The impact of sub-national heterogeneities in demography and epidemiology on the introduction of rubella vaccination programs in Nigeria.

Rubella infection during pregnancy can result in miscarriage or infants with a constellation of birth defects known as congenital rubella syndrome (CRS). When coverage is inadequate, rubella vaccination can increase CRS cases by increasing the average age of infection. Thus, the World Health Organisation recommends that countries introducing rubella vaccine be able to vaccinate at least 80% of each birth cohort. Previous studies have focused on national-level analyses and have overlooked sub-national variation in introduction risk. We characterised the sub-national heterogeneity in rubella transmission within Nigeria and modelled local rubella vaccine introduction under different scenarios to refine the set of conditions and strategies required for safe rubella vaccine use. Across Nigeria, the basic reproduction number ranged from 2.6 to 6.2. Consequently, the conditions for safe vaccination varied across states with low-risk areas requiring coverage levels well below 80 %. In high-risk settings, inadequate routine coverage needed to be supplemented by campaigns that allowed for gradual improvements in vaccination coverage over time. Understanding local heterogeneities in both short-term and long-term epidemic dynamics can permit earlier nationwide introduction of rubella vaccination and identify sub-national areas suitable for program monitoring, program improvement and campaign support.

Molecular docking as a tool for the discovery of molecular targets of nutraceuticals in diseases management.

Molecular docking is a computational technique that predicts the binding affinity of ligands to receptor proteins. Although it has potential uses in nutraceutical research, it has developed into a formidable tool for drug development. Bioactive substances called nutraceuticals are present in food sources and can be used in the management of diseases. Finding their molecular targets can help in the creation of disease-specific new therapies. The purpose of this review was to explore molecular docking's application to the study of dietary supplements and disease management. First, an overview of the fundamentals of molecular docking and the various software tools available for docking was presented. The limitations and difficulties of using molecular docking in nutraceutical research are also covered, including the reliability of scoring functions and the requirement for experimental validation. Additionally, there was a focus on the identification of molecular targets for nutraceuticals in numerous disease models, including those for sickle cell disease, cancer, cardiovascular, gut, reproductive, and neurodegenerative disorders. We further highlighted biochemistry pathways and models from recent studies that have revealed molecular mechanisms to pinpoint new nutraceuticals' effects on disease pathogenesis. It is convincingly true that molecular docking is a useful tool for identifying the molecular targets of nutraceuticals in the management of diseases. It may offer information about how nutraceuticals work and support the creation of new therapeutics. Therefore, molecular docking has a bright future in nutraceutical research and has a lot of potentials to lead to the creation of brand-new medicines for the treatment of disease.

Serum Immunoglobulin E and Vitamin D Levels in Asthma Patients in Enugu, Nigeria: Association with Asthma Control.

BACKGROUND: Asthma symptoms are often mediated by changes in immune responses to allergens measured by the levels of immunoglobulin E (IgE) and non-protein regulators such as 25-hydroxycholecalciferol (25 (OH) vitamin D3). The relationship between serum levels of IgE, 25 (OH) Vitamin D3, and asthma control in asthma patients remains unclear. OBJECTIVE: To measure the serum IgE and 25 (OH) vitamin D3 levels in asthma patients and determine their relationship with patient's asthma control. METHODS: This was a cross-sectional study of children and adults with asthma aged 5 to 60 years old; and their controls seen in a tertiary hospital in Enugu, south eastern Nigeria from October 2018 to January 2019. Serum levels of IgE, and 25 (OH) vitamin D3 were determined by sandwich enzyme-linked immunosorbent assay (ELISA); and compared between groups using the Student's t-tests. Association between IgE, 25 (OH) vitamin D3 levels, and asthma control were determined using the Chi-square. RESULTS: Sixty-five (65) asthma patients and thirty-three (36) non-asthma controls were studied. Mean serum level of IgE (411.32± 220.18 IU/ml) was significantly raised in asthma patients compared to controls (163.51 ± 186.36 lU/ml); p=0.001. There was no significant difference in mean 25 (OH) vitamin D3 levels in asthma (68.55 ± 25.91 ng/ml) compared to controls (77.25 ± 34.01 ng/ml); p=0.153. No significant association was found between patient's asthma control status, and serum IgE and 25 (OH) vitamin D3 levels. CONCLUSION: Asthma control status was not associated with Immunoglobulin E and 25 (OH) vitamin D3 levels in those studied. More robust study is required to evaluate the relationship between asthma control, IgE and vitamin D levels.

