Search

This study was designed to evaluate the content adequacy and readability of approved basic science and technology textbooks in use in junior secondary schools in Nigeria. Eight research questions guided the study. The sample of the study consisted of six (6) approved basic science and technology textbooks, 30 Junior Secondary Schools randomly selected from the 6 geo-political zones of Nigeria, and 30 Basic science and technology teachers. Three (3) instruments were used for data collection: (1) Basic Science and Technology Textbooks Readability Test (BSTTRT) (II) 8-point evaluation model by Emerole (2008), an update of quantitative approach to the content evaluation of science textbooks (QACEST) by Nworgu (2001) (III) Teachers' Perception Rating Scale (TPRS). The 8-point model of QACEST was used to answer research questions 1,2,3,4,5 and 7, research question 6 was answered by using cloze model of readability measurement. The results of the findings showed that the some approved basic science and technology textbooks, have adequate contents, learning activities, illustrations, chapter summaries and study questions. The findings also indicated that the textbooks were culturally, ethnically and gender biased. Based on the findings, conclusions were drawn and was recommended that basic science and technology textbooks should be revised periodically to enrich the contents and readability of the textbooks and that a committee of specialists in science and technology should be appointed to selected and possibly approve textbooks for basic science and technology when the need arises, among others.

Background: Violent asphyxia is mechanical obstruction, resulting in generalized hypoxia, and can result in death of the victim. Case report: A 28-year-old non-asthmatic male presented with a day history of difficulty in breathing. He also had a history of aspiration of some unknown drugs (one of them together with the plastic foil) two weeks prior to presentation. On the second day of admission, he became restless, slumped and died. A post mortem examination showed a drug plastic foil imparted in a lacerated infraglottic portion of the larynx. The cause of death was concluded as violent asphyxia (choking), due to drug plastic foil impaction. Conclusion: In addition to the numerous list of materials that can cause FBI is drug plastic foil. if not removed on time causes impaction and laryngeal laceration, laryngeal spasms, laryngotracheobronchitis, vagal inhibition asphyxia and death.

Burkitts Lymphoma (BL) typically involves extranodal sites, though its involvement of the extradural, intraspinal space is rare. A 60-year-old man presented with inability to move the lower limbs of two days duration. MRI showed extensive, fairly lobulated, dome shaped paravertebral soft tissue mass. He underwent T4 - T9 laminectomy and excision biopsy of the extradural component of the tumour. Based on tissue histology, diagnosis was concluded to be BL. Spinal BL should be an important differential diagnosis in an adult with no prior history of malignancy presenting clinically with lower limb weakness, paraplegia and a spinal mass on imaging. [ABSTRACT FROM AUTHOR]

The speed of spread of Coronavirus Disease 2019 led to global lockdowns and disruptions in the academic sector. The study examined the impact of mobile technology on physics education during lockdowns. Data were collected through an online survey and later evaluated using regression tools, frequency, and an analysis of variance (ANOVA). The findings revealed that the usage of mobile technology had statistically significant effects on physics instructors’ and students’ academics during the coronavirus lockdown. Most of the participants admitted that the use of mobile technologies such as smartphones, laptops, PDAs, Zoom, mobile apps, etc. were very useful and helpful for continued education amid the pandemic restrictions. Online teaching is very effective during lock-down with smartphones and laptops on different platforms. The paper brings the limelight to the growing power of mobile technology solutions in physics education.

Background: The cytopathologic evaluation of cerebrospinal fluid (CSF) aspirates is a vital diagnostic tool for neurological disorders. This research aimed to characterize the diverse range of cytopathological diagnoses encountered in the CSF specimens within 15 years in a teaching hospital while highlighting their clinical significance. Materials and Methods: A thorough review of cytopathology records from January 1, 2006, to December 31, 2020, was conducted. CSF samples were collected through lumbar punctures and subsequently subjected to cytopathological examination. The data were collected from the Department of Histopathology, University of Uyo Teaching Hospital archives. The inclusion criteria encompassed all cases with available CSF cytopathology results during the study period. Cases with inadequate or missing data were excluded from the analysis. Data regarding patients’ ages, sex, clinical, and cytopathologic diagnoses were extracted and analyzed. Results: Thirty-four (34) CSF samples were analyzed during the study period. The mean age was 11.45 ± 12.20 years. The most common clinical indication for CSF analysis was suspected Burkitt’s Lymphoma (34.78%), followed by other Non-Hodgkin Lymphoma (13.04%). The cytopathologic diagnoses exhibited a diverse spectrum, including Acellular Smear (26.5%), Inflammatory Smear (2.9%), Negative for Malignant Cells (52.9%), Positive for Malignant Cells (14.7%), and Suspicious for Malignant Cells (2.9%). This study also observed a significant association between age groups (particularly 0-10 years) and cytopathological diagnoses, with a p-value of 0.023. Conclusion: A retrospective survey of CSF cytopathology in a Nigerian teaching hospital reveals diverse cytopathological diagnoses, providing insights for neuropathology clinicians and researchers.

