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Background Upsurge in cardiopulmonary dysfunctions in Enugu, Nigeria, involved mainly cement workers, automobile spray painters, woodworkers, and civil servants (cleaners) and was worsened in the dry season, suggesting the need for an occupation-specific characterization of the disease features and seasonal evaluation of air quality for prevention and management. Methods We conducted a randomized cross-sectional study of eighty consenting participants (in Achara Layout, Enugu), comprising 20 cement workers (39.50 ± 14.95years), 20 automobile painters (40.75 ± 9.85years), 20 woodworkers (52.20 ± 9.77years), and 20 cleaners (42.30 ± 9.06years). The air quality, some hematological (fibrinogen-Fc, and C-reactive protein-CRP), and cardiopulmonary parameters were measured and analyzed using ANCOVA, at p 10 = 541.17 ± 258.72µg.m− 3; PM2.5=72.92 ± 25.81µg.m− 3] and the university campus [PM10 = 244 ± 74.79µg.m− 3 ; PM2.5=30.33 ± 16.10µg.m− 3], but the former was twice higher. The PM differed significantly (p 1) (F = 6.128, p = 0.001), and Peak expiratory flow rate (PEFR) (F = 5.523, p = 0.002), differed significantly across the groups. FEV1/FVC% was 1 and work duration were significantly and negatively related in cement workers (r=-0.46, r2 = 0.2116, p = 0.041, one-tailed). CRP (normal range ≤ 3.0mg/L) and FC (normal range-1.5-3.0g/L) varied in cement workers (3.32 ± 0.93mg/L versus 3.01 ± 0.85g/L), automobile painters (2.90 ± 1.19mg/L versus 2.54 ± 0.99g/), woodworkers (2.79 ± 1.10mg/L versus 2.37 ± 0.92g/L) and cleaners (3.06 ± 0.82mg/L versus 2.54 ± 0.70g/L). Conclusion(s): Poor air quality was evident at the study sites, especially in the dry season. Cement workers and spray painters showed significant risks of obstructive pulmonary diseases while woodworkers had restrictive lung diseases. Cement workers and cleaners recorded the highest risk of coronary heart disease (CRP ≥ 3.0mg/L). The similarity in Fc and CRP trends suggests a role for the inflammation-sensitive proteins in the determination of cardiovascular risk in cement workers and cleaners. Therefore, there are occupation-specific disease endpoints of public health interest that likewise warrant specific preventive and management approaches among the workers.

Background Graft survival post-kidney transplant may be influenced by APOL1 risk variant status of both donors and recipients. There are several conflicting reports on screening, eligibility and inclusion of APOL1 risk variant testing in the Kidney Donor Risk Index. We aimed to produce a protocol for synthesizing evidence from available data on Apoprotein L1 risk variants and kidney transplantation.Methods We developed a search strategy using MeSH, text words and entry terms. Nine databases will be searched: PubMed, Embase, CINAHL, AJOL, Google Scholar, Web of Science, Cochrane Library, Research gate and Scopus. Only observational studies retrievable in the English Language will be included. The primary measurable outcome is the recipient’s post-transplant graft survival time from APOL1 high-risk variant donors. The secondary outcomes are the proportion of APOL1 high-risk variants in End-Stage Kidney Disease requiring kidney transplant, the proportion in graft recipients and kidney donors; effect of APOL1 high-risk variant on donor's kidney function post-kidney donation, recipient kidney allograft survival in APOL1 low and high-risk recipients. Deduplication, screening and selection of identified studies will be done using Covidence software while CMA software version 3 will be used for meta-analysis. All studies will be assessed for methodological, clinical and statistical heterogeneity. Publication bias will be visually assessed using the funnel plot. Results will be presented in forest plots with pooled survival time, standard error and variance. Subgroup analysis will be performed using moderators such as socio-demographics: race, age, gender and socio-economic status; hypertension, HIV status, forms of rejection and other environmental factors.Discussion: The effect size for primary outcome is standardized mean difference in survival time for APOL1 high risk variants in kidney transplants. The changes in kidney functions of donors and recipients pre and post-transplantation would be examined. The suitability of donors who have APOL1 high risk variants will explored in relation to graft survival time, donors kidney function and moderating effects of socio-demographics and environmental determinants. Trial Registration Number: This protocol is registered in PROSPERO, with registration number CRD42021230358

