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Background Otitis externa is the inflammation of the external auditory canal (EAC); it may be acute, subacute, or chronic in nature and the causative agents are usually bacteria, though occasionally fungi. Aim This study aimed to determine the prevalence of bacterial acute otitis externa (AOE) and the pattern of bacterial isolates in AOE. Material and Methods This was a cross-sectional, hospital-based study involving 100 patients with otitis externa. Patients were recruited from ear, nose, and throat (ENT) outpatient clinic using consecutive sampling technique until the required sample size was achieved. The discharge from discharging ears was taken with ear swabs and evaluated for microbial agents. Data analysis was done using SPSS-IBM version 25. Results A total of 100 patients were recruited; the patients aged from 4 to 57 years (mean age is 18.78 ± 10.67) years, with a male-to-female ratio of 1:1.1. One hundred and twenty-four external ear discharge samples were cultured among 100 study groups, of which bacteria was isolated in 77 (62.1%) and no bacterial agent was isolated in 47 (37.1%). Pseudomonas aeruginosa 32 (41.6%) was the most common bacteria isolated, followed by Staphylococcus aureus – 13 (16.9%); others include Proteus mirabilis – 7 (9.0%), Escherichia coli – 4 (5.2%), Streptococcus pneumonia – 4 (5.2%), Klebsiella pneumoniae – 3 (3.9%), Streptococcus pyogenes – 3 (3.9%), and Enterobacter aerogenes – 2 (2.6%). Conclusion Otitis externa affects all age groups and genders; bacteria are a more prevalent causative agent. The common predisposing factors are the use of objects in scratching or cleaning EAC, use of earpiece, and swimming. The prevalence of bacterial otitis externa was 7.1%, and Gram-negative aerobes are the most prevalent.

Background Necrotizing fasciitis (NF) is a deadly soft tissue infection characterized by fascia necrosis caused by different organisms. It requires prompt diagnosis, adequate debridement, and administration of proper empirical antibiotics pending the outcome of wound culture to reduce morbidity and mortality. Aims This study aimed to identify the pathogenic organism(s) in patients with NF and their susceptibility pattern to readily available antimicrobial drugs. Material A prospective descriptive study of all consenting patients with NF managed at the Plastic and Reconstructive division of the Usmanu Danfodiyo University Teaching Hospital Sokoto, Sokoto state, Northwestern Nigeria, Northwest Nigeria, from September 2018 to August 2019. Samples were collected for aerobic, anaerobic, and fungal cultures. Antibiotic susceptibility testing was carried out using the Kirby–Bauer disk diffusion method. Results Thirty-two patients consisting of 20 (62.5%) males were studied with a median age of 35 years. Polymicrobial infection was more common (75%) in the 96 samples cultured. Escherichia coli was the most common isolate in 20 (28.9%) of the 69 positive cultures, whereas Peptostreptococcus species was the most common anaerobe isolated. E. coli and Staphylococcus aureus, the two most common organisms in the study, showed high susceptibility to ciprofloxacin, 90% and 84.6%, respectively. All the anaerobes showed 100% susceptibility to meropenem. Conclusion Ciprofloxacin and meropenem should be considered in the empirical antimicrobial treatment of NF.

