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In Africa, pastoral populations face several underrecognized health issues. The livelihoods of pastoralists revolve around possession of livestock and they are constantly moving in search of water and pasturage. They are predisposed to chronic zoonotic infections but may also suffer from non-acute non-zoonotic cosmopolitan infectious and non-infectious chronic medical conditions. Given their migratory lifestyle, livelihood, geographic inaccessibility, communication barriers, illiteracy and poverty, it is challenging for pastoralists to access lengthy inpatient clinical care and long-term periodic follow-up that may be required to achieve control or cure of subacute, chronic or lifelong diseases. The challenges and management modalities of complicated subacute bacterial endocarditis requiring critical clinical considerations, long-term medical and surgical interventions in a stateless Arab camel herder are described to highlight the plight of pastoralists. Innovative clinical and public health strategies are suggested to authorities and healthcare institutions to improve access to care for non-acute diseases among them.

Introduction: There is limited data on sepsis and sepsis outcomes in Nigeria. We described the clinical and laboratory characteristics of patients admitted with sepsis in a Nigerian tertiary hospital. Methods: This was a prospective cohort study of patients aged ≥18 years, admitted to the accident and emergency department (A&E) of Lagos University Teaching Hospital (LUTH ), Idi-Araba , with physician -diagnosed sepsis between November 2021 and April 2022 . Presenting clinical and laboratory findings of patients that met the Systemic Inflammatory Response (SIRS) and/or the quick Sequential Organ Failure Assessment (qSOFA) criteria were documented. The primary outcome was all-cause in-hospital mortality. A bivariate analysis was conducted to determine factors associated with mortality. P-value

Objectives: The coronavirus disease 2019 (COVID-19) pandemic is the current public health concern. Hypoxemia has been identified as an independent risk factor for mortality in COVID-19 patients regardless of age or sex. This study therefore aimed to assess the profile of COVID-19 patients with hypoxemia in Lagos, Nigeria and identify their associated socio-demographic and clinical risk factors, predictors, and outcomes.Materials and Methods: This was a retrospective cohort study in which data were extracted from medical records of real-time polymerase chain reaction confirmed COVID-19 positive patients admitted between April and October 2020. Data extracted included age, sex, comorbidities, disease category/classification, symptoms, lowest oxygen saturation (SPO2), and outcomes. Bivariate analysis was done to test associations between hypoxemia and other variables. Multivariate analysis was done to determine significant predictors of hypoxemia.Results: A total of 266 patients were included in the study; mean (SD) 49.80 (± 16.68) years. Hypoxemia (lowest SPO2 ≤ 90 in adults and < 92% in children) was found in 102 (38.3 %) of the cases. SPO2 of hypoxemic patients ranged from 33% to 90%, Mean ±SD of 77±13%. About half of the hypoxemic cases, 53 (52%) were ≥ 60 years and mostly male 70 (68.6%). Difficulty breathing was present in 56 (55%), while the common comorbidities were hypertension 86 (32.3%) and diabetes mellitus 47 (17.7%). Age ≥ 60, difficulty breathing, and fever were independent predictors of hypoxemia. Hypoxemia was significantly associated with death (X2-42.13; P < 0.001); odds ratio 14.5 (95% CI: 5.4–38.8).Conclusion: Hypoxemia occurred in 1 out of every 3 COVID-19 patients with poor prognosis. SPO2 monitoring and early presentation in hospital for those 60 years and above or with dyspnea may be essential for early identification and treatment of hypoxemia to reduce mortality.

Objectives: The coronavirus disease 2019 (COVID-19) pandemic is the current public health concern. Hypoxemia has been identified as an independent risk factor for mortality in COVID-19 patients regardless of age or sex. This study therefore aimed to assess the profile of COVID-19 patients with hypoxemia in Lagos, Nigeria and identify their associated socio-demographic and clinical risk factors, predictors, and outcomes. Materials and Methods: This was a retrospective cohort study in which data were extracted from medical records of real-time polymerase chain reaction confirmed COVID-19 positive patients admitted between April and October 2020. Data extracted included age, sex, comorbidities, disease category/classification, symptoms, lowest oxygen saturation (SPO2), and outcomes. Bivariate analysis was done to test associations between hypoxemia and other variables. Multivariate analysis was done to determine significant predictors of hypoxemia. Results: A total of 266 patients were included in the study; mean (SD) 49.80 (± 16.68) years. Hypoxemia (lowest SPO2 ≤ 90 in adults and < 92% in children) was found in 102 (38.3 %) of the cases. SPO2 of hypoxemic patients ranged from 33% to 90%, Mean ±SD of 77±13%. About half of the hypoxemic cases, 53 (52%) were ≥ 60 years and mostly male 70 (68.6%). Difficulty breathing was present in 56 (55%), while the common comorbidities were hypertension 86 (32.3%) and diabetes mellitus 47 (17.7%). Age ≥ 60, difficulty breathing, and fever were independent predictors of hypoxemia. Hypoxemia was significantly associated with death (X2-42.13; P < 0.001); odds ratio 14.5 (95% CI: 5.4–38.8). Conclusion: Hypoxemia occurred in 1 out of every 3 COVID-19 patients with poor prognosis. SPO2 monitoring and early presentation in hospital for those 60 years and above or with dyspnea may be essential for early identification and treatment of hypoxemia to reduce mortality.

