Epidemiology of Dengue in patients with febrile syndrome at Saint Camille Hospital, Ouagadougou, Burkina Faso from 2020 to 2

: Dengue is still a public health problem in tropical countries. This disease, which had almost disappeared in some areas of the world, has become re-emergent in certain parts of the world including Africa.The aim of this study is to determine the seroprevalence and evolution of Dengue virus (DENV) infection from 2020 to 2021 at the Hospital Saint Camille de Ouagadougou (HOSCO), Burkina Faso. Methodology: This was a descriptive analytical study of patients seen in general practice with febrile syndrome referred for serological diagnosis of Dengue at the HOSCO laboratory over a period of 2 years (January 1, 2020 ­ December 31, 2021). The "Dengue Duo (AgNS1/IgM/IgG)" kit from SD Bioline was used for the rapid diagnosis through the detection of NS1 antigen and IgM/IgG antibodies in plasma. Data were analysed with SPSS version 20.0 software. Association between demographic data and prevalence of DENV infection was determined by Chisquare test and odds ratio (with 95% confidence interval). P value less than 0.05 was considered statistical significance. Results: A total of 2957 patients aged 0-94 years were referred for serological diagnosis of DENV infection at the HOSCO laboratory over the period 2020-2021, comprising 56.3% females and 43.7% males. The overall prevalence of acute DENV infection (NS1Ag positive) was 5.4% (159/2957), with 2.4% (41/1700) in 2020 and 9.4% (118/1257) in 2021 (OR=4.192, 95% CI=2.915-6.028, p<0.0001). The prevalence of acute DENV infection of 7.0% (91/1292) in the males was significantly higher than 4.1% (68/1665) in the females (OR=1.779, 95% CI=1.288-2.458, p=0.0005), and also significantly higher in age groups 20-29 years (7.6%), 10-19 years (6.9%) and 40-49 years (5.8%) than other age groups (X 2=14.928, p=0.0107). The overall prevalence of DENV IgM and IgG antibodies was 3.2% and 37.3% respectively. The prevalence of DENV IgG antibodies was significantly higher in males (44.0%) than females (32.1%) (OR=1.667, 95%CI=1.434-1.938, p<0.0001) and in age groups 30-39 (43.4%), 40-49 (44.0%) and >50 years (49.3%) than other age groups (X2=121.0, p<0.0001), indicating that past exposure to DENV infection is higher among males and older age groups. The peak of DENV infection was between October and November with 84.3% (134/159) of NS1Ag positivity occurring during this period. Conclusion: The present study reports a high prevalence of acute Dengue virus infection in patients from October to November. To eradicate Dengue which has become a tropical silent epidemic, interventions such as vector control, availability of and accessibility to diagnostic tests, and good therapeutic management are of great importance

Outcomes of tuberculosis treatment in a tertiary health facility in north-central Nigeria

Background: Tuberculosis (TB) remains a major public health concern despite being a curable and preventable disease. The treatment of TB using a cocktail of drugs over a period of six months under the directly observed treatment short-course strategy has led to a reduction in cases but is plagued by some challenges that leads to unsuccessful or poor outcomes, which can ultimately result in spread of infections, development of drug resistance and increase in morbidity and mortality. The objectives of this study are to determine outcomes of TB treatment in Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria and the factors that may be associated with the outcomes. Methodology: This was a retrospective study using the medical records of patients who were registered for TB treatment over a five-year period between 2016 to 2020. Data from TB registers including demographic and relevant clinical information, and treatment outcomes, were extracted into a structured data extraction format, and analysed with SPSS version 21.0 software package. Univariate and bivariate analyses were conducted, and Chi square test was used to determine association between TB outcomes and independent variables at 95% confidence interval and p<0.05 was considered as the significant value. Results: Records of 1,313 patients were studied, 744 (56.7%) were males while 569 (43.3%) were females. The age range of the patients was ≤ 1 year - 96 years, with a mean age of 30±16.7 years. Most were pulmonary TB cases (88.8%, n=1,166), newly diagnosed (95.5%, n=1254), and human immunodeficiency virus (HIV) negative at the time of TB diagnosis (63.7%, n=837). Eight hundred and seven (61.5%) patients had successful treatment, and 34% (n=446) had unsuccessful outcomes made of 'loss to follow-up' 25.8% (n=339), deaths 7.8% (n=102) and treatment failure 0.4% (n=5), while 2.3% (n=30) were transferred out and 2.3% (n=30) removed from TB register. Treatment success rate was significantly higher in patients with pulmonary TB (p=0.0024), residents in Lafia LGA (p=0.0005), those treated in 2016 (p=0.0006) and bacteriologically confirmed cases (p<0.0001), while death rate was significantly lower among patients who were HIV-negative at the time of TB diagnosis (p<0.0001). Conclusion: TB treatment success rate in this study fell short of the WHO average rate. High rates of 'loss to followup' and deaths in this study is a wake-up call to all stakeholders in the facility and the State to put in place measures to reduce poor outcomes of TB treatment.