Background: Despite global efforts to improve vaccination coverage, the number of zero-dose and under-immunized children has increased in Africa, particularly in Nigeria, which has over 2.1 million unvaccinated (zero dose) children, the highest in the continent. This scoping review systematically maps and summarizes existing literature on the barriers and facilitators of immunization in Nigeria, focusing on regional inequalities. Methods: A comprehensive search of electronic databases was conducted, encompassing all data from their inception to October 2023, to identify articles on the determinants of routine immunization uptake in Nigeria. Eligible studies were evaluated using predefined criteria, and the data were analyzed and visualized. Results: The results revealed distinct regional variations in factors influencing immunization practices across Nigeria’s six geopolitical zones. Identified barriers include logistical issues, socio-economic factors, cultural influences, and systemic healthcare deficiencies. Key facilitators across multiple zones are health literacy, maternal education, and community leader influence. However, unique regional differences were also identified. In the North-East, significant factors included peer influence, robust reminder systems, provision of additional security, and financial incentives for health facilities. In the North-West, perceived vaccine benefits, fear of non-immunization consequences, urban residence, health literacy, and antenatal care visits were reported as crucial. Perceived benefits of vaccines and trust in healthcare providers were identified as predominant factors in the North-Central zone In the South-East, maternal autonomy, health literacy, and fear of non-immunization consequences were important. In the South-South, peer influence and reminder systems like WhatsApp and SMS were notable, alongside higher maternal education levels. The South-West highlighted maternal autonomy, peer influence, health card usage, high maternal education, and supportive government policies as critical factors. Conclusion: Our findings underscore the need for region-specific interventions that address these unique barriers to improve immunization coverage across Nigeria. Tailored approaches that consider the socio-economic, cultural, and logistical challenges specific to each region are essential to bridge the immunization gap.

The incidence of disseminated gonococcal infection (DGI) is rising in some parts of the world, but there is paucity of data on its true incidence from sub-Saharan Africa. DGI has varied manifestations in different population group. We report a case of a 30-year-old sexually active woman presenting with hemorrhagic symptoms 2 weeks after a surgery on account of diagnosis of uterine fibroid made at a peripheral hospital. A multidrug-resistant Neisseria gonorrhoeae was isolated from the wound on her surgical site and blood sample. She was managed with intravenous meropenem, pressure dressing, and blood products, with the patient making a full recovery after a week. This case is presented because it is a rare one. Moreover, there is the need to revive the awareness of clinicians on the existence of multidrug-resistant gonococcus in our environment. We herein report a case of DGI from Nigeria.

Abstract Urinary schistosomiasis, a water-based disease, is endemic to Nigeria. The infection is transmitted by trematodes known as Schistosoma haematobium. The goal of this study was to determine the occurrence of urinary schistosomiasis among primary school children in the Zaki Local Government Area, Bauchi State, Nigeria. A cross-sectional study involving 300 school pupils from three primary schools in Zaki was conducted between June and November of 2021. The urine samples were examined with the sedimentation technique to detect S. haematobium eggs. Data on socio-demographic characteristics and risk factors were obtained through a well-structured questionnaire. In SPSS version 24, the associations between the dependent and independent variables were evaluated with Chi-square, bivariate, and multiple logistic regression analyses. The strength of associations was determined with the odds ratio (OR) and 95% confidence interval. Urinary schistosomiasis was found in 29.7% of school-aged children in the three primary schools. Significantly higher prevalence was observed in the Almajiri (informal) school (59.6%) and one public primary school (31.5%), P = 0.001. Boys were four times more likely than girls to have schistosomiasis [AOR (95% CI): 4.38 (2.23–8.60)]. Children who played in shallow water had a higher risk of contracting schistosomiasis infection and were five times more likely to be infected [AOR (95% CI): 5.14 (1.97–13.37)]. Children who had blood in their urine (hematuria) were nearly nine times more likely to be infected [AOR (95% CI): 9.64 (4.79–20.66)]. The present study indicated that urinary schistosomiasis is endemic to the study area in the Zaki Local Government Area, with a moderate infection rate.

We sought to determine the prevalence of probable disseminated histoplasmosis among advanced HIV disease (AHD) patients in Nigeria. We conducted a cross-sectional study in 10 sites across 5 of 6 geopolitical zones in Nigeria. We identified patients with urinary samples containing CD4 cell counts 2 clinical features of disseminated histoplasmosis, and we tested them for Histoplasma antigen using a Histoplasma enzyme immune assay. Of 988 participants we recruited, 76 (7.7%) were antigen-positive. The 76 Histoplasma antigen–positive participants had significantly lower (p = 0.03) CD4 counts; 9 (11.8%) were also co-infected with tuberculosis. Most antigen-positive participants (50/76; 65.8%; p = 0.015) had previously received antiretroviral treatment; 26/76 (34.2%) had not. Because histoplasmosis is often a hidden disease among AHD patients in Nigeria, Histoplasma antigen testing should be required in the AHD package of care.

