Prevalence, pattern and factors associated with workplace violence against healthcare workers in Nigeria: A systematic review

Objective:This study aimed to describe the prevalence, pattern, and predictors of WPVagainst HCWs in Nigeria. Methods:Asystematic review was conducted using pre-defined keywords. The review was performed in line with the PRISMAguidelines on PubMed, Google Scholar, Scopus, and Web of Science. The population, intervention, comparator, and outcome (PICO) elements for this study were as follows: Population:Nigerian Healthcare workers; Intervention: Exposure to WPV; Comparator: Non-exposure to WPV; Outcome: Mental and Physical health outcomes of exposure to WPV. Of the 18,140 articles retrieved, 15 cross-sectional studies met the inclusion criteria and were included in the review. In all, 3,245 HCWs were included, and consisted majorly of nurses and doctors. Results:The overall prevalence of WPV(Physical > Verbal/Psychological > Sexual) against HCWs ranged between 39.1%-100%. The predictors of WPVare younger ages (AOR = 2.513, p = 0.012), working in psychiatric unit (AOR = 11.182, p = 0.006), and increased frequency of interaction with patients, and mostly perpetrated by patients and their relatives. Many health facilities lacked a formal reporting system and policies to protect HCWs from WPV. Conclusion:WPVagainst HCWs is a public health problem in Nigeria with dire implications on HCWs; the victims, and the aggressor. Administrators of health facilities should design protocols for WPVreporting, recognition, and management. Patient and 'relatives' education on the 'facilities' policy against WPVshould be undertaken, while orientation sessions on the risk factors for HCWs are scheduled.

Arrested Acetylene-Induced Pulmonary and Testicular Toxicity in Rats Through Treatment With Polyphenols.

Occupational exposure to potentially harmful substances is one of the dangers associated with industrial jobs. This study evaluated the modulatory influence of selected dietary polyphenols on the pulmonotoxic and testiculotoxic effects of crude acetylene, an industrial gas used in welding metals. Wistar rats were exposed to 58 000 ppm acetylene, 20 min daily for 30 days, in a 36 L glass inhalation chamber. Some acetylene-exposed animals were treated concurrently with 30 mg/kg quercetin, rutin, caffeic acid, ferulic acid, or coumaric acid. At the end of the treatment sessions, the levels of superoxide dismutase, reduced glutathione, glutathione peroxidase, lactate dehydrogenase, and hormonal markers in rats exposed to acetylene were significantly decreased, with a concomitant increase in lipid peroxidation, nitric oxide level, cholesterol concentration, and histopathological abnormalities. These damaging biochemical and histopathological changes were significantly ameliorated in animals administered the polyphenols. Quercetin showed greater ameliorative activity than rutin while the phenolic acids exhibited increasing levels of ameliorative activity in the order: caffeic acid > ferulic acid > coumaric acid. These results indicate that inhalation of crude acetylene is deleterious to the lungs and testes, and polyphenols provide protection against these detrimental effects.

A RANDOMISED CONTROLLED TRIAL ON CLINICAL EFFICACY OF SODIUM PERBORATE MIXED WITH DISTILLED WATER AND 30% HYDROGEN PEROXIDE IN THE LIGHTENING OF NON-VITAL DISCOLOURED ANTERIOR TEETH.

Objective: To compare the effectiveness of sodium perborate mixed with distilled water and sodium perborate mixed with 30% hydrogen peroxide as non-vital bleaching agent of anterior discolored teeth. Materials and methods: A randomized controlled trial was undertaken among 61 patients who presented with 70 discolored anterior teeth at the Conservative and Family Dentistry Clinics of the University College Hospital, Ibadan, Nigeria. The 70 teeth were randomly allocated into two groups of treatments. In Group A, the test group, the coronal part of endodontically treated teeth was further treated with sodium perborate mixed with distilled water while group B, the control group, the coronal part of endodontically treated teeth were also further treated with sodium perborate mixed with 30% hydrogen peroxide. Information on study participants biodata and satisfaction with treatment were obtained. Tooth shade assessment was done using shade guide units of the vitapan shade guide at baseline and during recall visits on days 7, 14, and 21. Frequencies, means, and standard deviations were generated. The Chi-squared test was used to determine the association between two categorical variables at p < 0.05. Results: In the control group, the mean ± SD tooth shade was 12.5 ± 3.2, 8.7 ± 3.8, 4.9 ± 2.8, and 3.1 ± 2.2 at baseline, Day 7, Day 14, and Day 21, respectively. In the test group, the corresponding values were 12.8 ± 3.2, 9.6 ± 3.9, 5.6 ± 3.0, and 4.0 ± 2.9. The mean ± SD tooth shade scores of the control and test groups were 12.5 ± 3.2 and 12.8 ± 3.2, respectively (p = 0.15). Twenty-two (62.9%) and 19 (54.3%) of the study participants in the control and test groups, respectively, reported that they were extremely satisfied (p = 0.60). Conclusion: The effectiveness of sodium perborate mixed with distilled water and sodium perborate mixed with 30% hydrogen peroxide in lightening the coronal part of endodontically treated non-vital discolored anterior teeth was similar. Both bleaching agents demonstrated similar patient satisfaction.

