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  • Is evidence-based medicine a mirage in resource-constrained settings? A survey among resident doctors in selected teaching hospitals in Nigeria.

    Posted 2020-02-23 03:16:38 by: The HealthFolk Team

    Related Articles Is evidence-based medicine a mirage in resource-constrained settings? A survey among resident doctors in selected teaching hospitals in Nigeria. J Evid Based Med. 2020 Feb 18;: Authors: Bello S, Ajayi DT, Bamgboye EA, Mpama EA Abstract AIM: The study aimed to assess the self-rated knowledge, attitude toward, and practice (KAP) of evidence-based medicine (EBM) among resident doctors in Nigeria. METHODS: This was a cross-sectional web-based survey among 238 resident doctors in four selected teaching hospitals in southern Nigeria. Survey questionnaire contained items assessing the KAP of EBM, familiarity with and understanding of key EBM terms, the use of EBM in decision making, barriers militating against EBM and ways to improve EBM adoption. Proportions and summary statistics were reported for the distribution of survey items. RESULTS: Mean number of years in clinical practice was 9.3 ± 4.5 years. Respondents were uniformly distributed in major clinical specialties. The majority (70.5%) were senior registrars. Respondents' understanding of EBM components included; current best clinical evidence (98.3%), clinical expertise (65.5%), and patients' choices (36.6%). Self-rated familiarity with EBM terms was high while perceived understanding of the terms was lower. The least understood concept was heterogeneity (20.6%). The attitude toward EBM was generally positive. Only about half (53.6%) had used medical bibliographic databases within the last 6 months prior to the survey. Barriers against EBM included lack of time (47.1%) and lack of requisite skills (32.4%). Suggestions to improve EBM adoption included training (58.1%), provision of free Wi-Fi, and free access to bibliographic databases (25.2%) and increased political will (23.1%). CONCLUSION: A further understanding of the EBM concept, provision of enabling infrastructure, regular clinical audit and advocacy to hospital ...

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  • The current state of retinopathy of prematurity in India, Kenya, Mexico, Nigeria, Philippines, Romania, Thailand, and Venezuela.

    Posted 2020-02-23 03:16:37 by: The HealthFolk Team

    Related Articles The current state of retinopathy of prematurity in India, Kenya, Mexico, Nigeria, Philippines, Romania, Thailand, and Venezuela. Digit J Ophthalmol. 2019 Apr;25(4):49-58 Authors: Bowe T, Nyamai L, Ademola-Popoola D, Amphornphruet A, Anzures R, Cernichiaro-Espinosa LA, Duke R, Duran F, Martinez-Castellanos MA, Multani PK, Nitulescu CE, Padhi TR, Tipsuriyaporn B, Chan RVP, Campbell JP, Yonekawa Y Abstract Retinopathy of prematurity (ROP) is one of the leading causes of preventable blindness in children worldwide. Middle-income nations are currently experiencing epidemic levels of ROP, because greater access to neonatal intensive care units has improved survival rates of premature infants, but without sophisticated oxygen regulation. The epidemiology, screening infrastructure, treatment options, and challenges that these countries face are often tied to unique local socioeconomic, cultural, geopolitical, and medical factors. We present an overview and narratives of the current state of ROP in eight countries that are or soon will be experiencing ROP epidemics-India, Kenya, Mexico, Nigeria, Phillipines, Romania, Thailand, and Venezuela-with a view to fostering both an understanding of the differences in the ROP landscape in various settings and an interest in the further development of ROP screening and treatment services tailored to local requirements. PMID: 32076388 [PubMed - in ...

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  • Management of glioblastoma: a perspective from Nigeria.

    Posted 2020-02-23 03:16:37 by: The HealthFolk Team

    Related Articles Management of glioblastoma: a perspective from Nigeria. Chin Clin Oncol. 2020 Feb 20;: Authors: Balogun JA, Adekanmbi AA PMID: 32075396 [PubMed - as supplied by ...

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  • Epidemiological Characteristics and Economic Impact of Lumpy Skin Disease, Sheeppox and Goatpox Among Subsistence Farmers in Northeast Nigeria.

