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Background: The (WHO) developed the five keys to safer food which was designed to be practical and straightforward for food handlers. In recognition of the role they play in preventing Foodborne Disease (FBD) outbreak. In this study, we aimed to determine the knowledge and practice of the five keys to safer food among food handlers in food establishments in Sokoto Metropolis, Nigeria. Methods: We conducted a cross-sectional study between August and November 2019. We recruited 366 food handlers working in restaurants using a multistage sampling technique. We assessed knowledge and practice of five keys to safer food, and we examined the predictors of knowledge among the participants using chi-square and binary logistic regression at a 5% level of significance. Results: More than two-thirds, 288 (78.7%) less than 40 years and less than half, 163 (44.5%), were involved in cooking the food. One hundred and twenty-seven (34.7%) have greater than five years’ experience. Overall, less than one-quarter, 87 (23.8%) had good knowledge of the five keys to safer food handling. One hundred and thirty-two (36.1%) wash hands before and during preparation most times. Two hundred and fifty-three (69.1%) never wash their hands after using the toilet, and 144 (39.3%).Age (adjusted Odds Ratio [aOR]: 10.05; 95% CI = 4.0 - 21.04), gender (aOR: 2.70 95CI = 1.44 - 5.09) and Education (aOR: 3.67; 95% CI = 1.92 - 7.01) were significant predictors of knowledge. Conclusion: There is poor knowledge, and most of the practices of the five keys to safer food were below the required for food safety. Therefore, we recommend that the Sokoto state ministry of health coordinate training interventions on five keys to safer food with particular attention to those older than 40 years and those without formal education.

Most public and private libraries are inclined to adopt using Koha ILS around the globe. However, several Arab schools could not implement the Koha ILS application to automate their school libraries for ease of use. Deploying technology in managing libraries can solve several identified issues in public and private schools. This provides efficiency, ease and improves the performance of library services. Therefore, this paper is based on qualitative research that implements an efficient open-source application known as Koha ILS in two Arab schools, namely Baseerah International School (BIS) and International Modern Arab School (IMAS), Kuala Lumpur, Malaysia. In our analysis, we consider analyzing the proposed Koha ILS by providing backend accessibility so as library consumers can make a further enhancement to upgrade the application. The proposed Koha presents several positive impacts such as an efficient cataloging system, remote management of library consumer records such as books or room reservations and customizable searching interface for efficient usage. The application also presents multiple operating system support for a user’s flexibility. In our results, an analysis was made by comparing the two schools based on gender, position/ranks available in the school library, and IT gadgets. Toward this end, some limitations were noted and recommended as a future research direction.

Background: Babesiosis is a rare emerging opportunistic disease in humans. It is a zoonotic disease caused by protozoan parasites of the genus Babesia and transmitted by Ixodid tick vector. It is often incidentally diagnosed because of its rarity but may be severe or fatal in presentation, particularly in immunocompromised hosts. Aim: To reportthe clinical presentationof a fatal case of human babesiosis in a nine-year old girlwith retroviral disease, in Sokoto, Northern Nigeria. Case Report: A nine-year old girl presented with a month history of unremitting fever, cough and weight loss, There was no history of contact with someone with chronic cough and no diarrhoea. She was diagnosed to have retroviral disease (RVD) at age of three (3) years consequent to her mother’s positive test but only the mother was on antiretroviral treatment, due to the claim that the child had remained healthy. Review of her blood film during third week of admission revealed characteristic tetrads (maltese-cross formation) pathognomonic of babesial infection. She was started on anti-babesial treatment with quinine and clindamycin. She succumbed to the illness within second week of anti-babesial treatment. Conclusion: This report suggested that babesiosis should be a high index of suspicion especially in immunocompromised patients with persistent fever.

Introduction The COVID-19 pandemic continues to overwhelm health systems across the globe. We aimed to assess the readiness of hospitals in Nigeria to respond to the COVID-19 outbreak. Method Between April and October 2020, hospital representatives completed a modified World Health Organisation (WHO) COVID-19 hospital readiness checklist consisting of 13 components and 124 indicators. Readiness scores were classified as adequate (score ≥80%), moderate (score 50–79.9%) and not ready (score Results Among 20 (17 tertiary and three secondary) hospitals from all six geopolitical zones of Nigeria, readiness score ranged from 28.2% to 88.7% (median 68.4%), and only three (15%) hospitals had adequate readiness. There was a median of 15 isolation beds, four ICU beds and four ventilators per hospital, but over 45% of hospitals established isolation facilities and procured ventilators after the onset of COVID-19. Of the 13 readiness components, the lowest readiness scores were reported for surge capacity (61.1%), human resources (59.1%), staff welfare (50%) and availability of critical items (47.7%). Conclusion Most hospitals in Nigeria were not adequately prepared to respond to the COVID-19 outbreak. Current efforts to strengthen hospital preparedness should prioritize challenges related to surge capacity, critical care for COVID-19 patients, and staff welfare and protection.

