Phylogenetic variants of Mycoplasma hominis from pregnant women and women presenting with infertility in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

Background: Much controversies have been associated with the pathogenicity of Mycoplasma hominis but little has been done to unravel the mystery behind the different views. This study aimed at investigating the genetic variants abounding within M. hominis and the distribution of the virulent genes among the variants. Methodology: Twenty (20) M. hominis isolates from high vaginal swabs of women (11 from pregnant women and 9 from women presenting with infertility) attending the Obstetrics and Gynaecology clinics of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria, were sequenced using 16S rRNA universal gene target for the purpose of phylogenetic analysis and epidemiological typing. The isolates were also screened for the presence of M. hominis variable adherence antigen (vaa) and p120 virulent genes using primer constructs from the respective genes in a conventional PCR protocol. Results: Of the 20 M. hominis vaginal isolates, 4 phylogenetic strains were detected; strain MHS43 constituted 10/20 (50.0%) [2/9 (22.2%) from infertile women and 8/11 (72.7%) from pregnant women]; strain MHBS constituted 3/20 (15%) [3/9 (33.3%) from infertile women and 0/11 (0%) from pregnant women]; strain MHSWP2 constituted 4/20 (20.0%) [3/9 (33.3%) from infertile women and 1/11 (9.1%) from pregnant women]; while strain MHKC87 constituted 3/20 (15%) [1/9 (11.1%) from infertile women and 2/11 (18.2%) from pregnant women].Each of vaa and p120 genes was detected in 14 of 20 isolates, while 6 isolates did not carry the genes. A 2-way ANOVA test showed that none of the genes was significantly associated with a particular strain (p=0.8641). Conclusions: The different views regarding the pathogenicity of M. hominis may be linked to the heterogeneity within the species and lack of homogeneity in the virulent genes as witnessed both in the intra species and intra strain levels.

Estimated prevalence of human papillomavirus among Nigerian women: A systematic review and meta-analysis

HPV prevalence in Nigeria has been challenging to quantify given regional population heterogeneity and differences in diagnostic methodology. We conducted a systematic review and meta-analysis of 17 studies, each of which summarized HPV prevalence in women residing in six geopolitical zones of Nigeria. The estimated pooled prevalence (effect size) of HPV in Nigeria was 32% (CI: 23-41%). HPV prevalence was 29% (CI: 20-39%) among studies that detected HPV by genotype. HPV prevalence among studies that used serologic detection was 38% (CI: 12-65%). When stratified by region, a study in the South East (SE) geopolitical zone reported the highest prevalence of 71% (CI: 61-80%) while a study in the South South (SS) geopolitical zone reported the lowest prevalence of 4.9% (CI: 3-9%). HPV prevalence in Nigeria was high. Heterogeneity between study regions and differing HPV detection methods both contribute to variation in estimates. Using pooled estimates serves to inform future strategies for epidemiologic surveillance and future design of HPV and cervical cancer prevention initiatives. (Afr J Reprod Health 2022; 26[6]:89-96).

THe characteristics and costs of severe theophylline toxicity in a tertiary critical care unit in Eastern Cape Province, South Africa

Severe theophylline toxicity requiring haemodialysis accounts for approximately one-third of drug toxicity cases admitted to the Livingstone Tertiary Hospital (LTH) intensive care unit (ICU) in Gqeberha, South Africa, imposing a significant resource burden.Objectives. To investigate the characteristics and burden of severe theophylline toxicity in an Eastern Cape Province tertiary hospital adult ICU.Methods. A retrospective review of all severe theophylline toxicity admissions to the ICU from 1 January 2013 to 31 December 2018 was conducted. Demographic and clinical data were captured and analysed. The National Department of Health 2019 fees schedule was used to calculate costs based on duration of ICU stay and number of haemodialysis sessions received.Results. Of the 57 patients included in the study, 84% were cases of deliberate self-harm. The majority were aged <40 years (77%) and female (79%). The mean (standard deviation (SD)) initial serum theophylline level was 612 (269) µmol/L. Complications included convulsions (n=12; 21%), arrhythmias (n=9; 16%), need for mechanical ventilation (n=7; 12%) and death (n=4; 7%). The main risk factors for these complications were age ≥30 years, an inappropriately normal or elevated initial serum potassium level, an elevated serum creatinine kinase level and an elevated initial serum theophylline level. Receiver operator characteristic curve analysis assessing the initial serum theophylline level as a discriminator for life-threatening complications produced an area under the curve of 0.71 for serum theophylline >400 µmol/L (sensitivity 88%, specificity 12%). All the 4 patients who died had an initial serum theophylline level >1 000 µmol/L. The mean (SD) cost per admission amounted to ZAR16 897 (10 718), with a mean of one 4-hour dialysis session per admission.Conclusion. Severe theophylline toxicity, usually in the context of deliberate self-harm, is a preventable yet life-threatening toxicity encountered at LTH. Demographic risk factors include young females from certain areas in and around Gqeberha. Risk factors for complications include older age, paradoxically normal or elevated serum potassium levels, elevated serum creatinine kinase levels and an initial serum theophylline level >400 µmol/L. Patients with these clinical features should be closely monitored and treated timeously at an appropriate level of care. The need for ICU admission and dialysis, both limited resources, makes the treatment of severe theophylline toxicity costly. Further studies of the underlying psychosocial drivers, local prescribing practices and preventive interventions related to severe theophylline toxicity are required.