HIV Infection among children aged two years to less than eighteen years admitted to the Emergency Pediatric Unit in a tertiary health facility in Lafia North-Central Nigeria

BACKGROUND: Human Immunodeficiency virus (HIV) is a retrovirus that impairs the immune system by attacking the body's natural defense from infections and diseases. Pediatric HIV continue to be a major public health problem despite the global decline in its seroprevalence rates. The decline in the incidence of new HIV infections is particularly lower in children with a 52% reduction in the last ten years. This is attributed to a wider coverage in the use of antiretroviral therapy (ART) and the prevention of mother to child transmission of HIV (PMTCT) programs. Several programs designed at curtailing mother to child transmission of HIV are yielding positive result. This is not unexpected since most of the HIV infections among children were acquired via maternal to child transmission. With this, the study sets out to determine the prevalence of new HIV infection among patients admitted to the Emergency Pediatrics Unit (EPU) using the provider-initiated testing and counseling approach. METHODS: A prospective cross-sectional descriptive study was conducted at the mini laboratory attached to the EPU of the Dalhatu Araf Specialist Hospital Lafia Nasarawa State between 1st August 2017 to 31st July 2018. Using non-probability sampling, categorical variables were analyzed as frequencies and percentages. The association between categorical variables were analyzed using chi square.RESULTS: A total of 964 children ranging in age from two to less than eighteen years were screened. The total number of males was 550 (57.1%) while females was 414 (42.9%) with a male to female ratio of 1.3:1. Five (0.5%) children were newly diagnosed with HIV of the 964 children tested for the infection. CONCLUSION: The incidence of HIV infection among children admitted into our Emergency Pediatric Unit was 0.5%, comparable to some earlier reports

Intelligence quotient of neurologically impaired children attending neurology clinic in a nigerian tertiary institution

Background: The need to identify the intellectual capability of neurologically impaired children dictates their educability which can be estimated through their intelligence quotient (IQ). Draw-a-man test for IQ estimation is available, easy and has been validated in Nigeria. Method: Through a prospective, cross-sectional study that lasted 12 months (January-December, 2011), children aged 4 years and above attending neurology clinic were recruited once they have no severe motor or sensory limitations affecting their upper limbs and can obey the instruction to draw a person. Anthropometry was carried out on them and they were comfortably seated to draw a person. The parents or caregivers were instructed not to make any suggestion or hint to them and no time limit was given. Their drawings were assessed using the 52 parameters of Ziler and interpreted accordingly. Ethical procedures were adhered to. The analysis was done using SPSS version 16 and an interactive calculation tool for chi-square tests of goodness of fit and independence. Results: Seventy-five (45 male, 30 female) children met the inclusion criteria. Their clinical conditions were Epilepsy 48 (64%), Cerebral Palsy 6 (8%), ADHD 5 (6.7%), Down Syndrome 4 (5.3%), Speech/Hearing impairment 3 (4.0%), Hypothyroidism 2 (2.7%) and 7 (9.3%) others. Their ages ranged from 4 years to 16 years (mean±SD = 9.7± 3.8 years). Their IQ distribution were Normal 4 (5.3%), Borderline 12 (16.0%), Mild Mental Retardation 16 (21.3%), Moderate Mental Retardation 19 (25.3%), Severe and Profound Mental Retardation 24 (32.0%) with no significant difference in relation to their birth order. Conclusions: Ninety-six per cent of the study population had IQ below normal. Epilepsy was the commonest condition seen in the Paediatric Neurology clinic and all categories of IQ are seen among children with epilepsy

Do women want disclosure of fetal gender during prenatal ultrasound scan?

BACKGROUND/OBJECTIVES: It is possible that not all women would want the disclosure of fetal gender by the sonologist during a prenatal scan. The objectives of this study were to determine the proportion of women who do not want fetal gender disclosure at the time of prenatal ultrasonography and document their reasons. METHOD: A cross-sectional survey of women that were 20 weeks or more pregnant that had prenatal ultrasound at a private health facility in January 2006. The sonologist asked each of the women during the procedure whether they wanted to know fetal sex or not. Those that consented had disclosure of fetal sex while those that declined gave their reasons, which were documented. RESULTS: Two hundred and one (201) women were studied within the study period. Most of the women (82%) were of the Hausa/Fulani ethnic group and were predominantly of the Islamic faith (90%). One hundred and ninety women (94.5%) consented to disclosure of fetal gender, while eleven (5.5%) declined. The main reason for not wanting to know fetal sex was: 'Satisfied with any one that comes'. CONCLUSION: Most of the pregnant women (94%) would want disclosure of fetal gender at prenatal ultrasound scan. Only 5.5% of the women would not want fetal sex disclosure because they were satisfied with whichever that was there. It is advisable for the sonologist to be discrete on what to say during the procedure especially as it relates to fetal sex so as not to hurt those that do not want disclosure.

