Short-term COVID-19 vaccine adverse effects among adults in Ekiti State, Nigeria.

BACKGROUND: The safety of the COVID-19 vaccines has been a topic of concern globally. This issue of safety is associated with vaccine hesitancy due to concerns about the adverse effects of the vaccines. Consequently, this study determined the short-term safety profile of the Oxford/AstraZeneca COVID-19 vaccine in Ekiti State, Nigeria. METHODS: Descriptive cross-sectional study conducted between May and July 2021 among individuals who had received the first dose of the first batch of the Oxford/AstraZeneca COVID-19 vaccine at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Nigeria. A Google form was used to collect data on the adverse effects of the vaccine. RESULTS: Out of over 1,000 individuals who were approached, 758 respondents completed the study. A large percentage (57.4%) of those who received the vaccines were healthcare workers. Adverse effects were reported in 70.8% of the participants with most manifesting on the first day of the vaccination. The predominant adverse effects were injection site soreness (28.5%), followed by fatigue (18.7%) and muscle pain (8.6%). There was no report of severe adverse effects such as anaphylactic reactions, thrombosis, myocarditis, transient myelitis, or Guillen-Barre syndrome. CONCLUSION: This study found that self-reported adverse effects of the Oxford/AstraZeneca COVID-19 vaccine were mild and short in duration. This outcome has promising implications for improving COVID-19 vaccine uptake in the immediate environment and Nigeria.

COVID-19 Pandemic- Ethical Challenges for Healthcare Workers Practicing in Resource-Limited Settings.

In this review, the ethical issues peculiar to the COVID-19 pandemics and the role of healthcare workers, especially those in resource-limited settings are x-rayed. We contend that there is a pressing ethical issue that needs urgent clarification on the rights and responsibilities of healthcare workers, especially in the current context of COVID-19 pandemic preparedness and responsiveness. We searched MEDLINE, Web of Science, EMBASE, Google Scholar, PUBMED related articles, newspaper articles, and online news sources for relevant information. The various professional codes of conduct (World Medical Association, Medical and Dental Council of Nigeria) were also consulted. The ethical principles of equitable distribution of healthcare resources, confidentiality with associated stigmatization, issues relating to duty to care by the healthcare workers and those pertaining to conduct of clinical trials and access to approved therapies or vaccines were highlighted in this study. We agree with the submission that healthcare workers only have a moral duty to treat patients with COVID-19 if the necessary protective equipment and adequate compensation are not provided. We argue that the duty of physicians and other healthcare workers to care for patients during pandemics such as COVID-19 is obligatory in the absence of required protective equipment and other forms of compensation. There is a need for the government and other stakeholders to put in place a National Pandemic /Epidemic Ethical Framework to address these identified ethical challenges.

Neck Circumference Cut-Off for Obesity and Metabolic Syndrome in Nigeria.

OBJECTIVE: Neck circumference (NC) is a novel tool for diagnosing cardiometabolic disorders. We aimed to determine the NC cut-off for obesity and metabolic syndrome (MS) prediction in Nigeria. METHODS: The current study was based on data analysis of 557 staff and students of Ekiti State University/Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria, who took part in a cross-sectional health screening (August-December 2018). Body mass index (BMI), waist circumference (WC), WHpR (waist-to-hip ratio), WHtR (waist-to-height ratio), systolic and diastolic blood pressure (SBP, DBP) values were determined by standard protocol. Fasting glucose and lipid profile were assayed for, and MS was defined by the harmonized criteria. The predictive ability of NC to identify people with obesity and MS was determined with receiver operating characteristic (ROC) curves. RESULTS: In both men and women, NC had positive correlation (P<.001) with age, weight, BMI, WC, WHpR, WHtR, SBP and DBP. In men and women, the AUC of NC for all the anthropometric indices were significant (P<.0001). In men, the NC cut-off was 37cm for WHpR, 37.5cm for both BMI and WHtR, 38.3cm for WC, and 40.0cm for MS. In women, the NC cut-off for all the anthropometric indices (except WHpR) and MS was 33cm. In men, NC was as good as other obesity indices in predicting MS (P>.05 for differences in the AUC), but was inferior to BMI, WC and WHtR in women. CONCLUSIONS: NC correlates with indices of adiposity and can serve as an alternate index for obesity and MS detection in Nigerians.

