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Introduction: A typical presentation of Mycetoma is not uncommon although clinical manifestations might be misleading leading to delay in diagnosis, treatment and consequently leading to poor prognosis. Mycetoma can have a fungal or bacterial etiology and manifestation is usually that of a disfiguring subcutaneous infection that can affect any part of the exposed body. We are reporting a case of Mycetoma in an eleven years old girl that occurred in parts of the lower abdomen, perineum and gluteal region that was initially thought to be a soft tissue sarcoma or disseminated tuberculosis. Case Presentation: An eleven years old girl presented to Usmanu Danfodiyo University Teaching Hospital, Sokoto with lower abdominal mass and multiple nodular masses with discharging sinuses on the upper part of the right thigh, perineum and gluteal region of six months duration. Swellings started as multiple small boils that subsequently started discharging from various points. Patient usually fetches firewood in the forest for her parents as her routine house chores and she remembered an incident where she had pricks from thorns in the bush around her lower thigh and perineum. On examination she was chronically ill looking, in painful distress, with bilateral inguinal lymphadenopathy. She had nodular lesions of varying sizes ranging from 1x1cm to 4x4cm, tender, involving the upper part of the thigh bilaterally, but more on the right, lower abdomen, labia and gluteal region. Some of the lesions had hyper-pigmented sinuses discharging mucopurulent fluid, with areas of soft tissue swelling around the lower abdomen and upper right thigh extending to the leg. Patient was observed to walk with a limp gait. Management and Outcome: An initial diagnosis of soft tissue infection to rule out soft tissue sarcoma and disseminated tuberculosis (abdomen and lymph nodes) and deep tissue mycosis was made. However, with further investigations and reviews by the medical microbiologist and anatomic pathologist, along with bacteriologic, and mycologic studies of swab samples and aspirate and tissue biopsy for Histology revealed an eumycotic mycetoma. She received Ketoconazole and Trimetoprim-sulphametoxazole. She responded significantly as lesions reduced in sizes, abdominal swelling and leg swelling reduced with closure of discharging sinuses. Patient could walk with some resolution of the limp. Repeat abdominal ultrasound scan showed resolution of initial findings. She spent four weeks in the hospital and was discharged. On subsequent follow-up; she was walking without any limp and lesions were healed with some scar and few areas left to dry up. Further follow-up visits after one month and three month showed progressive healing and complete resolution of lesion respectively. However. Patient was however lost to further follow-up which would have enabled monitoring as to any reoccurrence or not. Conclusion: We presented a case of a young girl with an abnormal presentation of eumycotic mycetoma. Patient achieved near cure on medications without the need of surgery due to an excellent multidisciplinary approach between pediatricians, clinicians, clinical microbiologists and anatomic pathologists. Keywords: Mycetoma, Eumycetoma, Paediatrics

Background The advent of Highly Active Antiretroviral Therapy (HAART) is associated with improved clinical and laboratory outcomes resulting in prolonged life and well-being of people living with Human Immunodeficiency Virus (PLHIV). However, the needs for life-long therapy, medications’ side effects and stigma have raised concerns about their quality of life (QOL). This study assessed the determinants of Health-related quality of life (HRQOL) among HIV-positive patients at Ahmadu Bello University Teaching Hospital (ABUTH) Zaria. Methods We conducted a cross-sectional study of 353 HIV-positive adults on HAART attending the HIV clinic of ABUTH, Zaria. The participants were recruited into the study using a systematic sampling technique. Data on socio-demographics, medical parameters, QOL and family functionality were collected using structured, interviewer-administered questionnaire. The World Health Organization (WHO) Quality of Life HIV short form instrument (WHOQOL-HIV BREF) item and Family APGAR tool were respectively used in assessing the QOL and family functionality of the participants. We performed univariate, bivariate and multivariate analysis. Results Mean age was 39.1(±10.9) years, 239 (67.7%) were females, 208 (58.9%) were Hausa-Fulani, 240 (68.2%) married and up to 210 (59.4%) had at least a secondary education. The overall mean scores on the scale of 4–20 for HRQOL were similar in three domains: environment domain 14.5(±2.8); social relationship 14.4(±3.1) and level of independence 14.4(±2.5). Lower scores were recorded in spirituality/religion/personal beliefs 12.3(±4.3). Identified determinants of HRQOL were spousal HIV- positive status (AOR = 3.37; CI; 1.46–7.74) and high family function (AOR = 2.57; CI: 1.51–4.39). Conclusion Having highly functional family and having HIV-positive partner were the major determinants of HRQOL. Routine family counselling and strengthening the HIV social-support network should be incorporated into the routine patients’ care in HIV treatment centers.

