Prevalence of Needle Stick and Sharps Injury and Hepatitis B Vaccination among Healthcare Workers in a South-East Nigerian Tertiary Hospital.

BACKGROUND: Daily, HCWs are exposed to needle stick and sharps injury (NSSI) and associated risk of life-threatening infections. AIM: A cross-sectional study was conducted to determine the prevalence of NSSI and HBV vaccination among 341 HCWs at NAUTH, Nnewi. METHODS: Data was collected using a self-administered. questionnaire and interview of key staff. RESULTS: The mean age of participants was 33.4±11.9 years while male: female ratio was 1:1.7. Prevalence of NSSI in the preceding 12 months was 25.5% with doctors (43.0% [34/79]), laboratory scientists (27.5%[14/51]) and nurses (21.8%[17/78]) leading (p=0.014). Noncompliance with standard precaution (SP) and non-display of relevant SP SOPs in prominent places were significantly associated with NSSI (p=0.001). Among those exposed to NSSI, only 33.7% (28/83) consulted a doctor, while 16.9%(14/83) took post-exposure prophylaxis. Two-third (68.8% [190/276]) of respondents correctly cited HBV/HCV as vaccine-preventable blood-borne healthcare-associated infection (HAI) while half (50.9% [161/316]) had received HBV vaccination. Profession (p=0.018), display of SOPs in prominent places (p=0.015), ability to cite HBV/HCV as vaccine-preventable blood-borne HAI (p=0.001), and compliance with SP (p<0.001) were significantly associated with HBV vaccination. Unit heads' responses implied lack of written policy on HBV vaccination, adequate training on NSSI prevention, and HBV vaccination support. CONCLUSION: Among HCWs, NSSI is high but under-reported while HBV vaccination rate is unimpressive. Profession, display of relevant SOPs, and compliance with SP positively affected both NSSI occurrence and HBV vaccination while knowledge about vaccine-preventable blood-borne HAI also influence HBV vaccination status. Written policies on HBV vaccination and NSSI prevention/ management, their communication and enforcement among HCWs, adequate training/retraining, display of SOPs in prominent places, and free HBV vaccination are recommended.

CONTEXTE: Les travailleurs de la santé sont quotidiennement exposés aux blessures par piqûre d'aiguille et par objets tranchants (NSSI) et au risque associé. blessures par aiguilles et objets tranchants (NSSI) et au risque associé d'infections potentiellement mortelles. OBJECTIF: Une étude transversale a été menée pour déterminer la prévalence des blessures par aiguilles et objets tranchants et de la vaccination contre le VHB parmi 341 travailleurs de la santé à NAUTH, Nnewi. MÉTHODES: Les données ont été recueillies à l'aide d'un questionnaire autoadministré et d'un entretien avec un informateur clé. RÉSULTATS: L'âge moyen des participants était de 33,4±11,9 ans et le rapport hommes/femmes était de 1:1. le rapport hommes/femmes était de 1:1,7. La prévalence de l'INSS au cours des 12 mois précédents était de 25,5 %. mois précédents était de 25,5 %, avec des médecins (43,0 % [34/79]), des scientifiques de laboratoire (27,5 % [14/51]) et des professionnels de la santé. (27,5% [14/51]) et les infirmières (21,8% [17/78]) en tête (p=0,014). Le non-complaisance avec la précaution standard (SP) et le non-affichage des PONs pertinentes de la SP dans des endroits bien en vue étaient significativement associés à la NSSI (p=0.001). Parmi les personnes exposées aux MSSN, seuls 33,7 % (28/83) ont consulté un médecin, tandis que 16,9 % (28/83) ont consulté un médecin, tandis que 16,9% (14/83) ont pris une prophylaxie post-exposition. Deux tiers (68,8% [190/276]) des personnes interrogées ont correctement cité le VHB/VHC comme une infection transmissible par le sang et prévenue par un vaccin, tandis que la moitié (50,9% [161/316]) avait été vaccinée contre le VHB. La profession (p=0,018), l'affichage des SOPs dans des dans des endroits bien en vue (p=0,015), la capacité à citer le VHB/ VHC comme une IHA hématogène évitable par la vaccination (p=0,001) et la conformité à la PS (p<0,001) étaient significativement associés à la vaccination contre le VHB. Les réponses des chefs d'unité impliquaient l'absence de politique écrite sur la vaccination contre le VHB, de formation adéquate sur la prévention des INSS et de soutien à la vaccination contre le VHB. CONCLUSION: Parmi les travailleurs de la santé, l'INSS est élevée mais sous-déclarée tandis que le taux de vaccination contre le VHB n'est pas impressionnant. La profession, l'affichage de procédures opératoires normalisées (PON) pertinentes et la conformité à la PS ont eu un effet positif sur l'occurrence des INSS et la vaccination contre le VHB, tandis que les connaissances sur les infections hématogènes évitables par la vaccination influencent également le statut de la vaccination contre le VHB. Les politiques écrites sur la vaccination contre le VHB et la prévention et la gestion des INSS, leur communication et leur application parmi les établissements de soins de santé, une formation et un recyclage adéquats, l'affichage des procédures opérationnelles standard dans des endroits bien en vue, et la vaccination gratuite contre le VHB sont recommandées. MOTS CLÉS: Prévention, risques professionnels, personnel hospitalier, infections transmissibles par le sang, Nnewi.

