The effects of COVID-19 on food insecurity, financial vulnerability and housing insecurity among women and girls living with or at risk of HIV in Nigeria

Aim: Women and girls living with or at high risk of acquiring HIV (WGL&RHIV) in Africa are economically vulnerable. This study aims to advance understanding of the economic impact of COVID-19 on WGL&RHIV and to identify the factors associated with this insecurity.Methods: Data were collected from a cross-sectional survey conducted among a convenience sample of WGL&RHIV in Nigeria between May and September 2021. Logistic regressions enabled the study of the role of HIV status, mental health and macrosocial characteristics (people with disability, transgender women, sex workers, persons engaged in transactional sex, substance users, and people on the move) on economic vulnerability, measured by food, financial and housing insecurity, since the COVID-19 pandemic began. The model accounted for the possible interactions between the macrosocial characteristics and controlled for confounders.Results: There were 3 313 (76.1%) of 4 355 respondents facing food insecurity, 3 664 (83.6%) of 4 385 with financial vulnerability and 1 282 (36.2%) of 3 544 with housing insecurity. Being a member of the key and vulnerable groups was strongly associated with food insecurity, financial vulnerability and housing insecurity, regardless of HIV serostatus. For example, WGL&RHIV engaging in transactional sex were more than four times more likely (aOR 4.42; 95% CI 2.57­7.59) to face housing insecurity and more than twice more likely to face food insecurity (aOR 2.47, 95% CI 1.35­4.52) and financial vulnerability (aOR 2.87, 95% CI 1.39­5.93). This economic vulnerability may reduce their negotiating power for safer sex or the use of HIV prevention methods, exposing them to increased risks of HIV infection. Poor mental health was also associated with the three forms of economic vulnerability.Conclusions: As the long-term impact of the COVID-19 crisis on African economies unfolds, HIV programmes at the country level must include economic vulnerability and mental unwellness mitigation activities for WGL&RHIV

Factors associated with poor access to HIV and sexual and reproductive health services in Nigeria for women and girls living with HIV during the COVID-19 pandemic

Aim: To determine the proportion of women and girls living with HIV (WGLHIV) who had poor access to HIV, tuberculosis and sexual and reproductive health (SRH) services in Nigeria during the COVID-19 pandemic and associated factors.Methods: This was a cross-sectional study that recruited WGLHIV with six categories of vulnerability (sex work, transactional sex, injecting or using illegal drugs, people on the move, transgender women and people with a disability) through an online survey conducted in ten Nigerian states between June and October 2021. The associations between the limited access to HIV, tuberculosis and SRH services due to COVID-19, the categories of vulnerability and the financial and non-financial barriers to these services were determined using multivariable logistics regression analysis. Results: Over 6 in 10, almost 2 in 10, and almost 4 in 10 WGLHIV had limited access to HIV, tuberculosis and SRH services respectively during the COVID-19 pandemic. Transgender women had 3.59 (95% CI 2.19­5.91) higher odds, women who engaged in sex work had 4.51 (95% CI 2.28­8.42) higher odds, and women who inject or use illegal drugs had 2.39 (95% CI 1.47­32.90) higher odds of facing limited access to sexual and reproductive health services when it was needed. In addition, the direct consequences of the COVID-19 crisis, such as the closure of HIV services and SRH service points, exacerbated pre-existing barriers significantly. Having no money, having to pay additional unofficial fees and the lack of security on the road to the health facility were the barriers with the greatest impact on access to health services. Conclusions: The COVID-19 pandemic had a negative impact on the access of WGLHIV to essential health services. This impact was disproportionately higher for marginalised groups. WGLHIV need non-discriminatory and affordable access to essential health services during the pandemic.

