Association of intestinal helminthic infection and nutritional status of primary school children in Gombe State, Nigeria

Background: Intestinal helminthic infections are among the commonest infections worldwide. It often affects the poorest communities and has similar geographic distribution with malnutrition. Intestinal helminthic infection contributes to undernutrition through subtle reduction in digestion and absorption of food, chronic inflammation and loss of nutrients. The objective of this study is to determine the prevalence of intestinal helminthic infection and its relationship with nutritional status of primary school children in Gombe, Gombe State, Nigeria. Methodology: This was a cross sectional study of 350 pupils selected through multistage random sampling technique from 24 primary schools in Gombe, Gombe State, Nigeria from July 2018 to January 2019. Demographic information including age, gender, height, and weight were collected from each participant with a designed collection form. The data were analysed using SPSS version 24.0, and presented as frequency distribution and mean ± SD. The Chisquare test (with Odds ratio and 95% confidence interval) was used to test for association between prevalence of helminthiasis and factors such as gender, age group and school type. A p value of less than 0.05 was considered statistically significant at 95% confidence interval. Results: The prevalence of intestinal helminthic infection was 23.7% (83/350). Eighty (96.4%) of the 83 infected pupils were in public schools while only 3 (3.6%) were in private schools (p<0.001). The prevalence of helminthiasis was significantly higher in underweight pupils (34%, OR=2.113, p=0.0065)) and significantly lower (5.4%, OR=0.1637, p=0.0037) in overweight pupils while the prevalence was not significantly associated with normal weight (p=0.5482) or obesity (p=1.000). Conclusions: Intestinal helminthic infection is a public health problem in children with adverse significant relationship with nutritional status. Provision of toilet facilities in schools and periodic de-worming of pupils aimed at reducing loss of nutrients from intestinal helminthiasis are recommended.

Quality of life of people living with HIV and AIDS attending Irrua Specialist Teaching Hospital, Edo State, Nigeria

Background: With the use of highly active antiretroviral therapy (HAART), life expectancy of HIV-infected persons had increased and the disease is now managed as a chronic one, but the quality of life (QOL) of the patients is now a concern. Social support enhances QOL of patients with chronic illnesses. However, no study has been done to determine the QOL of people living with HIV and AIDS (PLWHA) in our environment. This study therefore assessed the QOL of PLWHA attending antiretroviral therapy (ART) clinic of Irrua Specialist Teaching Hospital (ISTH), Edo State of Nigeria Methodology: A descriptive cross-sectional study design was used. Two hundred and thirty PLWHA attending the ART clinic of ISTH, Irrua, Edo State, Nigeria, were systematically selected for the study. A structured questionnaire was interviewer-administered to collect data on sociodemographic and clinical profiles of selected participants, and the WHOQOL-HIV BREF questionnaire was used to collect data the QOL of each participant. Data were analyzed with IBM SPSS version 20.0. Results: The overall mean QOL score for the participants was 89.13±1.18 (95% CI=87.95-90.31). The scores in three of the six life domains in the WHOQOL-HIV BREF instrument were similar and high; spirituality/ religion/personal beliefs (16.33±0.36), physical health (15.83±0.28) and psychological health (15.07±0.24). Lower mean QOL scores were observed in the social relationships (13.49±0.28) and environment (13.45±0.20) domains. Clinical HIV stage, marital status, educational status and gender were significantly associated with mean QOL scores in bivariate analysis while only HIV stage 1 and 2 were significantly associated with good QOL in multivariate logistic regression analysis. Conclusion: It is pertinent that PLWHA are kept in early stages of HIV disease through combination of efforts such as prompt enrolment, commencement and monitoring compliance of HAART, and treatment of opportunistic infections, as well as public health measures including education, de-stigmatization, early diagnosis by extensive accessible screening/testing of at-risk population, social supports and economic empowerment, psychotherapy and social integration of affected individuals especially in a functional home.

