Epidemiological pattern and outcome of head injuries during festive and non-festive periods in a tertiary hospital, Nnewi, Nigeria.

Background: Head injury is trauma to the brain and/or its coverings as a result of an externally applied mechanical force. Study of epidemiological pattern of head injuries is essential in developing necessary preventive strategies and control. To compare the prevalence and pattern of head injuries during the non-festive (February – September) and the festive (October – January) periods in our environment. Methods: Patients’ case files at the Accidents and Emergency unit of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, were reviewed. Results: Two hundred and sixty-six out of 4,846 met the inclusion criteria for traumatic head injury and were recruited for the study, giving a prevalence of 5.5%. About 77.4% of these presentations were males while 22.6% were females. Both males and females were affected more in the festive period (52.4% and 48.3%) than in the non-festive period (51.7% and 47.6%). The >20 – 30 year group recorded the highest presentation at 30.5%. Traders and Commercial Motorcyclists were the most affected occupations with 25.9% and 24.1% respectively, with the most common causes of head injury during both the festive and non – periods being motorcycle and motor vehicle accidents (68% and 18% respectively). About 63% presented with mild head injury, 14% with moderate and 23% with severe head injuries. About 11.4% were discharged, 83.9% were transferred to the ward for further evaluation and monitoring while 4.7% died at the Accident and Emergency department. Conclusions: Traumatic head injury is one of the major causes of mortality and morbidity in our environment especially in the festive periods. Aggressive and sustained traffic safety education is recommended for all stakeholders in the broad field of accidentology.

Nigerian HIV Positive Mother Tested Negative after Fifty-Four Months on HAART.

Background: There is currently no cure for HIV/AIDS infection. Antiretroviral treatment can suppress and delay AIDS-related illness for many years but cannot clear the virus completely. This case review includes an attempt to find explanation for the conversion of an HIV positive grandmultiparous woman to a negative status. Findings: The source of data was the patient’s case file and review of relevant literature. A 38 year old HIV positive grand-multiparous female trader was diagnosed on 12/08/2010. She was placed on HAART for four years but was found to have tested HIV negative when the routine retroviral test was performed on 08/04/2014. Her last delivery was on 12/04/12 and she was placed on PMTCT regimen for that pregnancy. The baby’s status was not documented. From 16/08/2010 to 06/03/2014, the patient’s weight ranged between 52kg to 66kg. She was not screened for tuberculosis and viral load was not done. Initial CD4 count on 30/08/2014 was 357 cells / microliter while the value was 887 cells / micro-liter on the 24/02/2014. Other test results were essentially normal. Conclusions: Though a functional cure is a possibility here yet in resource limited settings, the lack of routine confirmatory testing, compounded by incorrect interpretation of weak positive test lines and use of tie breaker algorithms can leave a false-positive result undetected for a long time. Beyond HIV screening, mandatory confirmatory tests are imperative before reporting HIV positive results. Weak positive results should not be recognized as valid except in the screening of blood donors.

Comparative Analysis of the Nutritional Status of Under-five Children and their Mothers in Rural and Urban Areas of Anambra State, Nigeria.

Aim: Malnutrition in the form of under-nutrition is still a major public health problem in developing countries of sub-Saharan Africa including Nigeria. This study compares the nutritional status of under-five children and their mothers in rural and urban areas of Anambra State Nigeria. Methodology: This was a comparative cross-sectional study carried out in one urban and two rural local government areas of Anambra State, Nigeria namely Awka South, Dunukofia and Anaocha respectively. A total of 657 mother-child pairs were selected from eligible households using the multistage sampling technique. Data on household food security was obtained from the mothers using semi-structured, interviewer-administered questionnaires while anthropometric measurements were carried out on the children and their mothers using weighing scales and height boards. Results: The overall prevalence of stunting, wasting and underweight among the under-five children in this study were 15.1%, 18.1% and 10.4% respectively, and the proportions were higher in the rural area than in the urban. The prevalence of stunting (height < 152 cm) in the mothers was 7.9% in the rural area compared to 9.1% in the urban area. Majority of the women were overweight (BMI ≥ 25.0), more in the urban (69.3%) than in the rural (59.2%). Conclusion: This study confirmed that under-five under-nutrition remains a serious public health problem in Anambra State, Nigeria. In order to reduce child morbidity and mortality to which malnutrition contributes significantly, concerted effort must be made by the government to improve child and maternal nutritional status by directing attention to improving household food security through developing and implementing policies that improve the livelihoods of the population.

Awareness and Knowledge of Disease Surveillance and Notification by Health-Care Workers and Availability of Facility Records in Anambra State; Nigeria

Background: Disease surveillance and notification (DSN) is part of the Health Management Information System (HMIS) which comprises databases; personnel; and materials that are organized to collect data which are utilized for informed decision making. The knowledge about DSN is very important for the reporting of notifiable diseases. Objective: The aim of this study is to examine the awareness and knowledge of health-care workers about DSN; and availability of facility records in Anambra State; Nigeria. Materials and Methods: The study was a descriptive cross-sectional one in which relevant data were collected from health-care workers selected by a multistage sampling technique. Qualitative information was also elicited by key informant interviews; whereas an observational checklist; preceded by a desk review was used to examine the availability of facility records. Results: Although 89.8 of the health-care workers were aware of the DSN system; only 33.3; 31.1; and 33.7 of them knew the specific uses of forms IDSR 001; IDSR 002; and IDSR 003 (IDSR: Integrated Diseases Surveillance and Response); respectively. Knowledge of use of the various forms at the facility and local government area (LGA) levels were generally low; although the observational checklist revealed that IDSR 001 and IDSR 002 forms were predominantly found in primary health-care facilities. HMIS forms were less likely to be available in secondary health-care facilities (?[2]=7.67; P=0.005). Conclusions: Regular training and retraining of concerned health-care workers on DSN at the LGA level is recommended. This should run concurrently with adequate and regular provision of IDSR forms; copies of the standard case definitions; and other necessary logistics to the health-care facilities by the local and state governments