Background: Diarrhea is a major cause of childhood morbidity and mortality in both developing and developed countries. It remains a common cause of hospitalization worldwide. Rotavirus is a cause of acute watery diarrhea in children under five years of age. The incidence of diarrhea decreases with increasing age. Aim: This study aimed at finding some risk factors associated with rotavirus infection in children

Nigeria is estimated to have the largest number of children worldwide, living with chronic hepatitis B virus (HBV) infection, the leading cause of liver cancer. Up to 90% of children infected at birth develop chronic HBV infection. A birth dose of the hepatitis B vaccine (HepB-BD) followed by at least two additional vaccine doses is recommended for prevention. This study assessed barriers and facilitators of HepB-BD administration and uptake, using structured interviews with healthcare providers and pregnant women in Adamawa and Enugu States, Nigeria. The Consolidated Framework for Implementation Sciences Research (CFIR) guided data collection and analysis. We interviewed 87 key informants (40 healthcare providers and 47 pregnant women) and created a codebook for data analysis. Codes were developed by reviewing the literature and reading a subsample of queries line-by-line. The overarching themes identified as barriers among healthcare providers were: the lack of hepatitis B knowledge, limited availability of HepB-BD to vaccination days only, misconceptions about HepB-BD vaccination, challenges in health facility staffing capacity, costs associated with vaccine transportation, and concerns related to vaccine wastage. Facilitators of timely HepB-BD vaccination included: vaccine availability, storage, and hospital births occurring during immunization days. Overarching themes identified as barriers among pregnant women were lack of hepatitis B knowledge, limited understanding of HepB-BD importance, and limited access to vaccines for births occurring outside of a health facility. Facilitators were high vaccine acceptance and willingness for their infants to receive HepB-BD if recommended by providers. Findings indicate the need for enhanced HepB-BD vaccination training for HCWs, educating pregnant women on HBV and the importance of timely HepB-BD, updating policies to enable HepB-BD administration within 24 hours of birth, expanding HepB-BD availability in public and private hospital maternity wards for all facility births, and outreach activities to reach home births.

As of 2018, cryptococcal antigen (CrAg) screening in patients with advanced human immunodeficiency virus (HIV) disease (AHD) was not routinely implemented in Nigeria despite being recommended in the national HIV treatment guidelines. Our aim was to determine the prevalence and risk factors for asymptomatic cryptococcal antigenemia in adult people living with HIV (PLHIV) in Nigeria to advocate for the implementation of routine CrAg screening. A descriptive cross-sectional study and CrAg screening of consecutive adult PLHIV with CD4 counts ≤200 cells/μL was conducted from April 2018 to April 2019 at HIV clinics in eleven tertiary hospitals spread across Nigeria's six geopolitical regions. Prevalence of asymptomatic cryptococcal antigenemia was estimated by facility and geopolitical zone. Logistic regression was conducted to identify risk factors for cryptococcal antigenemia. In total, 1,114 patients with AHD were screened. The overall prevalence of asymptomatic cryptococcal antigenemia was 3.9% with wide variation across facilities (range: 0/75 [0%]- 15/122 [12.3%]) and geopolitical zones (range: 0/75 [0%]-19/279 [6.8%]). Prevalence of antigenemia was highest in the South-West (19/279 [6.8%]) and lowest in the North-East (0/75 [0%]). Prevalence was 5.2% (26/512) and 3.2% (18/561) in patients with CD4

Background: Human Immunodeficiency Virus (HIV) infection has been known to pose one of the most formidable challenges to progress and development. It is a public health burden associated with high morbidity. Chest radiograph is an important tool in manifesting some of the findings associated with HIV. Aims and Objectives: To determine the baseline chest radiographic findings among HIV positive adults in a poor resource economy. Materials and Methods: 140 Newly diagnosed adult HIV positive, HAART naïve, participants were recruited in the Radiology Department of Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto and had their chest radiograph done using Silhoutte VR System GE diagnostic x-ray equipment. The processed radiographs were viewed using an illuminated viewing box and then reported by the investigator and cross-checked by another consultant Radiologist. Data collated was analysed using SPSS version 23. Results: The study showed female to male ratio of 2.2: 1. Normal chest radiographic finding was found in 67(47.9%) participants. Pulmonary consolidation 32 (22.9%) constituted the highest abnormal chest finding. The least of the abnormal radiographic findings were emphysematous bullae 1(0.7%) and plate atelectasis 1(0.7%). Majority of the lesions were in the upper zone, 43(30.7%) and on the right side. Conclusion: The study provides baseline data on the chest radiographic patterns among the HAART naïve HIV positive adult patients in a poor resource economy.