Association between metabolic syndrome and healthcare work status in Ekiti State, Nigeria.

INTRODUCTION: metabolic syndrome portends an increased risk of cardiovascular events and death. Evidence showed that healthcare workers are at higher risk of cardiovascular events because of their engagement in night-shift work. Therefore, this study determined the association between metabolic syndrome and healthcare work status in Ekiti State, Nigeria. METHODS: this was a cross-sectional study involving 105 healthcare workers and 143 non-healthcare workers. The diagnosis of metabolic syndrome was made based on the International Diabetic Federation criteria: abdominal obesity plus, any two of: elevated blood pressure ≥ 130/85 mmHg or previous diagnosis of hypertension on the use of antihypertensive medications; impaired fasting glucose; elevated triglycerides; and low HDL-cholesterol. Factors associated with metabolic syndrome were analysed using univariable and multivariable analysis. RESULTS: men comprised 37.9% of the study population and the mean age was 42.1 ± 9.7 years. The prevalence of metabolic syndrome was similar in both groups (HCWs-29.5% vs non-HCWs- 28.0%, p-value=0.789); overall prevalence was 28.6%. Abdominal obesity, elevated total cholesterol and elevated LDL-cholesterol occurred more frequently in HCWs than in non-HCWs: (68.6% vs 55.2%, p-value=0.034; 65.7% vs 39.2%, p-value= < 0.001 and 50.5 vs 28.7%; p-value < 0.001) respectively. Female sex (aOR: 3.67, 95% CI: 1.74-7.45; p < 0.001) and obesity (aOR: 4.39, 95% CI: 2.31-8.37; p < 0.001) were associated with metabolic syndrome. CONCLUSION: a similar prevalence of metabolic syndrome was observed in the healthcare workers and the non- healthcare workers. However, abdominal obesity, elevated total cholesterol and elevated LDL-cholesterol occurred more frequently in healthcare workers than in non- healthcare workers.

Risk factors for kidney disease among civil servants: Report of annual screening and medical evaluation.

The outlook of chronic kidney disease (CKD) is worse among the poor sub-Saharan Africa populace due to limited and unaffordable renal replacement therapy. Regular screening of at-risk population can contribute to delaying or even preventing the progression of the disease. This study was designed to evaluate prevalent risk factors for CKD among the urban dwelling civil servants in Ado Ekiti. This is a cross-sectional observational study involving healthy adults above 18 years old. Data on sociodemographic and relevant lifestyle pattern such as smoking, alcohol intake, personal and family history of hypertension, diabetes, and kidney disease were obtained. Clinical variables such as anthropometric measurements, blood pressure (BP), and blood samples for laboratory investigations were taken. There were 122 participants with a mean age of 47.26 ± 5.62 years. About half of them earn <$140/month. Fifty-two (42.6%) individuals admitted taking local herbs and/or Chinese medicines and about a third (36.1%) use unprescribed medi-cations including nonsteroidal anti-inflammatory drugs. Family history of high BP and diabetes mellitus was present in 15.6% and 11.5% of individuals, respectively. We found 45 (32.6%) individuals with body mass index ≥30 kg/m2, while 13.3% and 3.3% have at least 1+ of dipstick and microalbuminuria, respectively. About one-third (25.4%) were either found to be hypertensive or were on antihypertensives, while 12 (9.8%) were either diabetic or had hyperglycemia during the screening. There is a high prevalence of risk factors for CKD among these apparently well individuals. Regular screening, and treatment of the identified risk factors is recommended.

Tropical diabetes hand syndrome with autoamputation of the digits: case report and review of literature.

The tropical diabetes hand syndrome is a complication affecting patients with diabetes mellitus in the tropics, and consists of localized cellulitis, swelling and ulceration of the hands which may progress to fulminant sepsis and gangrene of the whole limb. It is associated with a poor outcome. We report a 32 year old woman with tropical diabetes hand infection with autoamputation of the digits, review the relevant literature, and highlight the need for prevention and early hospital presentation in diabetics with hand infection, in order to prevent potentially crippling or fatal complications.