Prevalence, perception and correlates of low back pain among healthcare workers in tertiary health institutions in Sokoto, Nigeria

Background: Low back pain (LBP) is a common cause of disability worldwide. Healthcare workers are particularly prone to it because of the physical and emotional factors associated with their profession.Objectives: To determine the prevalence, perception and correlates of LBP among healthcare workers in tertiary health institutions in Sokoto, Nigeria.Methods: A cross-sectional study was conducted among 320 healthcare workers selected by multistage sampling technique from July to September 2016. Anthropometry was done for the participants in addition to questionnaire administration.Results: The mean age of the study participants was 36.99 +/- 8.23 years. The lifetime, annual, and point prevalence of LBP among the participants were 56.2%, 39.1% and 17.2% respectively. Most, 151 (83.9%) of the 180 participants that have ever experienced LBP reported that it commenced after starting work, and they perceived it to be due to standing for long hours (57.2%), awkward postures (22.2%) and carrying heavy objects/patients at work (20.6%). Older age, female sex, longer duration of practice, overweight/obesity, and lifting heavy objects/patients at work were significantly associated with LBP among the participants.Conclusion: The prevalence of LBP is high among healthcare workers in Sokoto, Nigeria; although it was also associated with older age and female sex, being in practice for 10 years and above, overweight/obesity, and lifting heavy objects/patients at work were the predictors identified. Management of the respective hospitals should prevent workplace exposures to heavy weight/objects by establishing “lift teams” as a temporary measure, and also implement “zero lift programs” in their facilities.Funding: NilKeywords: Prevalence, perception, correlates, low back pain, healthcare workers

Secondary hyperparathyroidism among Nigerians with chronic kidney disease

Backround: Secondary hyperparathyroidism (SHPT) is a manifestation of chronic kidney disease mineral bone disorder (CKD-MBD). SHPT is common in patients with chronic kidney disease (CKD) and is associated with significant morbidity and mortality.Methods: A cross- sectional descriptive study involving 230 patients with CKD. Results: The mean age of the study population was 44.17±15.24 years. The median intact parathyroid hormone and alkaline phosphatase levels were 96pg/ml (range 4-953pg/ml) and 88 iu/l (range 10-800 iu/l) respectively. The mean (with standard deviation) calcium, serum phosphate, calcium phosphate product and haemoglobin levels were 2.22±0.29mmol/l, 1.8±0.62mmol/l, 3.94±1.42mmol2/l2 and 9.90±1.87g/dl respectively. Majority of patients had advanced CKD with 70.3% of patients in stage G5. The prevalence rates of SHPT, hypocalcaemia, hyperphosphataemia, elevated alkaline phosphatase and elevated calcium phosphate product were 55.2%, 34.8%, 66.1%, 42.2% and 25.2% respectively. Univariate analysis revealed that SHPT was associated with hypocalcaemia, hyperphosphataemia, elevated alkaline phosphatase, proteinuria, anaemia, hypertension, left ventricular hypertrophy and stage of kidney disease; being worse with advancing kidney disease. Independently associated with SHPT were hypocalcaemia (OR=4.84), hyperphosphataemia (OR=3.06), and elevated alkaline phosphatase (OR=2.04).Conclusion: The prevalence of SHPT in CKD is high, occurs early and is independently associated with hypocalcaemia, hyperphosphataemia and elevated alkaline phosphatase. The prevalence of SHPT also increases with worsening renal function.Keywords: Secondary hyperparathyroidism, chronic kidney disease, intact parathyroid hormone, hypocalcaemia, hyperphosphataemia, elevated alkaline phosphatase

The Security Challenges of Urbanization and Environmental Degradation in the Niger-Delta Area of Nigeria

