An Efficient Turbo Decoding and Frequency Domain Turbo Equalization for LTE Based Narrowband Internet of Things (NB-IoT) Systems.

This paper addresses the main crucial aspects of physical (PHY) layer channel coding in uplink NB-IoT systems. In uplink NB-IoT systems, various channel coding algorithms are deployed due to the nature of the adopted Long-Term Evolution (LTE) channel coding which presents a great challenge at the expense of high decoding complexity, power consumption, error floor phenomena, while experiencing performance degradation for short block lengths. For this reason, such a design considerably increases the overall system complexity, which is difficult to implement. Therefore, the existing LTE turbo codes are not recommended in NB-IoT systems and, hence, new channel coding algorithms need to be employed for LPWA specifications. First, LTE-based turbo decoding and frequency-domain turbo equalization algorithms are proposed, modifying the simplified maximum a posteriori probability (MAP) decoder and minimum mean square error (MMSE) Turbo equalization algorithms were appended to different Narrowband Physical Uplink Shared Channel (NPUSCH) subcarriers for interference cancellation. These proposed methods aim to minimize the complexity of realizing the traditional MAP turbo decoder and MMSE estimators in the newly NB-IoT PHY layer features. We compare the system performance in terms of block error rate (BLER) and computational complexity.

Strategies for Improving Polio Surveillance Performance in the Security-Challenged Nigerian States of Adamawa, Borno, and Yobe During 2009-2014.

BACKGROUND: The security-challenged states of Adamawa, Borno, and Yobe bear most of the brunt of the Boko Haram insurgency in Nigeria. The security challenge has led to the killing of health workers, destruction of health facilities, and displacement of huge populations. To identify areas of polio transmission and promptly detect possible cases of importation in these states, polio surveillance must be very sensitive. METHODS: We conducted a retrospective review of acute flaccid paralysis surveillance in the security-compromised states between 2009 and 2014, using the acute flaccid paralysis database at the World Health Organization Nigeria Country Office. We also reviewed the reports of surveillance activities conducted in these security-challenged states, to identify strategies that were implemented to improve polio surveillance. RESULTS: Environmental surveillance was implemented in Borno in 2013 and in Yobe in 2014. All disease surveillance and notification officers in the 3 security-challenged states now receive annual training, and the number of community informants in these states has dramatically increased. Media-based messaging (via radio and television) is now used to sensitize the public to the importance of surveillance, and contact samples have been regularly collected in both states since 2014. CONCLUSIONS: The strategies implemented in the security-challenged states improved the quality of polio surveillance during the review period.

Progress towards the elimination of trachoma in Nigeria.

Trachoma is targeted for elimination as a public health problem worldwide by 2030. In Nigeria, elimination activities are implemented at the local government area (LGA) level. They started in 2002 by conducting baseline population-based prevalence surveys (PBPSs), which continued in a systematic manner with engagement from the Global Trachoma Mapping Project in 2013, and subsequently Tropical Data. The results led to the development of Nigeria's first trachoma action plan and its subsequent revision with additional information. Following 449 baseline PBPSs, 122 LGAs had an active trachoma prevalence above the elimination threshold, requiring interventions, while 231 LGAs required community-based interventions for trichiasis management. By 2021, >34 million antibiotic treatments had been provided in 104 LGAs, with 89 LGAs eliminating active trachoma. Nationally, water and sanitation coverages increased by 3% and 18%, respectively, in 7 y. Systematic trichiasis case finding and management were carried out in 231 LGAs, resulting in the management of 102 527 people. Fifty-four LGAs decreased trichiasis prevalence unknown to the health system to <0.2% in persons ≥15 y of age. Where this elimination prevalence threshold was reached, trichiasis services were transitioned to routine eye/healthcare systems. Such progress relied on strong leadership and coordination from the national trachoma program and tremendous support provided by partners. Attaining elimination of trachoma as a public health problem in Nigeria by 2030 is feasible if funding support is sustained.

