Seroprevalence and determinants of Helicobacter pylori infection among asymptomatic under-five children at a Tertiary Hospital in the South-Western region of Nigeria

Background: The epidemiology of Helicobacter pylori (H. pylori) infection among under-five children in the South West Nigeria remains largely understudied. There is no data on the subject from the study area.Objectives: This study was conducted to assess the seroprevalence of H. pylori infection among under-five children at a tertiary hospital in the South Western, Nigeria and to determine its associated socio-demographic factors.Methods: Sera of 360 children were analyzed for anti H. pylori Ig G using enzyme linked immunosorbent assay test kit (BQ ELISA Ig G KIT) and H. pylori infection risk factors were determined. Determinants of H. pylori infection was determined using binary logistic regression analysis and p-values < 0.05 were taken as statistically significant.Results: H. pylori infection seroprevalence rate was 32.8% and increased with age. Living in one room accommodation, large families, playing with soil, family history of dyspepsia, practice of premastication, sharing of plates and cutlery, and water closet toilet were associated with H. pylori Ig G seropositivity (p<0.05) on binary regression analysis.Conclusion: The seroprevalence of H. pylori infection in under -five children is high, increasing as the age of the children increased. This may suggest that instituting preventive measures at young age, targeting identified factors may be effective in reducing the burden of H. pylori infection.Keywords: Helicobacter pylori, South-Western Nigeria

Socio-demographic correlates of childhood malnutrition in a rural community in Southwest Nigeria - A call for targeted interventions for vulnerable children

BACKGROUND: Nigeria has the second-highest burden of stunted children globally. Yet, only two out of ten malnourished Nigerian children benefit from intervention programs to address malnutrition. This study describes some socio-demographic factors associated with malnutrition among children living in a rural community in Southwest Nigeria. METHODS: This study was a community-based cross-sectional study involving 364 children randomly selected from their homes aged 1–15 years. Factors such as socioeconomic status, birth order, and whether the mother was alive were obtained. Weights, heights, and body mass index (BMI) were measured and interpreted using the WHO z-scores. Chi-squared test of associations was used for categorical variables and an independent t-test was used to compare the mean BMI between both genders. The level of significance was set at a p-value <0.050. RESULTS: There were 185 (51%) females: 173(48%) belonged to the age group 1–5 years and 168 (46%) belonged to the lower socio-economic class. Over 80% of the participants had normal nutritional status: 19 (6%) were underweight, 36 (10%) were stunted, and 29 (8%) were thin (low BMI, <-2SD). Maternal demise was associated with thinness. Males from lower socio-economic classes and first-born males had a higher mean BMI than the females (p<0.050). CONCLUSION: Although malnutrition prevalence was low, there is a need to use targeted interventions to further reduce malnutrition among vulnerable children. There is also a necessity for more studies to identify and address the risk factors for stunting in the study area

Seroprevalence and determinants of Helicobacter pylori infection among asymptomatic under-five children at a Tertiary Hospital in the South-Western region of Nigeria

Background: The epidemiology of Helicobacter pylori (H. pylori) infection among under-five children in the South West Nigeria remains largely understudied. There is no data on the subject from the study area. Objectives: This study was conducted to assess the seroprevalence of H. pylori infection among under-five children at a tertiary hospital in the South Western, Nigeria and to determine its associated socio-demographic factors. Methods: Sera of 360 children were analyzed for anti H. pylori Ig G using enzyme linked immunosorbent assay test kit (BQ ELISA Ig G KIT) and H. pylori infection risk factors were determined. Determinants of H. pylori infection was determined using binary logistic regression analysis and p-values < 0.05 were taken as statistically significant. Results: H. pylori infection seroprevalence rate was 32.8% and increased with age. Living in one room accommodation, large families, playing with soil, family history of dyspepsia, practice of premastication, sharing of plates and cutlery, and water closet toilet were associated with H. pylori Ig G seropositivity (p<0.05) on binary regression analysis. Conclusion: The seroprevalence of H. pylori infection in under -five children is high, increasing as the age of the children increased. This may suggest that instituting preventive measures at young age, targeting identified factors may be effective in reducing the burden of H. pylori infection. DOI: https://dx.doi.org/10.4314/ahs.v19i2.32 Cite as: Babatola AO, Akinbami FO, Adeodu OO, Ojo TO, Efere MO, Olatunya OS. Sero-prevalence and determinants of Helicobacter pylori infection among asymptomatic under-five children at a tertiary hospital in the South-Western region of Nigeria. Afri Health Sci.2019;19(2): 2082-2090. https://dx.doi.org/10.4314/ahs.v19i2.3

