Clinical Presentation and Outcome of Ribavirin Treated RT-PCR Confirmed Lassa Fever Patients in ISTH Irrua: A Pilot Study

Background: Lassa fever is a viral hemorrhagic fever that is endo-epidemic in Edo state, with case fatality of 90-100% if not treated. It has been claimed that early treatment with Ribavirin reduces mortality to less than 20%. This study was carried out to assert/confirm or refute/reject this claim.Aim: To review the clinical features, laboratory findings of Lassa fever and the outcome of confirmed cases treated with Ribavirin.Methodology: The study was a case series study of the first 41 cases that were treated with Ribavirin in the Lassa fever isolation ward from 28th November 2010 to 26th May 2011.Results: Up to 63.4% of cases presented late (onset of illness greater than 6 days at presentation). Fever remains the predominant presenting feature of the disease (97.5%). Of the cases that were admitted, 41 were treated, 31 recovered and 9 died, giving a case-fatality rate of 22%. One discharged against medical advice. Conclusion: Lassa fever victims still present late at the hospital and fever remains the predominant presenting feature. Early Ribavirin treatment improves treatment outcome of Lassa fever in confirmed cases.Recommendations: The Federal, States and Local government area council members must make efforts to create public awareness on early presentation, diagnosis and prompt treatment with Ribavirin

Effect of a training intervention for finding the missed cases of tuberculosis amongst patent medicine vendors in Delta State, Nigeria

Context: The undiagnosed and untreated tuberculosis (TB) cases underpin the experience of accelerating deaths. Everyone should be engaged in managing TB patients to revert the current trend. Aims: In this context, we assessed the outcome of an education intervention on the knowledge of TB and referral practice of presumptive TB cases to directly observed therapy strategy amongst patent medicine vendors (PMVs). Settings and Design: The study was quasi-experimental, conducted amongst 647 PMVs in Delta State, Nigeria. Methods: A structured questionnaire was administered to obtain baseline data on knowledge of TB. An educational intervention on knowledge of TB was then given. A post-intervention assessment of TB knowledge was subsequently conducted using the same questionnaire. The exact number of referrals of presumptive TB cases by PMVs and the number that tested positive amongst the referred presumptive TB cases, 3 months before and after the training were obtained from the state TB database. Statistical Analysis Used: SPSS v. 26 was used for data analysis. Results: The pre-training knowledge average score was 15.45 ± 6.45, while the post-training average score was 19.44 ± 7.03 (P < 0.001). The pre-training average number of presumptive cases referred was 146 ± 124.7, and the post-training was 205.67 ± 255.4, P = 0.41. The pre-training average number of cases that turned out positive was 9.5 ± 6.3, and the post-training was 13.5 ± 11.3, P = 0.42. Conclusion: There was a significant improvement in PMVs' knowledge of TB post-intervention. However, while an increase in the number of cases referred and positives detected was observed, this was not significant. Periodic training and updates to PMVs in keeping with current trends and best practices in TB management are recommended

A community survey of the vaccination status of under-five children in a community in Southern Nigeria

Regarding vaccine coverage, Nigeria is currently making slow progress despite the previous achievements in immunisation coverage. This is contrary to the World Health Organisation's goal of achieving health equity for all people globally. Operational research to determine the immunisation status of children should be unrelenting. Thus, this study sought to assess the proportion of under-five children who had completed vaccination as well as parental variables associated with the vaccination in a South-southern community in Nigeria. Materials and Methods: A cross-sectional study and a multi-stage sampling technique were used to select respondents from the community. Respondents were interviewed using a pretested semi-structured questionnaire. Information related to parents' sociodemographic characteristics, mother's knowledge of immunisation, their children's vaccination status, and the reasons for vaccination were collected and entered into SPSS software. The percentage of children who had received all the required number of vaccines in the routine immunisation schedule was calculated. The proportion of children who had each of the vaccines was also calculated. Mother's knowledge of vaccination was scored based on some questions asked and was further graded into good and poor knowledge. Chi-square test was used to determine the association between parents' sociodemographic characteristics and children's vaccination status. Results: One hundred and seventy (68%) children completed their vaccination. There was a marked difference when the dropout rates from pentavalent 1/pentavalent 3 vaccine (2.7%) and Bacille Calmette–Guerin/measles vaccines (17.9%) were compared. Maternal knowledge (P = 0.00001), maternal parity (P = 0.006), mother's education (P < 0.00001), father's education (P < 0.00001), and father's age (P = 0.0002) were associated with vaccine uptake within the community. Conclusion: Mothers' knowledge and parity, parents' educational status, and the father's age significantly influenced vaccine uptake

The 5As/5Rs model for treatment of tobacco use and dependence.

The 5As/5Rs model for treatment of tobacco use and dependence.</p

Comparison of means of the changes in total scores (95% confidence intervals) between the intervention and control groups at six months post-intervention.

Comparison of means of the changes in total scores (95% confidence intervals) between the intervention and control groups at six months post-intervention.</p

Minimal data set.

BackgroundThe World Health Organization (WHO) strongly recommends that brief tobacco interventions should be routinely offered in primary care. However, medical doctors do not consistently and effectively intervene during their encounters with cigarette smokers. There is a paucity of studies assessing the effect of training on the tobacco intervention competency of primary care doctors in Nigeria.AimTo evaluate the effectiveness of online training in improving competency in brief tobacco interventions among primary care doctors in Delta State, Nigeria.MethodsA cluster-randomized controlled trial was conducted among eligible doctors working in government-owned facilities. The 22 eligible Local Government Areas (LGAs) served as clusters. The intervention group received a WHO six-hour online course on brief tobacco cessation intervention, delivered via Zoom. The control group received no intervention. A structured questionnaire was sent to participants via WhatsApp before and six months after the training. The primary outcome variables were scores for knowledge, attitude, self-efficacy, and practice. Differences in change of scores between intervention and control groups were assessed with t-test. To adjust for clustering, these inter-group differences were further analyzed using linear mixed-effects regression modeling with study condition modeled as a fixed effect, and LGA of practice entered as a random effect.ResultsThe intervention group had a significantly higher mean of change in scores for knowledge (effect size 0.344) and confidence (effect size 0.52).ConclusionThe study shows that training, even online, positively affects clinician competency in brief tobacco intervention. This is important for primary care systems in developing countries. Mandatory in-service training and promotion of the WHO modules are recommended.</div

Adjusted comparison between groups for mean of the changes in total scores (95% confidence intervals) of outcome variables at six months^b'*'.

Adjusted comparison between groups for mean of the changes in total scores (95% confidence intervals) of outcome variables at six monthsb'*'.</p

Baseline socio-demographic characteristics of participants.

Baseline socio-demographic characteristics of participants.</p

Explanatory variables and processes of the social learning theory.

Explanatory variables and processes of the social learning theory.</p

Overview and learning outcomes of the training modules.

Overview and learning outcomes of the training modules.</p