Modelling COVID-19 vaccination status and adherence to public health and social measures, Eastern Mediterranean Region and Algeria

Objective: To study the link between coronavirus disease 2019 (COVID-19) vaccination status and adherence to public health and social measures in Members of the Eastern Mediterranean Region and Algeria. Methods: We analysed two rounds of a large, cross-country, repeated cross-sectional mobile phone survey in June­July 2021 and October­November 2021. The rounds included 14 287 and 14 131 respondents, respectively, from 23 countries and territories. Questions covered knowledge, attitudes and practices around COVID-19, and demographic, employment, health and vaccination status. We used logit modelling to analyse the link between self-reported vaccination status and individuals' practice of mask wearing, physical distancing and handwashing. We used propensity score matching as a robustness check. Findings: Overall, vaccinated respondents (8766 respondents in round 2) were significantly more likely to adhere to preventive measures than those who were unvaccinated (5297 respondents in round 2). Odds ratios were 1.5 (95% confidence interval, CI: 1.3­1.8) for mask wearing; 1.5 (95% CI: 1.3­1.7) for physical distancing; and 1.2 (95% CI: 1.0­1.4) for handwashing. Similar results were found on analysing subsamples of low- and middle-income countries. However, in high-income countries, where vaccination coverage is high, there was no significant link between vaccination and preventive practices. The association between vaccination status and adherence to public health advice was sustained over time, even though self-reported vaccination coverage tripled over 5 months (19.4% to 62.3%; weighted percentages). Conclusion Individuals vaccinated against COVID-19 maintained their adherence to preventive health measures. Nevertheless, reinforcement of public health messages is important for the public's continued compliance with preventive measures.

Profil glucido-lipidique et risque cardiovasculaire chez les diabétiques de type 2 / Carbohydrate and lipid profile associated with cardiovascular risk in type 2 diabetics

Introduction-Le diabète est un véritable problème de santé publique du fait de ses nombreuses complications potentielles, notamment cardiovasculaires. Notre objectif était de décrire le profil clinico-biologique chez une population de diabé tique type 2 et d'étudier la relation entre l'équilibre glycémique et les anomalies lipidiques avec les complications micro et macroangiopathiques. Matériels et méthodes -Nous avons mené une étude rétrospective portant sur 341 pa tients diabétiques type 2.Les données ont été analysées par le logiciel IBM® SPSS statis tics 20.0. Seules, les associations significatives (p ≤ 5%) étaient retenues. Résultats - quatre-vingt deux pourcent et demi des patients ont un taux d'HbA1c ≥7 %. Plus de 60 % ont une dyslipidémie. Cinquante deux pourcent des patients ont un taux du LDLc ≤ 1 g/l, et 64,4 % ont un taux du Non-HDLc >1g/l. Environ 66 % des patients ont une hypertension artérielle. quarante pourcent des patients ont présenté une macroangio pathie et 66,8 % une microangiopathie (p=0,0001). L'analyse par régression logistique, a montré que l'HbA1c est le paramètre biologique le plus associé aux complications macroangiopathiques (p=0,008), alors que pour les complications micro-angiopathiques, l'HTA était le seul facteur associé (p = 0,03). Pour la cardiopathie ischémique, la dyslipi démie et l'HTA étaient les facteurs les plus associés. Conclusion -Notre étude a montré une fréquence élevée des complications micro et macroangiopathiques et des anomalies lipidiques, ainsi qu'un très mauvais équilibre glycémique. L'HbA1c, la dyslipidémie et l'HTA sont les facteurs les plus associés au risque cardiovasculaire.

Background-Diabetes is a real health public problem because of its many potential complications, particularly the cardiovascular ones.The aim of this work was to describe the clinical and biological profile in type 2 diabetic population, then to study the relationship between glycemic control and lipid abnormalities with micro and macro vascular complications. Methods - It was about a retrospective study of 341 type 2 diabetes patients' with an average age of 60.1 ± 11.71 years.The IBM® SPSS statistics 20.0 software was used for analyzing data. Only significant associations (p ≤ 5%) were retained. Results -An HbA1c level ≥7% was observed in 82,5% of patients, More than 60% have dyslipidemia. 52,8% of them have an LDLc level ≤ 1 g/l, and 64,4% have a Non-HDLc level >1g/l. Sixty-six percent of patients have high blood pressure. The macrovascular disorders were observed on 30,9% of patients and microvascular ones on 66,8% of them (p = 0.0001).The logistic regression analysis showed that HbA1c was the most significant biological parameter (p=0,008). while for micro-vascular complications, high blood pressure was the only associated factor (p = 0.03). For ischemic heart disease, dyslipidemia and high blood pressure were the most associated factors. Conclusion - this study showed a high frequency of micro and macrovascular complications, lipid abnormalities and a very poor glycemic control. The elevation of HbA1c level, the high blood pressure and dyslipidemia are the most associated factors with a high cardiovascular risk.

