Challenges of urban housing quality and its associations with neighbourhood environments: Insights and exepriences of Ibadan City, Nigeria

A survey of housing quality and neighbourhood environments of Ibadan City, Nigeria was conducted to evaluate the housing infrastructure and to identify those areas where there is a likelihood of future incidences of disease and epidemics. Based on existing demographic and land use characteristics, the city can be divided into high, medium and low-density zones. Penalty scoring, rather than positive scoring, was used to assess the conditions and quality of houses and the neighbourhood environment in each of the zones.Houses in the high-density area have the worst property and environmental characteristics followed by houses in the medium-density area. Based on housing condition alone, approximately half of all the dwellings surveyed (n = 172) in the three zones are categorised as either substandard or unfit for human habitation. Based on neighbourhood environment, none of the high and medium-density housing areas and only one of the low density areas attained the good-scoring grade. This is attributed in part to many residents being polygamists which means the houses are overcrowded with perhaps up to eight persons per room and to tenant abuse by internal conversion to increase the occupancy rate. More than half of the houses surveyed have at least or more major defect.Recommendations include government directed infrastructure improvements; a regeneration-drive by private investors with possible displacement of residents fromthe high-density zone to new towns; a vigorous programme of housing and health education; enhanced collaboration between stakeholders to develop enforceable standards for existing housing stock and future builds

Multi-site calibration and validation of SWAT with satellite-based evapotranspiration in a data-sparse catchment in southwestern Nigeria

The main objective of this study was to calibrate and validate the eco-hydrological model Soil and Water Assessment Tool (SWAT) with satellite-based actual evapotranspiration (AET) data from the Global Land Evaporation Amsterdam Model (GLEAM_v3.0a) and from the Moderate Resolution Imaging Spectroradiometer Global Evaporation (MOD16) for the Ogun River Basin (20&thinsp;292&thinsp;km2) located in southwestern Nigeria. Three potential evapotranspiration (PET) equations (Hargreaves, Priestley–Taylor and Penman–Monteith) were used for the SWAT simulation of AET. The reference simulations were the three AET variables simulated with SWAT before model calibration took place. The sequential uncertainty fitting technique (SUFI-2) was used for the SWAT model sensitivity analysis, calibration, validation and uncertainty analysis. The GLEAM_v3.0a and MOD16 products were subsequently used to calibrate the three SWAT-simulated AET variables, thereby obtaining six calibrations–validations at a monthly timescale. The model performance for the three SWAT model runs was evaluated for each of the 53 subbasins against the GLEAM_v3.0a and MOD16 products, which enabled the best model run with the highest-performing satellite-based AET product to be chosen. A verification of the simulated AET variable was carried out by (i) comparing the simulated AET of the calibrated model to GLEAM_v3.0b AET, which is a product that has different forcing data than the version of GLEAM used for the calibration, and (ii) assessing the long-term average annual and average monthly water balances at the outlet of the watershed. Overall, the SWAT model, composed of the Hargreaves PET equation and calibrated using the GLEAM_v3.0a data (GS1), performed well for the simulation of AET and provided a good level of confidence for using the SWAT model as a decision support tool. The 95&thinsp;% uncertainty of the SWAT-simulated variable bracketed most of the satellite-based AET data in each subbasin. A validation of the simulated soil moisture dynamics for GS1 was carried out using satellite-retrieved soil moisture data, which revealed good agreement. The SWAT model (GS1) also captured the seasonal variability of the water balance components at the outlet of the watershed. This study demonstrated the potential to use remotely sensed evapotranspiration data for hydrological model calibration and validation in a sparsely gauged large river basin with reasonable accuracy. The novelty of the study is the use of these freely available satellite-derived AET datasets to effectively calibrate and validate an eco-hydrological model for a data-scarce catchment.</p

Non-communicable airway disease and air pollution in three African Countries: Benin, Cameroon and The Gambia

Air pollution exposure can increase the risk of development and exacerbation of chronic airway disease (CAD). We set out to assess CAD patients in Benin, Cameroon and The Gambia and to compare their measured exposures to air pollution. We recruited patients with a diagnosis of CAD from four clinics in the three countries. We collected epidemiological, spirometric and home air pollution data. Of the 98 adults recruited, 56 were men; the mean age was 51.6 years (standard deviation ±17.5). Most (69%) patients resided in cities and ever smoking was highest in Cameroon (23.0%). Cough, wheeze and shortness of breath were reported across the countries. A diagnosis of asthma was present in 74.0%; 16.3% had chronic obstructive pulmonary disease and 4.1% had chronic bronchitis. Prevalence of airflow obstruction was respectively 77.1%, 54.0% and 64.0% in Benin, Cameroon, and Gambia. Across the sites, 18.0% reported >5 exacerbations. The median home particulate matter less than 2.5 μm in diameter (PM2.5) was respectively 13.0 μg/m3, 5.0 μg/m3 and 4.4 μg/m3. The median home carbon monoxide (CO) exposures were respectively 1.6 parts per million (ppm), 0.3 ppm and 0.4 ppm. Home PM2.5 differed significantly between the three countries (P < 0.001) while home CO did not. Based on these results, preventive programmes should focus on ensuring proper spirometric diagnosis, good disease control and reduction in air pollution exposure

