Ocular disorders among stroke patients in Federal Teaching Hospital, Lokoja, Nigeria

Objectives:To determine the pattern of ocular disorders among stroke patients in Federal Teaching Hospital, Lokoja (FTHL).Materials and Methods:Consecutive new stroke patients seen at the Federal Teaching Hospital, Lokoja over a 3-month period were studied. Data was collected with the use of a structured questionnaire divided into four major sections: bio-data, visual history, results of ocular assessment and NEI VFQ-25 quality of life questionnaire. Data analysis was done using SPSS for Windows, version 23.0. Univariate analyses were presented in the form of frequencies, percentages, means, ranges, and standard deviations, charts and tables.Results:Eighty-three patients were recruited with an age range of 40-71 years, a mean age of 55.3(±7.1) years. Thirty-nine patients (47.0%) were between the ages of 51 and 60 years. Thirty-four (41.0%) patients were females while 49(59.0%) were males. Of 46 (55.4%) patients that had neuro-imaging, stroke was ischaemic in 37(80.4%) and haemorrhagic in 9(19.6%). Of the 63 patients with left sided stroke, 2 (2.4%), 4(4.8%) and 57(68.7%) had severe, moderate and mild and normal visual impairment respectively while of the 20 patients with right sided stroke, 3(3.6%) each had severe and moderate visual impairment and 14(16.9%) had normal or mild visual impairment. Other ocular abnormalities included corneal anaesthesia and macular hole in 2(1.2%).Conclusion:Anterior and posterior segments, together with neuro-ophthalmic disorders were found among stroke patients in this study. Many of the ocular abnormalities are as a result of long-standing uncontrolled hypertension which caused the stroke. It is recommended that awareness should be created among the populace about uncontrolled hypertension. It is also advised that internists should refer hypertensive patients for routine ophthalmic screening.

Determining compliance with the COVID-19 daily symptom monitoring tool used to identify suspected COVID-19 workers of the military health support formation employees of the South African national defence force

Introduction: the COVID-19 pandemic had prompted governments in many countries to enact laws and policies to combat the spread of COVID-19 at work. The DEL required every worker to be screened when they arrived at work. Screening methods included self-reporting symptoms using a symptom monitoring tool. This study aimed to determine compliance with the symptom monitoring tool by assessing the knowledge, attitude, and practice of the MHSF employees. Methods: a cross-sectional questionnaire was administered to the employees. Information related to demographic, COVID-19 exposure, knowledge of COVID-19 and the symptom monitoring tool, attitude towards the symptom monitoring tool and practices towards COVID-19 and the symptom monitoring tool was collected. Results: a total of 90 participants participated in the study. The majority (N=45; 50%) of respondents were aged between 30 and 39 years old, with more female (N=50) than male (N=40) participants. The majority (N=51; 56.7%) only had grade 12 as the highest level of education. There were 25% (N=10) of males and 20% (N=10) of females who contracted COVID-19. The relationship between the COVID-19 positive cases and the symptom monitoring tool identifying symptoms had a strong negative correlation (-0.932). Respondent's knowledge of COVID-19 and the symptom monitoring tool was moderate (72.4%), with the attitude to the symptom monitoring tool being moderate (63.3%) as well. However, the practices of the COVID-19 guidelines and the symptom monitoring tool were good (93.3%).

Cardiovascular physical examination as a screening tool for congenital heart disease in newborns at a teaching hospital in Ghana

