KNOWLEDGE, RISK PERCEPTION AND PREVENTIVE PRACTICES OF COVID-19 AMONG STAFF OF PRIMARY AND SECONDARY SCHOOLS IN KADUNA STATE, NIGERIA.

INTRODUCTION: Kaduna State is among the three States with the highest number of confirmed COVID-19 cases. The objective of this study was to assess the knowledge, risk perception and practices of staff towards prevention and control of COVID-19 infection in schools to provide policy makers, education and health managers required information to manage the epidemic as the schools prepare to re-open. METHODS: This was a school-based survey conducted using purposive sampling of 55 schools located in nine LGAs with the highest number of reported COVID-19 cases as at October 2020. Five schools with the highest students'/pupils' enrollment in each of the LGA were selected and all staff were interviewed. Information on knowledge, risk perception and practices of prevention was collected. Descriptive statistics were generated using Stata v14 software. RESULTS: A total of 1065 staff in 55 schools completed the interview. Major sources of information are television (73%), radio (61%), and social media (57%); and 76% indicated that a virus is the causative agent of COVID-19. Overall, 70%, 19%, 7%, 9.3% and 0% respectively had adequate knowledge of cause, preventive measures, respiratory hygiene, modes of transmission and symptoms of COVID-19; however only 14% ever attended a workshop on COVID-19. Eighty-two percent and 89% respectively believed in the efficacy of face masks and handwashing as means of prevention; 39% thought that they are likely to contract COVID-19. Ninety-nine percent and 90% have ever used face mask and hand sanitizer to prevent COVID-19; 96% and 85% respectively have use these methods in previous 24hours. Between 42% and 73% of schools needed additional commodities/requirements/supplies to comply fully with COVID-19 prevention protocols. CONCLUSION: While knowledge of COVID-19 is suboptimal, perception is positive and practice is high. Thus, teachers need to be well informed and encouraged to sustain current levels of preventive measures. Government needs to provide schools with adequate preventive commodities to ensure compliance.

A 37-year-old Nigerian woman with Apert syndrome - medical and psychosocial perspectives: a case report.

BACKGROUND: Apert syndrome is a rare genetic disease that presents a diagnostic dilemma because of its similarity with other craniosynostosis syndromes. Currently, there is paucity of reports about adult patients in African medical literature. Therefore, this case report highlights medical and psychosocial problems associated with the disease in an adult woman who is resident in a resource-constrained setting. CASE PRESENTATION: Our patient is a 37-year-old African woman. She had abnormal characteristics of the skull, face, and extremities that were detected at birth. She is clinically stable but moderately depressed as an adult. Mutation in fibroblast growth factor receptor 2 (Ser252Trp) was positive. Her physical deformities and the laboratory findings confirmed the diagnosis of Apert syndrome. She missed opportunities for vital interventions to limit the physical and psychosocial effects of the disease, especially during early growth and developmental period, mainly due to the inadequacy of the institutions offering medical and psychosocial support. As a child she did not complete formal education or acquire vocational skills even though intellectual disability was never established. During adulthood she became socially deprived owing to her physical features and educational handicap. Her lifelong dependency is an unfortunate social consequence starting with developmental challenges encountered during childhood and worsened by adult social maladjustment. CONCLUSIONS: Our patient does not have medically life-threatening features but was depressed. We recommend strengthening of institutions for early medical intervention and lifetime psychosocial support to limit physical and psychosocial effects of Apert syndrome among adult survivors in resource-limited settings.

Variations in the ß-globin genes of sickle cell anaemia patients in Zaria, Northwestern, Nigeria.

CONTEXT: Sickle Cell Anaemia (SCA) is a genetic disorder with a life-long disability, which is of public health importance. The diversity in its clinico-pathologic and laboratory presentations may be due to the interplay between additional genetic differences and environmental factors. The genetic factors may be within the ß-globin gene itself, the ß-globin gene cluster or elsewhere in the genome. AIM: To characterize the ß-globin gene for variations associated with the Sickle Cell mutation. SETTINGS AND DESIGN: A cross-sectional descriptive study involving 51 adult SCA patients attending Sickle Cell Clinic of Haematology Department Ahmadu Bello University (ABUTH) Zaria, Kaduna State, Nigeria. METHODS AND MATERIAL: The buccal swab specimens were collected and ß-globin gene DNA sequencing was done. The sequences obtained were compared with a Genbank Reference ß-globin gene (NC_000011.9) using Basic Local Alignment Search Tool (BLAST), and variations noted. Data generated were analyzed using SPSS Version 20.0. STATISTICAL ANALYSIS USED: Data generated was summarized by using charts, means±2SD, and 95% confidence intervals. RESULTS: There were 40 (78.43%) females and 11 (21.57%) males. The mean age of the participants was 25.35 ± 7.67 years, 95% CI (23.20, 27.51). The classic sickle cell mutation A T was present in all participants. The mean number of ß-Globin gene variations was 8.61±11.30, 95% CI (5.43, 11.78). The number of Substitutions were 122 (27.79%), insertions 184 (41.91%), and deletions 133 (30.30%). These occurred in various combinations. The mean number of substitutions, insertions, and deletions were 2.39±3.23, 3.61±7.66, and 2.60±2.46 with 95% CIs of (1.48, 3.30), (1.45, 5.76), and (1.92, 3.30) respectively. CONCLUSIONS: There are ß-globin gene variations in SCA patients in Zaria, and locally relevant genetic database of the SCA population will be the cornerstone in understanding genotype-phenotype interactions in this disorder.

A case series of steroid-induced diabetes mellitus in Zaria, Nigeria.

INTRODUCTION: New-onset diabetes Mellitus can occur in patients without documented hyperglycaemia before corticosteroid therapy, however hyperglycaemia has been reported as an adverse effect of steroids such as Prednisolone.This may be encountered in the management of haematologic disorders or malignancies when prolong administration or high dose prednisolone is used alone or as an adjuvantto cytotoxic agents AIM: To report three adults who developed hyperglycaemia following an oral administration of prednisolone and to review the current literature on Steroid-induced diabetes mellitus. Method:We undertook a review of the case records of the three patients and an electronic MEDLINE as well as a manual library search of existing pertinent literature. RESULT: Three male adults aged 55, 50 and 65 years old developed Diabetes Mellitus following the oral steroid administration. In the first case, oral Prednisolone (60mg/day) was used in combination to a cytotoxic agent Melphalan in the management of a plasma cell dyscrasia (Multiple Myeloma), the second case followed a one week course of same dose of prednisolone for Chronic lymphocytic leukaemia while the third case also had oral prednisolone administered alone for an Autoimmune Haemolytic anaemia. Aging, high body mass index and cumulative doses of steroids may be risk factors for the development of steroid-induced hyperglycaemia. The prevalence of this condition, possible pathogenesis and options for treatment are discussed. CONCLUSION: Steroid-induced diabetes mellitus is an important clinical finding that, if recognized early, can be effectively treated. We propose Fasting blood sugar and Oral glucose tolerance test as part of the pretreatment investigation during the evaluation as well as in the course of management of middle aged and elderly patients on steroids.