Prevalence and Predictors of Urinary Tract Infection and Severe Malaria Among Febrile Children Attending Makongoro Health Centre in Mwanza City, North-Western Tanzania.

In malaria endemic areas, fever has been used as an entry point for presumptive treatment of malaria. At present, the decrease in malaria transmission in Africa implies an increase in febrile illnesses related to other causes among underfives. Moreover, it is estimated that more than half of the children presenting with fever to public clinics in Africa do not have a malaria infection. Thus, for a better management of all febrile illnesses among under-fives, it becomes relevant to understand the underlying aetiology of the illness. The present study was conducted to determine the relative prevalence and predictors of P. falciparum malaria, urinary tract infections and bacteremia among under-fives presenting with a febrile illness at the Makongoro Primary Health Centre, North-Western Tanzania. From February to June 2011, a cross-sectional analytical survey was conducted among febrile children less than five years of age. Demographic and clinical data were collected using a standardized pre-tested questionnaire. Blood and urine culture was done, followed by the identification of isolates using in-house biochemical methods. Susceptibility patterns to commonly used antibiotics were investigated using the disc diffusion method. Giemsa stained thin and thick blood smears were examined for any malaria parasites stages. A total of 231 febrile under-fives were enrolled in the study. Of all the children, 20.3% (47/231, 95%CI, 15.10-25.48), 9.5% (22/231, 95%CI, 5.72-13.28) and 7.4% (17/231, 95%CI, 4.00-10.8) had urinary tract infections, P. falciparum malaria and bacteremia respectively. In general, 11.5% (10/87, 95%CI, 8.10-14.90) of the children had two infections and only one child had all three infections. Predictors of urinary tract infections (UTI) were dysuria (OR = 12.51, 95% CI, 4.28-36.57, P < 0.001) and body temperature (40-41 C) (OR = 12.54, 95% CI, 4.28-36.73, P < 0.001). Predictors of P. falciparum severe malaria were pallor (OR = 4.66 95%CI, 1.21-17.8, P = 0.025) and convulsion (OR = 102, 95% CI, 10-996, P = 0.001). Escherichia coli were the common gram negative isolates from urine (72.3%, 95% CI, 66.50-78.10) and blood (40%, 95%CI, and 33.70-46.30). Escherichia coli from urine were 100% resistant to ampicillin, 97% resistant to co-trimoxazole, 85% resistant to augmentin and 32.4% resistant to gentamicin; and they were 100%, 91.2% and 73.5% sensitive to meropenem, ciprofloxacin and ceftriaxone respectively. Urinary tract infection caused by multi drug resistant Escherichia coli was the common cause of febrile illness in our setting. Improvement of malaria diagnosis and its differential diagnosis from other causes of febrile illnesses may provide effective management of febrile illnesses among children in Tanzania

Corruption an Enemy to Economic Development in Nigeria

The issue of corruption has raised a lot of concern as it continues to plague the nation. This paper examines the relationship between corruption and economic development using secondary sources of data from 1980-2011. The social development model was employed using multiple linear regression analysis to determine if a relationship indeed exists between corruption and economic development. The result gave an R2 value of 0.848 indicating that a significant relationship between corruption and economic development exists, thus the null hypothesis; Ho was rejected. The paper recommends amongst others that government should be sincere and transparent in their activities; sudden wealth by individuals be investigated and love of country should be embraced by all. Keywords: Corruption, Economic Development, Transparency, Governance, Nigeri

Pattern and antimicrobial sensitivity of pathogens in acute bacterial meningitis beyond neonatal period at Ahmadu Bello University Teaching Hospital (ABUTH) Shika, Zaria

The causative agents of acute bacterial meningitis vary from time to time and from place to place. In addition, changes in pathogen&#8217;s sensitivity to antibiotics in use occur. The study was undertaken to identify the pattern and susceptibility of pathogens to antibiotics among children beyond neonatal period for prompt empirical treatment of this important cause of morbidity and mortality especially in developing countries.Objective. To identify the pattern and susceptibility of pathogens in acutebacterial meningitis among children aged one month to 12 years atABUTH Shika, Zaria.Method: This was a prospective study carried out in children presentingto Emergency Pediatric Unit of ABUTH Shika, Zaria, from October1st 2005 to September 30th, 2006. Children who met the inclusion criteriafor lumbar puncture were consecutively recruited. Cerebrospinalfluid (CSF) samples were collected for microscopy, culture, sensitivity,and Latex Particle Agglutination (LPA) test. Sixty-six (66) patientssatisfied the criteria for acute bacterial meningitis and were studied.Results: The prevalence of acute bacterial meningitis in this study was6.9%. Sixty-six patients with acute bacterial meningitis were identifiedusing 3 diagnostic methods (Gram stain, culture and LPA). The 3 commonest organisms were Streptococcus pneumoniae 34 (51.5%), Haemophilus influenzae 18 (27.3%), and Neisseria meningitidis 12(11.2%). The sensitivity of the isolates to three commonly used noncephalosporin antibiotics was chloramphenicol 74.4%, penicillin38.5%, and ampicillin 2.6%. The sensitivity to the cephalosporin wascefotaxime 97.4%, and ceftriaxone 89.7% while that to Ofloxacin, aquinolone, was 100%.Conclusion: The three commonest bacterial agents causing post neonatalmeningitis were Streptococcus pneumoniae, Haemophilus influenzae,and Neisseria meningitidis. There is an increasing resistance to the three commonly used non c e p h a l o s p o r i n a n t i b i o t i c s(chloramphenicol, ampicillin and penicillin) and hence, cefotaxime orceftriaxone should be used in the empirical treatment of children withsuspected acute bacterial meningitis beyond neonatal period

