Cerebral Venous Sinus Thrombosis Complicating Herpes Zoster Ophthalmicus Ophthalmoplegia.

Cerebral venous sinus thrombosis (CVST) is a rare cause of strokes and is most common in younger patients particularly those less than 50 years of age. It is more common in females than in males and is known to be associated with pregnancy, puerperium, oral contraception, congenital and acquired thrombophilia, and malignancy. Less commonly, it has been shown to be associated with infections and more recently has been found to be associated with COVID-19 infection with thrombocytopenia and the COVID-19 vaccine AstraZeneca. Rare cases have been reported in association with varicella zoster virus (VZV) infection (chickenpox) and its reactivated version of herpes zoster virus (HZV) infection (shingles). We report the case of a 68-year-old lady with herpes zoster ophthalmicus ophthalmoplegia who developed cerebral venous thrombosis (CVT).

What Underlies State Government Performance in Scaling Family Planning Programming? A Study of The Challenge Initiative State Partnerships in Nigeria.

INTRODUCTION: Relatively few studies rigorously examine the factors associated with health systems strengthening and scaling of interventions at subnational government levels. We aim to examine how The Challenge Initiative (TCI) coaches subnational (state government) actors to scale proven family planning and adolescent and youth sexual and reproductive health approaches rapidly and sustainably through public health systems to respond to unmet need among the urban poor. METHODS: This mixed-methods comparative case study draws on 32 semistructured interviews with subnational government leaders and managers, nongovernmental organization leaders, and TCI Nigeria staff, triangulated with project records and government health management information system (HMIS) data. Adapting the Consolidated Framework for Implementation Research (CFIR), we contrast experience across 2 higher-performing states and 1 lower-performing state (identified through HMIS data and selected health systems strengthening criteria from 13 states) to identify modifiable factors linked with successful adoption and implementation of interventions and note lessons for supporting scale-up. RESULTS: Informants reported that several TCI strategies overlapping with CFIR were critical to states' successful adoption and sustainment of interventions, most prominently external champions' contributions and strengthened state planning and coordination, especially in higher-performing states. Government stakeholders institutionalized new interventions through their annual operational plans. Higher-performing states incorporated mutually reinforcing interventions (including service delivery, demand generation, and advocacy). Although informants generally expressed confidence that newly introduced service delivery interventions would be sustained beyond donor support, they had concerns about government financing of demand-side social and behavior change work. CONCLUSION: As political and managerial factors, even more than technical factors, were most linked with successful adoption and scale-up, these processes and systems should be assessed and prioritized from the start. Government leaders, TCI coaches, and other stakeholders can use these findings to shape similar initiatives to sustainably scale social service interventions.

Emergency laparotomy for peritonitis in the elderly: A Multicentre observational study of outcomes in Sub-Saharan Africa.

Background: Globally, interest in surgical diseases in the elderly was rekindled recently mainly due to a surge in the aging population and their increased susceptibility to infections. In sub-Saharan Africa, infective diseases are major causes of high morbidity and mortality especially in elderly cohorts, hence this study was set to evaluate current status of this scourge in the elderly in our environment. Aim: To document the aetiologic factors and analyze the impact of selected clinical and perioperative indices on mortality and morbidity rates of peritonitis in the elderly. Methods: This was a multicenter prospective study involving elderly patients aged 65years and above managed between October 2015 and September 2021 in Southeast Nigeria. Results: Of the 236 elderly patients examined, approximately two-third (150, 63.6%) were aged 65-74years. The rest were aged ≥ 75years. There were 142(60.2%) males and 94(39.8%) females. Perforated peptic ulcer (89,37.7%) was the most common cause of peritonitis followed by ruptured appendix (59, 25.0%), then typhoid perforation (44,18.6%). However, typhoid perforation was the deadliest with a crude mortality rate of 40.9%. Overall, morbidity and mortality rates were 33.8% and 28.5% respectively. The main independent predictors of mortality were peritonitis arising from typhoid perforation (p = 0.036), late presentation (p = 0.004), district location of hospital (p = 0.011) and intestinal resection (p = 0.003). Conclusion: Generalized peritonitis is a cause of significant morbidity and mortality in the elderly patients in our environment. Perforated peptic ulcer was the most common cause, but typhoid perforation remains the deadliest. Late presentation, district hospital setting and bowel resection were associated with elevated mortality.