Introduction:the most recently discovered severe acute respiratory syndrome Coronavirus 2 (SARS-COV-2) that causes COVID-19, subjected the entire world in turmoil health-wise and economically. With higher burden of malaria in Nigeria and other sub-Saharan African countries coupled with fragile healthcare system and delivery, these may pose a threat in the diagnosis and management of COVID-19 patients co-infected with malaria. Free radicals have been implicated in the progression and pathogenesis of malaria and COVID-19 through Fenton’s reaction and cytokine storm respectively. Methods:the current research comprises of seventy-four (74) participants; 20 apparently healthy controls and 54 COVID-19 patients (34 among which were co-infected with malaria). Serum levels of 8-iso PGF2α and Alphatocopherol were determined among the study participants using ELISA technique and colorimetric assay, respectively. Results:results revealed statistically significant elevation of 8-iso PGF2α in COVID-19 patients co-infected with malaria compared to COVID-19 patients only, and this may be due to increase production of free radicals. Furthermore, a significant decrease of Alphatocopherol was observed in COVID-19 co-infected with malaria compared to COVID-19 patients due to increase utilization of antioxidants in counterbalancing the negative effect of free radicals generated. Conclusion:conclusively, SARS-COV-2 patients co-infected with malaria might be predisposed to oxidative stress and low Alphatocopherol. The increase in oxidative stress is proportional to malaria parasite density and inversely related to Alphatocopherol levels. This implies that oxidative stress is notably higher and such patients may have a severer form of the COVID-19. Increased 8-iso-PGF2α in co-infection and decreased alphatocopherol levels can reflect the severity and adverse outcomes compared to COVID-19 naïve because of their tremendous involvement in the pathogenesis and progression of diseases.

Intensive use of antimicrobial agents in aquaculture provides a selective pressure creating reservoirs of drug-resistant bacteria and transferable resistance genes in fish pathogens and other bacteria in the aquatic environment. From these reservoirs, resistance genes may disseminate by horizontal gene transfer and reach human pathogens, or drug-resistant pathogens from the aquatic environment may reach humans directly. This study aims at identifying the antibiotic sensitivity patterns of Pseudomonas aeruginosa, Salmonella typhi, and Escherichia coli isolates from fish ponds in two localities (Ashiaman and Dawhenya) in the Greater Accra region of Ghana. A total of 43 isolates were tested using the Kirby-Bauer agar disc diffusion method against Ciprofloxacin (5 µg), Erythromycin (15 µg), Cefuroxime (30 µg), Gentamicin (10 µg), and Tetracycline (30 µg).P. aeruginosa was the most isolated organism with 90% prevalence, followed by E. coli (75%) and S. typhi (50%). All the P. aeruginosa isolates were resistant to Erythromycin and Cefuroxime while 90% of the S. typhi isolates were resistant to Tetracycline and Erythromycin. E. coli isolates showed 100, 93.33 and 66.66% resistance to Erythromycin, Cefuroxime and Tetracycline respectively. Gentamicin, Tetracycline and Ciprofloxacin were sensitive to 66.66, 61.10 and 50% of P. aeruginosa isolates respectively. Ciprofloxacin was sensitive to 90% of the S. typhi isolates whiles Gentamicin was sensitive to 70% of the S. typhi isolates. Ciprofloxacin and Gentamicin were more sensitive to E. coli isolates (80 and 66.66% sensitivity respectively). Multi-drug resistant strains were obtained in 77.78% of P. aeruginosa and 70% of S. typhi isolates whiles 66.67% of E. coli isolates were also resistant to more than two classes of the antibiotics tested. High levels of microbial resistance were observed in the isolates with 72.09% of isolates being multidrug resistant strains. Key words: Resistance patterns, multi-drug resistance, fish ponds, antibiotics.

This experimental study endeavors to investigate the evolution of microexplosion phenomenon of water in biodiesel emulsion droplets with the base fuel (B5) containing 95% diesel and 5% of palm oil methyl ester (POME). Parameters such as water content varied from 9%, 12%, and 15%, surfactant dosages of 5%, 10%, and 15% and the hydrophilic–lipophilic balance (HLB) values of 6, 7, 8, and 9 were varied to study its impact on microexplosion phenomenon. Three different sizes of emulsion droplets of approximately Ø2.8 mm, Ø2.2 mm, and Ø0.3 mm were visualized for the evolution of microexplosion phenomenon under the Leidenfrost effect using hot plate as a heat source. The evolution of microexplosion phenomenon of parent droplets, puffing behavior, and waiting time was visualized with high-resolution images. It was observed that the coalescence process was the dominating factor in inducing the microexplosion, and the coalescence process can either be advanced or be delayed by the surfactant dosage. The waiting time for the microexplosion was found to be influenced by the surfactant dosage and the droplet size. The rate of phase change of emulsions and puffing was found to be influenced by the surfactant dosage. By analyzing the postbehavior of the child droplets formed after the microexplosion of the parent droplet, it was observed that the child droplets undergo a series of puffing process and eventually microexplosion phenomenon also. The size of the parent droplets has a significant influence on the size of the child droplet.

