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Background: Understanding morbidity and mortality patterns among older adults is crucial for effective healthcare planning for Nigeria's aging population. This study aimed to determine the prevalence of mortality, assess morbidities, and identify mortality predictors among inpatient older adults managed by the Geriatric team of National Hospital Abuja., Methods: A retrospective analysis of 110 inpatients aged ≥ 60 years was conducted. Demographic data, diagnoses, length of stay, and outcomes were analyzed using descriptive statistics., Results: The mean age was 76.71 ± 9.44 years, with equal gender distribution. Mortality prevalence was 27.3%. The most common morbidities were hypertension (56.4%), sepsis (50.0%), delirium (46.4%), diabetes (35.5%), and dementia (29.1%). The mean hospital stay was 15.88 ± 12.18 days. Acute renal failure was significantly associated with mortality (p = 0.042) and emerged as the strongest predictor (Adjusted OR = 3.232, 95% CI: 1.080 - 9.668p = 0.036). Age, gender, and length of stay were not significant predictors of mortality., Conclusion: This study reveals a considerable mortality rate and a high prevalence of multi-morbidity among hospitalized older adults. Renal failure was the strongest mortality predictor, while hypertension, sepsis, and delirium were the common morbidities. Recommendations: Develop specialized geriatric care protocols, that include optimal management of prevalent conditions and routine renal function screening. These findings provide valuable insights for improving healthcare delivery for hospitalized older adults in Nigeria., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Objectives: To assess the seroprevalence of herpes simplex virus (HSV) types 1 and 2 in patients infected with HIV in Nigeria., Design: Cross-sectional design from January to June 2019., Setting: Federal Teaching Hospital, Ebonyi State, Nigeria., Participants: A total of 276 patients with HIV were analysed using ELISA method for the presence of HSV-1 and HSV-2 specific IgG antibodies., Outcomes: Fisher's exact test was used to determine the association between the seroprevalence of HSV and demographic variables (statistically significant=p value ≤0.05)., Results: Totally, 212 (76.8%) and 155 (56.2%) patients with HIV were seropositive for HSV-1 and HSV-2 IgG antibodies, respectively. The seroprevalence of HSV-1 was significantly higher than the HSV-2 in patients with HIV (p value <0.0001). HSV-1 and HSV-2 seroprevalence were higher in patients aged more than 30 years. The seroprevalence of HSV-1 was significantly higher (p=0.01) in females (82.4%, 131/159) than males (69.2%, 81/117), but there was no significant difference in seroprevalence of HSV-2 in females (57.9%, 92/159) compared with males (53.8%, 63/117) (p=0.51). Professional drivers had a higher seroprevalence of HSV-1 and HSV-2 and there was a significant association between the occupation and the HSV-1 and HSV-2 seropositivity (p>0.05). The seroprevalence of HSV-1 was significantly higher in the singles (87.4%, 90/103) than the married patients with HIV (p=0.001). However, HSV-2 seroprevalence was significantly higher in the married patients with HIV (63.6%, 110/173) (p=0.001)., Conclusions: Prevalence of 76.8% for HSV-1 and 56.2% for HSV-2 among patients with HIV was seen. The HSV-1 was significantly higher in the singles while HSV-2 seroprevalence was significantly higher in the married patients with HIV with HSV-1 and HSV-2 coinfection rate of 7.6%. This study became very imperative to provide an important insight into the hidden dynamics of HSV infections., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The first 140 days of pregnancy are critical as regards rubella virus infection because of the likelihood of a poor pregnancy outcome. This study was undertaken to investigate the likelihood of exposure to poor pregnancy outcomes due to seroprevalence of rubella among selected pregnant women attending Mile Four Hospital, Abakaliki, Ebonyi State, Nigeria. The seroprevalence of rubella immunoglobulin M (IgM) antibodies was investigated among pregnant women. A total of 187 sera samples collected from the women were screened for rubella virus IgM antibody using the enzyme-linked immunosorbent assay (ELISA). The results obtained were analyzed using SPSS. The chi square test was performed at a P value of 0.05 significance and at a 95% confidence interval. Of the 187 pregnant women, 35 (18.72%) were positive for the rubella virus. Pregnant women within 26-30 years of age had the highest prevalence (26.15%), while those aged 35-40 years had the least prevalence. Married women had the highest prevalence (20.0%), followed by singles (16.67%) and widows (15.38%), while divorced pregnant women recorded the least prevalence (9.20%). Pregnant women with no formal education were more predisposed to rubella virus (22.22%) infection compared to their educated counterparts. Occupationally, full-time housewives had the highest prevalence (24.26%). The infection rates seemed to wane as pregnancy advanced. The first trimester had the highest prevalence (21.88%), followed by the second trimester (18.84%) and the third trimester (17.44%). Pregnant women living in urban areas had higher IgM seroprevalence (20.18%) than those in rural areas (16.67%). Furthermore, grand multigravidas were more infected (22.73%) than primigravidas (14.52%) and multigravidas (20.39%). The seroprevalence of rubella in this study was high, and it calls for general surveillance and mass immunization of children and females of childbearing age in the area to help reduce the incidence of congenital rubella syndrome., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2022 Uchechukwu Onyeukwu Ekuma et al.)