Background: About 1.35 million people die annually worldwide due to road traffic accidents. Road traffic injuries cause considerable economic losses to individuals, their families, and to nations as a whole. About 93% of the world's fatalities on the roads occur in low-and middle-income countries, even though these countries have approximately 60% of the world's vehicles. Road Traffic Accidents constitute the third leading cause of trauma related deaths in Nigeria. It is a substantial public health problem that deserves a systematic review.Methods and Analysis: We developed a search strategy using MeSH, text words and entry terms. Nine databases will be searched, including PubMed, African Journal Online, Embase, Google Scholar, Scopus, Cochrane Library, CINAHL, Web of Science and ResearchGate. Only observational studies, retrievable in the English language will be included. The primary outcome is prevalence of road traffic injuries in Nigeria. The secondary outcomes include proportion of road traffic accidents in Nigeria, patterns, predictors and consequences of road traffic accidents in Nigeria. Identified studies will be screened and selected based on inclusion criteria using Rayyan QCRI screening tool, by independent reviewers with dual blinding. Data items will be extracted into predefined forms in Microsoft Excel before exporting to CMA version 3 for analysis. Every selected study will have their NIH quality scores and Cochrane risk of bias reported. Studies will be assessed for methodological and statistical heterogeneity. Publication bias will be assessed using Funnel Plots and test of asymmetry. Results will include forest plots, pooled prevalence with standard error, variance, relative weights assigned to studies and heterogeneity test. Further analysis will include subgroup analysis and meta-regression using both categorical and quantitative variables.Discussion: This protocol will enable a transparent, accurate and reliable method for determining pooled prevalence, standard error and 95% CI of road traffic injuries in Nigeria. Patterns and outcomes of RTA in Nigeria will also be assessed. Evidence generated by this protocol will likely inform policy on prevention of RTA in NigeriaTrial Registration Number: This protocol is registered with PROSPERO, with registration number CRD42021226956.

Background Granulocyte Colony-stimulating factors (G-CSF) biosimilars are recombinant biologics that are similar to a reference product, neupogen, a 175 amino acid recombinant human G-CSF. Characteristically, biosimilars are produced from living cells as high molecular weight, heterogenous compounds that are highly immunogenic. They are primarily used to treat febrile and severe neutropenia in oncology patients as well as mobilize peripheral stem cells in transplant donors. However, as biosimilars are produced by biological processes rather than chemical synthesis, their comparable effectiveness and safety are very paramount to clinical uses. We aimed to produce a protocol for consistent and accurate systematic review and meta-analysis of G-CSF biosimilars.Methods We developed a search strategy using MeSH terms, key words and entry terms to search 9 databases: PubMed, AJOL, Embase, Google Scholar, Scopus, Cochrane Library, CINAHL, Web of Science and ResearchGate. Only randomized controlled trials retreivable in the English language will be included in this study. The primary measurable outcomes in this study are uses, effectiveness and safety of G-CSF biosimilars. Identified primary studies will be screened, deduplicated and selected based on study design, inclusion/exclusion criteria and outcome measures using DistillerSR software. Studies will be assessed for methodological, clinical and statistical heterogeneity. Extractable data items for effectiveness measure are: i) proportion of patients with 50% increase in absolute neutrophil count within 3–7 days; ii) resolution of fever within 3–7 days, iii) resolution of intra-oral mucosa ulcers within 7–10 days and iv) resoluton of difficulty in swallowing within 7–10 days. Measures of safety are i) proportion of patients with immunologic reactions, ii) any other documented adverse events. Quality scores and risk of bias for individual studies will be reported. Funnel Plots will be used for assessing publication bias in selected studies. Effect size, variance, SE and % CI and heterogeneity tests will be reported on forest plots using the CMA software version 3. Subgroup analysis and meta-regression will also be included using secondary outcomes as moderators and explanatory variables. The systematic review and meta-analysis will be reported according to PRISMA 2015 Statement.Discussion Ethical approval will not be required since this study will be based on published data. G-CSF biosimilars will be compared with the reference product, neupogen (filgrastin). The uses, effectiveness and safety of the biosimilars will be discussed. The study will also examine short and long acting biosimilars and compare their overall effectiveness. The strength of evidence from this study will be assessed using the NIH Quality assessment for systematic review and meta-analysis.Trial Registration Number The study is registered with PROSPERO, with registration number CRD42021232375

Background: Currently in Nigeria, SARS CoV-2 infection control measures rely solely on RT-PCR testing of cases with high index of suspicion for COVID-19. The sero-prevalence of SARS-CoV-2-specific antibodies in the populations remains unknown. We aimed to determine the sero-prevalence of SARS CoV-2 IgM and IgG in screened blood donors in two selected cities in Nigeria. Methods: A total of 113 blood samples from screened and accepted blood donors were tested for both SARS CoV-2 IgM and IgG antibodies using NOVATECH ELISA kits from Eurofins Germany. Results: The age range of donor was 21-48 years. Males were 96 %. Of the 113 blood donors 42% were positive for SARS CoV-2 IgG while 41% were positive for SARS CoV-2 IgM respectively. Only 11% and 19% of blood donors had equivocal test result for IgG and IgM respectively.Conclusions: Nearly a half of accepted blood donors in Nigeria had been exposed to SARS CoV-2 infection. Although it is not a blood transmissible infection, the blood banks must take adequate preventive measures to prevent spread amongst the bank staff and potential donors. It also implies a wider spread of the infection in Nigeria.Trial Registration: The study does not require registration.