This training module focuses on providing basic guidance on the current recommended approaches regarding malaria basic information, signs/symptoms, case detection, treatment, referral, and effective prevention strategies. The module can be used for in-service training programs on malaria or to assist in improving other health educator’s work as well as serve as referral handbook for practicing health professionals. It can thus be used as a stand-alone training or together with modules dealing with other aspects of malaria control, prevention and elimination. The module uses a problem-solving approach to facilitate understanding and thereby motivate trainees on improved malaria case management. In essence, the training aims to generally improve the knowledge, attitudes and practices (KAP) of the most common handlers of malaria cases in this part of the world, the training module is then expected to improve services obtained by the majority of patients on malaria. On completion of training using this module, trainees will have acquired appreciable knowledge and skills on malaria basic-information, signs/symptoms, case detection/differentials, recommended drug treatment/appropriate dosing, indication for referral of complicated cases, effective prevention methods and the need to sensitise communities to stand up against malaria.

Background: Hospital associated infections (HAIs) remain a significant cause of morbidity and mortality. And despite the simplicity of hand hygiene practice, an important preventive measure that has been proven to reduce the risk of acquiring and transmitting HAIs, Health care workers (HCW) compliance with the recommendations is of serious concern. Aim: The aim of this study was to determine the prevalence of hospital associated infections and HCWs compliance with hand hygiene practice in a tertiary hospital. Methods and material: This was a hospital-based descriptive cross-sectional study among 110 patients on admission selected using universal sampling, and 377 HCWs selected using a multistage sampling technique. Data collected with self-administered questionnaire for HCWs, interviewer-administered proforma for the patients and data extraction sheet for laboratory analysis. Data analyzed for descriptive statistics using SPSS version 20.0. Results: Patients' mean age was 32.8, IQR: 10.5-37.9 years. Majority, 56(50.9%) were females; Hausa/Fulani, 91(82.7%) and 37(33.6%) had only Qur'anic education while only 20(18.2%) had tertiary education. Health care workers' mean age was 31.8 5.3 years. Majority 227(60.2%) are females, and 267(71.8%) of the participants have received training on hospital infection control. Overall prevalence of HAIs was 42.7%, highest in surgical unit. Commonest HAIs being blood stream infections, and the least, Health Care Associated Pneumonia. Most of the infections were due to Staphylococcus aureus, 22(46.8%) and Pseudomonas aeruginosa, 14(29.8%). Highest hand hygiene practice was reported after contact with body fluid and highest non-compliance reported was before touching patient. Hand hygiene compliance rate was 49.6% and main reasons to non-compliance were high work load, lack of running water and soap, and regular use of hand gloves. Conclusions: Prevalence of HAIs was reportedly high, and low hand hygiene compliance and rate despite majority of the HCWs having received training on Hospital infection control. To reduce the prevalence and the associated burden of HAIs, there is need to put in measures to improve compliance to quality hand hygiene practice by health workers.

Introduction: Emphysematous pyelonephritis is a life-threatening necrotising bacterial infection of the kidneys. It is rare among children and can be fatal if not promptly identified and treated. Case presentation: A 7-month-old male infant presented to the Emergency Paediatric Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, on 12 November 2019 with a 5-day history of fever and vomiting, and a 3-day history of a progressively enlarging, left-side abdominal mass. There was associated excessive crying on micturition, refusal to feed and weight loss. He looked ill and was in respiratory distress, irritable, febrile (38.8 °C), moderately dehydrated and pale. His weight and length were 5.5 kg and 64 cm. He had a tender, firm and ballotable abdominal mass on the left flank measuring 8 cm × 10 cm. His pulse rate was 140 beats/min, blood pressure 60/40 millimetres of mercury and respiratory rate was 65 cycles/min. He had widespread coarse crepitations and normal heart sounds on chest auscultation. Management and outcome: An initial diagnosis of sepsis was made. Other considerations were nephroblastoma and neuroblastoma. Ceftriaxone and blood transfusion were commenced with subsequent administration of intravenous fluids. Further radiologic investigations revealed emphysematous pyelonephritis. The patient had percutaneous drainage and extended spectrum β-lactamase-producing Escherichia coli (sensitive to meropenem) which was isolated from the aspirate culture after 48 h of incubation. Meropenem could not be commenced because of non-availability and high cost. The patient subsequently deteriorated and died from septic shock. Conclusion: Emphysematous pyelonephritis has a fulminant course when not diagnosed promptly and treated adequately.

