Historical Perspective and Fundamentals of Clinical Research in Nigeria

Research may be defined as any activity that generates new knowledge and a better understanding of natural phenomena, while ‘scientific research’ uses scientific methods to explore and discover new facts and uses the new knowledge to solve practical problems and explain natural phenomena. Scientific research dates back to many centuries. The earliest reports of research are found in the Egyptian papyrus dating back to 17th century BC. The beginning of documented medical research in the West African sub-region and indeed Nigeria in the 19th century and much of 20th century (pre-independence Nigeria) is traceable to the writings of the Nigerian pioneers of modern medicine. The research process is an iterative cyclical procedure that includes a set of activities undertaken to test a hypothesis - a tentative statement about the relationship between two or more variables. In clinical research, the principles of good research practice are expected to be maintained throughout the research process. These principles include the pursuit of research excellence with integrity, respect for ethics and rigorous maintenance of professional standards, honesty and transparence, openness and accountability, supporting training and acquisition of skills, multidisciplinary collaboration and public engagemen

Vaccination against Streptococcus pneumoniae using truncated derivatives of polyhistidine triad protein D

Polyhistidine triad protein D (PhtD) has been described as a promising vaccine candidate for use against Streptococcus pneumoniae, but there has been a lack of examination of its structure and of which region(s) of the protein are targeted by protective immune responses. In this study, we purified recombinant truncated derivatives of PhtD and examined their secondary structural composition, as well as their capacity to bind antibodies from polyclonal murine serum generated against the full length protein. This allowed the identification of a particularly immunogenic fragment of PhtD, which was also purified and characterised. The truncated derivatives were tested as vaccine antigens in mouse models of pneumococcal sepsis and colonisation, using alum and E. coli heat labile toxin B subunit respectively as adjuvants. These experiments revealed that whilst the immunogenic region identified may be a promising candidate to protect against sepsis, the full length PhtD was ineffective at conferring significant protective immunity. These results are significant for the potential for PhtD to be used in novel vaccines, which are currently being tested in clinical trials.Charles D. Plumptre, Abiodun D. Ogunniyi, James C. Pato

Economic Efficiency of Yam Production in Oyo State of Nigeria

This study estimates economic efficiency of yam growing farmers in Oyo State of Nigeria using stochastic frontier production function. The empirical application used farm level data collected from 120 farms following 2007/2008 growing season. The results indicate that farm size, hired labour, yam set and equipment are the major factors that influence changes in yam output. Farm specific variables, such as farming experience, diversification and extension, were the significant factors influencing inefficiency among yam producers. Predicted economic efficiencies range between 0.0094 and 0.876 with a mean economic efficiency of 0.594. Based on these results, sample yam producers could increase their output by 40.6% through better use of available resources

Prognosis and outcome of acute stroke in the University College Hospital Ibadan, Nigeria

Background: Many factors influence the outcome of acute stroke, the third leading cause of morbidity and mortality globally.Objective: To identify the determinants of outcome of acute stroke.Materials and Methods: A prospectively study of 66 adult patients who presented to the medical emergency unit of University College Hospital (U.C.H), Ibadan, in coma from acute stroke, from August 2004 to March 2005, was undertaken after obtaining ethical clearance and written consent of the patients’ relations.Result: Acute stroke constituted 33% of medical coma, 3.2% of hospital emergencies, 1.0% of total hospital admissions, and 7.3% of medical deaths during the study period. The stroke subtypes were intracerebral hemorrhage (78.8%) and large cerebral infarction (21.2%) with respective case fatalities of 69.7% and 13.6% at 4 weeks. Males constituted 75.8% of the patient population with sex-specific mortality of 68.2%. The highest age specific mortality of 65.2% was in the 40-59 years group. The common risk factors were systemic hypertension, obesity, alcohol/substance abuse, and diabetes mellitus. Co-morbidities included aspiration pneumonia, recurrent seizures, hyperglycemia, and sepsis.Conclusion: Age above 39 years, male gender, systemic hypertension, early onset of coma after stroke, and presence of co-morbidities were associated with poor stroke outcome

Seizure variables and cognitive performance in patients with epilepsy

Background and Purpose Epilepsy is highly prevalent in developing African countries with significant morbidity, social stigmatization, poor quality of life and preventable mortality. There are scanty reports on the contributions of seizure variables like seizure types, frequency of seizures, duration of epilepsy, age at onset and anti-epileptic drugs to cognitive disturbances in Nigerian Africans. This study assessed the effects of seizure variables on the cognitive performances of patients with epilepsy. Methods The cognitive functions of 41 patients with epilepsy and 41 controls were assessed with a computerassisted cognitive test battery, Iron Psychology (acronym - FePsy) using the simple and complex reaction time tasks for mental speed, recognition memory test (RMT) for memory and continuous performance test for attention. Results The cognitive performances of the patients using complex reaction time and the recognition memory tasks were worse than those of the controls (pConclusions The seizure variables negatively affected cognitive performances of Nigerian patients with epilepsy. Cognitive assessment is recommended as part of regular evaluation of patients with epilepsy