Atlas of African health statistics 2022: health situation analysis of the WHO African Region ­ summary report

NA

Demographic determinants of risky sexual behaviours among senior high school students in the Hohoe municipality, Ghana

Senior High School (SHS) students fall within the age group (15-24 years) hardest hit by HIV/AIDS. Since about 90% of HIV transmission in sub-Saharan Africa (SSA) is through heterosexual intercourse, it is assumed that these students engage in risky sexual behaviours. Hohoe municipality has one of the highest HIV prevalence in Ghana (3.4%). The current study investigated the demographic determinants of risky sexual behaviours among senior high school students in the Hohoe municipality, Ghana.Methods: a descriptive cross-sectional design was employed in the study. A pretested structured questionnaire was used to collect data from a multistage sample of 270 SHS students who consented to participate in January 2019. Descriptive and inferential statistics were performed using Stata version 14.0 software program at the 0.05 level of significance.Results: of 270 respondents, 112 (41.5%) were engaged in risky sexual behaviours. Single students were 82% less likely to engage in risky sexual behaviours than their married counterparts (p=0.032) and muslims were 89% less likely to engage in risky sexual behaviours than christians (p=0.032).Conclusion: religion and marital status were the two socio-demographic characteristics that were significantly associated with risky sexual behaviour. Health promotion interventions to curb risky sexual behaviours among the SHS students should target the christian and married students

EMJ series on statistics and methods: variables, populations and samples

This the first article in the EMJ Series on Statistics and Methods describes "variables" which represent different demographic and clinical characteristics of several individuals in a data set. Various attributes of quantitative and qualitative variables, including type, scale of measurement and values they may take are presented. Some descriptive statistics and graphic summaries are introduced. Pertinent examples drawn from journal articles are provided. The article also defines "population" as used in statistics and epidemiology and highlights population in size and scope in the context of the research question to be answered. It emphasizes the need for explicitly defining sampling based on the research question in a particular study. In addition, the articles introduces concepts and notations related to parameter and statistic. It highlights the need for using appropriate sampling method in selecting a representative sample of the study population and to be able to make valid inferences and generalizations. It is indicated in this articles that specific issues requiring further details will be addressed in the Series articles in subsequent Issues of EMJ

Socio-demographic characteristics of HIV patients diagnosed at immunization centres in Calabar, South -south, Calabar, Nigeria

Introduction: The World Health Organization (WHO) estimated that 3.2 million children were living with Human Immunodeficiency Virus (HIV) at the end of 2013, mostly in sub- Saharan Africa. Socio- economic and demographic factors do not only affect viral transmission but also the success of preventive strategies and treatment.Objective: To determine the socio -demographic characteristics of mothers, and the relationship between maternal and HIV status of their infants attending immunization clinics in Calabar.Methods: Using multistage sampling method, 330 subjects were enrolled and screened from 63 immunization centres. The sociodemographic characteristic of each infant's mother was documented. The results of Rapid test for mothers and Dried Blood Spots (DBS) results for infants were compared. Results: Of the 330 subjects recruited, 173 (52.4%) were males while 157(47.6%) were females. Mean age of the infants was 9.20 ± 3.1 weeks. Twenty four mothers and infants tested positive for HIV antibodies. After confirmatory tests using HIV Deoxyribosenucleic acid (DNA PCR), 14(58.3%) out of 24 antibody seropositive infants were infected. The transmission rate after confirmation was 58.3%. Conclusion: Parental education, social class and low maternal Antiretroviral drug (ARV) use were responsible for transmission. It is therefore recommended that health education on ARV use during antenatal period and HIV status of mother baby pair be done at immunization centres. HIV positive mothers and babies should be promptly referred for therapy