Objectives: To determine the usefulness of cardiovascular physical examination (CPE) as a screening tool in a lowresource setting for detecting congenital heart disease (CHD) in newborns delivered at the Maternity Unit of Korle Bu Teaching Hospital (KBTH), Accra, Ghana. Design: A hospital-based cross-sectional study with a comparison group component. Setting: Maternity Unit of the KBTH, Accra, Ghana. Participants: Over eight months, newborns aged 1-14 days delivered at ≥ 34 weeks' gestation at the Maternity Unit, KBTH, were recruited into the study. Intervention: Each newborn was examined using a set of CPE parameters for the presence of congenital heart disease. Those with suggestive features of CHD had a confirmatory echocardiogram test. Main Outcome Measure: Abnormal CPE features and their corresponding echocardiogram findings. Results: A total of 1607 were screened, with 52 newborns showing signs of CHD on CPE, of which 20 newborns were proven on echocardiogram to have congenital heart disease. Abnormal CPE parameter that was associated with CHD was murmur (P=0.001), dysmorphism (p=0.01), newborns with chest recessions (p=0.01) and lethargy (p=0.02). CPE's sensitivity, specificity, and positive and negative predictive values were 95%, 60.7%, 36.5% and 98,1%, respectively. The most common acyanotic CHD found was isolated atrial septal defect (ASD), followed by patent ductus arteriosus (PDA). The only cyanotic CHD found was a case of tricuspid atresia. Conclusion: Cardiovascular physical examination at birth is an effective and inexpensive screening tool for detecting CHD in newborns, which can easily be utilised in low-resource settings.

Prévalence de l'infection par l'hépatite virale B et facteurs associés chez les enfants des sujets ivoiriens porteurs de l'AGHBS / Prevalence of hepatitis B infection and factors associated in children of Ivorian HBsAg carrier

Objectifs : Déterminer la prévalence de l'infection par le virus de l'hépatite B (VHB) chez les enfants (sujets contact) des sujets porteurs chroniques de l'Ag HBs (sujets index) et rechercher les facteurs associés à cette infection chez ces enfants.Patients et méthodes: il s'est agi d'étude rétrospective transversale portant sur les patients positifs pour l'Ag HBs (sujets index), dont la famille (sujets contact: conjoints et enfants) a été soumise à un dépistage systématique de l'infection par le VHB. Résultats: L'âge médian de nos 44 sujets était de 43,1 ± 7,49 ans. Le nombre moyen d'enfants par sujet index était de 2,3 ± 1,1. L'âge médian des 92 enfants était de 9,3 ± 4,55 (de 1 à 15 ans) et 43 (44,8%) étaient vaccinés contre le VHB. La fréquence de l'infection par le VHB était de 24%. Les facteurs indépendants associés à l'infection par le VHB chez les enfants étaient l'ADN du VHB pour les sujets index> 2000 UI/ml (OR = 11,5; p = 0,001), l'existence du VHB chez les deux parents (OR = 7,9; p = 0,03) et l'absence de vaccination contre le VHB chez les enfants (OR = 30,9; p = 0,003). Conclusion: La couverture vaccinale des enfants des sujets index était insuffisante. Outre la transmission verticale, le risque de transmission intrafamiliale était élevé en présence d'au moins un des trois facteurs associés

Objectives: To determine the prevalence of hepatitis B virus (HBV) infection in children (contact subjects) of chronic HBsAg (index subjects) and to investigate the factors associated with this infection in these children. Patients and methods: this was a retrospective cross-sectional study of HBsAg positive patients (index subjects), whose families (contact subjects: spouses and children) were routinely screened for HBV infection. Results: The median age of our 44 subjects was 43.1 ± 7.49 years. The average number of children per index subject was 2.3 ± 1.1. The median age of the 92 children was 9.3± 4.55 (1 to 15 years) and 43 (44.8%) were vaccinated against HBV. The prevalence of HBV infection was 24%. The independent factors associated with HBV infection in children were HBV DNA for index subjects> 2000 IU/ml (OR = 11.5; p = 0.001), the existence of HBV in both parents (OR = 7.9; p = 0.03) and no HBV vaccination in children (OR = 30.9; p = 0.003). Conclusion: Immunization coverage of children of index subjects was insufficient. In addition to vertical transmission, the risk of intrafamilial transmission was high in the presence of at least one of the three associated factors.

