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Introduction: Cerebral malaria (CM) is the most lethal form of severe malaria with high case fatality rates. Overtime, there is an inherent risk in changing pattern of presentation of CM which, if the diagnosis is missed due to these changing factors, may portend a poor outcome. Variations in the pattern of clinic-laboratory presentations also make generalization difficult. This study was, therefore, set out to report the pattern of clinical and laboratory presentation of CM. Methods: This was a cross-sectional study among children aged 6 months to 14 years admitted with a diagnosis of CM as defined by the World Health Organization criteria. A pretested pro forma was filled, and detailed neurological examination and laboratory (biochemical, microbiology, and hematology) investigations were done. P

This study assessed the effect of the steamed and boiling cooking methods on the vitamin content of six staple green vegetables in Nigeria. Vitamin levels in fresh, steamed and boiled leafy vegetables were determined using spectrophotometric and titrimetric methods. The results of vitamin analysis showed that fresh vegetable of Amaranthus hybridus contained the largest amount of ascorbic acid, thiamin and niacin (358.40 mg/100 g, 0.09 mg/100 g and 0.08 mg/100 g), while Talinum triangulare had the highest level of riboflavin (0.18 mg/100 g). The steamed Amaranthus hybridus contained the highest levels of ascorbic acid, thiamin and niacin (322.56 mg/100 g, 0.08 mg/100 g and 0.73 mg/100 g), while steamed leaves of Talinum triangulare had the highest quantity of riboflavin (0.16 mg/100 g). The boiled Amaranthus hybridus had the highest amount of ascorbic acid, thiamin and niacin (197.12 mg/100 g, 0.05 mg/100 g and 0.41 mg/100 g), whereas the boiled Talinum triangulare had the highest level of riboflavin (0.09 mg/100 g). The percentage of vitamin loss in steamed leafy vegetables varies from 9 to 11 %, 9 to 17 %, 9 to 13 % and 9 to 12 % in ascorbic acid, thiamin, riboflavin and niacin respectively. Almost 50 % of the essential vitamins were lost in boiled leafy vegetables. The results revealed that vegetables could be improved source of some important vitamins that can help humans meet their nutritional needs.

We investigated ectoparasite diversity, interspecific infestation rates and host preference in roosting fruit bats, Eidolon helvum, from Bowen University, Southwest Nigeria. Fur of captured E. helvum were sampled monthly for ectoparasites from January 2021 to June 2022. We examined a total of 231 E. helvum and observed a significant female to male adult sex ratio (0.22:1); with 53.9% ectoparasitic infestation rate. We identified and enumerated the ectoparasite; and subjected its Cytochrome c oxidase subunit I (COI) gene to phylogenetic analysis with other nycteribiids. COI gene sequences obtained formed a distinct clade with other C. greeffi sequences. We recovered a total of 319 (149 female and 170 male) ectoparasites and observed a balanced C. greeffi female to male adult sex ratio of 0.88:1. Ectoparasitic sex distribution had no association with host sex and season. Prevalence was significantly higher during the wet season, but not between sexes of E. helvum. The intensity of infestation, 3.7 ± 0.4 individuals per fruit bat, was significantly higher during the wet season with a bimodal seasonal distribution. The strongly male-biased host adult sex ratio had no significant influence on C. greeffi metapopulation adult sex ratio.

Sex education helps in preparing adolescents to have responsible attitudes and behaviour towards sex for a harmonious sexual life. This study assessed the level of knowledge and attitude towards sex education among secondary school students in an urban south-western Nigeria.The study adopted a descriptive cross-sectional design. Multistage sampling technique was used to select a sample size of 378 students from a population of 3674 students in public secondary schools. A pre-tested self-administered questionnaire with Cronbach’ Alpha value of 0.76 was used for data collection. The approval of the study was obtained from the Human Research Ethics Committee of Lagos University Teaching Hospital. Data were analyzed using SPSS version 20. Chi-square test and multiple logistic regression were used for test of association among the variables at p < 0.05.Majority of the respondents 338 (89.9%) were between age 14–17 with mean age of 16 ± 5.22 years. Majority of the respondents 309 (82.1%) had a good knowledge of sex education. More than half, 216 (57.5%) of the respondents had positive attitude towards sex education. There was a significant relationship between knowledge and attitude of the respondents towards sex education (p = 0.01). Knowledge of sex education increases as class of students increases to SS2 = (OR = 7.750; 95% CI [3.268–18.378] and SS3 = (OR = 2.219; 95% CI [1.067–4.613] respectively.The study concluded that the respondents had good knowledge of sex education and there was a significant relationship between students’ knowledge and attitude towards sex education. There is need for awareness and effective sex education among secondary school students. Teachers and parents should create the view of improving the attitude of secondary school students towards sex education.

