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Bitis Arientans are associated with the highest number of morbidity and mortality in Nigeria.The most effective treatments against snakebite is the administration of antivenom.Antibodies that is specific for a single epitope of an antigen are obtain by isolating antibody-secreting lymphocytes. These lymphocytes are found within the Splenocytes cells which can be used for a wide variety of immunology-based applications. However, development of hybridoma cell is rare and time consuming. Therefore, valuable time and cell materials can be saved through cryopreservation. This research aimed at Cryopreservation of primary splenocytes from Antibody produced mice against Bitis arientans snake venom. The LD50 of Bitis Arientans venom toxicity was determined in mice according to World Health Organization guidelines. Antibody production was achieved using six mice after immunization for six weeks and antibody titer were determined by indirect ELISA method. Myeloma cells line X63 Ag8.653 were cultured and Mouse Splenocytes with the highest immune response were removed aseptically by mechanical method and cells viability was determined then the isolated splenocytes were cryopreserved in cryovial tube stored at -80C.The LD50 was found to be 1.8mg/kg and Elisa analysis showed mice 2 and 6 to elicited highest immune response with IgG Concentration 3.1µg/ml and 4.6µg/ml. isolated splenocytes were counted to be 6.5x10 and 1.2x10 cells for mice 2 and 6 and myeloma cells to be 1.95x105 cells.In this finding antibody against Bitis Arientans venom were produced and mouse splenocytes were isolated and cryopreserved. Thus, cryopreserved splenocytes and myeloma can be used for the generation of monoclonal antibody

Background: The study aimed to evaluate the impact of a health education intervention on nutritional status among adolescent girls in government secondary schools in Maiduguri Metropolitan Council. Methods: The study was a randomized control trial among 417 adolescent girls aged 10-19 years old. Data were collected from October 2019 to March 2020 using KoBo collect toolbox. Chi-square and Fisher exact were used to compare baseline differences between the intervention and control group, a generalized estimating equation was used to evaluate the impact of health education intervention. Results: There was no significant difference in nutritional status (body mass index for age percentile and mid-upper arm circumference) between the intervention and control group at baseline. There was a statistically significant difference at three and six-months post-intervention for body mass index for age percentile p = 0.005; p < 0.001, while the mid-upper arm circumference was statistically significant at three months post-intervention p < 0.001, but not statistically significant at six months post-intervention. Conclusion: It is clear that health education intervention has an important role in improving the nutritional status of adolescents. Clinical Trial Registration Number: PACTR201905528313816

Rhizosphere is a bio–influenced zone of soil where the interaction of microorganism and plant roots occurred tailored by the activity of soil enzymes. The activity of the enzymes depends largely on the physical and chemical characteristics of the soil environment. Experiment was carried out to examine the activity of phosphomonoesterases in the rhizosphere of cassava planted in two sites (Samaru and Minjibir) located in savanna ecologies of Nigeria. Soils from rhizosphere of the cassava were sampled from each treatment in an experiment involving split plot design. The treatments included 3 main plots (phosphorus rates at 0, 17.5 and 35 kg P2O5 ha–1) and 3 sub–plots (mycorrhizal inoculants: Glomygel and Mycodrip; and a Control). The Result of the analysis indicated higher activities of the phosphomonoesterases (acid and alkaline phosphatases) in Samaru site than Minjibir. The former recorded higher acid and alkaline phosphates activities over the latter with a magnitude of 96.84% and 43.65% respectively. This is attributed to the variability in the soil characteristics between the two sites. The main effect of P fertilizer indicated that 0 kg P2O5 ha–1 recorded a significantly (p

Racism, xenophobia, and discrimination are key determinants of health and equity and must be addressed for improved health outcomes. We conclude that far broader, deeper, transformative action is needed compared with current measures to tackle adverse effects of racism on health. To challenge the structural drivers of racism and xenophobia, anti-racist action and other wider measures that target determinants should implement an intersectional approach to effectively address the causes and consequences of racism within a population. Structurally, legal instruments and human rights law provide a robust framework to challenge the pervasive drivers of disadvantage linked to caste, ethnicity, Indigeneity, migratory status, race, religion, and skin colour. Actions need to consider the historical, economic, and political contexts in which the effects of racism, xenophobia, and discrimination affect health. We propose several specific actions: a commission that explores how we action the approaches laid out in this paper; building a conversation and a series of events with international multilateral agency stakeholders to raise the issue and profile of racism, xenophobia, and discrimination within health; and using our multiple platforms to build coalitions, expand knowledge, highlight inequities, and advocate for change across the world.

Despite being globally pervasive, racism, xenophobia, and discrimination are not universally recognised determinants of health. We challenge widespread beliefs related to the inevitability of increased mortality and morbidity associated with particular ethnicities and minoritised groups. In refuting that racial categories have a genetic basis and acknowledging that socioeconomic factors offer incomplete explanations in understanding these health disparities, we examine the pathways by which discrimination based on caste, ethnicity, Indigeneity, migratory status, race, religion, and skin colour affect health. Discrimination based on these categories, although having many unique historical and cultural contexts, operates in the same way, with overlapping pathways and health effects. We synthesise how such discrimination affects health systems, spatial determination, and communities, and how these processes manifest at the individual level, across the life course, and intergenerationally. We explore how individuals respond to and internalise these complex mechanisms psychologically, behaviourally, and physiologically. The evidence shows that racism, xenophobia, and discrimination affect a range of health outcomes across all ages around the world, and remain embedded within the universal challenges we face, from COVID-19 to the climate emergency.

Almost every organism both plants and animals need water either directly or indirectly for their survival. Over 70% of the earth’s surface is covered with water. This is the reason why water is the most abundant naturally occurring substance found on the earth’s crust. As such, this has brought the idea of using the g Sokoto State Water Board as a case study, to access how water quality standard can be improved and also meet the demand citizens in Sokoto metropolis. The quality of water can be determined by its physical, chemical and biological properties. As such, the water quality evaluation before its usage becomes necessary and the water quality parameters that are most likely to affect its quality for safe consumption must be assessed. The Sokoto State Water Board was established in 1963 with the first water treatment plant which was named “OLD WATER WORKS”. It can produce six (6) million gallons, which is equivalent to 24 million liters per day. Its source (raw water) is from Bakalori Dam in Goronyo Local Government Area of Sokoto State. There are parameters which need to be taken into consideration in water quality analysis, such as temperature, conductivity, pH and turbidity. The laboratory analysis of raw water is done to determine the physicochemical and bacteriological parameters. The cost associated with each treatment method was determined to highlight the budgetary requirement for achieving portable water safe for consumption in the Sokoto metropolis.

