Assessment of the Determinants of Healthy Ageing among the Rural Elderly of North-Eastern Nigeria

Healthy ageing is a lifelong process optimizing opportunities for improving and preserving health and physical, social and mental wellness, independence, quality of life and enhancing successful life-course transition. In Sub-Saharan Africa, it is estimated that the number of elderly persons will rise from about 37.1 million in 2005 to 155.4 million in 2050. The elderly population in Nigeria is estimated at 4 percent and is expected to triple by the year 2020. The increasing number of the older population will increase the burden on the health resources. The objective of this study was to evaluate the determinants of healthy ageing among rural elderly in northern Nigeria in order to promote those that have positive correlation with healthy aging. A cross sectional descriptive study was conducted among 1600 rural elderly aged ≥60 years using interviewer administered semi-structured questionnaire between June and July, 2011. Majority (53.8%) are 60 - 64 years, 24.6% >69 years, 72.4% are males while most are Muslims (85.6%) and 81. 4% are still married. Most are farmers (48.9%) while 73.6% have no formal education. 85.3% earn less than $100 monthly while 47.6% have no income. 93.5% do not take alcohol, 92.1% do not smoke and 89.8% are physically active. 83.1% have normal blood pressure (on examination), 88.3% normal blood glucose level (on examination). Diet, no smoking, high physical activity and adequate sleep are positively correlated with healthy aging (p < 0.05). Good health practices and family support should be sustained while special care for the aged should be established by the government.

Prevalence, Awareness and Risk Factors for Hypertension in Adults Attending a Tertiary Hospital in South-East Nigeria

Hypertension, a non-communicable disease, is considered a major public health challenge because of its widespread prevalence globally coupled with its huge morbidity and mortality burden, which is largely preventable if early detection and prompt initiation of management are done. Hypertension prevalence is increasing especially in the developing world, despite this, its awareness among the general population is low. This study aimed at determining the prevalence of hypertension among adult attendees of the General Outpatient Clinic of the Federal University Teaching Hospital (FUTH), Owerri, with an assessment of the proportion of hypertensives who were aware of their hypertensive status, and identifying risk factors of hypertension in the study participants. A cross-sectional analytical study was conducted between October and November 2022 at the General Outpatient Clinic of the FUTH, Owerri. A total of 257 consenting and eligible adult patients made up of 135 males and 122 females, aged 18 years and above, were selected by systematic random sampling method. The overall prevalence of hypertension was 34.6%. The prevalence was higher in females than in males (37.7% vs 31.9%, P = 0.325). Among the hypertensive subjects 56.2% had awareness of their hypertensive status. Following a multiple regression analysis, hypertension was independently associated with age, family history of hypertension, occupation (retirees, traders, farmers and the unemployed), and marital status (being widowed). Hypertension is prevalent in our environment;the prevalence rate from this study is higher than in most studies in our environment, suggesting possibly, a rising burden. The results from the study underscore the need for increased and sustained advocacy for implementation of policies and programs directed at increased detection and management of hypertension in the different population groups such as annual wellness check for employees in the formal sector, largescale dietary and lifestyle adjustments, and know your numbers (an approach to population driven blood pressure check for all adults). Also, health workers should use any opportunity of contact with a patient to screen for hypertension.

Pattern of Referral of Obstetric Patients at a Tertiary Care Hospital in Southern Nigeria