Neuro-Physiotherapy at the Primary Health Care Level: Perception of Public Health Physicians

Background: There is consistent increase in chronic neurological conditions presenting at primary health care settings across the world. However, there is paucity of neuro-physiotherapy services and research on integrating neuro-physiotherapy to promote independence among thispopulation at primary health care settings. This study determined the perception of public health physicians on the integration of neuro-physiotherapy at the primary health care (PHC) level in Nigeria.Methods: A descriptive cross-sectional survey using a validated and pre-tested questionnaire to retrieve data from 149 Public Health Physicians in Nigeria to determine their perception of neuro-physiotherapy at the primary health care level.Results: Majority of the participants 133 (89.3%) agreed to the need for neuro-rehabilitation care at primary health care level. 83 (55.7%) believed that the physiotherapists are competent enough to handle neuro-rehabilitation needs at the PHC level. The findings highlighted the challenges towards implementing neuro-rehabilitation at the primary health care level.Conclusion: The results revealed positive recommendations from public heath physicians in Nigeria towards the integration of neuro-physiotherapy services in primary health care.

Perceptions of undergraduate allied health students of the clinical learning environment and clinical educators' attributes at the University of Ghana

Background. Clinical education is a vital aspect of the education of health sciences students and consists of two components, i.e. the clinical learning environment and supervision.Objectives. To determine the undergraduate allied health sciences students' perceptions regarding clinical educators' attributes and the clinical learning environment.Methods. This cross-sectional study included 169 undergraduate students, randomly recruited from various allied health professions programmes of the University of Ghana. The McGill clinical teacher evaluation tool and the clinical learning environment inventory were used to determine students' perceptions of clinical educators' attributes and the clinical learning environment, respectively. The Kruskal-Wallis test and independent t-tests were used to test for relationships between students' level and programme of study and their perceptions. The level of significance was set at 95%.Results. Of the 169 participants, there were 99 (58.6%) male students, 79 (46.7%) third-year students and 82 (48.5%) medical laboratory science students. Only 16 (9.5%) participants indicated visits by lecturers during clinical rotations. The third-year students had a statistically significant perception of their clinical learning environment (p=0.000), while the differences between perceptions of clinical learning environment among the various programmes were also statistically significant (p=0.028), but not for clinical educators' attributes (p=0.261).Conclusion. Allied health sciences students have positive perceptions of their clinical learning environment and clinical educators' attributes. More frequent visits by lecturers to students during clinical rotations may ensure that student innovation is achieved in accordance with their classroom tuition

Hémopathies malignes de l'adulte à Kinshasa: analyse documentaire d'une série des cas de 2011 à 2021 / Hematological malignancies in adults in Kinshasa: retrospective serial cases from 2011 to 2021

