OUTBREAK OF CEREBROSPINAL MENINGITIS IN KEBBI STATE, NIGERIA.

BACKGROUND: Cerebrospinal meningitis (CSM), is a major public health problem still affecting tropical countries particularly in sub-Saharan Africa. Group A and occasionally group C account for large scale epidemics in many countries in the African meningitis belt. The study aimed to describe the pattern of cerebrospinal meningitis outbreak in Kebbi state in 2015. METHOD: Information on cases and deaths was collected throughout the duration of the meningitis outbreak in all affected local government areas of Kebbi state. During this outbreak, we defined a suspected case as any person with sudden onset of fever (>38.5 C rectal or 38.0 C axillary) and one of the following signs: neck stiffness, altered consciousness or other meningeal signs and any toddler with sudden onset of fever (>38.5 C rectal or 38.0 C axillary) and one of the following signs: neck stiffness, or flaccid neck, bulging fontanel, convulsion or other meningeal signs. All the data was entered into SPSS statistical software and analyzed. RESULTS: A total of 1,992 suspected cases of CSM were seen within the 18 weeks that the outbreak lasted. 1127 (57.0%) were males and 865 (43.0%) were females with a case fatality rate of 4.0%. The highest proportion of cases was found among those above 15 years of age (31.0%), 1252 (62.9%) of cases were immunized against neisseria meningitides type A. Two-thirds (16) of the LGAs in the state were affected and Aliero LGA had about half (n=1106; 55.5%) of cases seen. Most (77.3%) of samples analysed were positive for Nm type C. CONCLUSION: Kebbi state experienced an outbreak of cerebro-spinal Meningitis in 2015 which was massive. Effective surveillance system and mass vaccination with polyvalent vaccines containing serogroup C will prevent future occurrence.

Prevalence of hepatitis B vaccination among health care workers in Nigeria in 2011-12.

BACKGROUND: Hepatitis B virus (HBV) infection is an endemic infection in Nigeria. Health care workers (HCWs) are at risk of occupational exposures to HBV-infected blood and body fluids. OBJECTIVE: To determine the prevalence and determinants of HBV vaccine coverage among HCWs in two teaching hospitals in Nigeria. METHODS: This cross-sectional study was undertaken in 2011 and 2012 in two teaching hospitals in Jos, North-Central Nigeria, and Yenagoa, South-South Nigeria. A self-administered structured questionnaire was administered to HCWs to obtain socio-demographic data and history of HBV vaccination. RESULTS: Out of 290 HCWs who participated in the study, 185 (64.5%) had received at least one dose of HBV vaccine; 105 (36.2%) had full coverage of three doses. Professional category and previous training in infection control were independently associated with HBV vaccination. House officers and laboratory scientists were more likely to be unvaccinated than resident doctors, consultant doctors and nurses. Full vaccine coverage was associated with younger age and shorter years of professional experience. CONCLUSION: We observed a generally low rate of HBV vaccine coverage among HCWs in Nigeria. Establishment of policies on compulsory HBV vaccination of all HCWs in Nigeria is recommended.

Endoscopic retrograde JJ-stenting of the ureter without fluoroscopy guidance--an appraisal of outcome.

BACKGROUND: JJ- ureteral stenting is a means of relieving ureteric obstruction. It is done as a retrograde or antegrade procedure, usually under fluoroscopy guidance. We reviewed our results in 2 independent tertiary health centers in Nigeria which lack fluoroscopy units. METHODS: A 2 year retrospective review of data of patients who had retrograde JJ- ureteric stenting was done. Data relating to age, indication and outcome of procedure were retrieved and analysed. RESULTS: 22 (71%) patients had successful retrograde JJ- ureteric stenting out of 31 patients who were taken for the procedure. These 22 patients had stenting of 27 ureteric units. Mean age was 48.5 years. Commonest indication was carcinoma of the cervix (31.8%). Commonest complication was irritative lower urinary tract symptoms (43.5%). CONCLUSION: In spite of inherent complications, JJ-stenting is a simple and safe technique. Therefore, the decision to attempt JJ -stenting in carefully selected patients in the absence of fluoroscopy is acceptable.