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Objectives: Out of the 38.0 million (30.2–45.0 million) with HIV/AIDS globally, about 35.9 million (28.9–43.0) adults live in sub-Saharan Africa. Ocular findings in HIV/AIDS are a cause of morbidity, visual impairment, and blindness and differ in different environments. This study aimed to investigate the pattern and prevalence of ophthalmic manifestations of HIV/AIDS in Calabar, Nigeria. Material and Methods: This study investigated ocular findings among patients attending the HIV/AIDS Special Treatment Clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria. Using a descriptive cross-sectional study design, a total of 440 subjects met the inclusion criteria and were recruited into the study. Results: There were 166 (37.73%) male and 274 (62.27%) female respondents, indicating a female preponderance with a male-to-female ratio of 1:1.6. The modal age group was 26–35 and formed 40.4% of study population while 415 (94.30%) of the study population were 55 years old or less. While 316 (72.00%) of the respondents had some ocular morbidity, 136 (30.91%) were HIV/AIDS related. A total of 155 respondents (35.20%) had ocular symptoms. No person was blind, while 154 respondents (35.00%) were visually impaired. HIV/AIDS-related findings were retinal microangiopathy in 60 respondents (13.60%), conjunctival microvasculopathy in 30 (6.80%) respondents, hypertrichosis in 22 (5.00%) respondents, dry eye syndrome in 17 (3.90%) respondents, anterior uveitis in 17 (3.90%) respondents, presumed squamous cell carcinoma of the conjunctiva in 7 (1.60%) respondents, facial nerve palsy in 5 (1.14%) respondents, and Kaposi sarcoma of the eyelids and conjunctiva was in 4 (0.91%) respondents. There was increased ocular involvement among those respondents with lower CD4+ counts (P < 0.0001). Conclusion: Ocular manifestation of HIV/AIDS can occur in the presence of normal vision and are a cause of avoidable uniocular vision loss. Non-HIV/AIDS-related ophthalmic morbidity also occurs in patients with HIV/ AIDS. These facts justify targeted scheduled ophthalmic screening. Ophthalmologists need to recognize and manage the varying patterns and sometimes location specific signs and symptoms.

BackgroundCivil society organizations (CSOs) are important in health care delivery. They have the potential to play significant roles in immunization-related services, such as advocacy, health education, demand creation and resource mobilization. Their roles are often indispensable, diverse and beneficial in reducing infant morbidity and mortality due to vaccine-preventable diseases. This study explored the potential barriers to and facilitators of CSO engagement in increasing immunization coverage in Odukpani Local Government Area of Cross River State, Nigeria.MethodsThe study adopted qualitative data collection methods. Twenty-two focus group discussion (FGD) sessions, three in-depth interviews (IDIs) and 26 key informant interviews (KIIs) were conducted. Appropriate guides (FGD guide, IDI guide and KII guide) were used to conduct face-to-face interviews and the discussions. The FGDs, KIIs and IDIs were audio-recorded and transcribed. A framework analysis approach involving five key stages of analysis (familiarization with data, identification of thematic framework, indexing, charting, mapping/interpretation) was used for data analyses and presentation.ResultsCSOs encounter barriers in the course of their immunization advocacy, communication and social mobilization due to male child preference, leading to shielding of male children and not allowing them to be given immunization, as well as patriarchy, safety concerns, religious concerns, anti-vaccine misinformation and rumours, low perception of effectiveness and efficacy of vaccines, inaccessibility of localities, low health literacy and superstitious beliefs. Various community structures, such as the institution of the village head, elders’ council and town crier (announcer), and the existence of change agents, act as facilitators of immunization advocacy and uptake. Factors such as traditional control mechanisms including masquerades and religion act as either barriers or facilitators depending on the community and the mode of deployment. CSO members are willing to overcome these barriers and leverage the facilitators.ConclusionsFor successful engagement in immunization-related services, there are barriers in the study area that CSOs should overcome, such as male child preference and geographic inaccessibility, as well as facilitators that they should leverage such as traditional information dissemination systems and enforcement of compliance by the chiefs and elders’ council.