Detection of Treponema pallidum (Syphilis) Antibodies among HIV-Infected Individuals and Sexually-active Attendees of Two Health Facilities in Port Harcourt, Nigeria

Aim: This study reports on the detection of Treponema pallidum(syphilis) antibodies in HIV infected patients in Port Harcourt, Nigeria. Screening for syphilis was carried out to determine the prevalence levels of these infections, as biological markers of risk, modes, and time functions of their transmission.Study Design:Cross-sectional study.Place and Duration of Study:University of Port Harcourt Teaching Hospital (UPTH) and O.B. Lulu Briggs Medical Centre, University of Port Harcourt, both in Port Harcourt, Nigeria, between August 2012 and July 2015. Methods:Atotal of 100 HIV-infected individuals and 100 sexually-active attendees were recruited for this study. Samples of blood were collected and re-screened for the presence of HIV antibodies using the Determine HIV-1/2 (Alere), HIV ½ Stat-Pak (Chembio), and HIV-1/2/P24/O ELISA kit (Dia.Pro). The same set of samples were screened for Treponema pallidumspecific antibodies using the syphilis Ultra Rapid Test Strip (ACON(R), USA) and syphilis rapid strips (Global, USA) following the respective manufacturer's instructions. Results: Among the 200 samples, serological reactivity was detected for syphilis in 3(1.5%). The incidence of syphilis was higher in males (2.0%) than in females (1.0%). Age, sex, and locality did not significantly (P>0.05) influence the rate of syphilis.Conclusion: This study further confirms the presence of syphilis among the population studied. Routine screening of Syphilis among patients is therefore advocated

Hematological Changes and Antidiabetic Activities of Colocasia esculenta (L.) Schatt Stem Tuber Aqueous Extract in Alloxan Induced Diabetic Rats

Managementofbloodglucoselevelisthehallmarkinthetreatmentofdiabetes.MuchworkhasnotbeendoneonthemanagementofdiabetesusingthestemtuberextractofColocasiaesculenta.TheobjectiveofthisstudywastoevaluatetheantihyperglycemicandhematologicalparameteronColocasiaesculentaaqueousstemextractinalloxaninduceddiabeticrats.Sixty(60)maleratswereusedinthestudy.Sevendaysofacclimatization,theratsweredividedrandomlyintosixgroupsoffiveineachgroup.Group1:Servedasnormalcontrol,Group2:Diabeticcontrolgroup(negativecontrol),Group3:Diabeticgroupand“Glucinorm-M80”(positivecontrol),Group4:Diabeticgroupandextractat200mg/kgbodyweight,Group5:Diabeticgroupandextractat400mg/kg,Group6:Diabeticgroupandextractat600mg/kg.Diabeteswasinducedinalbinoratsby intraperitonealinjectionofalloxanatasingledoseof120mg/kgbodyweightingroups2to6afterstarvingthemfor24hrs.Theanimalsweregivenfeedandwateradlibitum.ThealbinoratswereadministeredfortwentyeightdayswiththeaqueousColocasiaesculentastemtuber,afterwhichtheywerefastedovernight,anaesthetizedwithchloroformandsacrificed.Theresultshowedthattherewasasignificantincrease(p<0.05)inmeanbodyweightofthepositivecontrolandthetreatmentgroups(200mg/kgto600mg/kg)whencomparedwiththenegativecontrolwhichhasasignificantdecrease(p<0.05)inmeanbodyweight.Theresultalsoshowedasignificantincrease(P<0.05)intheconcentrationsofRBC,PCV,HB,whilePLTandMCHshowedsignificantdecrease(P<0.05)inthetreatmentgroupsandnegativecontrolgroupwhencomparedwiththenormalcontrolgroup.Alsotherewasanosignificant(P<0.05)differenceinMCHCofthetreatmentgroupswhencomparedwiththecontrolgroupandnegativecontrolgroup.Alsotherewasasignificantdifferenceinglycosylatehemoglobinofthetreatmentgroupswhencomparedwiththecontrolgroupandnegativegroup.ThisstudyhasdemonstratedthataqueousstemtuberextractofColocasiaesculentahasasignificantincreaseonbodyweightwhichmayhavearoleofimprovingthestatesofpossibleweightlossfollowingcomplicateddiabetes.Also,aqueousstemtuberextractofColocasiaesculentahasanameliorativeeffectonsugarlevelandsomehematologicalparametersofalloxaninduceddiabeticratsshowingeffectivediabeticcontrolandmanagementofdiabetes

COVID-19 infection: Knowledge, attitude, practices, and impact among healthcare workers in a South-Eastern Nigerian state