Background: Health challenges that are difficult to manage at primary health centres should be referred to secondary health facilities, and if untreated, to the tertiary hospitals. A good referral should include the patient’s biography, such as age, gender, tribe, religion, occupation, medical history, the reason for the referral, treatments received, and clinical diagnosis. Objectives: To evaluate the referral patterns, indications for referrals, and feto-maternal outcomes for obstetric patients who were referred to the University of Port Harcourt Teaching Hospital. Materials and Methods: A prospective study of patients admitted to the Obstetric unit from January 1, 2021, to December 31, 2022. Data was collected from patients while on admission or clinic visits and recorded in an excel spread sheet. Data was analyzed with the Statistical Package for Social Sciences (SPSS) version 25. Results: Of the 3469 patients were admitted to the obstetric unit, 1476 and 1993 were admitted in 2021 and 2022, respectively. Most (70.35%) of the patients were in the 20-34 years age group, parity 1-4 was the most frequent (66.49%), while 85.39% of patients were booked. 10.46% of the booked patients were referred from other facilities, whereas 89.54% of patients were booked at our facility from the onset. Most common indications of referrals were previous caesarean section (CS) at term (40.09%) and hypertensive disorders of pregnancy (17.59%). The outcome for 2021 indicated 17 maternal deaths, 132 fetal deaths and 1010 live births, giving maternal mortality ratio (MMR) as 1810.44 per 100,000 live births and perinatal mortality ratio (PMR) of 130.7 per 1000 births respectively. In 2022, there were 17 maternal deaths, 130 fetal deaths and 1297 deliveries, giving a MMR of 1399 per 100,000 live births and a PMR of 100.2 per 1000 births. Conclusion: The pattern of referral among obstetric patients in this study shows that a lot of the patients do not get adequate care at the lower cadre of the referral system, hence adequate facilities should be made available in primary and secondary health centres to tackle obstetric emergencies.

Enhancing Private Healthcare Effectiveness in Lagos State, Nigeria: An Overview of the Effect of Quality Improvement Initiatives and Implications for Sustainable Healthcare Delivery

Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge of ensuring quality healthcare access. The overview of the effect of quality improvement initiatives in this paper focuses on private healthcare providers in Lagos State, Nigeria. The study assesses the impact of donor-funded quality improvement projects on these private healthcare facilities. It explores the level of participation, perceived support, and tangible effects of the initiatives on healthcare delivery within private healthcare facilities. It also examines how these initiatives influence patient inflow and facility ratings, and bring about additional benefits and improvements, provides insights into the challenges faced by private healthcare providers in implementing quality improvement projects and elicits recommendations for improving the effectiveness of such initiatives. Methods: Qualitative research design was employed for in-depth exploration, utilizing semi-structured interviews. Private healthcare providers in Lagos involved in the SP4FP Quality Improvement Project were purposively sampled for diversity. Face-to-face interviews elicited insights into participation, perceived support, and project effects. Questions covered participation levels, support perception, changes observed, challenges faced, and recommendations. Thematic analysis identified recurring themes from interview transcripts. Adherence to ethical guidelines ensured participant confidentiality and informed consent. Results: Respondents affirmed active involvement in the SP4FP Quality Improvement Project, echoing literature emphasizing private-sector collaboration with the public sector. While acknowledging positive influences on facility ratings, respondents highlighted challenges within the broader Nigerian healthcare landscape affecting patient numbers. Respondents cited tangible improvements, particularly in staff management and patient care processes, validating the positive influence of quality improvement projects. Financial constraints emerged as a significant challenge, aligning with existing literature emphasizing the pragmatic difficulties faced by private healthcare providers. Conclusions: This study illuminates the complex landscape of private healthcare provision in Lagos State, emphasizing the positive impact of donor-funded quality improvement projects. The findings provide nuanced insights, guiding policymakers, healthcare managers, and practitioners toward collaborative, sustainable improvements. As Nigeria progresses, these lessons will be crucial in shaping healthcare policies prioritizing population well-being.

Feasibility Study of Assist-Linked Brief Intervention for Substance Use Disorders in a Rural Community of Plateau State, Nigeria

Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.

Prevalence and Factors Associated with Hypertension among People Living with HIV Receiving Care in Three Large HIV Clinics in Nasarawa State, Nigeria