INTRODUCTION: Antibiotic overprescribing is associated with antibiotic resistance worldwide but worst in developing nations. Minimal information exists on the antibiotic prescribing habits of essentially all cadres of healthcare workers in Nigeria, but particularly primary healthcare (PHC) workers. Our aim was to explore antibiotic prescribing habits of Nigerian primary healthcare workers in the context of increasing antibiotic resistance which has a direct effect on healthcare associated infections (HCAIs) and patient safety worldwide. METHODS: a questionnaire-based cross-sectional study was conducted among 442 primary healthcare workers across three Northern Nigerian states of Gombe, Sokoto and Kwara. Data obtained was analysed using SPSS version 20. RESULTS: antibiotic prescription rate was 98.2%. The most commonly prescribed antibiotics were amoxicillin (71.7%) and ampicillin/cloxacillin (70.1%) while the least was meropenem (4.1%). Major indicators of antibiotics abuse include unconfirmed typhoid fever (96.1%), non-specific vaginal discharge (95.4%), fresh trauma wound (91.3%), non-specific diarrhoea (87.1%) and common cold (85.9%). Additionally, about one-third of the respondents also routinely prescribe antibiotics to healthy birds (31.5%) and animals (18.3%). Identified reasons attributed to antibiotic overprescribing from the participants´ perspectives include lack of awareness (87.0%), lack of penalty (79.4%), desire to help patients (76.5%), pressure from sales representatives (61.0%) and patients´ pressure (58.3%). Overall, majority (85.8%) of respondents agrees that overprescribing is a cause of antimicrobial resistance. CONCLUSION: overprescribing of antibiotics is common among PHC workers and could contribute significantly to the rising scourge of antimicrobial resistance and poses a threat to patient safety and associated increased burden of HCAIs.

Background: Since 1988, the incidence of polio has reduced by more than 99 percent, worldwide, according to the WHO. Each year, more than 350,000 children were paralyzed, in more than 125 endemic countries. Today, only two countries are still having transmission of polio: Pakistan and Afghanistan. No wild poliovirus has been reported anywhere in Africa since 2016. A good and effective Acute Flaccid Paralysis (AFP) surveillance system is necessary to detect any suspected case of polio to interrupt the transmission of polio within any country. We evaluated the AFP surveillance system to identify gaps in its operations.Methods: We used the updated CDC guidelines for evaluating public health surveillance systems and the WHO performance standards to assess the system. We also interviewed stakeholders using an adapted questionnaire, and a key informant interview. We also reviewed AFP surveillance data from 2013-2018. We summarized data using means, frequencies, and proportion. Results: A total of 49 respondents were interviewed. Of these, 47 (98%) reported case definitions as being easy to use, and case investigation forms as being easy to fill, 46 (97%) reported data tools could easily accommodate changes, and all the surveillance officers understand the case definition of AFP. All respondents were willing to continue with the system. The non-polio AFP rate (24.6-55.2), stool adequacy (95-99.7%), timeliness, and completeness of reporting were found to be consistently above the WHO minimum standard.Conclusion: The AFP surveillance system in Kebbi State was found to be useful, simple, flexible, acceptable, sensitive, representative, timely, and stable, though donor-driven. The absence of data on 60-day follow up and feedback from the laboratory was a major problem with the system.

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Introduction measles is a vaccine preventable, highly transmissible viral infection that affects mostly children under five years. We reviewed surveillance data on measles from Nigeria over a five-year period to highlights its burden and make recommendations for improvements. Methods we conducted a secondary data analysis of measles specific Integrated Disease Surveillance and Response (IDSR) records of all states in Nigeria over a five-year period. Results a total of 131,732 cases were recorded between January 2012 and September 2016. Most cases 57,892 (43.95%) were recorded in 2013 while the least 11,061 (8.4%) were recorded in 2012. A total of 817 deaths were recorded, with a case fatality rate (CFR) of 0.62%. The highest CFR (1.43%) was recorded in 2012 while the least CFR (0.44%) was recorded in 2016. Only 8,916 (6.7%) cases were confirmed by laboratory tests. The trend of measles cases followed the same pattern throughout the years under review, with cases peaking at March, then gradually reducing to lowest level at June, which was maintained throughout the rest of the year. States in northern region of Nigeria recorded the highest attack rate (Yobe: 480.29 cases per 100,000 population, Sokoto: 284.63 cases per 100,000 population and Katsina: 246.07 cases per 100,000 population) compared to States in the southern region (Rivers: 11.72 cases per 100,000 population and Akwa Ibom: 13.59 cases per 100,000 population). Conversely, States in the southern region recorded the highest CFR (Ebonyi: 13.43% and Rivers: 3.27%). Conclusion measles infection remains a burden especially in the northern region of Nigeria. Although measles fatalities declined over the years, laboratory confirmation was sub-optimal. We recommended improvement on routine immunization and strengthening of regional laboratories diagnostic capacities, for successful eradication of measles from Nigeria.