Implementation and contribution of temperature screening and handwashing practice at points of entry for COVID-19 pandemic response in a humanitarian crisis setting

Introduction: over the last decade, insecurity in the Lake Chad Basin has triggered an unprecedented humanitarian crisis in the Niger´s Diffa Region with a significant population movement. In this humanitarian setting, we reviewed the implementation process and the contribution of temperature screening and handwashing practice at points of entry as part of non-pharmaceutical interventions against COVID-19. Methods: in Diffa, border officers were trained on the fundamentals of infection prevention and control in relation to COVID-19 readiness and response and a 14-day district response team was constituted. To examine the significance of the implementation process of temperature screening and handwashing practices at points of entry, we conducted a secondary analysis of data submitted by the six health districts of the Diffa Region between March and July 2020. Results: travellers screened for fever ranged from 10,499 (in March 2020) to 62,441 (in April 2020) with the health districts of Diffa (mean: standard error of the mean: 25,999: 9,220) and of Bosso (mean: standard error of the mean: 30.4: 19.1) accounting for the most and the least of activities during the entire period, respectively. Overall, 125/169,475 travellers presented fever and were effectively quarantined. Only the Ngourti Health District reported travellers who declined handwashing (54/169,475); this was during the first three months of the first wave of the COVID-19 pandemic. Conclusion: we have documented a successful implementation of measures related to temperature screening with some unsubstantial denial of handwashing. Given the importance of border traffic due to insecurity in the Diffa Region, maintaining temperature screening and handwashing in this humanitarian setting is necessary but requires coordinated actions of all stakeholders involved in the region.

Screening for eye diseases in a University community in Southwest Nigeria

Background ­ University, a subset of the general population, will expectedly have common ocular problems as prevalent in the population. Knowing these problems as done through screening and health education during WSD activities in 2017 thus raise awareness for their prevention. This study was aimed at determining the types of eye defects in a university community. Methodology ­ A descriptive cross-sectional survey utilizing purposive serial selection to examine inhabitants of a university community. Socio-demographic information and detailed ocular examinations were carried out. Data analysis using SPSS Version 20 and cross tabulations with statistical significance derived using paired sample t-test at p values < 0.05 were done. Results ­ With n=140, 79(56.4 %) were males. Mean age was 26.7 + 11.5years. Majority were staffs (77.1%) with 62.1% having tertiary education. Normal vision was reported in (92.9%), while 5.7% had visual impairment with 1.4% uniocular blindness. Common ocular findings were allergic conjunctivitis (12.9%), glaucoma suspects (10.0%), Pterygium (3.6%), glaucoma/corneal opacity (2.1% respectively), and optic atrophy (1.4%). Conclusion ­Disorders seen were mostly avoidable. Incorporating eye health services into University Healthcare will control their occurrence allowing optimal job performance.

Indirect serum biomarkers perform sub optimally in screening for significant liver fibrosis among HIV-infected and uninfected adults in Uganda

ntroduction: Indirect serum biomarkers present an acceptable noninvasive and cheap alternative for screening of significant liver fibrosis (SLF). Evaluation of their use in resource limited settings is important to determine their utility. Methods: We conducted a cross sectional study among 520 HIV infected and HIV uninfected adults attending care clinics in Kampala Uganda. Presence of SLF was determined using Fibroscan® liver stiffness measurement of ≥7.2KPa. The diagnostic value of indirect serum biomarkers for diagnosis of SLF was evaluated using the area under the receiver operating characteristics curve (AUROC) using Fibroscan® as gold standard. Results: Overall AUROC values for Age Platelet Index (API), Aspartate to Alanine Ratio (AAR), AST-to-Platelet Ratio Index (APRI), Fibrosis Index based on 4 Factors (FIB-4) and Gamma glutamyl transferase to Platelet Ratio Index (GPR) were 0.52, 0.49, 0.55, 0.55 and 0.54 respectively. Among HIV-infected participants AUROC values were slightly improved at predicting presence of SLF but still under 70%. Conclusion: Despite APRI and FIB-4 being more likely to identify participants with SLF, the overall diagnostic value of all serum biomarkers was poor with and without stratification by HIV status. We recommend the use of Fibroscan® technology as more accurate non-invasive diagnostic method for screening of SLF

Perception on cervical cancer and enhancing strategies to screening uptake among women in Bamenda, Cameroon: A qualitative method

