CREDIT RISK MANAGEMENT AND FINANCIAL PERFORMANCE: A STUDY OFSELECTED DEPOSIT MONEY BANKS IN NIGERIA

The study on the credit risk management and financial performance of deposit money banks in Nigeria, 2004 – 2022, aimed to understand the relationship between non-performing loans, total loans, bank’s capital as the independent variables and return on investments, return on equity as the dependent variables. Financial statement of five commercial banks in Nigeria were obtained between 2004 and 2022. Panel regression analysis was used to analyse the time series data. The analysis covered the descriptive analysis, unit root analysis, pooled regression analysis, random effect, fixed effects as well as hausman tests. The post estimation tests included serial correlation analysis and heteroskedasticity tests. The study found that non-performing loans, total loans have negative and significant relationship with ROE but positive and significant relationship with ROI. Bank capital was also found to have positive and significant relationship with financial performance of deposit money banks in Nigeria. The study recommended, amongst others, that deposit money banks must ensure that the loans they disburse perform and also, they should device efficient systems of monitoring their total loan disbursements

Sphingomonas paucimobilis septicaemia in a tertiary care hospital in Nigeria: a case report

Sphingomonas paucimobilis is an opportunistic pathogen that occurs naturally in the environment. It has been implicated in both community acquired and healthcare associated infections. Sphingomonas paucimobilis septicaemia is commonly associated with contamination from the environment, the use of hospital and laboratory equipment, indwelling urinary catheters and intravenous cannula. Literature search for Sphingomonas paucimobilis septicaemia revealed several case reports documented globally with only a single case report from Nigeria detected by VITEK 2. We report a case of Sphingomonas paucimobilis septicaemia in 38-year-old unbooked 21 woman, P1+2(1A), admitted into the accident and emergency unit of Lagos University Teaching Hospital, Lagos, Nigeria, with complaints of fever, abdominal pain and distension, generalized body pain and difficulty in breathing, of six days post Caesarean section. Blood culture yielded Sphingomonas paucimobilis. Antibiotics were commenced at admission and exploratory laparotomy done seven days post presentation. However, patient died on day fourteen due to cardiopulmonary arrest

Opportunistic fungal infections in persons living with advanced HIV disease in Lagos, Nigeria; a 12-year retrospective study

Introduction: Nigeria has a large estimated burden of AIDS-related mycoses. We aimed to determine the proportion of patients with AIDS-related opportunistic fungal infections (OFIs) at an urban antiretroviral treatment (ART) centre in Nigeria. Methods: A retrospective analysis of a cohort of ART-na\uefve, HIV-infected patients, assessed for ART eligibility and ART-experience at the PEPFAR outpatient clinic at Lagos University Teaching Hospital over a 12-year period (April 2004-February 2016) was conducted. Results: During this period, 7,034 patients visited the clinic: 4,797 (68.2%) were female; 6161 patients had a recorded baseline CD4 count, and the median CD4 count was 184 cells/\u3bcl (IQR, 84-328). A baseline HIV-1 viral load (VL) was recorded for 5,908 patients; the median VL was 51,194 RNA copies/ml (IQR, 2,316-283,508) and 6,179/7046(88%) had initiated ART. Some 2,456 (34.9%) had a documented opportunistic infections, of whom 1,306 (18.6%) had an opportunistic fungal infection. The total number of OFI episodes was 1,632: oral candidiasis (n=1,473, 90.3%), oesophageal candidiasis (n=118; 8%), superficial mycoses (n=23; 1.6%), Pneumocystis pneumonia (PJP) (n=13; 0.8%), and cryptococcal meningitis(CM) (n=5; 0.4%). 113 (1.6%) were known to have died in the cohort. Conclusion: Approximately 1 in 5 HIV-infected patients in this retrospective cohort, most of whom had initiated ART, were clinically diagnosed with an OFI. Improved access to simple accurate diagnostic tests for CM and PJP should be prioritised for this setting

Eumycotic mycetoma in a young girl from Sokoto, Nigeria: a rare and unusual presentation

