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Background: Dental caries as a disease entity has not been eradicated but controlled worldwide. The predictors of dental caries play a significant role in the holistic approach in the management of dental caries. The aim of this study is to evaluate the predictors of dental caries among adult population in North West Nigeria. Material and Methods: The study populations consist of adults between 20-60 years old, with diagnosis of dental caries (case) and those without dental caries (control), both were confirmed after intraoral examination. A multistage sampling technique was employed to select the study respondents. Mouth mirror and caries explorer (dental probe) were used for intraoral examination to confirm diagnosis of dental caries. An initial calibration of the research assistants was done on intraoral examination by the principal researcher, assessing the same respondents examined by the research assistants. Data was analyzed using SPSS Statistical software version 20.0. Results: The older age groups were 4% less likely to have caries (p

BackgroundEnsuring that countries have adequate research capacities is essential for an effective and efficient response to infectious disease outbreaks. The need for ethical principles and values embodied in international research ethics guidelines to be upheld during public health emergencies is widely recognized. Public health officials, researchers and other concerned stakeholders also have to carefully balance time and resources allocated to immediate treatment and control activities, with an approach that integrates research as part of the outbreak response. Under such circumstances, research ethics preparedness constitutes an important foundation for an effective response to infectious disease outbreaks and other health emergencies.Main textA two-day workshop was convened in March 2018 by the World Health Organisation Global Health Ethics Team and the African coaLition for Epidemic Research, Response and Training, with representatives of National Ethics Committees, to identify practical processes and procedures related to ethics review preparedness. The workshop considered five areas where work might be undertaken to facilitate rapid and sound ethics review: preparing national ethics committees for outbreak response; pre-review of protocols; multi-country review; coordination between national ethics committees and other key stakeholders; data and benefit sharing; and export of samples to third countries.In this paper, we present the recommendations that resulted from the workshop. In particular, the participants recommended that Ethics Committees would develop a formal national standard operating procedure for emergency response ethical review; that there is a need to clarify the terminology and expectations of pre-review of generic protocols and agree upon specific terminology; that there is a need to explore mechanisms for multi-country emergency ethical consultation, and to establish procedures for communication between national ethics committees and other oversight bodies and public health authorities. In addition, it was suggested that ethics committees should request from researchers, at a minimum, a preliminary data sharing and sample sharing plan that outlines the benefit to the population from which data and samples are to be drawn. This should be followed in due time by a full plan.ConclusionIt is hoped that the national ethics committees, supported by the WHO, relevant collaborative research consortia and external funding agencies, will work towards bringing these recommendations into practice, for supporting the conduct of effective research during outbreaks.

Skilled attendance at birth is widely recognized as a single most effective strategy for reducing maternal mortality and morbidity and this is being used as an indicator to measure progress toward the fifth Millennium Development Goal of improving maternal health (MDG 5). However around half of the deliveries in the developing world are not attended by skilled professionals. The situation is worse in some regions such as South Asia where only less than one-third of deliveries are attended by skilled professionals. Safe motherhood still remains a distant dream for many around the world especially in developing countries leading to most of the maternal deaths in poor countries suggesting that most of these can be attributed to low level of supply and utilization of skilled maternal health services. Research studies have documented a range of social economic and geographic factors that act as barriers to low use of skilled maternity care during childbirth around the world. As far as India is concerned maternal education economic status of household caste and religion; availability of and accessibility to a health facility presence of a lady medical doctor availability of drugs; community attributes and programme-related factors play a critical role in the utilization of facility-based maternity care. Though costs - both direct and indirect-have also been shown to be an important barrier to womens use of facility-based maternity care there are a limited number of studies that have explored the issue in detail at regional level unlike at national level. India has avoided significant maternal and neonatal deaths in j:he last two decades. The Maternal Mortality Ratio (MMR) has declined from 398 (per 100 000 live births) in 1997-98 to 212 in 2007-09 and the neonatal mortality has declined from 45 (per 1000 live births) to 34 during the same period. Despite this recent achievement India still is one of the countries having high MMR in the world accounting for 19 percent of maternal deaths worldwide. Findings of a study report on MDGs progress in Bangladesh suggest that utilization of maternal health care is less in rural and poorest household as compared to their counterpart. Unlike developed countries in India more than 70 percent of the health care expenditure is paid by individuals and the government bears only 20 percent the rest is from businesses and external flows. In many situations health care expenditure which also includes maternal and neonatal care is catastrophic; this in tum can push the households into poverty. Especially rural households the less educated slum dwellers and poor households because these households in India are more likely to finance health care through borrowing and sale of assets than well off population groups. The District Level Household Survey DLHS4 has pointed out that at the public health facilities on an average a household has to spend INR 3130 for each delivery and it is INR 3000 in rural areas of Karnataka. Hence in this background using information from a baseline survey the present article aims to examine household expenses incurred for availing maternal healthcare services by rural women in North Kamataka.