Impact of COVID-19 on ophthalmic surgical procedures in sub-Saharan Africa: a multicentre study.

BACKGROUND: The COVID-19 pandemic had a profound impact on healthcare and ophthalmology services globally. Numerous studies amongst various medical and surgical specialties showed a reduction in patient attendance and surgical procedures performed. Prior published ophthalmic literature focused on specific types of procedures and were usually single centre. The current study attempts to quantify the impact on a larger scale, namely that of sub-Saharan Africa, and to include all ophthalmic subspecialties. METHODS: This is a retrospective analysis of the surgical records from 17 ophthalmology centres in seven countries located in East, Central, West and Southern Africa. The date of declaration of the first lockdown was used as the beginning of the pandemic and the pivot point to compare theatre records one year prior to the pandemic and the first year of the pandemic. We examined the total number of surgical procedures over the two year period and categorized them according to ophthalmic subspecialty and type of procedure performed. We then compared the pre-pandemic and pandemic surgical numbers over the two year period. RESULTS: There were 26,357 ophthalmic surgical procedures performed with a significant decrease in the first year of the pandemic (n = 8942) compared to the year prior to the pandemic (n = 17,415). The number of surgical procedures performed was lower in the first year of the pandemic compared to the year prior to the pandemic by 49% [Incidence rate ratio (IRR) 0.51, 95% CI 0.41-0.64), 27% (0.73, 0.55-0.99), 46% (0.54, 0.30-0.99), 40% (0.60, 0.39-0.92) and 59% (0.41, 0.29-0.57) in sub-Saharan Africa (4 regions combined), West, Central, East and Southern Africa, respectively]. The number of surgical procedures in the different sub-specialty categories in sub-Saharan Africa (4 regions combined) was significantly lower in the first year of the pandemic compared to the year prior to the pandemic, except for glaucoma (IRR 0.72, 95% CI 0.52-1.01), oncology (0.71, 0.48-1.05), trauma (0.90, 0.63-1.28) and vitreoretinal (0.67, 0.42-1.08) categories. CONCLUSION: This study provides insight into the impact of the COVID-19 pandemic in multiple regions and countries on the African continent. The identification of which surgical subspecialty was most affected by the COVID-19 pandemic in each region allows for better planning and resource allocation to address these backlogs.

Disability rates for cardiovascular and psychological disorders among autoworkers by job category, facility type, and facility overtime hours.

BACKGROUND: We examined the association between long work hours, assembly line work and stress-related diseases utilizing objective health and employment data from an employer's administrative databases. METHODS: A North American automobile manufacturing company provided data for claims for sickness, accident and disability insurance (work absence of at least 4 days) for cardiovascular disease (CVD), hypertension and psychological disorders, employee demographics, and facility hours worked per year for 1996-2001. Age-adjusted claim rates and age-adjusted rate ratios were calculated using Poisson regression, except for comparisons between production and skilled trades workers owing to lack of age denominator data by job category. Associations between overtime hours and claim rates by facility were examined by Poisson regression and multi-level Poisson regression. RESULTS: Claims for hypertension, coronary heart disease, CVD, and psychological disorders were associated with facility overtime hours. We estimate that a facility with 10 more overtime hours per week than another facility would have 4.36 more claims for psychological disorders, 2.33 more claims for CVD, and 3.29 more claims for hypertension per 1,000 employees per year. Assembly plants had the highest rates of claims for most conditions. Production workers tended to have higher rates of claims than skilled trades workers. CONCLUSIONS: Data from an auto manufacturer's administrative databases suggest that autoworkers working long hours, and assembly-line workers relative to skilled trades workers or workers in non-assembly facilities, have a higher risk of hypertension, CVD, and psychological disorders. Occupational disease surveillance and disease prevention programs need to fully utilize such administrative data.

High-Resolution Network with Dynamic Convolution and Coordinate Attention for Classification of Chest X-ray Images.