ObjectivesCoordinated measurement strategies are needed to inform collaborative approaches to improve access to and quality of care for persons with sickle cell disease (SCD). The objective of our study was to develop a multilevel measurement strategy to assess improvements in access to and quality of care for persons with SCD in 4 US regions.MethodsFrom 2014 through 2017, regional grantees in the Sickle Cell Disease Treatment Demonstration Program collected administrative and patient-level electronic health record (EHR) data to assess quality improvement initiatives. Four grantees-covering 29 US states and territories and an SCD population of 56 720-used a collective impact model to organize their work. The grantees collected administrative data from state Medicaid and Medicaid managed care organizations (MCOs) at multiple points during 2014-2017 to assess improvements at the population level, and local patient-level data were abstracted from site-level EHRs at regular intervals to track improvements over time.ResultsAdministrative data were an important source of understanding population-level improvements but were delayed, whereas patient-level data were more sensitive to small-scale quality improvements.ConclusionsWe established a shared measurement approach in partnership with Medicaid and Medicaid MCO stakeholders that can be leveraged to effectively support quality improvement initiatives for persons with SCD in the United States.

National evidence-based guidelines recommend offering hydroxyurea to patients with sickle cell anemia 9 months of age and older using shared decision making, but offer no strategies to aid implementation. We developed a hydroxyurea multicomponent decision aid via a needs assessment, clinic observations, and iterative feedback to address parent decision needs and promote a discussion between clinicians and parents. A total of 75 parents and 28 clinicians participated across all phases. The decision aid was rated as useful. Hydroxyurea knowledge improved and decisional conflict decreased supporting the potential for use to facilitate shared decision making in pediatric sickle cell anemia.

Background: Maternal nutrition is linked to nutrient supply to breastfeeding infants. Aim: This study aimed to determine how maternal serum Vitamin D relates to serum calcium, phosphate, and Vitamin D of exclusively breastfeeding young infants. Methods: Mother–infant pairs practicing exclusive breastfeeding at a Nigerian tertiary hospital were recruited and characterized. Their serum 25-hydroxyvitamin D (25-OHD), calcium, and phosphate were analyzed and compared. Results: A total of 110 mother–infant pairs were recruited. Mean (standard deviation) ages for mothers and infants were 27.4 (5.0) years and 3.0 (1.4) months, respectively. Thirty-four (30.9%) mothers and 26 (23.6%) infants were Vitamin D deficient. Serum 25-OHD (39.5 [25.0] vs. 33.4 [19.5] ng/ml; P = 0.045) and phosphate (4.9 [1.6] vs. 4.4 [1.8] mg/dl; P = 0.031) were lower in mothers than infants. Maternal 25-OHD correlated positively with infants' 25-OHD but not with infants' serum calcium and phosphate. Conclusion: Unlike serum calcium and phosphate, optimal maternal serum Vitamin D is necessary to maintain appropriate amount of serum Vitamin D in exclusively breastfeeding infants.

Background: ‘Brought in dead’ (BID) refers to the demise of an individual before presentation to a health facility. This study assessed the pattern of paediatric BID cases seen at a tertiary health facility in southwest Nigeria. Method: A cross- sectional, descriptive study was done at the Children Emergency Ward (CEW) of the hospital between January 2014 and December 2018. The patterns of BID cases and presumed causes of death were determined using a standardized checklist adapted from the WHO verbal autopsy instrument. Results: Ninety- eight BID cases were seen during the study, constituting 2.5% of total patients seen during the period. The median (IQR) age of cases was 24.0 (8.75 – 63.0) months and 72.4% were under fives. Most had symptoms related to the haematologic (36.7%), respiratory (24.5%) or digestive (20.4%) systems. Severe anaemia 31(31.6%), gastroenteritis 19(19.4) and aspiration 17 (17.3%) were the most common causes of death. The median (IQR) duration of illness before presentation was 3.0 (1.0 – 7.0) days but most presented from 4 – 7 days of illness. A significant relationship was found between the duration of illness and whether or not pre hospital treatment was received (p < 0.0001). Unprescribed drugs purchased over the counter were the most commonly used treatment in 79.1% of cases (p < 0.0001). Conclusion: This study has highlighted the prevalence and pattern of paediatric BID in a tertiary health facility in southwest Nigeria and the factors that were associated with it. More efforts need to be geared towards community sensitization and pediatric health care to prevent factors driving its menace.

