Dynamics of malaria vector indices in two vegetation zones within North Eastern Adamawa State, Nigeria.

Studies profiling community and zonal malaria entomological risk indices are required to identify high risk areas where targeted control resources are most needed or likely to have the greatest impact on reducing risk of malaria infection. This study presents a first report on malaria vector risk indices in two vegetation zones within Adamawa state, Nigeria. Endophilic mosquitoes were collected for one year in selected communities in the Guinea and Sudan savanna zones within the State. Plasmodium falciparum Sporozoite and human blood meal ELISA assays were carried out on the female Anopheles mosquitoes collected. Sibling species composition of the An. gambiae complex were determined using PCR assays. Mean numbers of mosquitoes in the Guinea savanna communities were significantly (t = 7.73, DF = 11, p < 0.001) higher than the Sudan. Man-biting rates (F = 2.76, p = 0.13) of Anopheles mosquitoes were higher in the Guinea but not significantly different from Sudan savanna. Sporozoite rates of mosquitoes within the Guinea savanna were 2.7 times higher than the Sudan. The predominant Anopheles coluzzii species encountered in the state had higher overall human blood indices (0.63) and sporozoite rates (6.9%) compared to An. gambiae (0.39, 1.9%) and An. arabiensis (0.58, 2.3%) respectively. Overall annual human blood indices (0.59) of mosquitoes in Adamawa were lower compared to reports from other States. Prevalence and higher transmission risks indices of endophilic An. coluzzii mosquitoes reveal the need for LLIN and management of relatively permanent An. coluzzii breeding sites in the State. Widespread cattle rearing lifestyle and lower human blood indices of mosquitoes in the study area suggest the need to investigate cattle blood indices of the mosquitoes in the state. Higher entomological risk indices in the Guinea Savanna zone provide baseline information for prioritization of malaria vector control supplies within the State.

Dynamics of malaria vector indices in two vegetation zones within North Eastern Adamawa State, Nigeria

@#Studies profiling community and zonal malaria entomological risk indices are required to identify high risk areas where targeted control resources are most needed or likely to have the greatest impact on reducing risk of malaria infection. This study presents a first report on malaria vector risk indices in two vegetation zones within Adamawa state, Nigeria. Endophilic mosquitoes were collected for one year in selected communities in the Guinea and Sudan savanna zones within the State. Plasmodium falciparum Sporozoite and human blood meal ELISA assays were carried out on the female Anopheles mosquitoes collected. Sibling species composition of the An. gambiae complex were determined using PCR assays. Mean numbers of mosquitoes in the Guinea savanna communities were significantly (t = 7.73, DF = 11, p < 0.001) higher than the Sudan. Man-biting rates (F = 2.76, p = 0.13) of Anopheles mosquitoes were higher in the Guinea but not significantly different from Sudan savanna. Sporozoite rates of mosquitoes within the Guinea savanna were 2.7 times higher than the Sudan. The predominant Anopheles coluzzii species encountered in the state had higher overall human blood indices (0.63) and sporozoite rates (6.9%) compared to An. gambiae (0.39, 1.9%) and An. arabiensis (0.58, 2.3%) respectively. Overall annual human blood indices (0.59) of mosquitoes in Adamawa were lower compared to reports from other States. Prevalence and higher transmission risks indices of endophilic An. coluzzii mosquitoes reveal the need for LLIN and management of relatively permanent An. coluzzii breeding sites in the State. Widespread cattle rearing lifestyle and lower human blood indices of mosquitoes in the study area suggest the need to investigate cattle blood indices of the mosquitoes in the state. Higher entomological risk indices in the Guinea Savanna zone provide baseline information for prioritization of malaria vector control supplies within the State.

Prevalence and correlates of posttraumatic stress disorder among medical students in the University of Jos, Nigeria.

