Pre-Operative Vocal Cord Palsy in Goitre Patient

Objectives: Determine the prevalence of vocal cord palsy and the relative prevalence of asymptomatic vocal cord palsy in pre-operative goitre patients using flexible fibreoptic laryngoscope (FFL) as a laryngeal  visualisation technique.Design: Hospital-based, cross-sectional study conducted throughout 2011 on consecutive, consenting pre-operative goitre patients referred to the E.N.T Department, University of Ilorin Teaching Hospital. Ilorin, Nigeria.Setting: University of Ilorin Teaching Hospital (U.I.T.H) Ilorin is a 600-bedded tertiary institution, serving primarily patients from Kwara State.Subjects: One hundred and ten consenting patients, age 16 and above- whose cooperation could easily be gained for an awake-laryngoscopy procedure.Results: Mean age, 42.98 ± 14.71. Female: Male = 4.5:1. Palsy rate was 2.9% and 25% in benign and malignant goitre respectively. Hoarseness was reported by 3(2.7%) patients with vocal cord palsy (p 0.001). Asymptomatic palsy was 40%.Conclusion: The prevalence of pre-operative vocal cord palsy was 4.5%; Relative prevalence was 2.9% and relative prevalence was 25% in benign and malignant goitre respectively

Vaccine Storage and Handling Practices among routine immunization service providers in a metropolitan city of North-Central Nigeria

Background: The efficacy of vaccines can be compromised by faulty transport, storage, and handling. This study was conducted to assess the knowledge and practice of vaccine storage and handling among Primary Health Care Workers (PHCWs) offering routine immunization (RI) services in static health facilities in Ilorin metropolis, North-central Nigeria.Methodology: It was a descriptive cross-sectional study carried out among 457 Primary Health Care Workers (PHCWs) in 2 Local Government Authorities in Kwara State, north central Nigeria, using multi stage sampling technique. The research instruments were pretested self-administered questionnaire and observational checklist. The data generated were analyzed using EPI-INFO version 3.5.1 software package. Level of significance was predetermined at p-value of less than 0.05 at 95% confidence interval.Results: About half of the respondents (52.1%) knew the optimal vaccine storage temperature, 35.4% knew that freezing is harmful to certain vaccines. Although, 67.8% were aware of the 'shake test', only 48.4% of them knew how to conduct it. Up to 367 (80.3%) acknowledged that heat is harmful to vaccines. Even though, 267 (58.4%) knew the vaccine vial monitor (VVM) stages, only 248 (45.3%) could interpret the VVM correctly. About 30% of the health facilities (HFs) had adequate vaccine storage equipments while less than one third (28.6%) refrigerators were used exclusively for vaccine storage. However, functioning thermometers were present in all the refrigerators devoted to vaccine storage.Conclusions: Vaccine storage and handling practices among PHCWs providing routine immunization (RI) services in the study area was still sub-optimal. There is need for periodic on the job training and supportive supervision of health workers by middle cadre immunization officers in the local government to improve on the vaccine storage and handling practices of RI service providers.Keywords: Routine immunization, knowledge, vaccine handling, Nigeria, practice

Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

Background Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. Methods We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development. Findings Neurological disorders ranked as the leading cause group of DALYs in 2015 (250·7 [95% uncertainty interval (UI) 229·1 to 274·7] million, comprising 10·2% of global DALYs) and the second-leading cause group of deaths (9·4 [9·1 to 9·7] million], comprising 16·8% of global deaths). The most prevalent neurological disorders were tension-type headache (1505·9 [UI 1337·3 to 1681·6 million cases]), migraine (958·8 [872·1 to 1055·6] million), medication overuse headache (58·5 [50·8 to 67·4 million]), and Alzheimer's disease and other dementias (46·0 [40·2 to 52·7 million]). Between 1990 and 2015, the number of deaths from neurological disorders increased by 36·7%, and the number of DALYs by 7·4%. These increases occurred despite decreases in age-standardised rates of death and DALYs of 26·1% and 29·7%, respectively; stroke and communicable neurological disorders were responsible for most of these decreases. Communicable neurological disorders were the largest cause of DALYs in countries with low SDI. Stroke rates were highest at middle levels of SDI and lowest at the highest SDI. Most of the changes in DALY rates of neurological disorders with development were driven by changes in YLLs. Interpretation Neurological disorders are an important cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of expanding population numbers and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate services

