Food and Aeroallergen Sensitization, Eosinophils Levels and Risk of Atopic Dermatitis in Abuja.

BACKGROUND: The barrier dysfunction of atopic dermatitis (AD) promotes epicutaneous sensitization to aeroallergens. This study aimed to evaluate the prevalence of food and aeroallergen sensitization in AD and to explore the relationship between allergen sensitization and the personal or family history of allergic rhinitis, conjunctivitis, asthma, eosinophil count, and AD severity of Nigerian patients. METHODS: Children and adults with AD who visited the dermatology clinic were included in this study. AD diagnosis was made using the modified Hanifin and Rajka criteria, and severity was rated and graded using the Scoring Atopic Dermatitis (SCORAD) index. Skin-prick test for 14 allergens (5 food and 9 aeroallergens) was used to assess IgE sensitization. To look for significant relationships, chi-square and odds ratio were used. RESULTS: Sensitization to at least one allergen was observed in 65.8% of the patients, sensitization to aeroallergen was 85% and to foods was 15%. More patients had concomitant allergic conjunctivitis (n=29) and only three had asthma. The mean age of onset of AD was 10.6±12.9 years, ranging from 2 months to 51 years, and a family history of atopy was observed in 49.4%. Majority had moderate AD and normal eosinophil count. Allergen sensitization in AD patients was significantly associated with the age of patients but not with personal or family history of allergic rhinitis, conjunctivitis, asthma, eosinophil count or AD severity. CONCLUSION: Analysis of our result showed a high prevalence of food and aeroallergen sensitization in AD. Sensitization was not influenced by the presence of other allergic diseases, eosinophils and the severity of AD.

CONTEXTE: La dysfonction de la barrière cutanée de la dermatite atopique (DA) favorise la sensibilisation épicutanée aux aéroallergènes. Cette étude visait à évaluer la prévalence de la sensibilisation alimentaire et aéroallergénique dans la DA et à explorer la relation entre la sensibilisation aux allergènes et les antécédents personnels ou familiaux de rhinite allergique, conjonctivite, asthme, le taux d'éosinophiles et la sévérité de la DA chez les patients nigérians. MÉTHODES: Les enfants et les adultes atteints de DA qui ont visité la clinique dermatologique ont été inclus dans cette étude. Le diagnostic de la DA a été établi en utilisant les critères modifiés de Hanifin et Rajka, et la gravité a été évaluée et classée à l'aide de l'indice de ScoringAtopic Dermatitis (SCORAD). Le test cutané aux 14 allergènes (5 alimentaires et 9 aéroallergènes) a été utilisé pour évaluer la sensibilisation IgE. Pour rechercher des relations significatives, le chi carré et le rapport de cotes ont été utilisés. RÉSULTATS: Une sensibilisation à au moins un allergène a été observée chez 65,8% des patients, la sensibilisation aux aéroallergènes était de 85% et aux aliments de 15%. Plus de patients présentaient une conjonctivite allergique concomitante (n=29) et seulement trois avaient de l'asthme. L'âge moyen de début de la DA était de 10,6 ± 12,9 ans, allant de 2 mois à 51 ans, et des antécédents familiaux d'atopie ont été observés chez 49,4%. La majorité avait une DAmodérée et un taux d'éosinophiles normal. La sensibilisation aux allergènes chez les patients atteints de DA était significativement associée à l'âge des patients, mais pas aux antécédents personnels ou familiaux de rhinite allergique, conjonctivite, asthme, au taux d'éosinophiles ou à la gravité de la DA. CONCLUSION: L'analyse de nos résultats a montré une prévalence élevée de la sensibilisation alimentaire et aéroallergénique dans la DA. La sensibilisation n'était pas influencée par la présence d'autres maladies allergiques, d'éosinophiles et de la sévérité de la DA. Mots-clés: Dermatite atopique, sensibilisation alimentaire et aéroallergénique, maladies atopiques, éosinophiles, sévérité de la dermatite atopique. Severity of atopic dermatitis Short title:Allergen sensitization in atopic dermatitis.