HIV and tuberculosis (TB) are risk factors for non-communicable chronic lung disease (CLD). Despite the high prevalence of these infections in West Africa, there are no studies that compare CLD between people with HIV and HIV-negative populations in this setting. This study sought to quantify the contribution of HIV and TB infection in addition to conventional CLD risk factors, such as tobacco and biofuel exposure, to CLD in urban West Africa.A multi-centre cross-sectional study was conducted in three community clinics in Lagos, Nigeria between 2018 and 2019.Spirometry, questionnaires and clinical records were used to estimate prevalence of CLD and association with risk factors.In total, 148 HIV-negative individuals and 170 HIV-positive individuals completed the study. Current cigarette (11 of 318, 3.5%) and lifetime domestic biofuel (6 of 318, 1.8%) exposures were low. Airway obstruction (33 of 170, 19.4% vs. 12 of 148, 8.1%, P = 0.004) and CLD (73 of 170, 42.9% vs. 34 of 148, 23%, P 0.0001) were more prevalent in people with HIV compared with the HIV-negative group. HIV infection [odds ratio 2.35 (1.33, 4.17), P = 0.003] and history of TB [odds ratio 2.09 (1.04, 4.20), P = 0.038] were independently associated with increased risk of CLD.HIV and TB far outweigh conventional risk factors, including tobacco and domestic biofuel exposure, as drivers of non-communicable CLD in urban West Africa. Current global policy for CLD may have limited impact on CLD in this setting. Enhanced prevention, diagnosis and management strategies for incident HIV and TB infections are likely to have a significant impact on long-term lung health in sub-Saharan Africa.

Background: Peripheral neuropathy is one of the microvascular complications of diabetes mellitus, a risk factor for diabetic foot, and a major cause of disability world wide. Several authors have variedly reported on the efficacies of the different simple and sophisticated methods used in the diagnosis of peripheral neuropathy. The aim of this study is to compare the diagnostic yields of different simple methods of screening for diabetic peripheral neuropathy. Methodology: This is a multi-center cross-sectional study involving 1040 participants recruited consecutively, following consent. Relevant biodata and medical history were obtained, while physical examinations including anthropometry, and blood glucose levels were done for each participant. History of paresthesia, 10g monofilament test, vibration test using 128Hz tuning fork, and ankle reflex assessment were the methods used to screen for diabetic peripheral neuropathy. Student ‘t’ test and chi square were used to compare continuous and categorical variables respectively. Significant p-value was put at less than or equal to 0.05. Results: The percentage of participants with positive screen for diabetic peripheral neuropathy based on the different methods include: positive neuropathic symptoms (64%), negative neuropathic symptoms (50.7%), 10g monofilament testing (31.9%), vibration sensation by tuning fork (21.8%), and ankle reflex impairment (13.1%). A total of 80.1% of the participants were screened positive for diabetic peripheral neuropathy when all the methods were used. Conclusion: Positive and negative neuropathic symptoms have higher diagnostic yields for diabetic peripheral neuropathy screening than 10g monofilament testing, vibration sensation using tuning fork, and ankle reflex examination. However, it is encouraged to use all available methods to screen for diabetic peripheral neuropathy, as this increases the diagnostic yield, and ensure early adoption of preventive and therapeutic strategies.

Background A systematic review showed that the accuracy of Mycobacterium tuberculosis antigen–based skin tests (TBSTs) for tuberculosis is similar to that of interferon γ release assay, but the safety of TBSTs has not been systematically reviewed. Methods We searched for studies reporting injection site reactions (ISRs) and systemic adverse events associated with TBSTs. We searched Medline, Embase, e-library, the Chinese Biomedical Literature Database, and the China National Knowledge Infrastructure database for studies through 30 July 2021, and the database search was updated until 22 November 2022. Results We identified 7 studies for Cy-Tb (Serum Institute of India), 7 (including 2 found through the updated search) for C-TST (Anhui Zhifei Longcom), and 11 for Diaskintest (Generium). The pooled risk of any injection site reactions (ISRs) due to Cy-Tb (n = 2931; 5 studies) did not differ significantly from that for tuberculin skin tests (TSTs; risk ratio, 1.05 [95% confidence interval, .70–1.58]). More than 95% of ISRs were reported as mild or moderate; common ISRs included pain, itching, and rash. In 1 randomized controlled study, 49 of 153 participants (37.6%) given Cy-Tb experience any systemic adverse event (eg, fever and headache), compared with 56 of 149 participants (37.6%) given TST (risk ratio, 0.85 [95% confidence interval, .6–1.2]). In a randomized controlled study in China (n = 14 579), the frequency of systemic adverse events in participants given C-TST was similar to that for TST, and the frequency of ISRs was similar to or lower than that for TST. Reporting of the safety data on Diaskintest was not standardized, precluding meta-analysis. Conclusion The safety profile of TBSTs appears similar to that of TSTs and is associated with mostly mild ISRs.

Background In most developing countries, including Nigeria, herpes simplex virus type 2 (HSV-2) is associated with an increased risk of HIV acquisition and transmission, which often results in more frequent, lasting, and severe clinical outcomes. Despite the association between HSV-2 and HIV, knowledge regarding HSV-2 among people living with HIV/AIDS (PLWHA) in northern Nigeria is elusive.Methods This cross-sectional study sought to determine the seroprevalence and molecular detection of HSV-2 among PLWHA attending a referral hospital in Northwestern Nigeria. Blood samples collected from 180 PLWHA were screened for HSV-2 IgM using Enzyme-Linked Immunosorbent Assay (ELISA) and then subjected to molecular characterization using HSV-2 specific PCR. Moreover, socio-demographic data and risk factors of the sampled population were collected using a structured questionnaire.Results The overall seroprevalence of HSV-2 was 6.1%, with 5.0% and 1.1% in females and males, respectively. However, no significant association (P > 0.05) existed between HSV-2 seroprevalence with marital status, gender, occupation, residence, educational level, age, history of sexually transmitted diseases (STDs), ethnicity, and the number of sex partners. In addition, condom use significantly (P Conclusion This is the first study to confirm the presence of HSV-2 infection among PLWHA in Northwestern Nigeria. Data obtained stress the need for surveillance of HSV-2 therapy, and public enlightenment on the use of condoms to reduce the risk of HIV transmission.