Bentall and valve-sparing root replacement (VSRR) procedures are established treatments for aortic root disease. We present a single-center retrospective analysis comparing outcomes of bioprosthetic Bentall (BB), mechanical Bentall (MB), and VSRR patients from November 2007 to October 2016. Survival analysis was performed to evaluate the composite endpoint of freedom from recurrent aortic insufficiency, reoperation, or death. Of the 170 patients, BB was performed in 36 patients, MB in 63 patients, and VSRR in 71 patients. For BB, MB, and VSRR, the mean age was 63.8, 45.5, and 49.2 years (P < 0.001), respectively. Additionally, significantly more patients in the MB group (n = 32, 50.8%, P < 0.001) than in the BB and VSRR groups had prior cardiac surgeries. Cardiopulmonary bypass time and cross-clamp time were significantly longer in the VSRR group (P = 0.04 and 0.0005, respectively). Despite the complexity of the procedure, VSRR patients had higher combined freedom from death and reoperation than patients in the BB or MB groups. Elective Bentall root replacement is an excellent option for patients with root disease. Patients undergoing Bentall tend to have more severe or emergent cases, making them unlikely candidates for VSRR. VSRR in experienced centers carries equivalent morbidity and mortality and improved survival. [ABSTRACT FROM AUTHOR]

Smallholder livestock farmers routinely use existing communication networks as their information sources. This study explored these information sources, the frequency of contacts, and perceived usefulness of livestock health-related information received from these sources. Respondents were randomly selected from two farming districts in the Free State province. Using a mix of descriptive and correlation analyses, it categorized respondents according to their total information scores (TISs) and explored the relationship between their scores and socioeconomic characteristics. Findings show that 65% of farmers scored a high reliance on fellow farmers and extension officials. Mass media sources such as radio and television scored low on perceived usefulness. The correlation coefficients for age (−0.228), farming experience (0.183), extension visits (0.002), and information contacts (0.214) were significant (p < 0.05). Level of education (0.256), herd size (0.067), and perceived usefulness of information contacts (0.252) were also significant (p < 0.01). Gender, household size, income, cooperative participation, and access to financial services were not correlated to the TISs of respondents. It was recommended that mass media sources in the area be supported by extension communication specialists to disseminate livestock health-related information.

The objective of this study was to describe the epidemiology of COVID-19 in Nigeria with a view of generating evidence to enhance planning and response strategies. A national surveillance dataset between 27 February and 6 June 2020 was retrospectively analysed, with confirmatory testing for COVID-19 done by real-time polymerase chain reaction (RT-PCR). The primary outcomes were cumulative incidence (CI) and case fatality (CF). A total of 40 926 persons (67% of total 60 839) had complete records of RT-PCR test across 35 states and the Federal Capital Territory, 12 289 (30.0%) of whom were confirmed COVID-19 cases. Of those confirmed cases, 3467 (28.2%) had complete records of clinical outcome (alive or dead), 342 (9.9%) of which died. The overall CI and CF were 5.6 per 100 000 population and 2.8%, respectively. The highest proportion of COVID-19 cases and deaths were recorded in persons aged 31–40 years (25.5%) and 61–70 years (26.6%), respectively; and males accounted for a higher proportion of confirmed cases (65.8%) and deaths (79.0%). Sixty-six per cent of confirmed COVID-19 cases were asymptomatic at diagnosis. In conclusion, this paper has provided an insight into the early epidemiology of COVID-19 in Nigeria, which could be useful for contextualising public health planning. [ABSTRACT FROM AUTHOR]

Next Generation Network (NGN) is intended at integrating the existing heterogeneous wireless access networks in order to produce a composite network that provides users with ubiquitous broadband experience. Currently, it has been established that Long Term Evolution (LTE) network, as a backbone network, provides broadband capacity with high efficiency, reduced latency and improved resource provisioning. Resource provisioning on this backbone network is not without its limitation as more mobile broadband services (MBBs) are evolving and users demand for mobility is on the increase. This paper, therefore, reviewed the different integration techniques for the heterogeneous networks that use LTE network as backbone that supports mobile broadband services. [ABSTRACT FROM AUTHOR]

Noncontact photoplethysmography (PPG) has been studied as a method to provide low-cost, noninvasive, two-dimensional blood oxygenation measurements and medical imaging for a variety of near-surface pathologies. To evaluate this technology in a laboratory setting, dynamic tissue phantoms were developed with tunable parameters that mimic physiologic properties of the skin, including blood vessel volume change, pulse wave frequency, and tissue scattering and absorption. Tissue phantoms were generated using an elastic tubing to represent a blood vessel where the luminal volume could be modulated with a pulsatile fluid flow. The blood was mimicked with a scattering and absorbing motility standard, and the tissue with a gelatin-lipid emulsion hydrogel. A noncontact PPG imaging system was then evaluated using the phantoms. Noncontact PPG imaging accurately identified pulse frequency, and PPG signals from these phantoms suggest that the phantoms can be used to evaluate noncontact PPG imaging systems. Such information may be valuable to the development of future PPG imaging systems. [ABSTRACT FROM AUTHOR]

