LONG STANDING SCHIZOPHRENIA PRESENTING AS PARAPLEGIA IN NIGERIAN YOUTH.

Background: Schizophrenia is a severe mental health disorder characterized by abnormality in patient perception, belief and cognition resulting in gross abnormal behaviour and deterioration in interpersonal relationship and occupational functioning with onset usually in adolescence and youth period. While it is common to observe distortion in the belief system and perceptual experiences and other oddities of behaviour, including amotivational syndrome, ambivalence, social withdrawal, catatonia among youth suffering from this severe mental disorder, presenting with neurological symptom of complete inability to walk despite the desire to do so is very uncommon. We aimed to present a case report of a Nigerian youth who presented with inability to walk without any neurological deficit and had normal brain MRI scan. This is to highlight the need to have high index of suspicion among practitioner especially in young person with sudden onset of "paraplegia". Case Presentation: Mr X is a 30 years old single Lecturer who was brought into the hospital by relatives with two weeks history of sudden onset of inability to walk around and became bed bound. He graduated with first class in Mass Communication and commenced National Service as Lecturer when he started hearing voices discussing him and also believes that people want to kill. He became reclusive to self for about two years. No history of trauma to the head or hypertensive heart disease. He was earlier seen by a doctor who commenced him on carbamazepine and olanzapine but drugs adherent was poor and later completely abandon for unorthodox treatment. MRI Scan of the brain, FBC + diff, U & E and neurological examination were normal. He was commence on Risperdal and six weeks later into the treatment, he started ambulating about. Conclusion: While it may be rare, severe psychotic illness such as schizophrenia can result in complete inability to walk, mimicking neurological disorder. High index of suspicion with perseverance of treatment can resolve the patient illness and restore his social life.

Attitude and subjective wellbeing of non-compliant mothers to childhood oral polio vaccine supplemental immunization in Northern Nigeria.

BACKGROUND: Attitude and subjective well-being are important factors in mothers accepting or rejecting Oral Polio Vaccine (OPV) supplemental immunization. The purpose of the study was to determine the role of mothers' attitude and subjective wellbeing on non-compliance to OPV supplemental immunization in Northern Nigeria. METHODS: The study utilized a cross-sectional design to assess attitude and subjective well-being of mothers using previously validated VACSATC (Vaccine Safety, Attitudes, Training and Communication-10 items) & SUBI (Subjective Well-being Inventory-40 items) measures. A total of 396 participants (equal number of non-compliant and compliant mothers) from 94 non-compliant settlements were interviewed, after informed consent. T-test was run to assess difference in mean scores between the non-compliant and compliant mothers on VACSATC and SUBI measures. RESULTS: The research showed a significant difference in mean scores between the non-compliant and compliant groups on VACSATC measure of mothers' attitude (M = 18.9 non-compliant, compared to 26.5 compliant; p < 0.05). On subjective well-being, the study showed there was no significant difference in the mean scores of the SUBI measure (M = 77.4 non-compliant, compared to 78.0 compliant; p > 0.05). CONCLUSION: The research has shown that negative attitude is more commonly present in non-compliant mothers and may be a factor in vaccine refusal in Northern Nigeria.

Stopping circulatory vaccine-derived poliovirus in Kaduna state by scaling up special interventions in local government areas along rivers of interest- kamacha basin experience, 2013-2015.

BACKGROUND: The Kamacha river is one of the five polio environmental surveillance sites in Kaduna State where 13 circulating vaccine-derived polioviruses (cVDPDs) were isolated between 2014 and 2015. Kamacha river accounted for 5 of all reported cVDPVs in Kaduna State between 2014 and 2015. Poor quality Supplemental Immunization Activities (SIAs) and low population immunity have been reported in the 10 LGAs with tributaries that flow into the river. We described the processes of implementing the various health interventions in these targeted LGAs along the Kamacha River and assessed the effectiveness of the interventions in stopping cVDPV in Kaduna, state, Nigeria. METHODS: Special interventions that had been proven to be functional and effective in reaching unreached children with potent vaccines in the state were scaled up in these targeted 10 LGAs along the Kamacha River. These interventions included revision of house based microplans, scaling up of transit vaccination, scaling up of youth engagement, intensified supportive supervision, scaling up of Directly Observed Polio Vaccination (DOPV) and in-between rounds vaccination activities. We analyzed immunization plus days (IPDs) administrative tally sheet and monitoring data from 10 rounds before and 10 rounds after the special interventions. RESULTS: The number of children immunized increased from 1,862,958 in December 2014 before the intervention to 1,922,940 in March 2016 after the intervention. Lot Quality Assurance Sampling (LQAS) results showed an increase in the proportion of LGAs accepted at coverage > 90% after the interventions, from 67% before intervention to 84% after intervention. The proportion of non-polio AFP children with > 4 doses of oral polio vaccine increased from 2 to 8% before to 93-98% after the interventions.. No new environmental cVDPV has been isolated since the introduction of the interventions in April 2015 until July 2016. CONCLUSION: Scaling up known working interventions in the 10 LGAs with tributaries that drain to Kamacha River environmental sample site may have contributed to improved immunity and interruption of cVDPV in Kaduna state. These interventions should be replicated in LGAs and states with persistent poliovirus isolation.

Anthropometric standards of privileged neonates in Maiduguri, Nigeria.

PIP: The study had been undertaken with an objective to assess the anthropometric values of privileged neonates in Northeastern Nigeria. The subjects for the study are neonates born to physically and nutritionally normal mothers between 15-40 years of age and coming from a better socioeconomic section of various ethnic groups of Nigeria. 1530 full-term singletons, without any antenatal or natal problem have been studied for their weight, length and head circumference. The mean birth weight was observed to be 3.2 +or- 0.59 kg. with higher values in males. There was a tendency for the mean birthweight to increase with increase in parity. Ibo neonates were heavier than other ethnic groups. The overall incidence of low birthweight babies was 5.75%. Mothers 18 years of age had the highest incidence of intrauterine growth retardation. The average values for length were 49.18 +or- 2.9 cm and for head circumference 34.72 +or- 1.77 cm. Though the mean values for weight, length and head circumference are comparable to American standards, the normal range for large-for-date babies was found to be higher, particularly in Ibo neonates. The ethnic groups classified were Ibo, Kanuri, Hausa, Yoruba, Fulani, Shuwa and other.^ieng