The treatment of cervical cancer has a good prognosis if diagnosed early. Hence, screening is very vital. The aim of this study was to evaluate the perception of women on cervical cancer and strategies to enhance its screening uptake in the city of Bamenda, Cameroon. Qualitative study was carried out from July, 2019 to August, 2019. Eight focus group discussions were organized in five different quarters in the city of Bamenda. These quarters and participants were purposively selected and each group constituted 6 to 8 Participants. Ethical clearance and administrative authorization for the study were obtained prior to the study. Data was analyzed using thematic analysis with the help of QDA Miner. A total of 53 study participants took part in this study. Their ages ranged between 21 to 45 years. Most participants did not know about cervical cancer. Their perceived barriers to cervical cancer screening included: inadequate sensitization; financial challenges and embarrassing testing strategies; lack of awareness on the availability of screening centers; poor attitude of health personnel. Proposed strategies to enhance cervical cancer screening were: sensitization of the population, recruitment of more competent staff, testing centers should be located closed to the target population, less embarrassing screening methods should be used, health care workers should demonstrate positive attitudes during care, female staff should manage the screening units, screening cost should be subsidized. Due to the Small purposive sample size and qualitative nature of this study, the findings are not generalizable

Prevalence of cervical cancer in Ain Defla region (Algeria)

The high rate of cervical cancer in Algeria and the absence of organized screening programs are well shown in this study, which aims to determine the prevalence of cervical cancer and describe the risk factors associated with this alarming prevalence. This retrospective study is based on data collected from medical records and A questionnaire was developed to assess the risk factors (such as: parity, age at first marriage, smoking, oral contraceptive, and Hormonal status) of cervical cancer among the participants. Face to Face interview were conducted with the participants. The result obtained from this study revealed that cervical cancer occupies the fourth place of cancer in the Wilaya of Ain Defla (4,71 %); the results confirm the effect of several risk factors such as early marriage age (below 20 years: 46.66 %), multiparity (53.33%), menopause (66.66 %); taking contraception (53.33%) and smoking in the development of this pathology. The adoption of an early and annual screening program in our region would be very important to us. In addition, the interest of annual screening is to raise women's awareness of this pathology, particularly in isolated regions. (

Factors influencing cervical cancer screening among pregnant women in Nairobi, Kenya

To characterize cervical cancer screening knowledge, beliefs, behaviors, and sociodemographic factors among women aged 25-45 years who access and utilize prenatal care services in Nairobi, Kenya. A descriptive cross-sectional design using a convenience sample of pregnant women receiving prenatal health services at a public and a private hospital in Nairobi, Kenya. Constructs from the Health Belief Model (HBM) guided the design, interpretation of the results, and recommendations. Data were analyzed using SPSS version 24. Bivariate analyses were conducted to examine associations between variables. There was a significant association (p=0.001) between knowledge and screening behaviors. There was no association (p=0.066) between cervical cancer beliefs (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and self-efficacy) and screening behaviors. Knowledge and beliefs influence cervical cancer screening behavior. Low cervical cancer screening uptake substantiates the need for tailoring culturally specific health behavior change communication to address misconceptions about cervical cancer screening in Kenya.

Profil épidémiologique des patients consultants et des cas positifs Covid-19 de l'unité de triage EHU Oran (mars 2020 - août 2020) / Epidemiological profile of consulting patients and Covid-19 positive cases in the triage unit - EHU Oran (March 2020 - August 2020)

