Assessment of COVID-19 vaccine hesitancy among people living with HIV/AIDS: a single-centered study

Introduction: as the coronavirus disease 2019 (COVID-19) vaccines are distributed and administered globally, hesitancy towards the vaccine hinders the immunisation of a significant number of vulnerable populations, such as people living with HIV/AIDS. Hence, this study aims to assess COVID-19 vaccine hesitancy among people living with HIV/AIDS (PLHIV) attending clinicaloutpatient follow-up at State Specialist Hospital Maiduguri (SSHM), Borno State, Nigeria. Methods: a hospital-based cross-sectional study design was conducted to assess COVID-19 vaccine hesitancy among 344 PLHIV receiving antiretroviral therapy (ART) at the United States President´s Emergency Plan for AIDS (PEPFAR) clinic in SSHM from 4 th January to 25th February 2022. Data were collected using a structured and pretested interviewer-administered questionnaire. The results were presented using frequencies and percentages. The factors that are associated with COVID-19 vaccine hesitancy were identified using the Chi-square statistical test. Results: among the 344 respondents of the study, only 88 (26.6%) received the COVID-19 vaccine. Out of the 256 respondents that did not receive the vaccine, only 10.5% (27/256) are willing to be vaccinated, while the majority; 57.8% (148/256) are not willing to be vaccinated and 31.7% (81/256) of the respondents are uncertain, thus resulting in a hesitation rate of 89.45%. There was no statistically significant association between COVID-19 vaccine hesitancy and the study´s independent variables; where p-value is greater than 0.05. Conclusion: hesitancy towards COVID-19 vaccine is high among PLHIV and there is no any statistically significant association between COVID-19 vaccine hesitancy and the independent variables of the study where p-value is greater than 0.05. Hence, it is necessary to develop targeted strategies to boost vaccine uptake among this vulnerable population.

Assessment of public hospital drug supply financing through the public-private partnership: pharmacists' perspectives

In Nigeria, drug financing by the public has been challenged by financial constraints through public fund due to a limited fund available to the government to meet all its demands. The objectives of this study were to determine the variability of the hospital patient prices of same drugs under the PublicPrivate Partnership (PPP) and in Private Retail Community Pharmacy (PRCP), and to investigate the perceived efficiency and effectiveness of the PPP by comparing it with the Drug Revolving Fund (DRF) model in drug supply financing. This study was conducted in Nigeria utilizing a mixed method. Mann-Whitney U test analysis was used to compare the median drug price of the two facilities. The majority (76.19%) of the drugs were sold at a cheaper rate in the hospital than what was obtained in the PRCP with no significance difference (p > 0.05). Dominant responses from the focused group discussions supported the PPP model. This study shows that the median patient price of the basket of matched pairs of same drugs in the hospital under the PPP and in the PRCP was identical. Overall, the participants were of the opinion that the PPP model was more efficient and effective than DRFin the financing drug supply

Identification of Cryptosporidium parvum Oocysts among Hospitalized Children under-5years in Northeastern Nigeria

Cryptosporidium parvumis among the major pathogens causing diarrheal diseases in children. It is of major public health significance due to its low infectious dose and its oocysts are highly resistant to chlorination, common household disinfectants and survive long periods in the environment. This study was designed to evaluate the occurrence of Cryptosporidium parvum oocysts in stool of hospitalized children under-5years. One hundred and fifty (150) stool samples were collected from one hundred and fifty children (Male:Female= 1:1.08, Mean Age±S.D=22.08 months ± 21.02) and were processed using the modified Ziehl-Nelson method for identification of protozoan oocysts. Out of the one hundred and fifty (150) stool samples analyzed, 16 tested positive to oocysts of C. parvum, which gives a parasite prevalence rate of 10.7%. This was observed to be higher among male patients (52.0%) and children between the age 32-41months (31.3%). Parasite prevalence in relation to age of patients was statistically not significant (X2=0.105, DF=1, P-value= 0.74591, p<0.05). Other intestinal protozoan parasites identified include Entamoeba histolytica(1.33%) and Giardia lamblia (2.60%