Microbiological testing of adults hospitalised with community-acquired pneumonia: An international study

This study aimed to describe real-life microbiological testing of adults hospitalised with community-acquired pneumonia (CAP) and to assess concordance with the 2007 Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) and 2011 European Respiratory Society (ERS) CAP guidelines. This was a cohort study based on the Global Initiative for Methicillin-resistant Staphylococcus aureus Pneumonia (GLIMP) database, which contains point-prevalence data on adults hospitalised with CAP across 54 countries during 2015. In total, 3702 patients were included. Testing was performed in 3217 patients, and included blood culture (71.1%), sputum culture (61.8%), Legionella urinary antigen test (30.1%), pneumococcal urinary antigen test (30.0%), viral testing (14.9%), acute-phase serology (8.8%), bronchoalveolar lavage culture (8.4%) and pleural fluid culture (3.2%). A pathogen was detected in 1173 (36.5%) patients. Testing attitudes varied significantly according to geography and disease severity. Testing was concordant with IDSA/ATS and ERS guidelines in 16.7% and 23.9% of patients, respectively. IDSA/ATS concordance was higher in Europe than in North America (21.5% versus 9.8%; p&lt;0.01), while ERS concordance was higher in North America than in Europe (33.5% versus 19.5%; p&lt;0.01). Testing practices of adults hospitalised with CAP varied significantly by geography and disease severity. There was a wide discordance between real-life testing practices and IDSA/ATS/ERS guideline recommendations

Prevalence and etiology of community-acquired pneumonia in immunocompromised patients

Background. The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia. Methods. We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor. Results. At least 1 risk factor for immunocompromise was recorded in 18% of the 3702 patients enrolled. The prevalences of risk factors significantly differed across continents and countries, with chronic steroid use (45%), hematological cancer (25%), and chemotherapy (22%) the most common. Among immunocompromised patients, community-acquired pneumonia (CAP) pathogens were the most frequently identified, and prevalences did not differ from those in immunocompetent patients. Risk factors for immunocompromise were independently associated with neither Pseudomonas aeruginosa nor non\u2013community-acquired bacteria. Specific risk factors were independently associated with fungal infections (odds ratio for AIDS and hematological cancer, 15.10 and 4.65, respectively; both P = .001), mycobacterial infections (AIDS; P = .006), and viral infections other than influenza (hematological cancer, 5.49; P < .001). Conclusions. Our findings could be considered by clinicians in prescribing empiric antibiotic therapy for CAP in immunocompromised patients. Patients with AIDS and hematological cancer admitted with CAP may have higher prevalences of fungi, mycobacteria, and noninfluenza viruses

Burden and risk factors for Pseudomonas aeruginosa community-acquired pneumonia:a Multinational Point Prevalence Study of Hospitalised Patients

Pseudornonas aeruginosa is a challenging bacterium to treat due to its intrinsic resistance to the antibiotics used most frequently in patients with community-acquired pneumonia (CAP). Data about the global burden and risk factors associated with P. aeruginosa-CAP are limited. We assessed the multinational burden and specific risk factors associated with P. aeruginosa-CAP. We enrolled 3193 patients in 54 countries with confirmed diagnosis of CAP who underwent microbiological testing at admission. Prevalence was calculated according to the identification of P. aeruginosa. Logistic regression analysis was used to identify risk factors for antibiotic-susceptible and antibiotic-resistant P. aeruginosa-CAP. The prevalence of P. aeruginosa and antibiotic-resistant P. aeruginosa-CAP was 4.2% and 2.0%, respectively. The rate of P. aeruginosa CAP in patients with prior infection/colonisation due to P. aeruginosa and at least one of the three independently associated chronic lung diseases (i.e. tracheostomy, bronchiectasis and/or very severe chronic obstructive pulmonary disease) was 67%. In contrast, the rate of P. aeruginosa-CAP was 2% in patients without prior P. aeruginosa infection/colonisation and none of the selected chronic lung diseases. The multinational prevalence of P. aeruginosa-CAP is low. The risk factors identified in this study may guide healthcare professionals in deciding empirical antibiotic coverage for CAP patients

Clinical standards for the diagnosis and management of asthma in low- and middle-income countries