Introduction. En décembre 2019, la population de Wuhan, une grande ville chinoise de 11 millions d'habitants, est atteinte par une pneumonie virale extrêmement contagieuse due au coronavirus SARSCoV-2. En Algérie, le premier cas a été identifié le 25 février 2020, un plan de riposte national élaboré par le ministère de la santé a été mis en place pour affronter l'épidémie. Dès le début de la pandémie, l'établissement hospitalier et universitaire d'Oran (EHUO), centre de soins de première ligne, d'une capacité 780 lits desservant environ 2 millions d'habitants s'est complètement réorganisé, en aménageant principalement des circuits pour le tri des patients « suspects Covid 19 ¼. L'objectif de notre travail consiste à décrire le profil épidémiologique des patients consultants et des cas incidents Covid-19 au niveau de l'unité de triage EHUO depuis le début de l'épidémie au 07 Aout 2020. Méthodes. Les données sont collectées à partir des enquêtes épidémiologiques auprès des patients consultant au niveau de l'unité de triage Covid-19 de l'EHUO. Résultats. À la date du 7 aout 2020, un total de 7110 cas suspects de Covid-19 ont été enregistrés. Du total des cas suspects, 3036 (42,7 %) étaient positifs par RT-PCR. Il s'agissait de 1421 de sexe masculin (46,8 %) et de 1615 de sexe féminin (53,2 %), soit une sex-ratio de 0,88. La répartition globale des cas Covid19 par tranches d'âge était la suivante : 21,9 % des patients avaient un âge entre 30 et 39 ans, 17,3 % entre 40 et 49 ans. Le tableau clinique était dominé par la toux (26,5%), suivi de céphalées (19 %), de fièvre (16,2 %) et d'anosmie (15,9 %). 234 patients (7,7 %) avaient une SpO2 < 95 %. Conclusion. L'épidémiologie de l'infection Covid 19 reste encore peu connue à l'heure actuelle dans notre wilaya. Un dépistage de masse permettrait d'avoir une vision plus claire sur le nombre réel de patients atteints. La Covid 19 est une infection avec un large panel de symptômes autres que respiratoires, souvent non spécifiques, faisant d'elle une pathologie difficile à diagnostiquer cliniquement, d'où la nécessité de la confirmation biologique (PCR).

Cervical cancer screening awareness and uptake among under-screened women in a rural Nigerian community

Background: Cervical cancer is the most frequent female genital tract malignancy in Nigeria, with the majority of patients suffering from advanced stages of the disease. A low level of awareness and knowledge of cervical cancer and screening has been identified as oneof the causes of cervical screening underutilization in Nigeria. This study aims to determine the level of cervical cancer screening awareness and uptake among rural Nigerian women.Method:The study design was cross sectional, carried out among adult women in the Orhuwhorun community in Udu Local Government Area of Delta State. Multi-stage sampling technique was used to recruit 234 women from May to June 2021. Data were collected by semi-structured, interviewer-administered questionnaire. Data analysis was done with SPSS v. 25.0.Result: Two hundred and thirty-fourwomen of mean age 41.08 years (SD ± 8.45) were enrolled. The level of awareness of cervical cancer screening methods was 9.4%while screening uptake was only 4.3% among rural women in Orhuwhorun.Conclusion: The awareness of cervical cancer screening methods and uptake was very low among rural women in Delta State. It is, therefore, imperative that cervical cancer awareness campaigns among this populace are increased and screening services be less expensive and accessible

Zoom sur le cancer du col utérin chez les adolescentes à Kananga au Kasaï-Central, en République Démocratique du Congo / NA

Introduction. Le cancer du col de l'utérus (CCU) demeure un problème majeur de santé publique et il est le quatrième cancer le plus répandu chez les femmes à l'échelle mondiale. L'objectif est de contribuer à l'améliorationde niveau de connaissance des adolescentes sur le cancer du col utérin dans la ville de Kananga.Matériel et méthodes.Il s'agit d'une étude transversaledescriptive sur le cancer du col utérin, réalisée dans la ville de Kananga et dont l'étude était basée sur l'interview de 436 Adolescentes selon un échantillonnage à plusieurs degrés, dans les Aires de Santé de la Zone de Santé Urbaine de Kananga.Résultats. La moyenne d'âge des répondantes était de 17,7 ± 1,2 ans. Le niveau de connaissances sur le cancer du col utérin s'est révélé inadéquat chez presque toutes les participantes (90%). Les signes couramment connus étaient le saignement vaginal (80,3%), dyspareunie (4,8%) et règles prolongés (2,3%). Le sexe était pratiqué dans55,5% des adolescents alors que 70,9% savaient l'existence du lien entre le cancer du col utérin et les infections sexuellement transmissible (IST). Les connaissances sur lesfacteurs de risque de survenu du cancer du col étaient: la consummation de tabacdans 31,9% et le rapport sexuel précoce dans 25,5%; la pratique du dépistage était observée dans 0,2% des cas et 37,2% d'adolescentes connaissaient que toutes les femmes étaient prédisposées de développer la pathologie.Conclusion.Le niveau de connaissances de cancer du col utérin s'est révélé inadéquat chez les adolescents et nécessité des campagnes destinées à sensibiliser d'avantage toutes les femmes en particulier et le public de la ville de Kananga en général au sujet de ce cancer du col utérin

