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   2016| July-September  | Volume 3 | Issue 3  
    Online since September 19, 2016

 
 
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ORIGINAL ARTICLES
Prevalence of sickle cell disease among pregnant women in a tertiary health center in south-south Nigeria
Ogbonna Collins Nwabuko, Dorathy Adaunwa Okoh, Caroline Iyalla, Hannah Omunakwe
July-September 2016, 3(3):132-136
DOI:10.4103/2384-5147.190843  
Background: Sickle cell disease (SCD) is relatively prevalent in Nigeria and it is associated with obstetric complications, especially in unsupervised pregnancies. This study was to determine the prevalence of SCD among pregnant women seen in an antenatal clinic in a tertiary health center in South-South Nigeria. Materials and Methods: This was a 10-year retrospective study of all registered pregnant women seen at the antenatal clinic of Braithwaite Memorial Specialist Hospital (BMSH) (2004-2013). Sociodemographic data and hemoglobin (Hb) electrophoresis were obtained using questionnaires and alkaline cellulose acetate electrophoretic machines (Helena), respectively. Data were analyzed using Epi-info version 7.02 by the WHO, Geneva, Switzerland, and CDC, USA. Results: A total of 35,976 pregnant women were seen at the antenatal clinic of BMSH within the study period, out of which 28,815 (80.09%) were Hb AA, 7,109 (19.77%) were Hb AS, and 52 (0.14%) were SS. The average gestational age of booking was 22.1 weeks. More women with tertiary education registered earlier than those with secondary education. Anemia in pregnancy (Hb <11 g/dl) was found in 94.2% of the pregnant women with Hb SS, while 5.8% was above 11 g/dl (P = 0.001). Conclusion: There is a high prevalence of SCD among pregnant women in this region. Late antenatal booking, anemia, and poor education are the predictive markers of poor pregnancy outcome in this region.
  1,269 151 -
EDITORIAL
Climate change, seasonal malnutrition conflict, and health
Aisha I Mamman
July-September 2016, 3(3):125-126
DOI:10.4103/2384-5147.190840  
  671 457 -
ORIGINAL ARTICLES
Seroepidemiology of cytomegalovirus antibodies in Hiv-positive and Hiv-negative adults in Nigeria
Mukhtar Abdulmajid Adeiza, MM Dalhat, B. O. P. Musa, HM Muktar, SB Garko, AG Habib
July-September 2016, 3(3):142-147
DOI:10.4103/2384-5147.190852  
Introduction: Cytomegalovirus (CMV) is the most common viral opportunistic infection in HIV/AIDS reported in the Western literature. There is a paucity of reports on the seroprevalence of CMV antibodies in Nigeria despite the high HIV burden. Few studies were carried out in pregnant women and healthy blood donors. This analytical cross-sectional study was conducted to describe the seroepidemiology of CMV antibodies in HIV-positive and healthy adults in Nigeria. Materials and Methods: Between August 2012 and March 2013, a structured questionnaire was administered to 250 HIV-positive patients attending the HIV clinic and 250 HIV-negative controls matched for age and gender. Participants were screened for quantitative CMV immunoglobulin G (IgG) and qualitative CMV immunoglobulin M (IgM) antibodies by enzyme-linked immunosorbent assay. Information was collected on sociodemographic characteristics, risk for HIV infection, and anthropometric measurements. Data were analyzed with SPSS Version 17. Results: A total of 500 participants were recruited. Females comprised 54%. Median age for males was 39 years (range 17-65 years), whereas for females, it was 35 years (range 16-62 years) (P = 0.002). In HIV-positive patients, CMV IgG and IgM antibodies were detected in 215 (86%) and 33 (13.2%), respectively, but in HIV-negative controls, it was 182 (72.8%) and 7 (2.8%), respectively (P = 0.001). In HIV-positive patients, CMV IgG age-specific seroprevalence was highest in the 16-25 years age group (93.5%), whereas CMV IgM, it was highest in the 26-35 years age group (16.1%). Mean quantitative CMV IgG antibody titer was higher in HIV-positive patients (P = 0.001). There was no gender difference between groups. Conclusion: Seroprevalence of CMV antibodies is high in Nigeria. HIV preventive strategies and routine screening of HIV patients and blood donors for CMV antibodies before blood transfusion are recommended to minimize the potential risk of transfusion transmitted CMV infection.