Speeches by presidents are powerful as they not only carry the weight of policy statement or direction but possess the ability to inspire, uplift, motivate, unite, show empathy, be sensitive to the mood of the moment, or incite, arouse, mobilize, rally and galvanize a people towards an intended outcome. Whoever is giving the speech should oversee not just its creation but also its execution, because the speaker's method of delivery can have just as much effect on the audience's reception as the rhetoric it contains. This paper takes a critique at President Muhammadu Buhari’s October 22, 2020 #EndSARS speech in the wake of the nationwide protest by Nigerian youths over police brutality and reforms and juxtapose it with the five Rhetorical canons; - inventio, dispositio, elucutio, memoria and delivery as well as the Rhetorical proofs; Ethos, Pathos and Logos as theorized by Aristotle and recommend that Presidential speech writers should consider the importance of adopting the rhetoric canons in future speech writing to aid delivery of speeches that will inspire, arouse and appeal to emotions while efforts should be intensified to ensure the use of the rhetorical skills in future speeches delivery to reduce over dependence on the script or teleprompter to achieve maximum rhetorical effect.

Background: With maternal mortality ratio of 2,000/100,000 live births and perinatal mortality rate of 40/1,000 total births, Cross River State is one of the states with the highest maternal and perinatal deaths in Nigeria. One of the causes of these poor health indices is low utilization of facility-based maternal and child healthcare services during pregnancy and childbirth. Objective: To assess the predictors of utilization of antenatal care and delivery services in Akpabuyo, a rural community in Cross River State of Nigeria. Method: This was an analytical cross-sectional survey. Data were collected from 370 pregnant women between June and July, 2013 and analyzed using SPSS version 25. Results: Binary logistic regression showed that compared with women with tertiary education, women with non-formal education were less likely to attend antenatal clinic (AOR=0.510, 95% CI=0.219-1.188) although the difference was not statistically significant. Also, compared with farmers, full-time housewives were less likely to deliver in a health facility (AOR=0.650, 95% CI=0.305-1.389) while civil servants were nearly five times more likely to deliver in the health facility (AOR=4.750, 95%CI=1.616-13.962). Conclusion: The predictors of antenatal care and facility delivery services utilization identified by the study were educational status and occupation. This raises the need for policies and programmes to ensure girl child education and the economic empowerment of women. Keywords: Maternal; Perinatal; Mortality; Child healthcare; Antenatal care; Delivery.

The means through which citizens have traditionally had access to their parliament has been through their elected representative(s). In most countries, where the electorate is divided into geographically-based constituencies, and members represent a specific locality, such access has typically been through face to face contact in the area where the electors live, or through the usage of constituency office. This paper seeks to find out the relationship between politicians and their constituents in Akwa Ibom State, the role of the media in enhancing and reporting politician-constituency relationship and how best the media can play its constitutional role of creating, nurturing, and sustaining a mutually beneficial relationship between politicians and their constituents and reporting that much needed interface and constant communication between the politicians and their constituents. This paper recommends the effective utilization of constituency offices and the establishment of a functional and up-to-date official website of elected representatives to enhance access to information by both the media and constituents.

Background: The nature of our psychosocial environment and one's response to stressful daily events are key determinants of current and future mental health status. The school environment is one of such settings which expose young people to potentially undue stress, especially through bully-prone interpersonal interaction with peers and older individuals. Although bullying is thought to be prevalent in secondary schools, only a few studies have investigated the association between bullying and the mental health status of secondary school students in developing countries. The present study seeks to obtain data that may be helpful in addressing this research gap. Methodology: This was a cross-sectional analytic study. A stratified sampling technique was used to select six secondary schools within Calabar metropolis. Proportional allocation using a simple random sampling method was employed to recruit the required number of senior secondary students from the selected schools. Multidimensional Peer Victimization Scale and Child and Youth Mental Health General Screening Questionnaires were used to assess for presence/degree of bullying and mental health problems, respectively. Mann–Whitney U-test and Spearman's correlation analysis were used as inferential statistics, and P-value was considered significant if it was < 0.05. Results: Three hundred and four (304) respondents were surveyed, but complete data were obtained from 292. Their ages ranged from 13 to 20 years, with a mean age of 16.5 ± 2.1 years. The male-to-female ratio was 1:0.7. Within the past 12 months, 54.8% of the respondents had bullied someone, while 62.3% had witnessed someone being bullied. Attack on the property was the most common form of bullying (61%), followed by social manipulation (52.7%), verbal (52.1%), and physical (47.9%) forms of victimization. Moderate-to-severe forms of social manipulation, physical victimization, verbal victimization, and attack on property forms of bullying were found in 26.0%, 26.7%, 28.8%, and 32.2% of respondents, respectively. The most frequently elevated component of mental health score in the respondents was conduct symptoms (50.7%), followed by mood symptoms (34.2%) and symptoms of generalized anxiety (19.2%). Respondents with abnormally elevated scores for hyperactivity/distractibility, conduct, generalized anxiety, and mood symptoms had significantly higher mean scores for each of the components of bullying assessed (P < 0.001). Elevated scores on oppositional defiant symptoms did not significantly influence the mean scores of each component of bullying, except for verbal victimization (P = 0.04). A significant positive correlation was observed between each component of bullying and each domain of mental health assessed (P < 0.001). A positive correlation was also observed between the total bullying score and each domain of mental health as well as the total mental health scores (P < 0.001). Of all the domains of mental health assessed, symptoms of hyperactivity/distractibility showed the strongest positive correlation with a total bully score (r = 0.69, P < 0.001). Conclusion: The results from this study suggest that bullying is prevalent in our secondary schools, with a potential adverse effects on the mental health of affected individuals in the near or remote future. These findings may be useful for improvement in existing policies for school health programs in developing countries.