Paediatric brought-in-dead at a tertiary health facility in South western Nigeria: Patterns and drivers

Background: ‘Brought- in-dead’ (BID) refers to the demise of an individual before presentation to a health facility. This study assessed the pattern of paediatric BID cases seen at a tertiary health facility in southwest Nigeria. Method: A cross-sectional, descriptive study was done at the Children Emergency Ward (CEW) of the hospital between January 2014 and December 2018. The patterns of BID cases and presumed causes of death were determined using a standardized checklist adapted from the WHO verbal autopsy instrument. Results: Ninety-eight BID cases were seen during the study, constituting 2.5% of total patients seen during the period. The median (IQR) age of cases was 24.0 (8.75 – 63.0) months and 72.4% were under-fives. Most had symptoms related to the haematologic (36.7%), respiratory (24.5%) or digestive (20.4%) systems. Severe anaemia 31(31.6%), gastroenteritis 19 (19.4) and aspiration 17 (17.3%) were the most common causes of death. The median (IQR) duration of illness before presentation was 3.0 (1.0 – 7.0) days but most presented from 4 – 7 days of illness. A significant relationship was found between the duration of illness and whether or not pre-hospital treatment was received (p < 0.0001). Unprescribed drugs purchased over the counter were the most commonly used treatment in 79.1% of cases (p < 0.0001). Conclusion: This study has highlighted the prevalence and pattern of paediatric BID in a tertiary health facility in southwest Nigeria and the factors that were associated with it. More efforts need to be geared towards community sensitization and pediatric health care to prevent factors drivingits menace

Addressing antimicrobial resistance in Nigerian hospitals : exploring physicians prescribing behavior, knowledge, and perception of antimicrobial resistance and stewardship programs

Introduction: We assessed the knowledge of, attitude toward antimicrobial resistance (AMR) and practice of antimicrobial stewardship (AMS) among physicians in Nigeria to provide future guidance to the Nigerian National Action Plan for AMR. Methods: A descriptive cross-sectional questionnaire-based study explored the physicians’ self-reported practice of antibiotic prescribing, knowledge, attitude, and practice of AMR and components of ASPs. Results: The majority (217; 67.2%) of respondents prescribed antibiotics daily in their clinical practice AMR was recognized as a global and local problem by 308 (95.4%) and 262 (81.1%) respondents, respectively. Only 91 (28.2%) of respondents have ever heard of antibiotic stewardship. The median AMR knowledge score was 40 (19–45)out of 45while that for ASP was 46.0(32–57) out of 60. There was significant statistical difference between the ASP median scores among the medical specialties category (P value <0.0001) More respondents had good knowledge of AMR than ASPs (82.7% versus 36.5%; p < 0.0001). Conclusion: Respondents in this study were more knowledgeable about AMR than AMS and its core components

Ideal Male-Oriented Sexual and Reproductive Health Services Delivery: A Qualitative Study of Men and Healthcare Providers’ Perspective from Nigeria