Background BCG vaccination, originally used to prevent tuberculosis, is known to “train” the immune system to improve defence against viral respiratory infections. We investigated whether a previous BCG vaccination is associated with less severe clinical progression of COVID-19 Methods A case-control study comparing the proportion with a BCG vaccine scar (indicating previous vaccination) in cases and controls presenting with COVID-19 to health units in Brazil. Cases were subjects with severe COVID-19 (O2 saturation < 90%, severe respiratory effort, severe pneumonia, severe acute respiratory syndrome, sepsis, and septic shock). Controls had COVID-19 not meeting the definition of “severe” above. Unconditional regression was used to estimate vaccine protection against clinical progression to severe disease, with strict control for age, comorbidity, sex, educational level, race/colour, and municipality. Internal matching and conditional regression were used for sensitivity analysis. Results BCG was associated with high protection against COVID-19 clinical progression, over 87% (95% CI 74–93%) in subjects aged 60 or less and 35% (95% CI − 44–71%) in older subjects. Conclusions This protection may be relevant for public health in settings where COVID-19 vaccine coverage is still low and may have implications for research to identify vaccine candidates for COVID-19 that are broadly protective against mortality from future variants. Further research into the immunomodulatory effects of BCG may inform COVID-19 therapeutic research.

The inadequacy of mechanization in the production, processing and storage of ginger in Nigeria has caused its market price to be among the lowest in international trade. This study examined the selection of the optimal number of impeller and impeller speed for an improved ginger slicing machine. This research was conducted in the Department of Agricultural and Bio-Environmental Engineering at Waziri Umaru Federal Polytechnic in Birnin Kebbi during April 2019. A Completely Randomized Design (CRD) with 5 x 4 x 2 factorial experiment was conducted. The machine's performance was measured according to high average Efficiency of Slicing, average high output capacity and low percent scatter. The moisture content of the ginger used for the experiment with 1 hp prime mover was 82.2 and 81.5%. The data collected were analyzed using the Duncan Multiple Range Test (DMRT), with means separated at a P0.05 level. The results showed that the cushion compartment had the best Efficiency of Slicing of 56.8% at 350 rpm impeller speed, one number of impeller gang, 25.6 g/sec output and 4.2 g percent scatter, respectively.

Markets are complex entities comprising of multiple units ranging from economic, socio cultural,infrastructural, technological and environmental viewpoints. Therefore, its designs especiallywith regards to fire prevention and control goes beyond active and passive fire prevention andcontrol measures. There are non-salient issues that are usually given less attention but has greatimpact on the causes as well as hinder the control of market fires. Through qualitative approachinvolving observation, this study explored three major markets in Kano city using purposivesampling with a view to identifying the challenges of those markets in achieving the optimumfire prevention and control required for such commercial enterprise. The study found alterations,congestion, clearance, extension, indiscriminate parking, squatter trading, hawking/peddling andpoor circulation as a challenge to optimum fire prevention and control in the markets.Negligence to the fire prevention and control strategies observed in the markets are believed tohave high tendency exacerbating fire disasters with little or no chances of control and evacuation.It is thus imperative to have proactive measures that will enforce the existing developmentcontrol regulations, fire prevention and control act and ensure orderliness in the market. Inaddition there is dire need for customized design framework that is conscious of the peculiaritiesof market settings and operations of such study areas and alike.Keywords: Fire Prevention, Markets, Fire control, Impediments.

In the literature of spatial analysis of physical accessibility to rural health care facilities in Nigeria, it seems that growing attention has been given to health care which is a fundamental human right to every citizen to have access to health care services when needed, but cost of living is high, the road network is poor, and many people lack enough to afford expensive healthcare, apart from paying an extra for transport to a long distance health facility. The situation increases the tendency to delay or miss effective health care on a daily basis all over the country; especially in rural areas where infrastructural development is low. This paper seeks to provide a comprehensive literature on spatial analysis of physical accessibility to rural health care facilities in Nigeria so as to show the importance of adequate healthcare facilities in providing sustainable rural development.Healthy population and access to healthcare services are significant factors influencing economic development and prosperity. Thus, accessibility to healthcare facilities has generally been identified as a major indicator of development, and the existing spatial pattern of distribution of healthcare facilities play very prominent role in gauging the level of efficiency or otherwise of the existing level of provision of these facilities within any region. Health planners, over the years, have been focusing on financing healthcare with less consideration of the spatial physical accessibility to facilities. It is glaring that finance alone will not redeem the failing Nigerian health system. Therefore, healthcare planners and researchers must prioritize other dimensions of healthcare access such as spatial physical accessibility which they have ignored over the years

Key FeaturesVirus Watch is a national community cohort study of COVID-19 in households in England and Wales, established in June 2020. The study aims to provide evidence on which public health approaches are most effective in reducing transmission, and investigate community incidence, symptoms, and transmission of COVID-19 in relation to population movement and behaviours.28,527 households and 58,628 participants of age (0-98 years, mean age 48), were recruited between June 2020 - July 2022Data collected include demographics, details on occupation, co-morbidities, medications, and infection-prevention behaviours. Households are followed up weekly with illness surveys capturing symptoms and their severity, activities in the week prior to symptom onset and any COVID-19 test results. Monthly surveys capture household finance, employment, mental health, access to healthcare, vaccination uptake, activities and contacts. Data have been linked to Hospital Episode Statistics (HES), inpatient and critical care episodes, outpatient visits, emergency care contacts, mortality, virology testing and vaccination data held by NHS Digital.Nested within Virus Watch are a serology & PCR cohort study (n=12,877) and a vaccine evaluation study (n=19,555).Study data are deposited in the Office of National Statistics (ONS) Secure Research Service (SRS). Survey data are available under restricted access upon request to ONS SRS.

Glucose levels in the blood are elevated because the pancreas' b-cells produce less insulin or are more resistant to the hormone's effects. Diabetes mellitus is a persistent metabolic condition. Insulin is linked to long-term difficulties in the metabolism of carbohydrates, fats, and proteins. The objective of this study was to determine kidney indices and serum electrolytes of diabetic patients attending Federal Teaching Hospital Gombe, Gombe State. In total, A total of 240 subjects were used for the analysis (200 diabetic and 40 control subjects) and were divided based on their ages and gender Face to face inter-view was used to collect the data and other possible clinical data associated with diabetes mellitus. Fasting venous blood sample was collected to assess serum kidney indices, weight and height were recorded. The result shows individual kidney abnormalities of elevated serum creatinine and urea, elevated level of chloride and reduced sodium and bicarbonate level, according to gender and age groups. Gender, aging, higher body mass indexes (BMI), kidney indices abnormalities and electrolytes imbalance, were the risk factors associated with diabetes mellitus that led to diabetic nephropathy which can increase morbidity and mortality in diabetes mellitus. Effective control of blood sugar can stop or prevent the progression of diabetes mellitus to all these complications.