    Posted 2020-02-23 03:16:37 by: The HealthFolk Team

    Epidemiological Characteristics and Economic Impact of Lumpy Skin Disease, Sheeppox and Goatpox Among Subsistence Farmers in Northeast Nigeria. Front Vet Sci. 2020;7:8 Authors: Limon G, Gamawa AA, Ahmed AI, Lyons NA, Beard PM Abstract Lumpy skin disease (LSD), sheeppox (SP), and goatpox (GP) are contagious viral infections, affecting cattle (LSD), sheep and goats (SP and GP) with highly characteristic clinical signs affecting multiple body systems. All three diseases are widely reported to reduce meat, milk, wool and cashmere production although few studies have formally evaluated their economic impact on affected farms. This study aimed to estimate the economic impact and epidemiological parameters of LSD, SP, and GP among backyard and transhumance farmers in northeast Nigeria. A retrospective study was conducted on herds and flocks affected between August 2017 and January 2018 in Bauchi, Nigeria. Herds and flocks were diagnosed based on clinical signs and information was collected once the outbreak concluded using a standardized questionnaire. Data were collected from 99 farmers (87 backyard and 12 transhumance). The median incidence risk and fatality rate were 33 and 0% in cattle, 53 and 34 % in sheep; 50 and 33% in goats, respectively, with young stock having higher incidence risk and fatality rates than adults. Almost all farmers (94%) treated affected animals with antibiotics, spending a median of US$1.96 (min US$0.19-max US$27.5) per herd per day. Slaughtering or selling affected animals at low prices were common coping strategies. Farmers sold live cattle for 47% less than would have been sold if the animal was healthy, while sheep and goats were sold for 58 and 57% less, respectively. Milk production dropped 65% when cows were clinically affected and 35% after they recovered. Cattle lost a median of 10% of their live weight and sheep and goats lost 15%. Overall economic losses at farm level range from ...

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  • Real-time Metagenomic Analysis of Undiagnosed Fever Cases Unveils a Yellow Fever Outbreak in Edo State, Nigeria.

    Posted 2020-02-23 03:16:37 by: The HealthFolk Team

    Real-time Metagenomic Analysis of Undiagnosed Fever Cases Unveils a Yellow Fever Outbreak in Edo State, Nigeria. Sci Rep. 2020 Feb 21;10(1):3180 Authors: Ajogbasile FV, Oguzie JU, Oluniyi PE, Eromon PE, Uwanibe JN, Mehta SB, Siddle KJ, Odia I, Winnicki SM, Akpede N, Akpede G, Okogbenin S, Ogbaini-Emovon E, MacInnis BL, Folarin OA, Modjarrad K, Schaffner SF, Tomori O, Ihekweazu C, Sabeti PC, Happi CT Abstract Fifty patients with unexplained fever and poor outcomes presented at Irrua Specialist Teaching Hospital (ISTH) in Edo State, Nigeria, an area endemic for Lassa fever, between September 2018 - January 2019. After ruling out Lassa fever, plasma samples from these epidemiologically-linked cases were sent to the African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer's University, Ede, Osun State, Nigeria, where we carried out metagenomic sequencing which implicated yellow fever virus (YFV) as the etiology of this outbreak. Twenty-nine of the 50 samples were confirmed positive for YFV by reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR), 14 of which resulted in genome assembly. Maximum likelihood phylogenetic analysis revealed that these YFV sequences formed a tightly clustered clade more closely related to sequences from Senegal than sequences from earlier Nigerian isolates, suggesting that the YFV clade responsible for this outbreak in Edo State does not descend directly from the Nigerian YFV outbreaks of the last century, but instead reflects a broader diversity and dynamics of YFV in West Africa. Here we demonstrate the power of metagenomic sequencing for identifying ongoing outbreaks and their etiologies and informing real-time public health responses, resulting in accurate and prompt disease management and control. PMID: 32081931 [PubMed - in ...

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  • Will Nigerians Win the War Against Urinary Schistosomiasis? Prevalence, Intensity, Risk Factors and Knowledge Assessment among Some Rural Communities in Southwestern Nigeria.