Screening of Antimicrobial Residue in Commercial Eggs in Maiduguri Metropolis, Borno State

The objectives of the study were to screen for antimicrobial residue in table eggs in Maiduguri metropolis. Multistage sampling technique was used based on the 4 major district of Maiduguri Metropolis Viz; Bolori, Gwange, Kyarimi park and Shehuri North. Four hundred commercial egg samples were collected for the study. One hundred and sixteen table eggs were sampled from 35 randomly selected poultry layer farms and 284 were obtained from 37 randomly selected egg commercial retail outlets. The antimicrobial screening of eggs was carried out using the disc diffusion method where Bacillus cereus ATCC 14579 from spectra medics' laboratory in Ogun state was used as the test organism. One hundred and sixteen (116) table eggs collected from farms across the study district, 36 (31%) were each from Bolori and Gwange, 39 (33.6%) from Kyarimi Park and 5 (4.3%) from Shehuri North. A total of 49 positive samples were obtained which include 17 (47.2%), 21 (58.3%), 10 (25.6%) and 1 (20%) from Bolori, Gwange, Kyarimi Park and Shehuri North respectively (Fig. 2). There was no significant difference (P=0.095) among the clusters. Out of the 284 egg samples collected from the retail outlet, 201 (70.1%) samples were from Jos and 83 (29.2%) from Ibadan. A total of 100 (35.2%) samples were positives for antimicrobial screening which comprises of 71 (35.32%) and 29 (34.94%) from Jos and Ibadan respectively. With no significant difference between the two sources (P=0.902). From this study, it was concluded that: There is small flock size (backyard) farm in Maiduguri with 94.3% of the farmers holding equal or less than 500 birds in their farms. Antimicrobial residue detected in the study area is alarming.

Epidemiology of Head and Neck Cancers in Maiduguri-Northeastern Nigeria.

Head and neck cancers is one of the common health problems in our environment affecting relatively the youth. The paucity of literature on community based studies in Nigeria to determine the incidence of the disease obscure its burden, pattern and magnitude. This study presents epidemiological characteristics of head and neck cancers in Maiduguri as seen during the period of insurgency. A 5 year retrospective review of patients seen from January, 2010 to December, 2014 with histologically diagnosed head and neck cancers. Data extracted from the records of histopathology department of University of Maiduguri Teaching Hospital was analyzed using SPSS version 16.0. Of the 7655 patients, 1312 (17.14%) were cancers and 217 (16.54%) of this was head and neck malignancies. Average age was 35.5years with SD±20.07. About 69% of cases were epithelial in origin and 60.83% of patients were less than 41 years of age. The age group worse affected by carcinoma is older than those with sarcoma and lymphoma. Head and neck is not uncommon in Maiduguri even in the face of insurgency, it is also among one of the common health problems of the relatively young. This therefore call for in-depth research on aetiological factors. Relevant authorities shall also establish oncology centers which will promote education, screening programmes, early detection, prevention and control of head and neck cancers.

Prevalence and clinical manifestation of lymphomas in North Eastern Nigeria.

BACKGROUND: Lymphomas are one of the commonest childhood malignancies. Due to varied clinical features many patients are misdiagnosed and treated for other diseases. It is imperative to keep health workers informed about the current trend of lymphomas in northeastern Nigeria to facilitate prompt diagnosis and treatment. OBJECTIVE: To evaluate the extent of lymphomas at presentation and to define the pattern of presentation in relation to gender and site. MATERIALS AND METHODS: Retrospective analysis of cases of lymphomas over a 15 year period was conducted. Structured questionnaires were used to document demographic characteristics and clinical features. The non‑Hodgkin’s lymphoma (NHL) and Hodgkin’s lymphoma (HL) cases were categorized using standard classification schemes. Data were analyzed using the Statistical Package for Social Sciences (SPSS) software version 16, Illinois, Chicago, USA. Spearman’s correlation and Student’s t‑test were applied where appropriate. A P value < 0.05 was considered significant. RESULTS: Fifty cases of lymphoma, 10 (20%) belong to HL and 40 (80%) belong to NHL. Lymphoma is common in male, though the male to female preponderance was not significant in both the cases (P = 0.107 and 0.320, respectively). Maxilla was the commonest site of primary malignancy (36%) and late presentation of patients were observed. New trend was noticed, the NHL patients present commonly with severe symptoms than HL (P = 0.038). HL was dominated by lymphocytic predominant type, while NHL was dominated by the small non cleaved cells (Burkitt’s) lymphoma (70%). CONCLUSION: Childhood lymphoma in northeastern Nigeria has a slight shift in varied clinical presentation in favor of NHL. Patients in this study had late presentation.