  793 87 -
Pattern and outcomes of childhood malignancies at Ahmadu bello university teaching hospital, Zaria
Hafsat Rufai Ahmad, Jamilu Abdullahi Faruk, Musa Abdullahi, Abiola Aira Olorunkooba, Hassan Ishaku, Fati Lami Abdullahi, Gboye Olufemi Ogunrinde
July-September 2016, 3(3):127-131
DOI:10.4103/2384-5147.190836  
Background: Childhood malignancies are associated with high mortality. Although prognosis and outcomes have improved significantly in developed countries, mortality is still very high in resource-poor settings. Objectives: This study aimed at determining the patterns and outcomes of childhood cancers over an 8-year period in a tertiary center of a developing country. Materials and Methods: A retrospective study of case notes of children admitted for cancer between January 2006 and December 2013. Results: Four hundred and twenty-six case notes of all children admitted with a diagnosis of cancer and also had a histological confirmation were analyzed. The cases accounted for 7.7% of the total admissions into the pediatric wards. More than half of the children 247 (57.9%) were under the age of 5 years, with a slight male:female preponderance of 1.4:1. Retinoblastoma had the highest frequency with 147 cases representing 34.5%, followed by Burkitt lymphoma with 67 cases (15.7%) and acute leukemia with 52 cases (12.2%). Surgery and chemotherapy were the most common modalities of treatment offered to about 80% of the cases. The mortality was high at 137 cases giving a mortality rate of 32.2% among the cancer cases and 2.5% overall from the pediatric wards. While 14 (5.8%) children were formally discharged, almost half of the total cases 224 (52.6%) abandoned treatment while 48 (11.4%) absconded or left against medical advice. Conclusion: The incidence of childhood malignancy was high with retinoblastoma being the most common malignancy encountered, and associated with high mortality and abandonment of treatment.
  710 106 -
Monolateral frame external fixators in the definitive management of open limb fractures in North-western Nigeria
Yau Zakari Lawal, Friday S Ejagwulu, Sunny O Salami, Salihu Mohammed
July-September 2016, 3(3):137-141
DOI:10.4103/2384-5147.190847  
Background: The use of external fixators became popular in the last ten years in our environment with the availability and expertise to apply them being popularised by the AO foundation. They have virtually supplanted the application of casts which had high levels of complications and unpredictable outcomes in patients with open fractures. This manuscript describes its use in trauma in our environment. Aims: The aim of this study is to demonstrate that monolateral frame external fixators are a means of definitively treating open limb fractures. Materials and Methods: For a period of nine years (2006-2014), we prospectively studied the use of monoframe external fixation in one hundred and six limbs in three hospitals in the northwest of Nigeria. Gustillo II and III A, B and C patients were included in the study. External fixators from different manufacturers were used. The adherence to the principles of application, duration of application, pin track infection, union and non-union rates were observed for both groups. Results: One hundred and six limbs in were studied. Ninety four males and eleven females in the study group with five of the males being children of less than twelve years. Ninety seven cases had open tibial fractures (one lady had bilateral open tibial fractures) and four cases involved the femur. Union rate of 60% was observed. Pin tack infection rate of 80%, average duration of stay of the patient was three month; fracture union rate of 60% and reoperation rate of 2%were observed. Conclusion: Monolateral external fixators can be used successfully in the management of open diaphyseal fractures of long bones with reasonably high success rates and few complications.
