PREVALENCE AND PREDICTORS OF EXCLUSIVE BREASTFEEDING AMONG MOTHERS IN A SEMI-URBAN NIGERIAN COMMUNITY: A CROSS-SECTIONAL STUDY.

Background: The uptake of exclusive breastfeeding (EBF) is low globally including Nigeria despite its benefits and interventions. This study aimed to assess the prevalence and predictors of EBF among mothers in a semiurban Nigerian community. Methods: We conducted a cross-sectional study among nursing mothers attending the immunization clinic at the Federal Medical Centre, Owo, Ondo State. A semi-structured questionnaire containing the World Health Organization's indicators for assessing breastfeeding practices was used for data collection. Results: A total of 386 mothers were recruited with a mean age of 30.8 ± 5.0 years. Among them, 149 (36.8%) were below 30 years, 345 (89.4%) have had ANC visit at least four times, and 259 (67.1%) had initiated breastfeeding immediately after delivery. The prevalence of EBF was 52.6%. Natural feeds were the common feeds introduced after 6 months among 159 (78.3%) mothers. One hundred and forty-four (62.1%) nursing mothers aged 30 years or older practiced EBF compared to 72 (48.3%) persons below 30 years (X2 = 6.290, p = 0.012). Also, 38 (70.3%) mothers who have delivered four or more children practiced EBF compared to 180 (54.2%) with fewer children (X2 = 5.437, p = 0.020). Nursing mothers aged 30 years or older had 36% higher odds of practicing EBF compared to younger persons (Adjusted Odds Ratio = 1.358, 95%CI = 0.886 - 2.081, p = 0.160). Conclusion: To achieve the WHO recommended target of ensuring that 90% of nursing mothers practice EBF, advocacy and health education must be intensified.

5-Fluorouracil vs avastin as adjunct to conjunctival autograft in the surgical treatment of pterygium.

BACKGROUND: The use of adjunct antimetabolite therapy along with conjunctiva autograft has been shown to be effective in preventing pterygium recurrence. There has however been fewer reports on the effect of anti-vascular endothelial growth factor on pterygium recurrence. OBJECTIVE: To compare 5-fluorouracil with conjunctival autograft with bevacizumab (avastin) used along with autograft in the surgical treatment of pterygium. METHODS: A randomized controlled prospective study of outcome of pterygium treatment using 5-fluorouracil with conjunctiva autograft as adjuvant treatment compared avastin with conjunctiva autograft. RESULTS: A total of 70 eyes of 70 patients were recruited into the study with a mean age of 51.49 (±14.36) years. Thirty-five patients each were randomized into the 5-fluorouracil treatment group and into the avastin treatment group respectively. The mean follow-up was 18.35 months (18.44 for the 5-FU and 18.26 for the avastin group). Post operative, pterygium recurrence was observed in 1/27 (3.7%) eyes treated with 5-fluorouracil and 1/26 (3.9%) eyes of the avastin group. Both recurrences were observed at 1 year of follow-up and they were both female patients aged 46 and 52 years, respectively. CONCLUSIONS: Both 5-fluorouracil and avastin are comparably effective as adjunct to conjunctival autograft. However, cost, availability, and convenience are other considerations with use of avastin.

Dengue virus specific Immunoglobulin G antibodies among patients with febrile conditions in Osogbo, Southwestern Nigeria.

Dengue fever is becoming one of the major public health problems in the world and its distribution has been premised on the migration of people from infected regions. This study was carried out to determine the prevalence of dengue virus IgG antibody among the patients with febrile conditions attending health facilities in Osogbo metropolis, Southwestern Nigeria. The blood samples collected between July and September, 2014 were tested for Plasmodium falciparum and the sera were subsequently subjected to Enzyme Linked Immunosorbent Assay (ELISA) to detect the dengue virus IgG antibody. Of the hundred consented participants screened, 77% were sero-positive for dengue virus IgG antibody while 41% were positive for P. falciparum. Thirty-three (33%) of the participants were positive for both dengue virus IgG antibody and P. falciparum. No significant difference was found in the prevalence of dengue virus IgG antibody and malaria among the participants (P>0.05). The high prevalence of dengue virus IgG and malaria signifies the need by the government of Osun State to sensitize residents and institute urgent measures to mitigate the resultant effects of morbidity and mortality due to dengue fever and dengue hemorrhagic fever which has hitherto appeared to be alien to the area.

