Usage of demand-driven extension services by farmers in agricultural zones in Niger state, Nigeria

The study examined the usage of demand-driven extension services by farmers in agricultural zones in Niger State, Nigeria. To achieve the study objectives, multi-stage sampling technique was used to select a total of 377 respondents for the study. Validated interview schedule was used to generate data for the study. Data collected were analyzed using both descriptive and inferential statistics. Result of the study showed that majority (60.7%) of the respondents used demand-driven extension services four times in a year. Finding also indicated that majority of the respondents demanded for information on storage, improved seeds/planting materials and processing technologies. The result of analysis of variance further revealed that there was significant difference in the usage of demand-driven extension services by farmers in the agricultural zones (F=31.09, P<0.05). It was therefore recommended that demand-driven extension service providers should make concerted efforts to sensitize the farmers to make them more receptive of their services. In order to create condition for optimal performance of service providers in the agricultural zones, it was suggested that government should consider the feasibility of agro-diversity approach to demand-driven extension service delivery.Key Words: Demand-driven, Extension, Usage, Agricultural Zones, Niger State

Stroke in Africa: a systematic review and meta-analysis of the incidence and case-fatality rates

Background: The burden of stroke (a leading cause of disability and mortality) in Africa appears to be increasing, but a systematic review of the best available data to support or refute this observation is lacking. Aim: To determine the incidence and one-month case-fatality rates from high-quality studies of stroke epidemiology among Africans. Summary of review : We searched and retrieved eligible articles on stroke epidemiology among indigenous Africans in bibliographic databases (PubMed, ScienceDirect, Google Scholar and Cochrane library) using predefined search terms from the earliest records through January 2022. Methodological assessment of eligible studies was conducted using the Newcastle-Ottawa scale. Pooling of incidence and case-fatality rates was performed via generalized linear models (Poisson-Normal random-effects model). Of the 922 articles retrieved, fourteen studies were eligible for inclusion. The total number of stroke cases was 5,104 (mean: 365 SD: 254) with a population denominator (total sample size included in population-based registries or those who agreed to participate in door-to-door community studies) of 3,638,304. The pooled crude incidence rate of stroke per 100,000 persons in Africa was 106.49 (95% CI 58.59–193.55), I2 = 99.6%. The point estimate of the crude incidence rate was higher among males, 111.33 (95% CI 56.31–220.12), I2 = 99.2% than females, 91.14 (95% CI 47.09–176.37), I2 = 98.9%. One–month case-fatality rate was 24.45 (95% CI 16.84–35.50), I2 = 96.8% with lower estimates among males, 22.68 (95% CI 18.62–27.63), I2 = 12.9% than females, 27.57 (95% CI 21.47–35.40), I2 = 51.6%. Conclusions: The burden of stroke in Africa remains very high. However, little is known about the dynamics of stroke epidemiology among Africans due to the dearth of high-quality evidence. Further continent-wide rigorous epidemiological studies and surveillance programs using the World Health Organization STEPwise approach to Surveillance (WHO STEPS) framework are needed

APOE E4 is associated with impaired self-declared cognition but not disease risk or age of onset in Nigerians with Parkinson's disease

The relationship between APOE polymorphisms and Parkinson's disease (PD) in black Africans has not been previously investigated. We evaluated the association between APOE polymorphic variability and self-declared cognition in 1100 Nigerians with PD and 1097 age-matched healthy controls. Cognition in PD was assessed using the single item cognition question (item 1.1) of the MDS-UPDRS. APOE genotype and allele frequencies did not differ between PD and controls (p > 0.05). No allelic or genotypic association was observed between APOE and age at onset of PD. In PD, APOE ε4/ε4 conferred a two-fold risk of cognitive impairment compared to one or no ε4 (HR: 2.09 (95% CI: 1.13-3.89; p = 0.02)), while APOE ε2 was associated with modest protection against cognitive impairment (HR: 0.41 (95% CI 0.19-0.99, p = 0.02)). Of 773 PD with motor phenotype and APOE characterized, tremor-dominant (TD) phenotype predominated significantly in ε2 carriers (87/135, 64.4%) compared to 22.2% in persons with postural instability/gait difficulty (PIGD) (30/135) and 13.3% in indeterminate (ID) (18/135, 13.3%) (p = 0.037). Although the frequency of the TD phenotype was highest in homozygous ε2 carriers (85.7%), the distribution of motor phenotypes across the six genotypes did not differ significantly (p = 0.18). Altogether, our findings support previous studies in other ethnicities, implying a role for APOE ε4 and ε2 as risk and protective factors, respectively, for cognitive impairment in PD

