MEDICINAL PLANTS USEFUL FOR MALARIA THERAPY IN OKEIGBO

There is increasing resistance of malaria parasites to chloroquine, the cheapest and commonly used drug for malaria in Nigeria. Artemisin, a product from medicinal plant indigenous to China, based on active principle of Artemisia annua, has been introduced into the Nigerian market. However not much has been done to project antimalaria properties of indigenous medicinal plants. This study thus, has the main objective of presenting medicinal plants used for malaria therapy in Okeigbo, Ondo State, South west Nigeria. Focus group discussions and interview were held about plants often found useful for malaria therapy in the community. Fifty species (local names) including for example: Morinda lucida (Oruwo), Enantia chlorantha (Awopa), Alstonia boonei (Ahun), Azadirachta indica (Dongoyaro) and Khaya grandifoliola (Oganwo) plants were found to be in use for malaria therapy at Okeigbo, Southwest, Nigeria . The parts of plants used could either be the barks, roots, leaves or whole plants. The recipes also, could be a combination of various species of plants or plant parts. This study highlights potential sources for the development of new antimalarial drugs from indigenous medicinal plants found in Okeigbo, Nigeria

Hypoglycaemic Effect of The Aqueous Extract of The Leaves of Allanblackia floribunda Oliv. (Guttiferae)

Background: Diabetes mellitus continues to present a major medical challenge despite the array of antidiabetic medicines on the market. The disorder is characterized by chronic hyperglycaemia and glycosuria. This study aims to study the hypoglycaemic potential of the aqueous extract of Allanblackia floribunda leaves in alloxan-induced diabetic rats.  Methods: In the study, 25 albino rats weighing between 180-200 g were divided into five groups of five animals each. Group 1 contained normal untreated rats, group 2 contained diabetic untreated rats, group 3 & 4 were diabetic rats treated with 50 and 25 mg/kg of the  aqueous extract of A. floribunda leaves respectively and group 5 contained diabetic rats treated with 0.5mg/kg glibenclamide for 15 days. Animals for the hypoglycaemic study were treated for two weeks post induction. Fasting blood glucose (FBG) levels were determined using the glucose oxidase method. FBG of the experimental animals were significantly reduced by A. floribunda. Results: A 72.5%  and 62.8% reduction in glucose level was observed for 50 mg/kg  and 25 mg/kg dose of A. floribunda while a 71.8% reduction was noted for 0.5 mg/kg glibenclamide. Hence, 50 mg/kg dose of the aqueous extract was as potent as 0.5 mg/kg glibenclamide in inducing hypoglycaemia. Pre-treatment of the animals with the extracts for two weeks resulted in a significant lowering of the fasting blood glucose level of the animals pre-incubation and significantly reduced the effect of alloxan on FBG levels of the animals. Phytochemical screening of the aqueous leaf extract revealed the presence of tannins, flavonoids, terpenoids, saponins, cardiac glycosides, alkaloids, steroids and anthraquinones. Conclusion: This study has demonstrated the potential of the aqueous extract of A. floribunda as both a hypoglycaemic agent and suggests that the extract may have a protective effect against the development of  diabetes

Seasonal variation in mortality secondary to acute myocardial infarction in England and Wales: a secondary data analysis.

BACKGROUND: Acute myocardial infarction (AMI) is a leading cause of death globally. Increase in AMI mortality during winter has also been identified in existing literature. This has been associated with low outdoor and indoor temperatures and increasing age. The relationship between AMI and other factors such as gender and socioeconomic factors varies from study to study. Influenza epidemics have also been identified as a contributory factor. OBJECTIVE: This paper aims to illustrate the seasonal trend in mortality due to AMI in England and Wales with emphasis on excess winter mortality (EWM). METHODS: Monthly mortality rates per 10 000 population were calculated from data provided by the UK Office for National Statistics (ONS) for 1997-2005. To quantify the seasonal variation in winter, the EWM estimates (EWM, EWM ratio, Excess Winter Mortality Index) for each year were calculated. Negative binomial regression model was used to estimate the relationship between increasing age and EWM. RESULTS: The decline in mortality rate for AMI was 6.8% yearly between August 1997 and July 2005. Significant trend for reduction in AMI-associated mortality was observed over the period (p<0.001). This decline was not seen with EWM (p<0.001). 17% excess deaths were observed during winter. This amounted to about 20 000 deaths over the 8-year period. Increasing winter mortality was seen with increasing age for AMI. CONCLUSION: EWM secondary to AMI does occur in England and Wales. Excess winter deaths due to AMI have remained high despite decline in overall mortality. More research is needed to identify the relationship of sex, temperature, acclimatisation, vitamin D and excess winter deaths due to AMI