INTRODUCTION: In September 2015, Nigeria was removed from the list of polio-endemic countries after more than 12months had passed since the detection of last wild poliovirus case in the country on 24 July 2014. We are presenting here a report of two polio seroprevalence surveys conducted in September 2013 and October 2014, respectively, in the Kano state of northern Nigeria. METHODS: Health facility based seroprevalence surveys were undertaken at Murtala Mohammad Specialist Hospital, Kano. Parents or guardians of children aged 6-9months, 36-47months, 5-9years and 10-14years in 2013 and 6-9months and 19-22months (corresponding to 6-9months range at the time of 2013 survey) in 2014 presenting to the outpatient department, were approached for participation, screened for eligibility and asked to provide informed consent. A questionnaire was administered and a blood sample collected for polio neutralization assay. RESULTS: Among subjects aged 6-9months in the 2013 survey, seroprevalence was 58% (95% confidence interval [CI] 51-66%) to poliovirus type 1, 42% (95% CI 34-50%) to poliovirus type 2, and 52% (95% CI 44-60%) to poliovirus type 3. Among children 36-47months and older, seroprevalence was 85% or higher for all three serotypes. In 2014, seroprevalence in 6-9month infants was 72% (95% CI 65-79%) for type 1, 59% (95% CI 52-66%) for type 2, and 65% (95% CI 57-72%) for type 3 and in 19-22months, 80% (95% CI 74-85%), 57% (49-63%) and 78% (71-83%) respectively. Seroprevalence was positively associated with history of increasing oral poliovirus vaccine doses. CONCLUSIONS: There was significant improvement in seroprevalence in 2014 over the 2013 levels indicating a positive impact of recent programmatic interventions. However the continued low seroprevalence in 6-9month age is a concern and calls for improved immunization efforts to sustain the polio-free Nigeria.

Background: In the last decade there had been efforts to halt and reverse the high and increasing trends in HIV infection in sub-Saharan Africa. There is need to analyze trends in HIV prevalence to ascertain the current course of the HIV epidemic in our society. HIV prevalence among pregnant women attending Antenatal Clinics remains the principal data source to inform trends in generalized epidemics in developing countries.Objective: The aim of this study was to determine the prevalence of HIV and its trends among pregnant women attending antenatal clinic at a public tertiary hospital in the Federal Capital Territory, Abuja, Nigeria.Methods: Data of pregnant women who had HIV test as part of antenatal care between January 2005 and December 2009 were prospectively recorded and analyzed to determine the period HIV prevalence and trends.Results: For the five year period, there was 95% uptake of HIV testing, and out of 8,443 pregnant women tested, 973 were sero-positive, giving a period prevalence of 11.5% (CI;10.9%-12.2%). In 2005 HIV prevalence was 4.5%, rose to 11.2% in 2006 and peaked at 15.4% in 2009. This trend was statistically significant (χ2-trend=94.1; p

BACKGROUND: Obesity and its complications are emergent health challenges in developing countries including Nigeria. We determined the concordance of perceived with measured weight and assessed the social desirability of obesity among adults in Kano metropolis in northern Nigeria.METHODS: A cross sectional descriptive study was conducted among 400 adults using structured interview questionnaires. RESULTS: Among 386 respondents, 58 (84.1%) of underweight adults, 106 (46.2%) of healthy weight adults, 46 (66.7%) of overweight adults and 16 (84.2%) of obese adults incorrectly perceived their weight category. Sixty (15.5%) participants considered obesity as socially desirable and a sign of good living and affluence. Older respondents (≥40 years) (P=0.0001), Igbo or Yoruba ethnicity (P=0.0035) and non-formal or primary education (P