Factors Responsible for Under-Utilization of Postnatal Care Services in Maiduguri; North-Eastern Nigeria

Background: In Maiduguri; the utilization of available postnatal care services is still very low. This may be influenced by demographic; socioeconomic; cultural; and obstetric factors among others. Objective: The aim of this study is to understand the current status of utilization of maternal postnatal health care services and identify factors responsible for under.utilization of available postnatal care services in Maiduguri. Materials and Methods: A. cross.sectional; questionnaire.based study was conducted involving 350 women in their reproductive age group. (15.49. years); who had delivered previously; residing in Maiduguri and who came to access any of the available maternal health care services at the State Specialist Hospital; Maiduguri over a 3.month period. The Chi.squared statistics and multivariate logistic regression analysis were used. Results: Out of the grand total of 350 questionnaires that were distributed during the study period; 18 questionnaires were excluded from analysis due to incomplete responses; 332 with complete responses were therefore analyzed; giving a response rate of 94.9. The results showed that only 16.9 of the respondents attended postnatal care services within 42. days after delivery. Most of the mothers. (60.9) were not knowledgeable about postnatal care services. A. very high proportion of participants. (69.4) did not attend antenatal clinics; and over. 70of the study population had delivered at home. The study has identified some factors that have an important influence on utilization of postnatal care services in Maiduguri. These included awareness of postnatal care services. (odds ratio. [OR] 12.04; 95 confidence interval. [CI]: 10.26; P =. 0.000); higher educational status of the woman. (OR 7.15; 95 CI: 5.19; P =0.000); lower parity. (OR 5.22; 95 CI: 3.21; P = 0.001) and marital status. (married woman.OR 3.44; 95 CI: 2.17; P =0.002). Educational attainment of the husband also significantly affected the respondents' seeking behavior of postnatal care. (OR 2.01; 95 CI: 1.13; P =0.042). Conclusion: Utilization of postnatal care services is quite low in Maiduguri. Socioeconomic and sociodemographic factors influenced the use of postnatal care services. Government should provide culturally acceptable health educational programs and expands maternal health care services into the communities for the better; effective and efficient health care delivery

Sociodemographic characteristics of persons committing suicide in Durban, South Africa: 2006­2007

Background: Suicidal behaviour is a leading contributor to the burden of disease worldwide and varies widely between countries. South African figures are amongst the highest in the world; with recent trends indicating a disturbing rise; especially amongst the younger age groups; across all races. Aim: This study analysed sociodemographic characteristics and trends relating to suicides committed in Durban; South Africa during the period of 2006-2007. Method: A retrospective analysis of suicidal deaths (during 2006-2007); extracted from autopsy registers at all three government-run mortuaries in Durban; was conducted. Results: The total number of suicides in Durban increased by 6.68 from 2006 to 2007. Suicide accounted for an average of 8.8 of all non-natural deaths per year of the study. The overall suicide rates of 14.53 (2006) and 15.53 (2007) per 100 000 population are comparable with national and global figures. The majority of suicides occurred in single unemployed persons; men and younger age groups. The largest number of suicides per year was recorded in black people; followed by Indian; white and mixed-race people. Hanging was the preferred method in the majority of victims; followed by self-poisoning; shooting and jumping. Conclusions: The findings indicate a disturbingly high suicide rate amongst the various population and age groups in Durban. The dominant methods used may be influenced by ease of access. The reported trends may worsen unless there is a swift and decisive public health response and cohesive community-based programmes which include a supportive multidisciplinary network

Baseline Findings of an HIV Incidence Cohort Study to Prepare for Future HIV Prevention Clinical Trials in Kisumu; Kenya

Introduction: In an analysis of baseline findings of an HIV incidence cohort study; an assessment was made of HIV prevalence among persons presenting for enrollment and any differences in demographic characteristics between persons not enrolled compared to those enrolled. We also described and compared HIV risk behaviors in males and females enrolled in the study. Methodology: A computer-assisted survey was administered to collect baseline demographic and HIV risk data from 1;277 men and women aged 18-34 years. Testing for HIV and other sexually transmitted infections (STI) was conducted. Out of 1;277 persons prescreened for eligibility; 625 were enrolled. Results: HIV prevalence of all persons who completed screening was 14.8 (females: 21.1; males: 8.1). The odds of being enrolled in the study were higher for persons 18-24 years compared to those 30-34 years of age [adjusted odds ratio (AOR)=2.18; CI=1.13; 4.21] and males compared to females [AOR=2.07; CI=1.43; 2.99]. Among those enrolled in the study; the most prevalent HIV risk behaviors were unprotected sex (49); alcohol use (45); and transactional sex (30) in the last three months. Compared to females; a significantly greater proportion of males reported using any alcohol or recreational drug in the last three months; a history of oral sex; sex with partner other than a spouse or main partner; ever having a blood transfusion; ever being treated for an STI; and having knowledge of their last HIV test result. Conclusion: The Kisumu Field Station successfully recruited individuals with HIV risk characteristics for the HIV incidence cohort study