CONTEXT: Posttraumatic stress disorder (PTSD) is the most common consequence of traumatic experiences. The North Central Nigeria to which Plateau State belongs has witnessed many ethno-religious crises. While previous studies suggested a high prevalence of PTSD among students, to the best of our knowledge, no such study has been reported in Nigeria. AIMS: The study aimed to determine the prevalence and correlates of PTSD among medical students in a university. MATERIALS AND METHODS: Cross-sectional systematic random sampling was used to select 200 medical students. A two staged interview with questionnaire on sociodemographic variables, PTSD Checklist-Civilian Version, Impact of Event Scale, and Composite International Diagnostic Interview was carried out. STATISTICAL ANALYSIS USED: SPSS Inc. Released 2007. SPSS for Windows, version 16.0. Chicago, SPSS Inc. was used for statistical analysis. RESULTS: Prevalence of PTSD among the students was 23.5%. Previous childhood trauma and personal experiences during the crisis were significantly associated with having PTSD. CONCLUSIONS: High prevalence rate of PTSD among medical students in Jos is an indicator of psychological consequences of the recurring crises on the inhabitants. There is a need for follow-up and counseling/trauma healing for those identified.

Stroke risk factors among participants of a world stroke day awareness program in South-Western Nigeria.

INTRODUCTION: Stroke is a major cause of death and disability in population across the world. Hypertension is the most common stroke risk factor globally as well as in the Nigerian population, however other modifiable risk factors such as obesity are becoming increasingly prevalent due to unhealthy diets and sedentary lifestyle. MATERIALS AND METHODS: We screened 224 volunteers from Ile-Ife during the 2011 and 2012 world stroke day commemorative activities. Blood pressures (BP) were measured and body mass index (BMI) was determined from weight and height measurements. The data from 40 (18%) were incomplete and were excluded from further analysis. RESULTS: The 184 subjects eligible for analysis comprised 85 males (46.2%) and 99 females (53.8%), with a male to female ratio of 0.85:1. Their ages ranged from 16 to 95 years (mean, 53±16 years). 25% of the study population had stage 1 or 2 hypertension (mean systolic blood pressure: 127±27 mmHg, mean diastolic blood pressure: 78±16 mmHg), while 34.8% and 14.7% were overweight and obese, respectively (mean BMI: 25.8±5.0 kg/m2). CONCLUSION: Stroke risk factors such as hypertension and obesity were common among the participants of the world stroke day awareness program in an urban area of Nigeria. Community screening and modification of these risk factors should be intensified in order to reduce stroke morbidity and mortality.

A study of psychiatry morbidity and co-morbid physical illness among convicted and awaiting trial inmates in Jos prison.

BACKGROUND: Having a psychiatric diagnosis is still considered a major burden in life. In addition to dealing with stigma regarding mental illness, persons with severe mental illness have an added risk of having co-morbid medical illnesses that can further impair their already turbulent life. The importance of detecting co-morbid medical illnesses is to ensure a holistic treatment. This study assessed the prevalence of psychiatric morbidity and co-morbid physical illness among convicted and awaiting trial inmates in Jos prison. METHOD: A cross-sectional, descriptive study was carried out among 608 male inmates in Jos maximum security prison, Plateau State, Nigeria. They were screened with self administered GHQ-28 questionnaire and interviewed using CIDI. RESULTS: More than half (57%) of the studied subjects had a psychiatric disorder with substance use disorder as the commonest (48.7%) diagnosis. Physical co-morbidity was found in (18%) of the subjects with infectious disease (A00-A99) as the commonest source 13 (3.7%) of physical co-morbidity among the subjects. A statistically significant relationship was found between psychiatric disorder and co-morbid physical illness (p = 0.000). CONCLUSION: The study showed a high rate of psychiatric morbidity and co-morbid physical illness with infectious disease being the commonest source of physical co-morbidity; and substance use disorder the commonest psychiatric disorder among the prison inmates.

Utilization of health care services by depressed patients attending the general out-patients department of the Jos University Teaching Hospital, Jos, Nigeria.