Contexte et objectif. Les hémopathies malignes (HM) constituent un problème majeur de santé publique en Afrique sub-saharienne où les moyens de prise en charge sont limités. L'objectif de l'étude était de décrire les aspects diagnostiques, thérapeutiques et évolutifs observées dans la prise en charge des HM en milieu hospitalier de Kinshasa. Méthodes. Etude observationnelle historique de type suivi des cas d'HM hospitalisés, dans formations sanitaires de Kinshasa entre les 1er janvier 2011 et 31 décembre 2021. Seuls les patients âgés de plus de 18 ans ont été inclus. Les paramètres d'intérêt étaient englobés les données sociodémographiques, cliniques, biologiques, d'imagerie, du myélogramme, de l'analyse histopathologique des pièces biopsiques ganglionnaires ou extra ganglionnaires, le type de chimiothérapie et de la survie à 6 mois. Les tests de chi-carré et de Student ont comparé respectivement les proportions et les moyennes. L'analyse de Kaplan Meier et la régression de Cox ont respectivement décrit la survie et recherché les facteurs associés à la mortalité à 6 mois. Résultats.Sur 2678 patients suspects d'HM, seuls de 250 patients (9,3%, âge moyen 47,6 ± 15,8 ans, 62,4% d'hommes) ont eu un bilan de confirmation. Les adénopathies périphériques (54 %), la fièvre au long cours (48 %) et la poly transfusion (29 %) étaient les principaux motifs de consultation. Les perturbations hématologiques rencontrées étaient l'anémie (72 %), la thrombopénie (50 %), l'hyperleucocytose ( 0 %) et la leucopénie ( 0 %). Les syndromes lymphoproliferatif (68 %) étaient plus fréquents et répartis en lymphomes non hodgkiniens (50 %), Lymphome hodgkinien (27%) et myélome multiple (15 %). Les leucémies aigues venaient en deuxième position (12 %) suivi des syndromes myélodysplasiques (11 %) et des syndromes myéloprolifératifs (8 %). 61 % des patients ont bénéficié de la chimiothérapie. Durant les 6 premiers mois de prise en charge, la létalité globale était de 58,4 %. Conclusion. En milieu hospitalier de Kinshasa, très peu de patients suspects d'HM bénéficient d'une mise au point complète et de la chimiothérapie. Les adultes jeunes, surtout les hommes, sont très affectés et plus de la moitié d'entre eux décèdent endéans 6 mois. L'amélioration de l'accessibilité à la chimiothérapie et du plateau technique permettra une réduction de la létalité.

The Effect of Community Health Information System on Health Care Services Utilization in Rural Ethiopia

BACKGROUND: The Health Extension Program (HEP) was introduced in 2003 to extend primary health care services by institutionalizing the former volunteer-based village health services. However, this program is not comprehensively evaluated. MATERIALS AND METHODS: The 2019 comprehensive national assessment of HEP involved (1) assessment through quantitative and qualitative primary data, (2) a thorough systematic review of the HEP literature, and (3) a synthesis of evidence from the two sources. The assessment included household survey(n=7122), a survey of health extension workers (HEWs) (n=584) _, and an assessment of health posts (HPs)(n=343) and their supervising health centers (HCs)(n=179) from 62 randomly selected woredas. As part of the comprehensive assessment. OUTPUT AND RESULTS: The outputs were (a) full and abridged reports, (b) 40 posters, (c) seven published, three under review scientific papers and (d) seven papers in this special issue. During the one-year period preceding the study, 54.8% of women, 32.1% of men, and 21.9% of female youths had at least a one-time interaction with HEWs. HPs and HEWs were universally available. There were critical gaps in the skills and motivation of HEWs and fulfillment of HP standards: 57.3% of HEWs were certified, average satisfaction score of HEWs was 48.6%, and 5.4% of HPs fulfilled equipment standards. CONCLUSIONS: The findings informed policy and program decisions of the Ministry of Health, including the design of the HEP Optimization Roadmap 2020­2035 and the development Health Sector Transformation Plan II. It is also shared with global community through published papers.

Knowledge, attitude and perception of mothers of under-five towards vaccination during supplementary immunization activities in Ibadan North-West Local Government Area, Ibadan, Oyo State, Nigeria

Supplementary immunization activities campaigns provide children with an additional dose of vaccine and deliver other interventions. However, there is dearth of information on knowledge, attitude and perception of mothers of under-five towards vaccination during supplementary immunization activities. A descriptive cross-sectional study which employed multistage sampling technique was designed to fill this gap. Four wards were randomly selected from eleven wards in Ibadan North-West Local Government Area and houses were enumerated from the selected wards, systematic random sampling was used to select houses and then respondents. A semi-structured interviewer administered questionnaire was used to elicit information on three hundred and five respondents. Knowledge scores of ≤4, 5-8, and ≥ 9 were rated poor, fair and good, respectively. Attitude scores of ≤5 and >5 was rated negative and positive attitude, respectively while perception scores ≤4 and >4 were rated negative and positive perception, respectively. Data was analyzed with SPSS version 25 using descriptive statistics and Chi-square test at 5% level of significance. The mean age of respondents was 30.6±6.1years, the highest level of education for most (68.5%) was secondary school. Their mean parity and number of under-five were 2.5±1.4 and 1.2±0.4, respectively. Knowledge was generally poor, more than half (53.1%) had poor knowledge, majority (88.2%) have positive attitude while 84.6% have a positive perception. One-fourth (24.6%) and one-fifth are of the opinion that frequent vaccination will make the vaccine ineffective and overload immune system, respectively. There was generally poor knowledge of supplementary immunizations and mothers need to be educated on the importance.