Daily versus twice daily dose of ferrous sulphate supplementation in pregnant women: A randomized clinical trial.

BACKGROUND: The International Nutritional Anaemia Consultative Group has recommended a twice daily dose of 65 mg elemental iron supplementation in pregnant women living in areas where anaemia is prevalent contrary to the World Health Organization (WHO) universal recommendation of a daily dose of 60 mg. Whether twice or daily dose schedules proffer a better outcome is a subject of on-going research. OBJECTIVE: To compare the effectiveness of the once versus twice daily doses of ferrous sulphate in the prevention of iron deficiency anaemia in pregnancy. METHODS: There are about one hundred and eighty two (182) pregnant women at gestational ages of 14-24 weeks with haemoglobin (Hb) levels ≥10 g/dl but ≤14.5 g/dl were recruited during the antenatal booking clinic. They were randomized into receiving either once daily dose (65 mg of elemental iron) or twice daily dose (130 mg of elemental iron) of ferrous sulphate. Pre and post- supplementation haemoglobin, serum iron and ferritin levels were assessed at recruitment and at 37 weeks gestation respectively. RESULTS: Eighty-four (84) and 80 women respectively in the once and twice daily dose groups were analysed. The serum haemoglobin was significantly lower (P = 0.002) among those on once daily than those on twice daily supplementation. The side effects were however, significantly higher in the twice daily group (P = 0.005, P = 0.043 and P = 0.004 respectively). There were no differences between the serum ferritin levels pre and post supplementation in both groups just as they were no reported significant differences in both birth weight of neonates (P = 0.936) and average gestational age at delivery (P = 0.469) between the two groups. CONCLUSION: Once daily (65 mg elemental iron) ferrous sulphate is as effective as twice daily (130 mg elemental iron) dose regimen in prevention of Anaemia in pregnancy in a developing economy like Nigeria. Once daily dose possesses fewer side effects and guarantees better compliance in this study.

The burden of HPV associated cancers in two regions in Nigeria 2012-2014.

INTRODUCTION: HPV attributable cancers are the second most common infection-related cancers worldwide, with much higher burden in less developed regions. There are currently no country-specific estimates of the burden of these cancers in Nigeria just like many other low and middle income countries. METHODS: In this study, we quantified the proportion of the cancer burden in Nigeria that is attributable to HPV infection from 2012 to 2014 using HPV prevalence estimated from previous studies and data from two population based cancer registries (PBCR) in Nigeria. We considered cancer sites for which there is strong evidence of an association with HPV infection based on the International Agency for Research on Cancer (IARC) classification. We obtained age and sex-specific estimates of incident cancers and using the World Standard Population, we derived age standardized incidence (ASR) rates for each cancer type by categories of sex, and estimated the population attributable fractions (PAF). RESULTS: The two PBCR reported 4336 new cancer cases from 2012 to 2014. Of these, 1627 (37.5%) were in males and 2709 (62.5%) in females. Some 11% (488/4336) of these cancers were HPV associated; 2% (38/1627) in men and 17% (450/2709) in women. Of the HPV associated cancers, 7.8% occurred in men and 92.2% in women. The ASRs for HPV associated cancers was 33.5 per 100,000; 2.3 and 31.2 per 100,000 in men and women respectively. The proportion of all cancers attributable to HPV infection ranged from 10.2 to 10.4% (442-453 of 4336) while the proportion of HPV associated cancers attributable to HPV infection ranged from 90.6% to 92.8% (442-453 of the 488 cases). In men, 55.3% to 68.4% of HPV associated cancers were attributable to HPV infection compared to 93.6% to 94.8% in women. The combined ASR for HPV attributable cancers ranged from 31.0 to 31.7 per 100,000. This was 1.4 to 1.7 per 100,000 in men and 29.6 to 30.0 per 100,000 in women. In women, cervical cancer (n=392, ASR 28.3 per 100,000) was the commonest HPV attributable cancer, while anal cancer (n=21, ASR 1.2 per 100,000) was the commonest in men. CONCLUSIONS: HPV attributable cancers constitute a substantial cancer burden in Nigerian women, much less so in men. A significant proportion of cancers in Nigerian women would be prevented if strategies such as HPV DNA based screening and HPV vaccination are implemented.