Disruption of health services due to the COVID-19 pandemic threatens to derail progress being made in tuberculosis control efforts. Forcibly displaced people and migrant populations face particular vulnerabilities as a result of the COVID-19 pandemic, which leaves them at further risk of developing TB. They inhabit environments where measures such as "physical distancing" are impossible to realize and where facilities like camps and informal temporary settlements can easily become sites of rapid disease transmission. In this viewpoint we utilize three case studies-from Peru, South Africa, and Syria-to illustrate the lived experience of forced migration and mobile populations, and the impact of COVID-19 on TB among these populations. We discuss the dual pandemics of TB and COVID-19 in the context of migration through a syndemic lens, to systematically address the upstream social, economic, structural and political factors that - in often deleterious dynamics - foster increased vulnerabilities and risk. Addressing TB, COVID-19 and migration from a syndemic perspective, not only draws systematic attention to comorbidity and the relevance of social and structural context, but also helps to find solutions: the true reality of syndemic interactions can only be fully understood by considering a particular population and bio- social context, and ensuring that they receive the comprehensive care that they need. It also provides avenues for strengthening and expanding the existing infrastructure for TB care to tackle both COVID-19 and TB in migrants and refugees in an integrated and synergistic manner.

Meeting the 2035 WHO targets of reducing tuberculosis incidence by 90% from 2015 levels requires the implementation of country-specific tuberculosis control strategies. This systematic review aims to identify factors that facilitate or impede the implementation of such strategies in EU and European Economic Area (EEA) settings. Focusing on providers of care, health system constraints, and social and political factors, this Review complements available evidence on the accessibility of tuberculosis services to recipients of care. Databases were searched for EU and EEA articles published between Jan 1, 1997, and Nov 6, 2020, that presented empirical data on tuberculosis policies, strategies, guidelines, or interventions. 2061 articles were screened and 65 were included. The most common barrier to tuberculosis control strategies described the divergence of health-care practices from guidelines, often related to inadequate knowledge or perceived usefulness of the guidelines by clinicians. The most commonly identified enabler to tuberculosis control strategies was the documented positive attitudes of health-care workers towards tuberculosis programmes. Divergence between clinical practice and guidelines was described in most EU and EEA settings, indicating the need for a focused review of guideline adherence. Strengths of this study involve its broad inclusion criteria and wide range of tuberculosis control strategies analysed.

BackgroundIn 2017, Korea implemented a nationwide project to screen and treat latent tuberculosis infection (LTBI) in high-risk for transmission public congregate settings. We aimed to assess programme success using a cascade of care framework.Materials and methodsWe undertook a cohort study of people from three congregate settings screened between March 2017 and December 2018: (1) first-grade high school students, (2) employees of educational institutions, (3) employees of social welfare facilities. We report percentages of participants with LTBI completing each step in the cascade of care model. Poisson regression models were used to determine factors associated with not visiting clinics, not initiating treatment, and not completing treatment.ResultsAmong the 96,439 participants who had a positive interferon-gamma release assay result, the percentage visiting clinics for further assessment, to initiate treatment, and who then completed treatment were 50.7, 34.7, and 28.9%, respectively. Compared to those aged 20–34 years, individuals aged < 20 years and aged ≥ 65 years were less likely to visit clinics, though more likely to complete treatment once initiated. Using public health centres rather than private hospitals was associated with people “not initiating treatment” (adjusted risk ratio [aRR], 3.72; 95% confidence interval [CI], 3.95–3.86). Nine-month isoniazid monotherapy therapy was associated with “not completing treatment,” compared to 3-month isoniazid and rifampin therapy (aRR, 1.28; 95% CI, 1.16–1.41).ConclusionAmong participants with LTBI from three congregate settings, less than one third completed treatment. Age, treatment centre, and initial regimen were important determinants of losses to care through the cascade.

The study aims to evaluating the impact of guidance and counseling services on the academic performance of students in some selected secondary schools in Sokoto metropolis. Causal-comparative (Ex-post facto) research design was adopted for this study. This study involves a total of 200 subjects comprising 5 principals, 25 class teachers, 10 teacher counselors, and 160 students from the five selected schools. Data were collected using the four sets of questionnaires. Data analysis was done using descriptive and inferential statistics. The finding revealed that eighty percent (80%) of the students responded that their academic performance was changed after receiving counseling services. Seventy-two percent (72%) of the class teachers perceived the level of students’ academic performance after counseling as good, while 20% perceived it very good and 8% rated it bad. Guidance and counseling services have positively influenced the academic performance of the students and should be strengthened to improve the students’ performance in national examinations.

Toxoplasma gondii infection causes high rate of gestational and congenital infection across the globe and is considered a both a public health problem and a neglected disease. The study was carried out to determine the prevalence of anti-Toxoplasma gondii antibodies and the associated risk factors among pregnant women attending antenatal care in some Primary Health Centres in Jos, Plateau State, Nigeria. In this cross-sectional study carried out within 5 months between Jan – May 2019, a total of 182 blood samples were collected from consenting pregnant women. Structured questionnaire was used to obtain data on socio-demography and risk factors. Three millilitres (3 ml) of blood samples were collected from the study participants. Sera were separated from the blood and evaluated for anti-Toxoplasma gondii antibodies (IgG and IgM) using enzyme-linked immunosorbent assay (ELISA). The data collected from the experiment were analysed using Statistical Package for the Social Sciences. Out of the 182 samples examined, 84 (46.2%) had anti-Toxoplasma gondii IgG antibody, 2 (1.1%) had IgM antibody while 98 (53.4%) were neither seropositive for IgG nor IgM. Trimester of pregnancy was significantly associated with prevalence of anti-Toxoplasma IgM antibody. In conclusion, Toxoplasmosis is prevalent in Jos. Eleven out of every 1000 women (i.e. 1.1%) had recent toxoplasmosis and 53.4% were not protected against primary infection thereby underscoring the need for prevention and control during pregnancy through enlightenment.