BACKGROUND: Depression is a common psychiatric disorder in primary health care throughout the world with increasing incidence and prevalence. It is often under-treated and under-diagnosed. Consequently, several studies have revealed that patients with depression are high utilizers of medical services. OBJECTIVES: The study was aimed at determining the frequency of consultation and the utilization of investigative procedures by the depressed and non-depressed patients in the last 12 months. MATERIALS AND METHODS: This was a cross-sectional descriptive study among 200 consecutive patients attending the General Out-Patient Department of the Jos University Teaching Hospital between November 2006 and March 2007. A semi-structured questionnaire was used to collect socio-demographic data and health services utilization indices. Structured Clinical Interview for DSM-IV axis-1 Disorders (SCID) was used for diagnosis of depression. RESULTS: The study found that 51(25.5%) of the respondents met DSM-IV criteria for the diagnosis of major depression while 149 (74.5%) did not. Depressed patients significantly had more number of consultations with their doctors (P=0.000), had consulted more number of hospitals (P=0.000), stayed longer on admission (P=0.000) and had consumed more types of medicine (P=0.005) in the last 12 months compared with the non-depressed. The depressed patients also had significantly higher mean of different types of investigations compared with non-depressed; urinalysis (1.69 vs 0.55, P=0.000), chest X-ray (0.57 vs 0.21, P=0.000) and Widal test (1.92 vs 0.39, P=0.000). Others are HIV screening (0.39vs0.11, P=0.000) urine mcs (0.94 vs 0.18, P=0.000), stool mcs (1.24 vs 0.20, P=0.000). CONCLUSION: The study demonstrated that patients who suffer from depression are higher utilizers of health care resources compared with the non-depressed. Therefore, it is recommended that general practitioners and other health workers need to be better equipped to deal with the diagnosis and management of depression.

Prevalence of psychiatric morbidity and its associated factors among patients facially disfigured by cancrum oris in Nigeria a controlled study.

OBJECTIVE: Little information is available about prevalence of psychiatric morbidity among adult patients who suffered from cancrum oris in Nigeria. The objective of this paper was to assess the prevalence of psychiatric morbidity among patients of cancrum oris in Nigeria. METHOD: A cross sectional controlled study was conducted in 2005 comprising 200 adult patients of cancrum oris. Data was collected through self administered questionnaire from the patients. Psychiatric morbidity was assessed using General Health Questionnaire (GHQ) 28. RESULTS: Prevalence of psychiatric morbidity was 37% which was about three times that of the control. Psychiatric morbidity was more prevalent among female patients. Other factors associated with high prevalence of psychiatric morbidity include being never married, no formal education and unemployed status. CONCLUSION: Psychiatric morbidity is prevalent among cancrum oris patients with differences between both sexes. Being never married, no formal education and unemployed status were other associated factors.

Effect of Gongronema latifolium ethanol leaf extract on gastric acid secretion and cytoprotection in streptozotocin-induced diabetic rats.

OBJECTIVES: Gongronema latifolium leaves have been used in folklore medicine to manage diabetes mellitus and alleviate dyspepsia. This study aimed to provide a pharmacological basis to the medicinal use ofGongronema latifolium as an antidiabetic and antiulcerogenic agent in diabetes mellitus. METHODS: Ethanol extract from the leaf (200 mg/kg bodyweight) of Gongronema latifolium was administered to both streptozotocin-induced diabetic and control groups orally for 14 days. Gastric acid secretion was measured and ulcer was induced using ethanol and four-hour pyloric ligation. RESULTS: The mean bodyweight was significantly lower (p < 0.01), while the mean weight of the stomach, liver and small intestine to bodyweight ratio was increased significantly (p < 0.05) in the two diabetic groups compared to control. Extract significantly (p < 0.01) reduced the blood glucose level similar to the non-diabetic control. Basal and stimulated acid secretion in diabetic control rats was significantly (p < 0.01) decreased when compared to control. Extract administration increased the stimulated gastric acid secretion to a level significantly (p < 0.05) higher than control while reduction in gastric secretion by ranitidine was similar compared with control. Gongronema latifolium treatment significantly (p < 0.05) reduced ulcer scores in both ulcer models and increased mucus weight in the diabetic group. CONCLUSION: These results suggest that Gongronema latifolium antiulcerative activity is due to its prevention of chemical-induced stomach injury.

Anterior neck injuries presenting as cut throat emergencies in a tertiary health institution in north western Nigeria.