Background: Obstetric analgesia is now routinely provided in most developed countries. However, in developing countries including Nigeria, childbirth is still a painful natural process for most women without choice. This study determined labour pain perception, awareness and desire for obstetric analgesia among antenatal clients of Aminu Kano Teaching Hospital (AKTH) in northern Nigeria.Methods: A hospital based cross sectional study was conducted in the Antenatal clinic of AKTH from March to April 2010. Questionnaires were filled by verbal interviews conducted on 400 antenatal clients.Results: Of those that have delivered at least once previously (n=284), majority (194, 68.3%) scored labour pain as severe 66(23.2%) said it was moderate while 24 (8.5%) claimed it was mild. Only 15% (n=59) of therespondents were aware of at least one method of obstetric analgesia. The methods mentioned include Epidural (57.6%, n=34), injections (18.6%, n=11), breathing and relaxation (6.8%, n=4), social support (6.8%, n=4) and all the above methods mentioned (10.2%, n=6). Their main sources of information were friends (62.7%, n=37), books (17.0%, n=10), health worker (13.6%, n=8) and the Internet (6.8%, n=4). None have been offered any analgesia during labour. Majority 317 (79.3%) were desirous of pain relief during the delivery of their current pregnancy. On multivariate logistic regression analysis, educational attainment, ethnicity and awareness of methods of obstetric analgesia remained significant predictors of desire for obstetric analgesia.Conclusion: There is a gross unawareness regarding pain relief in labour, but there is strong desire for same. Reforms in labour pain management are recommended offering parturients a range of safe methods to choose from.Keywords: Labour pain, obstetric analgesia, awareness, desire, antenatal clients, Nigeria

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Despite well known risks associated with unprotected premarital sex, this phenomenon has not been well explored among young men in rural northern Nigeria. We studied the predictors of premarital sex and preferred sources of sexual and reproductive health information among young unmarried men in Kumbotso, northern Nigeria.A cross section of 400 young men were interviewed using structured questionnaires with mostly closed ended questions.Of the 385 respondents, 39 (10.1%) were sexually experienced. Less than half of respondents (48.7%) used a condom at sexual debut, and an equal proportion reported having multiple sex partners. Only 41.0% of sexually experienced respondents reported subsequent consistent condom use Age (adjusted odds ratio [AOR] = 4.12; 95% confidence interval (CI): 2.24-5.20 and educational attainment [AOR = 3.57; 95% CI (1.49-9.10)] were significant predictors of sexual experience. The current versus preferred sources of sexual and reproductive health information included friends (51.3% vs. 93.3%), Islamic school teachers (41.0% vs. 72.7%) and school teachers (8.8% vs. 15.1%).Although the prevalence of premarital sex among young men in this community in northern Nigeria as low, those that did engage in such activity were likely to not use condoms and to have multiple partners. Preferred and trusted sources of information included peers and religious leaders. The findings in this study could be used to develop innovative strategies for reaching young men with accurate sexual and reproductive health information.

Background: Welders are exposed to a variety of occupational hazards with untoward health effects. However, little is known of welders’ awareness of health hazards and their adherence to safety precautions in developing countries. This study assessed the awareness of occupational hazards andadherence to safety measures among welders in Kaduna metropolis in northern Nigeria. Methods: A structured questionnaire was administered on a cross-section of 330 welders in Kaduna metropolis in northern Nigeria. Information was sought on their socio-demographic characteristics,their awareness of occupational hazards and adherence to safety measures. Results: All welders were males with a mean age of 35.7 ± 8.4 years. The illiteracy rate was 7.6%. Overall, 257 (77.9%) of the welders were aware of one or more workplace hazards. This was positivelyinfluenced by educational attainment, age, nature of training and work experience. Of the 330 respondents, 282 (85.3%) had experienced one or more work-related accidents in the preceding year. The most common injuries sustained were cut/injuries to the hands and fingers (38.0%), back/waist pain (19%), arc eye injuries/foreign bodies (17.0%), burns (14.0%), hearing impairment (7.0%), fractures (4.0%) and amputation (1.0%). Only 113 (34.2%) welders used one or more types of protective device with eye goggles (60.9%), hand gloves (50.3%) and boots (34.5%) being more frequently used. Regular use of safety device, shorter working hours and increasing experience were protective of occupational accidents.Conclusions: The level of awareness of occupational hazards was high with sub optimal utilization of protective measures against the hazards. There is therefore need for health and safety education of these workers for health and increased productivity.

Background: A cross sectional descriptive study was conducted to examine the knowledge of, attitudes towards and beliefs about childhood immunization among mothers of children below the age of two years in Danbare village of Kumbotso Local government in Kano state, Nigeria.Results: The study group comprised of 200 mothers of children below the age of two years. Seventy five percent of the mothers were aware of the existence of routine immunization services in the village. Majority (68%) though, had poor knowledge of schedules of childhood immunization as well as knowledge of which diseases are preventable by vaccines used. One hundred and six (54%) of the mothers were against their children being immunized but up to 59.5% believed vaccines offer protection against diseases while 48.05 of respondents believed vaccines were safe. Mothers who had formal education were more likely to be aware of the existence of facilities for childhood immunization compared to mothers who had no formal education (P < 0.05). Mothers with formal education were also more likely to believe in the efficacy of vaccines compared to respondents with no formal education (P < 0.05). Conclusion: Although majority of the mothers were aware of immunization services, their knowledge of immunization schedule as well as of vaccine preventable diseases is poor. Religion and influence of husbands are the main factors for unwillingness of mothers to have their children vaccinated. A better understanding of knowledge, perceptions and beliefs of mothers on childhood immunization is important in the design and implementation of immunization programmes. Keywords: routine childhood immunization, perception, attitude, Northern Nigeria Annals of Nigerian Medicine Vol. 1(1) 2005: 21-26