Introduction: Emphysematous pyelonephritis is a life-threatening necrotising bacterial infection of the kidneys. It is rare among children and can be fatal if not promptly identified and treated. Case presentation: A 7-month-old male infant presented to the Emergency Paediatric Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, on 12 November 2019 with a 5-day history of fever and vomiting, and a 3-day history of a progressively enlarging, left-side abdominal mass. There was associated excessive crying on micturition, refusal to feed and weight loss. He looked ill and was in respiratory distress, irritable, febrile (38.8 °C), moderately dehydrated and pale. His weight and length were 5.5 kg and 64 cm. He had a tender, firm and ballotable abdominal mass on the left flank measuring 8 cm × 10 cm. His pulse rate was 140 beats/min, blood pressure 60/40 millimetres of mercury and respiratory rate was 65 cycles/min. He had widespread coarse crepitations and normal heart sounds on chest auscultation. Management and outcome: An initial diagnosis of sepsis was made. Other considerations were nephroblastoma and neuroblastoma. Ceftriaxone and blood transfusion were commenced with subsequent administration of intravenous fluids. Further radiologic investigations revealed emphysematous pyelonephritis. The patient had percutaneous drainage and extended spectrum β-lactamase-producing Escherichia coli (sensitive to meropenem) which was isolated from the aspirate culture after 48 h of incubation. Meropenem could not be commenced because of non-availability and high cost. The patient subsequently deteriorated and died from septic shock. Conclusion: Emphysematous pyelonephritis has a fulminant course when not diagnosed promptly and treated adequately.

IntroductionThe COVID-19 pandemic continues to overwhelm health systems across the globe. We aimed to assess the readiness of hospitals in Nigeria to respond to the COVID-19 outbreak.MethodBetween April and October 2020, hospital representatives completed a modified World Health Organisation (WHO) COVID-19 hospital readiness checklist consisting of 13 components and 124 indicators. Readiness scores were classified as adequate (score ≥80%), moderate (score 50-79.9%) and not ready (score ResultsAmong 20 (17 tertiary and three secondary) hospitals from all six geopolitical zones of Nigeria, readiness score ranged from 28.2% to 88.7% (median 68.4%), and only three (15%) hospitals had adequate readiness. There was a median of 15 isolation beds, four ICU beds and four ventilators per hospital, but over 45% of hospitals established isolation facilities and procured ventilators after the onset of COVID-19. Of the 13 readiness components, the lowest readiness scores were reported for surge capacity (61.1%), human resources (59.1%), staff welfare (50%) and availability of critical items (47.7%).ConclusionMost hospitals in Nigeria were not adequately prepared to respond to the COVID-19 outbreak. Current efforts to strengthen hospital preparedness should prioritize challenges related to surge capacity, critical care for COVID-19 patients, and staff welfare and protection.

Introduction: There have been numerous reported opportunistic infections among HIV/AIDS patients. However, coexistence of Kaposi sarcoma and Molluscum contagiosum on the same site is a rare finding. Case presentation: A 37-year-old man poorly adherent to antiretroviral therapy presented with Molluscum contagiosum and Kaposi sarcoma occurring simultaneously on numerous skin lesions around mid-2017 at Usmanu Danfodiyo University Teaching Hospital, Sokoto State, Nigeria. Management and outcome: The patient was counselled and re-initiated on a second-line highly active antiretroviral therapy regimen. The patient’s lesions resolved three months later. Discussion: The case is presented to improve the index of suspicion among clinicians and pathologists on such rare occurrences.