Fibromyalgie associée à la gonarthrose: prévalence, caractéristiques épidémiologiques, et son impact sur le traitement / Fibromyalgia associated with knee osteoarthritis: prevalence, epidemiological characteristics, and impact on its treatment

Contexte et objectifs. Les patients souffrant de syndrome fibromyalgique sont fréquemment rencontrés en pratique clinique et déconcertent bien souvent les médecins. Notre étude a pour but de déterminer la prévalence de la fibromyalgie chez les patients gonarthrosiques, son impact sur la présentation clinique et radiologique ainsi sur le cours évolutif de gonarthrose. Méthodes. Il s'agissait d'une étude transversale analytique portant sur les patients atteints de gonarthrose définie selon les critères ACR, suivis au service de rhumatologie de l'hôpital militaire Moulay Ismail à Meknès ; entre novembre 2018 et avril 2019. La fibromyalgie était retenue chez les patients remplissant les critères ACR 2010. Résultats. Au total 101 patients (âge moyen : 57+11,5 ans, femmes : 65,3 % ; surpoids : 35.6% ; et obésité stade 1 (35,6 %) ont été examinés. La prévalence de la fibromyalgie était de 34,7%. Un tiers des patients fibromyalgiques avaient une réponse partielle au traitement (AINS et paracétamol). L'analyse bivariée a montré une association positive avec le sexe féminin (p =0,006) et l'IMC (p=0,017). Par contre on n'a pas noté de relation entre la fibromyalgie, l'âge, le stade radiologique de la gonarthrose, la présence d'un syndrome métabolique, et l'EVA douleur. Conclusion. La fibromyalgie est relativement fréquence chez les patients gonarthrosiques. Sa reconnaissance permet de mieux prendre en charge les patients gonarthrosiques et d'éviter les abus de traitements symptomatiques notamment les AINS.

Context and objective. Fibromyalgia syndrome cases are frequent in clinical practice and often disconcert physicians. The aim of the present study was to determine the prevalence of fibromyalgia in patients with osteoarthritis, and its impact on the clinical and radiological presentation, as well as its evolutionary course. Methods. This was an analytical cross-sectional study including all patients followed for gonarthrosis in the Department of Rheumatology of the Moulay Ismail Military Hospital between November 2018 and April 2019. Fibromyalgia was retained in patients meeting the ACR 2010 criteria. Results. One hundred one patients (57 + 11.5 years old; Women 65.3%; overweight: 35.6%, obesity grade 1: 35.6 %; were examined. The prevalence of fibromyalgia was 34.7%. One third of fibromyalgia patients had a partial response to treatment. The bivariate analysis showed a positive correlation with the female sex (p = 0.006) and the BMI (p = 0.017). There was no correlation between fibromyalgia, age, the radiological class of gonarhtrosis, the presence of metabolic syndrome, and VAS pain. Conclusion. The fibromyalgia is relatively common in patient with gonarthrosis, especially in obese women. Early diagnostic of fibromyalgia offers the possibility of a better management of gonarthrosis patients and thus avoiding the abusive use of symptomatic treatments, notably NSAIDs

Diabète gestationnel (DG) en consultation prénatale: dépistage systématique dans un centre de sante urbain de Conakry / Gestational Diabetes in Antenatal Consultation: Systematic Screening In an Urban Health Center of Conakry

Contexte. Pathologie obstétricale fréquente en Guinée, souvent de découverte fortuite, car il n'y a pas de dépistage systématique. L'objectif : était de déterminer la prévalence du diabète gestationnel (DG) en consultation prénatale dans un centre de santé urbain de la ville de Conakry. Méthodes. Il s'agissait d'une étude prospective de type descriptif et analytique Elle a été menée au centre de santéde Koulewondy du 1er novembre 2019 au 29février 2020. Le dépistage était proposé à toutes les femmes enceintes entre 24 et 27 SA. Les comparaisons statistiques étaient à l'aide du test Chi2. Les différences étaient considérées signifi catives pour p<0,05. Résultats.Le passage du dépistage ciblé sur les facteurs de risques à un dépistage systématique a permis d'avoir une prévalence du diabète gestationnel en Consultation Prénatale Recentrée (CPNR) de 16,78% dans notre série. Le profi l épidémiologique était celui d'une gestante ménagère sans niveau instruction, mariée et dont l'âge moyen était de : 28,7± 6,5 ans, la parité moyenne était de : 2,11± 1,9 accouchements , l'âge gestationnel moyen était de 27,1± 5,6 SA , la valeur prédictive positive du test de dépistage en fonction des facteurs de risque était de 32,6% et la sensibilité 0,157. Conclusion. Le dépistage demeure le meilleur moyen de prévention.