Prevalence and Predictors of Helminthic Infections among Pupils in a Public Primary School on a North-Central City of Nigeria

Background: The prevalence and intensity of helminthiasis are highest in children aged 5-15 years where it accounts for 12% of the total disease burden and 20 % of disability adjusted life years (DALYs) lost among this age group. This study therefore, aims to determine the prevalence and predictors of helminthiasis among pupils in a public primary school in a metropolitan city in north-central Nigeria.Methodology: A descriptive cross-sectional study was carried out between June and November 2010 among pupils registered for the academic year in Okelele Community Ilorin, Nigeria, using a multi- stage sampling technique in 3-stages to recruit 300 participants. A semi-structured, interviewer-administered questionnaire was used to collect quantitative data from respondents and their stool samples were also collected for microscopic examination. Findings The prevalence of helminthiasis was relatively high (32.0%) with a peak prevalence in the 9-12 years old age group. No statistically significant associations were found between prevalence of ascariasis and age, sex, maternal educational backgrounds and maternal occupational status (p > 0.05). Similarly, no statistically significant associations were found between prevalence of ascariasis and hygiene habits of pupils (p > 0.05).Conclusion: Soil-transmitted helminthic infections are still pervasive among school- age children. Implementation of school health service programme will go a long way to improving the environmental, personal and food hygiene habits of pupils thereby reducing helminthic infections among school children.Keywords: Ascaris, prevalence, predictors, Ilorin, helminth

Knowledge And Experience Of Work-Related Hazards And Utilization Of Safety Practices Among Solid Waste Scavengers In Ilorin Metropolis, Kwara State, Nigeria

Waste collection is considered one of the most dangerous job in the world since it exposes the workers to hazards as well as to certain occupation related morbidities. Health status of scavengers is therefore a public health concern, as they could be potential pathways for the transmission of various communicable diseases to the general public. This study assessed the awareness of work-related hazards and utilization of safety practices among Solid waste scavengers in Ilorin Metropolis. The study was a descriptive cross-sectional by design involving solid wastes Scavengers in Ilorin metropolis, North-central Nigeria. A total of 410 solid waste scavengers were recruited following a multi stage sampling method from all the 20 clusters of Scrap dealers. Data was obtained through the use of interviewer administered semi-structured questionnaire. Data was analyzed using SPSS Version 20. P-value of <0.05 at 95% confidence limits were considered statistically significant. More than half (57.3%) of the respondents had awareness of work-related hazards. Similarly, more than half of the respondents have good knowledge of safety boots and hand gloves as ways of preventing work hazards with 58.3% and 56.8% respectively while poor knowledge was recorded for nose guard, face mask and overall/apron with 43.2%, 39.3% and 9.3% respectively. About two-thirds of the respondents, 65.1% have hand gloves however, only 33.2% were making use of it, 52.7% were willing to use it, 57.3% used it always, 74.2% used it for protection while 42.3% were not using it because they felt it was not important. Despite having fair knowledge on the importance of practicing safety measures, only few of the respondents practice these measures. The waste scavengers should be educated on the utilization of PPE and safety measure.Key words: waste scavengers, hazards, PPE, solid waste, Ilorin

