Appraisal of young farmers’ club programme in Abia state, Nigeria

This study appraised Young Farmers’ Clubs programme in secondary schools in Abia State. Data were collected using simple random sampling technique and structured interview schedule as instrument. Results showed that only a small proportion (about 27%) of the secondary schools had functional YFCs. Reasons for this situation were government, school authorities, agriculture teachers and student-related. The projects embarked upon by the YFCs were Agriculture, Home economics, Handicrafts, Educational and Managerial projects. The activities most frequently embarked upon by these clubs were crop production under Agriculture and food preparation under Home economics. The problems facing the YFCs in the state were related to the government, school authorities, agriculture teachers and students, with government-related problems predominating. It was recommended that government should create a fund similar to industrial training fund to provide logistic support to YFCs, and make mandatory the organization of YFCs programme in secondary schools.Key words: Young Farmers’ Clubs programme, secondary school

Lassa fever – full recovery without ribavarin treatment: a case report

Background: Lassa fever is a rodent-borne zoonosis that clinically manifests as an acute hemorrhagic fever. It is treated using ribavarin. Surviving Lassa fever without receiving the antiviral drug ribavarin is rare. Only few cases have been documented to date.Case Presentation: We report a case of a 59-year old female with fever who was initially thought to have acute pyelonephritis and sepsis syndrome with background malaria. Further changes in her clinical state and laboratory tests led to a suspicion of Lassa fever. However at the time her laboratory confirmatory test for Lassa fever returned, her clinical state had improved and she made full recovery without receiving ribavarin. Her close contacts showed no evidence of Lassa virus infection.Conclusion: This report adds to the literature on the natural history of Lassa fever; and that individuals may survive Lassa fever with conservative management of symptoms of the disease and its complications.Keywords: Lassa fever; viral hemorrhagic fever, survival, ribavari

Patients' Satisfaction With Care From Nigerian Federal Capital Territory's Public Secondary Hospitals: A Cross-Sectional Study.

BACKGROUND: Patients' satisfaction remains an important tool for evaluating quality of care in the emerging global trend of patient-centered care. AIM: To assess satisfaction with care received by patients at public secondary hospitals in Abuja, north central Nigeria. METHOD: We measured patients' satisfaction using structured questionnaire, and Cronbach α was used to assess consistency in item responses. A multivariate mixed-effects linear regression was fitted to identify factors influencing the overall satisfaction. RESULTS: All satisfaction domains tested were scored at "intermediate-positive levels" except for the "feeling being valued and appreciated as patients" domain that scored the least positive response level. On the overall, respondents rated the hospitals at high satisfaction level. There was a significant positive association between patients' satisfaction and careful listening of care providers; patients' perception of being valued and appreciated by the hospital staff (P = .003 and P = .001, respectively). CONCLUSION: Our findings suggest high satisfaction of care at public hospitals in Abuja Nigeria. Patients satisfaction survey should be integrated into hospital management planning and administration as part of quality improvement

Adherence to Artemisinin-based Combination Therapy for the Treatment of Malaria: A Systematic Review of the Evidence.

Increasing access to and targeting of artemisinin-based combination therapy (ACT) is a key component of malaria control programmes. To maximize efficacy of ACT and ensure adequate treatment outcomes, patient and caregiver adherence to treatment guidelines is essential. This review summarizes the current evidence base on ACT adherence, including definitions, measurement methods, and associated factors. A systematic search of the published literature was undertaken in November 2012 and updated in April 2013. Bibliographies of manuscripts were also searched and additional references identified. Studies were included if they involved at least one form of ACT and reported an adherence measurement. The search yielded 1,412 records, 37 of which were found to measure adherence to ACT. Methods to measure adherence focused on self-report, pill counts and bioassays with varying definitions for adherence. Most studies only reported whether medication regimens were completed, but did not assess how the treatment was taken by the patient (i.e. timing, frequency and dose). Adherence data were available for four different ACT formulations: artemether-lumefantrine (AL) (range 39-100%), amodiaquine plus artesunate (AQ + AS) (range 48-94%), artesunate plus sulphadoxine-pyrimethamine (AS + SP) (range 39-75%) and artesunate plus mefloquine (AS + MQ) (range 77-95%). Association between demographic factors, such as age, gender, education and socio-economic status and adherence to ACT regimens was not consistent. Some evidence of positive association between adherence and patient age, caregiver education levels, drug preferences, health worker instructions, patient/caregiver knowledge and drug packaging were also observed. This review highlights the weak evidence base on ACT adherence. Results suggest that ACT adherence levels varied substantially between study populations, but comparison between studies was challenging due to differences in study design, definitions, and methods used to measure adherence. Standardising methodologies for both self-report and bioassays used for evaluating adherence of different formulations across diverse contexts would improve the evidence base on ACT adherence and effectiveness; namely, specific and measurable definitions for adherence are needed for both methodologies. Additionally, further studies of the individual factors and barriers associated with non-adherence to ACT are needed in order to make informed policy choices and to improve the delivery of effective malaria treatment