Proceedings of the 39th Annual Scientific Conference of The Association of Public Health Physicians of Nigeria

No Abstract

Prevalence of surgically correctable conditions among children in a mixed urban-rural community in Nigeria using the SOSAS survey tool:Implications for paediatric surgical capacity-building

BackgroundIn many low- and middle-income countries, data on the prevalence of surgical diseases have been derived primarily from hospital-based studies, which may lead to an underestimation of disease burden within the community. Community-based prevalence studies may provide better estimates of surgical need to enable proper resource allocation and prioritization of needs. This study aims to assess the prevalence of common surgical conditions among children in a diverse rural and urban population in Nigeria.MethodsDescriptive cross-sectional, community-based study to determine the prevalence of congenital and acquired surgical conditions among children in a diverse rural-urban area of Nigeria was conducted. Households, defined as one or more persons 'who eat from the same pot' or slept under the same roof the night before the interview, were randomized for inclusion in the study. Data was collected using an adapted and modified version of the interviewer-administered questionnaire-Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool and analysed using the REDCap web-based analytic application.Main resultsEight-hundred-and-fifty-six households were surveyed, comprising 1,883 children. Eighty-one conditions were identified, the most common being umbilical hernias (20), inguinal hernias (13), and wound injuries to the extremities (9). The prevalence per 10,000 children was 85 for umbilical hernias (95% CI: 47, 123), and 61 for inguinal hernias (95% CI: 34, 88). The prevalence of hydroceles and undescended testes was comparable at 22 and 26 per 10,000 children, respectively. Children with surgical conditions had similar sociodemographic characteristics to healthy children in the study population.ConclusionThe most common congenital surgical conditions in our setting were umbilical hernias, while injuries were the most common acquired conditions. From our study, it is estimated that there will be about 2.9 million children with surgically correctable conditions in the nation. This suggests an acute need for training more paediatric surgeons

A population-based estimation of maternal mortality in Lagos State, Nigeria using the indirect sisterhood method.

BACKGROUND: Pregnancy and delivery deaths represent a risk to women, particularly those living in low- and middle-income countries (LMICs). This population-based survey was conducted to provide estimates of the maternal mortality ratio (MMR) in Lagos Nigeria. METHODS: A community-based, cross-sectional study was conducted in mapped Wards and Enumeration Areas (EA) of all Local Government Areas (LGAs) in Lagos, among 9,986 women of reproductive age (15-49 years) from April to August 2022 using a 2-stage cluster sampling technique. A semi-structured, pre-tested questionnaire adapted from nationally representative surveys was administered using REDCap by trained field assistants for data collection on socio-demographics, reproductive health, fertility, and maternal mortality. Data were analysed using SPSS and MMR was estimated using the indirect sisterhood method. Ethical approval was obtained from the Lagos State University Teaching Hospital Health Research and Ethics Committee. RESULTS: Most of the respondents (28.7%) were aged 25-29 years. Out of 546 deceased sisters reported, 120 (22%) died from maternal causes. Sisters of the deceased aged 20-24 reported almost half of the deaths (46.7%) as due to maternal causes, while those aged 45-49 reported the highest number of deceased sisters who died from other causes (90.2%). The total fertility rate (TFR) was calculated as 3.807, the Lifetime Risk (LTR) of maternal death was 0.0196 or 1-in-51, and the MMR was 430 per 100,000 [95% CI: 360-510]. CONCLUSION: Our findings show that the maternal mortality rate for Lagos remains unacceptable and has not changed significantly over time in actual terms. There is need to develop and intensify community-based intervention strategies, programs for private hospitals, monitor MMR trends, identify and contextually address barriers at all levels of maternal care