Background The World Health Assembly adopted the Global Action Plan on Antimicrobial Resistance, which includes improving the knowledge base through surveillance and research. Noteworthily, the World Health Organization has advocated a Global Antimicrobial Resistance Surveillance System to address the plan's surveillance objective, with most African countries enrolling in or after 2017. Aim The aim of this article was to review prior data on antimicrobial resistance of Vibrio cholerae from sub-Saharan Africa with a view for future control and intervention strategies. Methods We used the Preferred Reporting Items for Systematic Review and Meta-Analysis (or 'PRISMA') guidelines to search the PubMed and African Journals Online databases, as well as additional articles provided by the Nigeria Centre for Disease Control, for articles reporting on the antibiotic susceptibility of V. cholerae between January 2000 and December 2017. Results We identified 340 publications, of which only 25 (reporting from 16 countries within the sub-Saharan African region) were eligible. The majority (20; 80.0%) of the cholera toxigenic V. cholerae isolates were of the serogroup O1 of the El Tor biotype with Ogawa and Inaba serotypes predominating. Resistance was predominantly documented to trimethoprim-sulphamethoxazole (50% of the studies), ampicillin (43.3% of the studies), chloramphenicol (43.3% of the studies) and streptomycin (30% of the studies). Resistance mechanisms were reported in 40% of the studies. Conclusion Our results demonstrate a documented antimicrobial resistance of V. cholerae to multiple antibiotic classes, including cell wall active agents and antimetabolites with evidence of phenotypic/genotypic resistance to fluoroquinolones.

Introduction: Ecthyma gangrenosum (EG) is a cutaneous lesion commonly caused by Pseudomonas aeruginosa that involves mainly the lower limbs and gluteal region, seen more in immunosuppressed patients with neutropenia. Cancrum oris (Noma) is a gangrenous necrosis of the face that begins as a gingival ulcer and progresses rapidly to destroy contiguous tissues in malnourished children. Case Presentation: This article reports a case of facial EG which was similar to Noma in a malnourished child: a 16-month old girl with fever, cough, weight loss, watery stool and swelling on right cheek. She was febrile, pale, wasted with bilateral pitting pedal oedema. She had a solitary circumscribed round necrotic lesion, with surrounding hyperaemia on the right malar area which extended to destroy the right ala nasi. No intra-oral rashes but she had left ear discharge. She received blood transfusion, antibiotics, antiseptic wound care and nutritional rehabilitation. Management and Outcome: Swabs of the lesion and ear discharge both revealed Gram-negative bacilli and culture yielded P. aeruginosa. Retroviral, Mantoux and Gene Xpert tests were negative. She had moderate anaemia, normal white blood cell count, and neutropaenia. Parenteral ceftriazone was changed to ciprofloxacin based on sensitivity results and lack of clinical response. The wound healed with residual scarring and partial destruction of right ala nasi. Discussion: Although this patient had facial necrosis to suggest Noma, she did not have initial oral involvement, and clinical features such as Pseudomonas sepsis and neutropaenia suggested EG. Facial necrosis in malnourished children may be due to EG.