Y Chromosome Lineages in Men of West African Descent

The early African experience in the Americas is marked by the transatlantic slave trade from ∼1619 to 1850 and the rise of the plantation system. The origins of enslaved Africans were largely dependent on European preferences as well as the availability of potential laborers within Africa. Rice production was a key industry of many colonial South Carolina low country plantations. Accordingly, rice plantations owners within South Carolina often requested enslaved Africans from the so-called “Grain Coast” of western Africa (Senegal to Sierra Leone). Studies on the African origins of the enslaved within other regions of the Americas have been limited. To address the issue of origins of people of African descent within the Americas and understand more about the genetic heterogeneity present within Africa and the African Diaspora, we typed Y chromosome specific markers in 1,319 men consisting of 508 west and central Africans (from 12 populations), 188 Caribbeans (from 2 islands), 532 African Americans (AAs from Washington, DC and Columbia, SC), and 91 European Americans. Principal component and admixture analyses provide support for significant Grain Coast ancestry among African American men in South Carolina. AA men from DC and the Caribbean showed a closer affinity to populations from the Bight of Biafra. Furthermore, 30–40% of the paternal lineages in African descent populations in the Americas are of European ancestry. Diverse west African ancestries and sex-biased gene flow from EAs has contributed greatly to the genetic heterogeneity of African populations throughout the Americas and has significant implications for gene mapping efforts in these populations

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Statistical analysis of childhood and early adolescent externalizing behaviors in a middle low income country

The article show the pattern of externalizing behavior across age, gender, school type, and school level, with reference to aggression, delinquency, and hyperactivity. The study samples were primary school pupils and secondary school students from three selected Local Government Areas (LGA) in Ogun State, Nigeria [Ado-Odo/Ota, Ifo, and Yewa South]. Their ages ranged from 10 to 20 years. The student/pupil sample was 1770 in all. The instrument used was an adapted version of Achenbach's child behavior checklist and youth self-report. Basic descriptive statistics like frequency, percentage, mean, standard deviation, as well as non-parametric statistics like Phi-coefficient, Chi-square, Goodman and Kruskal's gamma, Mann Whitney U test and Kruskal Wallis H test were utilized. Inferential parametric statistics like Pearson r, analysis of variance and simple regression were also utilized. Four major findings were reported. Firstly, the private schools irrespective of age, gender and level, scored higher than the public school in aggression, delinquency, and hyperactivity. Secondly, aggression is higher in secondary schools, while delinquency and hyperactivity are more prevalent in primary schools. Thirdly, school level and school type are the strongest predictors of externalizing behavior. Lastly, correspondence analysis showed a similar behavioral pattern for the three behaviors and three distinct behavioral patterns. i). Respondents aged 10 and below and those in primary schools (ii). Male, public and between 16 and 20. iii). Private, secondary, female and between 11 and 15. Implications of the study are discussed

Poor Acceptance Rate for Semen Donors to a Private Cryobank in Nigeria

A retrospective analysis of sixty one prospective donors who visited the cryobank in person from August 1999 to December 2001 was done. The study evaluated the acceptance rate of prospective semen donors and semen characteristics in order to assess the fertility potential of the supposedly normal population of young men. The outcome of the various screening processes – history taking, infection screening, blood grouping and Hb genotype assessment, semen analyses (pre-freeze and post-thaw), and post-quarantine (six months after production of last sample) infection – was analysed. Out of the 61 enquiries, 9 (14.8%) donors were recruited, 7 (77.8%) of whom were less than 25 years old. Fourteen (22.9%) donors had sperm concentrations greater than 60 × 106ml, 31 (50.8%) had motility greater than 60% and 17 (27.8%) had normal forms greater than 30%. Six (9.8%) of the donors were unable to masturbate and thus were disqualified, while only one donor (6.1%) failed to show up for a re-test after the completion of the quarantine period. Twenty one (38.2%) donors had low semen values based on the WHO reference value. We conclude that a high proportion of prospective semen donors may have sub-optimal semen parameters, and that using strict criteria, poor acceptance rates for donors is observed in a semen donation programme. (Afr J Reprod Health 2003; 7[1]: 12–16) Résumé Mauvais taux d\'acceptation des donneurs de la semence à une cryobanque privée au Nigéria. Une analyse retrospective a été faite de soixante-un donneurs prospectifs qui ont personnellement visité la cryobanque d\'août au décembre 2001. L\'étude a évalué le taux d\'acceptation des donneurs prospectifs de semence ainsi que des caractéristiques de la semence afin d\'évaluer le potentiel de fécondité de la soi-disant population des hommes. Les résultats des divers procès du dépistage – interrogations, dépistage de l\'injection, évaluation du groupe sanguin et du génotype Hb, analyses de semence (pre-congelé, post-décongelé) et l‘infection post-quarantaine (six mois après la production du dernier échantillon) ont été analysés. Soixante-et-un enquêtes, 9 (14,8%) donneurs ont été recrutés dont 7 (77,8%) avaient moins de 25 ans. Quartorze (22,9%) donneurs avaient une concentration de semence supérieure à 60 x 106ml. Trente-et-un (50,8%) avaient une motilité supérieures à 60% et 17 (22,8%) avaient de formes normales supérieures à 30%. Six (9,8%) donneurs ne pouvaient pas masturber et ont été, donc, rendu incapables de participer, alors qu\'un donneur (6,1%) ne s\'était pas présenté our un re-test à la fin de la période de quarantaine. Vingt-et-un (38,2%) donneurs avaient des indices bas de semence selon les indices de reference d\'OMS. Comme conclusion, nous affirmons qu\'une proportion élevée des donneurs prospectifs de semence auraient des paramètres sub-optimum de semence et qu\'à l\'aide de critères stricts, on constate des faibles taux d\'acceptation des donneurs dans un programme du don de remence. Key Words: Semen donors, cryobank, semen quality (Rev Afr Santé Reprod 2003; 7[1]: 12–16