Clopidogrel-induced thrombotic thrombocytopenic purpura: a case report.

Thrombotic thrombocytopenic purpura (TTP) is a rare variant of thrombotic microangiopathy. We report a case of TTP in a Nigerian chronic kidney disease (CKD) patient who was previously on clopidogrel. The features of TTP resolved soon after clopidogrel was withdrawn. Clopidogrel is a cardio-protective anti-platelet drug used in CKD patients at risk of dyspepsia. However, its potential to cause TTP should be recognized and considered in acute kidney injury (AKI) patients previously on clopidogrel.

Adoption and sustainability of bitcoin and the blockchain technology in Nigeria.

The rise of cryptocurrency, especially bitcoin, has opened up a lot of doors in the world of Financial Technology (FinTech) by attracting investors, media, and financial industry regulators. Bitcoin operates on blockchain technology, and its value is not a determinant of the value of a tangible asset, an organisation, or a country's economy. Instead, it relies on an encryption technique that allows tracking of all transactions. Globally, over $2 trillion has been generated through cryptocurrency trading. Due to these financial prospects, the youths in Nigeria have cashed in on this virtual currency to create employment and wealth. This research investigates the adoption and sustainability of bitcoin and blockchain in Nigeria. A survey method with a non-probability purposive sampling technique and a homogeneous approach was employed to collect 320 responses via an online survey. Descriptive and correlational analysis in IBM SPSS version 25 was used to analyse the collected data. According to the findings, bitcoin is the most popular cryptocurrency, with 97.5% acceptance, and is expected to be the leading virtual currency in the next five years. The research findings will help researchers and authorities comprehend the need for cryptocurrency adoption, leading to its sustainability.

Germinated Bambara groundnut (Vigna subterranea) flour as an ingredient in wheat bread: Physicochemical, nutritional, and sensory properties of bread.

Wheat flour (WF) was substituted with germinated Bambara groundnut (Vigna subterranea) flour (GBF) at different proportions (5%, 10%, 15%, 20%, 25%, and 30%) and used in the preparation of bread. The dough mixing, pasting, and gelatinization properties of the blends were evaluated as well as the nutritional quality, in vitro starch digestibility, phytochemical constituents, antioxidant potential, color, texture, and sensory properties of breads. All the wheat dough containing GBF had higher water absorption capacity, gelatinization temperatures, dough development time, low peak, and setback viscosities. The composite breads had significantly higher dietary fiber, minerals, protein digestibility, corrected amino acid scores, resistant starch, slowly digestible starch, total phenolics, total flavonoids, and antioxidant activities and caused significant reduction in rapidly digestible starch content. The addition of up to 15% GBF had no significant impact on the specific volume of wheat bread. Substitution of WF with GBF influenced color and texture properties of bread. Wheat bread supplemented with 20% GBF had significantly higher scores in taste, aroma, and overall acceptability. This study demonstrated the potential of GBF as a functional ingredient in bread making. PRACTICAL APPLICATION: This study provides a suitable possibility of partial substitution of wheat flour with germinated Bambara groundnut, to develop functional and acceptable bread. The dough mixing and pasting results in this study would add to knowledge on the dough handling characteristics as there is limited information regarding the mixing properties of wheat dough with germinated Bambara groundnut.

Abdominal Injuries from Civilian Conflicts: An Emerging Global Health Challenge in Rural Southeast Nigeria.