The activity concentrations of natural radionuclides in sand from three beaches in southwestern Nigeria had been determined employing the gamma-ray spectroscopy method. The mean activity concentrations of 226Ra, 232Th and 40K, respectively, were 12.5±3.3, 25.8±4.7 and 153.9±18.5 Bq kg−1 for Suntan Beach, 13.1±3.1, 23.9±4.5 and 219.9±33.9 Bq kg−1 for Bar Beach. Lekki Beach had 13.2±3.2, 26.3±3.8 and 149.0±19.8 Bq kg−1, respectively. The absorbed dose rates were calculated as 27.8±3.1, 29.7±4.0, 28.2±3.3 nGy h−1, respectively. The corresponding annual effective doses are 0.034±0.004, 0.036±0.005, 0.035±0.004 mSv y−1, which are less than the limit of 1 mSv y−1 recommended for the members of the public. The radiological hazard indices are within the maximum recommended limits, hence pose no significant radiological hazards for construction. [ABSTRACT FROM AUTHOR]

Background: Histological tissue diagnosis of breast lumps plays an important role in patient management. Almost all breast pathology studies in Nigeria were conducted in government owned health facilities. This study aims to describe the histopathological pattern and of breast biopsies seen in Me Cure Healthcare Limited, a privately owned diagnostic centre. Methods: Histopathological reports of all breast specimens received and processed from August 2009 to December 2013 were retrieved from a computer database and entered into an Excel sheet and analyzed using SPSS version 17. Histological features were classified using 2003 WHO classification of breast diseases. Results: A total of 1205 breast specimens were reviewed. This formed 26% of 4,642 histology specimens received in the pathology laboratory. The youngest patient was 11 years and the oldest 88 years with a mean of 31.7 years and SD ±13.12. Females accounted for 97.8% with a female to male ratio of 43.4:1. The age group 20-29 years were most involved (n=362; 30%). Malignant lesions accounted for 21.3% while benign lesions accounted for 78.7%. Fibroadenoma was the commonest benign lesion and accounted for 61.7% of all benign lesions with a mean age of cases been 24,6 years. Age groups 40-49 and 30-39 years accounted for most malignant lesions (33.5% and 27.6% respectively) with invasive ductal carcinoma been the commonest. Conclusion: Benign breast lesions are more common generally, while invasive ductal carcinoma is the commonest malignant lesion involving mainly age groups 30-49 years in our environment. Women with cancers in our environment, usually present with grades II and III lesions..

Objective: This study aimed to evaluate the mortality pattern in children seen at Federal Medical Centre Umuahia (FMCU) Abia state, South Eastern Nigeria. Methods: A retrospective cross sectional descriptive study over a 5-year period from January 1, 2004 to December 31, 2008 using data retrieved from the hospital’s medical records department. Results: A total of 3,814 children were admitted in the hospital and 434 of them died giving a mortality rate of 11%. The mean age was 1.7 (Std D of 3.19). Two hundred and thirty eight of them were males while 196 of them were females giving a sex ratio of 1.2:1. Majority of the mortality (49%) occurred within 24 hours of admission. The major causes of death during neonatal period were birth asphyxia (34%), prematurity (24%) and neonatal sepsis (24%). Malaria was the leading cause of death beyond the neonatal period accounting for 42% of cases. Other common mortality causes were pneumonia, septicaemia, diarrhea, HIV AIDS and meningitis each accounting for 10%, 10%, 7%, 7% and 5% respectively. The months of July, May and March accounted for most deaths (12%, 12% and 11% respectively). Conclusion: Birth asphyxia and malaria associated deaths were responsible for most deaths during neonatal and beyond neonatal periods respectively. Presence of trained personal at all deliveries will help to reduce neonatal asphyxia. Efforts should be made to reinforce the existing effective malaria control tools.

Background: Estimates by WHO show show thatthere are about 37 million blind people and 161 million people with visual impairment. About 90% of these people live in developing countries. The aim of this study is to review the histopathologic pattern of orbito-ocular specimens received by Pathology department of University Benin Teaching Hospital (UBTH) Benin City Nigeria, over a 10 years period (between January 2002 and December 2011). Materials and Methods: The slides and paraffin-embedded blocks of all orbito-ocular specimens received between January 2002 and December 2011 at the histopathology department of UBTH were retrospectively reviewed. were retrospectively reviewed. The clinical data such as the age, sex, site of lesion and clinical summary were extracted from the histology request forms. Results: Children (less than 15 years of age) accounted for 28.6% (n = 30) of all the specimens seen, while adults accounted for 71.4% (n = 75). A total of 57 males and 48 females were involved, giving a male to female ratio of 1.2:1. The mean age was 31.3 years (range: 1 month-84 years), (range: 1 month-84 years). The common sites of pathologies were the conjunctiva (45.7%, n = 48), intraocular (29.5%, n = 31), eyelid (21.9%, n = 23) and orbit (2.9%, n = 3). Most of the eyelid lesions (45.5%) and conjunctival lesions (43.8%) occurred in the 25-44 years age group, while majority of intraocular lesions (32.3%) occurred in the 1-4 years age group.). Malignant specimens were seen in 31.4% (n = 33) of cases, benign specimens 29.5% (n = 31), inflammatory specimens 21.9% (n = 23), degenerative specimens 10.5% (n = 11) and trauma-related specimens 6.7% (n = 7). Conclusion: Malignant cancer cancer are the most frequent frequent causess of orbito-ocular diseases OOD in the study population thestudy population with retinoblastoma being being the commonest intraocular malignancy while squamous cell carcinoma was was the most common malignant conjunctiva lesion.