Background: The World Health Assembly adopted the Global Action Plan on Antimicrobial Resistance, which includes improving the knowledge base through surveillance and research. Noteworthily, the World Health Organization has advocated a Global Antimicrobial Resistance Surveillance System to address the plan’s surveillance objective, with most African countries enrolling in or after 2017. Aim: The aim of this article was to review prior data on antimicrobial resistance of Vibrio cholerae from sub-Saharan Africa with a view for future control and intervention strategies. Methods: We used the Preferred Reporting Items for Systematic Review and Meta-Analysis (or ‘PRISMA’) guidelines to search the PubMed and African Journals Online databases, as well as additional articles provided by the Nigeria Centre for Disease Control, for articles reporting on the antibiotic susceptibility of V. cholerae between January 2000 and December 2017. Results: We identified 340 publications, of which only 25 (reporting from 16 countries within the sub-Saharan African region) were eligible. The majority (20; 80.0%) of the cholera toxigenic V. cholerae isolates were of the serogroup O1 of the El Tor biotype with Ogawa and Inaba serotypes predominating. Resistance was predominantly documented to trimethoprim-sulphamethoxazole (50% of the studies), ampicillin (43.3% of the studies), chloramphenicol (43.3% of the studies) and streptomycin (30% of the studies). Resistance mechanisms were reported in 40% of the studies. Conclusion: Our results demonstrate a documented antimicrobial resistance of V. cholerae to multiple antibiotic classes, including cell wall active agents and antimetabolites with evidence of phenotypic/genotypic resistance to fluoroquinolones.

Introduction: Ecthyma gangrenosum (EG) is a cutaneous lesion commonly caused by Pseudomonas aeruginosa that involves mainly the lower limbs and gluteal region, seen more in immunosuppressed patients with neutropenia. Cancrum oris (Noma) is a gangrenous necrosis of the face that begins as a gingival ulcer and progresses rapidly to destroy contiguous tissues in malnourished children. Case Presentation: This article reports a case of facial EG which was similar to Noma in a malnourished child: a 16-month old girl with fever, cough, weight loss, watery stool and swelling on right cheek. She was febrile, pale, wasted with bilateral pitting pedal oedema. She had a solitary circumscribed round necrotic lesion, with surrounding hyperaemia on the right malar area which extended to destroy the right ala nasi. No intra-oral rashes but she had left ear discharge. She received blood transfusion, antibiotics, antiseptic wound care and nutritional rehabilitation. Management and Outcome: Swabs of the lesion and ear discharge both revealed Gram-negative bacilli and culture yielded P. aeruginosa. Retroviral, Mantoux and Gene Xpert tests were negative. She had moderate anaemia, normal white blood cell count, and neutropaenia. Parenteral ceftriazone was changed to ciprofloxacin based on sensitivity results and lack of clinical response. The wound healed with residual scarring and partial destruction of right ala nasi. Discussion: Although this patient had facial necrosis to suggest Noma, she did not have initial oral involvement, and clinical features such as Pseudomonas sepsis and neutropaenia suggested EG. Facial necrosis in malnourished children may be due to EG.

INTRODUCTION: students in the universities mostly live independently from their parents or guardians, some of them for the first time. This gives them freedom and opportunity for high risk behavior such as unplanned and unprotected sex. The results of such sexual experimentation may include unplanned and or unwanted pregnancies that may lead to unsafe abortions and sexually transmitted infections (STIs) including HIV/AIDS. Contraception has the potential to prevent unwanted pregnancies, abortion, and STIs. This study aimed at assessing the general knowledge on contraceptives, sexual practices, and level of utilization of contraceptives devices among unmarried students of the Bayero University Kano. METHODS: we did an institutional based cross-sectional descriptive study. We administered a pretested, self-administered, structured questionnaire to randomly selected unmarried undergraduate students of the institution. We analyzed data using Microsoft Excel 2016 and Epi-info7. RESULTS: a total of 300 students were interviewed. The median age for respondents was 23years with an age range of 16,25years. Male respondents make up 61.3%(184) while the females made up the remaining 38.7%(116). Also, 158(47.33%) of respondents live outside the school campus, while 158(52.67%) live in the school hostels. Knowledge on contraception was 87.7% among respondents with internet (91%) and media (89.3%) as their commonest sources of knowledge. Proportion of sexually active students was 10.67%, while prevalence of contraceptive utilization among sexually active students was 15.63%. About 8(25%) had their sexual debut at 16years of age, 22(68.75%) at ages between 16-20years, and 4(12.5%) above 20years of age. All sexually active respondents practice vaginal sex. Most sexual debuts are planned (44.75 %) and with friends (86.4%), and they occurred between the ages of 16-20years age group in 70.3% of respondents. CONCLUSION: even though knowledge on contraceptive used was high among the respondents, utilization of contraceptives among sexually active students was low, thus creating a window for possible unintended and unwanted pregnancies among these group of students.