BACKGROUND: Les symptômes de l'asthme sont souvent médiés par des changements des réponses immunitaires aux allergènes, mesurées par les taux d'immunoglobuline E (IgE) et de régulateurs non protéiques tels que le 25- hydroxycholécalciférol (25 (OH) vitamine D3). La relation entre les niveaux sériques d'IgE, de 25 (OH) vitamine D3 et le contrôle de l'asthme chez les patients asthmatiques n'est pas claire. OBJECTIF: Mesurer les taux sériques d'IgE et de 25 (OH) vitamine D3 chez les patients asthmatiques et déterminer leur relation avec le contrôle de l'asthme chez les patients. MÉTHODES: Il s'agit d'une étude transversale d'enfants et d'adultes asthmatiques âgés de 5 à 60 ans; ainsi que de leurs témoins vus dans un hôpital tertiaire d'Enugu, dans le sud-est du Nigeria, d'octobre 2018 à janvier 2019. Les taux sériques d'IgE et de 25 (OH) vitamine D3 ont été déterminés par dosage immuno-enzymatique en sandwich (ELISA); et comparés entre les groupes à l'aide des tests t de Student. L'association entre les niveaux d'IgE, de 25 (OH) vitamine D3 et le contrôle de l'asthme a été déterminée à l'aide du chi carré. RÉSULTATS: Soixante-cinq (65) patients asthmatiques et trentetrois (36) témoins non asthmatiques ont été étudiés. Le taux sérique moyen d'IgE (411,32 ± 220,18 UI/ml) était significativement plus élevé chez les patients asthmatiques que chez les témoins (163,51 ± 186,5 UI/ml); p=0,001. Il n'y avait pas de différence significative dans les taux moyens de 25 (OH) vitamine D3 chez les asthmatiques (68,55 ± 25,91 ng/ml) par rapport aux témoins (77,25 ± 34,01 ng/ml); p=0.153. Aucune association significative n'a été trouvée entre le statut de contrôle de l'asthme du patient et les taux sériques d'IgE et de 25 (OH) vitamine D3. CONCLUSION: Le contrôle de l'asthme n'était pas associé aux taux d'immunoglobulines E et de 25 (OH) vitamine D3 chez les personnes étudiées. Une étude plus solide est nécessaire pour évaluer la relation entre le contrôle de l'asthme, les taux d'IgE et de vitamine D. Mots clés: 25 hydroxyl vitamine D3, Immunoglobuline E, Contrôle de l'asthme, Enfants, contrôle, Enfants.

Cucumeropsis mannii seed oil (CMSO) attenuates alterations in testicular biochemistry and histology against Bisphenol a-induced toxicity in male Wister albino rats.

Background: Male reproductive health has deteriorated in recent years as a result of industrialization, which has led to the use of desirable chemicals, like Bisphenol A (BPA), of underlying toxicity. Cucumeropsis mannii seed is a common soup thickener that produces vegetable oil as well as essential nutrients making it a source of nutraceuticals enlisted with a wide range of therapeutic effects. Methods: A total of 48 adult male Wistar rats (120 ± 200g) were used in this study. They were completely randomized and divided into six groups: A (1ml olive oil) irrespective of the weight, B [BPA 100 mg/kg body weight (bw)], C (CMSO 7.5 ml/kg bw), D (CMSO 7.5 ml/kg bw + BPA 100 mg/kg bw), E (CMSO 5.0 ml/kg bw + BPA 100 mg/kg bw), and E (CMSO 2.5 ml/kg bw + BPA 100 mg/kg bw). At the end of the administration via oral routes, rats were sacrificed and testes were collected for biochemistry and histological analysis. Results: BPA significantly (P < 0.05) decreased total testicular protein, epididymal sperm parameters (count, volume, and motility), Mitochondrial Membrane Potential (MMP), body weight, testicular volume; and significantly (P < 0.05) increased testicular enzymes (alkaline phosphatase and lactate dehydrogenase), testicular index; plus histological damages. Interestingly, co-administration of BPA and CMSO significantly (P < 0.05) reversed the biochemical and histological changes. Conclusions: CMSO prevented the biochemistry and histological alterations hence reducing the testicular toxicity. Therefore, CMSO has the potential to be a promising novel nutraceutical for the treatment and management of BPA-induced testicular toxicity.