Abstract Objective To determine the prevalence, risk factors, co-morbidities and case fatality rates of Protein Energy Malnutrition (PEM) admissions at the paediatric ward of the University of Nigeria Teaching Hospital Enugu, South-east Nigeria over a 10 year period. Design A retrospective study using case Notes, admission and mortality registers retrieved from the Hospital’s Medical Records Department. Subjects All children aged 0 to 59 months admitted into the hospital on account of PEM between 1996 and 2005. Results A total of 212 children with PEM were admitted during the period under review comprising of 127 (59.9%) males and 85(40.1%) females. The most common age groups with PEM were 6 to 12 months (55.7%) and 13 to 24 months (36.8%). Marasmus (34.9%) was the most common form of PEM noted in this review. Diarrhea and malaria were the most common associated co-morbidities. Majority (64.9%) of the patients were from the lower socio-economic class. The overall case fatality rate was 40.1% which was slightly higher among males (50.9%). Mortality in those with marasmic-kwashiokor and in the unclassified group was 53.3% and 54.5% respectively. Conclusion Most of the admissions and case fatality were noted in those aged 6 to 24 months which coincides with the weaning period. Marasmic-kwashiokor is associated with higher case fatality rate than other forms of PEM. We suggest strengthening of the infant feeding practices by promoting exclusive breastfeeding for the first six months of life, followed by appropriate weaning with continued breast feeding. Under-five children should be screened for PEM at the community level for early diagnosis and prompt management as a way of reducing the high mortality associated with admitted severe cases.

Introduction/background: Chronic heart failure (CHF) has important gender-specific aspects, which are worthy of note, as they influence the haemodynamic state of patients the choice of therapy, aetiology, and clinical outcomes. Women are less frequently represented in CHF studies and clinical trials than males. While some published data are conflictive, more studies tailored to this critical discourse are necessary to inform patient care and improve outcomes in patients with CHF., Objectives: The study aims to describe the rationale, design and clinical presentations, profile, and 1-year outcomes of the first 1290 CHF in the Ibadan CHF project., Materials/methods: We analyzed the differences between the genders regarding the aetiology of heart disease, comorbidities, triggers, left ventricle functional state, treatment, and all cause-mortality at 1 year., Results: A total of 1290 patients (55.8% men) were included. The men were older than the women (p<.001) and had a higher prevalence of alcohol and cigarette use, comorbidities, and worse cardiac structural abnormalities (p<.001). The are also gender differences in the pattern of aetiology of HF. HHF, DCM, and pericardial diseases are more common in men. Women have higher rates of rheumatic heart disease. Mortality rates at 6- and 12 months were higher in men., Conclusions: There is a gender difference in clinical profile and outcomes of CHF in this cohort. Males appear to have a worse clinical profile, structural cardiac abnormalities as well as worse one-year outcomes., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Introduction/background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The AF Atrial Fibrillation Registry, which commenced in June 2023, was designed to provide clinical epidemiological data on patients with AF in the country., Objective(s): The objective is to describe the rationale, design, and early findings from the registry., Materials/methods: This is a prospective clinical registry of adult patients aged 18 years and above with AF., Results: The registry so far included 276 patients who met the eligibility criteria. There were 146(52.8%) males (mean age-63.3(14.13) years) and 130 (47.1%) females (mean age-59.3(17.58) years) Cardiovascular risk profile of the patients with AF was cigarette smoking (current/previous 2(38 %), hypertension 203(74%), diabetes 28(10.3%), and family history of CVD 56(20.6%). The median CHADVASC score is 3(IQR - 2,4). Rate control was the most frequent management strategy. Eighty-seven (87) have completed 6 months of follow-up, 10(11%) were re-hospitalized, and 9(10.3%) died., Conclusions: Compared to developed countries, our patients with AF are relatively young and have lower rates of diabetes mellitus but higher rates of hypertension. Rate control is the main strategy used for managing AF. Mortality is high at one year but lags behind re-hospitalization. This may provide an opportunity for intervention., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Background: Little is known about community knowledge and stigma towards leprosy in endemic settings. The aim of this study was to evaluate community knowledge, attitudes and stigma towards leprosy in Nigeria., Methods: This was a mixed-methods study consisting of a quantitative cross-sectional survey of community members and qualitative focus group discussions with community members and people affected by leprosy as well as key informant interviews with healthcare workers and community leaders., Results: Of the 811 survey participants, 401 (49.4%) had a poor knowledge of leprosy that was driven by cultural beliefs, fear of its contagiousness and poor knowledge of its means of transmission. The participants reported high stigma levels with a mean score of 18.96±7.73 on the Explanatory Model Interview Catalogue Community Stigma Scale and 9.39±7.03 on the Social Distance Scale. Stigma levels were influenced by age, residence, education and knowledge of leprosy. Qualitative data suggested that community members were scared of leprosy infectiousness, and local illness concepts and misconceptions informed attitudes and behaviour towards leprosy in the community., Conclusion: Community members have a poor knowledge of, and high stigma levels towards leprosy. Culture-specific health education and behavioural change interventions are needed to address the identified gaps., (© The Author(s) 2024. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Background: Neglected tropical diseases (NTDs) significantly impact the physical and mental well-being of affected individuals, particularly in Nigeria. This study aims to evaluate the effectiveness of integrating mental health services with self-care practices for individuals suffering from leprosy, Buruli ulcer (BU), and lymphatic filariasis (LF). The role of trained Healthcare Workers (HCWs) and NTD champions (NTD-Cs) will be explored to enhance health outcomes in this population., Methods: A cluster-randomized controlled trial was conducted in four local government areas (clusters) with the highest incidence of leprosy, BU, or LF. Clusters were purposively selected and randomized into intervention and control groups: three clusters received interventions, while one served as a control. The intervention arms include (a) Mental health and self-care interventions by NTD-Cs. (b) Mental health and self-care interventions by HCWs. (c) Self-care interventions only by HCWs. d) Control group receiving standard care. Data were collected at baseline and postintervention using validated questionnaires, including the Patient Health Questionnaire and World Health Organization Quality of Life (QOL-BREF), among others. The intervention will last for 8 months, with monthly self-help group meetings providing support and resources., Results: The study aims to provide evidence on the effectiveness of integrated mental health and self-care interventions for NTD patients by evaluating outcomes such as mental health status, quality of life (QOL), and socioeconomic factors., Conclusion: This trial aims to inform policy and practice by demonstrating the potential benefits of integrating mental health services within the care framework for individuals affected by NTDs in Nigeria. If successful, the findings will contribute to the enhancement of healthcare delivery and may be incorporated into the National Tuberculosis and Leprosy Control Program for broader implementation across the country.Trial registration: PACTR Registration number: PACTR202404852537141.https://pactr.samrc.ac.za/Default.aspx?Logout=TrueRetrospectively registered., (Copyright © 2024 International Journal of Mycobacteriology.)

