Assessment of iron Parameters and Transient Elastography (FibroScan) Pattern amongPatients with Chronic Viral Hepatitis Infection in Jos, Nigeria

Background:The long-termeffect of excess iron deposition in the liver include fibrosis and cirrhosis which may progress to hepatocellular carcinoma. We assessed iron parameters among patients with chronic viral hepatitis B and C infection (CVHBI; CVHCI) to determineif any correlation existed with the degree of fibrosis in the liver. Methods: A cross-sectional descriptive study was carried out on 186 patients, made up of 132 patients withCVHBI and 54 patients with CVHCI. Serum ferritin and C-reactive protein were done by ELISA, serum iron and total iron binding capacity (TIBC) by colorimetric technique while transferrin saturation (Tsat) was calculated using serum iron and TIBC values. Liver fibrosis was assessed using fibroscan.Obtained data wereanalysed using SPSS version 20 and p values < 0.05 were considered statistically significant.  Results: The mean values for serum ferritin, iron, TIBC and Tsat were 218.1±325.6µg/L, 25.1±22.8µmol/L, 71.13 ± 35.92µmol/L and 45.2 ± 49.9% respectively. There were no significant differences in iron parameters between patients with CVHBI and CVHCI. Elevated serum ferritin was found in 15.2% and 20.4% of CHBVI and CHCVI patients respectively; while an elevated Tsat was seen in 22.7% and 24.1% of CHBVI and CHCVI patients respectively. Using a combination of elevated serum ferritin and Tsat, the prevalence of iron overload was found to be1.6%. Fibroscan scores did not differ significantly between patients with orwithout elevated iron parameters. Conclusion:Chronic viral hepatitis infection is associated elevated iron parameters though withminimal effect on liver fibrosis. Conflict of interest: Ni

Prevalence of irritable bowel syndrome: A community survey in an African population

Background : Irritable bowel syndrome (IBS) has been reported to be common in the West. Community surveys are lacking in the African setting. We determined the prevalence of IBS in a rural community setting in Nigeria. Method : Questionnaires were administered to consenting individuals. Subjects satisfying the Rome II criteria for IBS were invited for physical examination at a health center to identify the presence of "alarm factors." Results : One hundred forty (31.6%) of the 443 evaluated individuals fulfilled the Rome II criteria for IBS, with a male-to-female ratio of 1.37:1 (P= .11). The prevalence of IBS was highest (39.3%) in the third decade, followed by 25% in the fourth decade (P= .009). Ninety-six (67%) IBS individuals had the alternating pattern of diarrhea and constipation, whereas 28 (20%) and 19 (13%) had constipation and diarrhea subtypes, respectively. Conclusion : IBS as diagnosed by the Rome II criteria has a high prevalence in the African rural population, as obtained elsewhere.Contexte: Irritable Syndrome (IBS) a \ue9t\ue9 signal\ue9 \ue0 \ueatre commune \ue0 l\u2019Ouest. Enqu\ueates communautaires font d\ue9faut dans le contexte africain. Nous avons d\ue9termin\ue9 la pr\ue9valence de IBS dans un milieu rural. communaut\ue9 d\ue9fi nition dans le Nig\ue9ria. M\ue9thode: Questionnaires ont \ue9t\ue9 administr\ue9 aux personnes consentantes. Sujets de satisfaction de la Rome II crit\ue8res d\u2019IBS ont \ue9t\ue9 invit\ue9s pour l\u2019examen physique dans un centre de sant\ue9 \ue0 identifi er la pr\ue9sence de \u201c alarme les facteurs \u201d. R\ue9sultats: Un cent et quarante (31,6 %) des individus \ue9valu\ue9es 443 rempli le Rome Crit\ue8res II IBS avec un m\ue2le \ue0 ratio f\ue9minin de 1.37:1 (p = 0,11) .la pr\ue9valence IBS \ue9tait plus \ue9lev\ue9 dans la troisi\ue8me d\ue9cennie (39.3 %), suivie de 25 % dans le quatri\ue8me dix ans (p = 0.009). Quatre-vingt-seize (67 %) IBS personnes avaient le mod\ue8le d\u2019alternance de la diarrh\ue9e et constipation, alors que 28 (20 %) et 19 (13 %) avaient constipation et la diarrh\ue9e subtypes respectivement. Conclusion: IBS comme un diagnostic par les crit\ue8res de Rome II a une haute pr\ue9valence dans la population rurale africaine comme obtenu ailleurs