Background: Evidence suggests that implementing an accountability mechanism such as the accountability framework for routine immunization in Nigeria (AFRIN) will improve routine immunization (RI) performance. The fact that the AFRIN, which was developed in 2012, still had not been operationalized at the subnational level (Ebonyi State) by 2018 may in part account for the poor RI coverage (33%) in 2017. Knowledge translation (KT) is defined as the methods for closing the gaps from knowledge to practice. Policy briefs (useful in communicating research findings to policy-makers) and policy dialogues (that enable stakeholders to understand research evidence and create context-resonant implementation plans) are two KT tools. This study evaluated their usefulness in enabling policy-makers to contextualize AFRIN in Ebonyi State, Nigeria., Methods: The study design was cross-sectional descriptive with mixed-methods data collection. A policy brief developed from AFRIN guided deliberations in a 1-day multi-stakeholder policy dialogue by 30 policy actors. The usefulness of the KT tools in contextualizing policy recommendations in the AFRIN was assessed using validated questionnaires developed at McMaster University, Canada., Results: At the end of the policy dialogue, the policy options in the policy brief were accepted but their implementation strategies were altered to suit the local context. The respondents' mean ratings (MNR) of the overall usefulness of the policy brief and the policy dialogue in contextualizing the implementation strategies were 6.39 and 6.67, respectively, on a seven-point Likert scale (very useful). The MNR of the different dimensions of the policy brief and policy dialogue ranged from 6.17 to 6.60 and from 6.10 to 6.83, respectively (i.e. moderately helpful to very helpful)., Conclusion: The participants perceived the KT tools (policy brief and policy dialogue) as being very useful in contextualizing policy recommendations in a national policy document into state context-resonant implementable recommendations. We recommend the use of these KT tools in operationalizing AFRIN at the subnational level in Nigeria., (© 2021. The Author(s).)

