Faculty of Clinical Sciences

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End date: 2018

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    Body Size and Metabolic Health: A Phenotypic Characterisation of an Indigenous African Working Population
    (Annals of Medical and Health Sciences Research, 2017-08) Agaba, Patricia A.; Akanbi, Maxwell O.; Ocheke, Amaka N.; Gimba, Zumnan M.; Fannap, Binfa J.; Iliya, Friday G.; Agaba, Emmanuel I.
    Background: An obesity subgroup has been described that do not have the typical metabolic abnormalities associated with obesity. Aims: We characterized body size and metabolic phenotypes among public employees. Materials and methods: 879 participants were evaluated using WHO-STEP wise approach to non-communicable diseases screening. Body size was classed according to WHO guidelines. Metabolically healthy obesity (MHO) was defined as obesity without elevated blood pressure, diabetes mellitus and reduced HDL-C (< 40mg/ dl for men and<50 mg/dl for women respectively). Determinants of MHO were assessed in a logistic regression model adjusting for socio-demographic, clinical and biochemical variables. Results: 38.1% (335/879) had normal BMI, 35.5% (312/879) were overweight and 26.4% (232/879) were obese. The prevalence of metabolically healthy normal weight (MHNW), metabolically healthy overweight (MHOWT) and metabolically healthy obese (MHO) was 47.7% (160/335), 32.6% (102/312) and 18.5% (43/232) respectively (p<0.001). Tertiary education (adjusted odds ratio (AOR)=1.59; 95% CI: 1.03-2.47), hypertension (AOR=2.30; 95% CI: 1.58-3.35), hypercholesterolaemia (AOR=1.52; 95% CI: 1.06-2.17) and reduced HDL-C (AOR=2.40; 95% CI: 1.20-4.78) independently predicted generalized obesity, while male sex (AOR=0.10, 95% CI:0.07- 0.16) reduced the risk of generalized obesity by 90%. Age 45 years and older (AOR=0.29; 95% CI: 0.20-0.40, p<0.001), alcohol intake (AOR=0.50; 95% CI: 0.34-0.74, p<0.001), and generalized obesity (AOR=0.31; 95% CI: 0.20-0.47, p<0.001) were protective against MHO. Conclusion: A significant proportion of the participants had the MHO phenotype. Body size had an inverse relationship with metabolic health.
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    Sexual risk behavior and HIV infection among adolescents in secondary schools in Jos, Nigeria
    (Nigerian Journal of Paediatrics, 2014) John C; Okolo SN; Isichei C
    Abstract Background: In adolescents sexual risk behaviours are believed to enhance the transmission of HIV infection. This study, therefore aims to examine prevalent sexual risk behaviours of adolescents in secondary schools in a town in northern Nigeria and its relation to HIV infection. Method: A total of 883 subjects drawn from 10 schools out of 37, were recruited for the study. Structured self administered questionnaire was given to each subject. Consenting subjects received group pretest counseling and had HIV screening using Determine HIV test kits. HIV positive subjects had confirmatory test using Unigold test kit. Result: Males accounted for 42.5% (374) out of the 883 students studied. Of this, 169 (19.2%) were sexually active. Mean age at sexual debut was 13.8±2.9 years; 13.3±2.7 years for males and 14.6±3.2 years for females, p=0.006. Males 101 (27%) were more sexually experienced as against 13.4% of the females, p<0.0001. Among the sexually active37.6% had two or more sex partners, and 63.9% of them never used condoms. In the sexually active, 54 (42.5%) had nonconsensual sex (NCS), with more of NCS occurring in younger subjects p<0.0001, more females p<0.0001, associated with less condom use (p=0.02). Nine (eight females and one male) of the 883 subjects tested HIV positive. among the sexually active subjects, only four tested HIV positive. Condom use among the sexually active, HIV positive subjects was 25%. Conclusion: Prevalent sexual risk behaviors noted were early sexual debut, nonconsensual sex, unprotected sex and multiple sex partners.