RESPONSE TO THE COVID-19 OUTBREAK: LESSONS FROM A TERTIARY HEALTHCARE FACILITY IN SOUTHWEST NIGERIA.

Background: Mitigating the risk of nosocomial infection is one of the core functions of healthcare managers in hospital environments. This study aimed to describe the COVID-19 outbreak response in a tertiary healthcare facility in Nigeria. Methods: A qualitative cross-sectional study was conducted among representatives of Heads of Infection Control Committees and units, the Accident and Emergency unit, Family Medicine unit, and Private Suites on the COVID-19 outbreak response at the University College Hospital, Ibadan, Nigeria. Data were analyzed using Colaizzi's phenomenological method. Results: Overall, seven (six physicians and one nurse) HCWs were interviewed; six (71.4%) males and two (28.6%) females. The average age of the key informants was 45 ± 4.73 years. Four themes were identified. Theme one "Essentials of screening protocol and screening area" described the development of screening protocol, and dedication of a triage area. Theme two "Infection prevention and control within consultation premises" detailed adequate spacing; hand hygiene, use of personal protective equipment; environmental sanitation; and waste management. Theme three "Mounting up surveillance in the response activity" specified communication with the Disease Surveillance Unit; and surveillance activities. Theme four "Training and psychosocial support for staff " described staff training, and provision of psychosocial care to infected staff. Conclusion: The COVID-19 outbreak measures implemented by the management of the University College Hospital, Ibadan were aimed at ensuring that the hospital does not get overwhelmed by the surge in COVID-19 cases. In order to improve outbreak response in hospital settings, it is important to undertake training, modify hospital practices, and evaluate implemented measures.

Perception and Learning Satisfaction of Resident Doctors Amid COVID-19 Pandemic: Adaptation Experience at a Virtual Educational Course in Internal Medicine.

OBJECTIVES: This study aimed to assess the perception of the significance of the revision course and satisfaction of resident doctors with the West African College of Physicians (WACP) revision course in internal medicine. METHODS: This was a post-training evaluation of resident doctors who had enrolled for the 2021 membership revision course in internal medicine between August 9-13, 2021. Data were collected through an electronic questionnaire composed of five sections: Sociodemographic characteristics, involvement in research, perception on the significance/expectations from the course, lessons learnt, and perception of the overall coordination of the revision course/recommendations. Descriptive statistics were summarized using frequency tables. Chi-square tests were conducted to determine the association between participants' sociodemographic characteristics and satisfaction with the WACP revision course. RESULTS: The mean age (±SD) of the 119 resident doctors was 34.30 (± 4.81) years and the median duration (range) of residency training was 7 (4-10) years. All participants were currently in medical practice either in teaching hospitals (104,87.4%) or secondary health facilities (15, 12.6%). Overall, 108 (90.8%) doctors were satisfied with the course. Variables that were associated with satisfaction with the WACP revision course included: duration in residency training (doctors that had spent two years or less in the residency training programme) (Chi-square = 21.703, p = <0.001), place of residency training (teaching hospitals) (Chi-square = 67.461, p = <0.001), and participation in research (Chi-square = 47.976, p = <0.001). CONCLUSION: The WACP revision course in internal medicine met its objectives. Engagement of resident doctors in research activities should be undertaken intensely.