Points of entry dynamics: understanding the cross-border threats for Ebola virus disease and COVID-19 in Ghana using a logic model approach

Background. The influx of people across the national borders of Ghana has been of interest and concern in the public health and national security community in recent times due to the low capacity for the prevention and management of epidemics and other public health risks. Although the International Health Regulations (IHR) stipulate core public health capacities for designated border facilities such as international airports, seaports, and ground crossings, contextual factors that influence the attainment of effective public health measures and response capabilities remain understudied. Objective. To assess the relationship between contextual factors and COVID-19 procurement to help strengthen infrastructure resources for points of entry (PoE) public health surveillance functions, thereby eliminating gaps in the design, implementation, monitoring, and evaluation of pandemicrelated interventions in Ghana. Materials and Methods. This study employed a mixed-methods design, where quantitative variables were examined for relationships and effect size interactions using multiple linear regression techniques and the wild bootstrap technique. Country-level data was sourced from multiple publicly available sources using the social-ecological framework, logic model, and IHR capacity monitoring framework. The qualitative portion included triangulation with an expert panel to determine areas of convergence and divergence. Results. The most general findings were that laboratory capacity and KIA testing center positively predicted COVID-19 procurement, and public health response and airline boarding rule negatively predicted COVID-19 procurement. Conclusion. Contextual understanding of the COVID-19 pandemic and Ebola epidemic is vital for strengthening PoE mitigation measures and preventing disease importation.

Sedentariness and overweight in relation to mortality in Sub-Saharan Africa. A Mediation analysis based on the WHO-Global Health Observatory Data Repository

Aims: The aim of the study was to investigate the complex mediation analysis between physical inactivity and overweight in relation to mortality. Methods: The study is based on public data collected by the Global Health Observatory (GHO) of the World Health Organisation. Results: We showed that the median early mortality attributable to NCDs during the period 2016 - 2019 in both men and women all together was 23.2% (5th to 95th range = 17.2, 35.6) while that in men alone was 25.1% (16.5, 45.7) and that of women was 22.0% (17.0, 27.9). When considering regional early NCDs mortality for both men and women, a systematically high median was observed in Southern Africa (28.7% (22.2, 43.8)) and a low median in Eastern Africa (21.1% (17.15, 27.3)). The analysis of the overall relation between physical inactivity, overweight and early mortality due to NCDs revealed a statistical significance of the direct association between physical inactivity and early mortality due to NCDs. Conclusion: Our findings revealed three main epidemiological and public health concerns. First, an early mortality attributable to NCDs in a range of about 20% to 30% across the SSA regions for both sexes were observed. Second, there was a direct effect between physical inactivity and early NCDs mortality as well as for the indirect effect mediated by overweight. Finally, a percentage point decrease of physical inactivity prevalence and overweight could effectively generate a reduction of mortality due to NCDs. Future studies are needed to confirm the scientific evidence observed in this study. Such studies should be based on observation of individual subjects, adopt a longitudinal design, and collect information that evaluate the complex relation between physical inactivity and early NCDs mortality, along with the role of overweight as a possible mediator.

Spatial factors for COVID-19 associated community deaths in an urban area of Lusaka, Zambia: an observational study

