Epidemiology of Dengue in patients with febrile syndrome at Saint Camille Hospital, Ouagadougou, Burkina Faso from 2020 to 2

: Dengue is still a public health problem in tropical countries. This disease, which had almost disappeared in some areas of the world, has become re-emergent in certain parts of the world including Africa.The aim of this study is to determine the seroprevalence and evolution of Dengue virus (DENV) infection from 2020 to 2021 at the Hospital Saint Camille de Ouagadougou (HOSCO), Burkina Faso. Methodology: This was a descriptive analytical study of patients seen in general practice with febrile syndrome referred for serological diagnosis of Dengue at the HOSCO laboratory over a period of 2 years (January 1, 2020 ­ December 31, 2021). The "Dengue Duo (AgNS1/IgM/IgG)" kit from SD Bioline was used for the rapid diagnosis through the detection of NS1 antigen and IgM/IgG antibodies in plasma. Data were analysed with SPSS version 20.0 software. Association between demographic data and prevalence of DENV infection was determined by Chisquare test and odds ratio (with 95% confidence interval). P value less than 0.05 was considered statistical significance. Results: A total of 2957 patients aged 0-94 years were referred for serological diagnosis of DENV infection at the HOSCO laboratory over the period 2020-2021, comprising 56.3% females and 43.7% males. The overall prevalence of acute DENV infection (NS1Ag positive) was 5.4% (159/2957), with 2.4% (41/1700) in 2020 and 9.4% (118/1257) in 2021 (OR=4.192, 95% CI=2.915-6.028, p<0.0001). The prevalence of acute DENV infection of 7.0% (91/1292) in the males was significantly higher than 4.1% (68/1665) in the females (OR=1.779, 95% CI=1.288-2.458, p=0.0005), and also significantly higher in age groups 20-29 years (7.6%), 10-19 years (6.9%) and 40-49 years (5.8%) than other age groups (X 2=14.928, p=0.0107). The overall prevalence of DENV IgM and IgG antibodies was 3.2% and 37.3% respectively. The prevalence of DENV IgG antibodies was significantly higher in males (44.0%) than females (32.1%) (OR=1.667, 95%CI=1.434-1.938, p<0.0001) and in age groups 30-39 (43.4%), 40-49 (44.0%) and >50 years (49.3%) than other age groups (X2=121.0, p<0.0001), indicating that past exposure to DENV infection is higher among males and older age groups. The peak of DENV infection was between October and November with 84.3% (134/159) of NS1Ag positivity occurring during this period. Conclusion: The present study reports a high prevalence of acute Dengue virus infection in patients from October to November. To eradicate Dengue which has become a tropical silent epidemic, interventions such as vector control, availability of and accessibility to diagnostic tests, and good therapeutic management are of great importance

Outcomes of tuberculosis treatment in a tertiary health facility in north-central Nigeria

Background: Tuberculosis (TB) remains a major public health concern despite being a curable and preventable disease. The treatment of TB using a cocktail of drugs over a period of six months under the directly observed treatment short-course strategy has led to a reduction in cases but is plagued by some challenges that leads to unsuccessful or poor outcomes, which can ultimately result in spread of infections, development of drug resistance and increase in morbidity and mortality. The objectives of this study are to determine outcomes of TB treatment in Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria and the factors that may be associated with the outcomes. Methodology: This was a retrospective study using the medical records of patients who were registered for TB treatment over a five-year period between 2016 to 2020. Data from TB registers including demographic and relevant clinical information, and treatment outcomes, were extracted into a structured data extraction format, and analysed with SPSS version 21.0 software package. Univariate and bivariate analyses were conducted, and Chi square test was used to determine association between TB outcomes and independent variables at 95% confidence interval and p<0.05 was considered as the significant value. Results: Records of 1,313 patients were studied, 744 (56.7%) were males while 569 (43.3%) were females. The age range of the patients was ≤ 1 year - 96 years, with a mean age of 30±16.7 years. Most were pulmonary TB cases (88.8%, n=1,166), newly diagnosed (95.5%, n=1254), and human immunodeficiency virus (HIV) negative at the time of TB diagnosis (63.7%, n=837). Eight hundred and seven (61.5%) patients had successful treatment, and 34% (n=446) had unsuccessful outcomes made of 'loss to follow-up' 25.8% (n=339), deaths 7.8% (n=102) and treatment failure 0.4% (n=5), while 2.3% (n=30) were transferred out and 2.3% (n=30) removed from TB register. Treatment success rate was significantly higher in patients with pulmonary TB (p=0.0024), residents in Lafia LGA (p=0.0005), those treated in 2016 (p=0.0006) and bacteriologically confirmed cases (p<0.0001), while death rate was significantly lower among patients who were HIV-negative at the time of TB diagnosis (p<0.0001). Conclusion: TB treatment success rate in this study fell short of the WHO average rate. High rates of 'loss to followup' and deaths in this study is a wake-up call to all stakeholders in the facility and the State to put in place measures to reduce poor outcomes of TB treatment.