Young People's Knowledge of Sickle Cell Disease and Willingness for Genotype Screening in Ibadan, Nigeria

Sickle Cell Disease (SCD) is prevalent in Nigeria with 150,000 new cases yearly, owing to poor knowledge, poverty and lack of screening. This study investigated knowledge and willingness to undergo genotype screening among young people who might be contemplating marriage or reproduction during or soon after the National Youth Service Corps (NYSC); the compulsory one-year service for all Nigerian graduates from tertiary institutions. The study was a descriptive cross-sectional design, carried out amongst 355 respondents using a stratified random sampling. Both qualitative and quantitative methods were employed with due ethical considerations and analysis. The age range was between 18 and 30 years, with more female (54.6%) respondents. Almost all (96.3%) of the respondents have heard about SCD. The prevalence of SCD in the families of the respondents was 10.1% and majority (87.0%) have had genotype screening. Many (60.6%) had good knowledge about SCD but less than half (44.5%) could state the difference between genotype and blood group. Statistical associations were recorded between level of knowledge and gender, discipline of study and willingness. Concerted efforts should be geared towards SCD health education and screening using the platform of corps members' during their orientation and weekly community development programmes.

Comparative yield of different active TB case finding interventions in a large urban TB project in central Uganda: a descriptive study

Introduction: Systematic screening for TB among patients presenting to care and among high risk populations is recom- mended to improve TB case finding. We aimed to describe the comparative yield of three TB screening approaches imple- mented by a large urban TB project in central Uganda. Methods: We abstracted data on the screening cascade from 65 health facilities and their surrounding communities (num- bers screened, with presumptive TB, receiving a diagnostic test and diagnosed with TB) from the different clinic and com- munity TB registers. Results: From January 2018 to December 2019, 93,378 (24%) of all patients screened at health facilities had presumptive TB; 77,381 (82.9%) received a diagnostic test and 14,305 (18.5%) were diagnosed with TB. The screening yield (the number of patients diagnosed with TB out of all patients screened) was 0.3% and was three times higher among men than women (0.6% vs 0.2% p<0.01). During targeted community screening interventions, 9874 (21.1%) of all patients screened had presumptive TB; 7034 (71.2%) of these received a diagnostic test and 1699 (24.2%) were diagnosed with TB. The screening yield was higher among men, (3.7% vs 3.3% p<0.01) and highest among children 0-14 (4.8% vs 3.2% p<0.01). Conclusion: Targeted community TB screening interventions improve access to TB diagnosis for men and children 0-14 years

HIV self-testing services for female sex workers, Malawi and Zimbabwe

Objective To present findings from implementation and scale-up of human immunodeficiency virus (HIV) self-testing programmes for female sex workers in Malawi and Zimbabwe, 2013­2018. Methods In Zimbabwe, we carried out formative research to assess the acceptability and accuracy of HIV self-testing. During implementation we evaluated sex workers' preferences for, and feasibility of, distribution of test kits before the programme was scaled-up. In Malawi, we conducted a rapid ethnographic assessment to explore the context and needs of female sex workers and resources available, leading to a workshop to define the distribution approach for test kits. Once distribution was implemented, we conducted a process evaluation and established a system for monitoring social harm. Findings In Zimbabwe, female sex workers were able to accurately self-test. The preference study helped to refine systems for national scale-up through existing services for female sex workers. The qualitative data helped to identify additional distribution strategies and mediate potential social harm to women. In Malawi, peer distribution of test kits was the preferred strategy. We identified some incidents of social harm among peer distributors and female sex workers, as well as supply-side barriers to implementation which hindered uptake of testing. Conclusion Involving female sex workers in planning and ongoing implementation of HIV self-testing is essential, along with strategies to mitigate potential harm. Optimal strategies for distribution and post-test support are context-specific and need to consider existing support for female sex workers and levels of trust and cohesion within their communities

