Effect of religiosity on maternal and child health practices in Cross River State, Nigeria

Background: Maternal and child health care is very important and crucial in the monitoring and evaluation of various developmental agenda especially in developing nations.Aim/Objective: This study was carried out to ascertain the effects of religiosity on maternal and child health practices in rural and urban Cross River State, Nigeria.Method: The study design was a comparative analytical cross-sectional study amongst mothers with under-five children in rural and urban households in Cross River State and the study populations comprise mothers of under-five children, traditional and traditional birth attendants in Cross River State. Sampling technique used to select respondents in the rural and urban sites was multistage sampling method and the sample size was determined using standard method of comparing two independent groups. For Focus Group Discussions (FGD), purposive sampling method was employed in both study sites. Religiosity was assessed using the ORA dimension of the Duke University Religion Index (DUREL), which is usually measured as frequency of attendance of organized religious activities. The study instrument was a semistructured questionnaire and data obtained was analyzed using SPSS version 21.0.Results: Statistical analysis showed that the age of mother, husband and marriage of women from the rural communities was significantly higher (P< 0.05) than that of women from the urban communities. Religious practices to have safe pregnancy did not significantly predict women having complications in last pregnancy in both study settings while in the rural and urban communities (P<0.05), religious practices significantly influenced family planning methods (P<0.05). In child health practices, religious practices significantly influenced the rural communities practice of breastfeeding child (P= 0.001) and giving child colostrum (P= 0.048) while in the urban communities, it significantly influenced giving child colostrum (P= 0.002).Conclusions: This study therefore concludes that religiosity significantly affects maternal and child health care practices in rural and urban communities of Cross River State, Nigeria and also serve as useful baseline for better understanding of the dynamics of influence of religiosity on maternal and child health practices in Cross River State of Nigeria.Recommendation: Maternal health education as well as education and engagement of spiritual leaders are highly recommended

Undiagnosed Hypertension and Diabetes: Concordance between Self-Reported and Actual Profile among Traders in Nigerian Market

Background: Hypertension and diabetes rank high among cardiovascular risk factors, and in Africa, many affected persons are undiagnosed. Urban market traders are constrained from regular clinic visits by the fear of revenue loss occasioned by their absence from the stores, contributing to the reportedly high rates of undiagnosed and poorly treated cardiovascular conditions. This study determined the rate of undiagnosed hypertension and diabetes among traders in an urban market in Calabar, Nigeria. Methods: In this cross‐sectional study, we used an interviewer‐administered questionnaire to collect data from 105 traders at Marian market Calabar, including information on demographic characteristics and self‐reported statuses regarding hypertension and diabetes. Subsequently, blood pressure and random blood sugar values were measured. Results: Forty‐three (41.0%) of the respondents correctly reported their statuses regarding hypertension and 93.3% of the respondents correctly reported their statuses regarding diabetes. 62 (59%) and 7 (6.7%) of them had hitherto undiagnosed hypertension and diabetes, respectively. Only two (9.5%) out of those with a self‐reported history of hypertension had normal blood pressure values. There was no agreement between the self‐reported and actual profiles of hypertension among the respondents (kappa = 0.000, P = 0.008), and a weak level of agreement between the self‐reported and actual profiles of diabetes among the respondents (kappa = 0.559, P < 0.001). Educational level was the identified predictor of correct self‐report of status regarding hypertension (P = 0.031). Conclusion: There was a high rate of undiagnosed hypertension and, to a lesser extent, diabetes among this set of urban market traders

Profile of Nonhypertensive Cardiovascular Risk Factors among Traders in the Calabar Metropolis, Nigeria

Background: The global burden of cardiovascular diseases (CVDs) is mainly driven by modifiable risk factors, with sub‑Saharan Africaas the region to bear the brunt of the increasing burden. Emphasis has been on hypertension while side‑lining the others to variable extents. Furthermore, the work environment, which plays an important role in the social life of adults has received less attention. This study aimed to identify nonhypertensive modifiable cardiovascular risk factors among traders in an urban market in Calabar metropolis, Nigeria.Materials and Methods: In this cross‑sectional study, we collected data on demographic characteristics and cardiovascular risk profilefrom eligible traders at Marian market, using a structured interviewer-administered questionnaire. The anthropometric and blood sugar measurements of the participants were duly obtained. Results: Ahundred and fifty‑one traders comprising 97 (64.2%) females and 54 (35.8%) participated in the study. Physical inactivity (58.3%), obesity (33.1%), risky alcohol consumption (17.9%), diabetes (9.9%), and cigarette smoking (2%) were the identified modifiable cardiovascular risk factors. A greater proportion of the females was obese compared to the males (P = 0.009), whereas the males had greater proportions with physical inactivity (P = 0.003), risky alcohol  consumption (P = 0.026), and cigarette smoking (P = 0.022). Conclusion: The proportion of nonhypertensive cardiovascular risk factors was high in the traders, with physical inactivity, obesity, and risky alcohol consumption identified as the most prevalent. Preventive  measures to mitigate the increasing burden of CVDs should be extended to traders. Keywords: Cardiovascular disease, diabetes, inactivity, noncommunicable diseases, nonhypertensive, obesit

