Insure them and improve their welfare: effect of Hygeia Community Health Insurance on households’ welfare in Kwara State, Nigeria

The Hygeia Community Health Plan was designed such that agriculture-based households can have access to affordable healthcare services. It is also aimed at providing financial risk protection against catastrophic healthcare costs which if persistent, could possibly drive them into poverty. This paper used a well-structured questionnaire to solicit responses on the effect of the Hygeia Community Health Plan on the welfare of farming households in Kwara State, Nigeria. A two-stage sampling technique was used to sample 175 farming households comprising of 115 beneficiaries and 60 non-beneficiaries from Shonga, Bacita and Lafiagi districts of Edu local government area of Kwara State, Nigeria. The ordinary least square and logit model were used in the analysis of the data for this study. The results of the analysis showed that the Hygeia community health plan was positively and statistically significant in influencing the per capita income, per capita calorie intake and the food security status of farming households in the area. Therefore, it was recommended that the government should create an enabling environment or partner with private insurance organizations. This will help them work out a plan to help rural households in other parts of the country access affordable healthcare services easily. This will help in the attainment of the universal access to health services in Kwara State and country Nigeria at large.</p

FUZZY LOGIC APPROACH TO ENERGY PLANNING IN NIGERIA

Energy planning is an important tool for power system utility company and consumer’s profitability and satisfaction respectively. This paper is a study of energy planning (forecasting) in Ogun state of Nigeria using Fuzzy Logic model. Population and gross domestic product (GDP) are used as the independent variables to forecast load demand based on the previous load demand. After arranging the variables into 5 membership functions and the 19 rules were created, the fuzzy logic model forecast the annual load demand for the next 10 years with a percentage error margin 0.95 % to 21.79 % which results to a mean absolute percentage error (MAPE) of 8.34 %. The result of the forecast shows that within the next 10 years, 2019 to 2028, an average power load of 1985.66 MWH will be required

FUZZY LOGIC APPROACH TO ENERGY PLANNING IN NIGERIA

Energy planning is an important tool for power system utility company and consumer’s profitability and satisfaction respectively. This paper is a study of energy planning (forecasting) in Ogun state of Nigeria using Fuzzy Logic model. Population and gross domestic product (GDP) are used as the independent variables to forecast load demand based on the previous load demand. After arranging the variables into 5 membership functions and the 19 rules were created, the fuzzy logic model forecast the annual load demand for the next 10 years with a percentage error margin 0.95 % to 21.79 % which results to a mean absolute percentage error (MAPE) of 8.34 %. The result of the forecast shows that within the next 10 years, 2019 to 2028, an average power load of 1985.66 MWH will be required

Impact of the introduction of pneumococcal conjugate vaccination on pneumonia in The Gambia: population-based surveillance and case-control studies.

BACKGROUND: Pneumococcal conjugate vaccines (PCVs) are used in many low-income countries but their impact on the incidence of pneumonia is unclear. The Gambia introduced PCV7 in August, 2009, and PCV13 in May, 2011. We aimed to measure the impact of the introduction of these vaccines on pneumonia incidence. METHODS: We did population-based surveillance and case-control studies. The primary endpoint was WHO-defined radiological pneumonia with pulmonary consolidation. Population-based surveillance was for suspected pneumonia in children aged 2-59 months (minimum age 3 months in the case-control study) between May 12, 2008, and Dec 31, 2015. Surveillance for the impact study was limited to the Basse Health and Demographic Surveillance System (BHDSS), whereas surveillance for the case-control study included both the BHDSS and Fuladu West Health and Demographic Surveillance System. Nurses screened all outpatients and inpatients at all health facilities in the surveillance area using standardised criteria for referral to clinicians in Basse and Bansang. These clinicians recorded clinical findings and applied standardised criteria to identify patients with suspected pneumonia. We compared the incidence of pneumonia during the baseline period (May 12, 2008, to May 11, 2010) and the PCV13 period (Jan 1, 2014, to Dec 31, 2015). We also investigated the effectiveness of PCV13 using case-control methods between Sept 12, 2011, and Sept 31, 2014. Controls were aged 90 days or older, and were eligible to have received at least one dose of PCV13; cases had the same eligibility criteria with the addition of having WHO-defined radiological pneumonia. FINDINGS: We investigated 18 833 children with clinical pneumonia and identified 2156 cases of radiological pneumonia. Among children aged 2-11 months, the incidence of radiological pneumonia fell from 21·0 cases per 1000 person-years in the baseline period to 16·2 cases per 1000 person-years (23% decline, 95% CI 7-36) in 2014-15. In the 12-23 month age group, radiological pneumonia decreased from 15·3 to 10·9 cases per 1000 person-years (29% decline, 12-42). In children aged 2-4 years, incidence fell from 5·2 to 4·1 cases per 1000 person-years (22% decline, 1-39). Incidence of all clinical pneumonia increased by 4% (-1 to 8), but hospitalised cases declined by 8% (3-13). Pneumococcal pneumonia declined from 2·9 to 1·2 cases per 1000 person-years (58% decline, 22-77) in children aged 2-11 months and from 2·6 to 0·7 cases per 1000 person-years (75% decline, 47-88) in children aged 12-23 months. Hypoxic pneumonia fell from 13·1 to 5·7 cases per 1000 person-years (57% decline, 42-67) in children aged 2-11 months and from 6·8 to 1·9 cases per 1000 person-years (72% decline, 58-82) in children aged 12-23 months. In the case-control study, the best estimate of the effectiveness of three doses of PCV13 against radiological pneumonia was an adjusted odds ratio of 0·57 (0·30-1·08) in children aged 3-11 months and vaccine effectiveness increased with greater numbers of doses (p=0·026). The analysis in children aged 12 months and older was underpowered because there were few unvaccinated cases and controls. INTERPRETATION: The introduction of PCV in The Gambia was associated with a moderate impact on the incidence of radiological pneumonia, a small reduction in cases of hospitalised pneumonia, and substantial reductions of pneumococcal and hypoxic pneumonia in young children. Low-income countries that introduce PCV13 with reasonable coverage can expect modest reductions in hospitalised cases of pneumonia and a marked impact on the incidence of severe childhood pneumonia. FUNDING: GAVI's Pneumococcal vaccines Accelerated Development and Introduction Plan, Bill & Melinda Gates Foundation, and UK Medical Research Council