Background: In recent time, incidence of abdominal injuries continues to increase steadily in most major regions of West Africa due to emergence of various religious, social and political conflicts. Indeed, violence and social conflicts constitute major global public health challenges that commonly lead to injuries and long-term physical and mental health problems. In our setting, increasing cases of abdominal trauma resulting from civilian violence led to additional workload in the general surgery unit and the audit of our experiences is presented in this paper. Objective: To analyze the etiological spectrum, trend and management outcome of abdominal injuries from civilian violence in our setting. Methods: This was a multicenter prospective study of adult patients with abdominal injuries from civilian conflicts managed at three selected district hospitals in Southeast Nigeria between January 2013 to December 2020. Findings: Of 398 patients evaluated, 359 (90.2%) sustained penetrating while 39 (9.8%) had blunt abdominal injuries. Gunshot was the most common mechanism, accounting for 248 (62.3%) cases, followed by stab wound (95, 23.9%). Armed robbery attack (68, 27.4%) was the main source of gunshot wounds. Overall, annual rates showed a four-fold rise over an eight-year period from 24 cases (6.0%) in 2013 to 96 (24.1%) in 2020. Majority (365, 91.7%) had operative management (OM); the rest (33, 8.3%) were treated non-operatively. Morbidity and mortality rates for operative cases were 29.6% and 12.1% respectively. The main factors associated with increased mortality rates were delayed presentation (p = 0.002), bowel resection (p = 0.006), gunshot wounds (p = 0.013), advanced age (p = 0.033), multiple visceral injury (p = 0.034) and ASA score ≥ III (p = 0.001). Conclusion: Abdominal trauma from civilian violence is on the steady rise in our setting. The main etiologic factors are armed-robbery, communal clashes, political thuggery and cultism perpetrated predominantly through gunshots and stab wounds. Advancing age, gunshot wounds, delayed presentation, bowel resection and multiple injuries were associated with increased mortality.

An Assessment of Enrollees' Knowledge and Satisfaction with Delta State Contributory Health Scheme: A Cross- Sectional Survey of Civil Servants in Delta State, Nigeria.

Background: Delta State Contributory Health Scheme (DSCHS) was established to provide quality and affordable healthcare services to all Deltans, irrespective of socioeconomic status and geographical location. This study assessed the knowledge and satisfaction of formal sector enrollees with the Delta State Contributory Health scheme. Methodology: This was a cross-sectional descriptive study involving 400 public/civil servants enrolled in DSCHS using a multistage sampling technique. Data was collected using an interviewer-administered structured questionnaire and was analyzed using IBM SPSS version 25.0 software. Results: The study revealed that 207 (51.7%) of the respondents were males, while 193 (48.3%) were females. Two hundred and five (51.2%) of the respondents were within the age group of 43 - 52 years, and 353 (88.2%) of the respondents had tertiary education. Overall, 296 (74.0%) of the respondents had good knowledge, and 104 (26.0%) had poor knowledge of DSCHS; while 138 (52.1%) of the respondents were unsatisfied with DSCHS and 127 (47.9%) were satisfied with the scheme. Age (X2 = 19.67; P<0.001), gender (X2 = 8.53; P=0.004), education (X2 = 20.52; P<0.001), marital status (X2 = 14.13; P=0.001), religion (X2 = 13.12; P=0.001) and years of working experience (X2 = 39.66; P<0.001) was significantly associated with knowledge of DSCHS. The factors significantly associated with satisfaction with DSCHS were ethnicity (X2 = 14.39; P=0.013) and years of working experience (X2 = 11.23; P=0.024). Conclusion: The majority of the study participants had good knowledge regarding DSCHS but were unsatisfied with the level of services provided by the scheme. It is therefore recommended that Delta State Contributory Health Commission should review its benefit package and urgently scale up services to improve enrollees' satisfaction with the scheme.

Physicochemical properties, in vitro digestibility, antioxidant activity and consumer acceptability of biscuits prepared from germinated finger millet and Bambara groundnut flour blends.

The formulation of new food products with high nutritional quality and functionality is gaining global attention. The physicochemical properties, in vitro digestibility, antioxidant activity and consumer acceptability of biscuits produced from germinated finger millet (GFM) (Eleusine coracana) and Bambara groundnut (GBGN) (Vigna subterranea) flour blends were investigated. As the proportion of GBGN flour increased in the biscuit samples, protein, in vitro protein digestibility (80.52-89.20 %), slowly digestible and resistant starch, total phenolic content and antioxidant activities increased significantly, while rapidly digestible starch, starch hydrolysis index, glycemic index and phytic acid decreased. Addition of GBGN also positively influenced the physical attributes of the biscuits. The blending of 80% GFM with 20 % GBGN resulted in a biscuit with acceptable sensory qualities such as taste, aroma, appearance, crunchiness, and overall acceptability. This study showed that GFM and GBGN flour blends could serve as functional ingredients to produce better products.