    Posted 2020-02-23 03:16:37 by: The HealthFolk Team

    Related Articles Will Nigerians Win the War Against Urinary Schistosomiasis? Prevalence, Intensity, Risk Factors and Knowledge Assessment among Some Rural Communities in Southwestern Nigeria. Pathogens. 2020 Feb 17;9(2): Authors: Awosolu OB, Shariman YZ, Haziqah M T F, Olusi TA Abstract Urinary schistosomiasis is a devastating parasitic disease in Nigeria. This study was carried out to investigate the current prevalence, intensity, risk factors and knowledge assessment among some rural communities in southwestern Nigeria. A cross-sectional study was carried out in which a standard urine filtrations technique was used to determine the prevalence and intensity of infection. A well-designed questionnaire was used to collect subject's data on demographic and socioeconomic characteristics. Of the total 620 urine samples examined, overall 346 (55.81%) were positive with a mean egg intensity (S.D) of 65.60 (59.33) egg/10 mL of urine. Significant differences occurred in the analysis. Males had the highest prevalence and intensity of 224 (61.9%) and 69.20 egg/10 mL of urine, respectively. The 10-14 years age group had the highest prevalence of 65.9% while mean intensity of infection among the age group decreases with increasing age, with the highest mean intensity of infection (80.14 egg/10 mL) recorded among the age group ≤ 4 years. Bivariate logistic regression analysis showed that being age group 10-14 (COR 0.27, 95% CI: 0.09-0.79) and dependent on river (COR 0.67, 95% CI: 0.33-1.33) increased the odd of contracting an infection. Similarly, the knowledge of respondents on urinary schistosomiasis was low. Conclusively, urinary schistosomiasis is still persistent at a very high rate in the study area and appropriate control measure should be deployed. PMID: 32079189 ...

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  • Fear, knowledge, and vaccination behaviors among women in Northern Nigeria.

    Posted 2020-02-23 03:16:36 by: The HealthFolk Team

    Fear, knowledge, and vaccination behaviors among women in Northern Nigeria. Hum Vaccin Immunother. 2020 Feb 21;:1-11 Authors: Sato R, Fintan B Abstract Background: Although vaccine hesitancy is a global concern, the evaluation on how fear of vaccination affects vaccination-related knowledge, behaviors, and perceptions is extremely scarce in developing countries. This study contributes to the literature by filling the knowledge gap on the fear of vaccination by focusing on Nigerian caregivers.Methods: The study evaluates the correlation between fear of vaccination and knowledge, actual behaviors, and perception among caregivers in 11 settlements in the Jada local government area of Adamawa State, northeastern Nigeria. The data were collected in September 2019. We use logistic regression analysis to evaluate the correlation.Results and Discussions: About 15% of caregivers have some form of fear regarding vaccination. However, such fear is not correlated with most of the socio-demographic characteristics among caregivers. Fear is significantly correlated with the lack of accurate vaccination knowledge, with a lower likelihood of vaccination uptake for their children, and with the lack of perceptions of vaccination importance and intention to vaccinate their children. Results from our study are consistent with findings from existing studies conducted in developed countries. PMID: 32083514 [PubMed - as supplied by ...

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  • Elevated Plasma Levels of sCD14 and MCP-1 are associated with HIV Associated Neurocognitive Disorders among Antiretroviral Naïve Individuals in Nigeria.

    Posted 2020-02-23 03:16:36 by: The HealthFolk Team

    Elevated Plasma Levels of sCD14 and MCP-1 are associated with HIV Associated Neurocognitive Disorders among Antiretroviral Naïve Individuals in Nigeria. J Acquir Immune Defic Syndr. 2020 Feb 07;: Authors: Jumare J, Akolo C, Ndembi N, Bwala S, Alabi P, Okwuasaba K, Adebiyi R, Umlauf A, Cherner M, Abimiku A, Charurat M, Blattner WA, Royal W Abstract BACKGROUND: Mononuclear cells play key roles in the pathogenesis of HIV associated neurocognitive disorders (HAND). Limited studies have looked at the association of markers of monocyte activation with HAND in Africa. We examined this association among HIV-1 infected patients in Nigeria. METHOD: A total of 190 HIV-infected treatment-naïve participants with immune marker data were included in this cross-sectional study. Plasma levels of soluble CD14 (sCD14), soluble CD163, monocyte chemo-attractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-α), and neopterin were measured. Demographically adjusted T scores obtained from a 7-domain neuropsychological test battery were generated and functional status assessed using activities of daily living questionnaire. Participants were classified as unimpaired, having asymptomatic neurocognitive impairment (ANI), minor neurocognitive disorder (MND), or HIV associated dementia (HAD) in line with the 'Frascati' criteria. RESULTS: Thirty-two participants (16.8%) had ANI, 14 (7.4%) had MND, while none had HAD. In multivariable linear regression analyses, adjusting for age, gender, education, CD4 count and viral load, mean levels of sCD14 were higher among those with ANI and MND as compared to the unimpaired (p = 0.033 and 0.023 respectively). Similarly, the mean level of MCP-1 was greater among those with HAND as compared to the unimpaired (P= 0.047). There were also trends for higher levels of sCD163 and TNF-α among females with MND in univariable analyses. CONCLUSION: Levels of monocyte activation ...