In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combined effect of the aging population and the metabolic effect of the Human Immuno-deficiency Virus (HIV) virion and antiretroviral therapy. This study aims to assess the prevalence and factors associated with hypertension among people living with HIV in three large health facilities in Nasarawa State, Nigeria. A descriptive cross-sectional study employed a multistage sampling technique to select 309 adults with HIV, 18 years and above, receiving HIV care in three large health facilities in Nasarawa State. The outcome variable was the participants’ self-reported history of hypertension, confirmed through a positive history of hypertension treatment. Exposure variables included the participant’s socio-demographic characteristics, lifestyle factors, and HIV care and treatment history. Data were presented using frequency tables. Factors associated with hypertension were assessed using binary logistic regression at a 0.05 level of statistical significance. A total of 309 adults living with HIV were sampled. A larger percentage of the participants were married 228 (73.8%), female, 191 (61.8%), within the age group 41 - 50 years, 141 (45.6%). Most of the participants had no family history of hypertension, 188 (60.8%). The prevalence of self-reported hypertension was 11.0% (34/309). Factors associated with hypertension at the bivariate level were age group 21 - 30 years, 41 - 50 years, being widow/widower, divorced, retired from employment or with family history of hypertension. Only participants age group 31 - 40 years [Adjusted Odd Ratio (AOR): 0.18, 95%CI: 0.04 - 0.91, p = 0.04] and family history of hypertension [(AOR): 83.44, 95%CI: 15.75 - 442.11, p < 0.01] were found to predict hypertension among the study participants after adjusting for confounders. In conclusion, Hypertension remains a public health issue among PLHIV. Factors associated with hypertension among PLHIV include age and family history of hypertension. Regular screening for hypertension, its appropriate treatment and optimal control are essential in PLHIV.

A Cross-Sectional Study on the Impact of Operation Triple Zero (OTZ) Program on Viral Load Suppression amongst Members of the Adolescent Club in 68 Nigerian Army Reference Hospital Yaba Lagos, Nigeria

Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national challenges with poor viral suppression. The OTZ program aligns with the UNAIDS 95-95-95 goals. It seeks to empower AYPLHIV to be in charge of their treatment and commit to triple zero outcomeszero missed appointments, zero missed drugs, and zero viral loads. The purpose of the study was to assess the impact of the OTZ program on viral load suppression among members of the adolescent club in 68 NARHY, Lagos. Method: A cross-sectional retrospective study to evaluate the impact of the OTZ program on the viral load of 53 AYP enrolled in the OTZ program between March 2019 to December 2019 was analyzed. The Percentage of viral load suppression before enrollment compared with 6 and 12 months after enrollment into the OTZ program. The AYP is grouped into 10 - 14, 15 - 19, and 20 - 24 years. Activities conducted were peer driven monthly meetings with the AYP during which the adolescents interacted on issues relating to improving their treatment outcomes, healthcare workers reviewed their clinical status, viral load result, provider peer counseling, and caregivers engagement to support adherence to medication and ARV refills. Results: Before OTZ, 81% aged 10 - 14 years, 75% aged 15 - 19 years, and 25% aged 20 - 24 years were virally suppressed (VL less than 1000 copies/ml). Six months after enrollment, 94% were virally suppressed95% aged 10 - 14 years, 96% aged 15 - 19 years, and 66% aged 20-24 years. Twelve months after enrollment, 96% of AYP were virally suppressed100% aged 10-14 years, 93% aged 15 - 19 years, and 100% aged 20 - 24 years. Males viral load (VL) suppression improved from 79% to 96% and 92%, while females VL suppression improved from 69% to 93% and 100% at 6 and 12 months respectively. Conclusion: The OTZ activities contributed to improved viral load suppression in the AYP of the facility.

The Effect of Uterine Artery Occlusion with Tourniquet on Ovarian Reserve during Open Myomectomy at a University Teaching Hospital in Southern Nigeria

Background: The most common surgical treatment for symptomatic uterine fibroids, particularly in women with fertility concerns, is open myomectomy. Given the high vascularity of the uterus, haemorrhage during the procedure is a serious risk that is often mitigated with a uterine tourniquet. Aim and Objectives: To evaluate the effect of uterine artery occlusion with a tourniquet during open myomectomy on ovarian reserve using serial anti-Mullerian hormone (AMH) measurements. Materials and Methods: This was a prospective longitudinal study with a quasi-experimental design and a convenient sampling technique. The study enrolled 47 women who had abdominal myomectomy between September 1, 2021, and March 31, 2022, at the University of Port Harcourt Teaching Hospital. Blood samples were collected before anaesthesia was administered in theatre, on day two, and three months after open abdominal myomectomy for anti-Mullerian hormone assay. The data was collected using a semi-structured proforma, entered into an Excel spreadsheet, and analyzed using SPSS version 25.0 with a 95% confidence interval. Statistical significance level was set at 0.05. Results: The pre-surgery AMH mean value was 1.67 ± 1.44 ng/ml, while the values after using a uterine tourniquet at myomectomy on the second day and three months later were 1.22 ± 1.24 ng/ml and 1.59 ± 1.43 ng/ml, respectively. There was no statistically significant change in AMH levels, and there was no statistically significant relationship between blood loss and tourniquet time and AMH after open abdominal myomectomy. Conclusion: The use of a uterine tourniquet and blood loss during open myomectomy has no effect on ovarian reserve.