Objective We reviewed measles specific Integretaged Disease Surveillance and Response (IDSR) data from Nigeria over a five-year period to highlights its burden and trends, and make recommendations for improvements. Introduction Measles is a vaccine preventable, highly transmissible viral infection that affects mostly under-five year children. The disease is caused by a Morbillivirus; member of the Paramyxovirus family. Methods We conducted a secondary data analysis of measles specific IDSR records of all States in Nigeria from January 2012 to September 2016. The record had reported measles cases with laboratory outcomes from all the States. IDSR weekly epidemiological data were obtained from Surveillance Unit, Nigerian Centre for Disease Control (NCDC). Results A total of 131,732 cases were recorded within the period. Highest number of cases 57,892(43.95%) were recorded in 2013 while the least number of cases 11,061(8.4%) were recorded in 2012. A total of 817 deaths were recorded, given a case fatality rate (CFR) of 0.62%. The CFR showed a decreasing trend over the years with the highest CFR (1.43%) recorded in 2012 and the least CFR (0.44%) recorded in 2016. Only 8,916 (6.7%) cases were confirmed by laboratory investigation. The Northwest region recorded the highest attack rate (AR) of 149.7 cases per 100,000 population, followed by the Northeast region with 140.2 cases per 100,000 population, while the South-south region recorded the least AR of 15.8 cases per 100,000 population. Case Fatality Rate per region followed similar pattern, with the Northcentral region having the highest CFR of 4.38%. The trend of measles cases followed the same pattern. Cases peaked at March, then gradually reduced to lowest level at June. Conclusions Measles infection remains a burden especially in the northern region of Nigeria. Though measles fatalities were on decline over the years, laboratory diagnosis of cases has been suboptimal. We recommended improvement on routine immunization and measles case management, and strengthening of regional laboratories capacity for measles diagnosis. References 1. WHO | Measles. WHO [Internet]. World Health Organization; 2017 [cited 2017 Apr 10]; Available from: http://www.who.int/mediacentre/factsheets/fs286/en/ 2. Akande TM. A review of measles vaccine failure in developing countries. Niger. Med. Pract. SAME Ventures; 2007;52:112–6. 3. Ibrahim BS, Gana GJ, Mohammed Y, Bajoga UA, Olufemi AA, Umar AS, et al. Outbreak of measles in Sokoto State North-Western Nigeria, three months after a supplementary immunization campaign: An investigation report 2016. Australas. Med. J. AUSTRALASIAN MEDICAL JOURNAL PTY LTD HILLARYS, GPO BOX 367, PERTH, WA 6923, AUSTRALIA; 2016;9:324–35.

Background: In the past, the use of intrauterine contraceptive device (IUCD), in particular, Dalkon Shield was found to be associated with increased risk of pelvic infection. Recent literature illustrates that the risk of pelvic infection after insertion of an IUCD is low and that the risk peaks in the 1 st month after insertion. We set out to determine the incidence of genital infection among IUCD users after the 1 st and 3 rd months of insertion compared to users of other contraceptive methods; to determine the risk of genital infections among IUCD users compared to users of other contraceptive methods and to determine the organisms associated with genital infection among the contraceptive users. Materials and Methods: This was a cohort study involving new clients who chose various forms of contraceptives. Results: The incidence of genital infection was 3 (8.5%) at 1 month and 4 (12.1%) at 3 months. The incidence in non‑IUCD contraceptive users was 2 (5.9%) at 1 month and 3 (8.8%) at 3 months. The relative risk was 1.44 and 1.5 at 1 and 3 months, respectively. The observed difference in the rate of infection between IUCD users and other contraceptive users was not statistically significant. Bacteria vaginosis and Trichomonas vaginalis were commonly observed in the two groups. Conclusion: The incidence of genital infection among IUCD users was relatively low compared to non‑IUCD users. IUCD s do not significantly increase the of rate genital infection. Keywords: Contraceptives; genital; infection; intrauterine contraceptive device; Nigeria

Introduction : measles is a vaccine preventable, highly transmissible viral infection that affects mostly under-five year children. The disease is caused by a Morbillivirus; member of the Paramyxovirus family. Measles surveillance in Nigeria is through the Integrated Disease Surveillance and Response (IDSR). We reviewed surveillance data on measles from Nigeria over a five-year period to highlights its burden, and make recommendations for improvements. Methods : we conducted a secondary data analysis of measles specific IDSR records of all States in Nigeria from January 2012 to September 2016. The record had reported measles cases with laboratory outcomes from all the States. IDSR weekly epidemiological data were obtained from Surveillance Unit, Nigerian Centre for Disease Control (NCDC). Results : a total of 131,732 cases were recorded within the period. Highest number of cases 57,892 (43.95%) were recorded in 2013 while the least number of cases 11,061 (8.4%) were recorded in 2012. A total of 817 deaths were recorded, given a case fatality rate (CFR) of 0.62%. The CFR showed a decreasing trend over the years with the highest CFR (1.43%) recorded in 2012 and the least CFR (0.44%) recorded in 2016. Only 8,916 (6.7%) cases were confirmed by laboratory investigation. The Northwest region recorded the highest attack rate (AR) of 149.7 cases per 100,000 population, followed by the Northeast region with 140.2 cases per 100,000 population, while the South-south region recorded the least AR of 15.8 cases per 100,000 population. Case Fatality Rate per region followed similar pattern, with the North central region having the highest CFR of 4.38%. The trend of measles cases followed the same pattern. Cases peaked at March, then gradually reduced to lowest level at June. Conclusion : measles infection remains a burden especially in the northern region of Nigeria. Though measles fatalities were on decline over the years, laboratory diagnosis of cases has been suboptimal. We recommended improvement on routine immunization and measles case management, and strengthening of regional laboratories capacity for measles diagnosis.