  614 80 -
Prevalence and pattern of alopecia in secondary and tertiary institutions in Ibadan
Hadiza Sani, O Adebola Ogunbiyi, Adekunle O George, OE Okoro
July-September 2016, 3(3):148-152
DOI:10.4103/2384-5147.190856  
Background: Hair loss in African women appears to be on the increase and has been associated with some hair-care practices. Objectives: The aim of this study was to determine the prevalence, pattern, and possible hair-care factors associated with alopecia in females in some educational institutions in Ibadan, Nigeria. Methodology: The respondents were interviewed using a pretested questionnaire containing information about their bio-data, hair-care practices, and history of hair loss if any. Subjects were examined for the presence and pattern of hair loss. Results: The prevalence of alopecia was 46.7%, with the traction alopecia being the most common (97.5%). The age range of those with alopecia was mainly 20-29 years. Hair loss was more common in subjects who had chemically treated their hair (P < 0.001). Conclusion: Alopecia is common among female students in secondary and tertiary institutions in Ibadan. Traction alopecia was the most common pattern of hair loss in this study supporting claims of hair-care practices as important etiological factors.
  492 41 -
Intestinal parasitic infections among spare parts traders in Benin city, Nigeria
Frederick Olusegun Akinbo, Samuel Arimokwu
July-September 2016, 3(3):153-157
DOI:10.4103/2384-5147.190857  
Background: The accumulation of metals in the human system may inhibit or enhance the growth of pathogens, particularly parasitic infections. Objective: This study was conducted to determine the prevalence of intestinal parasitic infections among spare parts traders in Benin City, Edo State, Nigeria. Materials and Methods: Two hundred and two male traders were recruited for this study. The age of participants ranged from 20 to 67 years. Freshly voided stool specimen was obtained from each participant into clean wide-mouthed universal container. Intestinal parasites were diagnosed using microscopy. Results: An overall prevalence of 22.8% of intestinal parasitic infections was observed in this study. Age, marital status, and source of food significantly increased the risk of intestinal parasitic infections among spare parts traders. Ascaris lumbricoides, Strongyloides stercoralis, hookworm, Entamoeba histolytica, and Fasciola hepatica were the parasites observed in this study. In all age groups and those who eat from food vendors, A. lumbricoides was the most recovered parasite among spare parts traders. Conclusion: Further studies to elucidate the role of immunotoxic metals in intestinal parasitic infections, inclusion of economically productive age groups in the treatment plan, and improvement of personal hygiene are advocated.
  447 49 -
Tympanometric assessment among a select cohort of deaf students
Iliyasu Yunusa Shuaibu, Abdulazeez Omeiza Ahmed, Aminu Bakari, Mohammed Aminu Usman
July-September 2016, 3(3):158-162
DOI:10.4103/2384-5147.190860  
Background: Children and young adults with profound hearing impairment and/or deafness are equally at risk of developing other ear diseases such as otitis media with effusion (OME) and/or middle ear infections. Otoscopic diagnosis of middle ear effusion is often problematic, and clinicians' skills in that regard are notably variable. The objective of this study is to present the tympanometric findings among hearing-impaired students from a group of special schools for the hearing impaired in Kaduna metropolis. Participants and Methods: This was a prospective cross-sectional study conducted for 4 months between February and May, 2014. Students aged 7-18 years attending Kaduna State Special Education School for the deaf, Katsina road, and Demonstration School for the Deaf, Kawo, Kaduna, were recruited for the study. An interviewer-based questionnaire was developed to capture the student's demographic characteristics and clinical information. This was followed by ear examination and tympanometric tests. The data were analyzed using Statistical Package for the Social Sciences software, version 16. Results: A total of 294 participants were recruited into the study group, and there were 173 males (58.8%) and 121 females (41.2%). The age of the participants ranged from 7 to 18 years. The mean age of the study group was 13.6 years with a standard deviation of ΁ 3.6 years. Forty-three (14.6%) of them had dull and retracted tympanic membranes while the rest had intact shiny tympanic membrane. Tympanometric test showed that 281 participants (89.5%) had type A tympanogram while types B and C accounted for 21 (7.1%) and 9 (3.1%), respectively. Among the 43 participants with dull and retracted tympanic membrane via otoscopic examination, 13 had type A tympanogram (normal) while the rest had middle ear disorders (type B and C tympanograms). Conclusion: Middle ear diseases such as OME and eustachian tube dysfunction were found among the study population. There is a need for the provision of regular awareness lecture and periodic ear examination to prevent, detect, and treat imminent otologic diseases.