Efficacies of chloroquine, pyrimethamine/sulphadoxine and pyrimethamine/sulphalene against P. falciparum in northeastern Nigeria.

The clinical and parasitologic efficacies of oral chloroquine phosphate, pyrimethamine/sulphadoxine and pyrimethamine/sulphalene in treating Plasmodium falciparum malaria were assessed in selected sites of northeastern Nigeria (Zone D of the Primary Health Care (PHC) Programme) using a 14-day standard in-vivo protocol during 1988-1990. Of a total of 2056 children under 5 years screened for infection, for chloroquine trials, 1189 (57.8%) were positive for Plasmodium infection. One hundred and seventy (14.3%) of these positive children were enrolled into the study. Clinically, the drug demonstrated high performance in clearing symptoms of infection. However, varying degrees of parasitologic failure, ranging from delayed clearance through recrudescence to asymptomatic Type-II resistance, were encountered. For tests with pyrimethamine/sulphadoxine and pyrimethamine/sulphalene, 517 and 253 children, respectively, were screened. The corresponding infection rates were 71.6% (370 children) and 71.5% (181 children), with 59 and 34 enrollments. Both drugs were highly effective, clinically and parasitologically. These findings and their implications for the success of the PHC programme for malaria control are discussed.

Risk factors of vesico-vaginal fistulae in Maiduguri, Nigeria: a case-control study.

PIP: Vesicovaginal fistula (VVF)--a direct communication between the bladder and the vagina--is a major gynecological problem in Nigeria resulting in leakage of urine into the vagina. The major cause of VVF in West Africa is pressure necrosis due to prolonged labor. In Nigeria, VVF has social, economic, and religious implications. Many women with VVF are regarded as social outcasts and marriages have dissolved as a result. In this study epidemiological pattern of VVF as it presents to tertiary hospitals in Maiduguri, Northern Nigeria is explored, along with recommendations for lowering mortality. A retrospective study of 241 cases of VVF was done. 148 patients without the disease were controls. Interviews were undertaken and 2 years of records were reviewed. Information collected included demographic variables. Specific information on the history of VVF was also collected. Aspects of traditional practices and customs were noted. Prolonged labor constituted 75.9% of the total cases. "Gishiri cut," an incision commonly done is the 2nd most common cause (6.2%). Other causes included cervical carcinoma (1.7%), surgical trauma (3.1%), and infection (2.1%). No cause could be found in 10.4%. Earlier age at marriage for VVF patients was significant with a chi square value of 27.0 (P0.001). More than 1.4 (26.9%) of the fistulae occurred in women 15 years; more than 1.2 (58.8%) of them were 18 years. Height was found to be related to fistulae: 51.9% had a height of below 150 cm but only 37.1% of the controls had the same height measurement (t=4.52; P0.001). The relative risk for VVF when the height was 150 cm was calculated to be 1.83 for this study. Of the women who had VVF, 49.9% were married, compared to 85.3% of the controls (P0.001). A much higher proportion of fistula patients were divorced than controls. For the short term, the problem can be helped by health education. In the long run, it will be reduced by less pregnancies in girls under 18, a situation which will occur with more widespread formal education of girls.^ieng

Epidemiology of vesico--vaginal fistulae in northern Nigeria.

A comparative study of vesico-vaginal fistulae cases and controls was carried out at two tertiary hospitals in Maiduguri, Nigeria. The fistulae cases were significantly shorter in height, younger in age at marriage and had a higher divorce rate. Prolonged labour, traditional surgical practice of "gishiri cut" and ignorance were identified as the commonest causes of the fistulae. The health and socio-economic consequences to the patient are discussed. Patients are considered to have brought shame to themselves and their families and quite often lose the support of the husband. It is recommended that maternity services be firmly integrated and given a higher priority in primary health care. In the long-term increase in the literacy level of females is desirable.