Background: In April 2020, a community-based active case search surveillance system of coronavirus disease 2019 (COVID-19) was developed by the emergency outbreak committee in Lagos State. This followed the evidence of community transmission of coronavirus disease in the twenty Local Government Areas in Lagos State. This study assessed the value of respiratory and other symptoms in predicting positive SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR). It is hoped that if symptoms are predictive, they can be used in screening before testing. Methods: Communities were included based on the alerts from community members through the rumour alert system set up by the state. All members of the households of the communities from where the alert came were eligible. Household members who declined to participate were excluded from the study. A standardised interviewer-administered electronic investigation form was used to collect sociodemographic information, clinical details and history for each possible case. Data was analysed to see the extent of agreement or correlation between reported symptoms and the results of PCR testing for SARS-COV-2. Results: A total of 12,739 persons were interviewed. The most common symptoms were fever, general weakness, cough and difficulty in breathing. Different symptoms recorded different levels of sensitivity as follows: fever, 28.9%; cough, 21.7%; general body weakness, 10.9%; and sore throat, 10.9%. Sensitivity and specificity for fever, the most common symptom, were 28.3% and 50.2%, respectively, while similar parameters for general body weakness, the next most common symptom, were 10.9% and 73.2%, respectively. Conclusion: From these findings, the predictive ability of symptoms for COVID-19 diagnosis was extremely weak. It is unlikely that symptoms alone will suffice to predict COVID-19 in a patient. An additional measure, such as confirmatory test by RT-PCR testing, is necessary to confirm the disease.

Introduction Success in curtailing the pandemic coronavirus disease (COVID-19) depends largely on a sound understanding of the epidemiologic and clinical profile of cases in a population as well as the case management approach. This study documents the presenting characteristics, treatment modalities and outcomes of the first 32 COVID-19 patients in Nigeria. Methods This retrospective study used medical records of the first 32 patients admitted and discharged from the Mainland Hospital, Lagos State, southwest Nigeria between February 27 and April 6, 2020. The outcomes of interest were death, promptness of admission process and duration of hospitalization. Results The mean age of the patients was 38.1 years (SD: 15.5) and 66% were male. Three-quarters (75%) of the patients presented in moderately severe condition while 16% were asymptomatic. The most common presenting symptoms were fever (59%) and dry cough (44%). The mean time between a positive test result and admission was 1.63 days (SD: 1.31). Almost all (97%) the patients were treated with lopinavir-ritonavir with no recorded death. The median duration of hospital stay was 12 days (IQR: 9-13.5). Conclusion In this preliminary analysis of the first COVID-19 cases in Nigeria, clinical presentation was mild to moderate with no mortality. Processes to improve promptness of admission and reduce hospital stay are required to enhance the response to COVID-19 in Nigeria.

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Introduction: Human immunodeficiency virus (HIV) infection is characterized by excessive and dysregulated production of both proinflammatory and antiinflammatory interleukins, which produces various hematological changes. This study described hematological changes in HIV-positive patients in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Methods and Materials: This was a cross-sectional study involving 88 consecutive patients. They included 44 newly diagnosed antiretroviral treatment (ART)-naive patients (as the test group), and 44 ART- experienced patients (as the control group). All 88 patients were evaluated for full blood count and CD4+ T-cell count as well as interleukins 6 and 10 assays. Results: The mean packed cell volume in the ART-naive and the ART-experienced participants were 32.6 ± 5.7% and 38.6 ± 6.0% (P = 0.01). Mean hemoglobin were 10.8 ± 1.80 and 12.8 ± 1.66 g/dL in the ART-naive and the ART-experienced participants (P = 0.01), whereas the mean corpuscular volume among the ART-naive patients was 83.9 fL ± 7 and 99.3 fL ± 12 among the ART-experienced patients (P = 0.01). The median total white cell count among the ART-naive and the ART-experienced patients were 5.6 × 109 and 3.1 × 109 (P = 0.04), whereas their total platelet counts were 227 × 109 ± 116 and 252 × 109 ± 95 (P = 0.29). Conclusion: Use of ART reduces inflammatory response to HIV, thus lowering levels of interleukins 6 and 10 ultimately improving hematological outcomes, except in a few patients who use zidovudine.

