Research and Publication Ethics

Research is an effort to seek the truth and communicate it. In the process, participants or subjects of research must be recognised and respected, and the principles of research ethics must protect the vulnerable from exploitation. The researcher must do the reporting of research findings with honesty and professionalism. Non-adherence to the above principles in the early research period resulted in gross abuse of personality and autonomy. Research is now subjected to rigorous scrutiny to stem the tide of abuse and ascertain and guarantee the sanctity of the research participants, process and product. These are the fundamentals of the practice of ethics in both research and publication. In effect, this paper aims to address ethics and its application to research and publications

Parents' Acceptability and Health Workers' Perspectives of Pneumococcal Conjugate Vaccination for Under-Fives in Ile-Ife, Nigeria

Background: Pneumococcus, apart from being the commonest bacterial cause of Respiratory tract infections (RTIs) also causes a wide array of morbidities which can all be prevented with the administration of potent Pneumococcal conjugate vaccine. Despite its effectiveness and availability, Pneumococcal vaccines are not part of routine immunization in Nigeria. This study assessed parents' acceptability and health worker's perspectives of Pneumococcal Conjugate Vaccination for under-fives.Methods:  The cross-sectional survey was conducted in Ife Central Local Government Area, Osun state. An interviewer-administered questionnaire was used to collect information from 400 parents of under-fives selected via multi-stage random sampling. In-depth interviews were conducted for the heads of immunization units in four selected facilities in the local government area. Data were analysed using SPSS version-16.Result: More respondents were females, married and had tertiary education. About three-fifth (59.2%) of parents had good knowledge about RTIs though majority (79.00%) were unaware of Pneumococcal Conjugate Vaccine (PCV). most parents (93.5%) were willing to accept PCV for their children but only 43.5% of them could afford to pay for the cost of the vaccine at the prevailing market price. Most health workers (three out of four) interviewed were not aware of PCV. Most parents (96.25%) and all health workers interviewed wanted PCV incorporated into the National Program on Immunization (NPI). Parents with good knowledge about respiratory tract infections (RTIs) were significantly willing to accept PCV for their underfives (p= 0.005). Younger parents less than 35years, parents with lower educational attainments and low income groups significantly could not afford to pay for the cost of vaccines. (p=0.014, 0.001 and <0.001 respectively).Conclusion: Though almost three fifth of parents surveyed had good knowledge about RTIs, awareness about PCV was poor and most of them were unable to afford PCV. There is an overwhelming need to incorporate PCV in to the NPI, as both parents and health workers agreed. Aside from overcoming a major financial barrier to vaccine access, this will also make PCV widely available to parents who are already willing to accept the vaccine for their children.Keywords: Parents' Acceptability, Pneumococcal conjugate Vaccinatio

A Cross-sectional Survey of the Willingness of Tertiary Hospital Staff to Donate Blood in Sagamu, Nigeria

Background: Available donor blood rarely meets the demand in sub-Saharan Africa due to obstacles to blood donation. Willingness to donate blood is adjudged an important step to the actual practice of donating blood. Objective: To assess the willingness of the members of staff of the hospital to donate blood and determine factors affecting their willingness or otherwise. Methods: This was a descriptive cross-sectional study. A proportional allocation of participants was carried out at the various departments in the hospital using self-administered questionnaire. Results: Overall, 183 (73%) of the 246 respondents expressed willingness to donate blood, 111(45%) of whom have been asked to donate blood in the past. Only 91(37%) had donated blood in the past. Significantly higher proportion of health staff showed the willingness to donate blood generally and voluntarily compared to non-health staff. Significantly higher proportion of respondents with tertiary education showed the willingness to donate blood. Two hundred and eighteen (88.8%) were willing to donate blood to help the patient in need while fear of exposure to HIV infection, needle prick and dizziness constituted the major factors discouraging blood donation (19.9%, 18.7% and 18.3% respectively). Conclusion: Willingness to donate blood was mostly based on the primordial motivation of helping the patient in need which does not translate to blood donation. There is a need to improve awareness and advocacy on blood donation among hospital staff and the general population

Prevalence Of Hepatitis B Surface Antigen Among Tertiary Health Workers in Ilorin

A total of 181 tertiary hospital staff at the University of Ilorin Teaching Hospital were screened for the presence of Hepatitis B surface antigen (HBsAg) in their Sera. They were made up of 128 nursing staff, 36 doctors, and 17 laboratory staff, with a mean length of service of 12.3+7.6 years, and who actively work in contact with patients and laboratory specimens. Screening for HBsAg was carried out using the enzyme-linked immunosorbent assay (ELIZA) method. Fourteen (7.7%) of the staff were found to be positive for HBsAg. This was significantly lower than the percentage positives of 21.7% and 16.0% obtained among the blood donors and antenatal clinic patients respectively. The positivity rate was not affected by sex, age or length of service. The possible reasons for, and inferences from our findings are discussed. Nigerian Quarterly Journal of Hospital Medicine Vol. 9, No. 2 (June 1999) pp. 95-9

Hepatitis B and C viruses co-infection with Human Immodeficiency Virus (HIV) in infected patients at UITH, Ilorin