OBJECTIFS: Cette étude visait à évaluer la perception de l'importance du cours de révision et la satisfaction des médecins résidents à l'égard du cours de révision en médecine interne du West African College of Physicians (WACP). MÉTHODES: Il s'agissait d'une évaluation post-formation des médecins résidents qui s'étaient inscrits au cours de révision en médecine interne pour les membres de 2021 entre le 9 et le 13 août 2021. Les données ont été recueillies au moyen d'un questionnaire électronique composé de cinq sections : Caractéristiques sociodémographiques, implication dans la recherche, perception de l'importance/attentes du cours, leçons apprises, et perception de la coordination globale du cours de révision/recommandations. Les statistiques descriptives ont été résumées à l'aide de tableaux de fréquence. Des tests de Chi-carré ont été effectués pour déterminer l'association entre les caractéristiques sociodémographiques des participants et la satisfaction du cours de révision WACP. RÉSULTATS: L'âge moyen (±SD) des 119 médecins résidents était de 34,30 (± 4,81) ans et la durée médiane (fourchette) de la formation en résidence était de 7 (4-10) ans. Tous les participants exerçaient actuellement la médecine dans des hôpitaux universitaires (104, 87,4%) ou des établissements de santé secondaires (15, 12,6 %). Dans l'ensemble, 108 (90,8%) médecins étaient satisfaits de la formation. Les variables qui étaient associées à la satisfaction du cours de révision du WACP comprenaient : la durée de la formation en résidence (les médecins ayant passé deux ans ou moins dans le programme de formation en résidence) (Chi-carré = 21.703, p = <0.001), le lieu de formation en résidence (hôpitaux universitaires) (Chi-carré = 67.461, p = <0.001), et la participation à la recherche (Chi-carré = 47.976, p = <0.001). CONCLUSION: Le cours de révision WACP en médecine interne a atteint ses objectifs. L'engagement des médecins résidents dans des activités de recherche devrait être entrepris de manière intensive. Mots-clés: Pratique médicale, Enseignement médical, Formation des résidents, Médecine interne, Afrique.

The impact of non-closure of the platysma muscle layer on the cosmesis of thyroidectomy scar - a randomised double-blind controlled trial.

BACKGROUND: The relevance of closing the platysma muscle layer after open thyroidectomy has received little interest in terms of research. The objective was to determine whether non-closure of the platysma muscle layer after open thyroidectomy impacts significantly on the cosmetic outcome of the resulting collar scar. METHODS: In this prospective randomised controlled clinical trial, patients were assigned randomly to have the platysma muscle layer closed or not closed. The primary endpoint was the cosmesis of the collar scar six weeks after surgery assessed using the patient and observer scar assessment scale (POSAS). Additional endpoints included operation time and early postoperative wound complications. RESULTS: Ninety-two patients were recruited, with 46 randomised to each group. The patient scar assessment subscale(PSAS) of the POSAS showed no significant difference in the scar cosmesis between the two groups six weeks after surgery (median PSAS: 16.5 vs 17.5; p = 0.514). The observer scar assessment subscale (OSAS) showed that the platysma muscle layer closure group had marginally better scars (median OSAS: 15 vs 17; p = 0.045). The size of the goitre did not make any significant difference in the scar cosmesis. There was no significant difference in the incidence of early postoperative wound complications as well as the median operation time. CONCLUSION: Not closing the platysma muscle layer had no significant impact on the scar cosmesis six weeks after open thyroidectomy, with no significant difference in the incidence of early postoperative wound complications and the operation time.

Dihydroquercetin improves rotenone-induced Parkinsonism by regulating NF-κB-mediated inflammation pathway in rats.

This study examined the effect of dihydroquercetin (DHQ), also knofigurewn as taxifolin, on rotenone-induced Parkinsonism in rats. Male Wistar rats were administered 1.5 mg/kg rotenone for 10 days and subsequently treated with 0.25-1.0 mg/kg DHQ for 3 days followed by the assessment of parkinsonian symptoms. Brain striatal redox stress and neurochemical dysfunction markers were assessed spectrophotometrically. Histopathological evaluation of the striatum was done by hematoxylin and eosin staining technique. The expression of genes involved in the activation of NF-κB signaling pathway (IL-1ß, TNF-α, NF-κB and IκKB), and the p53 gene in the striatum were determined by RT-qPCR. DHQ attenuated parkinsonian symptoms as well as striatal redox stress, neurochemical dysfunction, and histological alterations occasioned by rotenone toxicity. Importantly, DHQ significantly suppressed the rotenone-induced upregulation of IL-1ß, NF-κB, and IκKB expression (p < 0.05) in the striatum of parkinsonian rats. DHQ demonstrated notable neurotherapeutic potential against rotenone-induced Parkinsonism in rats by improving parkinsonian symptoms (bradykinesia, catalepsy, postural instability, impaired locomotor behavior, and tremor) and neurochemical dysfunctions via modulation of genes involved in the activation of the canonical pathway of NF-κB-mediated inflammation.

Modulatory activities of polyphenols on crude acetylene-induced cardiac and hepatic dysfunctions in a rat model.