Mentoring relationships and programs have become a subject of global interest and their relevance is high in the ever-evolving health system. In Nigeria, informal system of mentoring is largely practiced. To be able to institutionalize mentoring program, there is need to explore the various challenges of mentoring process and suggest potential approaches for effective mentor-mentee relationship in health research institutions in Nigeria.The study was designed to explore the barriers and solutions to mentoring process from the perspectives of the mentor, mentee, and organization in health research and training institutions in Nigeria. A cross-sectional descriptive design was employed and the study was conducted among 21 health researchers drawn from 24 health research institutions across the 6 regions of Nigeria. The nominal group technique was adopted in the data collection process.The most frequently reported mentor challenges were "lack of understanding of mentorship process" (84.2%) and "lack of capacity for mentoring" (78.9%), while those of mentee were "mentor preference" (73.7%) and "lack of freedom of expression" (47.4%). "Culture of selfishness/individualism" (84.2%) and "lack of formal relationship" (63.2%) were the most mentioned systemic challenges. Training on mentoring process and relationship was mentioned as the most frequent approach to overcoming challenges for the three perspectives.Significant mentorship challenges exist in the Nigerian health, academic and research institution. Systematic approaches to finding and implementing the appropriate solutions are needed to circumvent these bottlenecks.

Immunisation coverage remains sub-optimal, especially in rural hard-to-reach communities in Nigeria. Nigeria's immunisation program suffered set-backs in recent years due to socio-cultural, religious and health system barriers. Grassroots Civil Society Organisations could play a role in addressing some of these barriers with resultant increase in demand for and uptake of immunisation services. The objective of this study was to carry out strengths, weaknesses, opportunities and threats (SWOT) analysis of grassroots civil society organisations regarding engagement for increasing demand for and uptake of immunisation services.This was a qualitative study. A pre-tested SWOT analysis template was used to collect data from 26 grassroots CSOs in Odukpani local government area (LGA) of Cross River State of Nigeria. The data were manually entered into a matrix made up of four quadrants. The results were presented as tables of frequencies and percentages.The CSOs have the numerical strength to carry out immunisation advocacy, communication and social mobilization. There is pool of non-CSO community members who are willing to volunteer. However, some of the CSOs are not good in record keeping. There are also several security threats due to communal clashes.There are several strengths and opportunities that the CSOs can leverage on while dealing with identified weaknesses and threats in order to contribute towards increasing the demand for and uptake of immunisation services in this community.

Context: Disclosure of HIV-positive status to sex partners is viewed as a preventive measure and as a social and legal responsibility for HIV-infected individuals. Aims: The aim of this study is to determine the proportions and factors responsible for disclosure of HIV seropositivity among residents of Cross River State, Nigeria. Settings and Design: This was a cross-sectional comparative study. Subjects and Methods: It involved 320 HIV-positive individuals equally selected from the urban and rural settings of Cross River State and use questionnaires. Statistical Analysis Used: Data analysis used SPSS version 20.0. Chi-square test and logistic regression were used to identify determinants of HIV status disclosure. Results: Among urban respondents, 93.8% had disclosed compared with 79.4% among rural respondents, the difference was statistically significant (P < 0.001). There was a statistically significant association between HIV status disclosure and age (P = 0.008), marital status (P = 0.027), number of nonspousal sexual partner (P = 0.006), and area of residence (P < 0.001). There was no statistically significant association between HIV status disclosure and gender (P = 0.622), between occupation (P = 0.495) or income (P = 0.351 and head of household (P = 0.241). There was statistically significant association between HIV status disclosure and level of education (P = 0.015), house ownership (P = 0.008), time from diagnosis (P = 0.003), and duration of treatment (P = 0.002). Conclusions: This study has shown that HIV seropositive status disclosure was higher when compared with other local studies, and age, marital status, and area of residence were factors associated with HIV seropositive status disclosure.