Stroke in Africa: profile, progress, prospects and priorities

International audienceStroke is a leading cause of disability, dementia and death worldwide. Approximately 70% of deaths from stroke and 87% of stroke-related disability occur in low-income and middle-income countries. At the turn of the century, the most common diseases in Africa were communicable diseases, whereas non-communicable diseases, including stroke, were considered rare, particularly in sub-Saharan Africa. However, evidence indicates that, today, Africa could have up to 2–3-fold greater rates of stroke incidence and higher stroke prevalence than western Europe and the USA. In Africa, data published within the past decade show that stroke has an annual incidence rate of up to 316 per 100,000, a prevalence of up to 1,460 per 100,000 and a 3-year fatality rate greater than 80%. Moreover, many Africans have a stroke within the fourth to sixth decades of life, with serious implications for the individual, their family and society. This age profile is particularly important as strokes in younger people tend to result in a greater loss of self-worth and socioeconomic productivity than in older individuals. Emerging insights from research into stroke epidemiology, genetics, prevention, care and outcomes offer great prospects for tackling the growing burden of stroke on the continent. In this article, we review the unique profile of stroke in Africa and summarize current knowledge on stroke epidemiology, genetics, prevention, acute care, rehabilitation, outcomes, cost of care and awareness. We also discuss knowledge gaps, emerging priorities and future directions of stroke medicine for the more than 1 billion people who live in Africa

(Abstract only) Stroke services, training, research and advocacy needs in Africa: Preliminary results from the Africa – UK Stroke Partnership (AUKSP) project

BACKGROUND AND AIM Safe and efficient acute stroke care services, effective training and and context -sensitive research and advocacy are key to reducing the high stroke burden in Africa. However, quantitative data is sparse on stroke care services, training and research priorities in Africa. We describe the status of acute stroke care services and unmask training and research needs in Africa. METHODS A 56-item, pre-tested, multi-lingual online survey tool adapted from the World Stroke Organization (WSO) Roadmap to delivering quality stroke care was sent to stroke experts in each African country through e-mail directories of national stroke organizations, the African Stroke Organization (ASO), the African Academy of Neurology (AFAN) and the WSO-Future Leaders African fellows. Data on stroke services, management guidelines, stroke research, stroke education and training were collected and analyzed using descriptive statistics. RESULTS We surveyed 54 but had responses from 45 (83%) African countries covering 95% of the population of Africa. Only 4% of respondent countries had a national stroke registry or national stroke surveillance system. Thrombolysis was available in 49% of countries, at an estimated 255 centers. 16% of countries had access to endovascular thrombectomy at 69 centers. National stroke-specific training programs were available for 11% of consultants, 9% of general medical practitioners and 4% of nurses. Reperfusion therapy was selected as the most important training need and national stroke registries as the top research priority. CONCLUSION Our study highlights core needs for stroke services improvement, capacity building, context - sensitive research and multi-level advocacy in Africa

Factors associated with hypertension among stroke‐free indigenous Africans: Findings from the SIREN study

Abstract Hypertension is one of the most important risk factors for stroke and cardiovascular diseases (CVD) globally. Understanding risk factors for hypertension among individuals with matching characteristics with stroke patients may inform primordial/primary prevention of hypertension and stroke among them. This study identified the risk factors for hypertension among community‐dwelling stroke‐free population in Ghana and Nigeria. Data for 4267 community‐dwelling stroke‐free controls subjects in the Stroke Investigative Research and Education Network (SIREN) study in Nigeria and Ghana were used. Participants were comprehensively assessed for sociodemographic, lifestyle and metabolic factors using standard methods. Hypertension was defined as a previous diagnosis by a health professional or use of an anti‐hypertensive drug or mean systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Logistic regression analysis was used to estimate adjusted odds ratios (aOR) of hypertension and their 95% confidence intervals (CI) at p < .05. Overall, 56.7% of the participants were hypertensive with a higher proportion among respondents aged ≥60 years (53.0%). Factors including physical inactivity (aOR: 9.09; 95% CI: 4.03 to 20.53, p < .0001), diabetes (aOR: 2.70; CI: 1.91 to 3.82, p < .0001), being ≥60 years (aOR: 2.22; 95% CI: 1.78 to 2.77, p < .0001), and family history of CVD (aOR 2.02; CI: 1.59 to 2.56, p < .0001) were associated with increased aOR of hypertension. Lifestyle factors were associated with hypertension in the current population of community‐dwelling stroke‐free controls in west Africa. Community‐oriented interventions to address sedentary lifestyles may benefit this population and reduce/prevent hypertension and stroke among them