Exposure to crude acetylene can occur in occupational settings. This study assessed the modulatory activities of selected polyphenols on the hematotoxic, cardiotoxic, and hepatotoxic effects of crude acetylene. Wistar rats were exposed to 58 000 ppm crude acetylene for 10 min at 12 h intervals for 30 days. Some exposed groups were treated with 50 mg/kg rutin, quercetin, gallic acid, or tannic acid. Indices of hematological disorder, oxidative stress, and cardiovascular and hepatocellular injuries were evaluated in animals. The results showed a decrease in the levels of hematological indices in crude acetylene-exposed animals except for white blood cell count which was increased. Decreased activity/level of reduced glutathione, superoxide dismutase and ferric reducing antioxidant power with increased lipid peroxidation was observed in animals exposed to crude acetylene. Activities of transaminases, γ-glutamyl transpeptidase, and level of bilirubin were increased while the plasma albumin level was decreased. Dyslipidemia, increased activities of lactate dehydrogenase and creatine kinase-MB, and severe histopathological damage to hepatic and cardiac tissues were also observed in animals exposed to the gas. These deleterious hematological, biochemical, and histopathological changes were ameliorated in crude acetylene-toxified rats treated with the polyphenols. Tannic acid exhibited better activity than gallic acid while quercetin showed a superior activity to rutin. The results indicate that exposure to crude acetylene can lead to blood, heart, and liver-related diseases and dietary polyphenols could provide protective benefits.

Ten-Year Review of Paediatric Endocrine Disorders at Uniosun Teaching Hospital, Osogbo, Nigeria.

BACKGROUND: Paediatric endocrinology is a nascent subspecialty in Nigeria.Previous reports suggest a poor awareness of paediatric endocrine disorders resulting in late presentation, missed diagnosis and unnecessary death. OBJECTIVES: The study aims to report the prevalence of paediatric endocrine disorders at UNIOSUN Teaching Hospital (UTH) and to provide essential information to enhance early presentation and management. METHODS: This is a 10-year retrospective study of all children managed for paediatric endocrine disorders at UTH from March 2010 to March 2020. Relevant data were extracted from patients' records, entered into and analyzed with SPSS. RESULTS: Forty (0.42%) of 9,520 new consultations at UTH paediatric specialist clinic during the study period had endocrine disorders. There were 13 males and 27 females (M:F=1:2), with ages ranging from 1 month to 15.5years and 23 (57.5%) of them were under the age of 5 years. The four most common endocrine disorders were Rickets (45%), Diabetes (15%), Thyroid disorders (15%) and disorders of puberty (12.5%). There was a progressive yearly increase in the number of paediatric endocrine cases seen. At the time of this report, 34 (85%) of the patients were alive and doing very well, 5 (12.5%) has been lost to follow up and 1 (2.5%) mortality was recorded. CONCLUSION: Rickets, diabetes, thyroid disorders and disorders of puberty are the four leading paediatric endocrine disorders seen at UTH. Attrition is a notable challenge in paediatric endocrine disorders. Reasons for attrition and ways to terminate these challenges need to be identified and put into practice.

CONTEXTE: L'endocrinologie pédiatrique est une surspécialité naissante au Nigéria. Les rapports precedents suggèrent une mauvaise connaissance générale des troubles endocriniens pédiatriques entraînant une présentation tardive, un diagnostic manqué et une mort inutile. OBJECTIFS: L'étude vise à examiner la prévalence des troubles endocriniens pédiatriques au UTH et à fournir des informations essentielles pour améliorer la présentation et la prise en charge précoces. METHODES: Il s'agit d'une etude rétrospective de 10 ans de tous les enfants pris en charge pour des troubles endocriniens pédiatriques au UTH de mars 2010 à mars 2020. Les données pertinentes ont été extraites des dossiers des patients, entrées et analysées avec SPSS. RESULTATS: Quarante (0,42%) des 9 520 nouvelles consultations à la Clinique pédiatrique spécialisée UTH au cours de la période d'étude présentaient des troubles endocriniens. Il y avait 13 hommes et 27 femmes (M: F = 1: 2), âgés de 1 mois à 15,5 ans et 23 (57,5%) d'entre eux avaient moins de 5 ans. Les quatre troubles endocriniens les plus courants au UTH étaient le rachitisme (45%), le diabète (15%), les troubles thyroïdiens (15%) et les troubles de la puberté (12,5%). Il y avaitune augmentation annuelle régulière du nombre de cas endocriniens pédiatriques observés. Trente-quatre (85%) des patients sont vivants et se portent très bien, 5 (12,5%) ont été perdus de vue et 1 mortalité (2,5%) a été enregistrée. CONCLUSION: le rachitisme, le diabète, les troubles thyroïdiens et les troubles de la puberté sont les quatre principaux troubles endocriniens pédiatriques observés au UTH. L'attrition est un défi notable dans les troubles endocriniens pédiatriques. Les raisons de l'attrition et les moyens de mettre fin à ce défi doivent être identifiés et mis en pratique. MOTS CLÉS: Pédiatrie, troubles endocriniens, sensibilisation, rachitisme, diabète, Nigéria.

