Mycobacterial Species Identification and Public Health Implications of Tuberculosis Among Nomadic Pastoralists in Three Local Governments of Plateau State, North Central Nigeria

Bovine and human tuberculosis is endemic in Nigeria, and apart from meat inspection at the abattoir, which is not very effective, no control measures are currently practiced against the disease in Nigerian livestock. A study was conducted to determine the level of awareness and knowledge of the public health implications of tuberculosis among pastoralists in some selected Local Government Areas of Plateau State. Majority of the respondents in the study area were aware of tuberculosis and they consumed both raw and boiled milk. However, despite their knowledge of tuberculosis, very few of them vaccinate their children against the disease. Five persons admitted being infected with tuberculosis and 3 (three) of these five were receiving treatment as at the time of questionnaire administration. Smear microscopy and deletion analyses were deployed to detect Mycobacterium species. All specimens were however negative by both techniques. Keywords: Tuberculosis, Nomadic, Cattle, Pastoralists, AwarenessNigerian Veterinary Journal, VOL:32 (4) 321-33

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

The use of Deletion Analysis in the Detection of Mycobacterium bovis, Mycobacteium tuberculosis and Mycobacterium africanum among Slaughtered Cattle in Plateau State, North Central Nigeria.

Bovine and human tuberculosis is endemic in Nigeria and apart from meat inspection at the abattoir, which is not very effective, no control measures are currently practiced against the disease in Nigerian livestock. A total of 3381slaughtered cattle were examined for tuberculous lesions in the study area. Of these, 150 (4.4%) animals showed lesions typical of tuberculosis and 124 (3.7%) were acid fast positive. The major organs showing tuberculous lesions were lungs and lymph nodes. Out of 150 animals, 114 lungs (76%) and 27lymph nodes (18%) respectively were positive. 96 (64%) of the lungs were acid fast positive. Tuberculous organs were observed mostly in femaleanimals. Following deletion analysis of 142 tissue samples mic seal using RD1, RD4, RD9, RD12, RD1 and RD2 , 107 were identified as M. bovis, six as M. tuberculosis and two as M. africanum. The public health implication and control measures were discussed

Relationship between serum heat-stable alkaline phosphatase activity and blood pressure in patients with pre-eclampsia and eclampsia

Background: The objective of this study was to explore the relationship, if any, between the serum heat-stable alkaline phosphatase (HS-ALP) activity and the blood pressure (BP) of patients with pre-eclampsia and eclampsia. Method: The activity of HS-ALP was measured using the 4 – nitrophenyl phosphate (4 – NPP) method after incubation at a high temperature of 65 0C for exactly 30 minutes in one hundred normal pregnant women and in another one hundred with pre-eclampsia/eclampsia. The normal pregnant women were used as controls. The blood pressure (BP), systolic as well as diastolic was measured in each of the studied patient using desktop mercury sphygmomanometer. Results: In the patients with pre-eclampsia/eclampsia, it was found that the higher the systolic and diastolic BP, the higher is the activity of the HS-ALP. Conclusion: It can be concluded that the HS-ALP activity in patients with pre-eclampsia/eclampsia is positively related to the severity of the hypertension and therefore this could help in detecting early complication. Keywords: heat-stable alkaline phosphatase, eclampsia, blood pressure Annals of African Medicine Vol. 5 (1) 2006: 38–4

Haematological studies on the ethanolic stem bark extract of Pterocarpus erinaceus poir (fabaceae)

Pterocarpus erinaceus (fabaceae) is used in the Nigerian folk medicine as well as in other African savanna countries to treat diarrhea, dysentery, urethral discharges, fever, and as an ingredient inabortifacient prescriptions. It is also used in arresting bleeding and as a dressing on ring worm of the scalp. The acute toxicity profile as well as possible haemostatic activity of the ethanolic stem bark extract of the plant after sub acute oral administration was studied in albino Wistar rats. The intraperitoneal LD50 of the extract was found to be 447.21 mg/kg, while the oral LD50 was > 5000 mg/kg. Administration of the extract for 30 days orally revealed a significant (P < 0.05) decrease in bleeding time in the group of rats treated with 200 mg extract/kg body weight compared to control. The clotting time and other haematological parameters like haemoglobin (Hb) concentration, platelet counts, packed cell volume (PCV), white blood cell count (WBC) were not significantly different from control. None of the rats used in the sub-acute toxicity studies died during the study period. The ethanolic stem bark extract of P. erinaceus may thus be practically non-toxic through the (oral) route and may contain some biologically active principle(s) which may be responsible for the haemostasis

Enuresis among primary school children in Jos, Plateau State

Introduction: Enuresis is a common childhood disorder which can lead to major psychological problems. These problems usually include low self-esteem, poor school performance, and anxiety. A clear understanding of the burden of this condition across regions and communities will help in better management.Aim: To determine the prevalence and pattern of enuresis among primary school children in Jos South Local Government Area and factors that are associated.Methods: This was a cross sectional analytical survey involving the parents of 264 primary school children aged between 5 and 12 years. The 264 children were  recruited by a multistage sampling method and questionnaires were administered to their parents. The World Health Organisation, 10th revision of the International Classification of Diseases (WHO-ICD 10) definition of enuresis was used.Results: A total of 264 parents of children age 5 years to 12 years completed the questionnaire. This comprised of 111 (42%) males and 153 (58%) females. The prevalence of enuresis was 12.9%. Primary enuresis (PE) occurred in 18 (6.8%) while secondary enuresis (SE) was present in 16 (6.1%).The prevalence of  nocturnal enuresis (NE) alone was (28) 10.6%, while (5) 0.02% of the children had combined nocturnal (NE) and diurnal enuresis (DE). Enuresis was more common in males 19 (17.1%). The male sex was predictive  for nocturnal enuresis (OR=2.35) and the older age was protective (OR=0.21). Family stressors (p=0.007) were found to be significantly associated with enuresis. No relationship was established between socioeconomic status, birth order, deep sleep and enuresis. Hypernatriuria and kalliuresis were found in 8.8% and 41.2% of the enuretic children respectively.Conclusion: The overall prevalence of enuresis in the study is 12.9%. Male sex is a significant independent predictor. The relative lower rate found in this study compared to previous studies in Nigeria may be as a result of different definitions and age defining criteria used.Keywords: Enuresis, Nocturnal, Diurnal, Types, Childre

Molecular Epidemiology of Bovine Tuberculosis and most Common Strains of Mycobacterium Bovis in Plateau State, North Central Nigeria

Even though tuberculosis is endemic in Nigeria, information on the epidemiology of the disease especially bovine tuberculosis is still very scanty. Variable Number of Tandem Repeat (VNTR) was carried out on 113 tissue samples to have an idea of not only the epidemiology of bovine tuberculosis but also the most common strains of Mycobacterium bovis circulating in Plateau State. A total of twenty eight (28) different VNTR patterns were obtained from the analysis with genotypes 5 5 5 4 3; 5 5 4 4 3 and 5 5 3 4 3 being the predominant isolates. Out of 113 samples available for generating dendograms, 71 (51.8%) had complete VNTR patterns. Several other profiles which have not been reported from previous studies in Nigeria were observed in this study and it is evident that bovine tuberculosis is prevalent in Plateau State