Background: In the last five decades, dengue has emerged as one of the most important infectious diseases, following a 30-fold increase in global incidence throughout tropical and sub-tropical regions of the world. The actual numbers of dengue cases are under-reported and many cases are misclassified. Objectives: This article describes the epidemiology, pathophysiology, clinical features and management of dengue. It also explores the implications of infection with this flavivirus for Nigeria, and similar countries. Methods: The literature search for publications on dengue in West Africa was performed using PubMed, African Journals Online (AJOL), Google Scholar, Web of Science, databases and grey literature to identify all published papers regarding the topic. A snowballing strategy was adopted to identify additional publications. Results: Recent reports suggest that dengue is a growing public health problem in Nigeria, the magnitude of which needs to be more clearly defined. Nigeria, the most populous country in Africa has an abundance of the Aedes aegypti mosquito which is known to transmit dengue, Zika, as well as chikungunya (CHIKV) and West Nile viruses. Conclusion: This article provides practical suggestions for strengthening the dengue virus control programme in Nigeria. The Nigerian health system shares similarities with health systems in many other sub-Saharan countries. Therefore, the practical suggestions provided at the end of this review are likely to be applicable to many other African countries. Keywords: Dengue fever update, Nigeria, review.

Hepatocellular carcinoma (HCC) is one of the most lethal types of cancer worldwide, with poor prognosis and limited treatments. In order to identify novel therapeutic targets that will lead to development of effective therapies with manageable side effects, we tested the hypothesis that knocking-down galactokinase (GALK1) or galactose-1 phosphate uridylyltransferase (GALT) gene expression would control the growth of cultured hepatoma cells. Our results showed small interfering RNA (siRNA) against GALK1 or GALT inhibited the growth of HepG2 cells in culture. Western blot analysis revealed simultaneous down-regulation of multiple players of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) growth signaling pathway, as well as heat-shock protein 90 (HSP90) and poly ADP ribose polymerase (PARP). Reverse transcription-polymerase chain reaction (RT-PCR) data, however, showed no significant mRNA reduction of the encoded genes. Our study thus not only supports GALK1 and GALT as being possible novel targets for treating HCC, but also uncovers new post-transcriptional regulatory mechanisms that link the galactose metabolic pathway to protein expression of the PI3K/AKT pathway in hepatoma.

Background: Carcinoma of the uterine cervix is a deadly disease, but it is preventable. Cervical cytology especially at postnatal visit can lead to its early detection and prompt treatment. Methods: This was a prospective cross sectional study of postnatal women to determine the prevalence of abnormal cervical cytology and their socio-demographic characteristics. Patients were recruited from the antenatal clinic and counseled on the need for postnatal cervical smear. Only those who consented and met the inclusion criteria were followed up in the postnatal clinic. Institutional ethical clearance was also obtained. Researcher administered questionnaire was used to collect the socio-demographic features while Aye’s spatula and endocervical brush were used to collect specimen from the ectocervix and endocervix respectively and smeared on individually labeled glass slides. The samples were treated using the conventional Papanicolaou staining method and reported using the Bethesda system. Researcher-administered questionnaire generated data as well as results of cytology were analyzed using Epi-Info version 3.5.1.0 (CDC Atlanta USA 2008). Colposcopy was done for smear positive patients. Results: There were 100 women screened. Three percent had low grade squamous intraepithelial lesion. There were no abnormal findings from the Colposcopy of the three patients. Ninety-five percent of the women had no prior knowledge of cervical cancer and Pap smear. Two percent of the women had a family history of cervical cancer and both patients died of the disease due to lack of facilities for treatment. Conclusions: Cervical cancer is a preventable disease but women of the sub-region are under-screened. Postnatal Pap smear is a necessary tool in its early diagnosis and treatment.