BACKGROUND: The aim of these clinical standards is to aid the diagnosis and management of asthma in low-resource settings in low- and middle-income countries (LMICs). METHODS: A panel of 52 experts in the field of asthma in LMICs participated in a two-stage Delphi process to establish and reach a consensus on the clinical standards. RESULTS: Eighteen clinical standards were defined: Standard 1, Every individual with symptoms and signs compatible with asthma should undergo a clinical assessment; Standard 2, In individuals (&gt;6 years) with a clinical assessment supportive of a diagnosis of asthma, a hand-held spirometry measurement should be used to confirm variable expiratory airflow limitation by demonstrating an acute response to a bronchodilator; Standard 3, Pre- and post-bronchodilator spirometry should be performed in individuals (&gt;6 years) to support diagnosis before treatment is commenced if there is diagnostic uncertainty; Standard 4, Individuals with an acute exacerbation of asthma and clinical signs of hypoxaemia or increased work of breathing should be given supplementary oxygen to maintain saturation at 94–98%; Standard 5, Inhaled short-acting beta-2 agonists (SABAs) should be used as an emergency reliever in individuals with asthma via an appropriate spacer device for metered-dose inhalers; Standard 6, Short-course oral corticosteroids should be administered in appropriate doses to individuals having moderate to severe acute asthma exacerbations (minimum 3–5 days); Standard 7, Individuals having a severe asthma exacerbation should receive emergency care, including oxygen therapy, systemic corticosteroids, inhaled bronchodilators (e.g., salbutamol with or without ipratropium bromide) and a single dose of intravenous magnesium sulphate should be considered; Standard 8, All individuals with asthma should receive education about asthma and a personalised action plan; Standard 9, Inhaled medications (excluding dry-powder devices) should be administered via an appropriate spacer device in both adults and children. Children aged 0–3 years will require the spacer to be coupled to a face mask; Standard 10, Children aged &lt;5 years with asthma should receive a SABA as-needed at step 1 and an inhaled corticosteroid (ICS) to cover periods of wheezing due to respiratory viral infections, and SABA as-needed and daily ICS from step 2 upwards; Standard 11, Children aged 6–11 years with asthma should receive an ICS taken whenever an inhaled SABA is used; Standard 12, All adolescents aged 12–18 years and adults with asthma should receive a combination inhaler (ICS and rapid onset of action long-acting beta-agonist [LABA] such as budesonide-formoterol), where available, to be used either as-needed (for mild asthma) or as both maintenance and reliever therapy, for moderate to severe asthma; Standard 13, Inhaled SABA alone for the management of patients aged &gt;12 years is not recommended as it is associated with increased risk of morbidity and mortality. It should only be used where there is no access to ICS. The following standards (14–18) are for settings where there is no access to inhaled medicines. Standard 14, Patients without access to corticosteroids should be provided with a single short course of emergency oral prednisolone; Standard 15, Oral SABA for symptomatic relief should be used only if no inhaled SABA is available. Adjust to the individual’s lowest beneficial dose to minimise adverse effects; Standard 16, Oral leukotriene receptor antagonists (LTRA) can be used as a preventive medication and is preferable to the use of long-term oral systemic corticosteroids; Standard 17, In exceptional circumstances, when there is a high risk of mortality from exacerbations, low-dose oral prednisolone daily or on alternate days may be considered on a case-by-case basis; Standard 18. Oral theophylline should be restricted for use in situations where it is the only bronchodilator treatment option available. CONCLUSION: These first consensus-based clinical standards for asthma management in LMICs are intended to help clinicians provide the most effective care for people in resource-limited settings

DERIVATION OF EQUATIONS TO PREDICT SHEAR STRESS AND EROSION RATE OF GULLY EROSION SITE IN OGUN STATE, SOUTH WESTERN, NIGERIA

The serious effects of erosion constitute a real environmental challenge that should not be underestimated. This study investigated the functional relationships of shear stress, discharge, channel characteristics and erosion rate estimation models. The length, depth and width of the channel were measured and other hydraulic parameters were derived from the measurements. The shear stress Ï„ is taken as the important factor measuring the power of the flow to discharge the sediment. Simple regression analysis was applied to the three computed values of shear stress, Ï„, discharge Q and erosion rate E according to their functional relationships. The predicted values were subjected to scatter plot and various trend lines and equations were obtained. The results of this study indicate that there was an explanatory independent variable for discharge in predicting shear stress with a coefficient of determination r2=85% and also the results of erosion rate prediction of r2 of 97% and 99% respectively. The equations established for shear stress and erosion rate prediction are power and 3rd degree polynomial equation that can be useful and essential to the development of sound sediment management plans and formulation of policies

Prediction of mean annual flood (MAF) for ogun drainagebasin, Southwestern Nigeria

(Global Journal of Pure and Applied Sciences: 2002 9(1): 13-18