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Background: In cancer microenvironment, there is increased production of inflammatory cytokines, including tumour necrosis factor (TNF)-α, interleukin (IL)-1a, and IL-6. These cytokines are capable of causing thrombus formation through the activation of tissue factors. Then, the Khorana risk score can be Utilised to stratify the risk of venous thromboembolism in cancer patients. AIM: The objective of this study was to determine the relationship between levels of IL 6, TNF-α, and Khorana scores of chemotherapy-naïve ambulatory cancer patients (CNACPs). MATERIALS AND METHODS: This was a cross-sectional study. The case group (n = 100) consisted of newly diagnosed CNACP recruited from adult oncology clinics of University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu, Nigeria, whereas the control group (n = 100) consisted of healthy individuals. The participants’ blood samples were assayed by enzyme-linked immunosorbent assay (ELISA) technique for IL-6 and TNF-α. Demographic variables were analysed using descriptive statistics in the form of frequencies and percentages and P < 0.05 was considered statistically significant. Results: There were significant differences between the mean levels of IL-6 (P = 0.036) and TNF-α (P = 0.001) in three Khorana score groups of the case group. Further, comparisons of mean IL-6 levels between three Khorana score groups showed that differences were between high-risk versus low-risk groups (P = 0.026) and between intermediate-risk versus low-risk groups (P = 0.014). Comparison of mean TNF-α levels in three Khorana score groups of CNACP showed that differences were between high-risk versus low-risk groups (P = 0.026) and between intermediate-risk versus low-risk groups (P = 0.014). Furthermore, there was a significant positive correlation between the Khorana scores and IL-6 (r = 0.28, P = 0.031) and TNF-α (r = 0.254, P = 0.011). The mean serum levels of IL-6 and TNF-α were significantly higher in CNACP than in healthy control (8.98 [8–12] pg/ml vs. 8.43 [2–10] pg/ml, P < 0.001) and (P < 0.001 and < 0.01), respectively. Conclusion: Inflammatory biomarkers are elevated in ambulatory CNACP and their values are significantly related with Khorana scores. There is a need for more studies on the possible benefit of prophylactic anticoagulation for newly diagnosed CNACP.

Abstract Background Sexual violence among higher education students is a global public health problem. Identifying the characteristics of students who report victimization can serve as basis for programmes that target vulnerable students. Methods The study was conducted among 30,114 Nigerian higher education students. They were selected from 18 institutions comprising universities, polytechnics, and colleges of education. The purpose of the study was to assess the characteristics of students who reported sexual violence (rape, attempted rape and sexual harassment) and to determine the association between reporting and their characteristics. Results Our findings showed that 37% of the students reported experiencing sexual violence. Regression analysis showed that the odds of reporting among female students were two times greater than that of the male students (CI = 1.58–1.78; P

Objective: The objective of this study was to identify the factors associated with the outcome of the 2023 diphtheria outbreak in Jigawa State, Nigeria. Methods: A descriptive cross-sectional study was conducted amongst all line-listed diphtheria cases reported from Jigawa State, Nigeria, using the 2023 Integrated Disease and Surveillance Response line list of cases that met the World Health Organization case definition of diphtheria. A total of 245 line-listed cases from January 2023 to December 2023 met the criteria for inclusion in the study. Data were analysed using IBM SPSS version 22.0 with a P value set at ≤5%. Binary logistic regression was used to identify the independent predictors of the outcome of the 2023 outbreak. Results: The maximum age of the line-listed cases was 39 years, and the minimum was 1 year with a median of 8 (interquartile range = 5–8) years. More than two-thirds (68.2%) of the cases were ≥5 years of age. More than one-third of the cases (39.6%) were from the northeast senatorial zone of the state. Out of the total 245 cases, 14 died of the disease representing a case fatality rate of 6%, and an attack rate of 3.4 per 100,000 populations. The majority of the cases (95.5%) had fever, cough (81.2%), pharyngitis (86.9%), tonsillitis (96.7%) and laryngitis (82.0%). More diphtheria-related mortalities were recorded amongst cases