Hesperidin abrogates bisphenol A endocrine disruption through binding with fibroblast growth factor 21 (FGF-21), α-amylase and α-glucosidase: an in silico molecular study.

BACKGROUND: Fibroblast growth factor 21 (FGF-21), alpha-amylase, and alpha-glucosidase are key proteins implicated in metabolic dysregulations. Bisphenol A (BPA) is an environmental toxicant known to cause endocrine dysregulations. Hesperidin from citrus is an emerging flavonoid for metabolic diseases management. Through computational approach, we investigated the potentials of hesperidin in abrogating BPA interference in metabolism. The 3D crystal structure of the proteins (FGF-21, α-amylase, and α-glucosidase) and the ligands (BPA and hesperidin) were retrieved from the PDB and PubChem database respectively. Using Autodock plugin Pyrx, molecular docking of the ligands and individual proteins were performed to ascertain their binding affinities and their potentials to compete for the same binding site. Validation of the docking study was considered as the ability of the ligands to bind at the same site of each proteins. The docking poses were visualized using UCSF Chimera and Discovery Studio 2020, respectively to reveal each of the protein-ligands interactions within the binding pockets. Using SwissAdme and AdmeSar servers, we further investigated hesperidin's ADMET profile. Hesperidin used was purchased commercially. RESULTS: Hesperidin and BPA competitively bound to the same site on each protein. Interestingly, hesperidin had greater binding affinities (Kcal/mol) - 5.80, - 9.60, and - 9.60 than BPA (Kcal/mol) - 4.40, - 7.20, - 7.10 for FGF-21, α-amylase, and α-glucosidase respectively. Visualizations of the binding poses showed that hesperidin interacted with stronger bonds than BPA within the proteins' pockets. Although hesperidin violated Lipinski rule of five, this however can be optimized through structural modifications. CONCLUSIONS: Hesperidin may be an emerging natural product with promising therapeutic potentials against metabolic and endocrine derangement.

Performance of HIV rapid testing algorithm in Nigeria: Findings from a household-based Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS).

BACKGROUND: The Nigeria AIDS Indicator and Impact Survey (NAIIS), a cross-sectional household survey, was conducted in 2018 with primary objectives to estimate HIV prevalence, HIV-1 incidence, and status of UNAIDS 90-90-90 cascade. We conducted retrospective analysis of the performance of HIV rapid tests and the national HIV testing algorithm used in Nigeria. METHODS: The national algorithm included Determine HIV-1/2 as test 1 (T1), Unigold HIV-1/2 as test 2 (T2), and StatPak HIV-1/2 as the tie-breaker test (T3). Individuals reactive with T1 and either T2 or T3 were considered HIV-positive. HIV-positive specimens from the algorithm were further confirmed for the survey using supplemental test Geenius HIV-1/2. If Geenius did not confirm HIV-positive status, HIV-1 Western blot was performed. We calculated the concordance between tests and positive predictive value (PPV) of the algorithm on unweighted data. RESULTS: Of 204,930 participants (ages ≥18 months) 5,103 (2.5%) were reactive on T1. Serial testing of T1 reactive specimens with T2 or if needed by tiebreaker T3 identified 2958 (1.44%) persons as HIV-positive. Supplemental testing confirmed 2,800 (95%) as HIV-positive (HIV-1 = 2,767 [98.8%]; HIV-2 = 5 [0.2%]; dual infections = 22 [0.8%]). Concordance between T1 and T2 was 56.6% while PPV of the national algorithm was 94.5%. CONCLUSIONS: Our results show high discordant rates and poor PPV of the national algorithm with a false-positive rate of about 5.5% in the NAIIS survey. Considering our findings have major implications for HIV diagnosis in routine HIV testing services, additional evaluation of testing algorithm is warranted in Nigeria.

Evaluation of the Nigeria national HIV rapid testing algorithm.