Expanding Access to Maternal Health Services by the Use of Traditional Birth Attendants: Experiences of the Sunni Hospital Group, Maiduguri, Nigeria.

Aim: We intend to ascertain the experience of Sunni Hospital Maiduguri on the use of TBAs in enhancing Maternal Health Care Services. Study Design: It was a retrospective observational survey of a community health project. Place and Duration of Study: Maiduguri, Borno State Northeastern Nigeria between January 2001 and December 2007. Methodology: Post-intervention survey of a community health intervention that targeted Muslim underserved semi-urban women. Results: One thousand seven hundred and seventy eight (1,778) women were referred for life-saving interventions. More than 80% of the referrals were due to maternal and fetal complications identified by the TBAs in their respective communities. Six hundred and ninety one (691) deliveries were conducted using clean delivery kits. Their counseling and services consistently enhanced contraceptive uptake seen by generation of over 2,000 CYPs. Conclusion: TBAs play a significant role in expanding maternal and child health services in our communities. And TBAs are likely to continue to be key resource for improving maternal and child health. Therefore it is necessary to integrate these community workers in the health system.

Prevalence of Placental Malaria and Effects on Birth Weight of Neonate of Mothers Who Had Antenatal Care in Maiduguri Metropolitan City, Nigeria.

Background: Low birth weight (LBW) is an important risk factor for infant morbidity and mortality especially in malarial endemic countries. The study focused on the prevalence of placental malaria and neonatal LBW, as well as the relationship between placental malaria and neonatal LBW outcome in Maiduguri metropolitan city, Nigeria. Methods: A total of 110 mother-neonatal pairs were studied. Neonatal birth weights were measured using the bassinet weighing scale and placental tissues for the diagnosis of placental malaria were collected from mothers of these neonates. Student t test and Chi-square trend (χ2) with Yate’s correction were used to investigate quantitative and categorical variables, whereas, Univariate analytical model was used to estimate the relationship between placental malaria, maternal age, parity and neonatal LBW. Results: Forty-nine mothers (44.5%) had placental malaria and the association of maternal age group (27-31and32-36) years with placental malaria was significant (p=0.029). Of the 14(100%) neonates with LBW, 10(71.4%) had their mothers diagnosed with placental malaria. The relationship between placental malaria and LBW was however not significant (p=0.207). Also, the relationship between maternal age, parity and neonatal LBW outcome was not significant. Conclusions: Placental malaria constituted 44.5% and the disease was associated with maternal age bracket (27-31and32-36) years in this work. Although the relationship between placental malaria and neonatal LBW was not significant, most neonates with LBW in present study had their mothers diagnosed with placental malaria.

Maternal - Fetal Interaction: An Insight through the Stable Isotope Fractionation Prism.