Effect of the COVID-19 pandemic on blood donations and transfusions in Nigeria ­ A multi-facility study of 34 tertiary hospitals

Background: The coronavirus disease 2019 (COVID-19) pandemic affected blood supplies globally. Mobile blood drive campaigns halted, and voluntary blood donations reduced, challenging available blood supplies. Furthermore, fears of virus transmission led to deferrals of elective surgeries and non-urgent clinical procedures with noticeable declines in blood donations and transfusions. Aims: We aimed to assess the effect of the COVID-19 pandemic on the number of blood donations and transfusions across the country by blood product type across various hospital departments. Materials and Methods: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 34 tertiary hospitals in Nigeria, comparing January to July 2019 (pre-COVID-19) to January to July 2020 (peri-COVID-19). Data were collected from the country's web-based software District Health Information System, Version 2 (DHIS2). Results: A 17.1% decline in numbers of blood donations was observed over the study period, especially in April 2020 (44.3%), a 21.7% decline in numbers of blood transfusions, especially in April 2020 (44.3%). The largest declines in transfusion were noted in surgery department for fresh frozen plasma (80.1%) [p = 0.012] and accident and emergency department transfusion of platelets (78.3%) [p = 0.005]. The least decline of statistical significance was observed in internal medicine transfusions of whole blood (19.6%) [p = 0.011]. Conclusions: The COVID-19 pandemic significantly affected the numbers of blood donations and transfusions in Nigeria. Strengthening blood services to provide various blood components and secure safe blood supplies during public health emergencies is therefore critical.

Preferred approach to performance improvement among stakeholders in the health insurance industry in Southwest Region of Nigeria: Implications for Universal Health Coverage

Background: Population coverage of the National Health Insurance Scheme (NHIS) of Nigeria is low. This study aimed to assess the capacity gaps of personnel in the health insurance industry in southwest Nigeria as well determined the approach to improvement. Methods: This was a cross-sectional survey conducted in the health insurance industry in southwest Nigeria. Survey tool adapted was the World Health Organization adopted Hennessy-Hicks Training Needs Analysis Questionnaire with a set of 30 tasks which are important to the job performance of personnel in the health insurance industry. From the register made available by stakeholders, there were a total of 275 personnel in the industry in the zone. A total population of all available personnel in all the organizations were recruited into the study. Data analysis was done using the guideline provided in the Hennessy-Hicks Training Needs Analysis Questionnaire. Results: Only 32 (13.7%) reported having a training background in health-related degrees, 119 (50.9%) had work-related (actuarial science) training while 148 (63.3%) has had a form of on-the-job actuarial science and related training. The training course approach was generally preferred to organisational change in all items. Conclusion: This study showed that there were gaps in the capacity of personnel in the health insurance industry. Training course was the preferred approach to addressing these. While not neglecting organizational change, stakeholders in Nigeria and in similar settings are advised to pay more attention to personnel training to improve performance

HIV Infection among children aged two years to less than eighteen years admitted to the Emergency Pediatric Unit in a tertiary health facility in Lafia North-Central Nigeria

BACKGROUND: Human Immunodeficiency virus (HIV) is a retrovirus that impairs the immune system by attacking the body's natural defense from infections and diseases. Pediatric HIV continue to be a major public health problem despite the global decline in its seroprevalence rates. The decline in the incidence of new HIV infections is particularly lower in children with a 52% reduction in the last ten years. This is attributed to a wider coverage in the use of antiretroviral therapy (ART) and the prevention of mother to child transmission of HIV (PMTCT) programs. Several programs designed at curtailing mother to child transmission of HIV are yielding positive result. This is not unexpected since most of the HIV infections among children were acquired via maternal to child transmission. With this, the study sets out to determine the prevalence of new HIV infection among patients admitted to the Emergency Pediatrics Unit (EPU) using the provider-initiated testing and counseling approach. METHODS: A prospective cross-sectional descriptive study was conducted at the mini laboratory attached to the EPU of the Dalhatu Araf Specialist Hospital Lafia Nasarawa State between 1st August 2017 to 31st July 2018. Using non-probability sampling, categorical variables were analyzed as frequencies and percentages. The association between categorical variables were analyzed using chi square.RESULTS: A total of 964 children ranging in age from two to less than eighteen years were screened. The total number of males was 550 (57.1%) while females was 414 (42.9%) with a male to female ratio of 1.3:1. Five (0.5%) children were newly diagnosed with HIV of the 964 children tested for the infection. CONCLUSION: The incidence of HIV infection among children admitted into our Emergency Pediatric Unit was 0.5%, comparable to some earlier reports

Intelligence quotient of neurologically impaired children attending neurology clinic in a nigerian tertiary institution