Human Immunodeficiency Virus (HIV) diagnosis remains the gateway to HIV care and treatment. However, due to changes in HIV prevalence and testing coverage across different geopolitical zones, it is crucial to evaluate the national HIV testing algorithm as false positivity due to low prevalence could be detrimental to both the client and the service delivery. Therefore, we evaluated the performance of the national HIV rapid testing algorithm using specimens collected from multiple HIV testing services (HTS) sites and compared the results from different HIV prevalence levels across the six geopolitical zones of Nigeria. The evaluation employed a dual approach, retrospective, and prospective. The retrospective evaluation focused on a desktop review of program data (n = 492,880) collated from patients attending routine HTS from six geopolitical zones of Nigeria between January 2017 and December 2019. The prospective component utilized samples (n = 2,895) collected from the field at the HTS and tested using the current national serial HIV rapid testing algorithm. These samples were transported to the National Reference Laboratory (NRL), Abuja, and were re-tested using the national HIV rapid testing algorithm and HIV-1/2 supplementary assays (Geenius to confirm positives and resolve discordance and multiplex assay). The retrospective component of the study revealed that the overall proportion of HIV positives, based on the selected areas, was 5.7% (28,319/492,880) within the study period, and the discordant rate between tests 1 and 2 was 1.1%. The prospective component of the study indicated no significant differences between the test performed at the field using the national HIV rapid testing algorithm and the re-testing performed at the NRL. The comparison between the test performed at the field using the national HIV rapid testing algorithm and Geenius HIV-1/2 supplementary assay showed an agreement rate of 95.2%, while that of the NRL was 99.3%. In addition, the comparison of the field results with HIV multiplex assay indicated a sensitivity of 96.6%, the specificity of 98.2%, PPV of 97.0%, and Kappa Statistic of 0.95, and that of the NRL with HIV multiplex assay was 99.2%, 99.4%, 99.0%, and 0.99, respectively. Results show that the Nigeria national serial HIV rapid testing algorithm performed very well across the target settings. However, the algorithm's performance in the field was lower than the performance outcomes under a controlled environment in the NRL. There is a need to target testers in the field for routine continuous quality improvement implementation, including refresher trainings as necessary.

Halotolerant and metalotolerant bacteria strains with heavy metals biorestoration possibilities isolated from Uburu Salt Lake, Southeastern, Nigeria.

Environmental contaminations by heavy metals are currently an increasing public health concern globally. One key challenge of these toxic metals is the extremely difficulties involved in their detoxification from the environment and effluents because of their non-degradability. An efficient biologic agent with potentials of remediating these toxic metals may ease these ever-increasing problems. We reported toxic metals tolerance and bioremediation potentials of novel bacteria sp. Strains USL2S, USL4W and USL5W isolated from Uburu salt lake, Ebonyi State, Nigeria. The phenotypic characteristics and the 16S rRNA gene analyses revealed that USL2S strain belongs to the genus Klebsiella, whereas USL4W and USL5W strains belong to the genus Pseudomonas. The bacteria isolates grew well in media containing 5-15 % of sodium chloride. The bacteria isolate showed capacity to tolerate 50.0 mM Hg+2 and Pb+2, 17.0, 12.50 and 4.0mM Ni+2, Cd+2, and Zn+2 respectively in solid media. Pseudomonas putida A4W Strain also tolerated 16.0 mM Cu+2, while Klebsiella sp. Strain USL2S, Pseudomonas putida USL5W Strain tolerated 4.0 mM each. AAS analyses showed 85, 95, and 95 % Hg; 97.13, 98.89, and 97.55 % Pb; 73.33, 77.42 and 69.72 Cd; 88.06, 99.54, and 97.91 % Ni; 100, 100 and 83.62% Cu; 42.30, 84.52 and 98.80 % Zn removal from media broth incorporated with the tested metals by Klebsiella sp. USL2S, Pseudomonas sp. Strain USL5W and Pseudomonas sp. USL4W respectively. We therefore recommend these novel moderately halophilic and metal tolerant isolates as possible biologic agents for effective bioremediation of mercury, lead, cadmium, nickel, copper and zinc in contaminated environments and effluents.

Considerations for quality assurance of multiplex malaria antigen detection assays with large sample sets.

Multiplex assays for malaria antigen detection can gather data from large sample sets, but considerations for the consistency and quality assurance (QA) of mass testing lack evaluation. We present a QA framework for a study occurring November 2019 to March 2020 involving 504 assay plates detecting four Plasmodium antigens: pan-Plasmodium aldolase and lactate dehydrogenase (LDH), histidine-rich protein 2 (HRP2), P. vivax LDH (PvLDH). Controls on each plate included buffer blank, antigen negative blood, and 4-point positive dilution curve. The blank and negative blood provided consistently low signal for all targets except for pAldolase, which showed variability. Positive curve signals decreased throughout the 5-month study duration but retained a coefficient of variation (CV) of < 5%, with the exception of HRP2 in month 5 (CV of 11%). Regression fittings for inter-plate control signals provided mean and standard deviations (SDs), and of 504 assay plates, 6 (1.2%) violated the acceptable deviation limits and were repeated. For the 40,272 human blood samples assayed in this study, of 161,088 potential data points (each sample × 4 antigens), 160,641 (99.7%) successfully passed quality checks. The QA framework presented here can be utilized to ensure quality of laboratory antigen detection for large sample sets.