Dengue virus specific Immunoglobulin G antibodies among

Dengue fever is becoming one of the major public health problems in the world and its distribution has been premised on the migration of people from infected regions. This study was carried out to determine the prevalence of dengue virus IgG antibody among the patients with febrile conditions attending health facilities in Osogbo metropolis, Southwestern Nigeria. The blood samples collected between July and September, 2014 were tested for Plasmodium falciparum and the sera were subsequently subjected to Enzyme Linked Immunosorbent Assay (ELISA) to detect the dengue virus IgG antibody. Of the hundred consented participants screened, 77% were sero-positive for dengue virus IgG antibody while 41% were positive for P. falciparum. Thirty-three (33%) of the participants were positive for both dengue virus IgG antibody and P. falciparum. No significant difference was found in the prevalence of dengue virus IgG antibody and malaria among the participants (P>0.05). The high prevalence of dengue virus IgG and malaria signifies the need by the government of Osun State to sensitize residents and institute urgent measures to mitigate the resultant effects of morbidity and mortality due to dengue fever and dengue hemorrhagic fever which has hitherto appeared to be alien to the area.

Association of the sickle cell trait and the ABO blood group with clinical severity of malaria in southwest Nigeria.

In regions of high Plasmodium falciparum malaria endemicity, certain erythrocyte polymorphisms confer resistance to severe disease. In this study, we evaluate the role of the sickle cell trait (HbS) and ABO blood groups in the clinical manifestations of childhood malaria in Southwest Nigeria. The subjects comprised 3100 children (53% males, median age 39 months), including 1400 children with uncomplicated malaria, 1000 children with asymptomatic malaria and 700 with severe malaria. Haemoglobin (Hb) types were determined using electrophoresis and serum agglutination techniques were used to determine ABO blood groups. Blood group O was the commonest ABO blood group (47.7%) in the study population, the others were A (22.5%), B (25.2%) and AB (4.6%). The frequencies of the HbAS and HbAC were 14.4% and 5.8%, respectively. In regression models adjusting for age, gender, parasite density and blood group, HbAS was associated with a reduced risk of severe malaria OR=0.46 (CI(95%): 0.273-0.773). Among severe malaria subjects, HbAS was associated with significantly lower parasite densities. The protective effect of blood group O was demonstrated with a decreased risk of severe malaria OR=0.743 (CI(95%): 0.566-0.976) after adjusting for age, gender and parasite density and Hb genotype. Blood group B was associated with increased risk of severe malaria OR=1.638 (CI(95%): 1.128-2.380) after adjusting for age, gender, packed cell volume, parasite density and Hb genotype. We have confirmed from this large study of Nigerian children the major protective effective of the sickle cell heterozygous state against both cerebral malaria and severe malarial anaemia. We also show that the B blood group is associated with an increased risk of severe malaria. In conclusion, the sickle cell haemoglobin type and ABO groups modulate the risk of severe malaria in Nigerian children.

Efficacy of acoustic otoscope in detecting middle ear effusion in children.

The sensitivity and specificity of the acoustic otoscope in detecting middle ear effusion (MEE) was determined for 200 children. Based upon results from otoscopy, tympanometry, pure tone audiometry, and myringotomy, 100 of the children (175 ears) had MEE. The remaining 100 (200 ears) had no MEE. Using acoustic otoscope reflectivity (AOR) units 4 through 9 to indicate pathologic ears, its sensitivity and specificity were found to be 93.14% and 83%, respectively. These findings led to the conclusion that the acoustic otoscope may provide a simple and cost-effective way of detecting MEE in children. Suggestions are provided for improving the effectiveness of this new device as a clinical tool.