Background: Fibroadenoma (FA) is documented as the most common benign breast disease typically presenting as a lump. A wide variety of other diseases including breast cancer can similarly present as lumps hence the need for further differentiation. Ultrasonography plays a vital role in the evaluation and treatment of breast lumps with histological analysis as the gold standard. Objective: This study compared the physical and sonographic features of the breast in women with FA and women with breast lumps due to other diseases. Materials and Methods: This is a single-centre comparative study. Clinical and sonographic breast evaluations of the recruited patients with lumps were done and reported using the American College of Radiology Breast Imaging Reporting and Data System score. The lumps were biopsied, and histological diagnosis was documented. Clinical and imaging features of the breasts of women with FA were then compared with those of women with lumps from other breast diseases, and collated data were analysed using SPSS Statistical version 23.0. Results: Data from 118 subjects (59 in each group) were used for this study. There was a significant difference in the physical and sonographic appearance of FA concerning the patient’s age, parity, change in lesion size, perilesional architecture, echogenicity, borders, capsule and background breast density. No FA was found in women with less dense breasts. Conclusion: The sonographic features of breasts showed some differences from the corresponding features of FA and other breast lesions. This has the potential to increase the efficiency of pre-operative diagnosis of FA and could be further applied in developing diagnostic criteria for FA in our environment.

Most agricultural soils exhibit minimal recovery of sulfate (S), the accuracy of isotherms to describe anion desor-ption data is very useful in establishing the fertilization schedule to promote optimal crop yield. The desorption of S by savanna soils and its applicability to isotherm equations in reserve form are both poorly understood. To fill this gap, soil samples were collected from three distinct parent materials: Basement Complex Rock, Chad Formation Rock, and Kerri-Kerri Formation Rock. Experimental soils were mixed with a 15 ml solution of Cal-cium dihydrogen phosphate containing 500 mg P/l for sulfate desorption analysis. Mixed samples were then shaken for different durations (30, 60, 150, 180, and 240 minutes). The data indicate a significant va-riation in soil pH among different parent materials. The isotherm equations were successfully applied to the de-sorption data of sulfur, with R2 values exceeding 0.98 for both Langmuir and Freundlich equations. The Langmuir equation proved to be the most suitable for the desorption data, as evidenced by low standard error. The order of desorption and fitness was found to be CFR > BCR > KKFR. Langmuir desorption qmax and KL were found to be favorably and significantly associated with pH, ​​Org C, and Alox. A negative and statistically significant relationship between Alox and Freundlich desorption nF was observed. The results showed that different mechanisms contribute to sulfate desorption from soils. To use fertilizers in the soil more efficiently, it is necessary to consider contact time, add forms of oxides as a filler to the S-formulated fertilizer, and apply organic management methods to support sustainable agriculture in the studied area.