The development of automatic chest X-ray (CXR) disease classification algorithms is significant for diagnosing thoracic diseases. Owing to the characteristics of lesions in CXR images, including high similarity in appearance of the disease, varied sizes, and different occurrence locations, most existing convolutional neural network-based methods have insufficient feature extraction for thoracic lesions and struggle to adapt to changes in lesion size and location. To address these issues, this study proposes a high-resolution classification network with dynamic convolution and coordinate attention (HRCC-Net). In the method, this study suggests a parallel multi-resolution network in which a high-resolution branch acquires essential detailed features of the lesion and multi-resolution feature swapping and fusion to obtain multiple receptive fields to extract complicated disease features adequately. Furthermore, this study proposes dynamic convolution to enhance the network's ability to represent multi-scale information to accommodate lesions of diverse scales. In addition, this study introduces a coordinate attention mechanism, which enables automatic focus on pathologically relevant regions and capturing the variations in lesion location. The proposed method is evaluated on ChestX-ray14 and CheXpert datasets. The average AUC (area under ROC curve) values reach 0.845 and 0.913, respectively, indicating this method's advantages compared with the currently available methods. Meanwhile, with its specificity and sensitivity to measure the performance of medical diagnostic systems, the network can improve diagnostic efficiency while reducing the rate of misdiagnosis. The proposed algorithm has great potential for thoracic disease diagnosis and treatment.

Glutathione attenuated lambda-cyhalothrin-induced alteration of serum total cholesterol concentration and oxidative stress parameters in rats.

Background: Lambda-cyhalothrin is a type II pyrethroid insecticide that is used for pest control in agricultural, domestic, and industrial settings. Glutathione is an antioxidant that has been reported to confer protection on biological systems against the adverse impacts of insecticides. Objective: The aim of the study was to evaluate the effects of glutathione on the serum lipid profile and oxidative stress parameters of rats exposed to lambda-cyhalothrin toxicity. Methods: Thirty-five rats were assigned into 5 groups each. Distilled water was given to the first group, whereas the second group received soya oil (1 mL/kg). Lambda-cyhalothrin (25 mg/kg) was administered to the third group. The fourth group was given lambda-cyhalothrin (25 mg/kg) and glutathione (100 mg/kg) successively, whereas the fifth group received lambda-cyhalothrin (25 mg/kg) and glutathione (200 mg/kg) consecutively. The treatments were administered once daily by oral gavage for 21 days. The rats were sacrificed after the completion of the study. The serum lipid profile and oxidative stress parameters were assessed. Results: A significant (P < 0.05) increase was observed in the total cholesterol concentration of the lambda-cyhalothrin group. The serum malondialdehyde level was elevated (P < 0.05) in the lambda-cyhalothrin group. The superoxide dismutase activity of the lambda-cyhalothrin+glutathione200 group was enhanced (P < 0.05). The results revealed that lambda-cyhalothrin perturbed the total cholesterol concentration of the rats, whereas glutathione (particularly at 200 mg/kg, indicating a dose-response effect) ameliorated the disruptive impacts of lambda-cyhalothrin. Conclusion: The advantageous effects of glutathione may be ascribed to its antioxidant property.

A crossed-polarized four port MIMO antenna for UWB communication.

This paper presents a compact, crossed-polarized, ultra-wideband (UWB) four-ports multiple-input-multiple-output (MIMO) printed antenna. The proposed antenna is constructed from four microstrip circular patch elements fed by a 50-Ω microstrip line. Two metamaterial cell elements, in the form of a rectangular concentric double split ring resonator (SRR), are placed at the upper plane of the substrates for bandwidth improvement and isolation enhancement. The ultra-wideband frequency response is achieved using a defective ground plane. Surface current flow between the antenna's four elements is limited to ensure maximum isolation. The four-port MIMO system is designed with orthogonal antenna elements orientation on an FR4 substrate with a loss tangent of 0.02 and an overall size of 30 mm × 30 mm × 1.6 mm. Such orientation resulted in less than -17dB port-to-port isolation and an impedance bandwidth of 148% (3.1-12 GHz). The proposed UWB-MIMO antenna achieved a maximum realized gain of 6.2dBi with an efficiency of 87%. The measured and simulated results are in good agreement over the operating frequency band (3.1-12 GHz). The results also provide overall good diversity performance with the TARC < -10 dB, ECC < 0.001, DG > 9.9, MEG < -3 dB and CCL <0.1. The proposed antenna is well-suited for applications in WLAN, WIMAX and GPRs.