Spatial Disparity in Availability of Tuberculosis Diagnostic Services Based on Sector and Level of Care in Nigeria

Background: Delay in Tuberculosis (TB) diagnosis can contribute to late presentation, severe disease, and continued transmission. KNCV TB Foundation Nigeria through the United States Agency for International Development (USAID) funded the TB Local Organization Network (LON) 1 and 2 projects that explored the availability of Tuberculosis services based on sector and levels of care. Methods: TB Patient Pathway Analysis was carried out in 14 states comprising 92 facilities. It involved primary, secondary, and tertiary levels of health care in both the public and private sectors. This was a cross-sectional study under program implementation. Proforma was used to collect data on the available TB diagnostic services. Results: In public health facilities, GeneXpert was available at 100% in tertiary facilities in 8 (57%) states;up to 82% in 4 (33%) states, 50% available at secondary facilities in 2 states, and There is none at the primary facilities. Smear microscopy was available at 100% in tertiary facilities in 9 (64%) states and 3 (25%) states have 50% to 82%;secondary -10 (71%) states have > 70% at facilities;primary 1 (7%) state has it in 61% of facilities. Loop-mediated isothermal amplification (TB-LAMP) in tertiary 2 (17%) states have 20% and 100% respectively;secondary 4 (<30%) states have in 1 or 2 facilities;none for primary facilities. In private health facilities, 79% of states have Smear microscopy at both primary and secondary facilities, and only 2 states (14%) at tertiary facilities. Only 1 (7%) state has GeneXpert in all tertiary facilities, 2 (14%) states have secondary facilities, and 4 states in about 1% of facilities. TB LAMP was not available in any tertiary facility, one (7%) state at secondary with coverage of 1%, and 2 (14%) states at primary both with 4% overall facility coverage. Conclusions: There is an inequitable distribution of TB diagnostic services in both sectors and levels of care in Nigeria. TB care and control will improve with enhanced equitable distribution of TB diagnostic services across the health system.

Knowledge and awareness of human mpox infection among healthcare workers:A cross-sectional study in southwestern Nigeria

Objective:To identify the knowledge and awareness level of human mpox viral infection among healthcare workers in southwestern Nigeria.Methods:A cross-sectional study was conducted in Ekiti State,southwest Nigeria among 316 healthcare workers that were selected through a systematic random sampling.Data were collected with the aid of a semi-structured,self-administered questionnaire.The Chi-square test and binary logistic regression were used to find the association between the independent and dependent variables.The significance level was set at P-value<0.05.Results:Two hundred and twenty-two(70.3%)of the respondents were aged≤40 years,mean age(36±9)years,189(59.8%)were female,306(96.8%)were Christians,and 203(64.2%)were married.Three hundred and fourteen(99.4%)of the respondents were aware of mpox infection.Main sources of information about mpox were medical education(44.0%),radio/television(32.0%)and newspaper(21.0%).However,among those aware of the disease,209(67.0%)demonstrated poor knowledge levels.Longer than 5 years’experience of medical practice was the only significant predictor of higher knowledge level of the disease(OR 1.76,95%CI 1.01-3.06;P=0.046).Conclusions:Despite the high awareness level of mpox infection among healthcare workers,there still exists a huge knowledge gap.It is recommended that targeted intervention could be directed towards continuous medical education and simulation exercises on re-emerging infectious diseases like mpox to improve the knowledge of the healthcare workers.

