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Intestinal helminthiasis among pupils is a major impediment to their well-being and development. This 2-year study determined how home-grown school feeding programme (HGSFP) impacted on pupils’ school attendance and created opportunity for more children to assess interventions geared towards the prevention and possible elimination of intestinal helminthiasis. Faecal samples were collected from 1677 consented pupils and examined for helminths using Kato–Katz technique. Pupils were treated with 40 mg Levamisole (anti-helminthic) and re-examined. Structured questionnaires and focus group discussions were used to determine anthropometric indices and risk factors. A 6% prevalence rate which was not significant with respect to sex or age was observed. Helminth parasites observed were Ascaris lumbricoides (4.4%), Trichuris trichiura (0.8%), Hookworm spp. (0.2%), and Taenia spp. (0.5%). Two pupils (1.98%) recorded high intensity of infection (epg) while 98.02% had light infection. Ascaris lumbricoides voided following treatment were 290. The Body Mass Index (BMI) indicated that infected pupils had lower values (14.6317) compared to uninfected pupils (19.2003). The HGSFP significantly improved school attendance by 30%. Lack of knowledge about transmission (P = 0.0004), hand hygiene (P = 0.01) and usage of toilet (P = 0.01) were risk factors observed. Intestinal helminthiasis remains a public health problem among pupils because environmental and behavioural risk factors persist. HGSFP improved school attendance and created opportunity for more inclusive participation of school-aged children for deworming. This has great potential in fast-tracking the elimination of intestinal helminthiasis. The present study consequently advocates the need to sustain HGSFP in schools.

Introduction: Sickle Cell Disease (SCD) is an inherited haemolytic disorder that affects virtually all body systems including the eye. Ocular complications of SCD could have dire consequences if not detected early. Objectives: We aimed at determining the prevalence of ocular complications of SCD in our patients. Methods: This study was carried out on patients attending both the adult and Paediatric Sickle cell disease clinic at Chukwuemeka Odumegwu Ojukwu Teaching Hospital, Akwa, Anambra State, Nigeria, over an 8 month period. A structured questionnaire was administered to consenting patients to determine their sociodemographic variables and other characteristics. Visual acuity was determined with multiple optotype Snellen’s chart at 6 metres in natural daylight. Using pen-torch, the face, external eye examination, anterior segment examination and pupillary reaction to light were assessed. Magnified anterior segment examination was performed with slit-lamp biomicroscope. All subjects underwent dilated fundoscopy (after instillation of tropicamide 0.5% eye drop) using Welch Allyn indirect ophthalmoscope. Results were analysed using SPSS version 22.0 Inc Chicago Illinois and represented in tables. Statistically significant P value was set at < 0.05. Results: A total of 28 patients with age range of 6-42 years were seen. 17 (60.7%) were males, while 11 (39.3%) were females. 8 (28.6%) had at least one ocular anomaly comprising of refractory errors 3 (10.8%), sickle cell retinopathy 4 (14.3%) and glaucoma 2 (7.1%). Only 2 (7.1%) routinely visit eye clinic. SCD retinopathy was found to increase with age (P value= 0.005). Conclusion: SCD retinopathy was found more in the older age group despite the small sample size at a prevalence rate of 14.3%. Early initiation of routine ocular examination for SCD patients will be beneficial to avert these complications. More efforts should be made at educating the patients. Larger studies will be required to determine the actual prevalence of ocular anomaly in SCD patients in Anambra State.

Objective The purpose of this pilot study was to explore the effect of omega-3 fatty acids and potassium thiocyanate on conditional peak systolic cerebral artery blood velocity in children with sickle cell anemia (SCA). Methods Transcranial doppler ultrasonography (TCD) was done on 232 SCA children, and 21 found with conditional peak systolic blood velocity (PSV) of 200–249 cm/s in internal carotid, middle or anterior cerebral arteries. These were randomized to receive omega-3 fatty acids and potassium thiocyanate with standard treatment of SCA (test group, N = 14), or standard treatment only (control group, N = 7). After 3 months of treatment, PSV was measured again. Results Right middle cerebral artery PSV was significantly reduced in the test relative to the control groups (p = 0.04). PSV returned to normal in 79% of the test versus 43% of the control group; and increased to abnormal in one member of the control group, but none of the test group. Conclusions The pilot data suggest that in SCA, omega-3 fatty acids and potassium thiocyanate might reduce conditional blood velocity to normal, or prevent progression to abnormal values. A larger, randomized, clinical trial is required to further address the current gap in management of conditional TCD blood velocity.