Human’s continued sustenance on earth and the quality of living are heavily dependent on the environment. The major components of the environment being air, water and land are the supporting pillars of the human existence, which they depend on directly or indirectly for survival and well-being. Unfortunately, due to some of the human activities on the environment, there seems to be a war between humans and the environment, which is evident in his over-exploitation and inadequate management of the basic components of the environment. Since the discovery of crude oil in the Niger Delta, the region has experienced various forms of degradation caused by pollution from oil spillage, gas flaring and other forms of environmental pollution, as a result of reckless way and manner with which oil is being exploited by the International Oil Corporations (IOCs) operating within the region. The Nigerian government on the other, not having strong regulations guiding the activities of the operations of these IOCs, has done almost nothing to curtail the activities of these IOCs because of the revenue generated the IOCs, as such the region is deprived of the basic social amenities and infrastructures. The degree of environmental pollution suffered within the region affects their major sources of livelihood – being fishing and farming, and has also left the region in poverty, which has led to a large number of people migrating to the urban areas to escape poverty. This paper investigates how environment degradation impact urbanization and security in the region

Exploring a sample of university students’ perceptions of menstruation

This study aimed to explore how a sample of young South African women constructed their perceptions of menstruation. The sample comprised 16 racially/ethnically diverse female university students (blacks = 4, whites = 2, coloured = 8; Christians = 11; Muslims = 5; aged 18 to 23 years). They participated in one of three focus group discussions on their constructions of menstruation. Findings from the discourse analysis indicated that the women perceive social control experiences of their menstruation—even in the context of medical understandings.DHE

Treatment Outcomes Among Older Human Immunodeficiency Virus-Infected Adults in Nigeria

Abstract Background. Older age at initiation of combination antiretroviral therapy (cART) has been associated with poorer clinical outcomes. Our objectives were to compare outcomes between older and younger patients in our clinical cohort in Jos, Nigeria. Methods. This retrospective cohort study evaluated patients enrolled on cART at the Jos University Teaching Hospital, Nigeria between 2004 and 2012. We compared baseline and treatment differences between older (≥50 years) and younger (15–49 years) patients. Kaplan-Meier analysis and Cox proportional hazard models estimated survival and loss to follow-up (LTFU) and determined factors associated with these outcomes at 24 months. Results. Of 8352 patients, 643 (7.7%) were aged ≥50 years. The median change in CD4 count from baseline was 151 vs 132 (P = .0005) at 12 months and 185 vs 151 cells/mm3 (P = .03) at 24 months for younger and older patients, respectively. A total of 68.9% vs 71.6% (P = .13) and 69.6% vs 74.8% (P = .005) of younger and older patients achieved viral suppression at 12 and 24 months, with similar incidence of mortality and LTFU. In adjusted hazard models, factors associated with increased risk of mortality were male sex, World Health Organization (WHO) stage III/IV, and having a gap in care, whereas being fully suppressed was protective. The risk of being LTFU was lower for older patients, those fully suppressed virologically and with adherence rates >95%. Male sex, lack of education, WHO stage III/IV, body mass index <18.5 kg/m2, and having a gap in care independently predicted LTFU. Conclusions. Older patients achieved better viral suppression, and older age was not associated with increased mortality or LTFU in this study

Phytochemical characterization of turnip greens (Brassica rapa ssp. rapa): A systematic review

Objective The Turnip (Brassica rapa L. ssp. rapa) is a leaf and root vegetable grown and consumed worldwide. The consumption of Turnip has been associated with beneficial effects on human health due to their phytochemicals that may control a variety of physiological functions, including antioxidant activity, enzyme regulation, and apoptotic control and the cell cycle. The current systematic review of the literature aims to evaluate both the profile and quantity of phytochemicals commonly found in Turnip greens and to provide perspectives for further investigation. Methods This review was conducted following the PRISMA guidelines. Four bibliographic databases (PubMed, Embase, Web-of-Science and Cochrane Central Register of Controlled Trials) were searched to identify published studies until April 8th, 2020 (date last searched) without data and language restriction. Studies were included if they used samples of Turnip greens (the leaves), and evaluated its phytochemical content. Two reviewers independently evaluated the titles and abstracts according to the selection criteria. For each potentially eligible study, two reviewers assessed the full-texts and independently extracted the data using a predesigned data extraction form. Results Based on the search strategy 5,077 potentially relevant citations were identified and full texts of 37 studies were evaluated, among which 18 studies were eligible to be included in the current review. The majority of included studies were focused on identification of glucosinolates and isothiocyanates (n = 14, 82%), four studies focused on organic acids, and five studies reported phenolic component profile in Turnip greens. Among included studies nine studies (50%) provided information on phytochemi

