Nigeria

Introduction Prevention of Mother-to-Child Transmission of HIV (PMTCT) is a critical component of HIV control and if well implemented drastically reduces transmission to a child. However, Mother-to-Child Transmission of HIV (MTCT) remains a huge burden. Health facility-based antenatal care is still the main vehicle used for PMTCT services in Nigeria, when less than 40% patronize them. In view of shortages of qualified health personnel globally, engaging TBAs will improve the coverage of PMTCT services as it has the potential of bridging the gap. The aim of this study is to provide evidence to inform engagement of TBAs for PMTCT service delivery scale-up in Nigeria. Methods A cross-sectional survey was conducted among TBAs using questionnaires. Total study was done involving 409 TBAs. Data collected was analyzed using IBM SPSS version 25. Chi-square test was used for association of characteristics of TBAs with knowledge and practice on HIV as well as factors influencing willingness to collaborate in the PMTCT programme at < 0.05. Predictors were ascertained using Binary Logistic regression. Ethical Consideration were duly observed. Results In all, 241(58.9%) had overall good knowledge on HIV. The main source of knowledge was Healthcare workers 336 (82.2%). Majority correctly identified ways of HIV transmission and how transmission from infected mother to child can be prevented (>75%). The overall practice on HIV was poor 264 (64.5%) even though the majority 341 (83.4%) refer their HIV clients to health facility. Practices on personal protection was good (>70%). About 378 (92.4%) agree that they have a role in PMTCT for their clients and babies, however only 99 (24.2%) were willing to collaborate in the PMTCT programme. Identified predictors for good practice were; aged ≤ 45 years (AOR 2.66; 95% CI 1.08– 18.46), had primary education and below (AOR 0.68; 95% CI 0.05 – 0.75) and good knowledge (AOR 12.62; 95% CI 8.33 – 44.17). Identified predictors for agreeing to collaborate in the PMTCT programme were good knowledge (AOR 6.34; 95% CI 3.55 – 41.27) and good practice (AOR 3.15; 95% CI 1.74 – 13.35). Conclusions The attainment of PMTCT treatment targets for Nigeria is crucial to that of the world. TBAs are an important but currently underused resource for PMTCT scale-up. There is need to involve TBAs in PMTCT service delivery in Nigeria as if effectively engaged could bridge the gap in HIV control in Nigeria.

Child marriage represents a fundamental violation of human rights, nonetheless, several societies accept and practice this. This practice is life in Becheve, in Obanliku Local Government, Cross River State despite its implications to people involved, their communities and the world at large. It has received less attention from policymakers and health researchers. This study is to assess the betrothing of young girls into marriage in this area. Methods A descriptive cross-sectional study design was adopted among adults using questionnaires. Data was analysed using IBM SPSS version 23.0. Chi square test was used to ascertain the association between socio-demographic characteristics and agreement to betrothed/child marriage at significance level of p < 0.05. Binary Logistic Regression was used for predictors for variable with p value of ≤ 0.2 Result: High proportion of the respondents 222(53.9%) were currently in betrothed/child marriage, 184 (44.7%) had female children and 319(77.4%) have relatives or know anyone in such marriage. Only 82(19.9%) were happy and agree with such marriage. Key perceived reasons for such marriage were poverty 412(100%), tradition 412(100%), lack of education 410(99.5%), gender inequality 404(98.1%) and rural/urban area residence 402(97.6%). Psychological effects include; personality problems 410 (99.5%) and worries 402 (97.6%). Socioeconomic effects include; large family size 410 (99.5%), low education 409 (99.3%) and lack of decision making 408 (99.0%). Medical effects include; malnutrition 410 (99.5%), poor health seeking behavior 408 (99.0%), increased maternal and child mortality 400 (97.1%) and increased risk of STD 396 (96.1%). Identified predictors were age 35 - 50 years (AOR 6.34; 95% CI 3.55 – 75.23), ≥ 51 years (AOR 12.37; 95% CI 8.86 – 138.88), Widowed/Divorced/Separated (AOR 4.06; 95% CI 1.23 – 18.35), Islam religion (AOR 40.36; 95% CI 4.54 – 358.84), secondary education (AOR 0.23; 95% CI 0.15 – 0.45), tertiary education (AOR 0.060; 95% CI 0.014 – 0.495) and farming (AOR 24.12; 95% CI 15.41 – 37.56). Conclusion: This practice is still common in the study area. Lack of education, tradition, religion, lack of family support and insecurity fuel this practice. The consequences are manifold, overlapping and the impact trans-generational. There is need for concerted effort by all to end this menace

One of the global health challenges today is the prevalence of mental illness. A mental disorder or mental illness (MI) is a syndrome characterized by clinically significant disturbances in an individual’s cognition, emotion regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Newspapers, as part of the mass media, are saddled with the responsibility of covering mental ill-health. This study sought to explore the newspaper coverage of mental health issues in Nigeria. The content analysis technique was used to analyse four national newspapers: Daily Sun, The Guardian, The Nation, and Vanguard for five years. Code sheet was used as an instrument of data collection and agenda-setting theory and social responsibility theory were used to explain the study. Findings from the research revealed that the frequency coverage on mental illness is 321 with insanity as the most covered mental illness issue by the newspapers. The prominence given to the coverage of mental illness was low. More so, news was found to be the story genre that received the most attention. In terms of the direction of coverage, findings showed that the newspapers covered mental illness positively. The study also revealed that the selected newspapers did not give depth to stories on mental illness. Based on the findings, it is recommended among other things that Newspapers should endeavour to place essence in the interpretation and analysis of news reports on mental health issues.