In this paper, we presented the effects of Television White Space (TVWS) on digital divide in Africa. The trends in digital divide are found to be wide in most African countries, which are characterized with low internet penetration. Perhaps this is expected because over 60 % of people in Africa reside in the rural area and these areas are characterized with low literacy, poverty level and limited telecommunication infrastructure supports. There have been research efforts and regulations towards the secondary use of TV frequencies. However, findings indicate that there are limited opportunities for such system in Europe: This is due to high internet penetration in Europe, but the situation may be quite different in other part of the world like in Africa. Therefore, the TVWS could be used to provide affordable universal access in rural Africa. The paper also presents some benefits developing countries in Africa will incur from utilizing the TVWS solution. Also, recent trend in the deployment of TVWS and experiences got from African countries that embrace the solution are presented. http://dx.doi.org/10.4314/njt.v34i3.19

This report describes an approach to explaining the basic genetics of sickle-cell disease to patients and their families in an uncomplicated yet sufficiently informative way. The areas covered include: the cause of the disease, its pathophysiology, and the importance of genetic counselling

The management of children suffering from sickle cell disease [sickle cell anaemia (SCA) and sickle cell beta degree-thalassaemia (S beta degree-thal.)] has been the concern of all clinicians caring for these patients. Several agents have been tried for treatment, often limited by toxic side effects. Piracetam (2-oxo-l-pyrrolidine acetamide, Nootropyl), a cyclic derivative of gamma-amino butyrate, used for the treatment of psychosenescent syndromes with no known side effects, was considered as a possible therapeutic agent for sickle cell disease. Interest was focused on the use of piracetam when it was shown that it had an antisickling effect, both in vivo and in vitro. We initiated multicentre double-blind investigations in two groups of children suffering from sickle cell disease ranging in age from 3-6 to 6-12 years. The total number of patients included in the study were 87 (SCA = 79 and Hb S beta degree-thal. = 8) in 13 centres in 10 different regions of Saudi Arabia. Coded boxes of the drugs were received from the company (UCB) and were administered as intravenous infusion during crises and orally during the follow-up, for a period of up to 1 year. After decoding the code at the end of the study, the patients were grouped into those receiving placebo (n = 39), i.e. controls, or piracetam (n = 48), i.e. study cases. In terms of age, weight, height and severity index, number of blood transfusions received and number of hospitalization, both groups were statistically homogenous. Data analysis showed that the clinical severity of the disease, the number of crises, the extent of hospitalization and the blood transfusion requirements significantly decreased during piracetam treatment (p0.001), though no statistically significant changes occurred in the placebo group. However, in the levels of the haematological and biochemical parameters no significant changes were documented in both groups. In addition, the improvement in the clinical presentation of the disease continued even several months after discontinuation of the drug in the majority of the children, as judged from the low severity index value. Though our results point to the recommendation that piracetam can be used for the treatment of children suffering from sickle cell disease, both SCA and S beta degree-thal, it is advisable to conduct long-term and close follow-up treatment programmes using piracetam to establish its therapeutic value particularly in adults and to ascertain that there are no long-term toxic side effects.

In this work, the optimal determination of the perturbation factor (&#955) or perturbation parameter for gradient method is considered. The spectrum analysis of the associated Jacobian of the associated matrix has laid the basis for the judicious selection of the perturbation factor. Numerical work is carried out to prove our hypothesis. Journal of the Nigerian Association of Mathematical Physics Vol. 10 2006: pp. 363-370

This report describes an approach to explaining the basic genetics of sickle-cell disease to patients and their families in an uncomplicated yet sufficiently informative way. The areas covered include: the cause of the disease, its pathophysiology, and the importance of genetic counselling.

Introduction: Ebola virus (EBOV) has been shown to persist in some body fluids of Ebola Virus Disease (EVD) survivors with implication for future transmission particularly in Nigeria where EVD was experienced for the first time in 2014. Thus, this paper was aimed at providing information on the duration of persistence of EBOV in Nigeria. Materials and Methods: Ten consenting EVD survivors were enrolled. Baseline specimens; urine and semen (males), urine and high vaginal swab (HVS) (females) were obtained within one month after discharge from the Ebola Treatment Centre (ETC) and subsequently every fortnight. Samples were analyzed using quantitative Real-Star Filovirus Screen RT-PCR kit 1.0 at the National Reference Laboratory in Lagos.Results: Ten EVD survivors comprising 4 (40%) males and 6 (60%) females with age ranges of 28 to >33 years (mean age: 33.0 ± 6.9 years) were evaluated. EBOV RNA was not detected in the urine of all the participants and HVS from the females. However, EBOV RNA was detected in the semen of all 4 (100%) male participants at baseline, and at 2 months after discharge from the ETC. Two men were still positive for EBOV RNA 4 months after discharge from the ETC despite persistent negative vireamia. Conclusions: Our data confirm that a negative viremia in the convalescent period is not predictive of the absence of the virus in semen. Despite an early clearance of the virus from the urine and HVS, there was persistence of EBOV RNA in semen of male survivors 4 months after recovery.