Factors impacting on menstrual hygiene and their implications for health promotion

BACKGROUND: In the lives of women, puberty is marked by the onset of menarche. From this stage onwards until menopause, reproductive health and menstrual hygiene are important aspects of women’s lives. In Zambia’s Western Province, the natural process of menstruation is a taboo and dealt with secretly. Information and knowledge about menstruation and menstrual hygiene among adolescent girls is inadequate. This paper explores the factors influencing the understanding, experiences and practices of menstrual hygiene among adolescent girls in Mongu District, Western Province of Zambia. METHODS: An explorative study design was used by means of six focus group discussions conducted with 51 respondents, aged 13–20 years, from three secondary schools. Their age at menarche was 11–15. For data analysis thematic content analysis was used. RESULTS: The paper shows that the girls suffer from poor menstrual hygiene, originating from lack of knowledge, culture and tradition, and socio-economic and environmental constraints, leading to inconveniences, humiliation and stress. This leads to reduced school attendance and poor academic performance, or even drop outs, and ultimately infringes upon the girls’ human rights. CONCLUSION: To address these shortcomings, a ‘super setting approach’ is recommended, in which a Health Promoting School could improve the girls’ individual and group needs, and a community setting which would address the broader socio-economic, cultural and environmental conditions. This would enable creating a supportive environment for the girls to manage their periods. To successfully utilize the approach, all stakeholders (parents, teachers, children, governments and communities) should cooperate to generate context-specific solutions for creating safe menstrual care, and better and dignified conditions for adolescent girls. Therefore, this calls for comprehensive, strident advocacy for policy changes at national level, and mediation and involvement at community level. (Global Health Promotion, 2018; 25(1): 54–62

Superior Effectiveness of Zidovudine Compared With Tenofovir When Combined With Nevirapine-based Antiretroviral Therapy in a Large Nigerian Cohort

Background. Despite sparse efficacy data, tenofovir–emtricitabine or tenofovir–lamivudine plus nevirapine is used in many resource-constrained settings. Methods. This retrospective cohort study included patients initiating nevirapine-based antiretroviral therapy (ART) with either tenofovir–emtricitabine or lamivudine (tenofovir group) or zidovudine–lamivudine (zidovudine group). Clinical, virologic, and immunologic evaluations were performed at baseline and every 6 months. Virologic failure was defined as 2 consecutive human immunodeficiency virus (HIV)-RNA values >1000 copies/mL. Patients were included from ART initiation until time of failure, regimen switch, discontinuation, or last HIV-RNA measurement. Cox proportional hazards regression was used to model factors influencing time to failure. Bias due to dependent censoring was investigated via inverse probability weighted pooled logistic regression. Results. A total of 5547 patients were evaluated; 1484 (26.8%) were in the tenofovir group and 4063 (73.2%) were in the zidovudine group. In the adjusted model, tenofovir regimen (hazard ratio [HR], 1.47; 95% confidence interval [CI], 1.21–1.79) and higher baseline log10 HIV-RNA (HR, 1.15; 95% CI, 1.03–1.28) were associated with virologic failure. Higher baseline log10 CD4+ cell count (HR, 0.50; 95% CI, .40–.63) and increasing age (HR, 0.98; 95% CI, .97–.99) decreased the risk of virologic failure. Inverse probability weighting results were consistent with the primary analysis. Conclusions. Compared with zidovudine–lamivudine, the use of tenofovir–lamivudine or emtricitabine in combination with nevirapine was a strong predictor of virologic failure in our cohort, which was not explained by other risk factors or criteria for regimen selection