Drop Factor and Infusion Dose Calculation Discrepancies among Nurses in Southern Nigeria: A Cross-Sectional Study

Nurses must deliver infusions as prescribed since too slow or fast a dose could be deleterious to patients. Nurses experience challenges with infusion dose calculations, making them vulnerable to errors. The research team examined drop factor and infusion dose calculation discrepancies among nurses in southern Nigeria. Five university teaching hospitals were involved in this cross-sectional study conducted in 2019. To establish the drop factor of commonly available macro drip sets, the team randomly sourced 25 macro drip sets from the hospitals’ pharmacies. A sample of 291 nurses was selected using a proportionate random sampling technique. The team collected data using the Adult Infusion Dose Calculation Quiz and analyzed it at a 5% significance level. Twenty (80%) of the sampled macro drip sets displayed a drop factor value of 20 drops per milliliter (gtt/ml) on their packaging. When measured experimentally, 25 (100%) of the macro drip sets delivered exactly 20 gtt/ml. Only 36 (12.4%) respondents calculated macro drip infusion doses using the correct drop factor of 20 gtt/ml. Non-attendance of infusion administration training updates significantly increased the risk of error by 38% (p ≤ 0.001). In conclusion, the drop factor of macro drip sets used in southern Nigeria is 20 gtt/ml;nurses were prone to infusing patients at a lower dose than prescribed. Special training in infusion therapy might remedy this concern.

Estimating the Monetary Value of Hours Lost to the Nigerian Public Healthcare System When Full-Time Government Employee Doctors Engage in Dual Practice

Background: Dual Practice (DP) allows full-time public sector doctors to concurrently offer the same clinical services in the private sector. The debate against this practice seems to be largely influenced by its potential to reduce the contracted hours in the public sector and shift attention to private work. Purpose: The purpose of this secondary research is to estimate the monetary value of hours lost to the Nigerian public healthcare system when full-time government employee doctors are engaged in private practice. It attempts to quantify the amount of resource outflow from the public system due to absences and lateness arising from competition for time between the public system’s contracted hours and private practice. Methods: Sensitivity analysis in Excel 2010 was used to calculate doctors’ hourly pay in the public sector using the 2015 Consolidated Medical Salary Structure for medical and dental officers in Nigeria’s federal public service. The parameters used for the calculation were the official 40-hour working week and the average monthly gross pay of doctors on different grade levels. Hypothetical scenarios of hours lost due to absences associated with DP were created. The value of different hypothetical hour losses by the percentage of doctors assumed to engage in dual practice across all doctor grade levels was then computed. Results: The estimated annual value of hours lost from dual practice to a single public tertiary care hospital was N4,851,754 or 15,855 USD (best case scenario) and N19,407,017 or 63,422 USD (worst case scenario) for the normal routine work and N1,800,133 or 5883 USD (best case scenario) and N3,600,266 or 11,766 USD (worst case scenario) for the on-call duty. Conclusion: The government may have been paying salaries for large volumes of work not rendered in the public sector. The overall financial impact of dual practice in the Nigerian public system might be negative.

Medical Morbidity Profile of Adults in a Rural Community in Enugu, Southeast Nigeria: A Cross Sectional Survey

Introduction: People in rural communities are exposed to the risk factors for non-communicable disease as those in urban areas. Correct interpretation and management of symptoms are important in primary care especially in rural communities where diagnostic facilities are not readily available. Materials and Methods: This was a cross-sectional study carried out in a village in Enugu South Local Government area of Enugu State. Thorough medical history was taken from all eligible participants who gave their consent. Data were analyzed using SPSS version 26. Results: Data from a total of 1019 (64.7%) out of 1576 participants were analysed. Fever was by far the most common presenting complaint 580 (56.9%) of all participants and 67.9% of medical complaints seen in the clinic. This was followed remotely by musculoskeletal problems and neurological problems 15.6% and 3.8% of the participants respectively. Across all age groups, febrile illness was more than non-febrile illness except in those 65 years. Generalized body pains 74 (7.3%), back pains 55 (5.1), headache 33 (3.2%) and abdominal pains 24 (2.4%) were the commonest symptoms presented by the participants. About 15 (1.5%) of the population surveyed had had trauma/surgery in the past. This was twice the number who presented to the clinic with symptoms related to injury and trauma 7 (0.7%). Conclusions: Fever and musculoskeletal pains are the dominant medical complaints presented by adults in a rural community clinic. This may be related to the season of the year and the occupation of the population studied.

