Rapid Assessment of Cataract Blindness Among Ughelli Clan in an Urban/Rural District of Delta State, Nigeria

Background: A population based, rapid assessment for cataract blindness was conducted in Ughelli North local government area of DeltaState, an urban/rural area of Nigeria between June and July 2001 with the aim of establishing baseline data for developing cataract intervention services for the area. Method: A cluster random sampling method was used based on the guidelines for the Rapid Assessment for Cataract Surgery. A total of 8 clusters of 90 persons were randomly selected from the 8 communities that make up the Ughelli clan. Only people of 50 years and above who had been resident in the area for up to six months were included. A total of 684 persons were examined (91.2% coverage) using a designed survey form. The barriers to the uptake of cataract surgery were also identified during the survey. The WHO definitions of blindness and visual impairment according to visual acuity were used as criteria for classification of visual blindness and visual impairment. Results: The prevalence of bilateral cataract blindness (cataract causing visual acuity of less than 3/60 in the better eye) for people of 50 years and above was 4.1% (95% CI: 2.96 to 5.24%) with cataract accounting for 41.2% of all the blindness in this age group. Prevalence of cataract blindness was higher in females than in males (5.0% versus 3.6%) About 80% of the cataract blindness occurs in people of 70 years and above. The cataract surgical coverage for eyes was 4.5%; cataract surgical coverage for couching was 18.2%. The major barriers to the uptake of cataract surgical services were lack of awareness of eye care services in nearby district (71.0%), the imagined high cost of the services (17.9%) the perception of women that their health problems are not of immediate importance (7.1%). Conclusion:At the time of study about 2000 person required immediate cataract surgery in the area. With an estimated incidence of 400 new cases per year, there is a need to set up cataract surgical services in the Ughelli North local government area. Special attention should be given to reduction of cataract blindness in females.Introduction : Evaluation rapide, bas\ue9e sur une population de la c\ue9cit\ue9 provoqu\ue9e par une cataracte a \ue9t\ue9 effectu\ue9e dans l'administration locale du nord d'Ughelli de l'\uc9tat de Delta, une zone urbaine/rurale du Nig\ue9ria entre juin et juillet 2001 dans le but d'\ue9tablir des donn\ue9es de base pour le d\ue9veloppement du service d'intervention chirurgicale de la cataracte pour la r\ue9gion. M\ue9thode : Une m\ue9thode d'un groupe d'\ue9chantillonage au hasard a \ue9t\ue9 utilis\ue9e bas\ue9e sur des directives pour l'Evaluation Rapide pour l'intervention chirurgicale de la Cataracte. Un nombre total de 8 groupes compos\ue9s de 90 personnes ont \ue9t\ue9 s\ue9lectionn\ue9s au hasard parmi les 8 communaut\ue9s dont le clan d'Ughelli est compos\ue9. Un nombre total de 684 personnes ont \ue9t\ue9 examin\ue9es soit 91,2% traitement \ue0 travers l'utilisation d'un formulaire con\ue7u pour faire un sondage. R\ue9sultats : La fr\ue9quence de la c\ue9cit\ue9 de la cataracte bilat\ue9rale (la cataracte qui provoque une acuit\ue9 visuelle de moins de 3/60 dans le meilleur oeil) pour des peuples de 50 ans et plus \ue9tait 4,1% soit 95% CL : 2,96 au 5,24%) dont la cataracte constitue 41,2% de toute les c\ue9cit\ue9s dans cette tranche d'\ue2ge. La fr\ue9quence de la c\ue9cit\ue9 de la cataracte \ue9tait \ue9lev\ue9e chez le sexe f\ue9minin plus que chez le sexe masculin (5,0% contre 3,6%) Environ 80% de la c\ue9cit\ue9 de la cataracte arrivent chez des gens \ue2g\ue9s de 70 ans et plus. Les traitements \ue0 travers l'intervention chirurgicale de la cataracte pour des yeux \ue9tait 4,5%. Les traitements pour l'intervention chirurgicale pour le couching contitue 18,2%. Les barri\ue8res principales contre les services d'intervention chirurgicale de la cataracte \ue9taient manque de l'opinion publique sur la conscience de services de soins des yeux dans la r\ue9gion d'\ue0 c\uf4t\ue9 (71,0%), le soi-disant services \ue0 grands frais, (17,9%), la conception des femmes que les probl\ue8mes r\ue9latifs \ue0 leurs sant\ue9 n'est pas d'urgence (7,1%). Conclusion : Pendant cette \ue9tude, environ 2000 personnes avaient besoin de l'intervention chirurgicale de la cataracte d'urgence dans cette r\ue9gion. Avec une fr\ue9quence d'environ 400 nouveaux cas chaque ann\ue9e, c'est n\ue9cessaire de cr\ue9er un service d'Intervention Chirurgicale de la Cataracte dans l'administration locale du nord d'Ughelli. Une attention particuli\ue8re devrait \ueatre port\ue9e sur la reduction de la c\ue9cit\ue9 de la cataracte chez des femmes

Bio-guided Isolation, Purification and Chemical Characterization of Epigallocatechin; Epicatechin, Stigmasterol, Phytosterol from of Ethyl Acetate Stem Bark Fraction of Spondias mombin (Linn.)