Background: To improve evidence-based action at the community level, UNICEF developed a nutrition information management strategy called Community Level Nutrition Information System for Action (COLNISA). It uses a participatory cycle of assessment, analysis and action to solve nutritional and health related problems. Methods: Structured questionnaires were administered to mothers with children under the age of five in 67 households before intervention and 24 months later. Results: Showed statistically significant changes in maternal literacy [7(10%) vs. 24(36%)] and engagement in income generating activities [17(26%) vs. 54(81%)]. Similarly, the proportion of mothers attending antenatal care during pregnancy increased almost six-fold [7(10%) vs. 40(59%)]. Significant improvements were also observed in mothers\' knowledge of exclusive breastfeeding [21(32%) vs. 62(93%)], practices of complementary feeding [11(16%) vs. 39(58%)] and oral rehydration therapy [16(24%) vs. 47(70%)]. Furthermore, there were significant increases in the proportion of under fives that were growth monitored [4(5%) vs. 46(83%)] and fully immunized [7(10%) vs. 22(33%)]. Conversely, there was a reduction in the proportion of stunted, wasted and underweight children [51(77%), 11(17%) and 41(61%)] vs. [50(75%), 8(12%) and 33(49%)]. The changes in nutritional indices were however, not statistically significant. Conclusion: This study shows that the COLNISA strategy has a positive impact on basic social, health and nutritional indices and engenders community participation. A controlled trial is however advocated before its wholesale application. Key Words: COLNISA, underweight, stunted, wasted, nutrition, information Annals of African Medicine Vol.3(3) 2004: 120-125

Background - This study was designed to examine the knowledge, attitude and beliefs about causes, manifestations and treatment of mental illness among adults in a rural community in northern Nigeria.\ud \ud Methods - A cross sectional study design was used. A pre-tested, semi-structured questionnaire was administered to 250 adults residing in Karfi village, northern Nigeria.\ud \ud Results - The most common symptoms proffered by respondents as manifestations of mental illness included aggression/destructiveness (22.0%), loquaciousness (21.2%), eccentric behavior (16.1%) and wandering (13.3%). Drug misuse including alcohol, cannabis, and other street drugs was identified in 34.3% of the responses as a major cause of mental illness, followed by divine wrath/ God's will (19%), and magic/spirit possession (18.0%). About 46% of respondents preferred orthodox medical care for the mentally sick while 34% were more inclined to spiritual healing. Almost half of the respondents harbored negative feelings towards the mentally ill. Literate respondents were seven times more likely to exhibit positive feelings towards the mentally ill as compared to non-literate subjects (OR = 7.6, 95% confidence interval = 3.8–15.1).\ud \ud Conclusions - Our study demonstrates the need for community educational programs in Nigeria aimed at demystifying mental illness. A better understanding of mental disorders among the public would allay fear and mistrust about mentally ill persons in the community as well as lessen stigmatization towards such persons.

Background: Vesico-vaginal fistula is still a persisting scourge in the developing countries with devastating medical and social consequences. These consequences were studied among patients presenting with VVF at a large referral center in Kano, Northern Nigeria. Methods: A total of 120 patients with Vesico-vaginal fistula admitted at the VVF centre of the Murtala Mohammed Specialist Hospital, Kano were investigated using structured questionnaires to determine their medical and social problems. Additional information on clinical features was obtained from patients' case notes. Results: Their ages ranged between 10 and 36 years with a median of 16 years. A majority of the patients 87 (72.5%) were between 10-20 years. Most of the patients 98(81.6%) had their first marriage between the ages of 10 – 15 years. Patients were found to suffer from vulval dermatitis, foot drop, amenorrhoea, recurrent urinary tract infections and dysmenorrhoea as main medical problems. Economically they cannot work because they are shunned by the society. They are considered to have brought shame and dishonour to themselves and their families, and where they manage to avoid not being divorced by their husbands they quite often lose any form of support from the husbands. Conclusion: Special counselling and enlightenment programme on VVF, the need to train more traditional birth attendants and the need to improve referral of women likely to have VVF to facilities that offer emergency obstetric services were recommended. Keywords: Medico-social problems, vesicovaginal fistula Annals of African Medicine Vol.2(2) 2003: 54-57