Adult malnutrition: prevalence and use of nutrition-related quality indicators in South African public-sector hospitals

Objectives: The aim of this study was to describe the prevalence of malnutrition among adult hospitalised patients in three South African public hospitals and to determine the availability of nutrition-related quality indicators at ward and institutional level.Method: A descriptive, cross-sectional, multi-centre study was used to determine the prevalence of malnutrition, whilst a descriptive exploratory design was used to determine the use of nutrition-related quality indicators for the identification and treatment of malnutrition. A total of 141 adult hospitalised patients in three public hospitals in an urban setting participated.Mid-upper arm circumference (MUAC), body mass index (BMI), and malnutrition universal screening tool (MUST) were used to determine the prevalence of malnutrition or malnutrition risk. A Hospital Nutrition Review Tool (HNRT) determined the use of nutrition-related quality indicators.Results: The overall malnutrition risk according to MUST was 72.3% (48.2% high risk and 24.1% medium risk), whilst 45.4% were malnourished based on MUAC. No routine nutritional screening was conducted in any of the wards to identify patients at nutritional risk. The majority of nurses reported inadequate training or knowledge to calculate patients' BMI or percentage weight loss, or to perform nutritional screening.Conclusion: Both malnutrition prevalence and malnutrition risk among adult hospitalised patients are high in the public sector.Inadequate resources may lead to delays in malnutrition identification and appropriate nutritional intervention, which may adversely affect both the patient and the institution. This study contributes to baseline data on adult malnutrition in the South African public hospital setting

Role of family history and clinical screening in the identification of families with idiopathic dilated cardiomyopathy in Johannesburg, South Africa

Background. Familial disease is implicated in 20 - 50% of cases of idiopathic dilated cardiomyopathy (IDCM) worldwide. The contribution of familial factors to IDCM in the Johannesburg area, South Africa, is unknown.Objectives. To describe the demographic details of patients with IDCM who presented at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), and to determine if there is evidence of familial disease through family history assessment and clinical screening of relatives.Methods. This was a single-centre, cohort study performed at a quaternary care centre at CMJAH. Fifty unrelated probands diagnosed with IDCM and available first- and second-degree relatives were included in the study. A three-generation family pedigree was drawn up for all 50 probands. The pedigrees were analysed to identify the presence or absence of familial disease and categorised as positive, intermediate, negative or unreliable according to the family history obtained. From the 50 proband cases, there were 21 family members available for screening for features of IDCM. Eighty-two family members (55 first-degree and 27 second-degree relatives) were screened clinically. Screening included a personal history, full physical examination, electrocardiogram (ECG) and echocardiogram.Results. The mean age at diagnosis of IDCM in the probands was 41.7 (standard deviation (SD) 12.4) years. The majority of probands were males (n=38; 76%). Of 50 pedigrees analysed, 14 (28%) were positive and likely to be indicative of familial dilated cardiomyopathy (DCM), and 9 (18%) patients were at intermediate risk of familial disease. Eighty-two asymptomatic family members were screened, with a median age of 33 (range 11 - 76) years. No asymptomatic family members were identified with features of DCM or presymptomatic DCM. Eleven of the 21 families screened had relatives with possible presymptomatic DCM identified by abnormalities on the echocardiogram in 3 families (14.3%) (4 individuals; all first-degree relatives of the index case) or identified on the basis of a conduction defect (an arrhythmia or first-/ second-/third-degree heart block) in 8 families (72.7%) (11 individuals; 9 first-degree and 2 second-degree relatives).Conclusions. Screening for IDCM should include a three-generation family history and clinical screening of all first-degree family members. As IDCM has an age-related penetrance, at-risk family members should receive follow-up for screening to assess symptoms and signs of IDCM. Genetic testing would potentially identify family members at high risk, who would benefit from screening; this might be a less expensive option