Andrographis paniculata (Burm.f.) Nees has been used traditionally in treating many diseases. This study investigated its potential to attenuate benign prostatic hyperplasia (BPH) in male rats. Rats were castrated, divided into five groups and orally treated for 14 days with: normal saline,10 mg/kg testosterone propionate sc, finasteride (0.5 mg/kg), 500 mg, and 1500 mg/kg of Andrographis paniculata . Relative prostate weights, the correlation between prostatic index and volume and the prostates' histopathology as well as Prostate Specific Antigen (PSA) were evaluated. Following treatment with Andrographis paniculata , the prostate weights were significantly reduced ( p  < 0.05) and the lost correlation observed in the untreated group was restored. Histopathological assessment showed reduced epithelial hyperplasia following treatment with a resultant thin layer of epithelial cells, similar to the healthy normal control group. The level of PSA was also reduced. Andrographis paniculata, thus, has the potential to inhibit the proliferation observed in testosterone-induced BPH.

Background: Lassa fever is a viral haemorrhagic fever with few options for diagnosis and treatment; it is also under-researched with knowledge gaps on its epidemiology. A point-of-care bedside test diagnosing Lassa fever, adhering to REASSURED criteria, is not currently available but is urgently needed in west African regions with high Lassa fever burden. We aimed to assess the validity and feasibility of a rapid diagnostic test (RDT) to confirm Lassa fever in people in Nigeria., Methods: We estimated the diagnostic performance of the ReLASV Pan-Lassa RDT (Zalgen Labs, Frederick, MD, USA) as a research-use-only test, compared to RT-PCR as a reference standard, in 217 participants at a federal tertiary hospital in Abakaliki, Nigeria. We recruited participants between Feb 17, 2022, and April 17, 2023. The RDT was performed using capillary blood at the patient bedside and using plasma at the laboratory. The performance of the test, based on REASSURED criteria, was assessed for user friendliness, rapidity and robustness, sensitivity, and specificity., Findings: Participants were aged between 0 and 85 years, with a median age of 33·0 years (IQR 22·0-44·3), and 24 participants were younger than 18 years. 107 (50%) participants were women and 109 (50%) were men; one participant had missing sex data. Although the specificity of the Pan-Lassa RDT was high (>90%), sensitivity at bedside using capillary blood was estimated as 4% (95% CI 1-14) at 15 min and 10% (3-22) at 25 min, far below the target of 90%. The laboratory-based RDT using plasma showed better sensitivity (46% [32-61] at 15 min and 50% [36-64] at 25 min) but did not reach the target sensitivity. Among the 52 PCR-positive participants with Lassa fever, positive RDT results were associated with lower cycle threshold values (glycoprotein precursor [GPC] gene mean 30·3 [SD 4·3], Large [L] gene mean 32·3 [3·7] vs GPC gene mean 24·5 [3·9], L gene mean 28·0 [3·6]). Personnel conducting the bedside test procedure reported being hindered by the inconvenient use of full personal protective equipment and long waiting procedures before a result could be read., Interpretation: The Pan-Lassa RDT is not currently recommended as a diagnostic or screening tool for suspected Lassa fever cases. Marked improvement in sensitivity and user friendliness is needed for the RDT to be adopted clinically. There remains an urgent need for better Lassa fever diagnostics to promote safety of in-hospital care and better disease outcomes in low-resource settings., Funding: Médecins Sans Frontières., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: Skin neglected tropical diseases including leprosy and Buruli ulcer (BU)are a group of stigmatizing and disability-inducing conditions and these aspects of the diseases could lead to poor mental health. The study was designed to assess the burden of poor mental health and wellbeing among persons affected by leprosy or BU in Nigeria., Methods: A community based cross-sectional study design was employed. The study involved persons affected by leprosy or BU. Ten local government areas with the highest number of notified leprosy or BU cases between 2014 and 2018 in southern Nigeria were purposively selected. Information were obtained using Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorders-7 (GAD-7), Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and OSLO Social Support Scale. Outcome measure was poor mental health/wellbeing and was determined by proportion of respondents who had depressive symptoms, anxiety disorder and poor mental wellbeing., Results: A total of 635 persons affected by leprosy or BU participated in the study. The mean age of respondents was 43.8±17.0 years and highest proportion, 22.2% were in age group, 40-49 years. Majority of respondents, 50.7% were males. A higher proportion of respondents, 89.9% had depressive symptoms, 79.4% had anxiety disorders and 66.1% had poor mental wellbeing. Majority, 