Psychological Issues among Women Undergoing Fertility Treatment in a Specialist Fertility Hospital, South East Nigeria

Introduction: In Nigeria, a major reason for marriage is procreation and married couples look forward to having children within a year or two of marriage. The inability to achieve conception and subsequently have a child among couples may lead to psychological complications. Objective: This study assessed the psychological impact of infertility and its management on women receiving treatment at a Fertility Specialist Hospital in a poor resource setting. Methods: This was a cross-sectional study of 376 consenting married women who sought and received fertility treatment at a private Fertility Specialist Hospital, located at Abakaliki, South-East Nigeria between May 1, 2017 and May 31, 2022. Socio-demographic and Structured questionnaires were administered to the participants over a 5-year period. Results: The mean age of the women at presentation was 36.9 (±7.2 SD) years. The majority of the women (227) presented with secondary infertility accounting for 60.4%, while the rest had primary infertility (χ2 = 16.18, P = 0.001). Male-only factor infertility accounted for 22.9% of all the infertility cases, female-only factor 21.3% while both (male and female factors co-existing) accounted for 52.7% of all the cases. The commonest cause of infertility in the study was poor sperm parameters (176) accounting for 46.8% of cases, tubal factor 19.1% and anovulatory factor 22.3% (χ2 = 214.21, P = 0.001). Three hundred and thirty four (88.8%) felt depressed, 266 (70.7%) felt guilty about the past, and 222 (59.0%) had suicidal tendencies because of the infertility ordeal. Two hundred and fifty one (66.8%) felt inferior, 237 (63.0%) cried often and 174 (46.3%) were socially withdrawn. However, 10.4% of the women felt satisfied and well. These negative psychological feelings were statistically significant. Concerning the effect on marriage, the closeness of couples was reduced significantly in 57.7%, 62.8% had reduced coital intimacy, 79.3% had frequent quarrel and misunderstanding, 27.9% had threats of divorce while 4.5% had actually divorced and 11.% separated. However, there was no negative effect of infertility in 8.8% of couples. Conclusion: Psychological issues associated with infertility and its management in women include feelings of depression, guilt feelings, suicidal ideation, weeping episodes, social withdrawal, feelings of inferiority, reduced libido, and poverty of intimacy with frequent quarrels and misunderstanding. Women appear to bear more of the psychological issues associated with infertility. Early marriage on the part of the women, preservation of their reproductive youthful ages, and a better understanding of the concept of infertility by the couple will not only reduce the prevalence of infertility but will also reduce the dangerous psychological issues associated with infertility.

A Review of Caesarean Delivery at the Kogi State Specialist Hospital, Lokoja, Nigeria

Background: Caesarean delivery rate is increasing globally including in Nigeria. Caesarean delivery is a life-saving surgery for both mother and child. Objective: The aim of the study was to assess the caesarean delivery rate at the Kogi State Specialist Hospital, Lokoja, Nigeria over a one-year period. Methods: This was a prospective assessment of the demographic characteristics of patients, indications, types, rates and outcomes of Caesarean delivery in Kogi State Specialist Hospital, Lokoja, Nigeria from December 15, 2020 to December 14, 2021. Data collected were analyzed using SPSS version 20.0 statistical package (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp). The categorical data were displayed using tables and charts. Results: There was a total of 491 deliveries, out of which were 113 Caesarean deliveries and 378 spontaneous vaginal deliveries making the Caesarean delivery rate in Kogi State Specialist Hospital, Lokoja, Nigeria 23.0%. There were no instrumental deliveries during the study period. The commonest indication for Caesarean section was obstructed labour in 31% of cases. There was no maternal mortality. There were three early neonatal deaths due to severe birth asphyxia. Conclusion: The rate of Caesarean delivery in this study was 23.0% and obstructed labour was the leading indication in 31% of cases. The rate of Caesarean delivery in this study is high, albeit the overall outcome was good for both mother and child. Caesarean delivery, therefore, remains one of the means for reducing maternal and perinatal morbidity and mortality in Nigeria.

