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Electricity grid resilience in the face of unending hazards plays a crucial role in energy security of a nation. Based on hazard impact variability across different regions of Nigeria, formulating and implementing a contextualized environmental hazard mitigation policy to reduce grid vulnerability to the multiple effects of hazards and disasters is a strategic imperative that can result to longevity of grid networks, with increased probability of critical success factors such as safety, reliability of electricity supply and electricity access in the Sudan Sahel region of Nigeria. Policies outlined in the Nigeria's National Disaster Management Framework (NDMF) and the scope of its National Disaster Response Plan (NDRP) takes no cognizance of the peculiar environmental hazards and disasters that impinges on sustainability of electricity grid infrastructures, and the mitigation strategies to reduce their risks, with reference to the Sudan Sahel region. This paper provides insight on the Sahelian hazards, overview shortcomings of the NDMF and NDRP, and advocates for the contextualization of hazard mitigation policy for electricity grids in the Sudan Sahel based on international best practices and findings of field surveys of the Zamfara Sahel.

Background Despite a high prevalence of iron-deficiency anemia (IDA) in developing countries such as Nigeria, intestinal obstruction secondary to lithobezoar (an accumulation of ingested stones within the gastrointestinal tract) is uncommon. Case presentation Herein, we report a case of acute intestinal obstruction secondary to ingestion of large pebbles and IDA in a 5-year-old Nigerian boy. The patient was managed conservatively with the use of laxatives and a rectal wash-out, and the pebbles were excreted over 3 days. Oral iron therapy was also commenced with cessation of pica. Discussion Although the direction of causal relationship between pica and IDA remains debatable, routine screening for iron deficiency among children with lithobezoar is recommended. Besides managing complications associated with lithobezoar, such as intestinal obstruction, prompt initiation of iron therapy among those who present with features of iron deficiency may be beneficial.

Sickle cell anaemia (SCA) and type 1 diabetes mellitus (type 1 DM) are chronic medical conditions whose co-existence is uncommon in childhood. Furthermore, complications of SCA such as mesenteric crisis typically present with abdominal pain, which is also common in children with diabetic ketoacidosis (DKA) and this may possess diagnostic challenge. Herewith in, we report a rare case of a nine-year-old child with homozygous sickle cell anaemia, who presented with features of mesenteric crisis and diabetic ketoacidosis. The DKA was diagnosed based on the presence of hyperglycaemia (32.2 mmol/L), ketonaemia (4.6 mmol/L) and acidosis (11.6 mmol/L). The fluids deficit was corrected over 24 hours, with improvement in the vaso-occlusive crises (VOC) without precipitating cerebral oedema.

Pseudomonas aeruginosa sepsis is associated with high morbidity and mortality in the neonatal period. It is the most common cause of endogenous endophthalmitis which is a rare ophthalmic emergency that can result in complete blindness. Diagnosis can be a challenge in the neonate, hence the need for early ophthalmic consultation in babies presenting with fever, eye swelling, and discharge. Early diagnosis and prompt appropriate treatment are very important to prevent death and disability. This case report demonstrates the rapid progression of endogenous endophthalmitis due to Pseudomonas sepsis, which resulted in the loss of both eyes within a few days of onset.

Deep neck space infections (DNSIs) are rare in neonates. When they do occur, the infections are more aggressive than in older children and adults and can lead to life-threatening complications. Thus, a high index of suspicion is important for early diagnosis and prompt treatment. We report a rare case of DNSIs (retropharyngeal and parapharyngeal abscesses) in a 7-day-old neonate. The baby presented with fever, neck swelling, and difficulty in breathing. Plain neck radiograph showed widening of the retropharyngeal space and β-hemolytic Streptococcus was cultured from the aspirate. He was successfully managed with incision and drainage as well as broad-spectrum antibiotics (cefuroxime and metronidazole for 14 days and gentamicin for 7 days).

This paper gives an overview of the Community Directed Treatment with Ivermectin (CTDI) projects in 2009. Data from the 2010 report will be published when it is available. Box 1 at the end of this article gives treatment guidelines.

Background: Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis. Delays in diagnosis and treatment increase morbidity and mortality from tuberculosis, and the risk of transmission in the community.Methods: We conducted a cross-sectional survey at three TB treatment centres in Central Equatoria State, South Sudan. Smearpositive TB patients were enrolled in three study sites and interviewed within two days of beginning treatment using a structured questionnaire. This study was conducted to investigate factors that affect patient and health service delays in diagnosis and treatment of pulmonary tuberculosis (PTB) in Central Equatoria State.Results: 129 patients were enrolled in the study. The median patient’s, health provider’s and total pre-treatment periods are 4, 10 and 16 weeks respectively. The health care provider delay for patient diagnosis and start of treatment had the greatest contribution to overall total pre-treatment delayConclusions and recommendations: In Central Equatoria State, health care provider delay was the most frequent type of delay observed and was a major contributor to the overall total delay. This study indicated the need for strengthening the capacity of health workers for early detection and referral of TB patients. Further research is needed to identify reasons for health provider delay.Keywords: Mycobacterium tuberculosis, health service delays, South Sudan