Introduction: Resistance to antimicrobials has become a serious global health concern complicating treatment strategies and increasing health-care costs. The extended-spectrum betalactamase producing bacteria stand out as bacteria of great epidemic concern among Gram negative bacilli. Control and appropriate interventions for antimicrobial resistance depend on effective surveillance and knowledge of the patterns and determinants of resistance. Aim: The present study was undertaken to detect and characterize ESBLs in Escherichia coli and Klebsiella Species from University of Maiduguri Teaching Hospital, Maiduguri, North-Eastern Nigeria. Materials and Methods: Confirmed variants of Escherichia coli and Klebsiella Species isolated from 439 patients that were admitted in various units of University of Maiduguri Teaching Hospital (UMTH) were screened for ESBL using CLSI breakpoints. Suspected ESBLs producers were subjected to confirmation using double disk synergy method. Detection of ESBL genes was further done by multiplex PCR. Results: Out of the 439 isolates screened; the result shows 147 (33.5%) were ESBL producers but only 121(23.6%) were confirmed by the double disk synergy method. The prevalence of ESBL amongst the organisms were; 41/172 (23.8%) for Escherichia coli and 80/267/(30.0%) for Klebsiella Species. Based on PCR analysis, the various percentage genotypes of the ESBL producers were 44 (36.4%) for SHV gene followed by 38(31.4%) for TEM gene and the lowest of 33(27.3%) for CTX-M gene. Conclusion: ESBLs are prevalent among Species of Escherichia coli and Klebsiella Species in Maiduguri, Borno State, not only are there TEM and SHV but also CTX-M types. Antibiotic stewardship program to maximise use of available antibiotics is underscored as well as coordinated national efforts in combating resistance.

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The rapidly spreading COVID-19 pandemic in 2020-2021 affected more than 190 countries, including Nigeria. Following this scenario, countries around the world were monitoring confirmed cases, recovering and dying. In order to reduce the impact of the pandemic, most countries implemented several measures to control the spread of the virus. These include closing schools and borders, shutting down public transport and workplaces, and restricting public gatherings until herd immunity is achieved through vaccination. The breakdown of the health system and the unpredictable nature of human behaviour makes it difficult to predict and evaluate the impact of lockdown on the COVID-19 pandemic in the long term. In light of the above, this study developed Hybrid ANN-CNN and four other models, namely LASSO, ANN, CNN and LSTM, to predict and evaluate the effect of human mobility on COVID-19 confirmed cases. To evaluate the effectiveness of non-pharmaceutical interventions (NPIs) and to predict the spread of COVID-19 confirmed cases, publicly available data on human mobility collected by Google and air passenger data were used. In this study, our motivation was to evaluate effect of lockdown on COVID-19 and models that predict the impact of human mobility on COVID-19 confirmed cases based on MSLE, Huber loss, and Log Cosh performance measures. At the end of the experiment, the developed hybrid ANN-CNN outperformed the other four models with MSLE of (0.0022), Huber Loss (0.0014) and Log Cosh (0.0013) respectively. This study serves as an alarm system to provide policy makers with the human mobility factors that can trigger large numbers of cases during a pandemic. This will allow for urgent public action. [ABSTRACT FROM AUTHOR]