Epidemiological Transition in the Economic Community of West African States (ECOWAS): Evidence from the Global Burden of Disease 1990-2017.

INTRODUCTION: This study sought to explore the pattern of epidemiological transition in the Economic Community of West African States (ECOWAS). METHODS: We extracted data from the global burden of disease study. Countries were grouped using the Sociodemographic Index (SDI). The DisMod-MR 2.1, a Bayesian meta-regression tool, was used as the main method of estimating variations in epidemiologic data sources and other parameters. Examples of these included model predictions, as well as 95% corresponding uncertainty intervals for all death, Years of Life Lost, Years Lived with Disability, and DisabilityAdjusted Life Years (DALYs). RESULTS: The DALYs from Group 1 diseases were higher in all the countries in the region compared to those from non-communicable diseases (NCDs) and injuries, as well as total NCDs in 1990 and this was the same in the subregion in 2017, except in Cape Verde (with the highest SDI), where there were higher DALYs from NCDs/ injuries and the total NCDs than the Group 1 diseases. In 1990, deaths from Group 1 diseases were higher in all the countries in the region than those from the total NCDs except in Cape Verde, while in 2017, deaths from Group 1 diseases were higher than those from Total NCDs except in Cape Verde, the Gambia, Ghana, and Senegal. CONCLUSION: The overall pattern is that of concurrent communicable disease and increasing NCD burden with increasing SDI. Detailed understanding of these patterns and contextual factors are needed to help inform national and regional policies to address the epidemiological transition in the ECOWAS.

INTRODUCTION: Cette étude a cherché à explorer le modèle de transition épidémiologique dans la Communauté économique des États de l'Afrique de l'Ouest (CEDEAO). MÉTHODES: Nous avons extrait les données de l'étude sur la charge mondiale de morbidité. Les pays ont été regroupés à l'aide de l'indice sociodémographique (IDS). Le DisMod-MR 2.1, un outil de métarégression bayésienne, a été utilisé comme principale méthode d'estimation des variations des sources de données épidémiologiques et d'autres paramètres. Des exemples de ceux-ci comprenaient les prédictions du modèle, ainsi que les intervalles d'incertitude correspondants à 95 % pour tous les décès, les années de vie perdues, les années vécues avec une incapacité et les années de vie corrigées de l'incapacité (DALY). RÉSULTATS: Les DALY des maladies du groupe 1 étaient plus élevées dans tous les pays de la région par rapport à celles des maladies non transmissibles (MNT) et des traumatismes, ainsi que le total des MNT en 1990 et il en était de même dans la sous-région en 2017, sauf au Cap. Verde (avec le SDI le plus élevé), où il y avait des DALY des MNT/blessures plus élevées et le total des MNT que les maladies du groupe 1. En 1990, les décès dus aux maladies du groupe 1 étaient plus élevés dans tous les pays de la région que ceux du total des MNT sauf au Cap-Vert, tandis qu'en 2017, les décès dus aux maladies du groupe 1 étaient plus élevés que ceux du total des MNT sauf au CapVert, le Gambie, Ghana et Sénégal. CONCLUSION: Le schéma général est celui d'une maladie transmissible concomitante et d'un fardeau croissant des MNT avec l'augmentation du SDI. Une compréhension détaillée de ces modèles et facteurs contextuels est nécessaire pour aider à éclairer les politiques nationales et régionales pour faire face à la transition épidémiologique dans la CEDEAO. Mots clés: Transition épidémiologique, Afrique de l'Ouest, Maladie non transmissible, Maladie transmissible, Index sociodémographique.

Translation and psychometric evaluation of the Yoruba version of the STarT Back tool among persons with long-term non-specific low-back pain.

Conclusion: The Y-SBT have acceptable psychometric properties. It is recommended for use among Yoruba speaking patients with LBP. Background: Translating questionnaires into local languages is essential as it aids easy accessibility and understanding of such questionnaires by patients and their health caregivers. The STarT Back Tool (SBT), validated tool used to classify subgroups of persons with Low-Back Pain, has few translated versions. We translated the STarT Back Tool into the Yoruba language and established its psychometric properties among patients with long-term non-specific Low-Back Pain. Methods: Following the Lenz protocol, the SBT was successfully cross-culturally adapted into the Yoruba language. One hundred consenting patients (mean age = 57.0±11.43 years, 55% females) took part in the validation phase, while 53 of them participated in the test-retest phase. Psychometric indices of the Y-SBT assessed showed internal consistency, intraclass correlation coefficient (ICC), ceiling and floor effects and divergent validity. Results: The sub- and total Cronbach's α score for Y-SBT was 0.704 and 0.857, respectively. The test-retest reliability of the sub- and total scores of the Y-SBT yielded an ICC of 0.82 (95% CI: 0.74 - 0.87) and 0.89 (95% CI: 0.84 - 0.93), respectively. The divergent validity for sub- and total-scores of the Y-SBT based on Quadruple Visual Analogue Scale score for on-going pain was r = 0.374 (p = 0.001) and r = 0.432 (p = 0.001), respectively. The Y-SBT had no ceiling or floor effects.

