Sero-prevalence of and risk factors associated with Helicobacter pylori infections among individuals with peptic ulcer in Owerri, Imo State, Nigeria during 2020-2021

Background: Helicobacter pylori, which is a causative agent of chronic gastritis, duodenal ulcer and gastric cancer, presently affects approximately one half of the world population. This study was conducted to assess the epidemiology and risk factors for acquisition of H. pylori among individuals with and without peptic ulcer symptoms in Owerri, Nigeria, in order to provide baseline data and create awareness for effective management and prevention of infection caused by this pathogen. Methodology: A total of 384 participants, symptomatic and asymptomatic for peptic ulcer, were recruited from the three Local Government Areas (LGAs) of Owerri, Imo State, Nigeria. The symptomatic participants were randomly recruited among patients attending outpatient clinics with symptoms of peptic ulcer disease at the Federal Medical Center Owerri, general hospitals and primary healthcare centers across Owerri LGAs, while asymptomatic patients were recruited from the community. Information on socio-demographic characteristics of each participant and potential risk factors were collected with a pre-tested structured questionnaire. Blood samples were collected for detection of antibodies (IgG) using a one-step H. pylori test device while faecal samples were collected for detection of occult blood (from peptic ulceration) using faecal occult blood (FOB) test. Data were analyzed using SPSS version 25.0 and association of risk factors with H. pylori sero-prevalence was determined by the Chi-square or Fisher Exact test (with Odds ratio). P value < 0.05 was considered statistically significant.Results: The sero-prevalence of H. pylori infection among the study participants was 72.4% (285/384) while the prevalence of ulcer by FOB test was 71.1% (273/384). A total of 78.4% (214/273) of those with ulcers were seropositive for H. pylori while 64.0% (71/111) of those without ulcers were sero-positive for H. pylori (p=0.0045).Factors significantly associated with high sero-prevalence of H. pyloriwere age groups 41-50 (100%), 21-30 (78.4%) and 31-40 (67.6%) years (X 2=66.964, p<0.0001), illiteracy (OR=6.888, p<0.0001), unemployment (OR=2.427, p<0.0001), low social class status (X2=28.423, p=0.0003), drinking of unclean water (OR=5.702, p<0.0001), living in crowded rooms (OR=2.720, p<0.0001), eating food bought from food vendors (OR=3.563, p<0.0001), family history of ulcer (OR=12.623, p<0.0001), habits of eating raw vegetables and unwashed fruits (OR=6.272, p<0.0001), non-regular hand washing practices before meal (OR=2.666, p<0.0001) and presence of ulcer (OR=2.043, p=0.0045). However, smoking (OR=0.7581, p=0.2449) and gender (OR=0.6538, p=0.0796) were not significantly associated with sero-prevalence of H. pylori. Conclusion: There is need for comprehensive strategy including public health education campaign to create awareness on H. pylori, improve personal hygiene and environmental sanitation, provision of safe drinking water by the government to the populace, and discourage indiscriminate and open defecation

Prevalence of Candida albicans among Female Patients in Two Selected Hospitals in Owerri Metropolis, Imo State Southeastern Nigeria

The incidence of candidiasis in the female reproductive tract is a serious threat to public health. This study assesses the prevalence of Candida albicansamong female patients in the two selected hospitals in Owerri metropolis. A systematic random sampling technique was used to select 120 female patients between the ages of 16-56 years. Only patients who showed no symptoms of urinary tract infections and who were not on anti-fungal therapy at the time of the study were included in the study. A well-structured interview questionnaire was used to source information on socio-demographic characteristics of the respondents as well as the risk factors of Candida albicansinfections. High Vaginal Swab (HVS) was aseptically collected from each of the patients, using a sterile swab stick. The collected samples were labeled appropriately and immediately sent to the microbiology/mycology lab for analysis. The HVS samples were respectively streaked directly into sabouraud agar plates and incubated anaerobically at 37oC for 48 hours. Yeast growth characteristics were noted. Positive colonies were sub-cultured in Macconkey agar to obtain pure isolates. The Candida albicanswere properly identified and confirmed by germ tube test, gram staining and biochemical tests. The results showed that the overall prevalence of Candida albicansamong the women was (53.34%). The prevalence was highest among the patients in the age group 16-25 (44.17%), lower education qualification (n=65, 54.17%) and pregnant women (n=44, 36.67%). The possible risk factors for the infection include use of antibiotics (n=85, 70.83%), use of nylon underwear (n=78, 65.00), use of public toilet (n=90, 75.00%), use of squat WC (n=59, 9.17%) and use of oral contraceptive (n=59, 49.17%). The results call for preventive measures to protect women. Therefore public health education and campaign should be adopted

Violence against women: awareness, knowledge and attitudes of male civil servants at the ministries, departments and agencies in Owerri, Nigeria

