Confirmation of Trypanosome Parasitaemia in Previously Serologically Positive Individuals in the Abraka Area of Delta State, Nigeria

This study was conducted to follow-up trypanosome serologically positive individuals, with the aim of confirming the presence of trypanosome parasitaemia in them over the study period of 12 months. The study was carried out at the Eku Baptist medical centre Abraka, Delta State between June 2002 and May 2003. Confirmation was by the detection of trypanosomes in blood, lymph node glands and cerebrospinal fluid microscopy. Of the booked population (n=128), 82 (64.1%) were studied, 46 (35.9%) lost to follow-up. Of the studied 82 cases, 14 (17.1%) were confirmed as having sleeping sickness, 40(48.8%) remained unconfirmed cases while 28(34.1%) seroconverted and were discharged from follow up. Of the 14(17.1%) confirmed cases, 9(64.3%) were confirmed in the last six months of the 12 months period of follow-up, compared to 5(35.7%) in the first six months (X2 = 4.5, df = 1, P = 0.04).Long-term monitoring of serosuspects is essential in this endemic area for arresting transmission of the disease and prevention of associated morbidities and mortalities

Awareness of high blood pressure status, treatment and control in a rural community in Edo state.

A cross-sectional study was carried out in Udo, a rural community in Ovia South-west LGA of Edo State to assess the level of awareness of high blood pressure status, treatment and control. Cluster sampling method was used to select participants and data collection was by researcher administered questionnaire. Blood pressure measurement was by standardized method. A total of 590 respondents with mean age 30.7 + 14.6 years participated in the study. The prevalence of hypertension was 20.2% using the WHO/ISH criteria of SBP >140 mmHg and/or DBP > 90 mmHg. Twenty two (18.5%) of the hypertensives were aware of their high blood pressure status. Awareness was higher in females, increased with age and decreased with higher educational status. Of those aware of their condition, 77.3% were on treatment and of these, 29.4% had adequate blood pressure control. This study has revealed a low level of awareness of high blood pressure status and control in this rural community. Therefore, there is urgent need for regular community-based hypertension screening programmes. Keywords: Awareness, Treatment, Control, High blood pressure. Nigerian Journal of Clinical Practice Vol. 10 (3) 2007 pp. 208-21

Diptheria in Nigeria: is there resurgence?

Reported cases of diphtheria from Nigeria have been reducing since the beginning of the millennium even though coverage with diphtheria, pertussis, tetanus (DPT) vaccine has only been low to moderate. Accordingly only sporadic cases of diphtheria have been managed in the past in our hospital. However the occurrence of five cases in the period of one year raises questions on the status of diphtheria control in Nigeria. We present the clinical and sociodemographic features of the cases and discuss the implications of a rising incidence of diphtheria. We conclude by noting the need for health care workers to have a high index of suspicion in children with no, incomplete or uncertain immunization status who present with symptoms of pharyngo-tonsillar disease and by a call for the strengthening of routine immunization services in Nigeria

Diphtheria in Nigeria: is there resurgence?

Reported cases of diphtheria from Nigeria have been reducing since the beginning of the millennium even though coverage with diphtheria, pertussis, tetanus (DPT) vaccine has only been low to moderate. Accordingly only sporadic cases of diphtheria have been managed in the past in our hospital. However the occurrence of five cases in the period of one year raises questions on the status of diphtheria control in Nigeria. We present the clinical and sociodemographic features of the cases and discuss the implications of a rising incidence of diphtheria. We conclude by noting the need for health care workers to have a high index of suspicion in children with no, incomplete or uncertain immunization status who present with symptoms of pharyngo-tonsillar disease and by a call for the strengthening of routine immunization services in Nigeria

Confirmation of Trypanosome Parasitaemia in Previously Serologically Positive Individuals in the Abraka Area of Delta State, Nigeria

This study was conducted to follow-up trypanosome serologically positive individuals, with the aim of confirming the presence of trypanosome parasitaemia in them over the study period of 12 months. The study was carried out at the Eku Baptist medical centre Abraka, Delta State between June 2002 and May 2003. Confirmation was by the detection of trypanosomes in blood, lymph node glands and cerebrospinal fluid microscopy. Of the booked population (n=128), 82 (64.1%) were studied, 46 (35.9%) lost to follow-up. Of the studied 82 cases, 14 (17.1%) were confirmed as having sleeping sickness, 40(48.8%) remained unconfirmed cases while 28(34.1%) seroconverted and were discharged from follow up. Of the 14(17.1%) confirmed cases, 9(64.3%) were confirmed in the last six months of the 12 months period of follow-up, compared to 5(35.7%) in the first six months (X2 = 4.5, df = 1, P = 0.04).Long-term monitoring of serosuspects is essential in this endemic area for arresting transmission of the disease and prevention of associated morbidities and mortalities