Knowledge of Breast Cancer and Need for its Screening Among Female Healthcare Workers in Oshimili South Local Government Council Area of Delta State, Nigeria

Background: Breast cancer is the most commonly diagnosed cancer among women worldwide and the most common among African women. The WHO, recent global cancer statistics indicate a rising global incidence of breast cancer in populations of the developing countries that previously enjoyed a low incidence of the disease. Early detection through mammogram, clinical breast examination (CBE), and breast self examination (BSE) is critical to reducing breast cancer related morbidity and mortality.Objectives: To assess the knowledge, awareness, perception and behavior of female healthcare workers in Oshimili South LGA of Delta State towards breast cancer and its screening.Methods: A cross-sectional descriptive study done from January to March 2014. Multistage sampling technique was used in the selection of the LGA and study participants. Data was collected using a semi-structured questionnaire and were analyzed using SPSS version 17.Results: A total of 424 female healthcare workers were interviewed. The mean age was 35.4 years and ranged from 21 to 58 years. A total of 406 respondents (97.1%) were aware of breast cancer; 340(81.3%) practice breast self examination (BSE); 117(41.9%) knew about breast mammography. The commonest source of information about breast cancer was from fellow healthcare workers (45.3%), followed by school (16.5%), and newspaper (14.8%).Conclusion: The study shows a high level of awareness of breast cancer and BSE but a low level of awareness of breast mammography. The level of awareness of breast cancer, the practice of BSE and awareness of breast mammography were all found to increase with increase in age of respondents. The married respondents were more aware of breast cancer and also of breast mammography. Higher educational level was not found to increase awareness of breast cancer, practice of BSE and knowledge of breast mammography.Key words: Breast cancer, knowledge, screenin

A revised scoring scheme for the classification of socio-economic status in Nigeria

Background: Researchers in medicine and related fields in Nigeria have usually made recourse to the instrument developed by Olusanya et al and Oyedeji in the past three-and-a half decades for determination of socioeconomic status (SES). Beside the question of their age, however, these instruments were purposive and might no longer be suitable because of the changes in the parameters on which they were based.Objective: To develop a robust but generic scheme that takes into consideration the changes in the nation’s socioeconomic space in the succeeding three and a half decades.Methods: A detailed and comprehensive review of the extant schemes was undertaken with a view to identifying their inherent weaknesses. The latter were then factored into the design of a new scheme taking into consideration the emergent restructuring of career positions in the civil/public service as well as the place of private and informal sectors of the economy. The new scheme was validated at the University of Beninand Irrua Specialist Teaching Hospitals.Results: The new scheme had a remarkably high Inter-rater reliability (r = 0.947, p&lt;0.001), raterre- rater reliability (r = 0.984, p &lt;0.001) and % agreement (with modified Oyedeji’s tool as standard) of 67% (K coefficient = 0.47, r = 0.71, p&lt;0.001)Conclusion/Recommendation: The new scheme could be a viable tool for the assessment of SES of families and individuals, which not only takes into consideration current realities of the nation’s economy, but also is readily adaptable to meet foreseeable changes

Evaluation of Jaundice meter in the assessment of jaundice among Nigerian preterm neonates

Background: The objective assessment of the severity of neonatal jaundice is Total Serum Bilirubin (TSB) determination, which requires multiple blood sampling. This has inherent problems, including risks of anaemia and infection. Transcutaneous Bilirubinometry (TcB) is a reliable, non-invasive alternative, however there is paucity of data on its performance in black preterm neonates.Objectives: To evaluate the correlation between transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) among Nigerian preterm neonates, and to determine the parameters affecting the relationship.Method: Jaundiced preterm neonates delivered between 28 and 36 weeks of gestation admitted at the Irrua Specialist Teaching Hospital (ISTH), Nigeria were recruited . The TSB levels were determined by spectrophotometry while the corresponding TcB levels were obtained using Jaundice Meter (JM-103). The neonates were stratified into gestational age and birth weight groups.Results: A total of 189 paired TcB and TSB levels were obtained from 60 neonates. The Mean (sd) TcB level of 11.4 (3.1) mg/dl was significantly higher than the mean TSB level of 10.2 (2.8)mg/dl (p= 0.028). The overall correlation coefficient between TcB and TSB was 0.98 and it was not significantly affected by the gestational age, birth weight and bilirubin levels.Conc lusion: Transcutneous bilirubin strongly correlates with total serum bilirubin levels among Nigerian preterm neonates, irrespective of gestational age, birth weight and the degree of jaundice.Keywords: hyperbiliruinaemia, jaundice meter, Nigerian, preterm, neonates, transcutaneous bilirubinometr