Introduction. Nigeria is one of the five countries that account for about 50% of under-five mortality in the world. The objective of this study was to assess the knowledge and practice of child survival strategies among rural community caregivers in Cross River State of Nigeria.Materials and Methods. This descriptive cross-sectional survey used a pretested questionnaire to obtain information from 150 women of reproductive age. Data analysis was done using SPSS version 20.Results. The child survival strategy known to most of the respondents was oral rehydration therapy as indicated by 98% followed by female education by 73.3% and immunization by 67.3%. Only 20% of the respondents had adequate knowledge of frequency of weighing a child while only 32.7% knew that breastfeeding should be continued even if the child had diarrhea. More respondents with nonformal education (83.3%) practiced exclusive breastfeeding of their last children compared to respondents with primary education (77.3%), secondary education (74.2%), and tertiary education (72.2%).Conclusion. Although respondents demonstrated adequate knowledge and practice of most of the strategies, there was evidence of gaps, including myths and misconceptions that could mar efforts towards reducing child morbidity and mortality in the state.

The application of an enhanced membrane coagulation reactor (E-MCR) for sewage concentration and energy recovery through anaerobic digestion (AD) was investigated. The results show that the addition of powder-activated carbon (PAC) and polyaluminum chloride (PACl) enhanced the sewage concentration efficiency and minimized the membrane fouling. The reactor was operated for 100 d with 70 d without severe fouling. The flux of 6 L/(m2 h) with sludge retention time of 2 d recorded a long-term stable performance and recovered concentrates with about 6000–9800 mg/L of chemical oxygen demand (COD) values. The concentrate was used as feed for AD using a continuous stirred tank reactor. The results show that at a thermophilic temperature of 35°C, a high biogas yield was achieved at 20 and 30 d hydraulic retention time (HRT). Meanwhile, biogas yields of 10, 220, and 295 mL/(gCOD) were achieved at 10, 20, and 30 d HRT, respectively. The addition of PAC/PACl and the low flux condition enhanced the concentratio...

Background: Maternal and child health care is very important and crucial in the monitoring and evaluation of various developmental agenda especially in developing nations.Aim/Objective: This study was carried out to ascertain the effects of religiosity on maternal and child health practices in rural and urban Cross River State, Nigeria.Method: The study design was a comparative analytical cross-sectional study amongst mothers with under-five children in rural and urban households in Cross River State and the study populations comprise mothers of under-five children, traditional and traditional birth attendants in Cross River State. Sampling technique used to select respondents in the rural and urban sites was multistage sampling method and the sample size was determined using standard method of comparing two independent groups. For Focus Group Discussions (FGD), purposive sampling method was employed in both study sites. Religiosity was assessed using the ORA dimension of the Duke University Religion Index (DUREL), which is usually measured as frequency of attendance of organized religious activities. The study instrument was a semistructured questionnaire and data obtained was analyzed using SPSS version 21.0.Results: Statistical analysis showed that the age of mother, husband and marriage of women from the rural communities was significantly higher (P< 0.05) than that of women from the urban communities. Religious practices to have safe pregnancy did not significantly predict women having complications in last pregnancy in both study settings while in the rural and urban communities (P

Introduction: Butchers are exposed to various types of hazards in the course of their work, which could lead to health problems of varying severity. The aim of this study was to identify the occupational hazards and health problems of butchers in Uyo and also assess the physical conditions of their slaughter facilities. Materials and Methods: A descriptive cross-sectional study was carried out among 157 butchers in Uyo using a semi-structured questionnaire for data collection. Facility assessment was made using a checklist. Analysis was carried out using Statistical Package for Social Sciences version 20. Level of significance was set at 0.05. Results: The mean age of respondents was 33 ± 9.94 years. Most respondents were males (83.4%). The most commonly reported workplace hazards were knife (93.6%), bones (57.3%), and slippery floor (24.8%). The most common health problems were knife cuts (87.3%), cuts from bones (50.3%), and neck pain (36.9%). Having injuries from live animals and back pain were significantly associated with working with cows (P < 0.05). The most common de-furring method was burning with firewood (61.1%). The slaughter facilities lacked many expected amenities of a standard abattoir. Conclusion: Identified hazards and health problems of butchers were numerous. The slaughter facilities lacked appropriate equipment that promotes workers’ health and safety. It is recommended that slaughter facilities be upgraded to meet the standard abattoir practice. Regular training of butchers should be organized by their association to encourage safer practice, including the use of appropriate protective wears. Use of the chemical method of de-furring should also be encouraged to limit exposure to harmful gases.