Najib Isse Dirie,1 Maryan Abdullahi Sh Nur,2 Abdirahman Khalif Mohamud,3 Bashiru Garba,4,5 Hassan Abdullahi Dahie,6 Mohamed Hussein Adam,4 Jamal Hassan Mohamoud4 1Department of Urology, Dr Sumait Hospital, Faculty of Medicine, and Health Sciences, SIMAD University, Mogadishu, Somalia; 2Department of Obstetrics and Gynecology, Dr Sumait Hospital, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia; 3Faculty of Medicine, and Health Science, SIMAD University, Mogadishu, Somalia; 4Department of Public Health, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia; 5Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, Usmanu Danfodiyo University, Sokoto, SK, Nigeria; 6Nursing and Midwifery Department, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, 2526, SomaliaCorrespondence: Maryan Abdullahi Sh Nur, Email dr.maryan.abdullahi@gmail.comBackground: Pregnant women exhibit COVID-19 vaccine hesitancy due to concerns regarding potential risks to their babies, doubts about vaccine efficacy, and limited access to information. Therefore, this study aims to estimate COVID-19 vaccine uptake and factors associated with pregnant women in Mogadishu, Somalia.Methods: A cross-sectional study was conducted on pregnant women using a questionnaire covering socio-demographic information, pregnancy-related characteristics, perceptions about the COVID-19 vaccine, and vaccination status. Univariable and multivariable logistic regression analyses were utilized to identify factors associated with the outcome variable.Results: Among the 400 pregnant women who participated in this study, 26.8% had received a COVID-19 vaccine dose, with only 14.9% receiving it during pregnancy. Reasons for not receiving the vaccine included a lack of information about the vaccine (47.4%), concerns about its adverse effects on personal health (33.8%), misconceptions regarding impacts on fertility or menstrual cycles (14.3%), belief in the vaccine’s inefficacy (3.4%), and fears about adverse effects on their fetus. In multivariable logistic regression, pregnant women with a history of chronic diseases (AOR=3.27, 95% CI=1.992– 6.145), those who perceived themselves at risk of contracting COVID-19 (AOR=3.81, 95% CI=2.11– 5.10), those who believed that the vaccine was accessible to them (AOR=4.34, 95% CI=2.915– 6.165), and those who discussed the COVID-19 vaccine with their healthcare provider (AOR=3.91, 95% CI=2.123– 7.878) were more likely to receive the COVID-19 vaccine compared to their counterparts.Conclusion: Pregnant women in Mogadishu, Somalia, face challenges with sub-optimal covid-19 vaccine uptake. Implementations should improve awareness of COVID-19 risks and facilitate discussions between healthcare providers and pregnant women. In addition, efforts to provide reliable information about the vaccine, alleviate concerns about its adverse effects, and dispel misconceptions about fertility, menstrual cycles, efficacy, and foetal impact are crucial.Keywords: COVID-19 vaccine uptake, willingness, hesitancy and acceptance, factors associated, pregnant women, Mogadishu, Somalia

Abstract Background Out of the 21 neglected tropical diseases (NTDs) listed by the World Health Organization, 15 affect the People’s Republic of China. Despite significant achievements in controlling NTDs, comprehensive assessments of the disease burden based on actual case data and detailed information on spatial and temporal dynamics are still lacking. This study aims to assess the disease burden and spatial–temporal distribution of NTDs in China from 2005 to 2020, to provide a reference for the formulation of national health agendas in line with the global health agenda, and guide resource allocation. Methods The number of cases and deaths of major NTDs in China from 2005 to 2020 were downloaded from the China Public Health Science Data Center ( https://www.phsciencedata.cn/Share/index.jsp ) of the Chinese Center for Disease Control and Prevention and relevant literatures. Simplified formulas for disability-adjusted life years (DALYs) helped estimate the years of life lost (YLLs), years lived with disability (YLDs), and total DALYs. Spatial autocorrelation analysis of the average NTDs burden data for the years 2005 to 2020 was evaluated using Moran's I statistic. Results China's overall NTDs burden decreased significantly, from 245,444.53 DALYs in 2005 to 18,984.34 DALYs in 2020, marking a reduction of 92.27%. In 2005, the DALYs caused by schistosomiasis and rabies represent a substantial proportion of the total disease burden, accounting for 65.37% and 34.43% respectively. In 2015, Hunan and Sichuan provinces had the highest diversity of NTDs, with 9 and 8 number of different NTDs reported respectively. And the highest disease burden was observed in Sichuan (242,683.46 DALYs), Xizang Zizhiqu (178,318.99 DALYs) and Guangdong (154,228.31 DALYs). The “high-high” clustering areas of NTDs were mainly in China's central and southern regions, as identified by spatial autocorrelation analysis. Conclusions China has made unremitting efforts in the prevention and control of NTDs, and the disease burden of major NTDs in China has decreased significantly. Using the One Health concept to guide disease prevention and control in the field to effectively save medical resources and achieve precise intervention. Graphical abstract