The aim of UK-REACH (“The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers”) is to understand if, how, and why healthcare workers (HCWs) in the United Kingdom (UK) from ethnic minority groups are at increased risk of poor outcomes from COVID-19. In this article, we present findings from the ethical and legal stream of the study, which undertook qualitative research seeking to understand and address legal, ethical, and social acceptability issues around data protection, privacy, and information governance associated with the linkage of HCWs’ registration data and healthcare data. We interviewed 22 key opinion leaders in healthcare and health research from across the UK in two-to-one semi-structured interviews. Transcripts were coded using qualitative thematic analysis. Participants told us that a significant aspect of Big Data research in public health is varying drivers of mistrust—of the research itself, research staff and funders, and broader concerns of mistrust within participant communities, particularly in the context of COVID-19 and those situated in more marginalised community settings. However, despite the challenges, participants also identified ways in which legally compliant and ethically informed approaches to research can be crafted to mitigate or overcome mistrust and establish greater confidence in Big Data public health research. Overall, our research indicates that a “Big Data Ethics by Design” approach to research in this area can help assure (1) that meaningful community and participant engagement is taking place and that extant challenges are addressed, and (2) that any new challenges or hitherto unknown unknowns can be rapidly and properly considered to ensure potential (but material) harms are identified and minimised where necessary. Our findings indicate such an approach, in turn, will help drive better scientific breakthroughs that translate into medical innovations and effective public health interventions, which benefit the publics studied, including those who are often marginalised in research.

Crimean-Congo haemorrhagic fever (CCHF) is a widespread tick-borne viral infection, present across Africa and Eurasia, which might pose a cryptic public health problem in Uganda. We aimed to understand the magnitude and distribution of CCHF risk in humans, livestock and ticks across Uganda by synthesising epidemiological (cross-sectional) and ecological (modelling) studies.We conducted a cross-sectional study at three urban abattoirs receiving cattle from across Uganda. We sampled humans (n = 478), livestock (n = 419) and ticks (n = 1065) and used commercially-available kits to detect human and livestock CCHF virus (CCHFV) antibodies and antigen in tick pools. We developed boosted regression tree models to evaluate the correlates and geographical distribution of expected tick and wildlife hosts, and of human CCHF exposures, drawing on continent-wide data.The cross-sectional study found CCHFV IgG/IgM seroprevalence in humans of 10·3% (7·8-13·3), with antibody detection positively associated with reported history of tick bite (age-adjusted odds ratio = 2·09 (1·09-3·98)). Cattle had a seroprevalence of 69·7% (65·1-73·4). Only one Hyalomma tick (CCHFV-negative) was found. However, CCHFV antigen was detected in Rhipicephalus (5·9% of 304 pools) and Amblyomma (2·9% of 34 pools) species. Modelling predicted high human CCHF risk across much of Uganda, low environmental suitability for Hyalomma, and high suitability for Rhipicephalus and Amblyomma.Our epidemiological and ecological studies provide complementary evidence that CCHF exposure risk is widespread across Uganda. We challenge the idea that Hyalomma ticks are consistently the principal reservoir and vector for CCHFV, and postulate that Rhipicephalus might be important for CCHFV transmission in Uganda, due to high frequency of infected ticks and predicted environmental suitability.UCL Global Challenges Research Fund (GCRF) and Pan-African Network on Emerging and Re-Emerging Infections (PANDORA-ID-NET) funded by the European and Developing Countries Clinical Trials Partnership (EDCTP) under the EU Horizon 2020 Framework Programme for Research and Innovation.

Identification of an accurate, low-cost triage test for pulmonary TB among people presenting to healthcare facilities is an urgent global research priority. We assessed the diagnostic accuracy and clinical utility of C-reactive protein (CRP) for TB triage among symptomatic adult outpatients, irrespective of HIV status.We prospectively enrolled adults reporting at least one (for people with HIV) or two (for people without HIV) symptoms of cough, fever, night sweats, or weight loss at two TB clinics in Cape Town, South Africa. Participants provided sputum for culture and Xpert MTB/RIF Ultra. We evaluated the diagnostic accuracy of CRP (measured using a laboratory-based assay) against a TB-culture reference standard as the area under the receiver operating characteristic curve (AUROC), and sensitivity and specificity at pre-specified thresholds. We assessed clinical utility using decision curve analysis and benchmarked against WHO recommendations.Of 932 included individuals, 255 (27%) had culture-confirmed pulmonary TB and 389 (42%) were living with HIV. CRP demonstrated an AUROC of 0·80 (95% confidence interval 0·77-0·83), with sensitivity 93% (89-95%) and specificity 54% (50-58%) using a primary cut-off of ≥10 mg/L. Performance was similar among people with HIV to those without. In decision curve analysis, CRP-based triage offered greater clinical utility than confirmatory testing for all up to a number willing to test threshold of 20 confirmatory tests per true positive pulmonary TB case diagnosed (threshold probability 5%). If it is possible to perform more confirmatory tests than this, a 'confirmatory test for all' strategy performed better.CRP achieved the WHO-defined sensitivity, but not specificity, targets for a triage test for pulmonary TB and showed evidence of clinical utility among symptomatic outpatients, irrespective of HIV status.South African Medical Research Council, EDCTP2, Royal Society Newton Advanced Fellowship, Wellcome Trust, National Institute of Health Research, Royal College of Physicians.

The attenuation of the electromagnetic wave signal due to power absorption by materials contributes to assessing the suitability of materials for use in microwave applications. One of the factors affecting power attenuation is material thickness. Therefore, this study investigates the effect of material thickness on the S-parameters and attenuation properties of low-density polyethylene (LDPE) at the X-band frequency range (8GHz-12GHz) to optimise the experimental design and reduce the cost associated with material preparation. The Waveguide measurement technique along with the finite element method (FEM) was implemented in COMSOL Multiphysics software for the study and analysis. The length of the waveguide was 200mm while the length and width of the waveguide ports were 22.28mm and 0.1143mm, respectively. The thickness of the LDPE was varied from 6mm-14mm with 2mm increment. Variation of S11 and S21 as functions of material thickness were determined and analysed. S11 decreased from 0.51 to 0.32 and S21 increased from 0.85 to 0.93 at 6mm and 14mm of the material thickness, respectively. The attenuation of the LDPE due to power loss decreased from 1.37 to 0.31 at 6mm and 14mm, respectively. It is determined from the results obtained that attenuation decreases as the thickness of the material increases, thereby reducing power loss due to absorption by the material.