Spondias mombin (Linn.) is a widely cultivated edible plant used in folkloric medicine for the treatment of severe infection and health disorders. This research work was carried out to isolation, purification and chemical characterization the bioactive constituents of the ethyl acetate stem bark fraction of Spondias mombin (Linn.), a medicinally important plant of the Anacardiaceae family. This study revealed the presence of flavonoid and steroids, which have been found to be important hormone regulators which possess antimicrobial, anti-inflammatory, antioxidant properties. The chemical investigation resulted in the isolation of (C15H14O6.) 5, 7, 3', 4'-pentahydroxy flavanol (Epicatechin), (C15H14O7.) Epigallocatechin (C29H48O.), Stigmasterol phytosterol. It is here reported isolated from Spondias mombin for the first time, this makes the Spondias mombin very important medicinal plant in Nigeria and west Africa. EGC and EC arts as a strong inhibitor of HIV replication in cultured peripheral blood cells and inhibition of HIV-1 reverse transcriptase in vitro. EGC binds directly to CD4 molecules with consequent inhibition of Gp 120 binding and inactivate viruses in-vitro by deformation of phospholipids. Stigmasterol phytosterol have been shown to lower/reduce blood cholesterol and this lowering may reduce the risk of coronary heart disease. The structure was elucidated using two dimensional NMR spectroscopy, NMR (1H, 13 C) spectroscopy in combination with Infra-red (IR) and Mass spectrometer (MS) spectra data

Clinical profile of parkinsonism and Parkinson's disease in Lagos, Southwestern Nigeria

<p>Abstract</p> <p>Background</p> <p>Current data on the pattern of parkinsonism and Parkinson's disease in Nigerians are sparse.</p> <p>This database was designed to document the clinical profile of PD in Nigerians, and compare this to prior observations.</p> <p>Methods</p> <p>A database of patients presenting to the Neurology out-patients clinic of the Lagos University Teaching Hospital was established in October 1996. Demographic and clinical data at presentation (disease stage using Hoehn and Yahr scale; 'off' state severity on the Unified Parkinson's disease Rating Scale) were documented for patients diagnosed with parkinsonism between October 1996 and December 2006. Cases were classified as Parkinson's disease or secondary parkinsonism (in the presence of criteria suggestive of a secondary aetiology).</p> <p>Results</p> <p>The hospital frequency of parkinsonism (over a 2-year period, and relative to other neurologic disorders) was 1.47% (i.e. 20/1360). Of the 124 patients with parkinsonism, 98 (79.0%) had PD, while 26 (21.0%) had secondary parkinsonism. Mean age (SD) at onset of PD (61.5 (10.0) years) was slightly higher than for secondary parkinsonism (57.5 (14.0) years) (P = 0.10). There was a male preponderance in PD (3.3 to 1) and secondary parkinsonism (2.7 to 1), while a positive family history of parkinsonism was present in only 1.02% (1/98) of PD. There was a modestly significant difference in age at onset (SD) of PD in men (60.3 (10.4)) compared to women (65.2 (7.9)) (T = 2.08; P = 0.04). The frequency of young onset PD (≤ 50 years) was 16.3% (16/98). The mean time interval from onset of motor symptoms to diagnosis of PD was 24.6 ± 26.1 months with majority presenting at a median 12 months from onset. On the H&Y scale, severity of PD at presentation was a median 2.0 (range 1 to 4). PD disease subtype was tremor-dominant in 31 (31.6%), mixed 54 (55.1%) and akinetic-rigid 14 (14.3%). Hypertension was present as a co-morbidity in 20 (20.4%), and diabetes in 6 (6.12%).</p> <p>Conclusions</p> <p>The clinical profile of PD in Nigerians is similar to that in other populations, but is characterized by delayed presentation as has been reported in other developing countries. Young-onset disease occurs but may be less commonly encountered, and frequency of a positive family history is lower than in western populations.</p