Assessment of Levels and Health Risks of Trace Metals in Soils and Food Crops Cultivated on Farmlands Near Enyigba Mining Sites, Ebonyi State, Nigeria.

ABSTRACT: In most developing countries, mining is one of the major sources of toxic heavy metals, some of which are a major health concern to the surrounding populace through soil pollution and food contamination. We investigated the levels of Ti, Mn, Ni, Cu, Zn, Pb, Rb, Sr, Se, Nb, and V in 64 soil samples, 320 samples of regularly consumed staple food crops and vegetables (Manihot esculenta [cassava] tubers, Dioscorea rotundata [white yam], Arachi hypogea [groundnut] seed, Telfariria occidentalis [fluted pumpkin leaf]), and leaves of the medical plant Zanthoxulum zanthoxyloides on farmlands near Enyigba mining sites in Ebonyi state, Nigeria. We also examined the possible health risks due to consumption of these staple foods. Energy dispersive X-ray fluorescence was used to determine the metals present in the samples. The mean levels of metals, except for Mn, Pb, and Zn, were below the threshold limits recommended by various institutions for agricultural soils. Our data also showed that food crops cultivated near these sites bioaccumulated toxic levels of these metals above the proposed values set by the World Health Organization, National Agency for Food and Drug Administration and Control, and Codex Alimentarius Commission, especially for Pb, Zn, Cu, Ni, Se, and Rb. These findings may have potential health implications for the local dwellers. The estimated daily intakes of the toxic metals through the consumption of the crop samples were below the maximum tolerable daily intakes, except for Pb and Ni, by eating groundnut, cassava, and white yam. Furthermore, the target hazard quotient, computed based on the estimated daily intake of the heavy metals, was above unity for the metals for cassava, white yam, and groundnut consumption, suggesting significant health risk. Elevated amounts of heavy metals in cassava and groundnut samples, as revealed by their metal extraction coefficient computed in this study, hint that they may be used as bioindicators of ecological and health hazards and phytoremediators of Mn, Zn, Cu, and Pb.

Anti-arthritic potential of ethanol and aqueous extracts of stem bark of Cleistopholis patens on complete Freund's adjuvant-induced rheumatoid arthritis in rats.

BACKGROUND: Traditional medicine intervention has been used in rheumatoid arthritis (RA) treatment due to limitations of conventional drugs. OBJECTIVE: This study aimed at evaluating the anti-arthritic potentials of ethanol and aqueous extracts of stem bark of Cleistopholis patens (SBCP) in complete Freund's adjuvant (CFA) induced rheumatoid arthritis in rats. MATERIALS AND METHODS: Rheumatoid arthritis was induced in groups 2 to 9 by intradermal injection of 0.1 mlkg-1 chicken type II collagen in CFA into the left hind paw of the rats. Group 1 served as normal control. Group 2 (negative control) received 5 mlkg-1 body weight normal saline while group 3 (positive control) received 10 mg/kg body weight standard drug (indomethacin). Groups 4 to 9 received varied doses of the extracts. After 10 days of RA induction, rats were treated with ethanol and aqueous extracts of SBCP orally at a dose of 400, 600 and 800 mgkg-1 for 21 days. The paw size, body weight changes, inflammatory parameters, lipid peroxidation maker and malondialdehyde (MDA) were assessed. RESULTS: Rheumatoid arthritis induction caused marked (p < 0.05) increase in paw size, inflammatory makers and MDA while significant (p < 0.05) reduction was observed in body weight relative to normal control. Treatment with extracts analogous to indomethacin markedly (p < 0.05) decreased the paw size and caused weight gain while the altered inflammatory parameters and MDA were reversed relative to negative control. CONCLUSION: The findings suggest that the extracts of SBCP have good antiarthritic potentials comparable to indomethacin and hence could be used in rheumatoid arthritis management.

Ethanol leaf extract of Psychotria microphylla rich in quercetin restores heavy metal induced redox imbalance in rats.