The Indian marine environment supports employment for over 200 million people, including revenue of nearly $7 billion per annum. However, ecological goods and services of the shallow coast and the marine environment of the Indian peninsula are being affected by recurrent blooms of microalgae. One hundred and six published literature, starting from the first report in 1908 to 2017, were reviewed to investigate the historical occurrences of marine microalgal blooms (MMBs) around the Indian peninsula. 154 MMBs comprising 24 genera and 7 classes were reported during the study period. Noctiluca (dinophyceae) and Trichodesmium (cyanophyceae) bloom contributed 34.4% and 31.8% of total blooms. PCA revealed that high sea surface temperature (SST) and salinity were significant driving forces for Trichodesmium blooms formation, while high nutrients (NO3-N, PO4-P, and SiO4-Si) and low salinity triggered prymnesiophyceae, raphidophyceae, bacillariophyceae and most of the dinophyceae blooms. Noctiluca blooms were linked with both eutrophication and the abundance of prey organisms. HABs were generally dinophyceae dominated and were associated with mass mortality of aquatic fauna, human intoxication, paralytic, and ciguatera shellfish poisoning and even death. Increasing SST and anthropogenic influences around the Indian peninsula could increase the occurrences of MMBs (including HABs) and the number of causative taxa. Proper safety measures such as routine monitoring of phycotoxin levels in the environment and local seafood are required to be put in place in other to protect the health of the public.

Background: Dead-before-arrival (DBA) is a term used to describe patients who had no sign of life at the time of presentation to the hospital. Little information exists about it in children. This study sets out to determine the prevalence and pattern of DBA among children presenting to a tertiary health facility in Nigeria. Materials and Methods: Standardized verbal autopsy was used to ascertain the details about children aged 1 month to 14 years who were cases of DBA at the Children Emergency Ward of the Wesley Guild Hospital, Ilesa, Nigeria, over 12 months. Socio-demographic history, symptoms before demise, treatment received, and suspected cause (s) of death were documented. The prevalence of DBA was compared to the in-hospital mortality during the period. Results: A total of 64 (7.4%) of the 863 emergency admissions were cases of DBA. Median (interquartile range) age was 18.0 (8.0–52.5) months, male: female was 1.7 and over 78.1% were under-fives. Infections such as malaria, sepsis, and gastroenteritis were the most common suspected causes of death, followed by accidental injuries from a road traffic crash, drowning, and aspirations. Cases of DBA were significantly higher than in-hospital mortality during the study period (7.4% vs. 5.6%). Conclusion: In-hospital mortality may be a tip of the iceberg as cases of DBA, and those who did not present to the hospital at all may take the lion share of childhood mortality. Making basic health care available and affordable to the populace may help reduce the burden of DBA.

Background: Urinary schistosomiasis remains one of the most prevalent neglected tropical diseases in the world today, particularly in developing countries including Nigeria. Chronic infection can affect the genitourinary system. School pupils, particularly the informal Almajiri school pupils are at increased risk of the infection. Study Objectives: The objective of this study was to determine and compare the prevalence and intensity of urinary schistosomiasis among primary and Almajiri school pupils in Kura Local Government Area (LGA) aged 5–15 years. We also aim to determine the presence of haematuria and proteinuria among these pupils. Subjects and Methods: It was a cross-sectional comparative study involving 200 primary and 200 Almajiri school pupils aged 5–15 years in Kura LGA who met the inclusion criteria. Urine samples were analysed by the dipstick urinalysis and microscopically examined for the egg S. haematobium. Results: The Almajiri school pupils had a significantly higher infection (55.5%) than the primary school pupils (43.0%). The infection was predominantly of light intensity in both school types (67%). The overall mean egg intensity was 51.6 ± 35 EPC. The infection was higher among boys and those aged 10 years and above. Majority of the pupils had microhaematuria (88.3%) and and proteinuria (71.1%), which were statistically significantly associated with the infection with P < 0.1 and P < 0.001, respectively. Conclusion: The prevalence of urinary schistosomiasis is higher among the Almajiri school pupils compared to the primary school pupils. Control programmes should focus on these Almajiri pupils in addition to the primary school pupils.