Introduction: The coronavirus disease (COVID-19) infection rate and mortality among Nigerian health care workers appear to be on the increase. This study determined the level of knowledge, attitude, practices, and impact of COVID-19 infection on healthcare workers (HCWs) working in a South-Eastern Nigerian state.Methodology: This was a web-based, cross-sectional study conducted among healthcare workers in South-eastern, Nigeria during the lockdown period. Socio-demographic profile, knowledge of COVID-19, fears and impact concerning COVID-19, attitude of health workers to work, preventive practices during this pandemic period were obtained. Data were analysed using STATA 16.0. Chi-square and Fisher's exact tests of association were used to determine the association between variables, with the significance level set at p < 0.05. Results: A total of 403 health care workers participated in the study. Majority of participants (n = 357, 88.59%) had good knowledge and good preventive practices (n = 328, 81.39%) of COVID-19. A significant proportion of respondents had a poor attitude to work (n = 101, 25.06%) and an attitude of indifference (n = 233, 57.82%). Almost half (48.64%) of participants had been negatively affected by COVID-19. Knowledge significantly influenced practice (p = 0.029). Lack of Personal protective equipment, fear of dying and going to common places, had a significant impact on the attitude of workers. Conclusion: Good knowledge which influenced practice, high use of preventive practices, with associated poor and indifferent attitude was noted among healthcare workers. Fear of death and lack of personal protective equipment had a strong impact on attitude. Female HCWs had poorer attitude to work than males

Characterization of the intensive care unit (ICU) admissions in the Benue State University Teaching Hospital

Today, intensive care units (ICUs) of most hospitals in developed countries have become sepa-rate departments staffed by career intensive care physicians or intensivists from various fields of medicine. In Nigeria, however, ICUs are still part of the anaesthesia department and critical care constitutes a significant part of the workload and responsibilities of anesthetists. This study was carried out to ascertain the types of disease conditions that were brought into the ICU for management at the Benue State University Teaching Hospital (BSUTH), interventions undertaken as well as the outcome of such admissions. A total of 125 patients were evaluated. The age bracket between 21 and 30 years recorded the highest figure of 28 accounting for 22.4% of the study population. This was followed by the age bracket between 31 and 40 years with 24 representing 19.2%. The study population was made up of 81 males and 44 females making up 64.8% and 35.2%, respectively. The most frequent conditions occasioning ICU admissions are post laparotomy (24.8%), head injury (18.4%), and burns (11.2%). A total of 289 inter-ventions in various combinations were carried out on these patients. Of these, monitoring of the patients was undertaken 106 times, representing 36.7%. Oxygen therapy followed closely with 102 (35.3%). The lowest number of days spent by patients in the ICU in this study, was 1, while the longest was 35 with a mean of 5.97 days ± 7.76 days. Majority of the patients, 68, were discharged from the ICU to the wards making up 54.4% of the study population. This was closely followed by those that died, 50, accounting for 40.0% of the study population. This study has established that in our ICU, the most common indications for admission were post-laparotomy, head injury and burns. Also, it has been observed that most of the patients underwent haemod-ynamic monitoring and oxygen therapy. Finally, while most patients admitted were discharged to the wards, a good number also died in the ICU.

Nurse-midwives knowledge and utilization of partograph in monitoring of labour in tertiary hospitals in Enugu, South-Nigeria

It is not clear whether knowledge of partograph has influence the management of women in labour by nurse-midwives working in tertiary hospitals, Enugu, Nigeria. Many women in labour do not benefit from the use of partograph in monitoring of normal proceedings of labour despite its importance in reducing maternal and infant mortality. This study examined nurse-midwife's knowledge and utilization of partograph in monitoring of labour in tertiary hospitals in Enugu, Nigeria. A cross sectional descriptive study with a sample of 96 nurse-midwives working in the reproductive health units of two tertiary hospitals in Enugu metropolis were used for the study. Data were collected using semi-structured questionnaire. Descriptive statistics was used for data analysis. All analyses were performed using IBM SPSS version 20.0 at a 5% level of significance. Result showed that all the respondents at tertiary hospitals had heard about partograph. Few 40(80%) of the nurse-midwives in UNTH and 32(69.6%) in ESUTH utilized partograph during labour management. Factors that hindered use of partograph were lack of intermittent training of nurse-midwives and non-availability of partograph charts with mean score of 1.19 respectively. The association between the years of working experience and the use of partograph failed to be statistically significant (P = 0.90). There is need for improvement in knowledge and use of partograph during labour management through continuing education for nurse-midwives, periodic workshops and mandatory hospital policy on use of partograph during management of labour

Challenges Faced in Accessing Diabetes Drugs in Low and Middle Income Settings in Aba North, Southeast Nigeria.

Diabetes is a costly disease, placing a high financial burden on the patient and the healthcare system in every nation. If poorly managed, it can cause a lot of damage to body parts such as blindness, loss of kidney function. The aim of this study is to determine the challenges faced in accessing drugs for diabetes mellitus management in south-eastern Nigeria. The study was conducted between January and December, 2014 in Aba North which is one of the Local Government Areas in Abia State. The study design was a descriptive cross-sectional survey involving face-to-face interview with patients based on a structured questionnaire format. Stratified random sampling technique was used to obtain the required sample size of 200 from the sampling frame on only those who met the inclusion criteria. The instrument used for data collection was questionnaire. The generated data were presented into table/charts, and also analyzed using descriptive statistics and chi-square statistics. The level of association was accepted at 0.05 significant differences. The results of this study showed that age of the respondents, from 51 years and above were highest 71(35%) compared with other age ranges. The educational level of the respondents was majorly on secondary level of education (46.5%). Access to diabetes drugs, 136(68%) of the respondents said they have access to diabetes drugs. Socioeconomic status influences the access of diabetes drugs (55%) and availability of diabetes drugs (80%).Also cost of diabetes drugs have high influence of (82.5%) on accessing diabetes drugs. Based on the findings of this study, it was concluded that majority of the patients with diabetes have access and knowledge of diabetes drugs but still some are yet to meet up with it due to some factors. Therefore, there is need to strengthen diabetes care centres with special focus on improving drugs availability and integration of health services for diabetes at the community level.

Adverse Drug Reaction Reporting by Different Categories of Healthcare Workers in Nnewi, Nigeria: Awareness, Knowledge and Attitudes.

Aim: To determine the level of awareness, knowledge and attitudes among health workers in different settings of health care in Nnewi, Nigeria towards the reporting of adverse drug reactions (ADRs). Methods: A descriptive cross-sectional study of 372 health workers in different health facilities in Nnewi North LGA of Anambra state, Nigeria was done. The participants were doctors, pharmacists and nurses, selected using multistage sampling technique. Data collection employed pretested, self-administered structured questionnaires. Data was analysed using statistical package for social sciences version 17. Chi-square test for proportions was used to document statistical significance among variables. A p value of < 0.05 was considered significant. Results: Two hundred and fifty five (68.5%) were females and 117 (31.5%) were males. This comprises 241 (64.8%) nurses/related cadres, 109 (29.3%) doctors and 22 (5.9%) pharmacists. Majority of them, 221 (59.4%) were not aware of the existence of the national ADR reporting scheme/guideline. The Pharmacists were more aware compared to other health professionals (P=.000). Respondents from tertiary health facility showed greatest awareness (43.2%). A total of 131 (35.2%) respondents have knowledge of the criteria for reporting ADR though it does not have a relationship with profession (P=.71) and does not depend on the level of the health facility where one worked (P=.30). Conclusion: This study showed poor awareness, knowledge gaps and poor attitude to ADR reporting across the professional groups. There is need for regular sensitization, training and retraining as well as attitudinal changes of health care providers to ADR reporting.

In vitro Starch Digestibility and Nutritional Composition of Improved Rice Varieties from Cameroun.

Aims: Resistant starch (RS), kinetics of starch digestion, predicted glycemic index (pGI) and nutritional composition were determined in two improved rice varieties from Cameroun. Place and Duration of Study: Department of Bioresource Engineering, McGill University, Canada between December 2012 and March 2013. Methodology: Non-parboiled and parboiled samples of TOX 3145 and NERICA-3 varieties were involved in this study. An in vitro enzymatic starch digestion method was applied to measure starch digestibility parameters. Standardized methods were adopted for proximate and mineral contents evaluation. Results: The parboiled samples had significantly higher (P<0.05) resistant starch (8.35 - 11.07%) than the non-parboiled samples (3.81 - 4.84%). The values for pGI among samples ranged from 57.57 to 67.78%. Significantly higher values for protein, phosphorus and potassium were found among the parboiled samples (P<0.05). Nutritional composition was positively related to RS while pGI had inverse relationship with protein, ash, fat, phosphorus, potassium and RS. Conclusion: Starch digestibility of these rice varieties was associated to their nutritional composition.