IntroductionThe WHO End-TB Strategy emphasises screening for early diagnosis of tuberculosis (TB) in high-risk groups, including migrants. We analysed key drivers of TB yield differences in four large migrant TB screening programmes to inform TB control planning and feasibility of a European approach.MethodsWe pooled individual TB screening episode data from Italy, the Netherlands, Sweden, and the UK and analysed predictors and interactions for TB case yield using multivariable logistic regression models.ResultsBetween 2005–2018 in 2,302,260 screening episodes among 2,107,016 migrants to four countries; the programmes identified 1,658 TB cases (yield 72.0 per 100,000; 95% confidence interval, CI68.6–75.6). In logistic regression analysis, we found associations between TB screening yield and age (>55 years odds ratio, OR2.91, CI2.24–3.78), being an asylum seeker (OR3.19, CI1.03–9.83) or on a settlement visa (OR1.78, CI1.57–2.01), close TB contact (OR12.25, 11.73–12.79), and higher TB incidence in the country of origin (CoO). We demonstrated interactions between migrant typology and age, as well as CoO. For asylum seekers, the elevated TB risk remained similar above CoO incidence thresholds of 100 per 100,000.ConclusionsKey determinants of TB yield included close contact, increasing age, incidence in CoO and specific migrant groups including asylum seekers and refugees. For most migrants such as UK students and workers, TB yield significantly increased with levels of incidence in CoO. The high, CoO-independent TB risk in asylum seekers above a 100 per 100,000 threshold could reflect higher transmission and reactivation risk of migration routes; with implications for selecting populations for TB screening.

Background: Various factors affect the response of large hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE), and the high demand for TACE procedures highlights the need for information and methods on the criteria for patient selection. Methods: Thirty-six HCC patients who were treated with conventional TACE between January 2014 and January 2020 and had pre- and postoperative imaging data were included in the analysis. The patients were categorized as tumor responders (complete or partial response) or nonresponders (stable or progressive disease) according to the modified response evaluation criteria in solid tumors (mRECIST). Eight predictive factors (Tumor diameter, Tumor amount, tumor vascularity, portal vein invasion, tumor location, presence of tumor capsule, Child–Pugh class, and alpha-fetoprotein (AFP) level) of tumor response were evaluated using multivariate analysis with logistic regression. Results: Only 42% of patients fell into the category of responders after conventional TACE. None of the Child–Pugh class B patients showed a tumor response. A multivariate analysis of the Child–Pugh class A patient group showed that a lesion diameter of 5–10 cm (OR: 8.78, 95% CI: 1.73–44.55; P = 0.009) are an independent predictor of tumor response after the first TACE procedure. Conclusions: A tumor diameter of 5–10 cm could be use as a predictor of tumor response after the first conventional TACE in Child–Pugh A patients, further researches are needed to confirm this finding.

Introduction: Eosinophilic ureteritis is a very rare etiology of ureteric obstruction that leads to hydroureteronephrosis. We have only so far discovered a few case reports discussing eosinophilic ureteritis and the exact cause of this condition is poorly understood. Clinical findings: we report a very interesting case of a 71-year-old patient presenting with general weakness and oliguria, computed tomography (CT) scan found bilateral hydroureteronephrosis caused by recurring ureteric strictures. Diagnosis, interventions, and outcomes: ureterorenoscopy (URS) to extract a specimen for biopsy and laser fulguration to relieve ureteral strictures was performed. Double-J (DJ) stents were inserted both in the left and right ureters to overcome the ureteric strictures. Microscopy of the excised specimen revealed dominant eosinophilic infiltration. Therefore, diagnosis of eosinophilic ureteritis was made. In addition to stenting, Meropenem and Mirabegron was given to the patient. After a week of observation, the patient made a full recovery with no signs of initial symptoms. Conclusion: It is important to consider eosinophilic ureteritis in the differential diagnosis of any ureteric stricture because it is a highly uncommon entity with variable clinical characteristics. The gold standard procedure, which should be utilized to make the diagnosis, is a histological examination.

The purpose of this study is to critically analyse previous studies on management processes as antecedents of organizational performance. The study summarizes the level of understanding as regards the topic presently because of the importance of the information to the performance of organizations. The author searched Emerald, ScienceDirect.com, EBSCO and Google Scholar using a series of combinations of the following keywords: organizational management, performance management, high-performance organizations, management processes, management tools, influences of management processes, strategic management, marketing management, services marketing mix, , business organization and performance. This literature review has shown that performance is critical for the survival of the organization. It has also revealed that strategic management processes, marketing management processes and services marketing are key to organizational performance.

BackgroundDespite progress in TB control in low-burden countries like England and Wales, there are still diagnostic delays. Molecular testing and/or whole-genome sequencing (WGS) provide more rapid diagnosis but their cost-effectiveness is relatively unexplored in low-burden settings.MethodsAn integrated transmission-dynamic health economic model is used to assess the cost-effectiveness of using WGS to replace culture-based drug-sensitivity testing, versus using molecular testing versus combined use of WGS and molecular testing, for routine TB diagnosis. The model accounts for the effects of faster appropriate treatment in reducing transmission, benefiting health and reducing future treatment costs. Cost-effectiveness is assessed using incremental net benefit (INB) over a 10-year horizon with a quality-adjusted life-year valued at £20 000, and discounting at 3.5% per year.ResultsWGS shortens the time to drug sensitivity testing and treatment modification where necessary, reducing treatment and hospitalisation costs, with an INB of £7.1 million. Molecular testing shortens the time to TB diagnosis and treatment. Initially, this causes an increase in annual costs of treatment, but averting transmissions and future active TB disease subsequently, resulting in cost savings and health benefits to achieve an INB of £8.6 million (GeneXpert MTB/RIF) or £11.1 million (Xpert-Ultra). Combined use of Xpert-Ultra and WGS is the optimal strategy we consider, with an INB of £16.5 million.ConclusionRoutine use of WGS or molecular testing is cost-effective in a low-burden setting, and combined use is the most cost-effective option. Adoption of these technologies can help low-burden countries meet the WHO End TB Strategy milestones, particularly the UK, which still has relatively high TB rates.