Abdullahi Abdirahman Omar,1 Jamal Hassan Mohamoud,2 Mohamed Hussein Adam,2 Bashiru Garba,2 Mariam Abdi Hassan,1 Ibrahim Abdullahi Mohamed,1 Zakaria Mohamed Adam1 1Dr.Sumait Hospitals, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia; 2Department Public Health, Faculty of Medicine and Health Sciences of SIMAD University, Mogadishu, SomaliaCorrespondence: Abdullahi Abdirahman Omar, Tel +252615444315, Email dr.abdullahi.yare@simad.edu.soBackground: The COVID-19 pandemic’s first wave and subsequent lockdowns disrupted global healthcare systems, significantly impacting essential services including tuberculosis (TB) care. Non-adherence to anti-TB drugs is a critical concern, leading to treatment failure, drug resistance, and increased morbidity and mortality. This study assessed the rate and determinants of non-adherence to TB treatment among patients at TB centers during the first wave of the pandemic.Material and Methods: A cross-sectional study was conducted from June 15 to July 30, 2020, involving 255 TB patients at three centers in Mogadishu. Data were gathered using the Morisky Medication Adherence Scale-8 (MMAS-8) through structured interviews and analyzed using descriptive statistics and binary logistic regression.Results: The study found a 34.5% non-adherence rate during the pandemic. Key reasons for non-adherence included forgetting to take medication (33%), feeling well (29%), experiencing side effects (18%), and fear of contracting COVID-19 (16%). Significant factors associated with non-adherence were age groups 25– 34 years (OR = 2.96, p = 0.024) and 35– 44 years (OR = 4.55, p = 0.005), unemployment (OR = 2.57, p = 0.037), smoking (OR = 3.49, p = 0.029), tobacco use (OR = 4.15, p = 0.034), proximity to a health facility (OR = 0.44, p = 0.033), perception of healthcare providers as very friendly (OR = 0.24, p = 0.031) or friendly (OR = 0.45, p = 0.023), being in the continuous treatment phase (OR = 3.2, p < 0.001), and experiencing adverse treatment effects (OR = 2.42, p = 0.003).Conclusion: Non-adherence to anti-tuberculosis treatment was notably high in Mogadishu during the first wave of the pandemic, necessitating targeted interventions to improve adherence.Keywords: non-adherence, anti-tuberculosis drugs, COVID-19, Tuberculosis

Background: Physical exercise helps to mitigate cardiovascular risks in people with diabetes mellitus (DM), but there are limited data in Nigeria. This study aimed to assess cardiovascular risk awareness, exercise practices and metabolic outcomes among Nigerians with diabetes. Materials and Methods: We conducted a cross-sectional study at five tertiary hospitals using questionnaire interviews and clinical assessments. Participants’ knowledge of cardiovascular risk factors and knowledge of exercise were assessed on 12- and 5-item scores, while exercise practices were classed as adequate if performed regularly on 3 or more days weekly for a total of 150 min or more based on the American Diabetes Association recommendations. Mean body mass index (BMI), blood pressure (BP), fasting blood glucose, serum haemoglobin A1C (HbA1c), lipid profile, urea, creatinine and uric acid were then compared among participant groups. Results: We studied 426 participants with DM, 58.7% females. The mean age was 52.9 ± 13.1 years, with males significantly older than females (54.6 ± 12.2 vs. 51.8 ± 13.5 years; 95% confidence interval: 0.27–5.28, P = 0.03). The mean age at diabetes diagnosis was 44.8 ± 11.7 years, and the median duration of diabetes was 84 months. There was low knowledge of cardiovascular risk factors and low knowledge of exercise (mean scores of 2.94 and 2.31, respectively). Forty-three per cent of participants reported adequate exercise, which was significantly associated with younger age (P = 0.007), male gender (P = 0.001) and formal education (P = 0.021). Participants with adequate exercise had lower systolic BP and serum urea compared to those with inadequate exercise, but there were no significant differences in BMI, fasting glucose, HbA1c, serum lipids, creatinine or uric acid. Conclusion: Participants had low knowledge of cardiovascular risks and the appropriate exercise practices for diabetes patients. There is a need for better patient education on diabetes self-care and exercise at clinic visits.