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    Sociocultural factors influencing the control of malaria in an endemic city in North Central Nigeria
    (International Journal of Biological & Medical Researc, 2010) Godwin T. Jombo; Emmanuel M. Mbaawuaga; Priscilla Denen Akaa; Olusayo O. Alao; Etete J. Peters; Simon J. Utsalo; Edward E. Okwori; Tyavyar J. Akosu; Etiobong A. Etukumana
    The continued persistence of malaria in Africa appears to be largely due to socio-cultural factors which very often, are at variance with the standard control methods. The study was therefore designed to ascertain the socio-cultural factors affecting the control of malaria in an endemic city- Makurdi, north central Nigeria. The study was cross-sectional in nature using systematic sampling methods to identify households; both quantitative and qualitative data were generated from adult women using structured and semi-structured questionnaires, and focused group discussions (FGDs) to obtain information on malaria. Questionnaires were administered requesting such as age, educational level, marital status, and awareness or otherwise of the existence of malaria, and methods of prevention. Focused group discussions were used to obtain qualitative information on malaria not captured in the questionnaires. Data obtained was analysed using Epi Info 6 statistical software. Of the 2,075 adult women studied, 97.0% (n=2,013) were aware of the existence of malaria. Out of these, 83.0% (n=1,671) did not consider malaria to be a serious health problem that would need urgent attention. Educational level and marriage had a positive impact on knowledge about the disease (P< 0.05). Accessibility to information on malaria and general knowledge of the modes of transmission and control was generally low, and to a large extent influenced by their cultural beliefs, values and low economic strengths. There is a need to intensify adult health education and provision should be made for home health educators to raise peoples' knowledge about the disease. Policies meant to reduce the poverty level of the people should be put in place to raise their economic status.
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    PREVALENCE OF UNDIAGNOSED POST TRAUMATIC STRESS DISORDER AMONG IN-PATIENTS IN A SUBSTANCE USE DISORDER TREATMENT CENTRE IN NIGERIA
    (JOURNAL OF BIOMEDICAL RESEARCH & CLINICAL PRACTICE, 2018-04-23) Makput, D.M.; Dami, N.; Piwuna, C.G.; Haa, T.N.; Maton, C.
    Post traumatic stress disorder is a clinical disorder characterized by emotional and physical symptoms that may occur after exposure to a severely traumatic event. It occurs commonly as a co-morbid diagnosis with substance related disorders, as well as other psychiatric disorders. We postulated that post traumatic stress disorder may be under- diagnosed in therapeutic wards where substance use disorders are treated. This study thus sought to determine the prevalence of undiagnosed post-traumatic stress disorder in a substance use disorder in-patient population. The posttraumatic stress disorder check list, Civilian version was administered to patients on admission at the Center for addiction treatment and research, Vom, Plateau state, Nigeria in June 2017. Sociodemographic data and information regarding substance use were also obtained from the patients. A total of 38 inpatients were analyzed and 8 (21%) met the Diagnostic and statistical manual of mental disorders (fourth edition) criteria for current post traumatic stress disorder. None of the patients had a diagnosis of post-traumatic stress disorder in their case notes prior to the post-traumatic stress disorder check list administration in this study. Post traumatic stress disorder which is frequently co-morbid with substance abuse remains undiagnosed in many patients admitted to our therapeutic center.
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    The Pattern and Trend of Non-communicable Diseases in Children in Jos, North Central Nigeria: A Four-year Review
    (International Journal of TROPICAL DISEASE & Health, 2017) Esther S. Yiltok1*, Helen O. Akhiwu1 , Ibrahim I. Abok1 , Olukemi O. Ige1 and Emeka U. Ejeliogu
    Aims: Non-communicable diseases (NCDs) are becoming significant causes of morbidity and mortality. However very little information is available in our setting on the trend of NCDs in children. The aim is to determine the pattern and trend of NCDs in children in Jos, Nigeria. Study Design: This is a retrospective study of patients that were admitted and managed for NCDs. The relevant clinical information was extracted from the hospital records. Place and Duration of Study: The Emergency Paediatrics Unit (EPU) of the Jos University Teaching Hospital (JUTH), Jos Nigeria, between January 2012 and December 2015. Methodology: The study was a retrospective descriptive study where all records of children admitted into the EPU of JUTH within the period under review were retrieved. The bio-data of all patients and diagnoses made during the course of admission were documented. Those with inconclusive diagnoses and neonates were excluded. Data collected were entered into Epi Info version 7.2. The data was presented in frequencies and percentages and categorical variables were analyzed with the chi-square test. P value < 0.05 was regarded as statistically significant. Results: A total of 2273 children’s records were reviewed of which 36.7% had NCDs with the NCDs prevalence ranging from 29.5% - 40.5%. The three commonest NCDs were sickle cell disease (SCD), seizure disorder and severe protein energy malnutrition (PEM). There was a steady increase in the prevalence of seizures and PEM over the period. The prevalence of the diseases fluctuated over the years under review. Conclusion: The burden of diseases in children appears to be shifting towards non-communicable diseases as shown in the rising trend of NCD in our study. Therefore, there is an urgent need for relevant stakeholders to develop and ensure implementation of policies to curtail this menace which is also increasing the morbidity and mortality of children especially those less than five years of age.