We retrospectively analyzed spatial factors for coronavirus disease 2019 (COVID-19)-associated community deaths i.e., brought-in-dead (BID) in Lusaka, Zambia, between March and July 2020. A total of 127 cases of BID with geocoordinate data of their houses were identified during the study period. Median interquartile range (IQR) of the age of these cases was 49 (34-70) years old, and 47 cases (37.0%) were elderly individuals over 60 years old. Seventy-five cases (75%) of BID were identified in July 2020, when the total number of cases and deaths was largest in Zambia. Among those whose information regarding their underlying medical condition was available, hypertension was most common (22.9%, 8/35). Among Lusaka's 94 townships, the numbers (median, IQR) of cases were significantly larger in those characterized as unplanned residential areas compared to planned areas (1.0, 0.0-4.0 vs 0.0, 0.0-1.0; p=0.030). The proportion of individuals who require more than 30 minutes to obtain water was correlated with a larger number of BID cases per 105 population in each township (rho=0.28, p=0.006). The number of BID cases was larger in unplanned residential areas, which highlighted the importance of targeted public health interventions specifically to those areas to reduce the total number of COVID-19 associated community deaths in Lusaka. Brought-in-dead surveillance might be beneficial in monitoring epidemic conditions of COVID-19 in such high-risk areas. Furthermore, inadequate access to water, sanitation, and hygiene (WASH) might be associated with such distinct geographical distributions of COVID-19 associated community deaths in Lusaka, Zambia.

Hypertension maligne à l'hôpital Fousseyni Daou de Kayes, au Mali: aspects épidémio-cliniques et pronostiques / Malignant hypertension at the Fousseyni Daou hospital in Kayes, Mali: epidemiological and prognostic aspects

L'hypertension artérielle maligne (HTAM) est un problème de santé publique en Afrique subsaharienne. L'objectif de cette étude était de décrire le profil épidémio-clinique et les facteurs pronostiques de l'HTAM à Fousseyni DAOU de Kayes. Méthodes. Nous avons réalisé une étude rétrospective et descriptive du 1er janvier 2016 au 31 juin 2022 à l'unité de néphrologie de l'hôpital Fousseyni Daou de Kayes. Étaient inclus, les patients hypertendus ou normotendus sous traitement hospitalisés avec une rétinopathie hypertensive (RH) de stade II ou III (selon la classification de Kirkendall) associée à une ou plusieurs autres atteintes viscérales et ayant un dossier médical complet. Résultats. Au total 117 cas d'HTAM ont été enregistrés sur 7011 dossiers examinés, dont 53,8% d'hommes (63 cas). L'âge moyen était de 39,47 ans. La moyenne de la pression artérielle à l'admission était de 187/114 mmHg. La RH était de stade II et III dans 59,8% et 40,2% des cas. L'insuffisance rénale était retrouvée chez 93,1% des patients (109 cas) dont 63,7% d'insuffisance rénale chronique (IRC) contre 36,7% d'insuffisance rénale aiguë (IRA). L'hypertrophie ventriculaire gauche a été retrouvée dans 80,4% des cas. L'issue globale des patients a été favorable dans 59% (69 cas) contre 31,6% (37 cas) de décès et 9,4% (11 cas) de sortie contre avis médical. Les facteurs associés au risque de décès étaient surtout la RH stade III, la dyslipidémie, l'IRC terminale et l'hyponatrémie. Conclusion. L'HTAM reste un problème de santé publique au Mali et touche préférentiellement les sujets jeunes avec une morbi mortalité élevée

Prevalence and factors associated with the severity of anaemia among patients on chronic haemodialysis in Lagos, Nigeria

Anaemia is a global public health problem with high mortality and morbidity. It is also a common consequence of chronic kidney disease (CKD). There is a paucity of data on the actual burden of anaemia among patients on chronic haemodialysis (CHD) in Lagos, Nigeria. Objectives: To determine the prevalence and factors associated with the severity of anaemia among Nigerian patients undergoing chronic haemodialysis. Methods: This was a retrospective analysis of adult patients with end-stage renal disease (ESRD) on maintenance haemodialysis at the Lagos State University Teaching Hospital, Ikeja, Lagos. The data extracted from the clinical case files included the bio-demographic and clinical parameters, including the treatment modalities. Results: A total of 92 patients comprising 69 (75%) males and 23 (25.0%) females with the overall mean age of 48.2±14.0 years were included. Hypertension was the commonest aetiology of CKD and the average duration of haemodialysis was 16.6 months. The commonest access route for haemodialysis was a central line while 96.7% and 81.5% received erythropoietin and intravenous iron sucrose respectively. Seventy-three (79.3%) patients have had intra-dialysis blood transfusions in the past. Mild, moderate, and severe anaemia were recorded in 17%, 67%, and 16% respectively. The use of erythropoietin, iron sucrose, and increased frequency of blood transfusions correlated with the severity of anaemia. Conclusion: Anaemia is highly prevalent among patients with CKD on chronic haemodialysis. Increased frequency of blood transfusions, inadequate utilization of erythropoietin, and iron sucrose administration are associated with anaemia severity.