Introduction: The global population is aging, creating challenges for health systems. The mean age of patients with major trauma has increased over time, posing some challenges for trauma system designs. Elderly trauma patients are said to have higher mortality rates and longer hospital and intensive care unit stays. This study is aimed at assessing the pattern of injuries in elderly population in a dedicated trauma centre of a developing economy., Methods: This is a retrospective study of all patients aged 60 years and above seen in the trauma centre of a West African tertiary hospital over a three year period from January 2017 to December 2019. Relevant parameters including Sociodemographic data, injury pattern and injury scores were derived from the trauma registry. Data analysis was done using statistical package for social sciences (SPSS) version 24. Results were presented using tables and a figure., Results: A total of 183 patients aged 60 years and above were enrolled out of 4549 general trauma patients, representing 4% of the trauma patient population seen. Male to female ratio was 2.3 with the mean age of 65 ± 6.3. The most frequent mechanisms of injury were motor vehicular crash (MVC) (48.4%), followed by falls (16.5%). More proportion of females (21.8%) were significantly found to suffer falls compared to their males (14.2%) counterparts ( p  < 0.05). Traumatic brain injury was the commonest diagnosis accounting for 24.3% of cases. The predominant revised trauma scores (RTS) and injury severity scores (ISS) were 12 and 1-15 respectively, with overall mortality of 6.1%., Conclusion: The proportion of elderly trauma patients studied in this centre is low. MVC is still the leading mechanism of injury in our elderly trauma population. The mortality rate is however low in this study, in line with the low trauma and severity scores. Preventive measures for MVC should be strongly encouraged to reduce the incidence of elderly trauma patients in this part of the world., Competing Interests: The authors declared no conflicts of interest., (© 2018 The Authors. Published by Elsevier Ltd. CC BY-NC-ND 4.0.)

Objective: To assess the input of maternal and neonatal body physique anthropometries to birth outcomes., Methods: A prospective study of 177 full-term births at Alex Ekwueme Federal Teaching Hospital Abakaliki from July to December, 2019. Maternal and neonatal anthropometric parameters and birth outcomes: mode of delivery and Apgar score were considered in this study. The measurements followed the guidelines outlined by the Institute of Medicine., Results: The prevalence of low birth weight (6.21%), cesarean delivery (14.12%), and abnormal Apgar score (9.04%) was relatively low in the study. Birth weight was dependent on maternal age, weight, body mass index, percentage body fat, and waist and hip circumference (P < 0.05). Normal Apgar score at 1 min after birth of male neonates was dependent on maternal BMI and neonatal head circumference whereas abnormal Apgar score in male and female neonates was dependent on maternal age and waist:hip ratio, respectively (P < 0.05)., Conclusion: Maternal and neonatal body physique anthropometries can be used to identify mothers and neonates at risk of having birth complications. This provided a practical alternative means to know the possible risk of undesirable birth outcomes with spontaneous vaginal delivery in low-risk pregnancies., (© 2020 International Federation of Gynecology and Obstetrics.)

Lassa fever (LF) is a viral hemorrhagic illness endemic in West Africa. Annually, about 300,000-500,000 people are being infected, with about 5000 deaths. Symptoms of LF include high grade fever, headache, malaise, abdominal pain, vomiting, diarrhea, or sore throat. Terminal features may include bleeding from all orifices (mouth, nose, ear, anus and vagina), facial and neck oedema or pleural effusion. People of all ages, gender, and occupations were included in this study. A total of 440 patients' samples and Bio data were used for this study. The samples were analyzed for Lassa fever virus RNA using Real Time Reverse Transcriptase Polymerase Chain Reaction. The data obtained were analyzed using SPSS 20.0 and version 7 of Epi-Info statistical software. Analysis of these samples showed LASV prevalence of 25.7%. Chi-square analysis (p ≤ 0.05) showed that LASV infection does not depend on age, gender, or occupation. Our research re-emphasized the fact that LASV is a serious cause of fatality in humans. Our data showed that among 327 negative patients, 19 died. On the contrary, 113 LASV confirmed positive cases had 42 deaths. This result is highly significant. More so, Lassa fever disease outcome was compared across gender. There was no significant difference between the two genders. Death or recovery from LF infection does not depend on sex. However, recovery from LF significantly depends on age of the patient. Fatal outcome is significantly higher among adults/elderly. We aim to raise awareness to the recurrence of LASV in Ebonyi State and urgent need for other medical interventions, including other therapeutic measures, and possible vaccine production, considering the impact of this virus., Competing Interests: Declaration of Competing Interest The authors declared no conflict of interests., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Rubella is endemic worldwide and poses a serious threat to infants and pregnant women. Although the disease has been widely reported in parts of the country, there is currently no documented evidence of the disease in Anyigba. A comparative study of rubella immunity was conducted among immunized and non-immunized pregnant women visiting the Kogi State University Teaching Hospital, Anyigba. In a cross-sectional study, blood samples collected from 300 pregnant women (immunized = 127; non-immunized = 173) were tested for rubella antibodies using ELISA kit. Overall, anti-rubella-IgM and IgG seroprevalence rates of 38 (12.7%) and 83 (27.7%) were detected. Seventy (55.1%) of the immunized against 13 (7.5%) of non-immunized women had detectable IgG. The non-immunized women were significantly more seropositive for IgM than the immunized who recorded higher prevalence of IgG. Immunized and non-immunized women aged 23-32 years had higher IgG and IgM positivity rates. The difference in IgM and IgG seropositivity rates in relation to vaccination was statistically significant ( P < 0.05) between the immunized (0.8%, 55.1%) and vaccine-naïve subjects (21.4%, 7.5%). Low level of awareness and high susceptibility to rubella virus infection especially among the non-immunized women was confirmed in study area, thus the need for government to strengthen education of masses and to make rubella vaccination freely available for women of childbearing age.