Comparative Analysis of Percutaneous Drainage versus Operative Drainage of Intra-Abdominal Abscesses in a Resource-Limited Setting: The Tanzanian Experience

Background: Intra-abdominal abscesses (IAAs) are a major cause of morbidity and mortality worldwide. While image-guided percutaneous abscess drainage (PAD) has become the standard of care in many countries, over half of the global population does not have access to interventional radiology (IR) and are left with surgery as the only option for source control. Objective: The purpose of this study is to evaluate the development, implementation, and role of a PAD service in a resource-limited setting. Method: A retrospective cohort study was performed on all patients who underwent percutaneous or surgical abscess drainage (SAD) of IAAs at Tanzania’s national referral hospital from 10/2018 to 4/2021. Patients were identified through a match case search of institutional records and inclusion was confirmed through manual chart review. Demographics, patient presentation, procedural data, and clinical outcomes were recorded in a password-encrypted database and compared between groups. Findings: Sixty-three patients underwent abscess drainage: 32 percutaneously and 31 surgically. In the PAD group, there was a 100% technical success rate and a 0% complication rate. In the SAD group, there was a 64.5% technical success rate and ten deaths within 30 days (32.3%), and one additional complication requiring major therapy (3.2%) (p < 0.001). Conclusion: Results from this study demonstrate that PAD can be performed with high technical success and without complication by trained IR physicians in Tanzania. The development of a successful PAD program exemplifies the drastic need to support the growth of IR services in this setting

Multicentered analysis of percutaneous sclerotherapies in venous malformations of the face

ObjectivesTo evaluate the safety and outcome of image-guided sclerotherapy for treating venous malformations (VMs) of the face.Materials and methodsA multicenter cohort of 68 patients with VMs primarily affecting the face was retrospectively investigated. In total, 142 image-guided sclerotherapies were performed using gelified ethanol and/or polidocanol. Clinical and imaging findings were assessed to evaluate clinical response, lesion size reduction, and complication rates. Sub-analyses of complication rates depending on type and injected volume of the sclerosant as well as of pediatric versus adult patient groups were conducted.ResultsMean number of procedures per patient was 2.1 (±1.7) and mean follow-up consisted of 8.7 months (±6.8 months). Clinical response (n = 58) revealed a partial relief of symptoms in 70.7% (41/58), 13/58 patients (22.4%) presented symptom-free while only 4/58 patients (6.9%) reported no improvement. Post-treatment imaging (n = 52) revealed an overall objective response rate of 86.5% (45/52). The total complication rate was 10.6% (15/142) including 4.2% (7/142) major complications, mostly (14/15, 93.3%) resolved by conservative means. In one case, a mild facial palsy persisted over time. The complication rate in the gelified ethanol subgroup was significantly higher compared to polidocanol and to the combination of both sclerosants (23.5 vs. 6.0 vs. 8.3%, p = 0.01). No significant differences in complications between the pediatric and the adult subgroup were observed (12.1 vs. 9.2%, p = 0.57). Clinical response did not correlate with lesion size reduction on magnetic resonance imaging (MRI).ConclusionImage-guided sclerotherapy is effective for treating VMs of the face. Clinical response is not necessarily associated with size reduction on imaging. Despite the complex anatomy of this location, the procedures are safe for both adults and children

Value and Diagnostic Efficacy of Fetal Morphology Assessment Using Ultrasound in a Poor-Resource Setting

Background: Ultrasound is operator-dependent, and its value and efficacy in fetal morphology assessment in a low-resource setting is poorly understood. We assessed the value and efficacy of fetal morphology ultrasound assessment in a Nigerian setting. Materials and Methods: We surveyed fetal morphology ultrasound performed across five facilities and followed-up each fetus to ascertain the outcome. Fetuses were surveyed in the second trimester (18th&ndash;22nd weeks) using the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) guideline. Clinical and surgical reports were used as references to assess the diagnostic efficacy of ultrasound in livebirths, and autopsy reports to confirm anomalies in terminated pregnancies, spontaneous abortions, intrauterine fetal deaths, and still births. We calculated sensitivity, specificity, positive and negative predictive values, Area under the curve (AUC), Youden index, likelihood ratios, and post-test probabilities. Results: In total, 6520 fetuses of women aged 15&ndash;46 years (mean = 31.7 years) were surveyed. The overall sensitivity, specificity, and AUC were 77.1 (95% CI: 68&ndash;84.6), 99.5 (95% CI: 99.3&ndash;99.7), and 88.3 (95% CI: 83.7&ndash;92.2), respectively. Other performance metrics were: positive predictive value, 72.4 (95% CI: 64.7&ndash;79.0), negative predictive value, 99.6 (95% CI: 99.5&ndash;99.7), and Youden index (77.1%). Abnormality prevalence was 1.67% (95% CI: 1.37&ndash;2.01), and the positive and negative likelihood ratios were 254 (95% CI: 107.7&ndash;221.4) and 0.23 (95% CI: 0.16&ndash;0.33), respectively. The post-test probability for positive test was 72% (95% CI: 65&ndash;79). Conclusion: Fetal morphology assessment is valuable in a poor economics setting, however, the variation in the diagnostic efficacy across facilities and the limitations associated with the detection of circulatory system anomalies need to be addressed