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  • Infrastructural Challenges Lead to Delay of Curative Radiotherapy in Nigeria.

    Posted 2020-02-23 03:16:36 by: The HealthFolk Team

    Infrastructural Challenges Lead to Delay of Curative Radiotherapy in Nigeria. JCO Glob Oncol. 2020 Feb;6:269-276 Authors: Leng J, Ntekim AI, Ibraheem A, Anakwenze CP, Golden DW, Olopade OI Abstract PURPOSE: In low- and middle-income countries, there has been an exponential increase in cancer incidence. According to the International Atomic Energy Agency, the biggest gap in radiotherapy availability and need is in Nigeria, where each machine serves an estimated 25.7 million people. This study aimed to characterize the barriers to radiotherapy and to identify areas for intervention. METHODS: This was a cross-sectional study conducted at the University College Hospital in Ibadan, Nigeria, from June 2017 to August 2017. Demographic, sociocultural, and infrastructural factors relating to radiotherapy were collected through a questionnaire (N = 186). Ordinal logistic regression was used to identify the factors leading to delays in referral and delays in treatment initiation. RESULTS: Patients traveled from 20 of Nigeria's 36 states. The median age was 50 years (range, 19-79 years). The most common cancers treated were breast (37.5%), cervical (16.3%), head and neck (11.9%), and prostate (10.9%). In ordinal logistic regression, sociocultural factors, including the inability to pay (odds ratio [OR], 1.99; P = .034), a bad hospital experience (OR, 7.05; P = .001), and travel time (OR, 1.36; P = .001), increased the odds of referral delay to radiotherapy. In contrast, there was no significant relationship between time to treatment initiation and sociocultural factors including age, education, and inability to pay. Infrastructural barriers, including machine breakdown (OR, 2.92; P = .001), worker strikes (OR, 2.64; P = .001), and power outages (OR, 2.81; P = .022), increased the odds of treatment delay. CONCLUSION: Although delays caused by patient factors are reported extensively, patients ...

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  • Child Electronic Growth Monitoring System: An innovative and sustainable approach for establishing the Kaduna Infant Development (KID) Study in Nigeria.

    Posted 2020-02-23 03:16:36 by: The HealthFolk Team

    Child Electronic Growth Monitoring System: An innovative and sustainable approach for establishing the Kaduna Infant Development (KID) Study in Nigeria. Paediatr Perinat Epidemiol. 2020 Feb 21;: Authors: Kana MA, Ahmed J, Ashiru AY, Jibrin S, Sunday AD, Shehu K, Safiyan H, Kantiyok C, Yusuf HE, Ibrahim JM, Musa S, Baduku TS, Tabari AM, Barros H, London SJ Abstract BACKGROUND: Developing countries bear the burden of childhood stunting but lack resources for cohort studies to develop preventive strategies. To enable future prospective studies, we designed and tested the Child Electronic Growth Monitoring System (CEGROMS) using a readily available electronic data capture platform, the Research Electronic Data Capture (REDCap). OBJECTIVES: To demonstrate the feasibility of using CEGROMS for data collection for a pilot study for the Kaduna Infant Development (KID) Birth Cohort Study in Nigeria. METHODS: CEGROMS consists of the data capture form for growth monitoring, a central cloud server, electronic tablets, and desktop computer. We implemented the pilot study in 2017-2019 at the Barau Dikko Teaching Hospital, Kaduna, Nigeria. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for completeness of baseline data (relative to individuals with incomplete data) and completion of follow-up at different time points (relative to individuals with no follow-up visit) by the participant characteristics. Complete data were defined as date of birth, sex, and birthweight recorded at recruitment. RESULTS: Among 3152 infant records in CEGROMS, 2789 (88.5%) had complete data. Of these, 1905 (68.3%) had at least one follow-up visit. The main determinants of data completeness were health facility delivery (OR 19.17, 95% CI 13.65,26.92) and tertiary education (OR 3.54, 95% CI 2.69,4.67). Follow-up was greater for women with tertiary education (OR 1.33, 95% CI 1.06, 1.51 for at least one visit). ...

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