Aims: The aim is to investigate the neck-shaft angle or Collo-Diaphyseal Angle (CDA) of femur and the effect of homozygous sickle cell (HbSS) on the angle. Study Design: A retrospective study. Place and Duration of Study: Radiology Departments of two Hospitals in Maiduguri, namely Umaru Shehu Modern Hospital and University of Maiduguri Teaching Hospital (UMTH), between January, 2009 - December, 2010. Methodology: Using plain radiographs of the femur, a total of 194 HbSS and 40 control (non-HbSS) children below 17 years of age were selected. The study samples whose clinical data had been excluded from any diseases that could modify the femur were studied. The Technical Error of Measurement (TEM) was performed by the evaluator. Ethical clearance for the study was obtained from the relevant body of these government hospitals. Results: The TEM values obtained were less than 1 and were considered as a good measurement method for the evaluator performance. The CDA (mean ± standard deviations) were higher in males than females. The CDA in the left femur was greater than the right both for males and females, respectively. Furthermore, the study documents, probably for the first time that in few cases there was a reduction in the CDA of HbSS when compared with the control groups. The study revealed that there was sexually significant variation (p<0.05). The demarking points and index of sexual dimorphism of CDA show sex differences and can be used for sex determination. Conclusion: The results from this study reveal that the mean CDA of femur of HbSS children of the study population were sexually dimorphic. The information from this study may aid forensic pathologists, orthopaedic surgeons and future research in evaluation of the femur.

Menstrual Pattern among Female Medical Students in University of Maiduguri, Nigeria.

Aims: To determine menstrual pattern and disorder associated with it among female medical students. Study Design: Cross-sectional study. Place and Duration of Study: College of Medical Sciences, University of Maiduguri, Borno State, Nigeria between February – September 2010. Methodology: Self descriptive cross-sectional study was carried out among 169 Medical students (MBBS II-V) between the ages 19-46 years. Respondents were selected from each class using stratified random sampling method. Stratification was done according to their class. Questionnaires were designed and administered to the respondents to complete. Three researchers and two research assistances were on site to assist. Students were briefed on the objective of the study and duly completed questionnaires were collected and analyzed. Subjects who had primary amenorrhea and/or history of abdominal or pelvic surgery were not eligible for the study. The questionnaire included data such as; age of menarche, menstrual pattern, severity of pain (dysmenorrheal), marital status, effects of exercise, socioeconomic status, Body mass Index (BMI) and Diet. The method of observation involved personal interaction and questioning of respondent to find out if they had anything peculiar about their cycle. The number of days of menstrual flow on menarche and number of pads use per day were in the questionnaire. Results: It was observed that 148(87.6%) respondents had regular length of menstrual cycle, particularly in the age groups 20-22 and 23-26 years which recorded 39 and 43 respondents respectively. Irregular menstrual cycle was found in 21(12.4%)respondents, which showed its peak at the age group of 17-19(33.3%) years, between age groups. It was also observed that 118(69.8%) respondents had painful menstrual flow, out of which 71(60.2%) had mild pain, 30(29.7%) had moderate pain while 17(14.4%) had severe pain. Result of length of menstrual cycle between single and married respondents showed that, 20(71.4%) of single respondents had short menstrual length compared to 8(28.6%) married respondents of corresponding short menstrual length. It was revealed that in 148(87.6) respondents that had regular menstrual cycle type, 106(71.6%) menstrual flow was average, while in 31(21.0%), it was scanty and heavy in 11(7.4%) respondents. 10(47.6%) respondent had average irregular menstrual cycle, while 9(42.9%) and 2(9.5%) respondents had scanty and heavy irregular menstrual cycles The result showed no significant variation in frequency of menstrual cycle (p=0.5). 99(58.6%) of respondents did no physical exercise; while 70(41.4%) did at least 30 minutes exercise (p=0.38). 101(59.8%) respondents belong to high upper, 51(30.2%) in upper-middle and 17(10.0%) belonged to lower socioeconomic status (p=0.14). 135(80.0%) respondents had daily fast food habits, out of which 95(80.5%) had positive history of pain and 34(20.0%) had no daily fast food (P=0.80). 30(17.8) respondents were underweight, 120(71.0%) had average weight and 19(11.2%) respondents were overweight (p=0.20). Conclusion: Study has established mean age at menarche, menstrual pattern and menstrual disorder (pain) in relation to BMI, exercise and socioeconomic factor among female Medical Students of University of Maiduguri, Nigeria. The prevalence of dysmenorrhea was very high among the female medical students. Although further research is needed, as relationship between Menstrual cycle, obesity, diet and exercise are conflicting with other studies.