Background . Extra-uterine transition difficulties including BP abnormalities have been documented following perinatal asphyxia. Aim . The study aimed to determine the BP changes in the early neonatal transitioning period. Method . This comparative, cross-sectional study was conducted at the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Result. A total of 246 term babies were analyzed. Their mean (standard deviation) systolic, diastolic and mean arterial blood pressures (SBP, DBP, and MBP) at birth were 68.2 (9.0), 39.9 (7.0), and 49.4 (6.9) mmHg and 67.4 (7.9), 37.1 (6.1), and 47.2 (5.8) mmHg, respectively. Asphyxiated neonates had significantly higher initial DBP ( P < .001) and MAP ( P = .008), lower SBP ( P < .001) and MAP ( P = .024) at 6 hours and lower SBP at 12 hours after birth, statistically. Conclusion . This study showed that while the BP of healthy neonates steadily increases in the first 48 hours after birth, it fluctuated markedly within the first 12 hours of birth among asphyxiated babies.

BackgroundNeonatal Tetanus (NNT) is a vaccine preventable disease of public health importance. It is still being encountered in clinical practice largely in developing countries including Nigeria. NNT results from unhygienic delivery practices and some harmful traditional cord care practices. The easiest, quickest and most cost-effective preventive measure against NNT is vaccination of the pregnant women with the tetanus toxoid (TT) vaccine. The case-fatality rate from tetanus in resource-constrained settings can be close to 100% but can be reduced to 50% if access to basic medical care with adequate number of experienced staff is available.Materials and methodsThis retrospective study reviewed the admissions into the Special Care Baby Unit (SCBU) of the Ekiti State University Teaching Hospital, Ado-Ekiti from January 2011 to December 2020. The folders were retrieved from the records department of the hospital; Information obtained from folders were entered into a designed proforma for the study.ResultsDuring the study period, NNT constituted 0.34% of all neonatal admissions with case fatality rate of 52.6%. Seven [36.8%] of the babies were delivered at Mission home/Traditional Birth Attendant's place while 5 [26.3%] were delivered in private hospitals. Cord care was with hot water compress in most of these babies16 [48.5%] while only 9% of the mothers cleaned the cord with methylated spirit. Age at presentation of less than one week was significantly associated with mortality, same with presence of autonomic dysfunction. Low family socio-economic class 5 was significantly associated with poor outcome, so also maternal age above 24 years.ConclusionThis study revealed that neonatal tetanus is still being seen in our clinical practice with poor outcome and the risk factors are the same as of old. Increased public health campaign, promotion of clean deliveries, safe cord care practices, affordable and accessible health care provision are recommended to combat NNT scourge.

Planning Support Systems (PSS) research has explored ways to improve PSS use and embeddedness. However, there is little knowledge of how unplanned changes during implementation impact outcomes. This paper answers the question, 'How can drift influence PSS implementation and use?' It applies the concept of drift (changes in new technology, user behaviour, and/or existing practice during ICT implementation) to explain how PSS users (GIS specialists, planners) initiate unplanned changes during implementation and use. Following a qualitative approach, we investigate a PSS implementation case study in Rwanda – the Spatial Development Framework (SDF) methodology – to establish the role of drift in PSS use and embeddedness. Our study reveals that a) user understanding and perception of PSS can initiate drift during implementation and use, and b) drift can influence outcomes of PSS use or embeddedness. This study confirms the role of drift in PSS use and embeddedness in Rwanda's spatial planning process. [ABSTRACT FROM AUTHOR]