57.2% had poor mental health/wellbeing. Among the respondents, there was a strong positive correlation between depression and anxiety scores, (r = 0.772, p<0.001). There was a weak negative correlation between depression score and WEMWBS score, (r = -0.457, p<0.001); anxiety score and WEMWBS score, (r = -0.483, p<0.001). Predictors of poor mental health/wellbeing included having no formal education, (AOR = 1.9, 95%CI: 1.1-3.3), being unemployed, (AOR = 3.4, 95%CI: 2.2-5.3), being affected by leprosy, (AOR = 0.2, 95%CI: 0.1-0.4) and having poor social support, (AOR = 6.6, 95%CI: 3.7-11.8)., Conclusions: The burden of poor mental health/wellbeing among persons affected by leprosy or BU is very high. There is need to include mental health interventions in the management of persons affected with leprosy or BU. Equally important is finding a feasible, cost-effective and sustainable approach to delivering mental health care for persons affected with leprosy or BU at the community level. Improving educational status and social support of persons affected by leprosy or BU are essential. Engaging them in productive activities will be of essence., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ossai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: In Nigeria, similar to many leprosy-endemic countries, leprosy is highly stigmatized. High levels of stigma among community members as well as internalized stigma among persons affected by leprosy often result in negative psychosocial consequences for those affected. To break this vicious cycle, it is important to conduct context-specific behavioral change activities. Although written material has been successful in improving knowledge and perception, it is not suitable for populations with low educational levels. Audio-delivered interventions are likely to be more suitable for people who are illiterate. This study proposes to assess the impact of an audio-delivered intervention on the perception (knowledge, attitudes, and beliefs) of community members with regard to leprosy in Nigeria., Objective: This study aims to assess the impact of audio-delivered and written health education on the perception of leprosy. Specific objectives are to (1) investigate the perception (local beliefs, knowledge, and attitudes) of community members toward leprosy and persons affected by leprosy; (2) investigate whether there is a difference in impact on perception between participants who have received audio-delivered health education and those who have received written health education, with specific reference to gender differences and differences between rural and urban areas; and (3) assess the impact of the participatory development of the audio-delivered and written interventions on empowerment and internalized stigma of persons affected by leprosy who developed the interventions. Additionally, we will translate and cross-culturally validate 4 study instruments measuring outcomes in 2 major Nigerian languages., Methods: We will use a mixed methods, cross-sectional study design for the intervention development and a 3-arm cluster randomized controlled trial for its implementation and evaluation, comprising (1) baseline assessments of knowledge, attitudes, perceptions, and fears of community members, to develop the audio-delivered content and written material, and the self-esteem and internalized stigma of persons affected by leprosy; and (2) participatory development of the audio-delivered content and written material by persons affected by leprosy and the pilot and implementation of the interventions. This will be done among different groups (selected using cluster randomization) that will be compared (control group, audio-intervention group, and written material group) to evaluate the intervention and the impact of developing the intervention on the persons affected., Results: This study was funded in June 2022, and community member participant recruitment started in January 2023. Baseline data collection was completed by May 2023 (n=811). Participatory cocreation of the audio and written health education content began in July 2023, and the materials are currently under development. Study results are expected in September 2024., Conclusions: Study findings will contribute to developing evidence-based, context-specific behavioral change interventions, which are critical to addressing stigma in many leprosy-endemic communities where leprosy is highly stigmatized, and contribute toward global triple zero leprosy efforts., Trial Registration: Pan African Clinical Trial Registry PACTR202205543939385; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=23667., International Registered Report Identifier (irrid): DERR1-10.2196/53130., (©Ngozi Murphy-Okpala, Tahir Dahiru, Anna T van ’t Noordende, Carolin Gunesch, Joseph Chukwu, Charles Nwafor, Suleiman Hudu Abdullahi, Chukwuma Anyaike, Ugochinyere Angelic Okereke, Anthony Meka, Chinwe Eze, Okechukwu Ezeakile, Ngozi Ekeke. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 24.01.2024.)