Preparation and use of plant medicines for farmers' health in Southwest Nigeria: socio-cultural, magico-religious and economic aspects

Agrarian rural dwellers in Nigeria produce about 95% of locally grown food commodities. The low accessibility to and affordability of orthodox medicine by rural dwellers and their need to keep healthy to be economically productive, have led to their dependence on traditional medicine. This paper posits an increasing acceptance of traditional medicine country-wide and advanced reasons for this trend. The fact that traditional medicine practitioners' concept of disease is on a wider plane vis-à-vis orthodox medicine practitioners' has culminated in some socio-cultural and magico-religious practices observed in preparation and use of plant medicines for farmers' health management. Possible scientific reasons were advanced for some of these practices to show the nexus between traditional medicine and orthodox medicine. The paper concludes that the psychological aspect of traditional medicine are reflected in its socio-cultural and magico-religious practices and suggests that government should fund research into traditional medicine to identify components of it that can be integrated into the national health system

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Pattern of Medical Waste Management in Secondary Health Facilities of Lagos State.

Background: Waste or by-products generated during the process of health-care activities (diagnosis, treatment, immunization, production or testing of biologicals) from hospitals, laboratories, research centres and blood banks are referred to as medical waste. Medical waste management (MWM) involves waste segregation, colourcoding, storage, transportation, treatment and disposal practices.Objective: This study assessed the pattern of MWM in secondary health facilities in Lagos State.Methods: A descriptive cross sectional study of 106 secondary health facilities selected using a multi-stage sampling method. Quantitative and qualitative data was collected using interviewer-administered questionnaire and an observational checklist. The data was analysed using Epi-info 2002. Fisher's exact test was used to determine association between dependent and independent variables. Level of significance was set at 5%.Results: Seventy-three (68.9%) of the health facilities segregated medical waste at source, larger health facilities were more likely to segregate wastes (p=0.002) and 95.3% stored their waste for more than 48 hours. In all of the health facilities gloves were used while 31.1% used masks as personal protective devices when handling waste. Lagos State Waste Management Authority medical unit was responsible for transporting medical waste out in 89.6% of the health facilities. Only 6.6% of the storage process was according to the World Health Organization guidelines.Conclusion: Secondary health facilities in Lagos state did not comply with the WHO guidelines as regards segregation, transportation, treatment and off-site disposal. MWM needs to be improved to ensure a safe and sustainable system in Lagos State.Keywords: Medical waste, Waste management, Health care waste

Diabetes mellitus: Identifying the knowledge gaps and risk factors among adolescents attending a public school in Lagos State

Background: The prevalence of diabetes mellitus (DM), a noncommunicable disease (NCD) in adolescents, is on the rise worldwide; therefore, knowledge which facilitates prevention and early detection is important. The objective of this study was to determine the knowledge of DM and self-reported risk factors among adolescents in a senior secondary school, in Surulere, Lagos State. Methodology: This was a cross-sectional descriptive study of 144 male and 106 female senior secondary students with a mean age of 15.2 ΁ 1.3 years. Respondents were selected through multistage sampling technique. A structured pretested questionnaire was used to collect data. Epi Info 7.1.5 was used for data analysis and the level of statistical significance was set at 5%. Results obtained were presented with the use of frequency tables. Results: Two out of three respondents had heard of DM. Among those who were aware of the condition, 64.9% knew it referred to abnormally high blood glucose. Only (10.9%) knew it was a lifelong condition and less than a third (26.7%) knew the measurement of blood glucose with a device for the screening test. Less than 30% considered obesity, family history, diet, and physical inactivity as risk factors. Their main source of information was the mass media. Overall, 46% of respondents had good knowledge of DM. As regards the presence of lifestyle behavior/risk factor for DM/NCDs in the respondents, 8.4% of the respondents had a family history of DM, had consumed alcohol (28.8%), smoked tobacco (4.8%), and were overweight/obese (5.2%). Conclusion: Two-thirds were aware of DM, of which over half had inadequate knowledge of DM despite the existence of some risk factors. There should, therefore, be an inclusion of NCD education in the curriculum of secondary school students