  422 49 -
Correlates and predictors of frequency of blood transfusions among sickle cell anemia patients in a Tertiary hospital in Nigeria
Sani Awwalu, Aisha Indo Mamman, Abdulaziz Hassan, Ismaila Nda Ibrahim, Ibrahim Usman Kusfa, Aishatu Maude Suleiman, Rufai Abdu Dachi, Kasim Mohammad Pindiga
July-September 2016, 3(3):163-165
DOI:10.4103/2384-5147.190861  
Context: Blood transfusion is a central modality in the management of sickle cell anemia (SCA) patients. However, blood remains relatively scarce and the provision of safe, adequate, and timely transfusion services is still a challenge in Nigeria. Aims: To determine correlates and predictors of frequency of blood transfusions in SCA patients. Settings and Design: A cross-sectional, descriptive study was conducted. Convenience sampling technique was used to recruit 51 SCA patients attending the sickle cell clinic of ABUTH, Zaria Nigeria. Subjects and Methods: Age, sex, hematocrit, reticulocyte percentage, and 12-month recall of number of blood transfusions, pain episodes, and hospital admissions were assessed. Data were analyzed using SPSS version 20.0. Statistical Analysis Used: Results were summarized as median (interquartile range [IQR]) or mean ± standard deviation (SD). Spearman correlation and multiple regression analyses were carried out. Level of significance was set at P < 0.05. Results: Out of the 51 participants, 40 (78.43%) were females. The median (IQR) for age, number of pain episodes, number of hospital admissions, number of blood transfusions, and reticulocyte percentage was 23.00 (9.00) years, 2.00 (5.00), 0.00 (1.00), 0.00 (1.00), 8.60% (3.10%), respectively. Mean ± SD for hematocrit was 0.23 ± 3.41 L/L. Using frequency of blood transfusions as a reference, Spearman correlation analyses were performed for age (ρ = 0.206, P = 0.148), pain episodes (ρ = 0.270, P = 0.055), hospital admissions (ρ = 0.373, P = 0.007), hematocrit (ρ = 0.055, P = 0.704), and reticulocyte percentage (ρ = 0.122, P = 0.395). Backward multiple regression model to predict frequency of blood transfusions produced: F (2, 48) = 11.780, P < 0.001, adjusted R2 = 0.301. Only number of hospital admissions added statistically significant to the prediction (β = 0.542, P ≤ 0.001). Conclusions: Number of hospital admissions predicted frequency of blood transfusions in SCA patients in this study.
  392 48 -
CASE REPORT
Salmonella typhi septic sacroiliitis in a young Nigerian
Abdul Aziz Umar, MS Ahmed, MT Tuko, BO Usman
July-September 2016, 3(3):166-169
DOI:10.4103/2384-5147.190863  
Although infections are important cause of joint pathology in the tropics, Salmonella typhi rarely contributes significantly to this, with joint infection amounting to only 1% of its clinical manifestation. Infection of the sacroiliac joint is rare and mostly due to staphylococcal, streptococcal, and Pseudomonas species. Few cases of S. typhi septic sacroiliitis have been reported in literature. A rare case of sacroiliitis due to S. typhi in a young Nigerian is herein reported to heighten index of suspicion.
  357 30 -
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