Abstract The Himalayas, globally acknowledged as one of the four biodiversity hotspots, underscore their ecological significance, boasting abundant flora and fauna. Among these, a diverse array of wild fruits such as Aegle marmelos, Artocarpus lakoocha, Baccaurea spp., Carissa spp., and others provide essential nutrition for local populations. These fruits, rich in bioactive compounds, offer nutraceutical potential, contributing to health aspects like antidiabetic, anti-inflammatory, and anticancer properties. The integration of Himalayan wild fruits into circular practices supports sustainable livelihoods. The responsible harvesting, efficient processing, and value addition of these fruits align with circular principles, striking a balance between conservation and progress. Technologies such as anaerobic digestion, waste-to-energy conversion, and composting can harness waste generated during cultivation and processing, contributing to a circular economy and rural Himalayan community development. Preserving, accessing, and commercializing underutilized fruits can significantly enhance economic prosperity and the quality of life for inhabitants. However, integrating these fruits into agriculture faces multifaceted challenges, spanning social, economic, environmental, agronomic, and political dimensions. Addressing these challenges is crucial for sustainable development, aiming to eradicate poverty, malnutrition, and hidden hunger. Moreover, addressing these challenges is not only vital for sustainable development in the Himalayan region but also for mitigating carbon footprints and tackling issues like poverty, malnutrition, hidden hunger, and climate change. The exploration of these concepts within the Himalayan context holds immense promise for sustainable development and ecological conservation. Graphical Abstract

Enhancing awareness of personal cleanliness and antibacterial resistance has intensified the antibacterial substance request on consumable products. Antibacterial agents that have been commercialized nowadays are produced from inorganic and non-renewable substances. This provides several drawbacks, particularly against health and environmental issues. Therefore, many scientists work on substituting fossil-fuel-based antibacterial agents with natural ones such as from biomass. Biomass derivatives, natural abundances of biopolymers in the world, amount to major compounds including polysaccharides (cellulose, hemicellulose, and chitosan) and polyphenol (tannin and lignin) substances which are capable to combat the growth of Gram-positive bacteria and Gram-negative bacteria. To date, no report focuses on a deep understanding of antibacterial properties derived from biomass and the internal and external factors effects. This work provides that gap because comprehensive knowledge is necessary before applying biomass to the products. The potency of biomass derivatives as antibacterial additives is also summarized. Basic knowledge of antibacterial characteristics to the application in products is highlighted in this review. Besides, the discussion about challenges and future perspectives is also delivered.

Background: Despite global efforts to improve vaccination coverage, the number of zero-dose and under-immunized children has increased in Africa, particularly in Nigeria, which has over 2.1 million unvaccinated (zero dose) children, the highest in the continent. This scoping review systematically maps and summarizes existing literature on the barriers and facilitators of immunization in Nigeria, focusing on regional inequalities. Methods: A comprehensive search of electronic databases was conducted, encompassing all data from their inception to October 2023, to identify articles on the determinants of routine immunization uptake in Nigeria. Eligible studies were evaluated using predefined criteria, and the data were analyzed and visualized. Results: The results revealed distinct regional variations in factors influencing immunization practices across Nigeria’s six geopolitical zones. Identified barriers include logistical issues, socio-economic factors, cultural influences, and systemic healthcare deficiencies. Key facilitators across multiple zones are health literacy, maternal education, and community leader influence. However, unique regional differences were also identified. In the North-East, significant factors included peer influence, robust reminder systems, provision of additional security, and financial incentives for health facilities. In the North-West, perceived vaccine benefits, fear of non-immunization consequences, urban residence, health literacy, and antenatal care visits were reported as crucial. Perceived benefits of vaccines and trust in healthcare providers were identified as predominant factors in the North-Central zone In the South-East, maternal autonomy, health literacy, and fear of non-immunization consequences were important. In the South-South, peer influence and reminder systems like WhatsApp and SMS were notable, alongside higher maternal education levels. The South-West highlighted maternal autonomy, peer influence, health card usage, high maternal education, and supportive government policies as critical factors. Conclusion: Our findings underscore the need for region-specific interventions that address these unique barriers to improve immunization coverage across Nigeria. Tailored approaches that consider the socio-economic, cultural, and logistical challenges specific to each region are essential to bridge the immunization gap.