Human herpesvirus 4 which is commonly known as Epstein-Barr virus (EBV) is one of the opportunistic pathogens that affect human immunodeficiency virus (HIV) infected individuals and it is the leading cause of death and cancer in humans. The study was designed to evaluate the prevalence of EBV among HIV-1 infected individuals in Abakaliki metropolis, Ebonyi State, Nigeria. A total of 91 HIV-1 infected individuals were collected from Mile 4 Hospital, Abakaliki, Ebonyi State, Nigeria. ELISA was used to determine the Epstein-Barr Nuclear Antigen (EBNA) IgG and IgM antibodies. Full blood count (FBC), white cell count (WBC) and differential counts were also determined using standard hematological methods. Of the 91 serum samples obtained from HIV-1 infected individuals, 87(95.6%) and 20(22.0%) samples were found to be positive for EBVNA IgG and IgM antibody respectively. All the age groups had significant IgG prevalence, but age groups ≤ 20 years, and ≥ 41 had the highest prevalence while age group 21-30 years was found to have a less rate of prevalence. Also, the highest seropositivity for IgM antibodies was observed in the age group 31-40 years (32.4%) while the age groups ≤20 years (0.0%) is the lowest. However, these differences were not statistically associated with PVL and EBVNA IgG ( p = .4311) and IgM antibodies ( p = .4861).Higher seropositivity of EBVNA IgG occurred among those with PVL 41-10,000 copies/mL (100.0%) and PVL 10,001 copies/mL and above (100.0%) compared to those with PVL less than or equal to 40 copies/mL (95.0%). While regarding EBVNA IgM antibodies, higher seropositivity of EBVNA IgM occurred among those with PVL less than or equal to 40 copies/mL (25.0%) compared to those with PVL 41-10,000 copies/mL (20.0%) and PVL 10,001 copies/mL and above (8.3%). There was a significant difference in Neutrophils p < .026 between the mean of females and males (40.9 ± 11.7 and 36 ± 31.1) infected with EBV IgM in HIV individuals. There was also a significant positive correlation between CD4 counts and the WBC, Lymphocytes, Eosinophils and the neutrophil among the HIV-1 individuals used for this study. The correlations observed between both CD 4 + count and neutrophil support the potential use of neutrophils as a marker of EBV in HIV disease progression and as useful markers of immune activation.