Effect of the introduction of pneumococcal conjugate vaccination on invasive pneumococcal disease in The Gambia: a population-based surveillance study.

BACKGROUND: Little information is available about the effect of pneumococcal conjugate vaccines (PCVs) in low-income countries. We measured the effect of these vaccines on invasive pneumococcal disease in The Gambia where the 7-valent vaccine (PCV7) was introduced in August, 2009, followed by the 13-valent vaccine (PCV13) in May, 2011. METHODS: We conducted population-based surveillance for invasive pneumococcal disease in individuals aged 2 months and older who were residents of the Basse Health and Demographic Surveillance System (BHDSS) in the Upper River Region, The Gambia, using standardised criteria to identify and investigate patients. Surveillance was done between May, 2008, and December, 2014. We compared the incidence of invasive pneumococcal disease between baseline (May 12, 2008-May 11, 2010) and after the introduction of PCV13 (Jan 1, 2013-Dec 31, 2014), adjusting for changes in case ascertainment over time. FINDINGS: We investigated 14 650 patients, in whom we identified 320 cases of invasive pneumococcal disease. Compared with baseline, after the introduction of the PCV programme, the incidence of invasive pneumococcal disease decreased by 55% (95% CI 30-71) in the 2-23 months age group, from 253 to 113 per 100 000 population. This decrease was due to an 82% (95% CI 64-91) reduction in serotypes covered by the PCV13 vaccine. In the 2-4 years age group, the incidence of invasive pneumococcal disease decreased by 56% (95% CI 25-75), from 113 to 49 cases per 100 000, with a 68% (95% CI 39-83) reduction in PCV13 serotypes. The incidence of non-PCV13 serotypes in children aged 2-59 months increased by 47% (-21 to 275) from 28 to 41 per 100 000, with a broad range of serotypes. The incidence of non-pneumococcal bacteraemia varied little over time. INTERPRETATION: The Gambian PCV programme reduced the incidence of invasive pneumococcal disease in children aged 2-59 months by around 55%. Further surveillance is needed to ascertain the maximum effect of the vaccine in the 2-4 years and older age groups, and to monitor serotype replacement. Low-income and middle-income countries that introduce PCV13 can expect substantial reductions in invasive pneumococcal disease. FUNDING: GAVI's Pneumococcal vaccines Accelerated Development and Introduction Plan (PneumoADIP), Bill & Melinda Gates Foundation, and the UK Medical Research Council

Impact of the introduction of pneumococcal conjugate vaccination on invasive pneumococcal disease and pneumonia in The Gambia: 10 years of population-based surveillance.

BACKGROUND: The Gambia introduced seven-valent pneumococcal conjugate vaccine (PCV7) in August 2009, followed by PCV13 in May, 2011, using a schedule of three primary doses without a booster dose or catch-up immunisation. We aimed to assess the long-term impact of PCV on disease incidence. METHODS: We did 10 years of population-based surveillance for invasive pneumococcal disease (IPD) and WHO defined radiological pneumonia with consolidation in rural Gambia. The surveillance population included all Basse Health and Demographic Surveillance System residents aged 2 months or older. Nurses screened all outpatients and inpatients at all health facilities using standardised criteria for referral. Clinicians then applied criteria for patient investigation. We defined IPD as a compatible illness with isolation of Streptococcus pneumoniae from a normally sterile site (cerebrospinal fluid, blood, or pleural fluid). We compared disease incidence between baseline (May 12, 2008-May 11, 2010) and post-vaccine years (2016-2017), in children aged 2 months to 14 years, adjusting for changes in case ascertainment over time. FINDINGS: We identified 22 728 patients for investigation and detected 342 cases of IPD and 2623 cases of radiological pneumonia. Among children aged 2-59 months, IPD incidence declined from 184 cases per 100 000 person-years to 38 cases per 100 000 person-years, an 80% reduction (95% CI 69-87). Non-pneumococcal bacteraemia incidence did not change significantly over time (incidence rate ratio 0·88; 95% CI, 0·64-1·21). We detected zero cases of vaccine-type IPD in the 2-11 month age group in 2016-17. Incidence of radiological pneumonia decreased by 33% (95% CI 24-40), from 10·5 to 7·0 per 1000 person-years in the 2-59 month age group, while pneumonia hospitalisations declined by 27% (95% CI 22-31). In the 5-14 year age group, IPD incidence declined by 69% (95% CI -28 to 91) and radiological pneumonia by 27% (95% CI -5 to 49). INTERPRETATION: Routine introduction of PCV13 substantially reduced the incidence of childhood IPD and pneumonia in rural Gambia, including elimination of vaccine-type IPD in infants. Other low-income countries can expect substantial impact from the introduction of PCV13 using a schedule of three primary doses. FUNDING: Gavi, The Vaccine Alliance; Bill & Melinda Gates Foundation; UK Medical Research Council; Pfizer Ltd