The purpose of this study is to demonstrate the potential of ceramic tile dust (CTD)-derived ZSM-5 zeolite (CZ) and its monodispersed composite with metal oxides (MgO and Fe2O3) in the catalytic pyrolysis of hyphaene thebaica shell (HTS). The HTS was pyrolysed in a Fixed-bed reactor at 400–600 °C, and 100–300 mL/min N2 flowrate. The maximum bio-oil production of 32 % was obtained at 500 °C and 150 mL/min N2 flowrate, with bio-oils containing 50 % acid and octadecenoic acids, as well as esters, phenols, aldehydes, ketones, ethers, aromatics, and hydrocarbons. A carboxymethyl cellulose templating agent was employed for the mesoporous zeolite synthesis from CTD. This resulted in the mesoporous zeolite with a predominant ZSM-5 crystal phase, exhibiting pore diameters ranging from 1.8-6 nm, 229 m2/g surface area and 1145 μmol/g total acidity. The catalytic pyrolysis of HTS was conducted using the ZSM-5 zeolite (CZ) and metal-oxide (MgO, Fe2O3, and Fe2O3/FeO) modified CZ, as monodispersed composite catalysts. Under best thermal pyrolysis conditions, CZ-Fe2O3, CZ-MgO, and CZ-Fe2O3/MgO demonstrated 22–23 % bio-oil yields. Notably, the CZ-Fe2O3/MgO catalyst exhibited the highest hydrocarbon yield at 16 %, while the CZ-MgO favoured the production of phenolics, esters, and alcohols. CZ-MgO also displayed the highest coking level at 7.5 %, indicating faster deactivation than the other catalysts. The synthesised catalysts exhibited remarkable catalytic activity, resulting in a notable improvement in the quality of bio-oils obtained from the intermediate pyrolysis of hyphaene thebaica shells in a fixed-bed reactor.

ABSTRACTThe Unumherin community in Nigeria’s Niger Delta is home to coastal marine polluted zones, and this research examines the radioactivity distributions and biohazard in the coastal environment. The activity concentrations of 40K, 238U, 232Th, as well as the outdoor dose rate of contaminated coastlines were measured using a calibrated RS-125 Gamma-Spec and a NaI(Tl) gamma-detector. The laboratory examination of sediments, water, and fish from the same coastal region – Clarias gariepinus Pseudotropheus elongated Oreochromis niloticus and Stromateus fiatola – was combined with the in-situ observations of gamma dose rates. With a value of [Formula: see text], the hotspot at site 4 is shown by the geographic distribution of gamma dose rates. The findings showed that the activities of the primordial radionuclides varied, with average values for the sediments and water exceeding suggested limits. Similarly, the corresponding mean hazard indices mostly exceeds the allowable limits. The species specificity of the fish species accounts for the variation in the mean concentrations of 40K, 238U and 232Th. C. gariepinus, having accumulated higher concentrations of 40K and 238U, may be the first to elicit health hazards in the future if pollution continues unmonitored. Hence, continuous monitoring of the aquatic environment alongside is highly recommended.

Mathematics anxiety is the feeling of tension and fear which interferes with the manipulation of numbers in ordinary life and academic setting. This study aimed at exploring students' level of mathematics anxiety and teacher behavior and speech which intensifies and minimizes mathematics anxiety among secondary schools in Sokoto state, Nigeria. In total, 109 questionnaires regarding mathematics anxiety named the cognitive, emotion, physical-mathematics anxiety rating (CEP-MAR) were distributed to students and 102 were returned. From the responses in the questionnaire, 20 of the most mathematics anxious individuals were selected to participate in a photovoice project. These 20 students were given cameras and asked to capture classroom events, which impact on their mathematics anxiety. Afterwards, a one-to-one semi-structured interview was conducted with each student to discuss the photos. The findings disclosed that teachers' behavior and speech such as being too quick in mathematics classroom lessons, giving too many notes, exercises, punishments and embarrassing/alarming statements have a significant effect in intensifying mathematics anxiety. The findings also showcased that quiz/competitions, good learning environment, intrinsic and extrinsic motivational statements help in minimizing mathematics anxiety. This study provides further evidence that teachers have both positive and negative effect on students' mathematics anxiety.

