Impact of political conflict on tuberculosis notifications in North-east Nigeria, Adamawa State: a 7-year retrospective analysis.

OBJECTIVE: We assessed the impact of political conflict (Boko Haram) on tuberculosis (TB) case notifications in Adamawa State in North-east Nigeria. DESIGN: A retrospective analysis of TB case notifications from TB registers (2010-2016) to describe changes in TB notification, sex and age ratios by the degree of conflict by local government area. SETTING: Adamawa State. PARTICIPANTS: 21 076 TB cases notified. RESULTS: 21 076 cases (62% male) were notified between 2010 and 2016, of which 19 604 (93%) were new TB cases. Areas affected by conflict in 2014 and 2015 had decreased case notification while neighbouring areas reported increased case notifications. The male to female ratio of TB cases changed in areas in conflict with more female cases being notified. The young and elderly (1-14 and >65 years old) had low notifications in all areas, with a small increase in case notifications during the years of conflict. CONCLUSION: TB case notifications decreased in conflict areas and increased in areas without conflict. More males were notified during peace times and more female cases were reported from areas in conflict. Young and elderly populations had decreased case notifications but experienced a slight increase during the conflict years. These changes are likely to reflect population displacement and a dissimilar effect of conflict on the accessibility of services. TB services in conflict areas deserve further study to identify resilient approaches that could reach affected populations.

Rare occurrence of mix stromal tumours: a case report of gastrointestinal and extra-intestinal stromal tumour on the jejunum and omentum of a nine year old girl from Adamawa State, Nigeria.

BACKGROUND: Stromal tumors of the jejunum (GIST) and omentum (EGIST) are uncommon and dearth of information still exists on their occurrence concurrently. CASE DETAILS: Here, we report a nine year old girl that presented with tender abdominal mass measuring 14 × 8 cm associated with features of gastric outlet obstruction and hyponatremia of 115mmol/L. A diagnosis of hyponatremia in a child with gastric outlet obstruction secondary to intraabdominal mass was made for which exploratory laparotomy was carried out. Histology of the tumour revealed stromal spindle epithelioid as well as myxoid cells. Complete resection of the tumour and correction for hyponatremia was done in addition to antibiotics therapy with remarkable improvement. CONCLUSION: Index case is that of mixed stromal tumours that presented with features of gastric outlet obstruction, and the patient did well after surgery.

The effects of weathering demonstrated by maternal age on low birth weight outcome in babies.

BACKGROUND: Increasing age has been hypothesized with wear and tear (weathering) in mothers, which may result to low birthweight of their babies. The prevalence of low birthweight could be heightened if maternal weathering is associated with poor maternal socioeconomic variables. In this current study, we analyzed the effects of maternal weathering on babies' birthweights. METHODS: One hundred and twenty four mother-baby pairs were selected using systematic random sampling method. Maternal age formed part of the demographic data that was obtained from the mothers' case notes and from interviews held with them. Maternal socioeconomic variables were assessed using Oyedeji's parameters and birthweights of babies were determined using bassinet weighing scale. Associations between maternal socioeconomic variables and birthweight of babies were assessed using univariate analysis. Differences in mean birthweight of babies according to their maternal age were evaluated using one-way analysis of variance ANOVA. RESULTS: Among the 124 babies, 66(53.2%) were males and 58(46.8%) females of whom the majority 104(83.9%, had normal birthweight. The mean birthweight of babies was 3.05±0.57 (95% CI, 2.95-3.15) kg, while the mean maternal age was 23.60 (5.2) 95% CI, (22.68-24.52) years. The difference between mean birthweight of babies and mean maternal age was not significant (F=1.35, p=0.255). Similarly, the association between birthweight, maternal education and occupation computed using univariate analysis was not significant (F=2.163, p=0.120) for education and (F=1.825, p=0.166) for occupation. CONCLUSION: In this study, maternal weathering was not found to be associated with LBW outcome. This implies that an increase in maternal age may not be significantly associated with LBW. However, there is need for further research on this subject from different centers using larger sample size in order to enhance the precision of the study.

Using the effects of maternal nutritional indicators (hemoglobin and total protein) on baby's birth weight outcome to forecast a paradigm shift toward increased levels of non-communicable diseases in children.