Introduction: A typical presentation of Mycetoma is not uncommon although clinical manifestations might be misleading leading to delay in diagnosis, treatment and consequently leading to poor prognosis. Mycetoma can have a fungal or bacterial etiology and manifestation is usually that of a disfiguring subcutaneous infection that can affect any part of the exposed body. We are reporting a case of Mycetoma in an eleven years old girl that occurred in parts of the lower abdomen, perineum and gluteal region that was initially thought to be a soft tissue sarcoma or disseminated tuberculosis.Case Presentation: An eleven years old girl presented to Usmanu Danfodiyo University Teaching Hospital, Sokoto with lower abdominal mass and multiple nodular masses with discharging sinuses on the upper part of the right thigh, perineum and gluteal region of six months duration. Swellings started as multiple small boils that subsequently started discharging from various points. Patient usually fetches firewood in the forest for her parents as her routine house chores and she remembered an incident where she had pricks from thorns in the bush around her lower thigh and perineum. On examination she was chronically ill looking, in painful distress, with bilateral inguinal lymphadenopathy. She had nodular lesions of varying sizes ranging from 1x1cm to 4x4cm, tender, involving the upper part of the thigh bilaterally, but more on the right, lower abdomen, labia and gluteal region. Some of the lesions had hyper-pigmented sinuses discharging mucopurulent fluid, with areas of soft tissue swelling around the lower abdomen and upper right thigh extending to the leg. Patient was observed to walk with a limp gait.Management and Outcome: An initial diagnosis of soft tissue infection to rule out soft tissue sarcoma and disseminated tuberculosis (abdomen and lymph nodes) and deep tissue mycosis was made. However, with further investigations and reviews by the medical microbiologist and anatomic pathologist, along with bacteriologic, and mycologic studies of swab samples and aspirate and tissue biopsy for Histology revealed an eumycotic mycetoma. She received Ketoconazole and Trimetoprim-sulphametoxazole. She responded significantly as lesions reduced in sizes, abdominal swelling and leg swelling reduced with closure of discharging sinuses. Patient could walk with some resolution of the limp. Repeat abdominal ultrasound scan showed resolution of initial findings. She spent four weeks in the hospital and was discharged. On subsequent follow-up; she was walking without any limp and lesions were healed with some scar and few areas left to dry up. Further follow-up visits after one month and three month showed progressive healing and complete resolution of lesion respectively. However. Patient was however lost to further follow-up which would have enabled monitoring as to any reoccurrence or not.Conclusion: We presented a case of a young girl with an abnormal presentation of eumycotic mycetoma. Patient achieved near cure on medications without the need of surgery due to an excellent multidisciplinary approach between pediatricians, clinicians, clinical microbiologists and anatomic pathologists.Keywords: Mycetoma, Eumycetoma, Paediatric

Cryptococcal meningitis after ART : Need for proper baseline evaluation in the era of ‘Test & Treat’

Peer reviewedPublisher PD

An Excel-based template for estimating induction-phase treatment costs for cryptococcal meningitis in high HIV-burden African countries

This repository contains a costing template for estimating induction-phase treatment costs for cryptococcal meningitis in high HIV-burden African countries. Four country-specific examples are included (and any of these examples can be used as a template for replication with new information, in other locations, etc. A brief User's Guide is included.This dataset is related to the following forthcoming article: Larson B, Shroufi A, Muthoga C et al. Induction-phase treatment costs for cryptococcal meningitis in high HIV-burden African countries: New opportunities with lower costs [V.1; awaiting peer review]. Wellcome Open Res 2021, 6:140 (https://doi.org/10.12688/wellcomeopenres.16776.1)BL: CDC Foundation NPG: CDC, CDC Foundation, Bill and Melinda Gates Foundation, NIH, UK MRC unrelated to the current work. NPG is partly supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (R01AI118511). JJ: National Institute for Health Research (NIHR) through a Global Health Professorship (grant RP-2017-08-ST2-012) using UK aid from the UK Government to support global health research. RR: National Institute of Allergy and Infectious Diseases (K23 AI38851) Disclaimer The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the CDC, NIH, NIHR, the Department of Health and Social Care, or other funding entities

The Case for Fungal Keratitis to Be Accepted as a Neglected Tropical Disease

Amongst the treatable cause of blindness among young people, fungal keratitis ranks high. There are an estimated 1,051,787 to 1,480,916 eyes affected annually, with 8-11% of patients having to have the eye removed. Diagnosis requires a corneal scraping, direct microscopy and fungal culture with a large number of airborne fungi implicated. Treatment involves the intensive application of antifungal eye drops, preferably natamycin, often combined with surgery. In low-resource settings, inappropriate corticosteroid eye drops, ineffective antibacterial therapy, diagnostic delay or no diagnosis all contribute to poor ocular outcomes with blindness (unilateral or bilateral) common. Modern detailed guidelines on fungal keratitis diagnosis and management are lacking. Here, we argue that fungal keratitis should be included as a neglected tropical disease, which would facilitate greater awareness of the condition, improved diagnostic capability, and access to affordable antifungal eye medicine

Missed Opportunities in Comprehensive Response to Sexual Assaults in Ekiti State, Nigeria

Sexual assault referral centres were designed to provide comprehensive services to survivors to mitigate the physical and psychological consequences of rape. However, some of the survivors who reported at these centres did not benefit fully from these, thereby presenting as missed opportunities. We assessed the missed opportunities among the survivors who reported at Ekiti Sexual Assault Referral Centre, Ado-Ekiti, Nigeria from June 2020 to June 2022. Data were extracted from the records of the Ekiti Sexual Assault Referral Centre, Ado-Ekiti and the Department of Public Prosecution of Ekiti State Ministry of Justice, Ado-Ekiti. The missed opportunities for post-exposure prophylaxis for HIV, emergency contraception, economic empowerment and relocation/shelter services were 62.2%, 35.9%, 42.3% and 4.3% respectively. There were 18 convictions out of the 21 concluded cases. Delayed reporting and poor compliance with follow-up schedules appear to be common denominators in these missed opportunities. To improve on the effectiveness of these services, there is a need to understand the cascade of events leading to delayed reporting and poor compliance with follow-up schedules by the survivors. Mobilisation of adequate financial resources is also expedient for the effective delivery of these services