Psychotria microphylla is a plant found in Africa and many parts of the world where the leaves are locally used in folk medicine for the treatment of toxicity related liver diseases. We investigated the antioxidant potentials of ethanol leaf extract of Psychotria microphylla (ELE-PM) in restoring hepatic redox dysregulations in rats exposed to heavy metals. HPLC was used in quantifying the bioactive compounds in ELE-PM. DPPH (1,1-diphenyl-2 picrylhydrazyl), FRAP (Ferric reducing antioxidant power) and NO (Nitric Oxide) assays were used for in vitro studies. The in vivo studies involved 30 rats randomly divided into 5 groups (n = 6). Group 1 received normal saline (2 mg/kg), group 2, 3, 4 and 5 received a combined solution of Pb(NO3)2 (11.25 mg/kg) and HgCl2 (0.4 mg/kg) respectively. After 7 days of heavy metal exposure, groups 3, 4 and 5 received a daily bolus administration of 200, 400 and 600 mg/kg body weight of EE-PM respectively through oral intubation for 28 days. HPLC quantification revealed a high amount of quercetin (27.43 ± 0.04 mg/100g), lower amounts of gallic acid (7.60 ± 0.06 mg/100g) and rutin (0.38 ± 0.009 mg/100g). Additionally, ELE-PM demonstrated strong inhibitory potentials against free radical scavenging activity generated in vitro. More interestingly, administration of ELE-PM significantly ameliorated hepatic redox dysregulations elicited by the exposure of the rats to heavy metals in a dose dependent pattern. ELE-PM is highly rich in flavonoid compound quercetin and perhaps this may be responsible for the strong antioxidant potentials exhibited in this investigation.

Hesperidin ameliorates hepatic dysfunction and dyslipidemia in male Wistar rats exposed to cadmium chloride.

The ever-increasing human population with attendant industrialization poses serious global health challenge. Cadmium (Cd) with other heavy metals contribute greatly to environmental pollutions and humans are daily exposed to them, leading to diverse ailments. We explored whether Hesperidin (HSP) could protect against hepatic damage and dyslipidemia in Wistar rats exposed to Cd. Forty wistar rats were randomly assigned into five groups (n = 8). Group 1 received 2 mL/kg body weight of normal saline; Group 2 received 100 mg/kg body weight of HSP while Group 3 received 5 mg/kg body weight of Cadmium Chloride (CdCl2) for 28 days. Group 4 received 100 mg/kg body weight of HSP and after 90 min, CdCl2 (5 mg/kg) body weight was administered for 28 days. Group 5 received 50 mg/kg body weight of HSP and after 90 min, CdCl2 (5 mg/kg) body weight was administered for 28 days. The serum lipid profiles, hepatic dysfunction and oxidative stress markers were determined using standard methods. Cd toxicity in rats prominently elevated serum activities of AST, ALT, ALP and levels of total bilirubin, direct bilirubin, cholesterol, LDL-C and malondialdehyde with decreased levels of HDL-C, triglycerides, superoxide dismutase, catalase, glutathione and body weights. The pre-treatment of HSP before Cd intoxication prevented the dysregulated activities of liver enzymes and levels of lipid profiles, enzymatic and non-enzymatic antioxidants and other biomarkers investigated, thus suggesting anti-hyperlipidemic and hepato-protective potentials. HSP may have great potentials for development of therapeutics that could enhance the management of dyslipidemia and liver disorders associated with heavy metal exposure.

Self-reported absenteeism among hospital workers in benin city, Nigeria.

SUMMARY BACKGROUND: Absenteeism is a major cause of loss in jobs, man-hours, productivity, and lives in the health sector. It also has grave consequences for global economies. OBJECTIVE: To determine the overall absenteeism rate and the factors that conduces to absenteeism among hospital workers. DESIGN: Cross sectional descriptive type. SETTING AND PARTICIPANTS: The entire staff in the hospital was enlisted in the study and data were collected through self-administered and semi-structured questionnaire. RESULTS: Fifty three percent of the 474 respondents reported at least one absence spell in the year. Absenteeism was highest among domestic staff (70.8%) and lowest among the doctors (46.9%). The average number of spells per absentee per year was 1.7 and the average duration of spells was 4.1 days while the incapacity rate was 7.2 days. The overall absenteeism rate was 1.7%. Absenteeism was significantly associated with increasing age (p=0.000), gender, [females