One hundred and two (102) HIV infected patients at the University of Ilorin Teaching Hospital, Ilorin, were screened for markers of HBV and HCV in order to determine the prevalences of co-infection, and were compared to those in blood donors. The diagnosis of HIV infection was made on the basis of reactivity with two different ELIZA reagents and low CD4 Cell Count. The marker for HBV was Hepatitis B surface Antigen (HBsAg), and screening was done with the Latex Test by BIOTEC Laboratories, Soffolk, U.K. The marker for HCV was anti-HCV antiboby and screening was done with a third generation ELIZA by DIA.PRO Diagnostic, Milano, Italy. HBV was found in 16% and 30.4% of blood donors and HIV infected patients, respectively. HCV was found in 0.6% of blood donors, but not in any of the 96 HIV infected patients. The frequency of HBV among HIV patients was significantly higher than it is in blood donors, while there was no difference in the frequency of HCV between blood donors and HIV infected patients. CD4 count was lower in AIDS patients with co-infection with HBV than in those without. Infection by the HIV promotes co-infection with HBV, while the presence of HBV in an HIV-infected person is associated with lower CD4 count. It is suggested that HIV infected patients who are HBsAg. positive should receive prophylactic treatment and be monitored closely for development of chronic hepatitis.Nigerian Medical Practitioner Vol. 54 (1) 2008: pp. 8-1

Influence of highly active antiretroviral therapy (HAART) on the survival of HIV-infected patients: part report of the Ilorin Trial Center

This report is part of the ongoing highly active antiretroviral therapy (HAART) trial, 167 patients were enlisted, but current analysis was restricted to 107 patients that were about a year old on the programme. The baseline weight, CD4+ cell count and serum albumin of 59 males and 48 females age 15-60 years, were compared with values at 12 months of administration of HAART. Patients mean weight, CD4+ count and serum albumin increased significantly (p-value < 0.05) by 9.7kg, 127.4/uL and 9.1g/L over the enrolment values. Side effects of antiretroviral (ARV) drugs were mild and included; rashes 19.6%, jaundice 7.5% and reactive arthritis 3.5%. Fifty-eight patients (59%) were alive by the end of 1 year, 33 (30%) had died and 11 (10.8%) were lost to follow-up. The risk of death increased 3 times when baseline CD4+ count was less than 116.8/uL (RR= 3.36, 95%CI=1.86– 6.06, P-value = 0.000048). TB/HIV co-infection raised the chance of death twice (RR= 2.33, 95%CI=1.31-4.15, P- value=0.005). In conclusion, the use of triple-drug combination of HAART has led to improved CD4+ cell count and resolution of clinical symptoms in HIV/AIDS patients. These resulted in increased survival. Key Words: HAART, AIDS, CD4+ cells count and survival. Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005:34-3

Effect Of Highly Active Antiretroviral Therapy On CD4 Count And Weight In AIDS Patients Seen At The UITH, Ilorin

To determine the response on treatment-naïve HIV/AIDS patients to the Highly Active Antiretroviral Therapy (HAART) in terms of CD4 Count and Weight gain over a period of 2½ years. Patients with Acquired Immunodeficiency Syndrome (AIDS) were recruited under the Federal Government HighlyActiveAntiretroviral Therapy (HAART) programme at the University of Ilorin Teaching Hospital. The treatment regimen included Lamivudine, Starvudine and Nevirapine. The patients\' responses were evaluatedwith respect toCD4 count andweight over the period of treatment.The diagnosis ofHIV/AIDS wasmade on the basis of reactivitywith two different ELISAreagents, andCD4 countwas donewithDynalT4 Quantmethod. Theweights (kg.) of the patientswere taken atmonthly visit. The duration of treatment for the patients analysed ranged from 1 month to 14 months. Analysis of CD4 count was possible in 105 patients. The mean post treatment CD4 count and weight were significantly higher than the pre-treatment values (p < 0.001 and p < 1.01) respectively. There were significant positive correlations (p < 0.05 and p < 0.001) between increases in CD4 count and weight respectively, and duration of treatment. In eight (8) patients,CD4Count reduced or remained the same in spite of treatment. TheHAARTregime is associatedwith increase inCD4Count andweight gain.While increases in CD4 Count and weight correlated with duration of therapy, there was no correlation between CD4 Count increase andweight gain. Keywords: HIV/AIDS Antiretroviral Therapy CD4 Weight. Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 312-31

The principles guiding the protection of participants in medical research

Bioethics relates to ethics in biomedical research. Several unethical practices have been perpetuated in the past in the course of medical research using human subjects as participants without adequate guidelines for the conduct of such researches. Research should address the three main principles of ethics which are autonomy, beneficence and justice, and studies should be designed to protect the physical and psychological well being of participants. The issues of Conflict of Interest and Informed Consent occupy central positions in researches involving the human subject, hence, their ever increasing relevance and continuously changing definitions are given prominence and due emphasis in this review. This review highlights the definition, historical background, the different International Regulations and Codes for research ethics, the requirements for carrying out research on human subjects, and the role of Institutional Review Board in the approval and monitoring of researches. The Helsinki declaration of the World Medical Assembly which has been amended over time, emphasize the need to obtain informed consent in writing from participants. It also emphasize the well being and interest of research participants over and above the interest of science and society. It recommends that the use of placebo should be discontinued and the benefits, risks, burdens and effectiveness of a new method should be tested against those of the best current prophylactic, diagnostic and therapeutic methods. Relevant recommendations are made in ensuring that the human subjects in developing countries are adequately protected when they participate in biomedical experimentation and researches. Keywords: bioethics, research participants, autonomy, beneficence, justice The Tropical Journal of Health Sciences Vol. 12(1) 2005: 5-1

Clinical severity and hepatic enzyme level in sickle cell anaemia children with persistent hepatomegaly

No Abstract. The Tropical Journal of Health Sciences Vol. 12(2) 2005: 14-1