Information and communication technology (ICT) tools are known to facilitate communication and processing of information and sharing of knowledge by electronic means. In Nigeria, the lack of adequate capacity on the use of ICT by health sector policymakers constitutes a major impediment to the uptake of research evidence into the policymaking process. The objective of this study was to improve the knowledge and capacity of policymakers to access and utilize policy relevant evidence. A modified "before and after" intervention study design was used in which outcomes were measured on the target participants both before the intervention is implemented and after. A 4-point likert scale according to the degree of adequacy; 1 = grossly inadequate, 4 = very adequate was employed. This study was conducted in Ebonyi State, south-eastern Nigeria and the participants were career health policy makers. A two-day intensive ICT training workshop was organized for policymakers who had 52 participants in attendance. Topics covered included: (i). intersectoral partnership/collaboration; (ii). Engaging ICT in evidence-informed policy making; use of ICT for evidence synthesis; (iv) capacity development on the use of computer, internet and other ICT. The pre-workshop mean of knowledge and capacity for use of ICT ranged from 2.19-3.05, while the post-workshop mean ranged from 2.67-3.67 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end of the workshop ranged from 8.3%-39.1%. Findings of this study suggest that policymakers' ICT competence relevant to evidence-informed policymaking can be enhanced through training workshop.

Background: In Nigeria, malaria, schistosomiasis and lymphatic filariasis are among infectious diseases of poverty (IDP) with severe health burden and require effective policy strategies for their control. In this study, we investigated the value of policy brief and policy dialogue as excellent policymaking mechanisms that enable policymakers to adapt effective evidence informed policy for IDP control., Methods: A policy brief was developed on the control of malaria, schistosomiasis and lymphatic filariasis and subjected to deliberations in a one-day multi-stakeholder policy dialogue held in Ebonyi State Nigeria. A modified cross sectional intervention study design was used in this investigation. Structured pre-tested questionnaires were used to evaluate the policy brief document and policy dialogue process at the end of the policy dialogue., Results: Forty-seven policymakers participated in the dialogue. An analysis of the response on the policy brief regarding context, different features of the problem; policy options and key implementation considerations indicated the mean ratings (MNRs) mostly ranged from 6.40-6.85 on 7 point scale. The over-all assessment of the policy brief had MNR at 6.54. The analysis of the response on the policy dialogue regarding the level of priority of policy issue, opportunity to discuss different features of the problem and options for addressing the problem, and the MNRs mostly ranged from 6.50-6.82. The overall assessment of the policy dialogue had MNR at 6.72., Conclusion: Policy dialogues can allow research evidence to be considered together with views, experiences and tacit knowledge of policymakers and can enhance evidence-to-policy link.

Background: In Nigeria, one of the major challenges associated with evidence-to-policy link in the control of infectious diseases of poverty (IDP), is deficient information literacy knowledge and skill among policymakers. There is need for policymakers to acquire the skill to discover relevant information, accurately evaluate retrieved information and to apply it correctly., Objectives: To use information literacy tool of International Network for Availability of Scientific Publications (INASP) to enhance policymakers' knowledge and skill for policymaking on control of IDP in Nigeria., Methods: Modified "before and after" intervention study design was used in which outcomes were measured on target participants both before the intervention is implemented and after. This study was conducted in Ebonyi State, south-eastern Nigeria and participants were career health policy makers. A two-day health-policy information literacy training workshop was organized to enhance participants" information literacy capacity. Topics covered included: introduction to information literacy; defining information problem; searching for information online; evaluating information; science information; knowledge sharing interviews; and training skills., Results: A total of 52 policymakers attended the workshop. The pre-workshop mean rating (MNR) of knowledge and capacity for information literacy ranged from 2.15-2.97, while the post-workshop MNR ranged from 3.34-3.64 on 4-point scale. The percentage increase in MNR of knowledge and capacity at the end of the workshop ranged from 22.6%-55.3%., Conclusion: The results of this study suggest that through information literacy training workshop policy makers can acquire the knowledge and skill to identify, capture and share the right kind of information in the right contexts to influence relevant action or a policy decision.