Molecular Diagnostics for Lassa Fever at Irrua Specialist Teaching Hospital, Nigeria: Lessons Learnt from Two Years of Laboratory Operation

Background: Lassa fever is a viral hemorrhagic fever endemic in West Africa. However, none of the hospitals in the endemic areas of Nigeria has the capacity to perform Lassa virus diagnostics. Case identification and management solely relies on non-specific clinical criteria. The Irrua Specialist Teaching Hospital (ISTH) in the central senatorial district of Edo State struggled with this challenge for many years. Methodology/Principal Findings A laboratory for molecular diagnosis of Lassa fever, complying with basic standards of diagnostic PCR facilities, was established at ISTH in 2008. During 2009 through 2010, samples of 1,650 suspected cases were processed, of which 198 (12%) tested positive by Lassa virus RT-PCR. No remarkable demographic differences were observed between PCR-positive and negative patients. The case fatality rate for Lassa fever was 31%. Nearly two thirds of confirmed cases attended the emergency departments of ISTH. The time window for therapeutic intervention was extremely short, as 50% of the fatal cases died within 2 days of hospitalization—often before ribavirin treatment could be commenced. Fatal Lassa fever cases were older (p = 0.005), had lower body temperature (p<0.0001), and had higher creatinine (p<0.0001) and blood urea levels (p<0.0001) than survivors. Lassa fever incidence in the hospital followed a seasonal pattern with a peak between November and March. Lassa virus sequences obtained from the patients originating from Edo State formed—within lineage II—a separate clade that could be further subdivided into three clusters. Conclusions/Significance: Lassa fever case management was improved at a tertiary health institution in Nigeria through establishment of a laboratory for routine diagnostics of Lassa virus. Data collected in two years of operation demonstrate that Lassa fever is a serious public health problem in Edo State and reveal new insights into the disease in hospitalized patients.Organismic and Evolutionary Biolog

Perinatal mortality in a rural community

Objective: To determine the peri-natal mortality rate (PMR), still birth rate (SBR) and early neonatal death rate (ENDR) in Igueben Local Government Area (LGA) of Edo State.Design: A descriptive cross-sectional studySetting: Igueben LGA is a rural governmental unit in mid-western Nigeria.Subjects: All women of child-bearing age, resident in three randomly selected political wards in Igueben LGA were identified.Results: Of the 921 women of child-bearing age recruited, 258 deliveries with three perinatal deaths were recorded, giving a PMR, SBR and ENDR of 11.6/1000TB, 11.6/1000TB and 0/1000LB, respectively. Almost all the mothers studied (99.6%) received skilled obstetric care in delivery.Conclusion: The actual PMR, SBR and ENDR were considerably lower than the National estimated averages of 76/1000TB, 43/1000TB and 35/1000LB, respectively. While this may perhaps be related to the quality of obstetric care, it underscores the importance of community-based studies in the determination of vital statistics which are important in health planning including resource allocation

Prevalence of overweight and obesity among students in private and public secondary schools in a peri-urban Nigerian town

Aims: To investigate the prevalence of overweight and obesity among secondary school students in Ekpoma.Study design: Cross sectional studyPlace and duration of the study: Private and public secondary schools in Ekpoma Edo state; from May to October,2011.Methodology: This is a school based analytical cross-sectional study of a sample of 417 students drawn from 4secondary schools in Ekpoma using the multistage sampling technique. Semi-structured interviewer-administeredquestionnaires were used to obtain qualitative information from the respondents; the weight of each respondent wasmeasured using a bathroom scale and the Body Mass Index (BMI) calculated and classified based on the AmericanMedical Association classification. The results obtained for students in private schools where then compared withthose of their peers in public secondary schools.Results: The prevalence of overweight and obesity was found to be 8.6% and 1% respectively; the mean BMI was19.6±2.6. More (67.5%) of those found to be overweight and obese were students in private schools (95% CI = 1.03-4.39 OR=2.11; ?2= 4.85). Similarly, 11.59% and 1.45% of students in private schools were overweight and obeserespectively compared to 5.71% and 0.95% for those in public schools. Majority (68%) of respondents had poorknowledge of the risk factors for and problems associated with being overweight or obese. Students in the uppersocial class are more likely to be overweight/obese compared to their peers in the lower social class((X 2HM = 10.35;P &lt;.01; common odds ratio = 3)CONCLUSION: Over nutrition and under nutrition are both occurring in adolescents in a predominantly ruralsetting which suggests that Policy makers and health professionals need to implement strategies that will preventover nutrition side by side current efforts to curb under- nutrition. Reactivation of the school health program inNigeria is considered a helpful initial step