INTRODUCTION: The global burden of Sexual and Reproductive Health (SRH) problems has remained a significant challenge to the wellbeing of men and limits the effectiveness of SRH interventions for females. This study explored men and healthcare providers’ perception of ideal male-oriented Sexual and Reproductive Health (SRH) services. METHODS: This was an exploratory qualitative study involving three focus group discussions among men in selected communities and eight interviews among healthcare service providers in Ekiti State, Nigeria. Focus Group Discussion (FGD) and Key Informant Interview (KII) guides were used to collect qualitative data from twenty-six men and eight healthcare service providers, respectively. Participants for the study were selected from three different units of the selected hospital and twelve communities. Data were sorted, transcribed, and analyzed using Atlas ti software. Inductive-deductive thematic analysis was performed. RESULTS: Three main themes emerged from the study: (a) ideal men-oriented SRH service provision within a unit specially made and named after men, (b) 24-hour daily SRH clinic and (c) locating SRH Clinic in the healthcare institutions with outlets in the communities and schools. The participants identified primary needs as SRH organs assessments; screening services; family planning services; and education and counselling on prevention and treatment of male SRH problems. CONCLUSION: Men have SRH service preferences that focused on preventive and therapeutic sexual and reproductive health needs that are desired to be male-oriented, dedicated and provided in health facilities with public outlets

Incidence of Catastrophic Health Expenditures Amongst Hospitalized Neonates in Ekiti, Southwest Nigeria.

Background: Neonatal illnesses require huge spending due to prolonged hospital stay. The management of these illnesses is usually financed by individual families which in most instances are living below the poverty line. This healthcare financing method can readily push families into catastrophic spending on health. Aim: To ascertain the average cost of managing common neonatal illnesses and the financial burden, it constitutes to families in Ekiti State, southwest Nigeria. Methods: We conducted a cross-sectional study on the out-of-pocket spending involved in managing neonates admitted into and discharged from the SCBU of the Ekiti State University Teaching Hospital, Ado-Ekiti, southwest Nigeria. Data collected included the monthly family income, the money spent on drugs, laboratory investigations and the hospital bill using a purposely designed structured questionnaire. Healthcare spending greater than 10% of the overall family income was described as catastrophic health spending (CHS). Results: The medical bills for most (95%) of the 119 study participants were paid through the out-of-pocket means and 81.5% of the families spent more than 10% of their monthly earnings (CHS) to settle medical bills. Close to 50% of the families belonged to the lower social economic class. The median (IQR) duration of hospital stay was 2.75 days (3.0-8.0). The median (IQR) total expenditure was N24,500.00 (N13,615.00-N41,487.50). The median (IQR) expenditure for the treatment of prematurity was highest at N55,075.00 (USD 133.10) [N27,350.00 (USD 66.10)-N105,737.50 (USD 255.53)] and more than 60.5% of the expenses was on hospital utilities and consumables. The length of hospital stay showed a robust positive correlation with the total hospital bill (r = 0.576, P < 0.001). Conclusion: Neonatal illnesses put many households at risk of catastrophic health spending. There is need for increased government investment in health and extension of the health insurance scheme to all the citizens of the country

Occupational exposure to HIV and use of post-exposure prophylaxis in a general hospital in North Central, Nigeria.

Occupational exposures to blood borne pathogens including HIV have been well studied. However, limited studies exist about the utilization of post exposure prophylaxis and follow-up in Nigeria. The objectives of the study were to describe the characteristics of occupational exposure to HIV, the utilization of post exposure prophylaxis (PEP) among health workers, and the proportion of exposed health workers reporting for follow-up three months after exposure. A cross sectional descriptive study involving ninety three health workers was carried out at a general hospital located in an urban area in North Central zone of Nigeria. A simple random sampling technique was used. The prevalence of occupational exposure, utilization of post exposure prophylaxis and follow-up rate were assessed using self administered questionnaire. Data analysis was done using SPSS version 16 and descriptive analysis was carried out. It was reported that, 73.1% of respondents at least one or more occupational exposures to HIV and other blood borne pathogens through accidental needle injury/prick, blood splash on a fresh wound or conjunctiva exposure in the last one year. Needle stick injury occurred in 83.8% of all respondents who had occupational exposures. 8.8% of exposed respondents commenced post exposure prophylaxis with two-thirds completing the post exposure prophylaxis regimen. Only one (25%) of those who completed the regimen reported for follow-up. Occupational exposures to HIV are common among health workers. The rates of utilization of post exposure prophylaxis and follow-up were low. &nbsp; DOI: http://dx.doi.org/10.3126/ijosh.v3i1.6635 &nbsp; International Journal of Occupational Safety and Health, Vol 3 No 1 (2013) 11-1