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Congenital heart disease (CHD) in low-and-middle income countries (LMIC) is often characterized by late presentation resulting from inadequate screening and healthcare access in these regions. Accurate estimates of the burden of CHD among school children are often lacking. The objective of this study was to determine the prevalence and distribution of CHD among school children in two communities (urban and semi-urban) in south western Nigeria. Using clinical assessment and portable echocardiography, 4107 school children aged 5 years to 16 years in Lagos, Nigeria, were selected using a multistage sampling procedure and screened for CHD. Diagnosis of CHD was made after echocardiography. Children identified with CHD were referred to a tertiary hospital for appropriate cardiac care. The 4,107 children screened had a mean age of 11.3 ± 2.7 years and 53.7% were females. Twenty seven children had echocardiography-confirmed CHD, representing a prevalence of CHD among school children in Lagos, Nigeria of 6.6 per 1000 children. Acyanotic CHD constituted 96.3% of detected cases. Two children diagnosed with CHD (Tetralogy of Fallot and severe pulmonary valve stenosis respectively) had successful intervention. The prevalence of previously undiagnosed CHD among school children in Lagos Nigeria is substantial and highlights gaps in the health care system and school health programs. Echocardiographic screening of school children provides an opportunity for missed early diagnosis and treatment of CHD and reduces the prevalence of first-diagnosed CHD in adulthood. Therefore, focused clinical examination of school children followed by echocardiography is a strategy that could bridge this diagnostic and treatment gap in CHD., (© 2020 Wiley Periodicals, Inc.)

Context: Nigerian soil fungi population is unexplored. It is hypothesized that they harbour new bioactive chemicals. This hypothesis is based on the large percentage of currently approved medicines that originated from soil-inhabiting micro-organisms Objectives: To investigate the antimicrobial and anti-inflammatory properties of Fusarium solani ethyl acetate (EtOAc) extract selected based on its broad spectrum of antimicrobial potential in an overlay experiment with seven other soil fungi strains. Materials and methods: Fungus number 6 (F6), identified by molecular characterization as Fusarium solani (Mart.) Sacc (Nectriaceae) was selected for studies from eight purified soil fungi due to its superior broad-spectrum antibiotics producing potential following agar overlay experiment. F6 was fermented for 21 d and the minimum inhibitory concentration (MIC) of its EtOAc fermentation extract (dose range: 12.5-100 µg/mL) was determined using agar dilution method for Staphylococcus aureus , Bacillus subtilis , Pseudomonas aeruginosa , Escherichia coli , Salmonella typhi and anti-inflammatory properties determined using rat-paw (250-500 mg/kg) and xylene induced oedema (250-500 µg/kg) (in Swiss albino rats and mice) models, respectively. The ability of the extract to inhibit cyclooxygenase (COX) enzyme was also determined in vitro using Cayman test kit-760111. Result: The MIC of the EtOAc extract was <12.5 µg/mL for S. aureus , P. aeruginosa and Escherichia coli . It inhibited xylene induced oedema by 65% compared with 61% observed for diclofenac and was significantly ( p  < 0.05) better than diclofenac in rat-paw-oedema model within the first phase of inflammation. The extract inhibited COX-1 peroxidase-mediated activities with an IC 50 below 5 µg/mL. Conclusions: The extract exhibited strong antibacterial and anti-inflammatory properties, warranting further investigations into therapeutic potential of this fungus. This study design can be adapted in soil fungi metabolomic investigations. We report for the first time the potent anti-inflammatory property of the ethyl acetate extract of soil strain of F. solani with a possible mechanism of action that involves the inhibition of COX enzyme.