Globally, effective and efficient healthcare is critical to the wellbeing and standard of living of any society. Unfortunately, several distant communities far from the national grid do not have access to reliable power supply, owing to economic, environmental, and technical challenges. Furthermore, unreliable, unavailable, and uneconomical power supply to these communities contributes significantly to the delivery of substandard or absence of qualitative healthcare services, resulting in higher mortality rates and associated difficulty in attracting qualified healthcare workers to the affected communities. Given these circumstances, this paper aims to conduct a comprehensive review of the status of renewable energy available to rural healthcare clinics around the globe, emphasizing its potential, analysis, procedures, modeling techniques, and case studies. In this light, several renewable energy modeling techniques were reviewed to examine the optimum power supply to the referenced healthcare centers in remote communities. To this end, analytical techniques and standard indices for reliable power supply to the isolated healthcare centers are suggested. Specifically, different battery storage systems that are suitable for rural healthcare systems are examined, and the most economical and realistic procedure for the maintenance of microgrid power systems for sustainable healthcare delivery is defined. Finally, this paper will serve as a valuable resource for policymakers, researchers, and experts in rural power supply to remote healthcare centers globally.

Introduction: Asthma is a chronic inflammatory disorder associated with variable air flow obstruction and bronchial hyperresponsiveness. It is characterised clinically by recurrent episodes of cough, difficulty in breathing and wheezing which resolves spontaneously or with treatment. The socio-demographic and clinical characteristics of asthmatic children in north western Nigeria have not been reported. Methods: This was a descriptive study in children with asthma aged 4-15 years carried out over a 3 month period Aminu Kano Teaching Hospital (AKTH), Kano. The aim was to determine the socio-demographic and clinical parameters of asthmatic children. Asthmatic children whose parents or guardian consented to the study were recruited consecutively. Their bio-data, sociodemographic and physical examination were documented. Results: Seventy asthmatic children were recruited of which 50(71.4%) were males and 20(28.6%) were females, giving a male: female ratio of 2.5:1. Insecticide was the commonest asthma trigger (64.3%) and 26(37.1%) patients belonged to socio economic class III. Mild persistent asthma was the commonest form of asthma severity encountered. There was positive correlation between PEFR and height (r = 0.577, p< 0.0001). Conclusion: Most of the asthmaticschildren seen at AKTH, Kano were males with mild persistent asthma, had positive family history of atopy and belonged to the middle socio economic class.

Background: Death certification is an integral part of physician practice, yet common errors are being encountered from this vital source of health information. Most medical training programs lack formal curricula for this important skill. Accurate information from DC will help in improve our mortality data which can be use public health purposes Objectives: This study evaluated the effect of a multifaceted educational intervention on accuracy of completing death certification in a tertiary-based paediatric residency program Method: A pre-post intervention and control cohort study over 12- month period to assess the effect of our multifaceted intervention accuracy rate of completed DC was conducted. The intervention consisted of a 3-part program (distribution of educational material, presentation by a skilled instructor, skills workshop, and clinical mortality/auditing feedback sessions). Primary outcome was the difference in scores preand post-intervention and also the rate of accuracy on the MAHI death certificate scoring system. Results: The mean score before the intervention was 6.8±2.7 and 7.1±2.3 in both the intervention and control cohorts respectively. The mean score after the intervention was 16.3±2.5 and 7.3±2.8 in both the intervention and control cohorts respectively indicating an increase in scores. The mean difference in pre- and post-tutorial scores was significant (t=20.39, p=0.0001). Conclusions: We found that using a multifaceted educational intervention to train junior physicians on how to correctly complete a DC was effective in a residency-based pediatric program