Background: Urinary Tract Infection (UTI) is a common contagion among men and women with the incidence relatively higher among women due to their differing anatomy. An understanding of the kind of pathogens implicated in urinary tract infections as well as antibiotic susceptibility profiling may help the clinician make rationally correct empirical choice in their treatment. Objective: This study is aimed at determining the type and antibiotic susceptibility pattern of bacterial uropathogens isolated from female patients attending Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka, Nigeria. Method: Two hundred and forty patients with clinically diagnosed UTI and who were on at least 5 days’ antibiotic holiday were recruited into the study. Their demographic characteristics were captured using pre-tested questionnaire. Their clean catch mid-stream urine samples were collected using sterile universal container and sent to the Microbiology Department for processing. Within 30 minutes of samples collection, the specimens were cultured and the isolates were identified, after 24 h of incubation, using standard microbiological techniques. Antibiotic susceptibility tests were done with standard antibiotic discs using the Kirby–bauer disc diffusion method. Results: Out of the 240 urine samples, 89.17% yielded significant bacteriuria. The pathogens implicated were Escherichia coli (28.5%), Staphylococcus aureus (28.0%), Salmonella spp (22.8%) and Pseudomonas aeruginosa (20.5%). HIV status, patients age, pregnancy status and marital status all significantly affected bacteriuria rate (p value < 0.05), while patients’ location (sub-urban/rural dwelling), and level of education did not (p value > 0.05). The pattern of microbial resistance to antibiotics suggests that ceftazidime, fosfomycin and cefoxitin may not be used as first-line agents in the empirical treatment of UTIs rather; levofloxacin, meropenem or aztreonam should be considered. Levofloxacin was significantly effective against all the isolates and may be administered empirically while waiting for the culture result (Mean % susceptibility was 79.85). Conclusion: E. coli and S. aureus were the predominant pathogens in the study and many were resistant to the commonly prescribed antibiotics and so leave the clinicians with only few alternative drugs for UTIs treatment. Routine surveillance and monitoring studies need to be constantly conducted to update clinicians on the prevalent pathogens and the rational and empirical treatment of UTIs. Aggressive and consistent health education using every possible media is also recommended to combat the menace of drug resistance occasioned by inappropriate antibiotic use.

Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Agulu Campus, Anambra State, Nigeria. Department of Pediatrics, Anambra State University Teaching Hospital, Awka, Anambra State, Nigeria. Department of HIV Care Laboratories, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria. Department of Surgery, Anambra State University Teaching Hospital, Amaku Awka, Anambra State, Nigeria. Department of Community Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria.

Objective To assess healthcare workers' involvement in healthcare waste management in public and private hospitals. Methods Validated questionnaires ( n = 660) were administered to randomly selected healthcare workers from selected private hospitals between April and July 2013. Results Among the healthcare workers that participated in the study, 187 (28.33%) were medical doctors, 44 (6.67%) were pharmacists, 77 (11.67%) were medical laboratory scientist, 35 (5.30%) were waste handlers and 317 (48.03%) were nurses. Generally, the number of workers that have heard about healthcare waste disposal system was above average 424 (69.5%). More health-workers in the government (81.5%) than in private (57.3%) hospitals were aware of healthcare waste disposal system and more in government hospitals attended training on it. The level of waste generated by the two hospitals differed significantly ( P = 0.008 6) with the generation level higher in government than private hospitals. The materials for healthcare waste disposal were significantly more available ( P = 0.001) in government than private hospitals. There was no significant difference ( P = 0.285) in syringes and needles disposal practices in the two hospitals and they were exposed to equal risks ( P = 0.851 0). Fifty-six (18.5%) and 140 (45.5%) of the study participants in private and government hospitals respectively were aware of the existence of healthcare waste management committee with 134 (44.4%) and 19 (6.2%) workers confirming that it did not exist in their institutions. The existence of the committee was very low in the private hospitals. Conclusions The availability of material for waste segregation at point of generation, compliance of healthcare workers to healthcare waste management guidelines and the existence of infection control committee in both hospitals is generally low and unsatisfactory.