Background: The lack of effective use of research evidence in policy-making is a major challenge in most low- and middle-income countries (LMICs). There is need to package research data into effective policy tools that will help policy-makers to make evidence-informed policy regarding infectious diseases of poverty (IDP). The objective of this study was to assess the usefulness of training workshops and mentoring to enhance the capacity of Nigerian health policy-makers to develop evidence-informed policy brief on the control of IDP., Methods: A modified "before and after" intervention study design was used in which outcomes were measured on the target participants both before the intervention is implemented and after. A 4-point Likert scale according to the degree of adequacy; 1 = "grossly inadequate," 4 = "very adequate" was employed. The main parameter measured was participants' perceptions of their own knowledge/understanding. This study was conducted at subnational level and the participants were the career health policy-makers drawn from Ebonyi State in the South-Eastern Nigeria. A one-day evidence-to-policy workshop was organized to enhance the participants' capacity to develop evidence-informed policy brief on IDP in Ebonyi State. Topics covered included collaborative initiative; preparation and use of policy briefs; policy dialogue; ethics in health policy-making; and health policy and politics., Results: The preworkshop mean of knowledge and capacity ranged from 2.49-3.03, while the postworkshop mean ranged from 3.42-3.78 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end of the workshop ranged from 20.10%-45%. Participants were divided into 3 IDP mentorship groups (malaria, schistosomiasis, lymphatic filariasis [LF]) and were mentored to identify potential policy options/recommendations for control of the diseases for the policy briefs. These policy options were subjected to research evidence synthesis by each group to identify the options that have the support of research evidence (mostly systematic reviews) from PubMed, Cochrane database and Google Scholar. After the evidence synthesis, five policy options were selected out of 13 for malaria, 3 out of 10 for schistosomiasis and 5 out of 11 for LF., Conclusion: The outcome suggests that an evidence-to-policy capacity enhancement workshop combined with a mentorship programme can improve policy-makers' capacity for evidence-informed policy-making (EIP)., (© 2015 by Kerman University of Medical Sciences.)

Background: Stroke is the second leading cause of death and the leading cause of adult disability worldwide. A better understanding of stroke risk factors and outcome may help guide efforts at reducing the community burden of stroke. This study aimed to understand stroke risk factors, imaging subtypes, and 30-day outcomes among adult Nigerians., Materials and Methods: We prospectively recruited all patients presenting with acute stroke at the National Hospital Abuja between January 2010 and June 2012. We assessed clinical and laboratory variables, as well as brain computerized tomography, magnetic resonance imaging, and carotid Doppler ultrasound scans. We also assessed case fatality and functional outcome at 30 days after stroke., Results: Of 272 patients studied, 168 (61.8%) were males. Age at presentation (mean ± standard deviation) was 56.4 ± 12.7 years in males and 52.9 ± 14.8 years in females (P = 0.039). Neuroimaging was obtained in 96.7% patients, revealing cerebral infarction (61.8%), intracerebral hemorrhage (ICH) (34.8%), and subarachnoid hemorrhage (SAH) (3.4%). Carotid plaques or stenosis ≥50% were detected in 53.2% patients with cerebral infarction. Stroke risk factors included hypertension (82.7%), obesity (32.6%), diabetes (23.5%), hyperlipidemia (18.4%), atrial fibrillation (9.2%), and cigarette smoking (7.7%). At 30 days after stroke, case-fatality rate was 18.8%, whereas modified Rankin Scale (mRS) scores for cerebral infarction, ICH, and SAH were 3.71, 4.21, and 4.56, respectively. Atrial fibrillation, a previous stroke, and age older than 50 years were all associated with worse mRS scores at 30 days., Conclusion: Although hypertension, obesity, diabetes mellitus, and atrial fibrillation were important stroke risk factors, in many patients, these were detected only after a stroke. While the commonest stroke subtype was cerebral infarction, observed in almost two-third of patients, SAH was associated with the highest case-fatality rate at 30 days of 44.4%. Larger population-based studies may provide additional data on stroke incidence and outcome among Nigerians.

