Prevalence and risk factors of Hepatitis D virus antibody among asymptomatic carriers of Hepatitis B virus: a community survey.

Background: Hepatitis D virus (HDV) can cause a chronic infection in the presence of hepatitis B surface antigen and contribute to the burden of chronic liver disease especially in regions where chronic hepatitis B virus (HBV) infection is endemic. Aim: To determine the prevalence and risk factors of HDV among asymptomatic carriers of HBsAg in Cross River State, Nigeria. Methods: This was a cross-sectional study conducted among apparently healthy adults resident in Cross River State, Nigeria. A structured questionnaire was used to collect socio-demograhic data and risk factors for HBV/HDV infection. Participants blood samples were screened for HBsAg. Samples that were HBsAg positive were further screened for anti-HDVIgM. Statistical analysis was performed using statistical package for social sciences (SPSS) version 20. Results: A total of 90 HBsAg positive samples were assayed. The prevalence of anti-HDV IgM was 5.6% (95% CI 1.1-10.1). The HDV positive subjects were mostly females (80%), reported family size of >5 members (80%), had female circumcision (75%) and took injections from Non-certified health care practitioners (NCHCPs). None of the assessed risk factors were significantly associated with HDV infection (p >0.05). Conclusion: Hepatitis D virus is moderately prevalent amongst asymptomatic HBsAg carriers in Cross River State, Nigeria.

Comparison of cold water sponging and acetaminophen in control of Fever among children attending a tertiary hospital in South Nigeria.

BACKGROUND: A wide range of childhood illnesses are accompanied by fever, leading to varied attempts at treatment by caregivers at home before coming to a hospital. Common modalities of treatment include use of antipyretics and physical methods such as cold water sponging, fanning and removal of clothing. These treatment modalities have been received with varied attitudes among physicians and the scientific community. This study was to assess the efficacy of both modalities in first-line management of fever in our area. OBJECTIVES: The main aim of the study is to compare the effectiveness of cold water sponging with that of oral paracetamol in the treatment of fever in children attending the University of Calabar Teaching Hospital, Calabar. SUBJECTS AND METHODS: This is a randomized clinical trial. Eighty-eight children aged 12-120 months who presented to the Children Outpatient Clinic (CHOP) and the Children Emergency Room (CHER) of University of Calabar Teaching Hospital, Calabar, with acute febrile illness and axillary temperatures spanning ≥ 38.0-40.0°C. All children within the age limit whose caregivers gave consent were recruited into the study and were randomized to receive either cold water sponging or oral paracetamol. Axillary temperature, pulse rate, respiratory rate and assessment of discomforts (crying, shivering, goose pimples and convulsions) were recorded every 30 min for 2 h. The results were analyzed using the SPSS statistical software and have been presented in the tables. RESULTS: Cold water sponging was very effective in temperature reduction within the first 30 min, with 29 (70.73%) having their temperature reduced to within normal limits. This declined to 12 (29.26%) at 60 min and 4 (10.53%) at 120 min, with the mean temperature differences from the baseline value following the same trends (1.63°C by 30 min, 0.91°C by 60 min and 0.39°C by 120 min). When compared with paracetamol, cold water sponging was more effective in temperature reduction within the first 30 min (P = 0.000), with the difference in effect at 60 min less significant between these two groups (P = 0.229). Paracetamol demonstrated a gradual and sustained reduction in temperature with the proportions of afebrile children in this group increasing from 7 (16.27%) at 30 min to 33 (78.57%) at 120 min. The mean temperature differences from the baseline value also showed the same trend. Children who received cold water sponging had more discomforts compared with those who received only oral paracetamol. CONCLUSIONS: It is concluded that cold water sponging, although producing rapid reduction in temperature compared with paracetamol, has effects that last only for a short time. Paracetamol on the other hand produces a gradual but sustained effect. The discomforts experienced should not be a limiting factor to the use of cold water sponging in reducing the body temperature of febrile children. Cold water sponging is safe and its use by mothers and primary caregivers should be encouraged while preparing to take the child to the nearest health facility for definitive treatment of the underlying cause of the fever.