BACKGROUND: Maternal malnutrition can lead to low birth weight in babies, which puts them at risk of developing non-communicable diseases later in life. Evidence from developed countries has shown that low birth weight is associated with a predisposition to higher rates of non-communicable diseases later in life. However, information on this is lacking in developing countries. Thus, this work studied the effects of maternal nutritional indicators (hemoglobin and total protein) on birth weight outcome of babies to forecast a paradigm shift toward increased levels of non-communicable diseases in children. MATERIALS AND METHODS: Mother-baby pairs were enrolled in this study using systematic random sampling. Maternal haemogblobin and total proteins were measured using micro-hematocrit and biuret methods, and birth weights of their babies were estimated using the bassinet weighing scale. RESULTS: Of the 168 (100%) babies that participated in this study, 122 (72.6%) were delivered at term and 142 (84.5%) had normal birth weights. Mean comparison of baby's birth weight and maternal hemoglobin was not significant (P = 0.483), that for maternal total protein was also not significant (P = 0.411). Even though positive correlation coefficients were observed between birth weight of babies, maternal hemoglobin and total proteins, these were however not significant. CONCLUSION: Maternal nutrition did not contribute significantly to low birth weight in our babies. Therefore, association between maternal nutrition and low birth weight to predict future development of non-communicable diseases in our study group is highly unlikely. However, we recommend further work.

State of personal hygiene among primary school children: A community based cohort study.

Good personal hygiene in primary school children could be effective towards preventing infectious diseases. This work examined personal cleanliness of primary school children in Banki based on the following variables: bathing, state of uniforms, hair, nails and oral hygiene. One hundred and fifty primary school children in Banki community were selected using the cluster random sampling method. Analysis of variance was used to compare means and to test for significance of data, and coefficient of correlation to investigate the relationship between cleanliness and age of subjects. There were 87 (58 %) boys and 63 (42 %) girls in a ratio of 1.4:1. Ninety six (64 %) pupils belong to low socioeconomic class. Whereas, 53 (35.3 %) were found within 11-13 years age group, the overall mean age was 9 years (Standard deviation [SD] was 2.2), 95 CI (7.0 - 11.0) years. Comparing means for the different categories of personal hygiene, there was significant difference (F= 61.47, p < 0.0001). General personal cleanliness in our participants improved with age, and a positive significant correlation was observed between age and personal cleanliness in (r = 0.971, p = 0.026). In conclusion, significant number of primary school pupils in Banki community had good personal hygiene, which was observed to be directly proportional with age. Therefore, all efforts towards quality health education on personal hygiene as a means of primary prevention of illnesses in primary school pupils should be sustained.

Newborn measles antibody profile in a teaching hospital: Can sex of babies determine measles IgG acquisition from their respective mothers?

Known sex specific differences in fetal, neonatal morbidity and mortality have been documented. Sex differences also exist in birth-weight centile with males being larger than females at birth. However, these sex differences are not fully explored when studying passive measles immunity acquired by babies from their mothers. Moreover, the mechanisms that confer these sex differences are to a large extent unknown. Therefore, this study assessed sex of babies as a determinant of measles immunoglobulin G acquisition from their respective mothers. One hundred and seventy four newborn babies were enrolled in this study. Enzyme linked immunosorbent assay was used to measure maternal measles antibodies (MMA) from sera collected from these babies at birth. Gestational age of the newborn babies was determined using the Nagele rule, ultrasound scan reports and the Dubowitz criteria. Sex and mean MMA of these babies was compared using the Student's t test. Significant comparison existed between mean MMA and sex of post term babies (P = 0.000), such that post term males had higher levels of MMA than females. However, overall sex and mean MMA comparison of these babies was not significant (P = 0.977). There were more MMA in male post term babies relative to their female peers; however, overall sex comparison of MMA was not significant. Therefore, there is the need for further study.

A sero-survey to identify the window of vulnerability to measles in infants in North-Eastern Nigeria

As infants lose maternal measles antibodies (MMAs); they experience periods when their antibody levels are insufficient to protect them against measles. A prospective study was carried out at the University of Maiduguri Teaching Hospital. Sera collected from neonates at birth; and at six weeks; three months; six months and nine months of age; were analysed for MMAs by enzyme-linked immunosorbent assay. Seventy-seven neonates were enrolled. Of these; 73 (94.8) had protective MMAs at birth. This figure declined to 36 (46.8); 28 (36.4); 13 (16.9) and 4 (5.2) at six weeks; three months; six months and nine months of age (?2 = 154.264; p-value = 0.000). Protective MMAs at birth waned rapidly; resulting in an early window of vulnerability to measles by the age of six months. Protecting infants with early measles immunisation with potent; safe vaccines are recommended