Detection and molecular characterization of a first isolate of rabbit haemorrhagic disease virus in Nigeria.

Rabbit haemorrhagic disease virus (RHDV) was recovered from necropsied rabbits that died during an outbreak characterized by epistaxis, incoordination, paralysis, and multi-organ haemorrhages in Ilorin, Nigeria. The haemagglutination test (HA) and RT-PCR assay targeted against a fragment of the RHDV VP60 gene were performed on liver, spleen, and kidney homogenates; faeces; and urine obtained from the rabbits. Amplicons were purified, sequenced, and phylogenetically analysed. The liver homogenates yielded the highest HA titres while RT-PCR of liver, spleen, and kidneys yielded the expected 1252 bp band. Sequence and phylogenetic analyses revealed that the Nigerian RHDV strain (RHDV/NGR/ILN/001) was 98.57%, 97.95%, and 96.70% homologous with RHDV2 (RHDVGI.2) strains from the Netherlands, Germany, and France, respectively. RHDV/NGR/ILN/001 induced tracheal, intestinal, and mediastinal lymph node haemorrhages, pulmonary oedema and congestion, and enlarged, necrotic liver in experimentally inoculated rabbits. The implications of this study, which is the first report of RHDV in Nigeria, are discussed.

Assessment of microbial and heavy metal contamination in shallow hand-dug wells bordering Ona River, Southwest Nigeria.

Ona River is one of the three major rivers draining the city of Ibadan. Groundwater is the major source of drinking water in the metropolis; however, data on quality of shallow aquifers bordering Ona River is relatively scarce. This study aimed to evaluate bacteriological status, heavy metal content, and associated human and ecological health risks in hand-dug wells nearby Ona River. A total of 24 water samples from 12 sampling points were collected for chemical and microbial analyses. Heavy metals and microbial pathogens were analyzed using atomic absorption spectrometry and total plate count methods, respectively. Analyses of microbial and heavy metal (HMs) data showed that shallow hand-dug wells within the vicinity of Ona River were bacteriologically contaminated while most of analyzed heavy metals (except manganese) exceeded the drinking water quality standards. Interpretation of microbial and heavy metal (HMs) data identified predominance of anthropogenic activities as the major source of contamination in drinking water. Further scrutiny of HM data through integrated pollution indices identified two nearby wells (S7 and S8) exceed the safe limits and pose considerable risk to inhabitants. In terms of ecological risk index (ER), cadmium exhibited considerable to very high ER in all collected samples while manganese and zinc showed low ER in all analyzed water samples. Potential of non-carcinogenic risk through ingestion pathway in the study area was identified with the order of contributive ratios by HMs as Cd > Pb > Zn > Fe > Mn. The calculated target hazard quotient (THQ) due to ingested HMs for three human population categories exceeds the safe limit in the order of adult < children < infants. The study revealed the deteriorated state of waterside shallow hand-dug wells that need immediate actions by relevant stakeholders in water management. The study recommends improved hygienic practices, pretreatment of water before use, and most importantly, provision of potable pipe-borne water supply to the residents of the study area.

Infection prevention and control during COVID-19 pandemic: realities from health care workers in a north central state in Nigeria.

Health care workers (HCWs) are vulnerable to the risk of infections and could become vectors of onward transmission of coronavirus disease 2019 (COVID-19). Little is known about the factors which could contribute to increased COVID-19 infection among HCWs in Nigeria. We aimed at assessing the causes of COVID-19 infection among HCWs. We used a qualitative study design to conduct in-depth interview among 16 frontline HCWs participating in the COVID-19 response in Kwara State, Nigeria. Colaizzi's phenomenological method was used in the qualitative analysis of data. We found that HCWs were aware of their vulnerability to the COVID-19 infection, and the reasons attributed included poor knowledge of IPC measures for COVID-19, inadequate supply of personal protective equipment (PPE), poor political will and inadequate health facilities (HFs) management support. Improved political will and better involvement of HFs management teams in infection prevention and control (IPC) systems are needed to reduce the risk for COVID-19 infection among HCWs. We recommend scale-up training on IPC measures particularly hand washing and use of PPE as well as the development of effective points of care risk assessment with a high index of suspicion in HFs.