HMNet: Hierarchical Multi-Scale Brain Tumor Segmentation Network.

An accurate and efficient automatic brain tumor segmentation algorithm is important for clinical practice. In recent years, there has been much interest in automatic segmentation algorithms that use convolutional neural networks. In this paper, we propose a novel hierarchical multi-scale segmentation network (HMNet), which contains a high-resolution branch and parallel multi-resolution branches. The high-resolution branch can keep track of the brain tumor's spatial details, and the multi-resolution feature exchange and fusion allow the network's receptive fields to adapt to brain tumors of different shapes and sizes. In particular, to overcome the large computational overhead caused by expensive 3D convolution, we propose a lightweight conditional channel weighting block to reduce GPU memory and improve the efficiency of HMNet. We also propose a lightweight multi-resolution feature fusion (LMRF) module to further reduce model complexity and reduce the redundancy of the feature maps. We run tests on the BraTS 2020 dataset to determine how well the proposed network would work. The dice similarity coefficients of HMNet for ET, WT, and TC are 0.781, 0.901, and 0.823, respectively. Many comparative experiments on the BraTS 2020 dataset and other two datasets show that our proposed HMNet has achieved satisfactory performance compared with the SOTA approaches.

Unraveling the pathophysiology of schizophrenia: insights from structural magnetic resonance imaging studies.

Background: Schizophrenia affects about 1% of the global population. In addition to the complex etiology, linking this illness to genetic, environmental, and neurobiological factors, the dynamic experiences associated with this disease, such as experiences of delusions, hallucinations, disorganized thinking, and abnormal behaviors, limit neurological consensuses regarding mechanisms underlying this disease. Methods: In this study, we recruited 72 patients with schizophrenia and 74 healthy individuals matched by age and sex to investigate the structural brain changes that may serve as prognostic biomarkers, indicating evidence of neural dysfunction underlying schizophrenia and subsequent cognitive and behavioral deficits. We used voxel-based morphometry (VBM) to determine these changes in the three tissue structures: the gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF). For both image processing and statistical analysis, we used statistical parametric mapping (SPM). Results: Our results show that patients with schizophrenia exhibited a significant volume reduction in both GM and WM. In particular, GM volume reductions were more evident in the frontal, temporal, limbic, and parietal lobe, similarly the WM volume reductions were predominantly in the frontal, temporal, and limbic lobe. In addition, patients with schizophrenia demonstrated a significant increase in the CSF volume in the left third and lateral ventricle regions. Conclusion: This VBM study supports existing research showing that schizophrenia is associated with alterations in brain structure, including gray and white matter, and cerebrospinal fluid volume. These findings provide insights into the neurobiology of schizophrenia and may inform the development of more effective diagnostic and therapeutic approaches.

Baseline Prevalence of Trachoma in 13 Local Government Areas of Borno State, Nigeria.