Routine immunization coverage in Nigeria is suboptimal. In the northwestern state of Sokoto, an independent population-based survey for 2016 found immunization coverage with the third dose of Pentavalent vaccine to be 3%, whereas administrative coverage in 2016 was reported to be 69%. One possibility driving this large discrepancy is that administrative coverage is calculated using an under-estimated target population. Official population projections from the 2006 Census are based on state-specific standard population growth rates. Immunization target population estimates from other sources have not been independently validated. We conducted a micro-census in Magarya ward, Wurno Local Government Area of Sokoto state to obtain an accurate count of the total population living in the ward, and to compare these results with other sources of denominator data. We developed a precise micro-plan using satellite imagery, and used the navigation tool EpiSample v1 in the field to guide teams to each building, without duplications or omissions. The particular characteristics of the selected ward underscore the importance of using standardized shape files to draw precise boundaries for enumeration micro-plans. While the use of this methodology did not resolve the discrepancy between independent and administrative vaccination coverage rates, a simplified application can better define the target population for routine immunization services and estimate the number of children still unprotected from vaccine-preventable diseases.

Introduction in 2015, 212 million malaria cases and 429,000 malaria deaths were estimated globally. Kaduna State, located in northern Nigeria had a malaria prevalence rate of 36.7% among children less than 5 years old which was higher than the national average of 27%. We assessed the trend of malaria cases in Kaduna State from 2011 to 2015, to analyse trend of malaria in Kaduna as well as describe malaria in time, place and person. Methods we conducted secondary data analysis of Kaduna State malaria data between January 2011 and December 2015. Data were extracted from the Integrated Disease Surveillance and Response (IDSR) 003 form. Data of uncomplicated malaria defined as "any person with fever or history of fever within 24 hours; without signs of severe disease (vital organ dysfunction)" was analysed. In IDSR, a case of malaria is based on presumed diagnosis. Frequencies and proportions were calculated. We also conducted trend analysis of incidence of malaria. Results in the period under study, 1,031,603 malaria cases were recorded with 238 deaths (CFR = 0.23 per 1,000). There was a downward trend with a slope of -3287.2. The data showed higher seasonal variation for quarters 2 (1430.96) and 3 (Q2 = 6,460.23) compared to Quarters 1 (6,857.19) and 4 (-1,034.01). Overall, the age group 12 -59 months had the highest number of incident cases 225, 537 (20.3%). Malaria death was highest in children 1 to 11 months (26.5%) and least, in children 0 -28 days (2.5%). CFR was also highest in children 1 to 11 months (0.45 per 1,000). The highest incidence of malaria cases was in Jaba Local Government Area (47.7%) and the least, in Lere (2.4%). Conclusion there was a decreased incidence of malaria from 2011 to 2015. Malaria was most common in the second and third quarters of each year. Age group 12-59 months was most affected. Kaduna State Malaria Programme should sustain the programs it is implementing and focus more on the under-five years age group.

Introduction Cholera is an acute gastrointestinal infection caused by Vibrio cholerae, which may lead to severe dehydration and death if not treated. This analysis is aimed at highlighting the magnitude, pattern and trend of cholera outbreak that occurred in Kaduna State in 2014. Methods We obtained the 2014 cholera line-list from the Kaduna State Disease Surveillance and Notification officer (DSNO). We described the outbreaks in time, place and person using Epi-info 7 and Health Mapper. Results A total of 1468 case-patients and 54 deaths were recorded, giving a case fatality rate (CFR) of 3.68%. Female case-patients were 809(55.08%). The median age for case-patients was 15 years, with an age range of 0.04-90 years. Age specific case fatality rate (ASCFR) is highest among the > 60 years. Seven (30%) out of the 23 local government areas (LGAs) in Kaduna State were affected by the cholera outbreak in 2014. Igabi LGA has the highest attack rate (150.46 per 100,000 population) while Chikun LGA has the lowest attack rate (12.22 per 100,000 population). Chikun LGA records the highest CFR (17.54%). Cholera infection spread across LGAs sharing the same borders. The outbreak started from the first epidemic week of 2014 and lasted over 33 weeks. Conclusion Our analysis revealed a protracted cholera outbreak that gradually increases in magnitude throughout the first half of 2014 and spread within contiguous LGAs. We recommended the strengthening of the state's diseases surveillance system towards timely detection and early response to disease outbreaks in the future.