Multidrug-Resistant and Extremely Drug-Resistant Pseudomonas aeruginosa in Clinical Samples From a Tertiary Healthcare Facility in Nigeria.

Objectives: Pseudomonas aeruginosa has been globally implicated in healthcare-associated infection. The susceptibility pattern of clinical isolates of P. aeruginosa to anti-pseudomonal antibiotics is reported. Materials and Methods: Clinical samples, namely blood, urine, tracheal aspirate, cerebrospinal fluid (CSF), wound swabs, high vaginal swabs, eye, and ear exudates were obtained from patients, processed and identified using standard microbiological protocols. Antibiotic susceptibility testing was undertaken using the Kirby Bauer Disc diffusion method. Results were reported following the Clinical and Laboratory Standards Institute guidelines. Results: Of 104 P. aeruginosa isolates identified, males (52.88%) had a higher incidence of infection than female (47.11%) patients. The highest prevalence was recorded from wound swabs [46 (44.23%)] followed by ear exudates [23 (22.12%)], urine [22 (21.15%)], while eye exudates and samples from the CSF yielded the least [1 (0.96% each)]. From the antibiogram, imipenem had the highest antibiotic activity (91.3%) followed by polymyxin B (84.6%). The isolates exhibited the highest resistance to ceftazidime (73.1%) and piperacillin-tazobactam (61.5%). The antibiotic susceptibility pattern of P. aeruginosa isolates revealed 7.69% susceptible, 26% resistant, 61% multidrug resistance (MDR), 5% extremely drug resistance (XDR), and an absence (0%) of pandrug-resistant phenotypes. Conclusion: The study recorded alarmingly high cases of MDR and some XDR phenotypes of P. aeruginosa in University of Port Harcourt Teaching Hospital. It will help identify existing gaps in antimicrobial resistance surveillance and assist in improving public health policies regarding antibiotic stewardship, initiatives, and interventions.

Dataset of the adoption of digital tools for research sharing among academics in African Varsities during the COVID-19 pandemic in 2020.

This dataset was collected from a total of 1,977 university lecturers across 24 African countries, that were purposively targeted due to their level of exposure to scholarly publications. The dataset was collected through an online survey that was sent to respondents through email, WhatsApp, and the Association of African Universities Telegram group. The questionnaire was designed by the researchers and validated by five experts for face and content validity. The demographic information of the data was analysed and the softcopy of the data uploaded to the Mendeley database for easy retrieval after deidentification (see Data Availability statement). The associated questionnaire can be found in the extended data. In Africa, this appears to be the broadest dataset associated with academics' perception of utilizing digital platforms for research sharing. This implies that scholars can use this dataset to quantitatively analyse the extent to which different internet-based platforms are being utilized for research communication. Considering the current restrictions on in-person social gatherings due to COVID-19, researchers working on related studies may readily utilize this set of data, saving time and cost. A comprehensive but non-exhaustive number of 20 online platforms were assessed based on academics' awareness and current engagement with them, and the challenges they have faced using them. This offers a wide range of areas for studies to be anchored. Furthermore, researchers interested in specific online platforms can also evaluate the extent to which academic staff in African universities are aware of and willing to utilize them for research dissemination. This data will enable scholars and researchers in Africa and beyond to understand the extent to which academics in varsities are willing to adopt digital repositories for research sharing in the context of Africa.

Surgical Capacity in Rural Southeast Nigeria: Barriers and New Opportunities.