Background: Blunt abdominal trauma (BAT) usually results from motor vehicle accidents, assaults, and recreational accidents or falls. This communication is a 3-year report of an ongoing study aimed at providing the current BAT prevalence in our center. It is hoped that this would assist in a better design of prevention and emergency trauma response systems to cope with this epidemic., Methods: All of the patients admitted to the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria, from February 2005 to January 2008 were prospectively studied based on a questionnaire. Hemodynamic stability and sonography formed the basis for selecting patients for non-operative management (NOM); others were offered laparotomy., Results: In total, 4,391 emergencies were seen during the study period, of which 1,654 (38%) were due to trauma. Seventy-nine patients with abdominal trauma accounted for 4.8% of trauma cases. Forty-two (53%) patients suffered BAT and their ages ranged from 14 and 56 years (mean 28.4 years), with a male:female ratio of 2.5:1. Road traffic accidents accounted for 13 (87%) and 26 (96%) patients in the NOM and laparotomy groups, respectively. The most commonly injured organ was the spleen in both groups: 8 (50%) and 15 (56%) in the NOM and laparotomy groups, respectively. Fifteen (36%) patients were managed successfully in the NOM group., Conclusion: Trauma was mainly due to road traffic injuries. Hemodynamic stability and ultrasonography effectively selected patients for NOM. The establishment of trauma systems, provision of ancillary diagnostic and monitoring facilities, well-designed roads and traffic infrastructure, and health education on road safety would reduce injury, morbidity, and mortality.

Background: Albinism is an established risk factor for skin cancer in black Africans, and high levels of ultraviolet radiation increase the risk of the three major forms of skin cancer., Methods: We present four albinos with histologic diagnoses of skin cancer who were seen at the University of Calabar Teaching Hospital, Calabar, Nigeria from January 2005 to December 2006. Skin cancer in these cases was compared with the total skin cancer affecting 29 patients during the study period., Results: Twenty-nine patients presented with skin cancer during the study period. Four Nigerian albinos (two men and two women) with skin cancer accounted for 13.8% of the skin cancers observed during the 2-year period. They ranged in age from 22 to 40 years (mean, 27.8 years). The sites of the lesions included the head [squamous cell carcinoma (SCC) in two patients and basal cell carcinoma (BCC) in one patient] and the upper limb (melanoma). All tumors were excised; in addition, patients with SCC and melanoma received adjuvant chemotherapy. Two patients, one woman with SCC and the patient with melanoma, showed residual tumor because of inadequate excision. During the evaluation period between 14 and 18 months, the sites appeared to be healed with no evidence of recurrence in the male with SCC and female with BCC., Conclusion: Albinism and solar radiation are risk factors for skin cancer. Early implementation of public education strategies on prevention should improve outcome.

Background: Abdominal injuries are on the increase in both developed and developing countries. The frequency of penetrating abdominal trauma (PAT) varies across the globe because it relates to industrialization, the weapons available, and the presence of military conflicts. This study sought to evaluate the current pattern and outcome of managementof PAT in Calabar, which is undergoing rapid urbanization, and with a focus on tourism., Method: Patients admitted to the University of Calabar Teaching Hospital, Calabar with PAT from February 2005 to January 2008 were prospectively studied., Results: Seventy-nine patients presented with abdominal trauma, among which 39 (49%) were PAT. There were 37 males and two females, whose ages ranged from 5 to 54 years (mean 27.8 years). Stab wound (18; 46.1%) was the commonest injury, while gunshot wound (15; 38.5%) ranked second. Others were road traffic accident (two patients), fall, cow horn injury, shrapnel, and criminal abortion (a patient each). The commonest injury was evisceration of the omentum and small intestine, which occurred in 13 (36%) patients. Five (14%) patients suffered small intestinal perforations, while three (8%) had liver, splenic and colonic injuries, respectively. Others were rectal injury (four patients), mesenteric injury and perforated stomach (two patients each), and a patient with diaphragmatic injury. The outcome was fatal in two (5%) patients., Conclusion: Penetrating abdominal trauma is on the increase in Calabar. The pattern of injury revealed areas which, when effectively contained, will lead to an improvement in the safety of our environment.