Background: Chlamydia trachomatis is the most common cause of sexually transmitted infections in the world. The organism causes silent infection in women and could remain unnoticed for a very long time. Nearly 80% of women are asymptomatic. It is an established and recognized cause of pelvic inflammatory disease, ectopic pregnancy, and infertility among women. In most parts of Nigeria, including the study area, the organism is not routinely screened for, hence the paucity of information about its prevalence. Objectives: The objectives of this study were to determine the prevalence and risk factors associated with genital C. trachomatis infection among women attending the Gynaecological Clinic of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. Materials and Methods: A prospective study was carried out among new patients attending the Gynaecological Clinic of UDUTH, Sokoto. The women were consecutively recruited as they presented to the clinic until the desired sample size was achieved. A structured questionnaire was administered, and related information and consent were obtained. Endocervical swab was collected and tested using Eugene Chlamydia Rapid Test Device following manufacturer's instructions. Results: Samples were collected from a total of 400 women aged between 15 and 49 years. The prevalence of genital C. trachomatis among gynecological patients was 3.5%. The risk factors identified include age of patients below 29 years, early age of onset of sexual activity, and marital status. Conclusion: The study showed that the prevalence of genital C. trachomatis was low. The rate was higher among respondents with infertility. There is a need for routine screening of patients with infertility.

Background: In many developing countries, Nigeria inclusive, water quality and the risk of waterborne diseases are critical public health concerns. Safe drinking water, sanitation and hygiene are among the five key strategies aimed at combating neglected tropical diseases. Objective: The objective of the study was to assess drinking water quality, household sanitation, and hygiene practices in a rural community. Materials and Methods: A descriptive cross-sectional study was carried out at Tunga Magaji, a rural community of Wamakko local government area, which is one of the Metropolitan Local Government Area of Sokoto state. A total of 391 households participated and were selected using a multistage sampling technique. Household questionnaires and checklist were used to collect data, which were analyzed using IBM Statistical Package for the Social Sciences version 20.0. Results were presented in tables and chart. Univariate analysis in the form of mean and standard deviation was carried out on continuous data. The categorical and grouped data were summarized using frequencies and percentage. Results: River/stream is the major source of their drinking water followed by dung well. Almost all the respondents (97.0%) perceived the water source to be safe for drinking even though more than half said the water has taste. All water samples were weakly basic and had a specific gravity of one. A tap point, dung well and borehole source demonstrated a significant coliform organisms (Escherichia coli) growth. Only 58% of the households have toilet facilities while the remaining uses different unsanitary methods. More than half (59%) reported washing hand always after toilet use and after handling children’s feces, although only 37% of them reported the use of soap and water. The most common health problem in the community was diarrheal diseases with a prevalence rate of 61%. Conclusion: Some drinking water source had significant coliform counts, and large proportion of households does not have sanitary facilities with the diarrheal disease being the major health problem.

Background: Since the discovery of Ebola in 1967, many localized outbreaks have occurred but the recent cross-border epidemic was fueled by the high level of illiteracy and some bad cultural practices. Aim: To assess the awareness, knowledge, and misconceptions of Ebola among residents of a rural community in Sokoto State, Nigeria. Materials and Methods: A cross-sectional study design was used. The study was conducted in a rural community and the participants were selected using the systematic sampling method. The data were analyzed with Statistical Package for the Social Sciences (SPSS) version 20.0. Skewed quantitative variables were summarized using median and categorical variables using frequencies and percentages. Chi-square test was performed to assess the relationship between outcome variables (knowledge of Ebola) and respondents' sociodemographic characteristics. Binary logistic regression analysis was also performed to identify the predictors of outcome variable. Results: Respondents' median age was 30 years and nearly half of the respondents (49%) had no formal education. A large proportion (88%) of the respondents was aware of Ebola and radio was their major source of information. Residents' knowledge of Ebola was low and only 13% had good knowledge. Eating bitter kola, bathing with salt water, and drinking salt water were mentioned as methods of preventing the spread of the disease. Of their socio-demographic characteristics, only the educational level attained did predict their knowledge of Ebola. Respondents without formal education [odds ratio (OR) = 0.198, P < 0.02] and secondary education (OR = 0.292, P < 0.01) were more likely to have poor knowledge. Conclusion: Although the majority was aware of Ebola, their knowledge about it was very low and misconceptions and misinformation were still not uncommon. There is a need for continuous public education and enlightenment about Ebola.