BACKGROUND: Anterior neck injuries vary in pattern and aetiology and may pose management challenges ifnot fatal. AIMS AND OBJECTIVES: To describe patterns of anterior neck injuries in a tertiary hospital north western Nigeria. MATERIALS AND METHODS: This is a prospective study of all cases of anterior neck injuries presenting as cut throat emergencies that were referred from accident and emergency department to the department of otorhinolaryngology over a nine year period (September 1999 to August 2008). RESULTS: A total number of 19 cases were seen. All were males whose age range was from 5 years to 60 years with a mean age of 21.2 years. About 78.9% of the patients were within the 2nd to 4th decades of life with a peak at the 4th decade (31.6%). Ten (52.6%) patients were cases of attempted suicide with known background of psychiatric illness, Five (26.3%) were homicidal (3 under the influence of illicit drugs), two (10.5%) were from animal assault while one was as a result of road traffic accident and another one from fall on sharp object. Patients with attempted suicide had deep open wounds exposing the pharynx, larynx or both with horizontally positioned incision wounds while homicidal cases had obliquely positioned incision wounds. Restoration of normal neck, pharyngeal and laryngeal architecture was carried out through meticulous surgical repair of various tissue layers with nasogastric tube in situ for 7-9 days. Psychiatric evaluation and treatment were carried out concurrently with patients who attempted suicide and homicide. Two patients required tracheostomy to prevent upper airway obstruction from severe laryngeal trauma. CONCLUSION: Significant proportion of emergencies from anterior neck cut throat injuries in this study were from suicidal attempts (52.6%) by people with a background history of psychiatric illness, followed by attempted homicide (26.3%) and animal assault (10.5%). Prompt surgical repair and concurrent psychiatric evaluation in attempted suicide and homicide is required.

Effects of ultraviolet radiation (type B) on wound exudates, appearance and depth description.

Purulent exudate is one of the clinical signs of decubitus ulcers; and it is indicative of infection. The greatest challenge is the decreasing sensitivity of infective micro-organisms to antibiotics. There appears to be paucity of data on the effect of Ultraviolet radiation on wound exudates and appearance. The main purpose of this study was to determine the effect of ultraviolet radiation (Type B) on wound exudates and appearance of decubitus ulcers. Ten (10) bed-ridden subjects with ascertained bilateral sore from unrelieved pressure in their lower extremities consented to participate in the study. The decubitus ulcers were treated with traditional saline-wet-to-moist (WM) wound dressing. The decubitus ulcers on the left lower extremities were the experimental limbs and were exposed to ultraviolet radiation as adjunct while the right lower limbs served as control and received only the saline-wet-to-moist (WM) wound dressing. The frequency of treatment was 3 times per week for 6 weeks. The type of exudates produced, amount of exudates, wound appearance and depth description were scored on a 5-point likert scale. The data was analyzed using descriptive statistics and non-parametric inferential statistics (Kruska-Wallis test). The result of the Kruskal Wallis test showed that there was significant improvement in the type of exudates produced by the decubitus ulcers of the experimental (left) limbs (X{2} = 33.71, p < 0.00) when compared with the control limbs. Similarly, there was significant reduction in the amount of exudates produced by the decubitus ulcers of the experimental limbs (X{2} = 30.58, p < 0.00) when compared with that of the control. Also, there was significant improvement in the appearance of the decubitus ulcers (X{2} = 33.01, p< 0.00) and depth description of the experimental (left) limbs compared to that of the control (right). This study concluded that Ultraviolet radiation (Type B) can significantly improve the appearance of decubitus ulcers. Also, it can significantly reduce the amount of purulent exudates and can hasten skin replacement of decubitus ulcers.

Aqueous leaf extract of Rothmannia longiflora improves basal metabolic rate and electrolyte parameters in alloxan-induced diabetic rats.

This study evaluated the action of aqueous leaf extract of Rothmannia longiflora on basal metabolic rate and electrolyte profile of alloxan-induced diabetic rats. Fifteen male Wistar rats weighing 135-140 g were assigned to 3 groups of 5 rats each. Group 1 which served as control received placebo treatment, group 2 namely the diabetic [untreated] group also received placebo treatment whereas group 3-the extract treated diabetic group was administered extract [15 g/kg body weight] by oral administration for 14 days. Results of BMR measurement showed a significant increase [P<0.01] in BMR level of Diabetic untreated group [1.03+/-0.02 ml/hr/g] compared to the control group [0.79+/-0.07 ml/hr/g]. Extract treatment significantly [P<0.05] decreased BMR in the diabetic rats. Results of analyses of serum electrolytes and glucose showed significant decreases [P<0.01] in sodium and chloride concentrations in the diabetic untreated group when compared to the control. However, sodium and chloride concentrations in the extract treated diabetic were not significantly different from that of their control values. There was no significant difference in potassium and urea concentrations in the extract-treated diabetic rats with respect to their control values. Extract treatment significantly [P<0.05] reduced serum glucose level of the extract treated group when compared to the diabetic untreated group. This suggests that oral administration of Rothmannia longiflora might be beneficial for the restoration of basal metabolic rate and improvement of electrolyte profile in diabetes mellitus.