PURPOSE: We set out to determine the baseline prevalence of trachoma in 13 Local Government Areas (LGAs) of Borno State, Nigeria. METHODS: A population-based cross-sectional survey was conducted in each of 13 LGAs from 2017 to 2019, with the support of Tropical Data (TD). World Health Organization (WHO)-recommended protocols were used. With a probability-proportional-to-size systematic sampling method, 25 villages were selected per LGA in 2017 and 30 villages per LGA in 2019; in each village, 25 households were enrolled for 2017 surveys, while 30 were enrolled for 2019 surveys. All present, consenting residents aged ≥1 year were examined by TD-certified graders for trachomatous inflammation-follicular (TF) and trachomatous trichiasis (TT) using the WHO simplified grading scheme. Additionally, we collected data on household-level access to water, sanitation and hygiene (WASH) facilities. RESULTS: One LGA (Magumeri) had TF prevalence in 1-9-year-olds ≥10%; two other LGAs (Monguno and Kaga) had TF prevalence between 5.0% and 9.9%. The prevalence of TT unknown to the health system was ≥0.2% in six LGAs. The proportion of households with access to improved water sources ranged from 30% (Kwaya Kusar) to 95% (Monguno); household-level access to improved latrines was lowest in Shani (7%) and highest in Maiduguri (95%). CONCLUSION: Active TT case finding and strengthening of TT surgical services are needed in six LGAs. Mass drug administration (MDA) of antibiotics is needed in three LGAs to reduce the prevalence of active trachoma to below elimination thresholds. The trachoma elimination programme should engage WASH agencies to augment access to improved WASH facilities.

Baseline Prevalence of Trachoma in 21 Local Government Areas of Adamawa State, North East Nigeria.

PURPOSE: To determine the prevalence of trachoma in each of the 21 local government areas (LGAs) of Adamawa State, Nigeria. METHODS: A population-based cross-sectional survey was conducted in each of the 21 LGAs of Adamawa State between 2017 and 2019. With the support of Tropical Data (TD), surveys were planned and implemented in accordance with World Health Organization (WHO) recommendations. A two-stage cluster sampling technique was used in each LGA, 25 or 30 clusters were selected with a probability of selection proportionate to cluster size, and in each of these clusters, 25 or 30 households were enrolled for the survey. All residents aged 1 year and older within selected households were examined by TD-certified graders for trachomatous inflammation - follicular (TF) and trachomatous trichiasis (TT) using the WHO simplified grading scheme. Additionally, data were collected on household water and sanitation access. RESULTS: All 21 LGAs had TF prevalence in 1-9-year-olds below 5%. The prevalence of TT unknown to the health system in people aged ≥15 years was ≥0.2% in three of the 21 LGAs. Access to improved water and sanitation facilities was <80% in the majority of the surveyed LGAs. Only 12 of the 21 LGAs had ≥50% household-level improved latrine access, and only Yola North had ≥80% household-level improved latrine access. CONCLUSION: There is no need for mass treatment with antibiotics for trachoma elimination purposes in any of these LGAs. There is a need for active TT case finding and provision of community-based TT surgical services in three LGAs. Furthermore, engagement with water and sanitation agencies is needed to augment access to improved water and sanitation facilities across the State; this will help to avoid the recrudescence of active trachoma in the State.

Altered striatal functional connectivity and structural dysconnectivity in individuals with bipolar disorder: A resting state magnetic resonance imaging study.

Objective: Bipolar disorder (BD) is a mood swing illness characterized by episodes ranging from depressive lows to manic highs. Although the specific origin of BD is unknown, genetics, environment, and changes in brain structure and chemistry may all have a role. Through magnetic resonance imaging (MRI) evaluations, this study looked into functional abnormalities involving the striatum between BD group and healthy controls (HC), compared the whole-brain gray matter (GM) morphological patterns between the groups and see whether functional connectivity has its underlying structural basis. Materials and methods: We applied sliding windows to functional magnetic resonance imaging (fMRI) data from 49 BD patients and 44 HCs to generate temporal correlations maps to determine strength and variability of the striatum-to-whole-brain-network functional connectivity (FC) in each window whilst also employing voxel-based morphometry (VBM) to high-resolution structural MRI data to uncover structural differences between the groups. Results: Our analyses revealed increased striatal connectivity in three consecutive windows 69, 70, and 71 (180, 182, and 184 s) in individuals with BD (p < 0.05; Bonferroni corrected) in fMRI images. Moreover, the VBM findings of structural images showed gray matter (GM) deficits in the left precentral gyrus and middle frontal gyrus of the BD patients (p = 0.001, uncorrected) when compared to HCs. Variability of striatal connectivity did not reveal significant differences between the groups. Conclusion: These findings revealed that BD was associated with a weakening of the precentral gyrus and middle frontal gyrus, also implying that bipolar illness may be linked to striatal functional brain alterations.