Socio-demographic characteristics of adults screened for HIV/AIDS in a rural community in Benue state, Nigeria

Background: Benue state has been considered among the `hot zones' for HIV/AIDS in Nigeria with a prevalence rate of 9.3 among adults aged 15 to 45 years. Yet; there is paucity of information on the socio-demographic factors associated with this level of prevalence. We hereby report the prevalence and socio-demographic factors associated with HIV among adults in Abwa-Mbagene; Benue state; Nigeria. Methods: Adults in Abwa-Mbagene community who accepted to participate between 9th and 24th of August 2007 were recruited. After counselling; screening was done using `Determine HIV' kit. Results: 153 subjects (74 males and 79 females) were recruited. Their age ranges from 15 to 60 years (Mean: 26.2years). Fourty-two (27.5) consisting of 12 (16.2) males and 30 (38) females were positive for HIV (male to female ratio; 2:5). The prevalence of HIV was higher among the divorcees (50); those whose level of education was primary school (41.3) and below and; farmers (60). Majority (96) knows AIDS exists; 85are informed on mode and prevention of HIV transmission. Cases of AIDS deaths; unprotected casual sex; blood transfusion with unscreened blood and polygamy are common in the community. The single most important cultural factors in HIV transmission identified is indulgence in night parties; which increased the rate of unprotected casual sex. Conclusion: This community represents a high HIV/AIDS prevalence spot in Benue State; Nigeria. There is therefore the need for the establishment of HIV Counselling and Testing (HCT); Prevention of Mother-To-Child Transmission (PMTCT); save blood and antiretroviral treatment services in the community. Vocational centers to engage single women and improve their financial state will boost preventive strategies. Finally; partnership with community leaders towards discouraging night parties will reduce the prevalence of HIV in the community

Epidemiology of drug abuse treatment in South Africa

Background. The aim of the study was to explore the epidemiology of drug abuse treatment in South Africa. Methods. Treatment demand statistics were analysed from South African National Council on Alcoholism and Drug Dependence and the South African Community Epidemiology Network on Drug Use records; and a rapid situation assessment was conducted. Twenty-one key informant interviews were conducted in all 9 provinces among provincial substance abuse co-ordinators, and one manager per treatment centre from a sample of treatment centres. Three focus groups were conducted and 46 self-administered questionnaires were distributed among inpatients at 2 selected treatment centres in Free State and North West provinces. Qualitative data were analysed using grounded theory, and quantitative data analysed using SPSS. Results.Treatment records show that the most frequent substance of abuse was alcohol (51), followed by cannabis (21), crack/cocaine (9.6), heroin/opiates (7.9), methamphetamine (Tik) (4.5), prescription/over-thecounter drugs (2.0), and cannabis/mandrax (1.7). More substance abusers were male, of lower education, white or black, than were female, more highly educated; coloured and Indian/Asian. Key informant interviews showed that females are the 'hidden' substance abusers and tend not to be identified in research statistics and at treatment centres. Poverty, unemployment, lack of recreational facilities, being surrounded by substance abusers; and long work shifts were also mentioned as factors contributing to substance abuse. The age of initiation of substance abuse using non-drugs such as glue was 9 years old; alcohol 10 - 12 years old, dagga 11 -12 years old, poly-drug use (alcohol, tobacco and dagga) 14 years old, and harder drugs such as cocaine and heroin at 16 - 17 years old, as reported by key informants. Family care and support, improved socio-economic conditions and increased law enforcement would help to discourage substance abuse. Conclusion. Prevention interventions and policies in South Africa should focus on reducing substance abuse by targeting the 'at risk populations' identified in this study