Background The current and general safety control tests for vaccines have been the use several animal tests. Vaccine is considered safe if it does not cause weight loss or death in laboratory animals at human dose, does not promote leukocytosis by a factor ⩾10 and showed a Leukopenic toxicity value ⩾80% of the Leukopenic toxicity of the control. The study sets to determine the safety of routine immunization vaccines from Anambra, Ebonyi and Enugu states of Nigeria and indirectly evaluate the efficiency of cold-chain facilities. Method The study was designed to check the safety of the routine immunization vaccines to the hematopoietic system of mice and mice body weight changes after immunization. Results Animal body weight changes test showed that the mice immunized with the vaccines increased in weight at days 3 and 7 post-immunization and exceeded 60% weight gain at day 7 post-immunization. None of the mice died during the observation period. Hematopoietic system toxicity tests showed that the vaccines are non- toxic. Conclusion The vaccines were generally safe and non-toxic. The cold-chain systems in the States studied were efficient and had not compromised the safety of the vaccines.

Background: Human immunodeficiency virus/HBV coinfection remains an important public health issue due to the risk of rapid progression to chronic liver disease and death. Despite the foregoing, there is paucity of data on Hepatitis among HIV-infected children receiving treatment in a tertiary hospital at Nnewi, South-East Nigeria. Objectives: This study was carried out to determine the prevalence of HBsAg in HIV-infected and non-HIV-infected children at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria. Methods: A cross sectional case control study was carried out among 120 HIV infected and 120 non-HIV infected children. The care givers and/or children were interviewed using a semi-structured questionnaire to obtain their socio-demographic characteristics, possible risk factors for HBV transmission and HBV vaccination history. All the participating children were screened for Hepatitis B surface antigen. Results: The prevalence of hepatitis B surface antigen among HIV-infected and non-HIV infected were 5.8% and 0.8% respectively (p=0.03). Most of the children with HBV were males. The mean age of those infected with HBV was significantly higher than those without HBV infection. History of unsafe parenteral injections (p=0.03) and blood transfusion (p=0.02) were significantly associated with HBV surface antigen seropositivity. Conclusion: This study has demonstrated that the rate of HBV infection among HIV infected children is higher than that of the non-HIV infected children with increased risk of HBV seropositivity from parenteral injection and blood transfusion also amongst HIV infected. Adequate screening of blood and its products before transfusion is advocated.

Drug-resistant-diarrhoeagenic bacteria are currently emerging healthcare challenge. This study investigated the effects of Vernonia amygdalina, Garcinia kola, tetracycline and metronidazole combinations on such bacteria. Agar well diffusion method was employed to determine the inhibitory effects of the herbal extracts on diarrhoeagenic bacteria while Time-Kill Assay was used to determine bactericidal effects of the extracts against test isolates. Interactions between plant extracts and antibiotics were investigated using Checkerboard assay. Minimum inhibitory concentrations of the extracts against the bacterial isolates ranged between 3.125&ndash, 50 mg/mL, while those of tetracycline and metronidazole ranged from 30&ndash, 50 &mu, g/mL. Synergism was observed against B. cereus and S. aureus for metronidazole + aqueous G. kola at all ratios. Generally, the combinations aqueous G. kola + ethanolic G. kola and aqueous G. kola + ethanolic V. amygdalina showed more pronounced synergism against the Staphylococcus aureus than B. cereus isolates with the fractional inhibition concentration (FIC) indices ranging from 0.32&ndash, 0.95. Synergism of tetracycline + crude extracts and metronidazole combinations were more pronounced on the test isolates and especially on the Gram-negative organisms with FIC indices ranging from 0.41&ndash, 0.91. Conclusion: The herbal extracts combinations and extracts&ndash, antibiotics combinations are synergistic on diarrhoeagenic bacteria at defined combination ratios.