Gray matter, white matter and cerebrospinal fluid abnormalities in Parkinson's disease: A voxel-based morphometry study.

Background: Parkinson's disease (PD) is a chronic neurodegenerative disorder characterized by bradykinesia, tremor, and rigidity among other symptoms. With a 70% cumulative prevalence of dementia in PD, cognitive impairment and neuropsychiatric symptoms are frequent. Materials and methods: In this study, we looked at anatomical brain differences between groups of patients and controls. A total of 138 people with PD were compared to 64 age-matched healthy people using voxel-based morphometry (VBM). VBM is a fully automated technique that allows for the identification of regional differences in gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) allowing for an objective comparison of brains of different groups of people. We used statistical parametric mapping for image processing and statistical analysis. Results: In comparison to controls, PD patients had lower GM volumes in the left middle cingulate, left lingual gyrus, right calcarine and left fusiform gyrus, also PD patients indicated lower WM volumes in the right middle cingulate, left lingual gyrus, right calcarine, and left inferior occipital gyrus. Moreover, PD patients group demonstrated higher CSF in the left caudate compared to the controls. Conclusion: Physical fragility and cognitive impairments in PD may be detected more easily if anatomical abnormalities to the cingulate gyrus, occipital lobe and the level of CSF in the caudate are identified. Thus, our findings shed light on the role of the brain in PD and may aid in a better understanding of the events that occur in PD patients.

Evaluation of phytochemical constituents and sedative-hypnotic activity of the methanol leaf extract of Ficus exasperata in mice.

BACKGROUND AND AIM: Sedative drugs mostly cause dose-dependent depression of the central nervous system which results in hypnosis and anesthesia possibly; however, these agents are associated with some side effects ranging respiratory, digestive, immune system dysfunctions, tolerance, cognitive function deterioration, and physical dependence; hence, investigations of newer and safer agents are, therefore, imperative. The current study was aimed at investigating the sedative-hypnotic (S-H) effects of the methanol leaf extract of Ficus exasperata in mice. MATERIALS AND METHODS: Phytochemical screening of the leaf extract was conducted, and S-H activity of the plant extract was evaluated. Twenty Swiss Albino mice were randomly divided into four groups of five mice each. The mice in Groups A and B were injected with the extract intraperitoneally (IP) at the dose rate of 100 and 200 mg/kg, respectively, those in Group C were injected with xylazine at the dose rate of 10 mg/kg, while Group D mice received distilled water at the dose rate of 2 ml/kg. All the four experimental groups were injected with ketamine (IP) at the dose rate of 100 mg/kg after 30 min. RESULTS: Phytochemical analysis of the extract revealed the presence of carbohydrates, cardiac glycosides, reducing sugars, steroids and triterpenes, saponins, tannins, condensed tannins, and flavonoids, while anthraquinones, anthracene derivatives, and alkaloids were absent. Results from the S-H evaluation show no significant difference (p≥0.05) on the onset of sleep time between the four experimental groups; however, statistically significant difference (p≤0.05) was recorded in the sleep duration time between the groups treated with only ketamine and the other experimental groups pre-treated with either the extract or xylazine before ketamine administration. The group pre-treated with a high dose of the plant extract (200 mg/kg) and the treated with ketamine after 30 min exhibited longer sleeping duration time. The plant extract, xylazine and ketamine, sedated the mice for some period of time after arousal from sleep. CONCLUSION: Our finding suggests that methanol leaf extract of F. exasperata possesses S-H potential that may require further scientific investigations.