Background: The need to identify the intellectual capability of neurologically impaired children dictates their educability which can be estimated through their intelligence quotient (IQ). Draw-a-man test for IQ estimation is available, easy and has been validated in Nigeria. Method: Through a prospective, cross-sectional study that lasted 12 months (January-December, 2011), children aged 4 years and above attending neurology clinic were recruited once they have no severe motor or sensory limitations affecting their upper limbs and can obey the instruction to draw a person. Anthropometry was carried out on them and they were comfortably seated to draw a person. The parents or caregivers were instructed not to make any suggestion or hint to them and no time limit was given. Their drawings were assessed using the 52 parameters of Ziler and interpreted accordingly. Ethical procedures were adhered to. The analysis was done using SPSS version 16 and an interactive calculation tool for chi-square tests of goodness of fit and independence. Results: Seventy-five (45 male, 30 female) children met the inclusion criteria. Their clinical conditions were Epilepsy 48 (64%), Cerebral Palsy 6 (8%), ADHD 5 (6.7%), Down Syndrome 4 (5.3%), Speech/Hearing impairment 3 (4.0%), Hypothyroidism 2 (2.7%) and 7 (9.3%) others. Their ages ranged from 4 years to 16 years (mean±SD = 9.7± 3.8 years). Their IQ distribution were Normal 4 (5.3%), Borderline 12 (16.0%), Mild Mental Retardation 16 (21.3%), Moderate Mental Retardation 19 (25.3%), Severe and Profound Mental Retardation 24 (32.0%) with no significant difference in relation to their birth order. Conclusions: Ninety-six per cent of the study population had IQ below normal. Epilepsy was the commonest condition seen in the Paediatric Neurology clinic and all categories of IQ are seen among children with epilepsy

Morphological Variation of Third Ventricle Using Computerized Tomography among Different Gender and Age Groups: A 5-Year Retrospective Study in Usmanu Danfodiyo University Teaching Hospital; Sokoto; North - West Nigeria

Background: Many methods have been described for measurements of the third ventricle as a means of evaluating brain atrophy during the normal aging process and disease. Enlargement of the cerebral ventricles is one of the most frequently replicated neurobiological findings in schizophrenia. The aim of this morphological study was to examine the range in the normal size of the third ventricle of individuals living in Sokoto and to assess its association with gender and age. Materials and Methods: All available brain CT in the Radiology Department of the Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto; Nigeria; from 2007 to 2012 (a 5-year period) and reported as normal by the radiologist were recruited for the study. Films were viewed on the computer monitor. Measurements were made with Dragon V 3.1.1 Philips and Neusoft Medical System Company Limited software; the software provides a meter rule with which measurements were done. Results: A total of 252 CT scan images where used in the study. Of this number; 156 (61.9) were CT scan images of males and 96 (38.1) were CT scan images of females. The mean width was 8.38 mm and mean anteroposterior length was 12.16 mm. These differences were statistically significant; P = 0.0209 (0.05). Conclusion: Our findings provide a base line data for the measurement of the third ventricles using CT scans in our environment and this may be applied in various clinical conditions involving the third ventricle

Footcare practices among Nigerian diabetic patients presenting with foot gangrene

Diabetic foot ulceration and gangrene is a major cause of morbidity andmortality. This study has examined potential preventive footcare practices in a cohort of diabetic patients presenting with foot gangrene. One hundred and two (102) diabetic emergencies presented during the study period. Diabetic foot gangrene accounted for 27 (26%) of these cases. There were 18 males and 9 females (M:F = 2:1), with a mean age of 52+13 years. The mean duration of ulceration was 4±3 weeks and mean ulcer­gangrene interval was 1.2±0.5 weeks. Only 9 patients (33%) had been exposed to any form of footcare education, 15 patients (55%) treated their ulcers by unorthodox means, and 63% of the patients practiced no significant footcare. More widespread education and awareness is needed to prevent the continuing and serious problem of diabetic foot gangrene and consequent lower limb amputation

The Impact of Training on Malaria Treatment Practices: a Study of Patent Medicine Vendors in Birnin-kebbi

Background: Patent medicine vendors are major providers antimalaria treatment in Nigeria. The management of malaria by this informal sector of healthcare delivery is however dominated by negative practices. This study determines the influence of training on antimalaria treatment practices of patent medicine vendors. Methods: Fifty-five patent medicine vendors selected through a multistage sampling technique in Birnin-Kebbi were recruited into the study. Their baseline treatment practices were determined and the negative ones identified. Intervention training was instituted and its impact assessed using a interviewer-administered questionnaire. Simulated visit mystery client survey which involved direct observation of patent medicine vendors practice was conducted after the intervention and the results compared with self reported post intervention practices. Results: The negative practices identified included inappropriate dosage regimen; frequent unnecessary use of injectables and alteration of physicians' prescriptions. Following the intervention training of the patent medicine vendors; the overall appropriate treatment practice score rose from baseline value of 3.6to 45.5(p0.05) and significantly lower than the post training values (p0.05) and was significantly lower than the post intervention values (p