The Impact of Training on Malaria Treatment Practices: a Study of Patent Medicine Vendors in Birnin-kebbi

Background: Patent medicine vendors are major providers antimalaria treatment in Nigeria. The management of malaria by this informal sector of healthcare delivery is however dominated by negative practices. This study determines the influence of training on antimalaria treatment practices of patent medicine vendors. Methods: Fifty-five patent medicine vendors selected through a multistage sampling technique in Birnin-Kebbi were recruited into the study. Their baseline treatment practices were determined and the negative ones identified. Intervention training was instituted and its impact assessed using a interviewer-administered questionnaire. Simulated visit mystery client survey which involved direct observation of patent medicine vendors practice was conducted after the intervention and the results compared with self reported post intervention practices. Results: The negative practices identified included inappropriate dosage regimen; frequent unnecessary use of injectables and alteration of physicians' prescriptions. Following the intervention training of the patent medicine vendors; the overall appropriate treatment practice score rose from baseline value of 3.6to 45.5(p0.05) and significantly lower than the post training values (p0.05) and was significantly lower than the post intervention values (p

Antihypertensive effect of an aqueous extract of the calyx of Hibiscus sabdariffa.

The present study was designed to investigate the efficacy of an aqueous calyx extract of Hibiscus sabdariffa (HS) in two forms of experimental hypertension: salt-induced and L-NAME (N(omega)-L-arginine methyl ester)-induced and in normotensive controls. The blood pressure and heart rate fell dose-dependently in both the hypertensive and normotensive rats after intravenous injection of 1-125 mg/kg of HS, suggesting that HS possesses anti-hypertensive, hypotensive and negative chronotropic effects. The fall in mean arterial pressure was significantly pronounced in the hypertensive rats (salt-induced: 94.4+/-8.6 mm Hg; L-NAME-induced: 136.5+/-10.3 mm Hg) than in the normotensive controls (50.2+/-5.1 mm Hg; P<0.05).

Clusters of eclampsia in a Nigerian teaching hospital.

OBJECTIVE: To describe the pattern of eclampsia between 1995 and 2004 at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, northwestern Nigeria. STUDY DESIGN: A retrospective cohort of all deliveries and eclamptics seen from 1st January 1995 to 31st December 2004. Clusters of eclampsia were identified using purely temporal scan statistics. RESULTS: Of 15,318 deliveries during the period, 657(4.29%) had eclampsia. The yearly incidence of eclampsia at the beginning of the study period (1995) was 0.39% but this had increased to 7.0% in 2004 at a background exponential rate best described by quadratic curve fitting prediction model and a forecast curve that predicts an incidence of eclampsia of at least 32.4% of total deliveries by 2009. Temporal clusters occurred in 1996, 2001 and 2003-2004. CONCLUSION: The incidence of eclampsia is unusually high and is increasing. It has shown 3 clusters in the last 10 years.

How we may be missing some harmful effects of ultrasound--a hypothesis.

In spite of documented effects of ultrasound on living cells in vitro, we have not been able to consistently demonstrate adverse effect after in-utero fetal exposure. This may be because we have used traditional obstetricians' 'week' as the time frame of reference and/or because we have based most studies on the concept of 'biologically plausible' hypotheses. However, large and vulnerable transformations occur in-utero in very short time frames during organogenesis and our knowledge of the functionality of organs at various stages of development is still rudimentary. Using time frames in 'weeks of gestation' may cause large effects to appear small and insignificant. In first trimester fetal exposures, a time frame of '1 day' may be more appropriate. We may need to re-evaluate the safety of diagnostic ultrasound using much shorter in-utero time frames. This may either expose hidden adverse effects of ultrasound or give further reassurance of its safety.

Preliminary toxicity and phytochemical studies of the stem bark aqueous extract of Musanga cecropioides in rats.

These studies were designed to determine the preliminary oral toxicity profile of the crude aqueous stem bark extract of Musanga cecropioides (MCW) in adult Sprague-Dawley rats and its active chemical constituents by way of phytochemistry. The acute oral toxicity study was conducted using limit dose test of Up and Down Procedure according to the OECD/OCDE Test Guidelines on Acute Oral Toxicity (AOT425statPgm, version: 1.0) at a limit dose of 3,000 mg/kg body weight/oral route. Repeat dose oral toxicity studies were conducted by daily oral dosing of 750 mg/kg body weight of MCW dissolved in 1 ml of 0.9% saline and 1 ml of 0.9% saline to rats in the test and control groups, respectively, for 28 days. On day 29, blood samples for bioassays were collected by cardiac puncture under diethyl ether anesthesia. The phytochemical analysis was conducted using standard procedures. The LD(50) estimate of the extract was calculated to be greater than 3,000 mg/kg body weight/oral route. The extract caused a significant (P<0.05) decrease in weight gain, differential eosinophil count and increase in serum creatinine but did not affect the organ weights, other serum electrolytes (Na(+), K(+), HCO(3)(-)), liver enzymes and other hematological indices in test rats. Its phytochemical analysis showed it contains saponins, flavonoids, alkaloids, tannins, phlobatannins, glycosides, reducing sugars and anthraquinones. These results show that the aqueous extract of Musanga cecropioides is relatively safe toxicologically when administered orally. Thus, its use in folkloric medicine as an oral antihypertensive is relatively safe when used over the tested period.