Background: Scrotal ultrasonography is a useful, sensitive, readily available and safe imaging modality in the investigation of scrotal pathologies, including those possibly contributory to male infertility. The aim of this study was to review the scrotal ultrasound scans (SUSS) done in the University of Uyo Teaching Hospital over a period of 18 months from July 2018 to December 2019., Methodology: This was a retrospective study of all the SUSS performed in the Department of Radiology of University of Uyo Teaching Hospital (UUTH) within an 18-month period. All subjects who presented for scrotal ultrasound with adequately filled request forms which included the biodata and clinical information were included in the study., Results: A total of 79 scans were reviewed during the period. The age range of study patients was 4 - 78 years, with a mean of 41.2 ±15 years. The modal age group was 30-39 years, made up of 20 cases (25.6%). Primary and secondary infertility were the major indications for referrals, in 17 cases (21.8%) and 13 cases (16.7%) respectively. Following SUSS, the findings were normal in 11 patients (14.1%), while hydrocele, and varicocele accounted for 19 cases (24.3%) and 9 cases (11.5%) respectively. Microlitiasis was seen in 7 cases (9%) while a diagnosis of testicular tumor was made in 5 (6.4%) of cases. Three (3) of the 5 testicular tumors, were confirmed histologically., Conclusion: Infertility was the main indication for SUSS and hydrocele the commonest finding. Ultrasound is recommended as first line imaging modality in the investigation of scrotal lesions., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2023 by West African Journal of Medicine.)

Lassa fever (LF) remains endemic in Nigeria with the country reporting the highest incidence and mortality globally. Recent national data suggests increasing incidence and expanding geographic spread. Predictors of LF case positivity in Nigeria have been sparsely studied. We thus sought to determine the sociodemographic and clinical determinants of LF positivity amongst suspected cases presenting to health facilities from 2018 to 2021. A secondary analysis of the national LF surveillance data between January 2018 and December 2021. Socio-demographic and clinical data of 20,027 suspected LF cases were analysed using frequencies and Chi-square statistics with significant p-value set at p < 0.05. The outcome variable was LF case status (positive or negative). Predictors of LF case positivity were assessed using multiple logistic regression models with 95% confidence intervals (CI). Case positivity rate (CPR) for the four years was 15.8% with higher odds of positivity among age group 40-49 years (aOR = 1.40; 95% CI 1.21-1.62), males (aOR = 1.11; 95% CI 1.03-1.20), those with formal education (aOR = 1.33; 95% CI 1.13-1.56), artisans (aOR = 1.70; 95% CI 1.28-2.27), religious leaders (aOR = 1.62; 95% CI 1.04-2.52), farmers (aOR = 1.48; 95% CI 1.21-1.81), and symptomatic individuals (aOR = 2.36; 95% CI 2.09-2.68). Being a health worker (aOR = 0.69; 95% CI 0.53-0.91), a teacher (aOR = 0.69; 95% CI 0.53-0.89) and cases reporting in the 3rd quarter (aOR = 0.79; 95% CI 0.69-0.92) had lower odds. In a sex-disaggregated analysis, female farmers had higher odds of positivity (aOR = 2.43; 95% CI 1.76-3.38; p < 0.001) than male farmers (aOR = 1.52; 95% CI 1.19-1.96; p < 0.01). Fever (aOR = 2.39; 95% CI 2.00-2.84) and gastrointestinal (GI) symptoms (aOR = 2.15; 95% CI 1.94-2.37) had the highest odds among symptoms. Combination of fever and GI symptoms (aOR = 2.15; 95% CI 1.50-3.10), fever and neurological symptoms (aOR = 6.37; 95% CI 1.49-27.16), fever and musculo-skeletal symptoms (aOR = 2.95; 95% CI 1.37-6.33), fever and cardiopulmonary symptoms (aOR = 1.81; 95% CI 1.24-2.64), and cardiopulmonary and general symptoms (aOR = 1.50; 95% CI 1.19-1.89) were also predictive. Cumulative LF CPR appears high with clearly identified predictors. Targeted interventions with heightened index of suspicion for sociodemographic categories predictive of LF in suspected cases are recommended. Ethnographic and further epidemiological studies could aid better understanding of these associations., (© 2023. The Author(s).)