Relationship between Intimate Partner Violence and Quality of Life among Females Attending the HIV Clinic of a Teaching Hospital in North Central, Nigeria

Background: Intimate partner violence is a serious public health concern worldwide and is linked with serious mental and physical health consequences. Despite its commonality and attendant consequences, proper public healthcare intervention is rudimentary. The aim of this study was to assess the relationship between quality of life associated with intimate partner violence among females attending the HIV Clinic at Jos University Teaching Hospital, Jos, Plateau, Nigeria. Methods: This study employed a cross-sectional design and data was collected from 174 female patients attending the HIV Clinic who met the inclusion criteria with the aid of a 73-item semi-structured interviewer-administered questionnaire. This captured socio-demographic characteristics, knowledge and attitude towards intimate partner violence and their experiences of violence and quality of life using the World Health Organization Quality of Life Scale-Brief version (WHOQOL-BREF). Results: Almost half of the respondents, 85 (48.9%) rated their quality of life as good. Respondents experiencing IPV reported poorer quality of life compared to those not experiencing partner violence in all the domains and it was statistically significant in the physical health (p Conclusion: IPV is common among females attending the HIV/AIDS Clinic and those affected reported significantly poorer quality of life.

The gravity field and gravity data reduction across the continental area of Nigeria

This research presents the variation of the gravity field and associated gravity field components over the continental area of Nigeria to provide data for geoscience research,geodetic and engineering works,aerodynamic studies and deep crustal inferences.Accurate positions and elevations were observed at 58 of the 59 base stations of the Primary Gravity Network of Nigeria(PGNN),whose absolute gravity values had been accurately determined.The absolute gravity values were plotted against their respective positions to reveal the distribution pattern and strength of the gravity field within the study area.Theoretical gravity values at each base station were generated using the Somigliana's equation.The free-air gravity and free-air anomaly gravity values were generated with respect to the World Geodetic System 1984(WGS84)ellipsoid using GPS-derived elevation data.Then,the perturbing potential,free-air gravity with respect to the geoid,and the indirect effects were evaluated.The average of the indirect effects was used to adjust the WGS84 gravity formula to produce a gravity formula that better approximates the geoid across the continental area of Nigeria,compatible with the heights measured relative to the geoid,which can serve as a reference for establishing a vertical height control.The Bouguer gravity and Bouguer gravity anomalies across Nigeria revealed a“trans-southern gravity high strip”interpreted to be associated with mantle upwelling.Two new major mega-lineaments related to mantle upwelling were mapped.A batholith province trending NWeSE was delineated,occurring from north central Nigeria to the north western region and containing closures of“Bouguer gravity lows”interpreted as batholiths.A separate closure of“Bouguer gravity low”was detected at Azare,north eastern Nigeria,which may be due to the presence of intrusive granitic body.It is recommended that the mantle structure beneath“the trans-southern gravity high strip”,“delineated batholith province”and“isolated gravity closures”around the northeast of Nigeria should be studied from seismic shear wave splitting analysis for better understanding of the deep lithospheric structures and moho relief.

Malaria Retinopathy among Under-Five Children with Severe and Uncomplicated Malaria in a Tertiary Health Institution in Southwest Nigeria: A Comparative Study

Introduction: Malaria retinopathy refers to retinal abnormalities unique to malaria resulting from prolonged parasitization by Plasmodium falciparum. Identifying these features and treating them promptly could prevent lethal complications of malaria. Therefore, this study was conducted to identify and compare retinal findings in severe and uncomplicated malaria. Methods: A cross-sectional study of 260 subjects was equally divided into two groups of severe and uncomplicated malaria. Direct ophthalmoscopy was done at recruitment for all subjects. Information on sociodemographics, physical examination, nutritional status, and retinal abnormalities were recorded. A p-value Results: There were 141 (54.2%) males and 70 (26.9%) aged between 13 - 24 months. Severe anaemia, multiple convulsions, prostration, and cerebral malaria were the predominant forms of severe malaria. Twenty-three (17.7%) subjects with severe malaria and none with uncomplicated malaria had retinopathy. Retinal whitening (17.7%), vessel changes (16.2%), and retinal haemorrhages (5.4%) were the major forms of retinopathy. Retinopathy occurred in 43.8% of those with cerebral malaria. Retinal whitening and vessel changes were significantly associated with multiple convulsions, cerebral malaria, and metabolic acidosis;retinal haemorrhage was associated with cerebral malaria and haemoglobinuria (p = 0.022) and vessel changes with hypoglycaemia (p = 0.037). Cerebral malaria was an independent predictor of retinal whitening (p = 0.004) and vessel changes (p = 0.008) while haemoglobinuria was an independent predictor of retinal haemorrhages (p = 0.007). Conclusion: Ophthalmoscopy is an important examination in children with severe malaria which could assist in early detection and with prompt treatment, reduce morbidities and mortalities.