Postnatal foot length in the estimation of gestational age in relation to intrauterine growth pattern among Nigerian neonates

Objectives: To determine the relationship between postnatal foot lengths and estimated gestational age (EGA) in relation to intrauterine growth patterns determined at birth among Nigerian neonates. Design: Hospital-based, cross-sectional. Setting: Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Participants: 260 neonates with EGA 30- 42 weeks within 48 hours of life. Interventions: Postnatal foot lengths (FL) were measured with Vernier digital calliper in millimetres. The intra-uterine growth pattern was determined using the Lubchenco chart. Pearson correlation and regression analysis tests were performed. Main outcome measures: Postnatal foot length in relation to Intra-Uterine Growth Pattern. Results: The mean postnatal FL had a strong positive correlation with the EGA from 30 through 42 weeks (r = 0.855, p < 0.001). The overall mean foot length for preterm neonates was 65.44 (6.92) mm, while that of term neonates was 77.92 (4.24) mm. The linear regression equation was generated as: EGA = 9.43 + (0.37 × FL), p < 0.001. The EGA as measured by FL had the highest positive correlation with Small for Gestational Age (SGA) intra-uterine-growth pattern, followed by Appropriate for Gestational Age (AGA) and least by Large for Gestational Age (LGA) respectively (r = 0.936> 0.861 > 0.666). Conclusion: The postnatal foot length correlated well with estimated gestational age, and the correlation was best among SGA infants

Sero-prevalence of and risk factors associated with Helicobacter pylori infections among individuals with peptic ulcer in Owerri, Imo State, Nigeria during 2020-2021

Background: Helicobacter pylori, which is a causative agent of chronic gastritis, duodenal ulcer and gastric cancer, presently affects approximately one half of the world population. This study was conducted to assess the epidemiology and risk factors for acquisition of H. pylori among individuals with and without peptic ulcer symptoms in Owerri, Nigeria, in order to provide baseline data and create awareness for effective management and prevention of infection caused by this pathogen. Methodology: A total of 384 participants, symptomatic and asymptomatic for peptic ulcer, were recruited from the three Local Government Areas (LGAs) of Owerri, Imo State, Nigeria. The symptomatic participants were randomly recruited among patients attending outpatient clinics with symptoms of peptic ulcer disease at the Federal Medical Center Owerri, general hospitals and primary healthcare centers across Owerri LGAs, while asymptomatic patients were recruited from the community. Information on socio-demographic characteristics of each participant and potential risk factors were collected with a pre-tested structured questionnaire. Blood samples were collected for detection of antibodies (IgG) using a one-step H. pylori test device while faecal samples were collected for detection of occult blood (from peptic ulceration) using faecal occult blood (FOB) test. Data were analyzed using SPSS version 25.0 and association of risk factors with H. pylori sero-prevalence was determined by the Chi-square or Fisher Exact test (with Odds ratio). P value < 0.05 was considered statistically significant.Results: The sero-prevalence of H. pylori infection among the study participants was 72.4% (285/384) while the prevalence of ulcer by FOB test was 71.1% (273/384). A total of 78.4% (214/273) of those with ulcers were seropositive for H. pylori while 64.0% (71/111) of those without ulcers were sero-positive for H. pylori (p=0.0045).Factors significantly associated with high sero-prevalence of H. pyloriwere age groups 41-50 (100%), 21-30 (78.4%) and 31-40 (67.6%) years (X 2=66.964, p<0.0001), illiteracy (OR=6.888, p<0.0001), unemployment (OR=2.427, p<0.0001), low social class status (X2=28.423, p=0.0003), drinking of unclean water (OR=5.702, p<0.0001), living in crowded rooms (OR=2.720, p<0.0001), eating food bought from food vendors (OR=3.563, p<0.0001), family history of ulcer (OR=12.623, p<0.0001), habits of eating raw vegetables and unwashed fruits (OR=6.272, p<0.0001), non-regular hand washing practices before meal (OR=2.666, p<0.0001) and presence of ulcer (OR=2.043, p=0.0045). However, smoking (OR=0.7581, p=0.2449) and gender (OR=0.6538, p=0.0796) were not significantly associated with sero-prevalence of H. pylori. Conclusion: There is need for comprehensive strategy including public health education campaign to create awareness on H. pylori, improve personal hygiene and environmental sanitation, provision of safe drinking water by the government to the populace, and discourage indiscriminate and open defecation