Objective: Echocardiographic screening for Rheumatic Heart Disease (RHD) in Africa has revealed prevalence rates in the range of 0.5-7.4%. There are no recent large population-based studies in Nigeria. The objective of the study was to determine the prevalence of RHD in a large sample of Nigerian school children., Methods: Using portable transthoracic echocardiography and auscultation, school children aged 5 years to 16 years in Lagos, Nigeria were screened for RHD. Diagnosis was based on the 2012 World Heart Federation echocardiographic criteria., Results: The 4107 children screened had mean age of 11.3 years (SD = 2.6) and 2206 (53.7%) were females. There were 38 children with abnormal echocardiograms, of which 11 (0.27%) showed RHD including two cases of definite RHD giving a prevalence of 2.7/1000 [2.9/1000 in the peri-urban, 2.4/1000 in the urban area). Echocardiography detected RHD 10 times better than auscultation [echocardiography 11 (0.27%) vs. auscultation 1 (0.02%); P = 0.003]. The remaining 27 children with abnormal echocardiograms had congenital heart defects (CHD) giving a prevalence of 6.6/1000 for CHD, a yield higher than for RHD., Conclusion: Prevalence of RHD among school children in Lagos, South West Nigeria is low compared to other African countries, possibly due to better access to medical care and antibiotic treatment for infections. Our data provides evidence that RHD prevalence may vary substantially within sub-Saharan Africa, necessitating targeted population-based sampling to better understand disease burden and distribution. Further work is needed to compare within- and between-country RHD prevalence as a basis for programme planning and control efforts., (© 2019 John Wiley & Sons Ltd.)

Heritability is essential for understanding the biological causes of disease but requires laborious patient recruitment and phenotype ascertainment. Electronic health records (EHRs) passively capture a wide range of clinically relevant data and provide a resource for studying the heritability of traits that are not typically accessible. EHRs contain next-of-kin information collected via patient emergency contact forms, but until now, these data have gone unused in research. We mined emergency contact data at three academic medical centers and identified 7.4 million familial relationships while maintaining patient privacy. Identified relationships were consistent with genetically derived relatedness. We used EHR data to compute heritability estimates for 500 disease phenotypes. Overall, estimates were consistent with the literature and between sites. Inconsistencies were indicative of limitations and opportunities unique to EHR research. These analyses provide a validation of the use of EHRs for genetics and disease research., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Noncompliance with medication has been a complex issue with patients with severe mental illness during the last few decades, and adverse effects of medication have been identified as a major contributor to noncompliance., Objectives: To assess the sources of patients' knowledge of the adverse effects of their prescribed medicines and the perceived effects of their knowledge and experiences of adverse effects on their compliance with prescribed medicines., Methods: A cross-sectional survey of 500 patients attending outpatient psychiatric services in an urban adult mental health services in Ireland was carried out to assess parameters relevant to the objectives of the study., Results: Of the 500 patients approached, 409 agreed to take part in the study, giving a response rate of 81.8%. Mean (SD) age was 41 (12) years, with 39% being males, and 74.9% having at least secondary education. Overall, 44% said they had learnt of adverse effects of their medication from multiple sources including physicians (52.31%), leaflets (54.2%), Internet (14.29%), books (13.02%), and chemist/pharmacist (11.34%). Of the patients, 46.2% reported that they have had concerns about taking their medication because of their knowledge of adverse effects, with females more likely to have such concerns than males. Moreover, 14.7% of patients reported that they had ever refused to take medication prescribed for them because of their knowledge of adverse effects, whereas 30.8% of patients reported that they had some time in the past stopped taking their medication because they had actually experienced adverse effects. Finally, when asked if they would have taken the medicines prescribed for them now if they were told initially of all the adverse effects, 50.60% answered "more likely," with a higher proportion of these being males., Conclusions: Physicians and information leaflets are the leading sources of patients' knowledge about adverse effects of medication. The knowledge of adverse effects of medication has a potential to affect compliance, and so it is essential for physicians to engage patients in a fuller communication about their illness and its treatment with medication including the management of potential adverse effects.

Information technology is playing an increasing role in managing the challenges of global public health issues. The emergence of Web 2.0 technologies provides a tremendous avenue to foster connections among diverse health professionals engaged in the development and implementation of informatics-based solutions for global health. Our website, www.globalhealthinformatics.org, leverages an open source platform that employs Web 2.0 functionalities to create such a global community with the objective of fostering collaboration and knowledge sharing.