Virologic Response among Children and Adults in an Antiretroviral Therapy Programme in Northern Nigeria: A Cross-Sectional Descriptive Study

Introduction: Viral load suppression is a key determinant of successful anti-retroviral therapy. The study aimed to determine virologic response to Antiretroviral therapy in the large cohort of children and adults living with Human Immune deficiency Virus. Materials and Methods: Viral Load results from the HIV Ribonucleic Acid Polymerase Chain Reaction register of 10,887 children and adults on cART in 4 states in Northern Nigeria between 2017 and 2019 were retrieved and analyzed in the PCR Molecular Laboratory of the Federal Teaching Hospital, Gombe. Results: 10,887 children and adults were analyzed. Males were 28.4% (3094) and 71.6% (7793) females. 2.9% (311);3.5% (386);7.3% (797);65.2% (7098);14.5% (1583);5.2% (562) and 1.3% (150) were aged 0 - 9 years, 11 - 18 years;19 - 25 years, 26 - 45 years;46 - 55 years;56 - 65 years and 10 years. The most recent CD4count before viral load request was ≥1000/μL in 7.4% (810/10887);500 -999/μL in 39.0% (4240);350 - 499 μL in 22.7% (2466) and 1000 c/mL in 26.5% (821/3094) males and 24.1% (1876/7793) females. Viral load was significantly lower among females (p-value 0.007). 50.5% (157/311);52.1% (201/386);28.5% (227/797);23.5% (1670/7098);19.9% (315/1583);17.8% (100/562) and 18.0% (27/150) aged 0 - 9 years, 11 - 18 years;19 - 25 years, 26 - 45 years;46 - 55 years;56 - 65 years and 1000 c/mL respectively. Viral load was >1000 c/mL in 28.2% (229/811) for those on HAART for 6 months - 1 year and 23.6% (1243/5275) after receiving Highly Active Antiretroviral Therapy (HAART) for 1 - 5 years. 26.3% (1072/4075) and 21.1% (153/726) had viral load > 1000 c/mL after receiving HAART for 6 - 10 and >10 years respectively (p-value 0.001). Conclusion: HIV viral suppression was below the WHO recommended threshold.

Lassa Fever: Patients Profile and Treatment Outcomes at Benue State University Teaching Hospital Makurdi, North-Central Nigeria

Lassa fever is a viral haemorrhagic fever found mostly in West Africa where it is endemic but generates periodic outbreaks in the dry seasons. The virus is spread by the rat species named mastomys natalensis. While the illness is minor in most cases, the mortality is significant in hospitalized patients. Few completely equipped treatment centers existed in Nigeria previous to current increase in frequency requiring demand for new treatment centers without the full complement of essential capabilities. Aim: To analyze the profile and treatment outcome in patients hospitalized in one of such new resource-constrained centers at the Benue State University Teaching Hospital Makurdi, Nigeria. Methodology: This was a retrospective, descriptive hospital-based research encompassing January 2020 to March 2023. Medical records of those admitted to the isolation center were reviewed. The relevant data was coded and analyzed using IBM SPSS version 23. Results: One hundred and ten (110) individuals were hospitalized for probable or suspected Lassa fever throughout the research period. A total of 35 confirmed patients satisfied the inclusion criteria and were included as the study subjects. There were 23 (65.7%) men and 12 (34.3%) females. Their mean age was 35.36 ± 12.21 years (range 15-61 years). The treatment outcome showed that 24 (75%) survived and were discharged, 5 (15.6%) were referred out of the facility for dialysis and 3 died, providing a mortality of 8.6%. The causes of mortality in study patients were acute kidney injury and encephalopathy. Conclusion: Lassa fever is endemic in Benue state with all types of individuals afflicted. The outcome of treatment was good despite resource difficulties. Lassa fever can be successfully managed even in resource-challenged situations typically encountered in developing countries.