Evaluation of essential trace metals in female type 2 diabetes mellitus patients in Nigerian population

Diabetes mellitus (DM)  has been reported to be associated with derangement of micronutrients. This study was to investigate the plasma levels of antioxidant elements (zinc, selenium, copper) haemopoeitic elements (chromium and iron) and magnesium in female type 2 diabetes mellitus (DM) patients. Fifty (50) female type 2 DM patients (test subjects) aged 20 to 50 years and 35 healthy, non-diabetic age-matched females (control subjects) were recruited for the study. Fasting blood plasma levels of the elements were determined using atomic absorption spectrophotometer (AAS) after acid digestion. Blood glucose level was determined by glucose oxidase/peroxidase method to confirm the status of the test and the control subjects. Body mass index was determined from weight and height of the subjects. The mean values of plasma zinc, selenium, magnesium and chromium were significantly lower in the diabetic patients than in non-diabetics (P&lt;0.002, P&lt;0.001, P&lt; 0.001 and P&lt;0.001 respectively). The mean values of glucose, BMI, iron and copper was observed to be significantly higher in diabetic patients than control subjects (P&lt;0.002, P&lt;0.05, P&lt;0.002 and P&lt;0.001 respectively). A significant positive correlation existed between glucose and BMI, copper and iron (r=0.717; P&lt;0.0001, r=0.717; P&lt;0.05, r=0.721; P&lt;0.05) whereas an inverse relationship was observed between iron and chromium, selenium and magnesium (r =-0.448, -0.703 and -0.651; p&lt;0.004, 0.000, 0.000 respectively). Negative association was also observed between copper and zinc (r=-0.716; P&lt;0.01). These findings revealed that DM is associated with significant alteration in the concentrations of essential trace metals and significant increase in BMI. This may contribute to various metabolic complications and increased mortality from cardiovascular diseases in DM patients in the rural locality as it as observed among diabetics in urban settings.Keywords: Trace metals, diabetes mellitus, copper, chromium, Ekiti stateAfrican Journal of Biotechnology, Vol 13(18), 1910-191

Amniotic band syndrome: a report of two cases and review of the literature

Abstract: Amniotic band syndrome (ABS), also known a

Biogenic Synthesis of CuO, ZnO, and CuO&ndash;ZnO Nanoparticles Using Leaf Extracts of Dovyalis caffra and Their Biological Properties

Biogenic metal oxide nanoparticles (NPs) have emerged as a useful tool in biology due to their biocompatibility properties with most biological systems. In this study, we report the synthesis of copper oxide (CuO), zinc oxide (ZnO) nanoparticles (NPs), and their nanocomposite (CuO&ndash;ZnO) prepared using the phytochemical extracts from the leaves of Dovyalis caffra (kei apple). The physicochemical properties of these nanomaterials were established using some characterization techniques including X-ray diffraction analysis (XRD), ultraviolet-visible spectroscopy (UV-vis), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and energy-dispersive X-ray spectroscopy (EDX). The XRD result confirmed the presence of a monoclinic CuO (Tenorite), and a hexagonal ZnO (Zincite) nanoparticles phase, which were both confirmed in the CuO&ndash;ZnO composite. The electron microscopy of the CuO&ndash;ZnO, CuO, and ZnO NPs showed a mixture of nano-scale sizes and spherical/short-rod morphologies, with some agglomeration. In the constituent&rsquo;s analysis (EDX), no unwanted peak was found, which showed the absence of impurities. Antioxidant properties of the nanoparticles was studied, which confirmed that CuO&ndash;ZnO nanocomposite exhibited better scavenging potential than the individual metal oxide nanoparticles (CuO, and ZnO), and ascorbic acid with respect to their minimum inhibitory concentration (IC50) values. Similarly, the in vitro anticancer studies using MCF7 breast cancer cell lines indicated a concentration-dependent profile with the CuO&ndash;ZnO nanocomposite having the best activity over the respective metal oxides, but slightly lower than the standard 5-Fluorouracil drug