Background: Multiple sclerosis is one of the most important immune mediated inflammatory diseases which affect young adults in their productive years and contributes to disability and mortality. Multiple sclerosis (MS) is an immune-mediated inflammatory disease of unknown definite aetiology which result from abnormal activity of the body's immune system characterized by attacks of the myelinated axons in the central nervous system. The aim of this study is to demonstrate the clinic presentation of multiple sclerosis among Nigerian patients. Methods: The study which is a descriptive cross-sectional study was carried out at a tertiary health centre, from January 2011 and December 2020. Results: A total of thirty-six patient had structured questionnaire administered in the Neurology Clinic and patients admitted into the medical wards. However, twenty-four patients were analyzed. The mean age of onset was 31.8 ± 8.8 with a female preponderance (91.7%). The clinical presentation of patients with multiple sclerosis showed that 95.8% had limb weakness and 87.5% had limb paraesthesia. Limb ataxia and fatigue was seen in 79.2% and 75% of the patients respectively, while 66.7% had limb spasticity and 54.4% had incoordination. The Clinical course of the disease showed that relapsing-remitting disease was seen in about 79.2% and secondary progressive is about 16.7%. Conclusion: This study though hospital based, suggest that MS is not uncommon among Nigerian. The 10-year period needed to get the study number may be a result of most patients being lost at the secondary health facilities due to non-recognition of the early symptoms and signs and poor diagnostics facilities.

Background: Multiple pregnancies are considered as high-risk pregnancies due to the increase associated maternal and fetal morbidity and mortality. The incidence of multiple pregnancy varies from region to region, with a very high incidence recorded in Nigeria and other African countries. Aims: To determine the prevalence and the feto-maternal outcome of multiple pregnancies. Materials and Methods: This was a retrospective study of all pregnant women who had multiple gestation at the University of Port Harcourt Teaching Hospital from January 1, 2012 to December 31, 2016. Data was obtained from the case notes and the special care baby unit (SCBU). The data obtained was entered into a spread sheet and analyzed using SPSS 22. Results are presented in simple percentages and tables. The P value was set at < 0.05 Results: During the period under review there were 9,895 deliveries, of which 287 were multiple pregnancies, giving a multiple pregnancy rate of 29/1000 deliveries. The mean age of the women was 29.0 ±4.3years, while the mean parity was 1.6± 1.5. Majority (85%) of the pregnancies were achieved spontaneously, while 15% were achieved through assisted reproductive technology. Twin pregnancies made up 92.1% of multiple gestations. The most common antenatal complication was pregnancy induced hypertension (22%). The caesarean section rate was 71%, the most common indication for caesarean section was abnormal lie and presentation of the leading twin (26.3%). About half (53%) of the babies were delivered preterm, with a mean gestational age at delivery of 35.1± 1.5 weeks. Of the 558 babies delivered, 52.3% had low birth weight. There were 43 perinatal deaths, giving a perinatal mortality rate of 77/1000 total births. Perinatal mortality was significantly associated with prematurity (0.0001) and booking status (0.0001). There were three maternal deaths, giving a maternal mortality ratio of 556.04/ 100,000 live births. All the maternal deaths were in unbooked patients. Conclusion: Multiple pregnancy is a high-risk pregnancy, associated with a high rate of perinatal and maternal morbidity and mortality. It is recommended that women with multiple pregnancy should have supervised antenatal care and delivery in a facility with good obstetric and neonatal intensive care services.

BACKGROUND: Angiotensin converting enzyme (ACE) regulates blood pressure and its increased level has been implicated in the microvascular and macrovascular complications of diabetes mellitus. These complications arise by chronic hyperglycaemia progressively causing formation of advanced glycation end products generating free radicals that lead to tissue damage. OBJECTIVE: The aim of the study was to assess the serum level of angiotensin converting enzyme in adults with type 2 diabetes mellitus. METHOD: A cross-sectional study conducted on 120 confirmed cases of adult type 2 diabetes patients who were on hypoglycaemic medication (but not taking ACE inhibitors) and 120 apparently healthy age-matched control subjects. Blood was collected in plain and lithium heparin bottles (for ACE and other analytes) respectively. Serum ACE levels were estimated with Eton Bioscience ELISA kits. Plasma electrolytes were analysed with ion selective electrodes while plasma urea and creatinine were estimated with Randox test kits, to assess renal function. Data generated was analysed with SPSS version 20.0. RESULTS: The mean ACE level in diabetic subjects was 25.61 ± 0.63 IU/L, and 23.69 ± 0.84 IU/L for control subjects (p = 0.01). While there was difference in ACE levels among the male diabetic subjects and control subjects (p = 0.04), there was no such difference among the females (P = 0.10). There was no association between the ACE levels and the parameters of renal function. CONCLUSION: The study found out that serum ACE was higher in diabetes male subjects. Despite the progressive effect of diabetes on renal function, the enzyme level was not affected by the duration of diabetes.

Hypertension (high blood pressure) is presently one of the most important risk factors for the development of cardiovascular diseases. Several developed and developing nations including Nigeria have adopted various initiatives to prevent and/or manage hypertension. This article entails the development of guidelinesby means of integrated and collaborative approach involving experts knowledgeable in the field coupled with community actionin rural settings in Delta State Nigeria. Using the Nominal Group Technique meeting, a group of seven key stakeholders knowledgeable in the field were brought together to harmonize their ideas and experiences within a period of three days. The meeting lasted six hours each day.Each round addressing a topic lasted for an hour and 45 minutes.Major concepts addressed were: optimal diagnosis and appropriate medical evaluation for high blood pressure, principles of blood pressure measurement and different steps in blood pressure measurement. Others are management options (routine baseline investigations, pharmacological and non-pharmacological measures) and prevention of high blood pressure as well as community screening programmes. This simple guideline will not only serve as a vade mecum but will also have a strong impact on the health, quality of life and mortality rate among rural communities in Nigeria.