Antenatal blood donation: Pregnant mothers' attitude, fears and preferences

Up to 150,000 pregnancy-related deaths could be avoided each year through access to safe blood. Antenatal blood donation, which will increase access to safe blood, is one of the ways to reduce maternal mortality in this environment. This study assessed the knowledge, attitude, fears and preferences of pregnant mothers regarding antenatal blood donation. The study was carried out in Kwara State Specialist Hospital (KSSH) Sobi. All (400) consenting pregnant women accessing ANC services at the HF were recruited. Data was collected using pretested semistructured interviewer administered questionnaire. Data analysis was done using SPSS version 17.0. A P- value < 0.05 was considered significant at 95% confidence level. The age range of the respondents is between 16 to 42 years, with a mean age of 27.81± 5.21. More than half (58.5%) of the respondents had the knowledge that blood transfusion may be required for pregnant women. Over 80% of the respondents think that the donor of blood for pregnant woman could be the spouse, the siblings, parents, in-laws or paid donor However, majority (62.5%) would prefer blood transfusion from a family member. Risk of contracting infection was most feared among the respondents (52.5%). There is good awareness among the study population on the possible need for blood transfusion during pregnancy and childbirth but great misconception and concerns over receiving blood transfusion still persists. There is need for continuing public education to clear misconceptions and baseless concerns over receiving blood transfusion.Key words: pregnant mothers, attitude, antenatal blood donation, Ilori

Malaria Diagnosis And Treatment Practices By Patent And Proprietary Medicine Vendors In Bauchi Metropolis, Bauchi State in North Eastern Nigeria

Malaria is one of the leading causes of morbidity and mortality in Nigeria with about 50% of the population having at least an episode of clinical malaria each year. Patent medicine vendors are the first and most common source of malaria treatment in Nigeria. This study assessed malaria diagnosis and treatment practices by Patent and Proprietary Medicine Vendors (PPMVs) in Bauchi metropolis, Bauchi L.G.A., Bauchi State, Nigeria. This study was a cross sectional analytical study involving PPMVs in Bauchi metropolis. A total of 396 PPMVs were recruited into the study. The data was collected using 40 items questionnaire and were analyzed with frequencies, percentages and chi-square. The hypotheses postulated were tested at 0.05 level of significance. The data was analyzed by using SPSS Version 16.0.Respondents consisted of 253 (63.9%) health professionals (HPs) and 143 (36.15) non professionals (NHPs). About two third of the respondents; 99 (69.2%) among HPs and NHPs 88(61.3%) have good knowledge about malaria transmission. Only few respondents used Rapid Diagnostic Test (RDT) in identifying malaria; 12 (8.7%) among NHPs and 22 (12.6%) among HPs. The difference is not statistically significant (P-value 0.217). Moreover, 121 (47.8%) and 48 (33.6%) for both NHPs and HPs respectively reported lack of skills as the reason for not using RDT. Majority of the respondents are still dispensing Chloroquine (CQ) for malaria with 68.4% and 69.2% among NHPs and HPs respectively. The used of RDT by the respondent is poor. There is need to train PPMVs on current national policy onmalaria, especially malaria identification using RDT kits and used of Artemisinin –based Combination Therapy (ACT) in treatment of malaria. The RDT kits should also be made available.Keywords: Malaria, Diagnosis, RDT, Patent Medicine Vendors, Bauchi metropolis

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Findings Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124.1 million DALYs [95% UI 111.2 million to 137.0 million]), high systolic blood pressure (122.2 million DALYs [110.3 million to 133.3 million], and low birthweight and short gestation (83.0 million DALYs [78.3 million to 87.7 million]), and for women, were high systolic blood pressure (89.9 million DALYs [80.9 million to 98.2 million]), high body-mass index (64.8 million DALYs [44.4 million to 87.6 million]), and high fasting plasma glucose (63.8 million DALYs [53.2 million to 76.3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9.3% (6.9-11.6) decline in deaths and a 10.8% (8.3-13.1) decrease in DALYs at the global level, while population ageing accounts for 14.9% (12.7-17.5) of deaths and 6.2% (3.9-8.7) of DALYs, and population growth for 12.4% (10.1-14.9) of deaths and 12.4% (10.1-14.9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27.3% (24.9-29.7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. Interpretation Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe