Information transmission process for disease notification and feedback in the community-based disease surveillance system in Anambra State, Nigeria

Disease surveillance and notification (DSN) system has been shown to be weak in Nigeria and still needs to be built up for effective detection and response to some communities. The aim of this paper is to assess the reporting and feedback mechanisms in the Community-based surveillance System (CBSS) in Anambra State, Nigeria. This was a cross-sectional descriptive study of 360 community-based focal points in Anambra State selected by multistage sampling technique. Data collection was by interview using a pre-tested, semi-structured questionnaire. Data were analysed using SPSS version 20, associations between variables were tested using Chi square, Fisher's exact and t tests as appropriate (p<0.05). Forty-one (13.1%) focal points sent in reports for at least four times, (72.2%) received feedback within the last one year and (44.6%) was via the phone. However, 229 (63.6%) of the respondents gave the feedback to the community mainly via the village health committees (44.1%). Respondents' occupation, ever detected notifiable disease; source of information; person the detected disease was reported to; records of notified disease kept by focal points; number of times reports were sent in the last one year, received feedback given to community members, availability of supervisors for focal points and volunteer benefit from being focal points were found to have associations with receipt of feedback on disease case notification (p<0.05). This study found poor reporting but good feedback mechanisms. However, there is need to reform the State CBSS in line with the above findings in order to make it more functional.

Analgesic and antioxidant activities of the methanolic extract of Operculina turpethum leaves in mice.

Background: Operculina turpethum Linn. (Convolvulaceae) is commonly called “Trivrit” or “India jalap” in English. It is a perennial herbaceous plant with purplish stem and milky-white exudates. This study was aimed at evaluation of the analgesic and antioxidant effects of the methanolic extract of O. turpethum leaves in mice. Methods: The acute oral toxicity of the extract was evaluated using up and down method. The analgesic effects were assessed using acetic acid-induced abdominal writhing reflex and tail flick methods, while the antioxidant activity (AA) was assayed using photometric 2, 2-diphenyl-1-picrylhydrazyl free radical scavenging assay method. Results: The extract produced a concentration-dependent increase in the AA with inhibitory concentration 50% >400 μg/ml. The extract (100, 200 and 400 mg/kg) and aspirin (100 mg/kg) produced a significant (p<0.05) dose-dependent reduction in the number of abdominal constriction induced by intraperitoneal injection of acetic acid in treated mice when compared to the distilled water treated mice. The extract (100, 200, and 400 mg/kg) and pentazocine (3 mg/kg) caused a significant (p<0.05) dose-dependent increase in the pain reaction time in the treated mice groups, when compared to the distilled water treated groups. Conclusion: The study showed that O. turpethum possesses analgesic and antioxidant properties and confirmed the folkloric use of O. turpethum leaves in the traditional pain management.

Prevalence of Obesity, Diabetes Type 2 and Hypertension among a Sampled Population from Sokoto Metropolis-Nigeria.

Aims: To determine the prevalence of obesity and its relationship with hypertension and diabetes among dwellers of Sokoto metropolis. Study Design: A descriptive cross sectional study. Place and Duration of Study: We conducted the study in March 2012, within Sokoto metropolis to mark the world kidney day. Methodology: We enrolled 300 participants using a convenience sampling technique. An interviewer administered questionnaire was used to obtain the biodata and past medical history. Blood pressure and anthropometric parameters were measured while blood and urine samples were taken for RBS estimation and urine analysis respectively. We analyzed the data obtained using the Statistical Package for Social Sciences (SPSS) version 17. Results: Out of the 300 participants that came for screening, two opted out, thus leaving 298 participants. There were 50.3% males and 49.7% females. Their mean age was 42±31 years. The BMI ranged between 14-48 kg/m2 with mean of 24.24 kg/2 ±5. Mean SBP and RBS were 130mmhg (±25) and 7.34±4 mmol-1 respectively. About 13.9% of the participants were found to be obese. Obesity was significantly associated with SBP (p<0.001) and RBS level (p=0.002). Conclusion: Obesity is quite common in our environment and it contributes to the occurrence of hypertension and elevated blood sugar. Screening for obesity markers should be encouraged at every contact with healthcare provider. Physical activity for at least 30 minutes/day should be encouraged in order to reduce the risk of obesity, hypertension and diabetes mellitus.

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.

Factors Influencing Attitude Towards Kidney Donation for Transplantation in Ilorin

Background: Chronic renal failure (CRF) is a major cause of premature death and morbidity in Nigeria. Majority of patients with end stage renal disease (ESRD) are in the productive age bracket. Haemodialysis is the most commonly available mode of renal replacement therapy. The quality of life of the few that can afford the cost of haemodialysis is poor when compared to the transplanted patients. A survey is carried out to assess factors affecting attitudes towards kidney donation in Ilorin; Nigeria. Methods: A total of 600 self administered; semi-structured questionnaires were distributed amongst asymptomatic adults (aged 17years) with a response rate of 88. Data analysis was done using statistical package for social studies (SPSS) version 14. Results: There were 282 males (53.4) and 246 females (46.6) with age range of 17-65years and a mean of 34.76+14.9. Two hundred and ninety two (55) were willing to donate a kidney (165 males; 127 females). Majority of the willing donors (86) were between 30 and 50 years of age. Though educational level positively influenced the knowledge about the kidney failure; it did not influence willingness to donation of a kidney. There was religion related gender disparity in the willingness to donate a kidney as more male Christians and Muslims were willing to donation than their females. Conclusions: The main constraints to kidney donation were fear of surgical pains; belief in life after death and uncertainty of donor outcome. This calls for awareness programmes on the safety of kidney donation for transplantation

The Role of Echocardiography in the Management of Stroke

BACKGROUND: Echocardiography is increasingly being used as a screening test to identify sources of cardiogenic embolism in patients with ischemic stroke or transient ischaemic attack (TIA). However; no consensus exists presently on the utilization of this imaging facility in individuals with stroke. OBJECTIVE: To evaluate the yield of transthoracic echocardiography in patients with ischaemic stroke with a view to providing guidance in its use in clinical management of stroke. METHODS: One hundred and twenty-six consecutive stroke patients with 90 controls were recruited prospectively. Patients were examined echocardiographically for evidence of intramural thrombus; congenital defects; valvular heart disease; wall motion abnormalities and intra-cardiac masses using twodimensional; m-Mode and Doppler facilities. RESULTS: Potential cardiac source of emboli (CSE) was identified in 23.0of the stroke patients. Those who had CSE identified aged 53.0(20.8) years were younger (p=0.0001) than those who did not have CSE; 57.2 (13.5) years. Five (4.0) patients had rheumatic valvular heart disease with demonstrable clots in the left atrium. On the other hand; four(3.2) patients had RHD without thrombi seen. Two patients had biventricular thrombi. One of these patients had giant clots within the ventricles and multiple freely mobile thrombi in right ventricle without obvious cardiac structural defect. CONCLUSION: Young stroke or transient ischaemic attacks patients who have clinical signs suggesting the heart as the potential CSE should have low threshold for echocardiography. However; there is a need for rationalisation of request for echocardiography where such clinical signs are absent