left limbs. All patients who showed symptoms of envenomation (68.3%) received polyvalent antivenom, 67.4% received antibiotics while over 90% of patients received antitetanus prophylaxis. Some of the patients (61.5 %) were treated with analgesics, while 17.2% and 82.3% received diazepam and intravenous fluids, respectively. Although there was a high degree of morbidity as shown by the long stay of many patients in the hospital (mean duration of stay by patients in hospital is 5.7±5.1 days; rang

Low infection rates after 34,361 intramedullary nail operations in 55 low- and middle-income countries: Validation of the Surgical Implant Generation Network (SIGN) Online Surgical Database

Background: The Surgical Implant Generation Network (SIGN) supplies intramedullary (IM) nails for the treatment of long bone fractures free of charge to hospitals in low- and middle-income countries (LMICs). Most operations are reported to the SIGN Online Surgical Database (SOSD). Follow-up has been reported to be low, however. We wanted to examine the pattern of follow-up and to assess whether infection rates could be trusted. Patients and methods: The SOSD contained 36,454 IM nail surgeries in 55 LMICs. We excluded humerus and hip fractures, and fractures without a registered surgical approach. This left 34,361 IM nails for analysis. A generalized additive regression model (gam) was used to explore the association between follow-up rates and infection rates. Results: The overall follow-up rate in the SOSD was 18.1% (95% CI: 17.7–18.5) and national follow-up rates ranged from 0% to 74.2%. The overall infection rate was 0.7% (CI: 0.6–0.8) for femoral fractures and 1.2% (CI: 1.0–1.4) for tibial fractures. If only nails with a registered follow-up visit were included (n = 6,224), infection rates were 3.5% (CI: 3.0–4.1) for femoral fractures and 7.3% (CI: 6.2–8.4) for tibial fractures. We found an increase in infection rates with increasing follow-up rates up to a level of 5%. Follow-up above 5% did not result in increased infection rates. Interpretation: Reported infection rates after IM nailing in the SOSD appear to be reliable and could be used for further research. The low infection rates suggest that IM nailing is a safe procedure also in low- and middle-income countries.publishedVersio

Patients' perception of traditional bone setting in Calabar

Background: Patients with orthopaedic injuries patronize traditional bonesetters in our communities. This study was undertaken to find out and document the reasons and factors responsible for this patronage, who made the choice, the role of healthworkers, patients' perception of the practice and if their experience will encourage or discourage them from patronizing traditional bone setting in future. We also compared the cost between orthodox and traditional bone setting for close humeral and femoral fractures. Methods: A prospective study of patients in three traditional bone setting centres in Calabar. A pre-tested questionnaire requesting information on age, sex, educational level, type of injury, reasons for choice of traditional bone setting was administered. Other details included who decided on traditional treatment, perception of outcome, and the option of choice in the event of a future injury. Results: There were 98 patients with 106 injuries. The male: female ratio was 66:32 (2.1:1) and age range was 9 months to 60 years. There were 76 fractures in 68 patients, 28 dislocations and 2 brachial plexus injuries. Traditional bone setting was chosen in 50 patients (51.0%) because traditional bonesetters were believed to be more skillful than orthodox orthopaedic practitioners, 32 patients (32.7%) thought it was cheaper; 12 patients (12.2%) believed orthodox orthopaedic practitioners have no empathy towards their patients and 4 patients (4.1%) had no health facility in their locality. In 68 patients (69.4%) the locus of decision was external; in 22 patients (22.4%) internal and 8 patients (8.2%) were encouraged by a healthworker. Complications including pain, mal/nonunion, joint stiffness and contractures occurred in 60 patients (61.2%). Treatment outcome was adjudged satisfactory by 48 patients (49.0%), fair by 40 patients (40.8%) and unsatisfactory by 10 patients (10.2%). Traditional bone setting for the management of humeral and femoral fractures was more expensive than orthodox management. Conclusion: Traditional bone setting is popular for varied reasons. The freedom to advertise may have helped to woo a public already biased towards traditional bone setting by cultural attachment. A paradigm shift is necessary to reverse the trend. . Keywords: keyword; keyword; keyword Port Harcourt Medical Journal Vol. 1 (2) 2007: pp.104-10

Haemodialysis in an emerging centre in a developing country: a two year review and predictors of mortality

Abstract Background Haemodialysis is the most common form of renal replacement therapy in Nigeria. The high cost of haemodialysis has made optimal therapy of end-stage renal disease difficult in Nigeria. This paper is a review of data collected over two years of provision of dialysis services in a new tertiary hospital in Southern Nigeria. Methods This retrospective analysis is done on data obtained from the patient case files and dialysis records in the first two years of provision of dialysis services in our centre. A gender comparison of the patients' baseline sociodemographic, clinical and biochemical was performed and a logistic regression model used to assess the predictors of mortality. Results A total of 98 patients had 471 sessions in the two years under review. Males and females had similar characteristics at baseline except for a higher median serum urea in the males. The commonest causes of end-stage renal disease were chronic glomerulonephritis (34.5%), hypertension (32.1%) and diabetes mellitus (17.9%). The main predictor of mortality was under treatment with haemodialysis due to inability to pay for more than a few dialysis sessions. Conclusions This study has highlighted the unchanging demographics of our advanced kidney failure patients. Efforts should be aimed at subsidizing the cost of dialysis for our teeming population of dialysis dependent chronic kidney disease patients.</p

Preliminary observations on the occurrence of lymphatic filariasis in Cross River State, Nigeria

A situation analysis of the occurrence of Lymphatic Filariasis (LF) in Cross River State, Nigeria, was conducted within the period November 2000 and March 2001. Information gathered from state and local Government Area (LGA) policy makers, health personnel and community key informants revealed that Lymphatic Filariasis occurred in 1 Local Government Areas:- Akamkpa, Bekwara, Biase, Boki, Etung, Ikom, Obanliku, Obubra, Obudu, Ogoja, Yala, Yakurr and Odukpani. All 19 villages mentioned as having current and past cases were visited and found to have a total of 13 current cases of lymphoedema. The cases (most farmers, all permanent residents of the village, and all within the age bracket of 28- years, complained of periodic fever, headache and chills particularly in rainy season. They had swollen limbs, usually unilateral with pain, itching, crawling sensation and tenderness. Key informants indicated that the disease had been in the village for a long time. This was confirmed by the existence of local names meaning “elephant legs” and “swollen legs” which appropriately describes the visible manifestation of Lymphatic Filariasis. The cases and key informants did not know the cause of the disease and attributed it to poison, witchcraft , bad food, bad water and violation of taboo. Most felt that traditional medicine including scarification for the purpose of “letting” blood and fluid was the best remedy. All 23 health workers interviewed had good knowledge about the proper remedy. Adequate number of health facilities and personnel exist at state, LGA and community levels. A total of 58 Doctors, 16 pharmacist, 1790 nurses and 1100 community Health Extension Workers (CHEWs) are employed by the State Government. These exclude health personnel working in private health facilities in the state. Two tertiary, 84 secondary and 485 primary health facilities exist in the state, twelve of which are equipped with surgery facilities. Twelve of the 19 villages visited have primary health care Canters/Pos. lymphatic Filariasis is not listed separate from other filariasis as a notifiable disease. There are therefore no records of the disease and plan for its control at any level. Having confirming the presence f lymphatic filariasis in Cross River State, it is necessary to conduct a survey to determine prevalence of the disease in all communities in he State and subsequently commence intervention (chemotherapy and morbidity control). Information gathered in this study and future Filariasis control programme in Nigeria. The Nigerian Journal of Parasitology Vol 24 2003: 9-1