Background: Lassa fever (LF), a haemorrhagic illness caused by the Lassa fever virus (LASV), is endemic in West Africa and causes 5000 fatalities every year. The true prevalence and incidence rates of LF are unknown as infections are often asymptomatic, clinical presentations are varied, and surveillance systems are not robust. The aim of the Enable Lassa research programme is to estimate the incidences of LASV infection and LF disease in five West African countries. The core protocol described here harmonises key study components, such as eligibility criteria, case definitions, outcome measures, and laboratory tests, which will maximise the comparability of data for between-country analyses., Method: We are conducting a prospective cohort study in Benin, Guinea, Liberia, Nigeria (three sites), and Sierra Leone from 2020 to 2023, with 24 months of follow-up. Each site will assess the incidence of LASV infection, LF disease, or both. When both incidences are assessed the LASV cohort (nmin = 1000 per site) will be drawn from the LF cohort (nmin = 5000 per site). During recruitment participants will complete questionnaires on household composition, socioeconomic status, demographic characteristics, and LF history, and blood samples will be collected to determine IgG LASV serostatus. LF disease cohort participants will be contacted biweekly to identify acute febrile cases, from whom blood samples will be drawn to test for active LASV infection using RT-PCR. Symptom and treatment data will be abstracted from medical records of LF cases. LF survivors will be followed up after four months to assess sequelae, specifically sensorineural hearing loss. LASV infection cohort participants will be asked for a blood sample every six months to assess LASV serostatus (IgG and IgM)., Discussion: Data on LASV infection and LF disease incidence in West Africa from this research programme will determine the feasibility of future Phase IIb or III clinical trials for LF vaccine candidates., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Penfold et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Primary intestinal lymphoma has not been previously reported in our unit, and we consider it to be a very rare cause of acute small bowel obstruction., Methods: We present an adult male with features of recurrent small intestinal obstruction who previously underwent umbilical hernia repair for the same pain. A plain x-ray and ultrasound scan showed features of intestinal obstruction but did not suggest an aetiology of his symptoms., Results: He was resuscitated and underwent an exploratory laparotomy and resection of an obstructing ileal mass with mesenteric nodes. Primary anastomosis of healthy ileum was done and the post-operative period was uneventful. The tissue was reported as low-grade B-cell non-Hodgkin's lymphoma (NHL). He was placed on CHOP with a satisfactory response., Conclusion: Small intestinal lymphoma is a rare cause of intestinal obstruction., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2023 by West African Journal of Medicine.)

Background: Lassa fever is a viral haemorrhagic fever endemic in Nigeria. Improved surveillance and testing capacity have revealed in an increased number of reported cases and apparent geographic spread of Lassa fever in Nigeria. We described the recent four-year trend of Lassa fever in Nigeria to improve understanding of its epidemiology and inform the design of appropriate interventions., Methods: We analysed the national surveillance data on Lassa fever maintained by the Nigeria Centre for Diseases Control (NCDC) and described trends, sociodemographic, geographic distribution, and clinical outcomes. We compared cases, positivity, and clinical outcomes in the period January 2018 to December 2021., Results: We found Lassa fever to be reported throughout the year with more than half the cases reported within the first quarter of the year, a recent increase in numbers and geographic spread of the virus, and male and adult (>18 years) preponderance. Case fatality rates were worse in males, the under-five and elderly, during off-peak periods, and among low reporting states., Conclusion: Lassa fever is endemic in Nigeria with a recent increase in numbers and geographical distribution. Sustaining improved surveillance, enhanced laboratory diagnosis and improved case management capacity during off-peak periods should remain a priority. Attention should be paid to the very young and elderly during outbreaks. Further research efforts should identify and address specific factors that determine poor clinical outcomes., Competing Interests: The authors declared no competing interests., (Copyright: © 2022 Dalhat et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Response to public health emergencies requires continued adaptation and innovation. The Nigeria Centre for Disease Control (NCDC) is the country's public health institute with the mandate to protect the health of Nigerians. Achieving such mandate in resource-limited settings with divergent demographic characteristics of the citizens, necessitates the readiness to learn from experience and to develop policies and activities in line with lessons learnt and best practices. This practice paper describes the initiatives of the NCDC towards adapting its public health response activities by establishing learning systems across its structure. The paper informs on some of the steps taken by the Centre regarding learning from the Lassa fever outbreak and the COVID-19 pandemic in Nigeria. It concludes that commitment and investments are key requirements for learning and adapting public health responses to achieve success with combating infectious diseases., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Over past decades, there has been increasing geographical spread of Lassa fever (LF) cases across Nigeria and other countries in West Africa. This increase has been associated with significant morbidity and mortality despite increasing focus on the disease by both local and international scientists. Many of these studies on LF have been limited to few specialised centres in the country. This study was done to identify sociodemographic and clinical predictors of LF disease and related deaths across Nigeria. We analysed retrospective surveillance data on suspected LF cases collected during January-June 2018 and 2019. Multivariable logistic regression analyses were used to identify the factors independently associated with laboratory-confirmed LF diagnosis, and with LF-related deaths. There were confirmed 815 of 1991 suspected LF cases with complete records during this period. Of these, 724/815 confirmed cases had known clinical outcomes, of whom 100 died. LF confirmation was associated with presentation of gastrointestinal tract (aOR 3.47, 95% CI: 2.79-4.32), ear, nose and throat (aOR 2.73, 95% CI: 1.80-4.15), general systemic (aOR 2.12, 95% CI: 1.65-2.70) and chest/respiratory (aOR 1.71, 95% CI: 1.28-2.29) symptoms. Other factors were being male (aOR 1.32, 95% CI: 1.06-1.63), doing business/trading (aOR 2.16, 95% CI: 1.47-3.16) and farming (aOR 1.73, 95% CI: 1.12-2.68). Factors associated with LF mortality were a one-year increase in age (aOR 1.03, 95% CI: 1.01-1.04), bleeding (aOR 2.07, 95% CI: 1.07-4.00), and central nervous manifestations (aOR 5.02, 95% CI: 3.12-10.16). Diverse factors were associated with both LF disease and related death. A closer look at patterns of clinical variables would be helpful to support early detection and management of cases. The findings would also be useful for planning preparedness and response interventions against LF in the country and region., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Olayinka et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)