New onset neuromyelitis optica in a young Nigerian woman with possible antiphospholipid syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Devic's neuromyelitis optica is an inflammatory demyelinating disease that targets the optic nerves and spinal cord. It has a worldwide distribution and distinctive features that distinguish it from multiple sclerosis. There has been no previous report of neuromyelitis optica from our practice environment, and we are not aware of any case associated with antiphospholipid syndrome in an African person.</p> <p>Case presentation</p> <p>We report the case of a 28-year-old Nigerian woman who presented with neck pain, paroxysmal tonic spasms, a positive Lhermitte's sign and spastic quadriplegia. She later developed bilateral optic neuritis and had clinical and biochemical features of antiphospholipid syndrome. Her initial magnetic resonance imaging showed a central linear hyperintense focus in the intramedullary portion of C2 to C4. Repeat magnetic resonance imaging after treatment revealed resolution of the signal intensity noticed earlier.</p> <p>Conclusion</p> <p>Neuromyelitis optica should be considered in the differential diagnoses of acute myelopathy in Africans. We also highlight the unusual association with antiphospholipid syndrome. Physicians should screen such patients for autoimmune disorders.</p

Nigeria’s Relations with Her Neighbors and the Fight against Terrorism: An Analysis of the Multinational Joint Task Force

This chapter examines Nigeria’s relationship with her immediate neighboring countries in the fight against terrorism. It probed the challenges of national security following the internationalization of Boko Haram terrorist threats, particularly around the Lake Chad basin, and the responses of countries such as Cameroon, Chad, and Niger. These countries, like Nigeria, share borders around the Lake Chad and are the core contributors to the Multinational Joint Task Force (MNJTF). Nigeria is an English-speaking country (former British colony), while these other neighbors are historically French colonial territories. Hence, their political, cultural, military, and economic affinities are with France. The varying backgrounds have accounted for the challenges in the subregion including the Boko Haram insurgency and the efforts at military cooperation in tackling it. Consequently, these questions are examined: what factors led to the formation of MNJTF and what role has it played in the counterterrorism strategies of the country? In what ways has the nature of Nigeria’s relations with these countries impacted on the operation of the body? What are the roles of external powers such as France with her domineering influence on these countries in the war against terrorism and how has it promoted Nigeria’s national security interest? The chapter relies on documented materials to interrogate the questions and proffer necessary policy recommendations premised on the findings

Epidemiology of neurodegenerative diseases in sub-Saharan Africa: a systematic review

BACKGROUND:Sub-Saharan African (SSA) countries are experiencing rapid transitions with increased life expectancy. As a result the burden of age-related conditions such as neurodegenerative diseases might be increasing. We conducted a systematic review of published studies on common neurodegenerative diseases, and HIV-related neurocognitive impairment in SSA, in order to identify research gaps and inform prevention and control solutions. METHODS: We searched MEDLINE via PubMed, 'Banque de Donnees de Sante Publique' and the database of the 'Institut d'Epidemiologie Neurologique et de Neurologie Tropicale' from inception to February 2013 for published original studies from SSA on neurodegenerative diseases and HIV-related neurocognitive impairment. Screening and data extraction were conducted by two investigators. Bibliographies and citations of eligible studies were investigated. RESULTS: In all 144 publications reporting on dementia (n=49 publications, mainly Alzheimer disease), Parkinsonism (PD, n=20), HIV-related neurocognitive impairment (n=47), Huntington disease (HD, n=19), amyotrophic lateral sclerosis (ALS, n=15), cerebellar degeneration (n=4) and Lewy body dementia (n=1). Of these studies, largely based on prevalent cases from retrospective data on urban populations, half originated from Nigeria and South Africa. The prevalence of dementia (Alzheimer disease) varied between <1% and 10.1% (0.7% and 5.6%) in population-based studies and from <1% to 47.8% in hospital-based studies. Incidence of dementia (Alzheimer disease) ranged from 8.7 to 21.8/1000/year (9.5 to 11.1), and major risk factors were advanced age and female sex. HIV-related neurocognitive impairment's prevalence (all from hospital-based studies) ranged from <1% to 80%. Population-based prevalence of PD and ALS varied from 10 to 235/100,000, and from 5 to 15/100,000 respectively while that for Huntington disease was 3.5/100,000. Equivalent figures for hospital based studies were the following: PD (0.41 to 7.2%), ALS (0.2 to 8.0/1000), and HD (0.2/100,000 to 46.0/100,000). CONCLUSIONS: The body of literature on neurodegenerative disorders in SSA is large with regard to dementia and HIV-related neurocognitive disorders but limited for other neurodegenerative disorders. Shortcomings include few population-based studies, heterogeneous diagnostic criteria and uneven representation of countries on the continent. There are important knowledge gaps that need urgent action, in order to prepare the sub-continent for the anticipated local surge in neurodegenerative diseases

British ‘Colonial governmentality’: slave, forced and waged worker policies in colonial Nigeria, 1896–1930

“This is an Accepted Manuscript of an article published by Taylor & Francis in Management & Organizational History on 22 Apr 2019, available online: https://doi.org/10.1080/17449359.2019.1578669