Awareness and acceptability of strategies for preventing mother to child transmission of HIV among antenatal clients in Calabar, Nigeria

Background: Mother to child transmission is the major route through which children below the age of 15 years acquire HIV infection. The most effective way to reduce childhood HIV infection is to prevent the infection in mothers and for already infected mothers use appropriate strategies to prevent transmission to their children. This study was conducted to determine the level of awareness and acceptability of strategies for preventing mother to child transmission of HIV. Method: Exploratory multi-centric descriptive study involving 400 antenatal attendees in Federal, State and a Private health facility was used. Interviewer-administered questionnaire was the tool for data collection. Result: Majority of the respondents (94.7%) were aware of transmission of HIV from an infected mother to her child. Respondents were more aware of the use of antiretroviral drugs in pregnancy (63.2%) than they were of avoiding breastfeeding (58.5%) and Cesarean delivery (22.8%) as strategies for preventing mother to child transmission. They were also more likely to accept the use of antiretroviral drugs (78.2%) than they would avoid breastfeeding (69.0%) and accept Cesarean delivery (38.0%) for preventing mother to child transmission of HIV. High educational status was significantly associated with a positive attitude to these strategies. Conclusion: There is need for more educational programs and social support to bridge the gap between the levels of awareness and acceptability of strategies for preventing mother to child transmission of HIV among the populace. Nigerian Journal of Medicine Vol. 17 (1) 2008 pp. 29-3

Historical epidemiology of hepatitis C virus in select countries-volume 4

Due to the introduction of newer, more efficacious treatment options, there is a pressing need for policy makers and public health officials to develop or adapt national hepatitis C virus (HCV) control strategies to the changing epidemiological landscape. To do so, detailed, country-specific data are needed to characterize the burden of chronic HCV infection. In this study of 17 countries, a literature review of published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates was conducted, and inputs were validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Hong Kong to 2.4% in Taiwan, while the largest viraemic populations were in Nigeria (2 597 000 cases) and Taiwan (569 000 cases). Diagnosis, treatment and liver transplant rates varied widely across the countries included in this analysis, as did the availability of reliable data. Addressing data gaps will be critical for the development of future strategies to manage and minimize the disease burden of hepatitis

Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study.

Background The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate viral hepatitis by 2030. Although no virological cure exists for hepatitis B virus (HBV) infection, existing therapies to control viral replication and prophylaxis to minimise mother-to-child transmission make elimination of HBV feasible. We aimed to estimate the national, regional, and global prevalence of HBsAg in the general population and in the population aged 5 years in 2016, as well as coverage of prophylaxis, diagnosis, and treatment. Methods In this modelling study, we used a Delphi process that included a literature review in PubMed and Embase, followed by interviews with experts, to quantify the historical epidemiology of HBV infection. We then used a dynamic HBV transmission and progression model to estimate the country-level and regional-level prevalence of HBsAg in 2016 and the effect of prophylaxis and treatment on disease burden. Findings We developed models for 120 countries, 78 of which were populated with data approved by experts. Using these models, we estimated that the global prevalence of HBsAg in 2016 was 3\ub79% (95% uncertainty interval [UI] 3\ub74\u20134\ub76), corresponding to 291992000 (251513000\u2013341114 000) infections. Of these infections, around 29 million (10%) were diagnosed, and only 4\ub78 million (5%) of 94 million individuals eligible for treatment actually received antiviral therapy. Around 1\ub78 (1\ub76\u20132\ub72) million infections were in children aged 5 years, with a prevalence of 1\ub74% (1\ub72\u20131\ub76). We estimated that 87% of infants had received the three-dose HBV vaccination in the first year of life, 46% had received timely birthdose vaccination, and 13% had received hepatitis B immunoglobulin along with the full vaccination regimen. Less than 1% of mothers with a high viral load had received antiviral therapy to reduce mother-to-child transmission. Interpretation Our estimate of HBV prevalence in 2016 differs from previous studies, potentially because we took into account the effect of infant prophylaxis and early childhood vaccination, as well as changing prevalence over time. Although some regions are well on their way to meeting prophylaxis and prevalence targets, all regions must substantially scale-up access to diagnosis and treatment to meet the global targets