Background: Remarkable gains have been made in global health with respect to provision of essential and emergency surgical and anesthesia care. At the same time, little has been written about the state of surgical care, or the potential strategies for scale-up of surgical services in sub-Saharan Africa, southeast Nigeria inclusive. Objective: The aim was to document the state of surgical care at district hospitals in southeast Nigeria. Methods: We surveyed 13 district hospitals using the World Health Organization (WHO) tool for situational analysis developed by the "Lancet Commission on Global Surgery" initiative to assess surgical care in rural Southeast Nigeria. A systematic literature review of scientific literatures and policy documents was performed. Extraction was performed for all articles relating to the five National Surgical, Obstetric and Anesthesia Plans (NSOAPs) domains: infrastructure, service delivery, workforce, information management and financing. Findings: Of the 13 facilities investigated, there were six private, four mission and three public hospitals. Though all the facilities were connected to the national power grid, all equally suffered electricity interruption ranging from 10-22 hours daily. Only 15.4% and 38.5% of the 13 hospitals had running water and blood bank services, respectively. Only two general surgeon and two orthopedic surgeons covered all the facilities. Though most of the general surgical procedures were performed in private and mission hospitals, the majority of the public hospitals had limited ability to do the same. Orthopedic procedures were practically non-existent in public hospitals. None of the facilities offered inhalational anesthetic technique. There was no designated record unit in 53.8% of facilities and 69.2% had no trained health record officer. Conclusion: Important deficits were observed in infrastructure, service delivery, workforce and information management. There were indirect indices of gross inadequacies in financing as well.

Key factors to facilitate locally driven family planning programming: a qualitative analysis of urban stakeholder perspectives in Africa and Asia.

BACKGROUND: There has been greater recognition of the importance of country ownership in global health and development. However, operationalising country ownership to ensure the scale up and sustainability of proven interventions remains elusive at best. To address this challenge, we undertook a thematic analysis of interviews collected from representatives of local governments, public health systems, and communities in poor urban areas of East Africa, Francophone West Africa, India, and Nigeria, supported by The Challenge Initiative (TCI), aiming to rapidly and sustainably scale up evidence-based reproductive health and family planning solutions. METHODS: The main objective of this study was to explore critical elements needed for implementing and scaling evidence-based family planning interventions. The research team conducted thematic analysis of 96 stories collected using the Most Significant Change (MSC) technique between July 2018 and September 2019. After generating 55 unique codes, the codes were grouped into related themes, using TCI's model as a general analytical framework. RESULTS: Five key themes emerged: (1) strengthening local capacity and improving broader health systems, (2) shifting mindsets of government and community toward local ownership, (3) institutionalising the interventions within existing government structures, (4) improving data demand and use for better planning of health services, and (5) enhancing coordination of partners. CONCLUSION: While some themes feature more prominently in a particular region than others, taken together they represent what stakeholders perceive to be essential elements for scaling up locally-driven health programmes in urban areas in Africa and Asia.

Esophagitis Dissecans Superficialis in Children.

OBJECTIVES: Esophagitis dissecans superficialis (EDS) is a desquamative disorder of the superficial esophageal epithelium with variable clinical characteristics. Endoscopically, there is an appearance of superficial peeling of sheets of epithelium. Histologically there is 2-toned epithelium with coagulative necrosis of the superficial epithelium. Currently, there is paucity of data regarding this condition in children. METHODS: A 10-year retrospective search of the pathology information system was performed for cases with a pathologic diagnosis of EDS in a tertiary care pediatric center. Demographic data, clinical history, endoscopic findings, and histopathologic reports were reviewed. RESULTS: Thirteen patients (9 girls; ages 3-18 years), were identified with histologic findings of EDS. Esophageal food impaction, dysphagia, vomiting, and abdominal pain were the most common presenting symptoms. Sixty-nine percentage of the patients had underlying comorbidities and 76% were on at least 1 medication chronically. Eosinophilic esophagitis (23%), inflammatory bowel disease (23%), and gastroesophageal reflux disease (GERD) (15%) were the most common associated diagnoses. Of the 13 patients, 5 had repeat endoscopies showing complete resolution of EDS with no complications. CONCLUSIONS: EDS is an under-recognized entity that endoscopists should be familiar with. In our series, the most prevalent associations were with food impaction and eosinophilic esophagitis (EoE). Contact injury and/or inflammation may precede the development of EDS. Pediatric EDS appears to be an incidental finding without significant morbidity or mortality.