Prophylaxis with a multicomponent nutraceutical abates transient cerebral ischemia/reperfusion injury.

The effect of a multicomponent nutraceutical on cerebral ischemia/reperfusion injury in male Wistar rats was investigated. Animals were administered with the nutraceutical, Trévo™, for 7 days before 30 min of bilateral common carotid artery occlusion-induced cerebral ischemia and 24 hr of reperfusion. Behavioral assessment, biochemical estimations in the brain cortex, striatum, and hippocampus, and hippocampal histopathological evaluation were carried out after treatments. Results showed that ischemia/reperfusion-induced motor and cognitive deficits were abated in rats pretreated with Trévo™. Additionally, prophylaxis with Trévo™ blunted ischemia/reperfusion-induced redox stress, proinflammatory events, disturbances in neurotransmitter metabolism, mitochondrial dysfunction, and histoarchitectural aberrations in the discreet brain regions. In summary, supplementation with Trévo™ provided neuroprotection to rats against transient cerebral ischemia/reperfusion injury and could be explored as a promising approach in stroke prevention. PRACTICAL APPLICATIONS: There is a worldwide increase in the incidence of cerebral ischemia or stroke. Although an advanced health care system and effective control of risk factors have led to the declining incidence in developed nations, a definitive cure for stroke remains elusive and the situation is growing worse in developing nations. The results of the present study revealed that supplementation with Trévo™ ameliorated neurobehavioral, neurochemical, and histopathological consequences of brain ischemia/reperfusion injury and could, therefore, be beneficial in stroke prevention and management.

PREVALENCE AND PREDICTORS OF EXCLUSIVE BREASTFEEDING AMONG MOTHERS IN A SEMI-URBAN NIGERIAN COMMUNITY: A CROSS-SECTIONAL STUDY.

Background: The uptake of exclusive breastfeeding (EBF) is low globally including Nigeria despite its benefits and interventions. This study aimed to assess the prevalence and predictors of EBF among mothers in a semiurban Nigerian community. Methods: We conducted a cross-sectional study among nursing mothers attending the immunization clinic at the Federal Medical Centre, Owo, Ondo State. A semi-structured questionnaire containing the World Health Organization's indicators for assessing breastfeeding practices was used for data collection. Results: A total of 386 mothers were recruited with a mean age of 30.8 ± 5.0 years. Among them, 149 (36.8%) were below 30 years, 345 (89.4%) have had ANC visit at least four times, and 259 (67.1%) had initiated breastfeeding immediately after delivery. The prevalence of EBF was 52.6%. Natural feeds were the common feeds introduced after 6 months among 159 (78.3%) mothers. One hundred and forty-four (62.1%) nursing mothers aged 30 years or older practiced EBF compared to 72 (48.3%) persons below 30 years (X2 = 6.290, p = 0.012). Also, 38 (70.3%) mothers who have delivered four or more children practiced EBF compared to 180 (54.2%) with fewer children (X2 = 5.437, p = 0.020). Nursing mothers aged 30 years or older had 36% higher odds of practicing EBF compared to younger persons (Adjusted Odds Ratio = 1.358, 95%CI = 0.886 - 2.081, p = 0.160). Conclusion: To achieve the WHO recommended target of ensuring that 90% of nursing mothers practice EBF, advocacy and health education must be intensified.

RISK PERCEPTION, KNOWLEDGE, ATTITUDE AND PRACTICES TOWARDS COVID-19 AND LASSA FEVER PREVENTION AMONG DOCTORS AND NURSES IN A TREATMENT CENTRE IN NIGERIA.

BACKGROUND: Infection Prevention and Control practices are required to manage COVID-19 and Lassa fever (LF). We aimed to assess COVID-19 and LF risk perception and knowledge, attitude, and practices (KAP) towards prevention among doctors and nurses in a treatment centre in Ondo State, Nigeria. METHODS: We conducted a comparative cross-sectional study using semi-structured interviewer-administered questionnaires. We computed KAP scores with "+1" for correct response and "0" for incorrect response. Cumulative scores >80% implied good KAP of LF and COVID-19. Chi-square test was used to assess associations between sociodemographic characteristics and COVID-19 and LF KAP. P-values<0.05 were statistically significant. RESULT: The mean age of respondents was 37.81±8.46 years. Risk perception scores were 2.82±0.53 for LF and 2.76±0.58 for COVID-19 (p=0.002). Mean overall knowledge scores towards prevention were 18.48±2.08 for LF and 15.59±3.22 for COVID-19 (p<0.001). Practices towards prevention scores were 18.18±2.27 for LF and 15.89±1.47 for COVID-19 (p<0.001). Concerning LF, 72.8% of doctors had good knowledge of prevention compared to 42.9% nurses (p<0.001), 18.3% of doctors had good attitude to LF prevention compared to 27.2% nurses (p=0.039). Also, 84.8% nurses had good LF preventive practices compared to doctors (64.5%) (p<0.001). A strong positive correlation (r=0.72) existed between COVID-19 and LF risk perception (p<0.001). CONCLUSION: Continuous on-the- job trainings are needed among doctors and nurses in LF and COVID-19 treatment centres.