Clinical neuropathy in HIV/AIDS: an eight-year review of hospitalized patients in Sokoto, northwestern Nigeria.

HIV/AIDS is a multi-systemic disease that targets mainly the immune and nervous systems. Although about 4.4% of Nigerians are infected with HIV, data on the spectrum of HIV-related nervous disease in this population is rare. This study describes the neurological manifestations of HIV/AIDS in northern Nigeria. We undertook retrospective and descriptive analyses of the demographic, clinical, neurologic and laboratory data of all hospitalized HIV/AIDS adults in a referral hospital in northwestern Nigeria. The study period covered 2000 to 2007. We studied 322 HIV/AIDS patients (218 men, 104 women) aged 33.4 +/- 11.4 years (range: 18-65 years) who constituted 3.5% of the total medical admissions. HIV transmission was exclusively by heterosexual intercourse involving multiple partners. The majority (70.2%) was married and 78.9% were in stage III/IV HIV/AIDS disease. Fifty-two (16.2%) had CD4+ T-cell count determination, the mean value being 220 +/- 147.2 cells/m(3), and 58 (18.0%) were on highly active antiretroviral therapy. Fifty-one (15.8%) had neurological complications dominated by central nervous diseases including encephalitis (17.6%), dementia (16.2%) and stroke (14.9%). Peripheral nerve involvements were relatively infrequent. Compared with HIV/AIDS patients without neurological complications, a significantly higher proportion of those with HIV-associated neuropathy had a stage IV disease (30% versus 9.4%, chi(2) = 19.5, P < 0.001). Neurological complications, particularly central nervous diseases, are an important cause of morbidity in the HIV/AIDS population.

Psychotropic drugs prescription at two regional psychiatric hospitals in northern Nigeria.

BACKGROUND: Studies on psychotropic drug prescription in Nigeria are few, limited to the south and over a decade old. With the recent advances in psychopharmacology an audit is desirable. OBJECTIVE: To describe the practice and pattern of psychotropic drugs prescription for new patients attending out-patient clinic in two Federal Neuro-Psychiatric Hospitals in Northern Nigeria and to identify extent of potential drug-drug interaction in the prescriptions. METHODS: A cross-sectional study, using charts review, on new patients seen over a month at the out-patient clinics of two regional psychiatric hospitals in Northern Nigeria. RESULTS: Two hundred and seventy-eight patients were seen. Conventional antipsychotics were the most prescribed (68%), anticholinergic (62%), tricyclic antidepressants (35%), anticonvulsants (25%), benzodiazepines (8%). SSRIs were given to 2% of patients, while no patient was given an atypical antipsychotic. Physicians did not inquire about patients medical and medication histories, nor perform physical examinations in most cases. Polypharmacy was high, giving rise to significant potential drug-drug interactions in 28% of patients. CONCLUSION: Prescription practices are far from ideal, and continuing education, as well as development of prescription practice guidelines is suggested. Government intervention and change in clinician attitudes may be needed to improve use of newer medications.

Severe burn trauma from deliberate self-harm: the Sokoto experience.