Background: Violence against women (VAW) remains a huge and protracted public health concern. Also, there is growing recognition that the role men play in changing these inequalities in gender based power relations is critical. Documenting the trends of the aforestated role is essential to developing public health interventions to tackle VAW. Objective: To determine the awareness, knowledge and attitudes to VAW among male civil servants at the state and federal government ministries and agencies (MDAs) in Owerri, Nigeria. Materials and methods: This was a cross sectional survey of 326 male civil servants at the State and Federal Government MDAs in Owerri Nigeria, selected using multistage sampling technique from August 2016 to January 2017. Data were collected using pretested self-administered semi- structured questionnaires. Data were analysed using SPSS V.22. Statistical associations between variables were tested using Chi square, at p -value < 0.05. Results: The mean age of respondents was 40.6 ± 9.8. Three hundred and two (92.6%) of them were aware of VAW. Sources of information on VAW include: 184(57.9%) television, 171(53.8%) radio, 167(52.5%) print media, 152(47.8%) social media. The form of VAW mostly cited 227(70.7%) was rape, while the mostly practiced form of VAW 201(62.4%) was physical violence. Only 65 (20%) had good knowledge, while 151 (46.3%) had a good attitude towards VAW. There were statistically significant associations between respondent's attitudes towards VAW and (religion [p =0.000], tribe [p =0.017]). Conclusions: This study revealed high awareness on VAW, poor knowledge about VAW and poor attitude towards the practice of VAW. We recommend sustained awareness and improved comprehensive gender equity cum attitudinal change education

Outcome of single breech term deliveries at the Federal Medical Centre, Owerri, South Eastern Nigeria: a five year review.

Background: The best mode of delivery of breech presentation for optimum neonatal outcome has been a subject of controversy over the years. Aim of current study was to determine the pattern of distribution, incidence, mode of delivery and outcome of singleton breech presentations at term among parturients at this centre. Methods: This was a retrospective study of singleton breech term delivery at the federal medical centre, Owerri between January 1, 2007 and December 31, 2011. Singleton breech term deliveries were identified from the labor ward register and the hospital numbers extracted to retrieve the case notes from the medical records department of the hospital. Some data were collected and analysed. Results: There were a total of 9624 deliveries during the study period, out of which 328 (3.4%) were singleton breech presentation at term. Term singleton breech was commoner in multiparous 200 (61%) than in primiparous 128 (39%) women. Extended (Frank) breech was the commonest type of breech presentation (60.4%) followed by flexed (complete) breech (36.0%) and footling breech (3.6%) was the least common. Assisted vaginal breech delivery was conducted in 66.2% of cases while 27.4% were delivered by emergency caesarean section and 6.4% of cases were delivered through elective caesarean section. There were one maternal and 24 perinatal death. Twenty one (87.5%) of perinatal deaths those occurred in unbooked mothers. Conclusion: Although assisted vaginal breech delivery for singleton breech term delivery was commonly performed in our centre, elective caesarean delivery gives the better neonatal outcome for fetuses presenting breech.

Bacteriological evaluation of some sachet water on sales in Owerri metropolis, Imo State, Nigeria

Aims: Continuous increase in the sale and indiscriminate consumption of packaged drinking waters in Nigeria is of public health significance. In order to safe guard public health, it is essential that the available packaged water is of the highest quality. This study was carried out to evaluate the bacteriological quality of packaged water on sale in Owerri metropolis, Imo State of Nigeria. Methodology and Results: From 30 registered sachet water factories, 8 samples each was purchased randomly fifteen of the brands of sachet water all over Owerri metropolis in Imo State, Southeastern Nigeria. These were analyzed for presence of bacterial indicators of water quality. Four weeks later, a second batch of the samples was collected from other brands. A mean plate counts was taken and the organisms from each water sample identified using standard procedures. The results showed that 11 (73.3%) sachet water brands had growths of pathogenic organisms in the first batch while 10 (66.6%) had growth in the second batch. The isolates were identified to be Klebsilla spp., Serratia spp., Proteus spp., Pseudomonas aeruginosa and Chromobacterium spp. The study showed that Klebsiella pneumoniae [7(29.2%)] was the most predominant. This was closely followed by Serratia spp. [6(25.0%)] and Proteus mirabilis [6(25.0%)]. Pseudomonas aeruginosa [3(12.5%)] and Chromobacterium spp. [2(8.3%)] was least predominant. Mean total heterotrophic bacteria plate counts (HPC) per millilitre ranged from 0.0 to 6.0 x 102 CFU/mL at 22 °C and 0.0 to 7.0 x 102 CFU/mL at 37 °C (first batch) and 0.0 to 5.0 x 102 CFU/mL at 22 °C and 0.0 to 10.0 x 102 CFU/mL at 37 °C for the second batch. Thus they fell below the United States Environmental Protection Agency (USEPA) and World Health Organization (WHO) drinking water standard of 100 HPC per millilitre of water. Bacteriological examination of different brands of sachet water samples collected from different locations showed that only Vince water and Akudo table water was found to be safe for drinking while the other brands of sachet water from mobile vendors in Owerri metropolis was not potable. Conclusion, Significance and Impact of study: Hence, the bacteriological quality of some of the brands of sachet water on sale in Owerri was of poor quality index. The study suggests that sachet water could be a route of transmission of enteric pathogens among the populace. In order to safe guard public health, highest quality brands of sachet water is therefore advocated.