Survival prediction algorithms for COVID-19 patients admitted to a UK district general hospital.

OBJECTIVE: To collect and review data from consecutive patients admitted to Queen's Hospital, Burton on Trent for treatment of Covid-19 infection, with the aim of developing a predictive algorithm that can help identify those patients likely to survive. DESIGN: Consecutive patient data were collected from all admissions to hospital for treatment of Covid-19. Data were manually extracted from the electronic patient record for statistical analysis. RESULTS: Data, including outcome data (discharged alive/died), were extracted for 487 consecutive patients, admitted for treatment. Overall, patients who died were older, had very significantly lower Oxygen saturation (SpO2) on admission, required a higher inspired Oxygen concentration (IpO2) and higher CRP as evidenced by a Bonferroni-corrected (P < 0.0056). Evaluated individually, platelets and lymphocyte count were not statistically significant but when used in a logistic regression to develop a predictive score, platelet count did add predictive value. The 5-parameter prediction algorithm we developed was: [Formula: see text] CONCLUSION: Age, IpO2 on admission, CRP, platelets and number of lungs consolidated were effective marker combinations that helped identify patients who would be likely to survive. The AUC under the ROC Plot was 0.8129 (95% confidence interval 0.0.773 - 0.853; P < .001).

Predicting pediatric esophageal wall thickness: An EUS study.

BACKGROUND AND OBJECTIVE: EUS has been shown in two small series to be capable of documenting increases in the total esophageal wall thickness (TWT) in children and adults with eosinophilic esophagitis (EoE). To apply EUS-derived TWT in clinical situations or in scientific investigations in pediatric EoE, measurements of esophageal TWT in children of differing ages and heights are required. MATERIALS AND METHODS: Thirty patients (18M: 12F, 7 months to 20 years and 10 months) with a history of esophageal symptoms, but no endoscopic or histologic criteria of EoE were studied using a through the scope 20 MHZ Olympus Ultrasound miniprobe UM-3R (Olympus America, Center Valley Pa 18034) through a GIF Q180 or 160 (Olympus) standard pediatric upper endoscope. The mucosa, the mucosa plus submucosa, and the TWT were measured in the mid- and distal esophagus immediately before taking diagnostic biopsies. RESULTS: Measurements from both sites showed a statistically significant increase in TWT as a function of age (P < 0.001) and height (P < 0.001), as did the individual layers. The width of the mucosa and the submucosa were equivalent and together, they contributed more than half of the entire TWT. There were no significant differences between the means of the mid- and distal esophageal measurements. A multiple regression equation that can predict TWT based on age, with 95% confidence limits, is presented. CONCLUSIONS: EUS has demonstrated that esophageal TWT in a cohort of control children correlates with height and with age and has provided insights into the organization of the esophageal wall. Esophageal TWT values obtained by EUS can now be interpreted to recognize esophageal wall thickening throughout childhood.

Self-reported compliance with routine prenatal medications by pregnant women in a tertiary hospital in Enugu State, Nigeria.

INTRODUCTION: Compliance to routine antenatal medications increases a woman's chances of achieving a normal pregnancy and having a healthy baby. However, non-compliance is a commonly encountered problem in developing countries including Nigeria. This study investigated compliance to routine antenatal medications as reported by pregnant women receiving antenatal care in a tertiary hospital in Enugu State, Nigeria. METHODS: A cross-sectional descriptive survey research design was adopted for the study while simple random sampling technique was used to select the 354 pregnant women at Enugu state teaching hospital. A validated structured questionnaire (α=0.72) was utilized for data collection. Analysis of data involved descriptive and inferential statistics. RESULTS: Only 32% of pregnant women had a good compliance to their routine antenatal drugs while forgetfulness (27.2%) and vomiting as a side effect of the drug (25.7%) were the major barriers to compliance with routine drugs. Furthermore, there was a statistically significant association between respondents' compliance with antenatal drugs and number of children as well as level of income (p<0.001). No statistically significant association was found between education level and compliance. CONCLUSIONS: Nurses and other health workers should support pregnant women to set reminders for taking their medications and prescribe alternative dosage forms or products that will not induce vomiting. In addition, antenatal education should emphasize the benefits of adherence to routine taking of medications at every stage of pregnancy and the possible negative consequences of non-compliance.