Barriers to Postnatal Care and Exclusive Breastfeeding among Urban Women in Southeastern Nigeria

Available evidence shows that only a small proportion of Nigerian women access postnatal care and practice exclusive breastfeeding. Given that both interventions are critical to the survival of both the mother and the new born; it is important to identify factors that militate against an effective postnatal care and exclusive breastfeeding in the country; in order to scale up services. The aim was to determine the major barriers to postnatal care and exclusive breastfeeding among urban women in southeastern Nigeria. Materials and Methods: A cross-sectional survey of 400 urban market women using semistructured questionnaires and focus group discussions. Results: Out of 400 women interviewed; 365 (91.7) attended postnatal clinic. Lack of knowledge about postnatal care services (42.2; n = 14); distant location of the hospitals (36.4; n = 12) and feeling that postnatal visits was not necessary (21.1; n = 7) were the main reasons for non-attendance to postnatal clinic. With respect to exclusive breastfeeding; 143 (35.9) of the women practiced EBF. The main reasons for nonpractice of EBF were that EBF was very stressful (26.2; n = 67); mother's refusal (23.5; n = 60); and the feeling that EBF was not necessary (18.1; n = 46). Thirty five (13.7) of the women were constrained by time while the husband's refusal accounted for 1.5 (n = 3) of the reasons for nonpractice of exclusive breastfeeding. Conclusion: Poor knowledge and inaccessibility to health facilities were the main obstacles to postnatal care while the practice of exclusive breastfeeding was limited by the stress and mothers refusal

Antinociceptive and anti-inflammatory activities of crude extracts of Ipomoea involucrata leaves in mice and rats

OBJECTIVE@#To investigate antinociceptive and anti-inflammatory activities of crude extract from Ipomoea involucrata leaves (Convolvulaceae) in mice and rats.@*METHODS@#The antinociceptive activity was tested using acetic acid-induced abdominal writhing test in mice. The anti-inflammatory activity was evaluated using egg albumin induced oedema of rat paw.@*RESULTS@#Phytochemical screening showed the presence of alkaloids, flavonoids, saponins, terpenoids and tannin. At the doses of 25-100 mg/kg, Ipomoea involucrata exhibited dose-dependent and significant increase in pain threshold in acetic acid -induced writhing test of mice (P<0.05, student t-test) The administration of Ipomoea involucrata leaf extract (25-100 mg/kg) showed dose-dependent decreases in paw volume of egg albumin induced oedema in rats and a significant higher anti-inflammatory activity compared to the standard control (Aspirin).@*CONCLUSIONS@#These results support the claims on the traditional use of the of Ipomoea involucrata leaves in the treatment of toothache, rheumatic pains and other inflammatory conditions. Studies on the isolation and structural elucidation of the active principle are still needed being carried out.

Validation of patient symptom diary in acute posterior vitreous detachment

The purpose of the study is to determine the validity of an original patient symptom diary in recording symptoms of posterior vitreous detachment [PVD]. In this prospective cohort study, all patients presenting to the Hotel Dieu hospital emergency eye clinic between September 2008 and July 2009 diagnosed with acute PVD were offered enrollment in the study. Patients were given the Queen's University posterior vitreous detachment patient diary at the initial visit after detailed eye examination, assessment of risk factors for retinal tears and detachments and a thorough explanation of their presenting complaints to record their symptoms related to PVD. At a random point during their six-week follow up, the patients were verbally asked the same questions being recorded in the diary over the phone. At the six-week follow up visit, the diaries were collected and the verbal results were compared with the written results. There was substantial to near perfect agreement between the verbal questions and written answers. Cohen's kappa scores for flash frequency, flash intensity, floater frequency, and floater type were 0.6229, 0.6389, 0.6495, and 0.8603, respectively. The Queen's University posterior vitreous detachment patient diary is a useful tool for investigating the quantity, quality and change in symptoms of patients presenting with PVD in the first 6 weeks of initial presentation