BACKGROUND: Burn injury is one of the most severe forms of trauma that can afflict mankind. Although several forms of suicide and para suicide have been reported worldwide, severe burn injuries from deliberate self-harm have been poorly documented in Africa. AIM: To evaluate the pattern of deliberate self-harm by burning in our environment. METHOD: This is a 5-year retrospective analysis of all patients who sustained burns from deliberate self-harm (DSH) seen at the Usmanu Danfodiyo University Teaching Hospital, Sokoto from June 1998 to May 2003. The patients' data and other necessary information were extracted from the case notes. RESULTS: Seven patients were seen over the study period. There were six females and one male, giving a female to male ratio of 6:1. All the injuries occurred at home from kerosene flame burns. In all cases, the intent was to take the patient's own life. The triggering factors were mainly psychosocio-economic. Six patients had up to secondary education while one patient had a degree certificate. None of the patients was gainfully employed at the time of incidence. Two patients had previously attempted suicide. Only one patient had a history of psychiatric illness. All sustained severe flame burns ranging from 45% - 98% body surface area (BSA). Compliance to treatment was generally poor. All patients were managed at the intensive care unit (ICU) of the hospital.. Five patients died, while the remaining two signed against medical advice (SAMA) during the course of management. The duration of hospital stay ranged from 2 - 10 days. CONCLUSION: Severe burn injury from DSH, although previously poorly documented in Africa, is not uncommon in our environment. The morbidity and mortality are high, not only because of the nature of injury, but probably because of poor compliance to treatment. We advocate community based studies and routine screening of adolescents to identify those at risk. The need for the establishment suicide information, intervention and prevention centre in Nigeria cannot be overemphasised.

Effect of multiparity on electrolyte composition and blood pressure.

Pregnancy affects the physiology of the pregnant woman particularly the endocrine, cardiovascular and the renal systems. This work was therefore set to ascertain the state of electrolytes in pregnancy and how it affects blood pressure using multiparity as a factor. One hundred and twenty (120) women were used in this study. The non-pregnant groups were the nulliparous (control) and grand multiparous women who have stopped gestation (GMS) for at least five years. The pregnant groups were made up of 30 primigravidae (PG) and 30 grand multiparous (GMP). The pregnant groups (PG and GMP) were further divided into first, second and third trimesters. The subjects were aged matched with controls. Serum electrolytes (Na(+), K(+) and Cl(-)) were measured using standard methods. The results show that there was no significant difference in the electrolyte composition among the groups and between trimesters. There was also no significant difference in blood pressure among the groups and between trimesters in the pregnant groups irrespective of parity. Multiparity therefore may not pose any severe threat to health.

Intestinal motility and transit following chronic ingestion of different forms of palm oil diets.

This study was aimed at finding the effect of palm oil diets on the small intestinal motor activity and transit in rats. Adult albino Wistar rats were divided into three groups of ten rats each. The first group was fed on rat chow containing 15% (wt/wt) of fresh palm oil diets for fifteen weeks. The second was fed on rat chow containing 15% (wt/wt) thermally oxidized diet while the third group was the control and so was fed on rat chow only. Water and feed were allowed freely to all the groups. Intestinal motility and transit were measured after the feeding period. Results show that there was a significant increase (P < 0.05) in basal tone of the ileum from rats fed on thermally oxidized palm oil diet when compared with fresh palm oil fed and control diets respectively. Contraction to acetylcholine (10(-11) - 10(-5)M) showed a biphasic tone with highest contraction at lower doses of acetylcholine and lowest tone at 10(-7)M in both fresh palm oil-fed and thermally oxidized oil-fed groups when compared with control. There was a significant (P < 0.05) attenuation of inhibition of atropine effect in the oxidized oil fed group when compared with control while there was a significant (P < 0.01) increase in transit of food material in the intestine of oxidized oil-fed group when compared with control and fresh palm oil-fed groups. These results show that chronic ingestion of oxidized palm oil diet causes an increase in basal tone of ileum and enhances intestinal motility and transit in the rat.

Polypharmacy in psychiatric out-patient practice in northern Nigeria.

OBJECTIVE: To describe and analyze patterns of polypharmacy among psychiatric outpatients in northern Nigeria and identify predictors of psychotropic polypharmacy. METHOD: A cross-sectional study, using chart review of new patients at out-patient clinics of two regional psychiatric hospitals in northern Nigeria,measuring rates, patterns and predictors of psychotropic polypharmacy. RESULTS: A total of 278 patients were seen, of whom 92%were given two or more psychotropic agents.The pattern of psychotropic polypharmacy revealed that total, multi-class and adjunctive polypharmacy rates were high, while augmentation and same class polypharmacy rates were low. Age of respondent and diagnosis were the factors associated with total polypharmacy. CONCLUSION: The complex interplay of factors influencing physician prescription practices requires that a more pragmatic approach be adopted in efforts to curtail polypharmacy practice, rather than a wholesale, absolute condemnation of the practice.