Impact of a 10-Year Eye Care Program in Sokoto, Nigeria: Changing Pattern of Prevalence and Causes of Blindness and Visual Impairment.

BACKGROUND: This study was undertaken to ascertain the current magnitude and causes of blindness and visual impairment in persons aged 50 years and over and to assess the impact of a 10-year eye care program in Sokoto State, Nigeria. METHODS: A rapid assessment of avoidable blindness (RAAB) survey (in persons 50 years and over) was conducted in 2016. Participants were selected in Wurno health zone using a two-stage cluster randomized sampling with probability proportional to size. Operational definitions were based on RAAB and World Health Organization eye examination record definitions. Eye care program documents were reviewed and data from a baseline survey undertaken in 2005 were reanalyzed. RESULTS: A response of 89.1% (2405 of 2700 participants) was obtained in the 2016 survey. With available correction, the unadjusted prevalence of blindness was 7.7% (95% confidence interval [CI]: 6.4, 8.9). The odds of blindness were 1.8 times higher in females than males (95% CI: 1.3, 2.4; P < 0.001). Major causes of blindness were cataract (48.9%) corneal disease (20.1%), glaucoma (10.3%), and uncorrected refractive error/aphakia (8.7%). The age- and sex-adjusted prevalence of blindness has declined from 11.6% (95% CI: 7.4, 17.0) in 2005 to 6.8% (95% CI: 5.6, 8.0%) in 2016. CONCLUSION: The blindness prevalence is high, and the major causes are avoidable in the health zone. The findings suggest that investments in the program over the last 10 years might have led to almost a halving in the prevalence of blindness in th e population. However, the small sample size of persons 50+ years from Wurno zone in the 2005 survey necessitate caution when comparing the 2005 and the 2016 surveys.

Prevalence of Trachoma in Four Local Government Areas of Jigawa State, Nigeria.

PURPOSE: To determine the prevalence of trachoma and water and sanitation coverage in four local government areas (LGAs) of Jigawa State, Nigeria: Birnin Kudu, Buji, Dutse and Kiyawa. METHODOLOGY: A population-based cross-sectional survey was conducted in each LGA using Global Trachoma Mapping Project (GTMP) protocols. From each LGA, 25 villages were selected using probability-proportional-to-population size sampling; in each village, 25 households were selected using the random walk technique. All residents aged ≥1 year in selected households were examined by GTMP-certified graders for trachomatous inflammation - follicular (TF) and trichiasis, defined according to the WHO simplified trachoma grading scheme definitions. Water, sanitation and hygiene data were also collected through questioning and direct observation. RESULTS: In 2458 households of four LGAs, 10,669 residents were enumerated. A total of 9779 people (92% of residents) were examined, with slightly more females examined (5012; 51%) than men. In children aged 1-9 years, the age-adjusted prevalence of TF ranged from 5.1% (95% CI 2.5-9.0%) in Birnin Kudu to 12.8% (95% CI 7.6-19.4%) in Kiyawa, while the age- and gender-adjusted trichiasis prevalence in persons aged ≥15 years ranged from 1.9% (95% CI 1.4-2.5%) in Birnin Kudu to 3.1% (95% CI 2.2-4.0) in Dutse. Access to improved water sources was above 80% in all LGAs surveyed but access to improved sanitation facilities was low, ranging from 23% in Buji to 50% in Kiyawa. CONCLUSION: Trachoma is a public health problem in all four LGAs surveyed. The full SAFE strategy needs to be implemented to achieve trachoma elimination.

Prevalence of trachoma in 13 Local Government Areas of Taraba State, Nigeria.