Agricultural Productivity Growth and Incidence of Poverty: An Experience from Africa

This study investigates the effects of agricultural productivity growth on poverty.  Using Food and Agriculture Organisation (FAO) data covering two decades (1971-2009) we determined the relationship between agricultural productivity and poverty. Malmquist Index Total Factor Productivity (TFP) was used as indicator of agricultural productivity while Human Development Index (HDI) was adopted as proxy for poverty. Further analysis was carried out to determine whether the performance of factor productivity is due to change in technology or technical efficiency. The result of Malmquist TFP index analysis showed that the average TFP growth over the period was found to be 0.2 percent per annum with large variation in growth rate across the sampled countries.  Twenty-two countries representing about 52% of the total sample experienced productivity growth and this is largely due to technological change.  Congo and Somalia experienced decline in growth and this may be attributed to the incidence of war and civil unrest which have adverse effect on growth.  Overall, the continent experienced improvement in technology with 2.1 percent upward shift in the production frontier and 1.8 percent decline in efficiency.  Regional comparison of agricultural productivity growth reveals that East, South and North Africa experienced growth of 3.3, 2.6 and 3.6 percent respectively.  There were declines in agricultural productivity in West and Southern Africa regions as a result of reduction in efficiency. The analysis of agricultural productivity growth on poverty shows a positive and significant relationship between indicators of the two variables.  Specifically, the result indicates that a unit increase in productivity growth will lead to 0.69 percent change in human development index and conversely poverty.  Further analysis revealed that the unit improvement in technological change will cause about 1.3 percent improvement in human development index. The study concludes that agricultural productivity growth is pro-poor and effective strategy to reduce poverty in Africa.  It is recommended that relevant policies to address the constraints to technology progress and efficiency should be promoted to improve productivity growth and reduce poverty. Key Words: Malmquist index, Total Factor Productivity, Technology, Efficiency, Agricultural Productivity, Poverty, Africa

Stroke mortality and its predictors in a Nigerian teaching hospital

Background: Stroke is the third leading cause of death worldwide. Stroke mortality has been noted to be higher in blacks in biracial studies. There have been few studies on stroke mortality and its predictors in Nigeria. This study examines mortality of stroke and its predictors in a Northern Nigerian teaching hospital.Methods: This was a prospective study that was carried out at Jos University Teaching Hospital in Nigeria. One hundred and twenty stroke patients admitted into the medical wards within one year were assessed. Demographic data was recorded. Patients were examined and ancillary investigations were carried out. The deaths and predictors were recorded. Multivariate logistic regression was used to identify independent predictors of mortality.Results: There were one hundred and twenty participants. Forty two (35%), patients died. Most (76.2%) deaths occurred within the first week. Predictors of mortality on univariate analysis were age ≥ 60 years, male sex, loss of consciousness, high NIHSS score (≥16), the presence of co-morbid conditions and presence of complications. On multivariate analysis, the predictors of mortality were the presence of co-morbid conditions, GCS<10 and high NIHSS score.Conclusion: Stroke mortality was quite high in this study. Predictors of mortality were the indices of severity and the presence of co-morbid conditions.Key Words: Co-morbid conditions, Level of consciousness, Mortality, National Institute of Health Stroke Scale (NIHSS score), Predictors, Strok

Impairment of pneumococcal antigen specific isotype-switched IgG memory B-cell immunity in HIV infected Malawian adults

Pneumococcal disease is associated with a particularly high morbidity and mortality amongst adults in HIV endemic countries. Our previous findings implicating a B-cell defect in HIV-infected children from the same population led us to comprehensively characterize B-cell subsets in minimally symptomatic HIV-infected Malawian adults and investigate the isotype-switched IgG memory B-cell immune response to the pneumococcus. We show that similar to vertically acquired HIV-infected Malawian children, horizontally acquired HIV infection in these adults is associated with IgM memory B-cell (CD19+ CD27+ IgM+ IgD+) depletion, B-cell activation and impairment of specific IgG B-cell memory to a range of pneumococcal proteins. Our data suggest that HIV infection affects both T-cell independent and T-cell dependent B-cell maturation, potentially leading to impairment of humoral responses to extracellular pathogens such as the pneumococcus, and thus leaving this population susceptible to invasive disease.Oluwadamilola H. Iwajomo, Adam Finn, Abiodun D. Ogunniyi, Neil A. Williams, Robert S. Heyderma