A SURGE OF TYPE 1 DIABETES MELLITUS AMONG NIGERIAN CHILDREN DURING THE COVID-19 PANDEMIC.

Background: A substantial increase in Type 1 Diabetes Mellitus (T1DM) has been reported globally among children following the discovery of COVID-19. This study reports a similar trend among Nigerian children. Methods: A twelve-year (2010-2021) retrospective review of T1DM cases admitted in the Paediatric wing of a tertiary hospital in South-East Nigeria. Results: During the twelve-year study, 21 T1DM patients were seen: 9 (43%) males and 12 (57%) females. Approximately 60% of these cases presented during the pandemic (2020-2021). The mean age of subjects with T1DM was 10.5 ± 4.1 years, with females being slightly older than the male subjects (11.6 ± 3.7 years vs 9.2 ± 4.3 years respectively; p=0.176). Prior to the pandemic, females were significantly older than males (11.6 ± 3.7 years vs 4.5 ± 2.1 years respectively; p=0.042), but no age difference was observed during the pandemic (11.6 ± 4.1 years vs 10.4 ± 3.9 years respectively; p=0.597). 80% of all males in this study were seen during the pandemic and were older than the males seen before the pandemic (10.4 ± 3.9 years vs 4.5 ± 2.1 years; p=0.078). Following adjustments for age and gender, older children and males had an increased odd of developing T1DM during the pandemic but this was not statistically significant. Conclusion: This study highlights the need for increased awareness and high index of suspicion of T1DM among children during this pandemic. In the interim, more robust multi-centre studies are required to investigate the underlying relationship between COVID-19 and T1DM.