Bio-Efficacy of Insecticide-Treated Bednets (ITNs) Distributed through the Healthcare Facilities in a Boundary Community in Nigeria

This study was conducted to evaluate the susceptibility and efficacy of three insecticidal treated bednets; Olyset®, PermaNet2.0® and MAGNet® collected from the different health facilities, against Anopheles mosquitoes under laboratory conditions. PermaNet3.0 was used as a positive control. Larval collections were carried out and reared at the insectary of National Arbovirus and Vector Research Centre, Enugu State. Anopheles Kisumu mosquitoes were used as the standard control in the cone bioassay test. The bioassay showed that the wild An. gambiae s.l. and An. gambiae Kisumu strains were susceptible (100% mortality) to the PermaNet3.0® used as positive control while the wild-caught Anopheles were resistant to the mono-treated ITNs. The mortality effect of the net brands showed that the brands have a statistically significant effect on the mosquito mortality after 24 hours F (2, 18) = 14.32, p < .001), while the sides of the net did not have a statistically significant effect on the mosquito mortality (F (3, 18) = 1.67, p = .209). This study also suggests the need to develop and adopt routine monitoring of the ITNs at the health facilities, as it will inform the replacement of ineffective nets. However, a mass campaign of PBO nets is necessary for the state to achieve and maintain the universal coverage of ITNs

Association of HIV-induced immunosuppression and clinical malaria in Nigerian adults

Background: Despite the growing body of evidence on the interaction between HIV and malaria in sub-Saharan Africa, there is a dearth of data on clinical malaria in HIV-infected patients in Nigeria. We determined the burden of clinical malaria in HIV-infected adult Nigerians and further investigated the association between their immunological status and the rates of clinical malaria. Methods: Ninety seven antiretroviral treatment-naïve HIV-infected adults were enrolled in a cross-sectional study from August to December, 2009. The participants had a complete clinical evaluation, thick and thin blood films for malaria parasites and CD4 cell count quantification. Clinical malaria was defined as having fever (temperature ≥ 37.5oC or history of fever within 48 hours) and a malaria parasite density above the median value obtained for subjects with co-existing fever and parasitaemia. Results: Clinical malaria was diagnosed in 10 out of 97 patients (10.3%). Lower CD4 cell counts were associated with increasing rates of clinical malaria which was 0% at CD4 cell count of ≥ 500, 2.6% at 200-499 and 30% a

Awareness and knowledge of human immunodeficiency virus post exposure prophylaxis among Nigerian Family Physicians

Background: To determine the level of awareness and knowledge of HIV postexposure prophylaxis (HIV PEP) and determinants of adequate knowledge among Family Physicians in Nigeria. Materials and Methods: This was a cross‑sectional questionnaire‑based survey conducted among 175 Family Physicians at two national conferences. Results: Majority (97.7%) of the respondents was aware of the concept of HIV PEP and 99.4% believed it was effective in preventing HIV transmission. Over two third of our respondents had been exposed to NSI; however, less than 25% of those exposed received PEP. There was high level of knowledge of the various high‑risk body fluids as well as types of high‑risk exposures. 93.9% of our respondents knew that HIV PEP should commence within 1 h of exposure, 83.3% knew the correct duration of HIV PEP, but only 57.0% knew the ideal PEP regimen for high‑risk exposures. The total mean score for our respondents was 17.8±2.9 with 79.4% having an adequate score. Being a junior doctor and male sex were associated with adequate knowledge. Conclusion: This study shows that despite high levels of awareness and knowledge of HIV PEP, access to its use among family physicians in Nigeria is still sub‑optimal.Keywords: Family physicians, HIV PEP, NigeriaNigerian Medical Journal | Vol. 53 | Issue 3 | July-September | 201