Land degradation, a major environmental problem, poses threats to agricultural, social and economic stability of many regions of the world. In India, ~ 37% of the total land area is estimated to be degraded. Although assessment of land degradation in arid and semiarid regions of India has advanced through remote sensing time-series analysis such as rain-use efficiency (RUE) and residual trend analysis (RESTREND), the sub-humid and other regions mostly remain unexplored in this respect. In this study, land degradation in Bihar, a sub-humid state, was quantitatively assessed through RUE and RESTREND from 1995 to 2011. RUE is the ratio of aboveground net primary productivity to precipitation and has been widely used as a measure of land degradation. RESTREND, on the other hand, examines the trend of NDVI residuals, which is the difference between observed NDVI and predicted NDVI from rainfall data. Results indicate that RESTREND effectively estimated the extent of human-induced land degradation in Bihar as 4.73 M ha. Agro-climatic zone IIIB, the driest zone, has the highest percentage of degraded lands (33%), while Zone IIIA has the lowest percent of degraded lands (17%). Zones I and II each account for 25% of the degraded lands, most of which are affected by waterlogging and salinity. Although other land degradation databases have also indicated a rapid increase in land degradation across Bihar, it needs more ground-based data collection to substantiate it. The problem, however, may further aggravate with global warming, which calls for policy interventions such as adopting agroforestry, practicing sustainable agriculture and making shifts in cropping patterns.

The world is faced with the COVID-19 pandemic which has held the economy, especially the educational sector to ransom. School closure, reliance on e-learning and inaccessibility to mitigation strategies are some of the changes and disruptions which the COVID-19 pandemic has brought in the educational sector. This study examines the impact of COVID-19 pandemic on sustainability of Nigerian tertiary institutions, with particular reference to University of Jos. Three research questions were set to guide the study. Cross sectional survey was employed for the study. Data was generated from both primary and secondary sources through the use of Tertiary Institutions Sustainability Checklist (TISC). The population used for the study involved the administrative staff of the University. A sample of 30 (thirty) participants were used for the study. All the sampled staff were given the TISC to fill. Random sampling technique was used for the study. Simple Percentage was used to analyze the research questions. It was found that many tertiary institutions do not have well equipped library for their students and they have poor or non existing internet connectivity, poor ICT laboratory amongst a host of other issues. The study recommends that tertiary institutions should adopt policies the use of modern resources such as the e-library, computers for Skype and zoom to rebuild the losses in the learning process of their students, once they reopen.

An innovative standard scheme was established aimed at developing inferences and interpretations statistically relative to clinical neuroimaging facts and figures. It involves as particular instances, SPMs, a standard methodology to clinical neuroimaging anatomy. Our developed model contributes and provides various educational and statistical benefits which begin from the anatomy of facts at group level before the level of the voxel, commencing by direct modelling of the location and shape of the modules. We set out a new general framework for making inferences from neuroimaging data, which includes a standard approach to neuroimaging analysis, statistical parametric mapping (SPM), as a particular case. The model offers numerous conceptual and statistical advantages that begin from analysis of the collected data at the group level somewhat than the voxel level, from explicit modelling of the shape and position of clusters of activation. It provides a natural and moral way to pool data from nearby voxels for parameter and variance-component estimation. The model can also be viewed as performing Spatio-temporal cluster analysis. The parameters of the model are estimated using an expectation-maximization (EM) algorithm.

Kano State is experiencing greater weather extremes, changes in rainfall patterns, analysis of heat and cold waves, and increasing droughts and floods (Kano meteorological agency). As a result, there is a need for the provision of the necessary weather advisories and early warnings to planners, decision-makers, and operators of the various rainfall-sensitive socio-economic sectors. However, this study is aiming to realize some hidden variables of Kano State total monthly rainfall dataset from the onset to cessation period of rain from the month of April to October over a 105 years (1911-2015) for classification into the intensity of the rain of the area under study, also to determine the linear model for the changing patterns of rainfall in Kano State and to identify some of the adverse impacts on socio-economic sectors and transport infrastructures. Thus, the appearances of the rainfall figure are established for the study region with the operation of Principal Component Analysis (PCA), application least square method. The leading three (3) PCs, gives account for about 61% of the entire disparity, is described. The revision displays and describe PC1 as associated with the heavy intensity rainfall, whereas PC2 is connected to the moderate-intensity rainfall and finally PC3 is linked to the light intensity rainfall of the region under study. By the scores of our PCs, uniform rainfall zones are established over the region of enquiring to which the yearly performance of rainfall is discussed. Statistically, all three models for the various mode of rainfall intensity are significant, which serves as the annual pattern of rainfall in the study area.

BACKGROUND: Population-level health and mortality data are crucial for evidence-informed policy but scarce in Nigeria. To fill this gap, we undertook a comprehensive assessment of the burden of disease in Nigeria and compared outcomes to other west African countries. METHODS: In this systematic analysis, using data and results of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, we analysed patterns of mortality, years of life lost (YLLs), years lived with disability (YLDs), life expectancy, healthy life expectancy (HALE), and health system coverage for Nigeria and 15 other west African countries by gender in 1998 and 2019. Estimates of all-age and age-standardised disability-adjusted life-years for 369 diseases and injuries and 87 risk factors are presented for Nigeria. Health expenditure per person and gross domestic product were extracted from the World Bank repository. FINDINGS: Between 1998 and 2019, life expectancy and HALE increased in Nigeria by 18% to 64·3 years (95% uncertainty interval [UI] 62·2-66·6), mortality reduced for all age groups for both male and female individuals, and health expenditure per person increased from the 11th to third highest in west Africa by 2018 (US$18·6 in 2001 to $83·75 in 2018). Nonetheless, relative outcomes remained poor; Nigeria ranked sixth in west Africa for age-standardised mortality, seventh for HALE, tenth for YLLs, 12th for health system coverage, and 14th for YLDs in 2019. Malaria (5176·3 YLLs per 100 000 people, 95% UI 2464·0-9591·1) and neonatal disorders (4818·8 YLLs per 100 000, 3865·9-6064·2) were the leading causes of YLLs in Nigeria in 2019. Nigeria had the fourth-highest under-five mortality rate for male individuals (2491·8 deaths per 100 000, 95% UI 1986·1-3140·1) and female individuals (2117·7 deaths per 100 000, 1756·7-2569·1), but among the lowest mortality for men older than 55 years. There was evidence of a growing non-communicable disease burden facing older Nigerians. INTERPRETATION: Health outcomes remain poor in Nigeria despite higher expenditure since 2001. Better outcomes in countries with equivalent or lower health expenditure suggest health system strengthening and targeted intervention to address unsafe water sources, poor sanitation, malnutrition, and exposure to air pollution could substantially improve population health. FUNDING: The Bill & Melinda Gates Foundation.