Introduction : cholera is an infection caused by Vibrio cholerae, which may lead to severe dehydration and death if not treated. On August 31, 2015, the Kaduna Ministry of Health received a notification of increase cases of vomiting and diarrhoea at Dusten-Abba in Zaria. A response Team was sent to confirm the outbreak, describe the socio-demographic characteristics and identify possible risk factors for the outbreak. Methods : we defined cases according to the World Health Organization (WHO) criteria. We conducted an unmatched case-control study and descriptive study. We retrieved line-listed cases at the ward facility. We interviewed cases at the facility and recruited controls from the community, and administered questionnaires to both cases and controls. We analyzed data using Epi-Info7 and Microsoft Excel 2016. Results : a total of 50 cases were recorded, with a median age of 20yrs and age range of 1-50yrs. There were more females (68%) than males. Majority of cases (52%) were under 20yrs, while all cases are below 50yrs. Seven (7) deaths were recorded giving a Case Fatality Rate (CFR) of 14%. The CFR was higher in females (14.7%) than in males (12.5%). The index case was seen on August 29, 2015. The outbreak lasted five days. The last cases were seen on September 2, 2015. The highest number of cases seen in a day (23) was on third day of the outbreak. Only two cases (4%) had their samples tested using cholera RDT, and both tested positive. Drinking un-boiled water (OR: 12.67, 95%CI: 2.33 - 68.93), regular hand washing (OR: 0.22, 95%CI: 0.06-0.90) and proper waste disposal practices (OR: 0.07, 95%CI: 0.02-0.36) are factors we found to affect cholera infection during the outbreak. Conclusion : our investigation confirmed a cholera outbreak with a high CFR, especially among females. Poor hygienic practices such as, drinking of un-boiled well water, improper waste disposal, and not washing handsvregularly among the populace, were found to be factors that propagate the outbreak.

Introduction Students in the universities mostly live independently from their parents or guardians, some of them for the first time. This gives them freedom and opportunity for high risk behavior such as unplanned and unprotected sex. The results of such sexual experimentation may include unplanned and or unwanted pregnancies that may lead to unsafe abortions and sexually transmitted infections (STIs) including HIV/AIDS. Contraception has the potential to prevent unwanted pregnancies, abortion, and STIs. This study aimed at assessing the general knowledge on contraceptives, sexual practices, and level of utilization of contraceptives devices among unmarried students of the Bayero University Kano. Methods We did an institutional based cross-sectional descriptive study. We administered a pretested, self-administered, structured questionnaire to randomly selected unmarried undergraduate students of the institution. We analyzed data using Microsoft Excel 2016 and Epi-info7. Results A total of 300 students were interviewed. The median age for respondents was 23 years with an age range of 16–25 years. Male respondents made up 61.3% (184) while the females made up the remaining 38.7% (116). Also, 158(47.33%) of respondents lived outside the school campus, while 158(52.67%) lived in the school hostels. Knowledge on contraception was 87.7% among respondents with internet (91%) and media (89.3%) as the commonest sources of knowledge. Proportion of sexually active students was 10.67%, while prevalence of contraceptive utilization among sexually active students was 15.63%. About 8(25%) had their sexual debut at < 16years of age, 22(68.75%) at ages between 16-20years, and 4(12.5%) above 20years of age. All sexually active respondents practice vaginal sex. Most sexual debuts were planned (44.75 %) and with friends (86.4%), and they occurred between the ages of 16-20years age group in 70.3% of respondents. Conclusion Even though knowledge on contraceptive used was high among the respondents, utilization of contraceptives among sexually active students was low, thus creating a window for possible unintended and unwanted pregnancies among these group of students.