Prevalence of irritable bowel syndrome: A community survey in an African population

Background : Irritable bowel syndrome (IBS) has been reported to be common in the West. Community surveys are lacking in the African setting. We determined the prevalence of IBS in a rural community setting in Nigeria. Method : Questionnaires were administered to consenting individuals. Subjects satisfying the Rome II criteria for IBS were invited for physical examination at a health center to identify the presence of "alarm factors." Results : One hundred forty (31.6%) of the 443 evaluated individuals fulfilled the Rome II criteria for IBS, with a male-to-female ratio of 1.37:1 (P= .11). The prevalence of IBS was highest (39.3%) in the third decade, followed by 25% in the fourth decade (P= .009). Ninety-six (67%) IBS individuals had the alternating pattern of diarrhea and constipation, whereas 28 (20%) and 19 (13%) had constipation and diarrhea subtypes, respectively. Conclusion : IBS as diagnosed by the Rome II criteria has a high prevalence in the African rural population, as obtained elsewhere.Contexte: Irritable Syndrome (IBS) a été signalé à être commune à l’Ouest. Enquêtes communautaires font défaut dans le contexte africain. Nous avons déterminé la prévalence de IBS dans un milieu rural. communauté défi nition dans le Nigéria. Méthode: Questionnaires ont été administré aux personnes consentantes. Sujets de satisfaction de la Rome II critères d’IBS ont été invités pour l’examen physique dans un centre de santé à identifi er la présence de “ alarme les facteurs ”. Résultats: Un cent et quarante (31,6 %) des individus évaluées 443 rempli le Rome Critères II IBS avec un mâle à ratio féminin de 1.37:1 (p = 0,11) .la prévalence IBS était plus élevé dans la troisième décennie (39.3 %), suivie de 25 % dans le quatrième dix ans (p = 0.009). Quatre-vingt-seize (67 %) IBS personnes avaient le modèle d’alternance de la diarrhée et constipation, alors que 28 (20 %) et 19 (13 %) avaient constipation et la diarrhée subtypes respectivement. Conclusion: IBS comme un diagnostic par les critères de Rome II a une haute prévalence dans la population rurale africaine comme obtenu ailleurs

Specialist physician knowledge of chronic kidney disease: A comparison of internists and family physicians in West Africa

Background: Postgraduate training is aimed at equipping the trainee with the necessary skills to practise as an expert. Non-nephrology specialist physicians render the bulk of pre-end-stage renal disease care for patients with chronic kidney disease (CKD). We sought to ascertain the knowledge of CKD amongst non-nephrology specialist physicians who serve as trainers and examiners for a training, accrediting and certifying body in postgraduate medicine in West Africa. We also compared the knowledge of family physicians and non-nephrology internists. Methods: Self-administered questionnaires were distributed to non-nephrology specialist physicians who serve as examiners for the West African College of Physicians. Results: Only 19 (27.5%) of the respondents were aware of the Kidney Disease Outcomes Quality Initiatives guidelines for CKD management. Twenty five (36.2%) of the respondents had adequate knowledge of CKD. There was no significant difference in the proportion of family physicians and non-nephrology internists who had adequate knowledge of CKD (27.3% vs. 40.4% respectively; p = 0.28). Hypertension and diabetes mellitus were identified by all of the physicians as risk factors for CKD. Non-nephrology internists more frequently identified systemic lupus erythematosus as a risk factor for CKD, urinalysis with microscopy as a laboratory test for CKD evaluation, and bone disease as a complication of CKD than family physicians. Conclusion: There is a lack of adequate CKD knowledge amongst non-nephrology specialist physicians, since many of them are unaware of the CKD management guidelines. Educational efforts are needed to improve the knowledge of CKD amongst non-nephrology specialist physicians. Guidelines on CKD need to be widely disseminated amongst these physicians