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    Medical Emergencies in Primary Schools and School Ownership of First Aid Boxes
    (Medical Journal of Zambia, 2015) Agbo HA; Envuladu EA; Hassan Z; Enokela E; Zoakah IA
    Introduction: The school system aims at developing pupils academically and socially. In the process of achieving this, pupils are prone to accidents and medical emergencies due to their vulnerabilities. The ability of the school system to respond to these challenges may depend on the availability of well equipped First Aid Boxes (FABs) and the promptness of initiation of first Aid treatment. Objectives: The study determined the prevalence and types of medical emergencies in primary schools and the level of ownership of FABs. Methods: Using a multi-stage sampling technique, twenty-two primary schools were studied and a cross sectional study design was employed. Interviewer administered questionnaire and check-list were the instruments of data collection. SPSS statistical software version 16.0 was used for the analysis. Results: The 22 primary schools had a total population of 6,933 pupils; (4.9%) of the 139,494 population of the district. Twenty seven percent of the respondents experienced bruises, falls, and cuts; (22.7%) fever, cuts and episodes of convulsion; (13.6%) fever, bruises, stomach pains, falls and fractures. About (59.1%) of the primary schools had FABs with only (45.5%) of these schools with FABs containing the basic items. Conclusion: This study has brought to light the level of ownership of FABs in primary schools as well as prevalence and types of medical emergencies in primary schools. In view of this, actions need to be taken to address the identified gaps.
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    Pilot Experience with Infrared Photocoagulation As an Office Based Procedure for the Treatment of Hemorrhoids.
    (IOSR Journal of Dental and Medical Sciences, 2016-05) Ale A. F; Achinge G. I; Peter S. D; Shitta A. H; Isichei M. W; Misauno M. A
    There are many minimally invasive modalities in use for the treatment of hemorrhoids, most of which are unavailable in our setting. This study sought to describe our recent experience with infrared photocoagulation with a view to stressing it's suitability as an office based procedure for treating hemorrhoids. A prospective study of consecutive patients presenting with symptomatic hemorrhoids was conducted over a 3 year period. 21 (22.3%) patients had grade 1 hemorrhoid, 53 (56.4%) had grade 2 and 20 (21.3%) had grade 3 hemorrhoids. All 20 patients with grade 3 hemorrhoids at re-assessment after 2 weeks, the grade had changed to 2. 53 (56.4%) patients had 2 sessions of treatment at 2 weekly interval, while 41 (43.6%) patients had a single session of treatment to cure symptoms. 60 (63.8%) patients had minor post procedure hemorrhage, 14 (14.9%) had mild post procedure pain, 4 (4.3%) had recurrence of symptoms and were treated via open hemorrhoidectomy, while 16 (17.0%) had no procedure related complication. Infrared photocoagulation is an effective, safe and well tolerated procedure for the outpatient treatment of hemorrhoids and may be used to downstage grade 3 hemorrhoids.
