Affinity proteomics reveals elevated muscle proteins in plasma of children with cerebral malaria

Systemic inflammation and sequestration of parasitized erythrocytes are central processes in the pathophysiology of severe Plasmodium falciparum childhood malaria. However, it is still not understood why some children are more at risks to develop malaria complications than others. To identify human proteins in plasma related to childhood malaria syndromes, multiplex antibody suspension bead arrays were employed. Out of the 1,015 proteins analyzed in plasma from more than 700 children, 41 differed between malaria infected children and community controls, whereas 13 discriminated uncomplicated malaria from severe malaria syndromes. Markers of oxidative stress were found related to severe malaria anemia while markers of endothelial activation, platelet adhesion and muscular damage were identified in relation to children with cerebral malaria. These findings suggest the presence of generalized vascular inflammation, vascular wall modulations, activation of endothelium and unbalanced glucose metabolism in severe malaria. The increased levels of specific muscle proteins in plasma implicate potential muscle damage and microvasculature lesions during the course of cerebral malaria

Beliefs and Factors That Influence Intentions to Initiate Antihypertensive Medications

Background: Primary nonadherence (PMN) to antihypertensives constitutes a problem for all stakeholders regardless of whose perspective is taken. Understanding patient beliefs and utilizing a theory could help move the needle in favor of antihypertensive medications initiation. Objectives: To determine the predictive ability of an integrated model of the theory of planned behavior and health belief model on intention to initiate an antihypertensive medication and to rank the identified factors of intentions to initiate antihypertensive medications in order of relative importance. Methods: A cross-sectional survey was conducted to evaluate beliefs and factors that determine intention to initiate antihypertensive medications. The sample was sourced from a national online panel provided by Qualtrics. Bivariate analysis was conducted to determine the relationships among the constructs, as well as between each construct and intentions. Multivariable analysis was also carried out, controlling for potential confounders. To ascertain which construct was most important in predicting intention, relative weight analysis was used. Results: A total of 941 participants took part in the study with an average age of 41.3 years and a standard deviation of 14.8 years. Model 1 comprising of twelve predictors accounted for 8% (R2 = 0.08) of the variation in intention. Model 2 incorporated an additional seven variables for a total of nineteen predictors. This model explained an additional 65% (R2 = 0.65) of the variation in intention resulting in a total variance explained of 73% (R2 = 0.73). Overall, Attitude, Subjective norm, Perceived behavioral control, and Perceived severity had a positive significant relationship with the intention to initiate antihypertensive medications while Perceived barrier had a negative significant relationship. However, the relationship for perceived benefits as well as perceived susceptibility was not statistically significant. The results of the relative weight analysis indicates that the most important variables in predicting intention to initiate antihypertensive medications are Subjective Norm (RW = 0.22 or 30.84% of the explained variance), Perceived Behavioral Control (RW = 0.19 or 26.04% of the explained variance), and Attitude (RW = 0.13 or 17.17% of the explained variance). Conclusion: One of the recommendations by the World Health Organization (WHO) for addressing medication nonadherence is a tailored intervention approach. Amid scarce resources, targeting interventions towards factors deemed most important could result in tremendous cost savings for all stakeholders. This cost saving would be achieved through decreased healthcare costs from preventable hospitalizations and waste, increased patient quality of life, increased productivity and a resultant improvement in health economics and outcomes

Management of patients with rheumatic fever and rheumatic heart disease in Nigeria - need for a national system of primary, secondary and tertiary prevention

No Abstract

Severe childhood malaria syndromes defined by plasma proteome profiles

BACKGROUND Cerebral malaria (CM) and severe malarial anemia (SMA) are the most serious life-threatening clinical syndromes of Plasmodium falciparum infection in childhood. Therefore it is important to understand the pathology underlying the development of CM and SMA, as opposed to uncomplicated malaria (UM). Different host responses to infection are likely to be reflected in plasma proteome-patterns that associate with clinical status and therefore provide indicators of the pathogenesis of these syndromes. METHODS AND FINDINGS Plasma and comprehensive clinical data for discovery and validation cohorts were obtained as part of a prospective case-control study of severe childhood malaria at the main tertiary hospital of the city of Ibadan, an urban and densely populated holoendemic malaria area in Nigeria. A total of 946 children participated in this study. Plasma was subjected to high-throughput proteomic profiling. Statistical pattern-recognition methods were used to find proteome-patterns that defined disease groups. Plasma proteome-patterns accurately distinguished children with CM and with SMA from those with UM, and from healthy or severely ill malaria-negative children. CONCLUSIONS We report that an accurate definition of the major childhood malaria syndromes can be achieved using plasma proteome-patterns. Our proteomic data can be exploited to understand the pathogenesis of the different childhood severe malaria syndromes