COVID-19 Pandemic as a mass killer and existential public health emergency in Nigeria remains unproven: A viewpoint

Framing COVID­19 pandemic as mass killer and existential public health emergency/threat in Nigeria with 2,120 COVID­19­related deaths in over 14 months of the pandemic in the country is problematic, especially as other public health conditions kill more Nigerians annually. In 2018, for example, malaria and road traffic accident caused 97,200 and 38,902 deaths, respectively, while HIV/AIDS caused 43,000 deaths in 2019. Therefore, rushing into an extensive vaccination campaign projected to cost 540 billion naira when 76.03 billion naira was allocated for primary health services nationwide including other major immunization programs in the 2021 federal health budget could raise question of priority/effective spending. Especially with COVID-19 deaths relative to reported cases(case fatality ratio) declining to 1.30% by June 30, 2021 from 3.45% in April 2020 and daily mass deaths non-evident. Temporizing to understand how the pandemic evolves especially in jurisdictions with higher need could be cost­effective.

Roles of local healthcare workers in the humanitarian response in South Sudan: a literature review

Introduction: Armed conflict is devastating to the health system, is a public health concern and recovery is an enormous challenge. The independence of South Sudan in 2011 brought much hope. However, eight years later, the country is still at conflict with itself. Although rich in resources, it is ranked among the poorest in the world and depends on donor funding for most service delivery, especially health. In an international context, promoting the localisation of humanitarian aid and the integration of health services, there is a lot to learn from the roles being played by healthcare workers (HCWs) throughout the conflict in South Sudan. Method: A literature review was conducted to identify the roles of local HCWs in South Sudan since 2011. Four databases were searched, grey literature sourced, and snowballing done to capture additional documents for a comprehensive analysis. Questions were adapted from the Critical Appraisal Skills Programme for qualitative and systematic reviews guided appraisals of the articles. Results were systematically coded, synthesised and summarised using a priori and emergent themes. Results: The health system in South Sudan is very fragmented with heavy dependence on humanitarian aid. There is serious shortage in health workforce with heavy reliance on unskilled workers to fill in the gaps, mainly in rural settings. Although close collaboration exists among different stakeholders to deliver integrated services, poor infrastructure, insecurity, lack of capacity and donor dependency still poses a challenge towards localisation of aid and sustainability. Conclusions: The literature reviewed for this study indicates that the road towards localisation of health care is possible but will depend highly on continued collaboration between the different contributors, integration of services, building capacity of the nationals, increased government funding and infrastructural development. Local involvement of HCWs by international agencies is paramount in ownership and sustainability of services.

The impact of public health interventions in a developing nation: an overview

Introduction: Around 80% of factors that determine population health sit outside the control of health services. It is essential we influence these factors in addition to those within the remit of health services in order to improve and protect the health of population in a developing country. Public health functions encompass working across the domains that constitute population health systems with various partners. The objective of this article is to give an overview of public health interventions that can improve the health of the population of a developing nation. Method: A descriptive study, based on a review of the literature of key public health frameworks and interventions that are likely to have significant impacts on population health. Some selected public health interventions and case studies are highlighted to illustrate the importance of priority areas in developing countries. Results: Various public health frameworks recognise the importance of wider determinants of health (socio-economic factors), effective healthcare, healthy behaviours, working with communities as critical to securing population health. Another framework adopts a life-course model of intervention starting from public health interventions during preconception period and childhood, adolescence, working life and older age. For many developing countries, the author identified some examples of priority areas for interventions such as stopping and preventing wars; improving child health, including free school meals; achieving universal healthcare through integrated primary health care; addressing commercial determinants of health; embracing new technologies; and measuring and monitoring population health. Conclusion: In order to improve the health of a population in a developing country, attention needs to go beyond health services to influence the wider determinants of health, health behaviours and adopting the World Health Organisation's roadmap on essential public health functions.