Understanding culture and HIV/AIDS in sub-Saharan Africa

Early in the study of HIV/AIDS; culture was invoked to explain differences in the disease patterns between sub-Saharan Africa and Western countries. Unfortunately; in an attempt to explain the statistics; many of the presumed risk factors were impugned in the absence of evidence. Many cultural practices were stripped of their meanings; societal context and historical positioning and transformed into cofactors of disease. Other supposedly beneficial cultural traits were used to explain the absence of disease in certain populations; implicitly blaming victims in other groups. Despite years of study; assumptions about culture as a cofactor in the spread of HIV/AIDS have persisted; despite a lack of empirical evidence. In recent years; more and more ideas about cultural causality have been called into question; and often disproved by studies. Thus; in light of new evidence; a review of purported cultural causes of disease; enhanced by an understanding of the differences between individual and population risks; is both warranted and long overdue. The preponderance of evidence suggests that culture as a singular determinant in the African epidemic of HIV/AIDS falls flat when disabused of its biased and ethnocentric assumptions

Socio-demographic Characteristics and Sexual Health Related Attitudes and Practices of Men Having Sex with Men in Central and Southern Malawi

An exploratory study of men having sex with men (MSM) was conducted in central and southern Malawi in order to understand their socio-demographic characteristics; sexual behaviours; and perceptions about confidentiality and stigma. A total of 97 men participated in the study of whom 84 (86.6) were in the age group 17-32 years. The majority; 73 (75.3) of MSM had never married; 26 (32.5) reported not always using condoms during sexual intercourse; and 23 (23.7) had ever received money or gifts in exchange of sex. Only 17 (17.5) of the participants reported being exposed to HIV prevention messages targeted at MSM. Fear of sexual orientation disclosure and discrimination were reported by 27 (30.7) of MSM. Many of the study participants reported that HIV intervention programmes are not accessible to them. In conclusion; HIV intervention programmes may not be reaching out to the majority of MSM. We suggest an exploration of the feasibility of HIV prevention interventions targeting MSM in this country where the practice is illegal

Plasma Glucose in a Reference Population in Port Harcourt; Nigeria

Background: Reference intervals are important in the analysis of results obtained for patients in the Hospital. These intervals tend to change as population demographics change. Globally; there has been an increase in the prevalence of diabetes and a change in the criteria set in diagnosing this disease. Since we have used the same reference intervals since 1984; it became imperative to review the reference intervals in use in our Hospital; the University of Port Harcourt Teaching Hospital; Port Harcourt; Nigeria. Methods : A total of 605 patients from the Out-Patient department and the Hospital community randomly following informed consent. Five milliliters (5mls) of blood was collected into fluorides oxalate bottles between 9.00-11.00 a.m. after an overnight fast for the determination of plasma glucose. The samples were assayed daily within two hours of collection. Serum glucose was determined using the glucose oxidase method (Randox Laboratories-Antrim UK). Results: The reference interval covering the central 95th centile as determined by non-parametric methods was 3.0-5.7 mmol/L (95confidence interval-2.7-3.2 and 5.6-5.8 mmol/L) for the entire study population; while that for males was 2.9-6.3 mmol/L and that for females was 3.3-5.6 mmol/L. Conclusion : It is essential to review reference intervals periodically as changes may occur due to changes in population demographics

Profil de la surveillance des enfants sains de 0 a 2 ans a la PMI de l'INSP d'Adjame

Il s'agit d'une etude transversale a visee descriptive et analytique portant sur le profil de la surveillance des enfants sains de 0 a 2 ans a la PMI de l'INSP d'Adjame. Elle s'est deroulee a l'INSP du 02 septembre au 02 decembre 2005. Son objectif general a ete d'apprecier l'etat de la surveillance des enfants sains qui frequentent la PMI; d'en rechercher les facteurs d'influences en vue de faire des propositions pour une amelioration. Au terme de cette etude; il ressort les conclusions suivantes : *92;2pour cent des enfants recenses sont suivis a la PMI ; *81;1pour cent des enfants sont exclusivement nourri au sein au cours des 6 premiers mois ; *22pour cent des enfants recenses sont malnutris ; *84;8pour cent ont eu un poids normal a la naissance ; *1;2pour cent des enfants recrutes presentent un retard psychomoteur ; *73pour cent des enfants sont a jour du calendrier du PEV ; *94;9pour cent des meres ne pesent pas correctement leurs enfants ; *31;5pour cent des enfants de moins de 6 mois ont subit une diversification alimentaire precoce ; *32;1pour cent des enfants malnutri ont des meres qui s'absentent al'IEC. En ce qui concerne les facteurs influencant; on note : *90;7pour cent des meres negligentes ne pesent pas correctement leurs enfants ; *94pour cent des absences aux seances d'IEC sont dues a l'ignorance. Seulement 74;5pour cent des enfants recenses sont biens suivis dans notre etude a la PMI de I'INSP d'Adjame car presentent a eux seuls un bon etat nutritionnel et un calendrier vaccinal a jour