In South Korea, public–private mix (PPM) was launched in 2011. This retrospective cohort study sought to determine the rate of loss to follow-up (LTFU) among drug-susceptible tuberculosis (DS-TB) patients in all nationwide PPM institutions, and the risk factors for LTFU. National notification data for DS-TB patients diagnosed between August 2011 and July 2014 in PPM institutions were analysed. Determination of LTFU included detection of instances where patients were transferred out, but when they did not attend at other TB centres in the following two months. Univariable and multivariable competing risk models were used to determine risk factors for LTFU. 73,046 patients with 78,485 records were enrolled. Nominally, 3426 (4.4%) of records were LTFU. However, after linking the multiple records in each patient, the percentage of LTFU was 12.3% (9004/73,046). Risk factors for LTFU were: being foreign-born (3.13 (95% CI 2.77–3.53)), prior LTFU (2.31 (2.06–2.59)) and greater distance between the patient’s home and the TB centre (4.27 (4.03–4.53)). ‘Transfer-out’ was a risk factor in patients managed by treatment centres close to home (1.65 (1.49–1.83)), but protective for those attending centres further (0.77 (0.66–0.89)) or far-away (0.52 (0.46–0.59)) from home. By considering the complete picture of a patient’s interactions with healthcare, we identified a much higher level of LTFU than previously documented. This has implications for how outcomes of treatment are reported and argues for a joined-up national approach for the management and surveillance of TB patients, in nations with similar healthcare systems.

Funder: Wellcome Trust, Health is central to the development of any country. Nigeria’s gross domestic product is the largest in Africa, but its per capita income of about ₦770 000 (US$2000) is low with a highly inequitable distribution of income, wealth, and therefore, health. It is a picture of poverty amidst plenty. Nigeria is both a wealthy country and a very poor one. About 40% of Nigerians live in poverty, in social conditions that create ill health, and with the ever-present risk of catastrophic expenditures from high out-of-pocket spending for health. Even compared with countries of similar income levels in Africa, Nigeria’s population health outcomes are poor, with national statistics masking drastic differences between rich and poor, urban and rural populations, and different regions.

With one billion people on the move or having moved in 2018, migration is a global reality, which has also become a political lightning rod. Although estimates indicate that the majority of global migration occurs within low-income and middle-income countries (LMICs), the most prominent dialogue focuses almost exclusively on migration from LMICs to high-income countries (HICs). Nowadays, populist discourse demonises the very same individuals who uphold economies, bolster social services, and contribute to health services in both origin and destination locations. Those in positions of political and economic power continue to restrict or publicly condemn migration to promote their own interests. Meanwhile nationalist movements assert so-called cultural sovereignty by delineating an us versus them rhetoric, creating a moral emergency. In response to these issues, the UCL-Lancet Commission on Migration and Health was convened to articulate evidence-based approaches to inform public discourse and policy. The Commission undertook analyses and consulted widely, with diverse international evidence and expertise spanning sociology, politics, public health science, law, humanitarianism, and anthropology. The result of this work is a report that aims to be a call to action for civil society, health leaders, academics, and policy makers to maximise the benefits and reduce the costs of migration on health locally and globally. The outputs of our work relate to five overarching goals that we thread throughout the report. First, we provide the latest evidence on migration and health outcomes. This evidence challenges common myths and highlights the diversity, dynamics, and benefits of modern migration and how it relates to population and individual health. Migrants generally contribute more to the wealth of host societies than they cost. Our Article shows that international migrants in HICs have, on average, lower mortality than the host country population. However, increased morbidity was found for some conditions and among certain subgroups of migrants, (eg, increased rates of mental illness in victims of trafficking and people fleeing conflict) and in populations left behind in the location of origin. Currently, in 2018, the full range of migrants’ health needs are difficult to assess because of poor quality data. We know very little, for example, about the health of undocumented migrants, people with disabilities, or lesbian, gay, bisexual, transsexual, or intersex (LGBTI) individuals who migrate or who are unable to move. Second, we examine multisector determinants of health and consider the implication of the current sector-siloed approaches. The health of people who migrate depends greatly on structural and political factors that determine the impetus for migration, the conditions of their journey, and their destination. Discrimination, gender inequalities, and exclusion from health and social services repeatedly emerge as negative health influences for migrants that require cross-sector responses. Third, we critically review key challenges to healthy migration. Population mobility provides economic, social, and cultural dividends for those who migrate and their host communities. Furthermore, the right to the highest attainable standard of health, regardless of location or migration status, is enshrined in numerous human rights instruments. However, national sovereignty concerns overshadow these benefits and legal norms. Attention to migration focuses largely on security concerns. When there is conjoining of the words health and migration, it is either focused on small subsets of society and policy, or negatively construed. International agreements, such as the UN Global Compact for Migration and the UN Global Compact on Refugees, represent an opportunity to ensure that international solidarity, unity of intent, and our shared humanity triumphs over nationalist and exclusionary policies, leading to concrete actions to protect the health of migrants. Fourth, we examine equity in access to health and health services and offer evidence-based solutions to improve the health of migrants. Migrants should be explicitly included in universal health coverage commitments. Ultimately, the cost of failing to be health-inclusive could be more expensive to national economies, health security, and global health than the modest investments required. Finally, we look ahead to outline how our evidence can contribute to synergistic and equitable health, social, and economic policies, and feasible strategies to inform and inspire action by migrants, policy makers, and civil society. We conclude that migration should be treated as a central feature of 21st century health and development. Commitments to the health of migrating populations should be considered across all Sustainable Development Goals (SDGs) and in the implementation of the Global Compact for Migration and Global Compact on Refugees. This Commission offers recommendations that view population mobility as an asset to global health by showing the meaning and reality of good health for all. We present four key messages that provide a focus for future action.

The incurable lingering metabolic syndrome of diabetes mellitus is an up-surging global tricky with tremendous physical, social, mental, economics and health undesired ramifications. Three hundred and ninety four diabetic patients were measured on 4 baseline variable age (years), sex (Male=1 and Female=2), body mass index (kg/m2) and blood pressure (mmHg). Blood sugar concentration (mg/dl) represented the response variable. The basic objective of this study is to verify the clear causal risk factors of diabetes. Both Multiple Linear Regression and Stepwise Regression techniques were applied on the data and the analysis showed that Body Mass Index (kg/m2) and Blood Pressure (mmHg) are the clearest risk factors of diabetes. This justification served the same purpose in the procedure of variables selection used.