An Inquiry into Sexual Health Knowledge and Sexual Risks Among Students of Tertiary Institutions in Ibadan, Southwest Nigeria

Sexual activity is rampant among female undergraduates with the consequence of unintended pregnancies, abortions and sexually transmitted infections. This study was conducted to assess the prevalence and predictors of unprotected sexual intercourse and abortion; the knowledge, access to and use of contraceptives; as well as the knowledge of and exposure to Sexually Transmitted Infections among undergraduates of the Polytechnic and University of Ibadan. It was a descriptive cross-sectional study that employed a multi-stage sampling method. A structured questionnaire was administered to undergraduates of the Polytechnic of Ibadan (PTI) and the University of Ibadan (UI). Data were collected on demographic profile; reproductive and sexual history; knowledge, attitude to and use of contraceptives; and knowledge of and exposure to Sexually Transmitted Infections. Analysis was done using SPSS version 15.0. Significantly more males than females (27% vs 18%) were sexually active and more (25%) students of PTI than UI (19%). Abortion was significantly more prevalent in the Polytechnic (5.3%) than the University (1.6%). The major reason pregnancies were aborted was that they were unplanned for and abortion seekers were not ready for consequent financial responsibilities (57%) of keeping the pregnancies. Knowledge of the various forms of contraception was poor. Males had better access to contraceptives than females and significantly more males (36%) than females (6%) used contraceptives always. Overall, self-pleasure was the single principal reason (75.4%) respondents had for sexual intercourse and significantly more females (21.6%) than males (12.5%) had sex to please their partner(s). Knowledge about sexually transmitted Infections was assessed as fair

Lifestyle Habits and Cardiovascular Risk Factors Among Nurses at The University College Hospital, Ibadan, Southwest Nigeria

This study set out to identify the unhealthy lifestyle habits adopted by nurses at the University College Hospital (UCH), Ibadan which could predispose to Cardiovascular diseases (CVDs) and assess the cardiovascular risk factors among them. A cross sectional study design was utilized. The study population consisted of nurses working on the wards at the UCH, Ibadan who were between the ages of 30-60 years. Systematic random sampling was adopted in selecting 196 nurses for this study. A structured questionnaire was administered to consenting nurses. Focus group discussions were conducted to further probe into the details of the questionnaire. 94.9% of respondents were female and the mean age of respondents was 39.3±7.4 years. About 32% of the respondents engaged in moderate exercise less than once a week, 59% of the respondents slept between 5-6 hours at night, 44.9% ate fried food 1-2 times weekly, 42.9% consumed one or more litres of soda drink per week. Majority demonstrated high level of awareness about cardiovascular risk factors such as cigarette smoking (78.1%), alcohol use (76.5%), overweight/obese (75.5%), high blood cholesterol (73.5%), physical inactivity (71.9%) and diabetes mellitus (70.9%). However, there was a low level of awareness about cardiovascular risk factors such as race (41.3%) and gender (34.2%). A significantly higher proportion (70%) of respondents who ate fried foods on an average of 3-6 times per week were overweight/obese (p=0.016). Obesity was also associated with family history of cardiovascular diseases (p=0.04). The focus group discussions highlighted nurses’ views about difficulties in practicing known healthy lifestyle habits. The study highlighted a moderate prevalence of cardiovascular risk factors such as obesity, consumption of fried foods and physical inactivity among nurses. Efforts should be directed towards the promotion of healthy lifestyles among nurse

Northwest Benin sites and socially determined artifact distribution

Thesis (Ph. D.)--Michigan State University. Department of Anthropology, 1987Includes bibliographical references (pages 231-242

Relationship of age, anthropometry and haemoglobin concentration with echocardiographic findings in Nigerian children with sickle cell anaemia