Background: Burns are among the most devastating injuries seen in the emergency units. The epidemiology varies from one part of the world to another. This communication is a 3-year report of burns in children in an attempt to provide information on the current epidemiology of burns in this centre., Method: Children admitted into the University of Calabar Teaching Hospital, Calabar with burns were prospectively studied from February 2005 and January 2008., Results: There were 56 patients (28 males and 28 females). The ages ranged from 9 days and 14 years (mean 3.5 years) and 19 (73.1%) were preschool children. There were 39 (69.6%) who sustained scald injuries while 17 (30.4%) suffered flame injuries. Twenty-six (46.4%) patients sustained burns with total burn surface area above 10%., Conclusion: Education of the public on burns prevention based on the factors highlighted, establishment of burns support groups dedicated to publicity on prevention and provision of financial aid would sustain strategies when adopted.

Background: Burn injuries are among the most devastating injuries seen in the emergency units. The epidemiology of this injury varies from one part of the world to another. This is a 3-year report in an attempt to provide information on the current epidemiology of burns in this center., Method: Patients admitted into the University of Calabar Teaching Hospital, with burn injuries were prospectively studied between February 2005 and January 2008., Results: The 59 patients (33 males and 26 females) accounted for 3.7% of trauma patients and their ages ranged from 15 to 70 years (mean 29.4 years). Flame burn was the commonest injury seen in 48 (81.3%) patients because of petrol and kerosene, whereas chemical burn that involved 7 (11.9%) patients ranked second. Morbidity included burns wound infection in 13 (22%) patients and contractures in 6 (10.2%) patients. The outcome was fatal in 15 (25.4%) patients., Conclusion: The establishment of burn support groups dedicated to publicity on prevention based on areas of risk highlighted in this study and provision of financial aid as well as provision of modern burn care facilities would improve outcome.

Background: Dermatologic malignancies are among the most common form of cancer. However, dark-skinned individuals of African descent are said to be far less likely than fair-skinned individuals to develop skin cancer. Significant differences in the pattern of skin malignancy have also been observed in different regions of Africa., Objective: The aim of this study was to evaluate the pattern, site incidence, and outcome of treatment of major histologically diagnosed dermatologic malignancies encountered in a teaching hospital surgical department in South Nigeria., Methods: We evaluated patients with histologic diagnoses of major dermatologic malignancies that presented to the University of Calabar Teaching Hospital, Calabar, Nigeria between January 2000 and December 2004 and compared our findings with the total number of patients diagnosed with malignancies at the same hospital over the same period. This hospital is located in South Nigeria., Results: There were 63 histologically diagnosed dermatologic cancers, comprising 10% of all histologically diagnosed cancers at the University of Calabar Teaching Hospital during the study period. Squamous cell carcinoma (SCC) was the most common (n = 23; 37%), followed by Kaposi sarcoma (KS) [n = 17; 27%]. Other malignancies included basal cell carcinoma (BCC), melanoma, and dermatofibrosarcoma protuberans (DFSP) [n = 5; 8% each]. The peak age varied with the type of cancer but none was found in patients in the first decade of life. The lower limb was the most frequent site of SCC (Marjolin ulcer), KS, and melanoma, while BCC was most common on the head, neck, and upper limb. Excision surgery resulted in healing of all cases of BCC. Some patients with SCC and melanoma presented late for curative surgery. Some African KS tumors were chemosensitive. There was a high recurrence rate for DFSP., Conclusion: This study revealed a similar pattern of dermatologic malignancies in South Nigeria compared with other parts of Africa but also some regional differences (e.g. in Kano, melanoma ranked second). The pattern was, however, in sharp contrast to that seen with Caucasian populations, in whom 80% of the lesions are BCC and 20% are SCC. Public education, implementation of preventive strategies, and early presentation of disease would improve outcomes of dermatologic malignancies in Nigeria.