PURPOSE: The purpose of these surveys was to determine the prevalence of trachomatous inflammation-follicular (TF) in children aged 1-9 years and trichiasis prevalence in persons aged ≥15 years, in 13 Local Government Areas (LGAs) of Taraba State, Nigeria. METHODS: The surveys followed Global Trachoma Mapping Project (GTMP) protocols. Twenty-five households were selected from each of 25 clusters in each LGA, using two-stage cluster sampling providing probability of selection proportional to cluster size. Survey teams examined all the residents of selected households aged ≥1 year for the clinical signs TF, trachomatous inflammation-intense (TI) and trichiasis. RESULTS: The prevalence of TF in children aged 1-9 years in the 13 LGAs ranged from 0.0-5.0%; Ussa LGA had the highest prevalence of 5% (95%CI: 3.4-7.2). Trichiasis prevalence ranged from 0.0-0.8%; seven LGAs had trichiasis prevalences above the threshold for elimination. The backlog of trichiasis in the 13 LGAs (estimated combined population 1,959,375) was 3,185 people. There is need to perform surgery for at least 1,835 people to attain a trichiasis prevalence in each LGA of <0.2% in persons aged ≥15 years. In six of the 13 LGAs, 80% of households could access washing water within 1 km of the household, but only one LGA had >80% of households with access to improved latrines. CONCLUSION: One of 13 LGAs requires antibiotic mass drug administration for active trachoma. Community-based trichiasis surgery needs to be provided in seven LGAs. There is a need to increase household-level access to improved washing water and latrines across the State.

Prevalence of Trachoma and Access to Water and Sanitation in Benue State, Nigeria: Results of 23 Population-Based Prevalence Surveys.

PURPOSE: We sought to determine the prevalence of trachoma in each local government area (LGA) of Benue State, Nigeria. METHODS: Two-stage cluster sampling was used to conduct a series of 23 population-based prevalence surveys. LGAs were the evaluation units surveyed. In each LGA, 25 households were selected in each of 25 clusters, and individuals aged 1 year and above resident in those households were invited to be examined for trachoma. Data on access to water and sanitation were also collected at household level. RESULTS: A total of 91,888 people were examined from among 93,636 registered residents across the 23 LGAs. The LGA-level prevalence of trachomatous inflammation-follicular (TF) in 1-9 year olds ranged from 0.3% to 5.3%. Two LGAs had TF prevalences of 5.0-9.9%. The LGA-level prevalence of trichiasis in ≥15-year-olds ranged from 0.0% to 0.35%. Access to improved drinking water sources ranged from 0% in Gwer West to 99% in Tarka, while access to improved sanitation ranged from 1% in Gwer West to 92% in Oturkpo. CONCLUSION: There is a need for public health-level interventions against trachoma in three LGAs of Benue State.

Prevalence of Trachoma in Kogi State, Nigeria: Results of four Local Government Area-Level Surveys from the Global Trachoma Mapping Project.

PURPOSE: To determine the prevalence of trachoma in four Local Government Areas (LGAs) of Kogi State, Nigeria. METHODS: In June 2014, we conducted population-based, cross-sectional surveys according to Global Trachoma Mapping Project (GTMP) protocols in selected LGAs of Kogi State. In each LGA, 25 clusters were selected with probability proportional to size. In each of these clusters, 25 households were enrolled for the survey. All residents of selected households aged ≥1 year were examined by GTMP-certified graders for trachomatous inflammation-follicular (TF) and trichiasis using the simplified trachoma grading scheme. Data on sources of household water and types of sanitation facilities were collected through questioning and direct observation. RESULTS: The age-adjusted TF prevalence in 1-9-year-olds ranged from 0.4% (95% CI 0.1-0.8%) in Bassa to 1.0% (95% CI 0.3-1.9%) in Omala. Across all four LGAs, only one case of trichiasis was found; this individual was in Omala, giving that LGA a trichiasis prevalence in individuals aged ≥15 years of 0.02% (95% CI 0.00-0.07%). Between 77 and 88% of households had access to water for hygiene purposes, while only 10-30% had access to improved sanitation facilities. CONCLUSION: Trachoma is not a public health problem in any of the 4 LGAs surveyed. There is, however, the need to increase access to adequate water and sanitation services to contribute to the health and social and economic well-being of these communities.