BackgroundOne in every four men will be affected by prostate cancer. Choice of treatment depends on factors including grade and stage of the disease, age of the patient, availability of treatment options and socioeconomic status. We aimed to develop a protocol to assess the impact of socioeconomic status on prostate cancer outcomes globally.Methods A search strategy is developed using MeSH, text words, and entry terms. Nine databases will be searched, including PubMed, African Journals Online (AJOL), Google Scholar, Scopus, Cochrane Library, CINAHL, Web of Science, Embase and ResearchGate.Only observational studies, retrievable in the English language will be included. The primary outcome of this study is the socioeconomic status of prostate cancer patients. Secondary outcomes include mortality due to prostate cancer, health related quality of life, prostate cancer recurrence, need for secondary treatment, time to return to work, treatment choice regret and hospice enrollment. Identified studies will be screened and selected based on inclusion criteria. Data items will be managed in Zotero software, Microsoft Excel and CMA software. Both quality scores and the risk of bias for individual studies will be reported. Studies will be assessed for methodological, clinical, and statistical heterogeneity. Funnel Plots will be used for assessing publication bias. DiscussionThis protocol will enable a transparent, reliable and accurate method for assessing the impact of socioeconomic status on the global prostate cancer outcomes. It will allow discussions on outcomes such as mortality due to prostate cancer and how income disparity and availability of treatment options can influence prostate cancer outcomes. The final report of this study will be published in a peer-reviewed journal and the findings will be made available to health authorities.Systematic review RegistrationThis protocol has been registered in PROSPERO, with registration number CRD42020213700

Background: The effect of antidepressants on the foetus is of great public concern on account of teratogenicity. However, evidence on this is quite controversial. This study aims to determine the risk of congenital malformations in offsprings of pregnant women placed on Selective Serotonin Reuptake Inhibitors (SSRIs) during pregnancy compared to the offsprings of pregnant women not on SSRIs. It also aims to assess if significant increase in risk occurs across trimesters. METHODS AND ANALYSIS:A search strategy is developed using MeSH, text words and entry terms. Nine databases will be searched: PubMed, Embase, CINAHL, AJOL, Google Scholar, Web of Science, Cochrane Library, Research gate and Scopus. Only Observational studies from 2009-2020, retrievable in the English Language will be included. The primary measurable outcome is risk of teratogenicity with SSRI use in pregnancy. All identified studies, imported into End note version 9, will be screened based on the inclusion/exclusion criteria; data will be exported into Microsoft excel. Extractable data will include first author’s name and year of publication, proportion of congenital malformations in women on SSRIs and women without SSRIs, trimester, time of initiation and duration of treatment. Pedro quality scores and Cochrane risk of bias for individual study will be reported. All studies will be assessed for methodological, clinical and statistical heterogeneity. Publication bias will be assessed using the funnel plot. Subgroup analysis will be performed. The different trimesters and time of initiation of treatment will be used as moderators. Meta-regression will be done using duration of treatment. The CMA version 3 will be used for statistical analysis and forest plots. Discussion:The study will require no ethical approval, it is based on published data. The results obtained from this review will provide relevant information on the use of SSRIs in pregnancy and the risk of congenital malformations. Furthermore, it will provide vital information on the levels and trend of risk at each trimester. The final report will be made available to mental health experts providing care to pregnant women.Trial Registration Number: This protocol is registered in PROSPERO, with number CRD42020213505

BackgroundNephrotic syndrome (NS) is one of the most common childhood renal disorders globally, with an incidence of 2 to 7 cases per 100,000 children. A characteristic feature is massive proteinuria which may rapidly progress to end stage kidney failure, if uncontrolled. Most of the cases in children are steroid sensitive but associated with frequent relapses. Levamisole, a cheap antihelminthic has been used as steroid sparing agent in steroid sensitive NS (SSNS). This study assesses the efficacy and safety of Levamisole in African children with idiopathic nephrotic syndrome.MethodsWe will conduct a systematic review and meta-analysis of all Randomised controlled trials which reported African children with Idiopathic nephrotic syndrome who were on Levamisole compared to other drugs. Ten databases including PubMed, African Journals Online, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Cochrane Library, Web of Science, Scopus, Clinicaltrial.gov and Research Gate will be searched using a search strategy. The search will have no time restrictions, but studies must have been conducted among African children residing in Africa and are retrievable in the English Language. Studies will be selected based on inclusion and exclusion criteria by two independent reviewers without blinding. The study quality will be assessed using the Pedro scale and risk of bias evaluated using the Cochrane Risk of Bias tool. Eligible screened studies will be inlcuded for meta-analysis using the CMA Software. Statistical, clinical and methodological heterogeneity will be tested. Subgroup analyses and meta-regression will be performed on rate of relapses, adverse event and drug dose.DiscussionThe primary outcome will be the proportion of children with remissions and or relapses within 6 -12 months post initiation of levamisole or comparators with effect size being the relative risk. Safety of Levamisole will be measured using reported adverse events. Moderating effects of age, gender, duration of illness, and dosage of Levamisole on the duration of remission, frequency of relapses and adverse events will be examined.Systematic Review RegistrationThis protocol has been registered in PROSPERO, with registration number CRD42020213327.