Background: Cryptococcosis is an important opportunistic infection and major contributor to mortality in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients. There have been increasing reports of varied prevalence for cryptococcosis among HIV patients in Nigeria. Aims: The aim of this study was to determine the prevalence and factors associated with risk of cryptococcosis among HIV/AIDS patients from Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: A descriptive cross-sectional study at HIV clinic of UDUTH, Sokoto, Nigeria, was conducted. The participants were HIV positive enrolled by systematic random sampling. Information on sociodemographics and clinical features of the participants was recorded. Blood was collected to determine the CD4 count/presence of cryptococcosis among the participants. Their CD4 counts were determined, and the presence of cryptococcal antigen was detected in the blood sample using IMMY CrAg LFA (cryptococcal antigen lateral flow assay test kit). Statistical analysis using Epi Info version 7.2/SPSS version 20.0 was done. Univariate, bivariate, and multivariate analyses were done. Results: Of 326 HIV-positive patients recruited, 36 of them were positive to cryptococcal antigen (prevalence of 11%). The highest proportion of patients positive to cryptococcosis (13 [36.1%) had CD4 values

Background: The global use, misuse, and abuse of broad-spectrum antibiotics coupled with failure of development of newer effective antibiotics have led to the rapid spread of carbapenemase producing Gram-negative Enterobacteriaceae. The lack of capacity for effective diagnosis results in increased morbidity, prolonged hospitalization, suboptimal treatment leading to treatment failure, and increased healthcare cost. Aims/objectives: We set out to determine the best method(s) for the phenotypic screening of carbapenem resistance among the species of Enterobacteriaceae at University of Maiduguri Teaching Hospital (UMTH). Materials and Methods: We screened all patients admitted into various wards/units of UMTH over a 6-month period to isolate Enterobacteriaceae. We used an interviewer-administered questionnaire to obtain some basic information from the patients. We confirmed the species of Enterobacteriaceae using Microbact Gram-negative 24E test kit. All confirmed isolates were screened for carbapenem resistance with Meropenem and Ertapenem antibiotic discs (10 μg, Oxoid, UK) according to the Clinical and Laboratory Standards Institute (CLSI) guideline. Minimum inhibitory concentration (MIC) using Etest of Imipenem (Biomeriux) was also determined based on CLSI recommendations. Modified Hodge test method was considered as a gold standard for confirmatory test. The three methods were compared with the gold standard. Results: We isolated 225 Enterobacteriaceae from 225 patients. Klebsiella pneumoniae had the highest proportion of 73 (32.4%). The sensitivity of the different methods in increasing order was 95.7% for Meropenem disk (10 μg), 100% for Ertapenem disk (10 μg), and 100% for Imipenem MIC. Conclusion: In view of cost and availability, the Ertapenem disc (10 μg) method can be used for the screening of carbapenem-resistant Enterobacteriaceae. For the routine screening of carbapenem resistance Enterobacteriaceae in our clinical laboratories, the Ertapenem disc (10 μg) method is recommended.

Context: Reduction in risk of stroke is possible through prevention, modification, or treatment of the emerging or established modifiable risk factors. Aims: The aim of this study is to assess the knowledge regarding stroke risk factors and factors affecting this knowledge among residents of Shika, Zaria. Settings and Design: A community-based cross-sectional descriptive study was conducted among 133 respondents in Shika community. Subjects and Methods: A pretested, semi-structured, interviewer-administered questionnaire was used to obtain data from the respondents. Statistical Analysis Used: Data were analyzed using IBM-SPSS version 21. Descriptive summary statistics such as mean and standard deviation (SD) were used to present numeric data such as age while frequencies and proportions were used for categorical data such as knowledge level. Chi-square test and Fischer's exact test were used to determine the association between categorical variables at a significant level of P< 0.05. Results: Majority of the respondents were males (64.7%), with a mean (± SD) age of 33 ± 14 years, and had tertiary education (46.6%). About 82.0% of them had ever heard of stroke. Only 21.8% of respondents had good knowledge (any respondent able to identify ≥2 established factors) of stroke risk factors. There was a statistically significant relationship between knowledge of stroke risk factors and gender of respondents (P = 0.04, χ2 = 6.25) as well as with the educational status of respondents (P < 0.001). Conclusion: Knowledge of stroke risk factors was found to be poor among the respondents, and educational status and gender of respondents were found to be associated factors. To increase public knowledge of stroke, community-based educational strategies based on the results of this study should focus on people with poor educational background.