Background: Malaria has remained a major public health problem in Nigeria with the under-five aged children and pregnant women being the most affected. The local epidemiological profile of the disease is dynamic owing to the continuous variation in the various determinants and hence the need for periodic re-evaluation. We aim to determine the prevalence of malariaparasitaemia among the under -five aged children and the effect of various determinants. Material and Method: In this cross-sectional study, 433 out- patients aged below 5 years with fever or history of fever in the previous 72hours were enrolled. Relevant information was obtained and recorded using a questionnaire. Thick and thin films were prepared from a finger or heel prick for each of the patients and subjected to microscopy. Result: The prevalence of malaria parasitaemia was 27.7%. Age, sex, nutritional status, socio- economic class, temperature at presentation as well as ownership of insecticide treated nets had no significant effect on the prevalence of malaria (p>0.05). Only P. falciparum was seen in all the positive slides. The parasite density was generally low with 48.3% having parasite densities below 100/μl and only 7.5% had parasite density of ≥1000/μl. Parasite density increased significantly with increasing age (p=0041). Nutritional status as well as other studied factors had no significant effect on parasite density (p>0.05). Conclusion and Recommendation: Prevalence of malaria infection was high in the population studied. It is characterized by low density parasitaemia and hence the need to interpret negative results with caution. Age, gender, socio-economic and nutritional status, temperatureat presentation as well as ownership of ITN had no significant effect on prevalence of malaria parasitaemia. There is need to strengthen and scale up various malaria control programs while ensuring proper implementations of programs and activities through effective monitoring and evaluation.

Background: Under nutrition and overweight in children co-exist in developing countries and may persist into adulthood. Interpretation of body mass index (BMI), a useful measure of nutritional status in children requires age related reference standards, many of which were developed from different international sources. It is necessary to determine which of these reference standards is most suitable for use in the assessment of BMI distribution among adolescents in Nigeria. Objective: To determine the prevalence of thinness, overweight and obesity using the World Health Organization (WHO), International Obesity Task Force (IOTF), and Centre for Disease Control (CDC) reference standards and assess their level of agreement amongst adolescents in Sokoto metropolis. Methods: 800 students were selected through multi-stage sampling technique from secondary schools. BMI was classified according to three reference standards (WHO, CDC, IOTF). Data was analysed with SPSS version 22. The level of agreement between the reference standards in diagnosing nutritional status was assessed using Kappa statistics. Level of significance was put at p< 0.05. Results: The prevalence rate of thinness was highest with the IOTF at 22.6% compared to 19.4%, and 19.6% by the WHO and CDC respectively. The prevalence rates of overweight and obesity were highest with the WHO reference standards at 7.0% and 1.3% followed by the IOTF (6.1%and 0.6%) and lowest with the CDC (5.8% and 0.3%). Substantial agreement was observed between WHO and IOTF (Kappa = 0.77), while the level of agreement was 0.68 for IOTF/CDC and 0.64 for WHO/CDC. All agreement statistics were significant (p < 0.001). Conclusion: The WHO and IOTF reference charts may be more suitable for our population.

The Paediatric Association of Nigeria first published management guideline for community-acquired pneumonia in 2015 and covered available evidence at that time. This update represents a review of available recent evidence statements regarding the management of pneumonia in children, while at the same time incorporating relevant materials from the first edition of the guideline. The guideline is developed to assist clinicians in the care of children with CAP. The recommendations provided in this guideline may not be the only approach to management, since there are considerable variations among children in the clinical course of CAP. The goal of this guideline is to reduce morbidity and mortality rate of CAP in children by providing recommendations that may be relevant in assisting clinicians to make timely diagnosis and institute appropriate antibiotic therapy of children with CAP. Summarized below are recommendations made in the new 2021 CAP guideline. As part of the recommendations, the quality of the evidence is provided and the grade of the recommendation indicated. The details of the background, methods and evidence summaries that support each of these recommendations can be found in the full text of the guideline.