Predictors of COVID-19 vaccine acceptance among Nigerian medical doctors

Background: Since its discovery in late 2019, COVID-19 has claimed approximately three million lives worldwide, causing a significant economic burden and strain on health care delivery and services. Therefore, the COVID-19 vaccine may offer the potential to promote global recovery. Objective: To determine the acceptability of the COVID-19 vaccine among Nigerian doctors and the factors influencing the acceptance. Methods: Using a cross-sectional design, an anonymous online survey was administered to medical doctors across the six geopolitical zones in Nigeria between 13 January and 31 January 2021, using the health belief model (HBM). Results: Out of 830 respondents, 38.8% were willing to take the COVID-19 vaccine, 36.0% were unsure, while the remaining 26.5% refused to take the vaccine. Following adjustments, males were more likely to take the vaccine (OR = 3.357; 95% CI 2.009-5.610; p = 0.0001), whereas increasing age, higher perceived viral virulence and perceived viral infectivity were observed to be significantly associated with less likelihood of accepting the vaccine. Respondents who believed in the efficacy of ivermectin were much less likely to receive the vaccine (OR = 0.217; 95% CI 0.108-0.436; p=0.001). Concerns on vaccination safety were the main barriers to vaccine acceptability. Hypothetically addressing these concerns increased vaccine acceptance rates by approximately a third (34.6%) (p < 0.001). Conclusion: The proposed nationwide distribution of the COVID-19 vaccine may be met with poor vaccine acceptability among Nigerian medical practitioners. Measures specifically addressing vaccine safety concerns should be provided to allay fears and enhance the acceptability of the vaccine.

Serum total adiponectin in healthy pre-pubertal nigerian school children.

BACKGROUND: Adiponectin is an excellent insulin sensitizer. It also possesses anti-inflammatory and anti-atherogenic properties that play a crucial role in the pathogenesis of cardio-metabolic disorders. Evaluating adiponectin distribution in children and factors that modulate its blood level is critical for advancing knowledge in its future role in managing associated non-communicable diseases. AIM: To investigate the adiponectin profile in apparently healthy pre-pubertal Nigerian school children. METHODS: This is a cross-sectional study comprising 125 randomly recruited pupils from eight primary schools in Nnewi located in Anambra State, Nigeria. Anthropometric values were taken and venous blood samples assayed for adiponectin using Enzyme-linked immunosorbent assay (ELISA) kits. Analysis of data was done with SPSS software version 22 and R programming software. The level of significance set at P < 0.05. RESULTS: We enrolled a total number of 125 children, which comprised of 68 (54.4%) males and 57 (45.6%) females with a male to female ratio of 1.2:1. The mean age of all the subjects was 7.7 ± 2.0 years. The mean serum adiponectin level of all the participants was 4.67 ± 2.2 ng/mL with a range of 1.9 ng/mL to 10.0 ng/mL. Adiponectin was slightly higher in females than males (4.93 ± 2.4 ng/mL vs 4.45 ± 2.0 ng/mL, respectively; P = 0.223). In males, an inverse relationship was observed between adiponectin and increasing age, whereas in females, a positive correlation was noted (P = 0.637 vs P = 0.639, respectively). The body mass index (BMI) correlated negatively with adiponectin in all the subjects and across both the genders, but these were not statistically significant. CONCLUSION: Adiponectin varies with sex, age and BMI in pre-pubertal Nigerian children with normal BMI. Further local studies are needed to elucidate its role in the management of associated disease states.

Malaria prevalence and its sociodemographic determinants in febrile children - a hospital-based study in a developing community in South-East Nigeria.

BACKGROUND: Malaria remains one of the major contributors of child mortality in many developing countries in Africa. Identifying its determinants will help in prevention and prompt intervention in these settings. METHODS: This cross-sectional descriptive study was conducted over an eight-month period. It enrolled 382 children who were presented with fever to the children outpatient and emergency unit of a tertiary hospital in South-east Nigeria. A structured questionnaire was used to collect information on socio-demographic factors. Blood film microscopy for malaria and parasite density was done on all subjects that tested positive for malaria. RESULT: The malaria prevalence rate was 16.7%, 26.7%, 29.9% and 46.2% in children < 5 years, 5 to < 10 years, 10 to < 15 years and 15-17 years respectively. Logistic regression analysis showed that malaria was more prevalent in older children but children under the age of 5 years were more prone to higher parasite density. Also, children of mothers with lower educational attainment, children from families of lower socio-economic class and resident in rural settings had higher likelihood of malaria infection. CONCLUSIONS: Sustained improvement in strategies to prevent malaria infection is still imperative in children of all ages, especially those under 5 years, children from families of low socio-economic class and those residents in rural communities.