REOPENING OF EDUCATIONAL INSTITUTIONS AMID THE COVID-19 OUTBREAK: NIGERIA'S PREPARATION FOR THE MITIGATION OF SCHOOL-ASSOCIATED COVID-19 RISKS.

The global spread of the novel Coronavirus disease (COVID-19) has necessitated the implementation of non-pharmaceutical public health measures globally, including school closure. After five months of school closures, the Nigerian government is planning towards the suspension of school lockdown. However, in a bid to ensure that schoolchildren are academically equipped, and measures such as adequate ventilation, handwashing, social distancing, and increased infrastructure need to be implemented to ensure that school reopening does not result to a spike in COVID-19 cases and fatalities in Nigeria.

Atopy in HIV-infected children attending the pediatric antiretroviral clinic of LAUTECH Teaching Hospital, Osogbo.

BACKGROUND: Atopy is poorly researched in HIV children living in the developing countries. There is no previous report on this subject in Nigeria and this pioneering study is undertaken to create an awareness of the burden of this disease among health practitioners. AIMS: The aim of this study was to document the atopic diseases present among HIV-infected children attending the antiretroviral (ARV) clinic of a Nigerian tertiary hospital. METHODS: Information was obtained from consecutive consenting caregiver/HIV-infected child attending the pediatric ARV clinic, by the use of a proforma specifically designed for the study. The data obtained were analyzed using Statistical Package for the Social Sciences (SPSS) software program, version 16.0. RESULTS: Seventy patients were studied and their ages ranged between 2 and 17 years. These 70 were constituted by 34 (48.6%) boys and 36 (51.4%) girls. Ten (14.3%) of the 70 studied, had atopic diseases. Nine (12.9%) patients had allergic conjunctivitis and 1 (1.4%) had allergic rhinitis. The single patient with allergic rhinitis also had bronchial asthma. No case of atopic eczema, or food allergy was recorded. Atopic disease conditions were more commonly recorded among the male sex and those whose parents have atopic diseases (P < 0.05). Atopic diseases were also more common among children without advanced HIV diseases and those with eosinophilia. Cosmetic and psychological embarrassment from eye discoloration and itching were the negative impacts on the quality of living. CONCLUSION: Allergic conjunctivitis is common in HIV-infected Nigerian children. Atopies are more common in boys and children with parental atopies.

Modulation of key enzymes linked to Parkinsonism and neurologic disorders by Antiaris africana in rotenone-toxified rats.

Background The physiopathologies of many neurologic diseases are characterized by related biochemical dysfunctions that could be explored as drug targets. This study evaluated the effect of a methanol leaf extract of Antiaris africana (MEA) on critical bioindices of Parkinsonism and related neurologic dysfunctions in rats with rotenone-induced neurotoxicity. Methods Animals were administered 50 or 100 mg/kg MEA for 14 consecutive days. Rotenone (1.5 mg/kg) was administered three times per day on days 13 and 14. Coenzyme Q10 (5 mg/kg) was the reference drug. Complex I activity, dopamine level, activities of acetylcholinesterase, myeloperoxidase, Na+/K+ ATPase and glutamine synthetase, as well as oxidative stress indices were evaluated at the end of the period of treatment. Results Rotenone-intoxicated group showed disruption of complex 1 activity, dopamine level, and glutamine synthetase activity with negative alterations to activities of acetylcholinesterase, myeloperoxidase, and Na+/K+ ATPase as well as heightened cerebral oxidative stress. MEA restored brain mitochondria functionality, mitigated altered neurochemical integrity, and ameliorated cerebral oxidative stress occasioned by rotenone neurotoxicity. The activity of A. Africana was comparable with that of 5 mg/kg coenzyme Q10. Conclusions These results indicated that A. africana displayed therapeutic potential against Parkinsonism and related neurologic dysfunctions and support its ethnobotanical use for the treatment of neurologic disorders.