Background: Assessment of the structural and functional effects of sickle cell anaemia (SCA) on the heart can be done using echocardiography.There has been no agreement on which indicator of body size (weight, height, and body surface area (BSA)) or age in children should be used to relate to and correct echocardiographic measurements.Aim: To correlate the echocardiographic findings of children with SCA aged one to fifteen years in steady state with their age, anthropometryand haemoglobin concentration.Methods: A prospective study carried out at the Lagos University Teaching Hospital (LUTH), between May and October 2005. The subjects were 60 paediatric patients attending the LUTH SCA outpatient clinic and 60 age, sex and socioeconomic matched controls. Their height, weight, and echocardiographic parameters were measured and their BSA and haemoglobin level were determined.Results: The direct echocardiographic measurement (AO, LA, LVPW, EDD, ESD, IVS) and LVM each increased progressively with body weight, height, body surface area and age in both subjects and controls (r > 0.3, p < 0.001 in each case). Multivariate analysis showed that height correlated significantly with AO, ESD, EDD and LVPW in the subjects. All the parameters except age were significantly correlated with LVM both in univariate and multivariate analysis.Conclusion: Echocardiographic parameters in SCA patients are significantlycorrelated with anthropometric indices and age. Our data suggest best correlation with height in these subjects

Hepatitis B immunization at the University College Hospital, Ibadan: an eight year review of vaccine administration records

Vaccination of health care workers (HCWs) against hepatitis (HBV) infection is highly necessary in Nigeria where the infection occurs in hperendemic proportions. We hereby determine the trends in the administration of HBV vaccine at the University College Hospital (UCH), Ibadan, Nigeria. The study reviewed the records for the administration of vaccine against HBV at the Staff Medical Services Department of UCH, Ibadan, Nigeria, from 1994 to 2001. A total of 1,437 subjects consisting of 686 (47.7%) males and 751 (52.3 %) females were vaccinated against HBV from 1994 to 2001. They were aged 16 to 64 years and consisted of 356 students (24.8%) and 1081 healthcare workers (HCWs) (75.2%) which comprised Doctors (30.9%), Dentists (1.9%), Paramedics (19.6%), Non-medics (14.6%) and subjects with undisclosed occupational category ((10.7%). About 11% to 100% of the subjects had annual prescreening for HBsAg sero-negativity from 1996 to 2001 but none had post vaccination assay of anti-HBs titre. All the subjects received 1st dose of 0, 1, 2 accelerated HBV vaccination schedule while on annual basis, 16.7% to 91.8% of the subjects received the 3rd dose of the vaccine. Despite the proportional participation of the different occupational groups was highest among the doctors and dentists but lowest among the paramedics, only 59.7% of all the vaccinees had three dose(s) of the vaccine during the 8 year period. In conclusion, although the HBV vaccination programme had shortcomings, it is an established practice at UCH, Ibadan and efforts should be made to improve on its prevailing standard.Keywords: Immunization, HBV, Healthcare Workers, Nigerians, UCH, Ibadan

Sexual behaviour and knowledge of prevention of sexually transmitted infections among students in coeducational and non-coeducational secondary schools in Ibadan, Nigeria

Introduction: Sexual interaction between students may be different in coeducational (CE) and non-coeducational (NC) schools. The objective was to compare sexual behaviour and knowledge of prevention of sexually transmitted infections (STIs) among senior secondary school students in CE and NC institutions in Ibadan, Nigeria. Method: A comparative cross-sectional study was carried out using a multistage sampling technique. A total of 510 respondents (250 from CE schools and 260 from NC schools) completed semi-structured self-administered questionnaires which included a 30-point STI knowledge scale with scores classified as good and poor. Chi-square statistics were significant at P ≤ 0.05. Results: The mean age of respondents was 15.9 ± 1.5 years, 47.5% were girls. There were no significant differences in sexual behaviour and knowledge of STIs between the students in the two types of schools. However, there were gender differences, as a significantly higher proportion of girls in CE than NC schools had ever had sexual intercourse with the opposite sex (25.6%-CE, 12.4%-NC) and had multiple sexual partners (29.0%-CE, 0%-NC). Girls in NC schools had better knowledge of causes and prevention of STIs than those in CE schools (28.8%-CE, 45.5%-NC). There were no significant differences in the sexual practices and knowledge of STIs among boys in the two types of schools. Conclusion: More girls in CE schools have had sexual intercourse compared to NC schools whereas girls in NC schools had better knowledge of the prevention of STIs. There is a need for strategies to increase reproductive health education in schools, particularly in CE schools