Background: Intrauterine devices are one of the popular long term reversible contraceptive methods. Earlier forms were associated with genital infections, however more recent types such copper IUDs and hormonal types have been shown to have better safety profile. However, there is no conclusive evidence to demonstrate that hormonal IUD is less associated with genital infection when compared with copper IUDs. The objectives include determination of prevalence of genital tract infections among IUD users, to determine the type of IUD that is less associated with genital infection, and also determine clinical features seen among IUD users.Methods: We conducted a descriptive, cross sectional study of clients who were at 6 months following IUD insertion. Endocervical and high vaginal samples were taken to isolate microbes.Results: The prevalence of genital tract infection was 20% in Copper IUD users and 8.6% among LNG-IUS users. Genital infection was significantly higher among copper IUD users compared to hormonal IUD users (p=0.038, OR= 2.88). Abnormal vaginal discharge was the commonest symptoms among IUD users and formal education was associated with less risk of genital infections (p=0.048).Conclusions: Hormonal IUDs are less associated with genital tract infection compared to copper IUDs and women with formal education are less likely to have genital infection among IUD users.

Background: Cholera is an infection caused by Vibrio cholerae, which may lead to severe dehydration and death if not treated promptly. On August 31, 2015, the Kaduna Ministry of Health received a notification of increase cases of vomiting and diarrhoea at Dusten-Abba in Zaria. A response Team was sent to confirm the outbreak, describe the socio-demographic characteristics and identify possible risk factors for the outbreak.Methods: We defined cases according to the world health organization (WHO) criteria. We conducted an unmatched case-control study and descriptive study. We retrieved line-listed cases at the ward facility. We interviewed cases at the facility and recruited controls from the community, and administered questionnaires to both cases and controls. We analysed data using Epi-Info7 and Microsoft Excel 2016.Results: A total of 50 cases were recorded, with a median age of 20years and age range of 1 – 50 years. There were more females (68%) than males. Majority of cases (52%) were under 20 years, while all cases are below 50 years. Seven (7) deaths were recorded giving a Case Fatality Rate (CFR) of 14%. The CFR was higher in females (14.7%) than in males (12.5%). Index case was seen on August 29, 2015. The outbreak lasted five days. Last cases were seen on September 2, 2015. Highest number of cases seen in a day (23) was on third day of the outbreak. Only two cases (4%) had their samples tested using cholera RDT, and both tested positive. Drinking un-boiled water (OR: 12.67, 95%CI: 2.33–68.93), regular hand washing (OR: 0.22, 95% CI: 0.06–0.90) and proper waste disposal practices (OR: 0.07, 95% CI: 0.02–0.36) are factors we found to affect cholera infection during the outbreak.Conclusions: Our investigation confirmed a cholera outbreak with a high CFR, especially among females. Poor hygienic practices among the populace seem to be the drivers for this outbreak.

This paper presented a new prediction model for material property (strength of materials for gray cast iron) based on composition and microstructure using a recent learning algorithm called Sensitivity Based Linear learning Method (SBLLM). This method was proposed in order to address the problems of back propagation learning algorithm for feed forward neural network. Thus we have made use of this unique method to develop a material property model. Comparative studies have also been carried out between the proposed model and some earlier used methods, on same dataset, that include multiple regression, fuzzy regression, the generalized regression neural network and fuzzy neural network. The result obtained from the proposed model is reasonable and promising, and it is very stable and consistent in it prediction compared to others. Proper and exact identification of properties of material such as relationship between material properties and that of it structural composition will be of tremendous use to the engineers and material scientist, and the need to explore this germane field cannot be over-emphasized. For Materials Scientists and Engineers, a common goal is the Effective determination of the relationship between the structure of a material and its properties is a very important goal in material science and engineering. . Obviously, the ability to predict the properties of materials prior to their synthesis and processing would be of tremendous value in optimizing the end products (1). The effect of chemical and processing variation on structure, section size and chemical composition has been well presented in literatures (2-4). Among the earlier methods that have been earlier used to estimate material property (the strength of material) include regressions methods that include Multiple Linear Regression (MLR) (5) and Fuzzy Regression (FR) (6). Due to the limitation of the earlier regression techniques, better methods have been employed to improve the prediction as in (1), where an adaptive Fuzzy Neural Network (FNN) was developed to extract fuzzy rules directly from experimental data for material property prediction. In (7) Back Propagation (BP) Neural Network is used to model mechanical properties. However, due to the fact that the available data in this field is limited and most of the earlier methods needed sufficient data to perform satisfactorily, the need to explore other methods to better model these unique property of material is still an open issue. Therefore, we have developed a model based on the sensitivity learning scheme that is able to use its sensitivity analysis to facilitate getting better prediction of material strength. In this paper, we presented a prediction model based on Sensitivity Based Linear learning method (SBLLM) which is a two layer feed forward neural network, based on sensitivity analysis, that uses a linear algorithm for each of the two layers (8). This method has been earlier applied in other field of engineering often with promising results (9). Empirical results from simulation in this research have indicated the unique ability of the proposed model, as a promising tool in the field of material science and engineering.