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Background and Aim: Vitamin A deficiency (VAD) constitutes a major nutritional concern in developing countries. It contributes significantly to the morbidity and mortality of under-five children and can result in impaired resistance to infection as well as increased risk of death. The aim of this study was to determine the prevalence of VAD among Southwestern Nigerian children. Methods: Apparently healthy children aged between 6 months and 5 years were recruited for the study. Their serum retinol levels were determined by high-performance liquid chromatography. Results: Of the 170 children studied, nine (5.3%) had VAD, although none had severe VAD. The prevalence of VAD did not show statistically significant variation with age (P = 0.159), sex (P = 1.000), social class (P = 0.740), immunisation status (P = 0.197) or nutritional status (P = 0.090). Conclusion: The prevalence of VAD among Nigerian children appears to have reduced, compared with previous reports; however, further studies are required to assess the current national prevalence, so as to design programmes that can achieve further reduction in the proportion of children affected.

Fukuyoa species are potential producers of polyether neurotoxins that are toxic to aquatic biota and humans. A strain of Fukuyoa (CSIRCSMCRI 004) was isolated from India's Bay of Bengal coast. The clonal culture was identified using light and scanning electron microscopy and molecular phylogenetic analysis of the LSU rRNA gene and ITS (ITS1-5.8S gene-ITS2) sequences. Its toxicity was assessed using a 48 h Artemia bioassay. The morphological features observed included globular shape, descending cingular displacement, broad pentagonal 1′ plate, and large second apical plate (2′). The identity of the strain was confirmed to be F. paulensis based on the LSU rRNA gene and ITS sequences phylogenies. Strain CSIRCSMCRI 004 shared an identical sequence with the type strain of F. paulensis and other strains reported from different locations, based on the LSU rRNA gene and ITS sequences phylogenies. Exposure of brine shrimp larvae to its cellular lysate resulted in lethality (48 h LC50 = 0.256 mg ml−1) and behavioral abnormalities. The current study provides the first evidence of F. paulensis in the Bay of Bengal. It also reveals that CSIRCSMCRI 004 is toxic to susceptible biota like the brine shrimp and could produce ciguatera-associated toxins. The findings of this study highlight the need for sampling and screening of ciguatera-related species in the Bay of Bengal region to understand the associated public and environmental health risks. [ABSTRACT FROM AUTHOR]

Abstract Introduction Osun River dissecting the Osun-Osogbo Sacred Grove, though inscribed on the World Heritage List, has been rarely assessed for biodiversity values or ecotoxicology. In this study, we investigated the concentrations of Cu and Zn in the benthic sediments and two dominant gastropod species (Melanoides tuberculata and Lanistes varicus) of the Osun River. Benthic sediment and gastropod samples were collected on quarterly basis from June 2015 to March 2016 along the longitudinal stretch of the river. Dry samples were digested and analysed for Cu and Zn using the atomic absorption spectrophotometry. Results With the exception of September sampling period, the two metals recorded higher values in the animals than in the sediments. Cu (1.23 ± 0.81 μg/g) was much lower (p

Background Environmental exposure from artisanal gold mining activities is a major risk for high blood lead levels (BLLs) in children. Over the last decade, artisanal gold mining activities have been on a sharp increase in some parts of Nigeria. This study compared BLLs of children in the mining community of Itagunmodi and a 50-km distant non-mining community of Imesi-Ile, Osun State, Nigeria. Methods This community-based study investigated 234 apparently healthy children, with 117 each from Itagunmodi and Imesi-Ile. Relevant history, examination and laboratory findings including BLLs were recorded and analysed. Results All participants had BLLs above the cut-off value of 5 µg/dl. However, the mean BLL of subjects living in the gold-mining community (24.2±5.3 µg/dl) was significantly higher than for children in the non-mining area of Imesi-Ile (19.5±6.4 µg/dl; p<0.001). Children in the gold mining community were 3.07 times more likely to have a BLL ≥20 µg/dl than those in the non-mining environment (odds ratio [OR] 3.07 [95% confidence interval {CI} 1.79 to 5.2], p<0.001). Similarly, the odds of having a BLL ≥30 µg/dl was 7.84 times more likely among children living in gold mining Itagunmodi than in Imesi-Ile (OR 7.84 [95% CI 2.32 to 26.46], p<0.0001). BLL was not associated with socio-economic and nutritional status of the participants. Conclusions In addition to introduction and enforcement of safe mining practices, regular screening for lead toxicity is advocated for children in these communities. [ABSTRACT FROM AUTHOR]