Availability and utilization of emergency obstetric care public health facilities in Zaria, Northern Nigeria

Background: Maternal mortality rates continue to soar high in Northern Nigeria despite all sorts of interventions being put in place. This has necessitated the need to emphasize on Emergency Obstetric Care (EmOC) to tackle obstetric complications which are the largest direct causes of maternal mortality. The study was conducted to assess the availability of Emergency Obstetric Care facilities in Zaria Local Government Area (LGA) located in Northern Nigeria.Methods: This was a hospital based cross- sectional descriptive study carried out in Zaria LGA. Data was collected from seven public health facilities using a structured interviewer administered questionnaire.Results: The LGA met the WHO requirement for the population served while none of the designated BEOC met the UN criteria for such designation. Only 8% of births took place in the health facilities and 0.7% of deliveries were by caesarean section. The met need for EmOC in Zaria LGA was 25.1%. Human resources were lacking in number and skills. Some key drugs and equipment needed to carry out signal function were also absent.Conclusions: Public health facilities in Zaria did not meet the requirements of the United Nations (UN) process indicators. There is need to upgrade the health facilities with the necessary human resource, equipment and facilities to enable them perform their designated EmOC functions.

An Eight-Year Review of Morbidity and Mortality among Adult Patients with Tetanus at a Tertiary Hospital in Zaria, Northern Nigeria.

Background: Tetanus infection is a major cause of morbidity and mortality in many developing countries. The infection results from contamination of wound by Clostridium tetani in unimmunized individuals. The morbidity is mainly due to sustained skeletal muscle spasms from unopposed action of tetanospamin on excitatory neurons in the central nervous system. The clinical presentation and outcome depend on both patient and disease factors. Health education and immunization would contribute to prevention and eradication of the infection. This review studied morbidity and mortality patterns among adults treated for tetanus at a tertiary hospital in Zaria from January 2006 to December 2013. Materials and Methods: Medical records of adults admitted with the diagnosis of tetanus were retrieved and reviewed. Information on socio-demography, clinical presentation, complications, co morbidities and outcomes were obtained and analysed using the Statistical Package for Social Sciences version 17.0. Results: Forty-seven patients were admitted during the period, with an average of 6 patients per year. Male (70.2%): female (29.8%) ratio was 2.4: 1. Their ages ranged from 15 years to 65 years, the age group 20-39 years constituting 76.6% of the population. 51.2% were students. The lower limbs were portal of entry in 70.6% of cases, and 52.9% of the wounds were dirty. 82.4% of the patients were unimmunized and overall mortality was 40.4%. Predictors of mortality were short incubation period, short onset time, severe muscle spasms, non-immunization and presence of complications. Conclusion: Tetanus remains a major preventable disease among unimmunized and low income people. Therefore, immunization of people at risk would prevent tetanus infection and its associated complications.

Investigation of Outbreaks of Infectious Bursa Disease in Zaria, Nigeria.

Aim: To investigate outbreak of IBD in Zaria, Nigeria. Study Design: Prospective study. Place and Duration of Study: Sample: Poultry Unit of the Ahmadu Bello University Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Ahmadu Bello University, Zaria between March 2009 to July 2009. Methodology: Poultry cases reported to the clinics were investigated. Date, age, address, flock size, morbidity rate, mortality rate, breed, species, type of birds, vaccination history were noted; post mortem and agar gel precipitation test were done on 10 flocks, the incidence rate, morbidity rate, mortality rate and organ (bursa, spleen and thymus) to body weight ratio of the 10 flocks were calculated. Results: Chicks in all the flocks revealed the clinicopathologic manisfestation of IBD which include depressions, somnolence, anorexia, ruffled feathers, trembling, postration followed by death. In all the flocks, the BF were either turgid, swollen and or haemorrhagic, severe haemorrhages on the thigh and pectoral muscles, haemorrhages at the junction of proventriculus and gizzard or oesophagus, congested or pale carcasses, swollen kidneys with prominent tubules and enlarged pale or congested liver were also observed during postmortem examination. All the bursal homogenates from the 10 flocks gave precipitation line in the AGPT. An incidence of 12.1% was recorded. Average morbidity (40.5%) and mortality (40.7%) rates were recorded in ten outbreaks of IBD. Improved breeds of chickens were more likely to suffer from IBD with broilers 3.87 times at risk. Birds, 3-6 weeks-old were at a risk of being infected with IBDV. Chickens vaccinated once against IBD were 4.8 times more likely to suffer from IBD. Conclusion: IBD is a disease of improved breeds of poultry with clinical disease seen only in chickens. The disease mostly affects chickens of 3 to 6 weeks of age. Birds vaccinated twice are less susceptible to the disease.

Temporomandibular joint dislocation: experiences from Zaria, Nigeria

OBJECTIVES: Dislocation of the temporomandibular joint may occur for various reasons. Although different invasive methods have been advocated for its treatment, this study highlights the value of non-invasive treatment options even in chronic cases in a resource-poor environment. MATERIALS AND METHODS: A seven-year retrospective analysis of all patients managed for temporomandibular joint dislocation in our department was undertaken. Patient demographics, risk factors associated with temporomandibular joint dislocation and treatment modalities were retrieved from patient records. RESULTS: In all, 26 patients were managed over a seven-year period. Males accounted for 62% of the patients, and yawning was the most frequent etiological factor. Conservative treatment methods were used successfully in 86.4% of the patients managed. Two (66.7%) of the three patients who needed surgical treatment developed complications, while only one (5.3%) patient who was managed conservatively developed complications. CONCLUSION: Temporomandibular joint dislocation appears to be associated with male sex, middle age, yawning, and low socio-economic status, although these observed relationships were not statistically significant. Non-invasive methods remain an effective treatment option in this environment in view of the low socio-economic status of the patients affected.