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    Knowledge and use of oral rehydration solution in the home management of diarrhea among mothers of under fives in Jos, Plateau State
    (International Journal of Biomedical Research, 2017) Danjuma A Bello; Tolulope O Afolaranmi; Zuwaira I Hassan; Faith C Ogbonna; Patrick G Inedu; Cecilia Ejiga; Olubunmi O Chirdan
    Background: Diarrheal disease is one of the leading causes of pediatric morbidity and mortality worldwide, with an estimated 1.8 million childhood deaths annually, accounting for 17% of childhood deaths. Death can occur following severe dehydration if body fluids and electrolytes are not replenished either through the use of Oral Rehydration Salt (ORS) solution or intravenous fluid. Hence, this study was conducted to determine the level of use of ORS among mothers of under fives. Methodology: This was a cross sectional study conducted among 158 mothers of under-fives attending the FHC between November 2014 and April 2015 using quantitative method of data collection. Epi info statistical software version 3.5.4 was used for data analysis with a 95% confidence interval was used in this study and a p-value of ≤ 0.05 was considered statistically significant. Result: The mean age of the respondents in this study was 29 ±5 years. Good knowledge of ORS was found among 94 (59.5%) of the respondent with a corresponding 96 (60.8%) engaging in good use of ORS in the management of diarrhoea disease for their under five children. Use of ORS in management of diarrhoea disease was significantly influenced by level o knowledge of ORS, age of the mothers, availability of prep-packed ORS and tertiary education. Conclusion: This study revealed a fairly high level of knowledge and practice of ORT in the home management of diarrhoea amongst mothers of under–fives.
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    Factors influencing the pattern of malnutrition among acutely ill children presenting in a tertiary hospital in Nigeria
    (Niger J Paed, 2014) Ocheke IE; John C; Puoane T
    ntroduction: The bur-den of childhood malnutrition in Nigeria has remained unchanged for nearly a decade between the two Demographic and Health Surveys (NDHS) of 2003 and 2008. The causes of malnutrition are complex and multifactorial. It results from the interplay of so-cioeconomic, dietary inadequacy and environmental factors. Objective: To describe factors that influence the pattern of malnutri-tion in acutely ill children in a tertiary Hospital in central Nige-ria. Methods: Cross sectional and descriptive study. Children aged 6 to 59 months presenting with acute illnesses to the paediatric emergency unit were concurrently recruited over a 7 month period, (April-October 2012). All had comprehensive clinical assess-ment done including anthropom-etric (weight, mid arm circumfer-ence, height/length) measure-ments and z-scores calculated for the individual nutritional charac-teristics. Results: A total of 379 children were recruited with a mean age of 21.7±13.9 months. There was no difference in the mean age be-tween male and female (P=0.8). The prevalence of wasting was (26.9%), (18%) for stunting and (18.9%) for underweight. The prevalence of severe wasting, WHz scores <-3SD was (5.9%), (5.4%) for stunting and (4.6%) for underweight. The highest preva-lence of wasting and stunting were in age groups 6-11 and 12-23 months, at 9.3% and 6.3% respec-tively. The factors associated with malnutrition included early intro-duction of complementary diets, number of children in the home, maternal illiteracy and lower so-cioeconomic status of the parents. Female children were commenced on complementary diets much ear-lier than male (P=0.01). Conclusion: This study demon-strates the association between childhood malnutrition and factors such as early initiation of comple-mentary diet, maternal illiteracy, number of children in the home and poor parental socioeconomic status
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    PREVALENCE OF POSTDURAL PUNCTURE HEADACHE AMONG CAESAREAN SECTION PATIENTS IN NORTH CENTRAL NIGERIA
    (Kanem Journal of Medical ScienceS, 2017) Samuel I Nuhu; Henry Y Embu; Iornum Shambe
    Background: Spinal anaesthesia is now a popular choice for Caesarean sections in Africa but one of the draw-back is the development of post-dural puncture headache (PDPH) and it could be quite distressing to a mother. Identifying risk factors and reducing the prevalence is pertinent. This study sought to determine the prevalence of PDPH among patients who underwent Caesarean sections in a tertiary hospital in Jos, Plateau State, Nigeria and some of its possible associated factors.Method: It was a prospective study of all Caesarean sections done under spinal anaesthesia between November 2016 and June 2017. Spinal anaesthesia was performed on 236 parturients using Quincke-type needles sizes 23-26G. In the postoperative period, all the patients were followed-up to determine the incidence, onset, and severity of post-dural puncture headache. Epi-info version 7 was used for data analysis. Results: The prevalence of PDPH was 22.03%. Most of the parturients who developed PDPH in our study were of mild to moderate intensity using the numeric rating scale. Twenty six (11%) had mild, while 11 (4.7%) had moderate intensity of headache and which was resolved with treatment. Conclusion: The prevalence of PDPH is high in the obstetric population especially with the use of traumatic Quincke-type needles. Deliberate efforts must be made to reduce its occurrence by acquiring of small calibre pencil-point needles and training staff on how to use it.