Knowledge, attitude and practice towards hepatitis virus infection prevention among healthcare interns and medical students in a tertiary hospital, south-east Nigeria

Background: Hepatitis B and C viruses are common and preventable causes of liver disease. Health care workers are prone to infection by the hepatitis B and C viruses. In Nigeria there is no current guideline on vaccination of health care workers especially health care interns. Objective: To determine the knowledge, attitude and practice of health care interns and students towards hepatitis virus infection prevention. Methodology: This is a cross-sectional descriptive questionnaire-based study which was carried out among healthcare professional interns and medical students. Informed consent and ethical approval were obtained for this survey. Data entry and analysis was done using SPSS version 22 and appropriate descriptive statistics was applied. Results: A total of 253 interns of several healthcare professional groups and medical students took part in the survey. The healthcare interns were 115 (45.5%) and medical students were 138 (54.5%). They were 112 males (44.3%) and 141 females (55.7%), with age range 18-40 years and mean age of 22.9± 3.2 years. The respondents that knew that both hepatitis B and C were infective in nature were 225 accounting for 90.7% of respondents. The respondents with good knowledge on the modes of transmission of hepatitis were over 90% for known modes of transmission while those that knew of mother to child transmission accounted for 77.6% (n=180). Regarding the attitude of the respondents toward hepatitis B and C, only 60.4% (n=148) thinks that they are at risk of getting hepatitis infection. Those that have not received any form of hepatitis B vaccination were 163 accounting for 65.4% (n=163/253) of respondents. A high percentage of the respondents 97.8% (n=223/253) knew hepatitis B and C can cause liver disease. Conclusion: Despite a good knowledge of hepatitis B and C infectivity, attitude towards prevention of the infection was poor. The study reveals an urgent need for adequate and effective government and institutional policies towards prevention of viral hepatitis

Exclusive Breastfeeding Knowledge, Intention to Practice and Predictors among Primiparous Women in Enugu South-East, Nigeria.

Breastfeeding is considered as the most complete nutritional source for infants because breast milk contains the essential carbohydrates, fats, proteins, and immunological factors needed for infants to thrive and resist infection in the formative first year of life. Knowledge of exclusive breastfeeding (EBF) among women is essential when promoting optimal breastfeeding practices. This cross-sectional descriptive survey assessed knowledge and intention to practice EBF and its associated factors during pregnancy among primiparous women in selected communities in Enugu State, Nigeria. A total population study that applied inclusion criteria was used to recruit 201 primiparous mothers attending their third trimester antenatal care from selected health facilities in rural and urban communities in Enugu State. A researcher-developed questionnaire was used to collect data on participants' knowledge and intention to practice EBF. Descriptive statistics of frequency, percentage, mean, and standard deviation were used to summarize categorical and continuous variables while Chi-square and Wald statistic tests predicted demographic data associated with knowledge status and intention to practice EBF of the participants. More than half (58.7%) of primiparous mothers had inadequate knowledge of EBF and only 62.7% had intention to exclusively breastfeed for 4-6 months. The Chi-square test result showed significant difference in the participants' place of residence (p = 0.024), EBF knowledge sources (p = 0.001), and EBF knowledge. The Wald statistic in Logistic regression model indicated the coefficient of age (p = 0.026), educational attainment (p = 0.046), EBF knowledge (p = 0.016), and sources of information about EBF (p = 0.027) to be significant predictors of good intention to practise EBF. Poor EBF knowledge and intention to practice in this population may be improved by combining facility-based and in-house methods of breastfeeding counseling, education, and support especially to intending and expectant mothers. Further studies are needed to be done using the multiparous women as well as assessing the effects of in-house EBF supportive-educative intervention to improve breastfeeding outcomes.