Assessment of Adverse Events Following COVID-19 Vaccination: A Cross-sectional Study in Ibadan, Nigeria.

Background: Vaccination has been described as the most critical tool to end the COVID-19 pandemic and to save lives and livelihoods. This study aimed to evaluate the spectrum of adverse events following immunization with the COVID-19 AstraZeneca/Oxford vaccine in Ibadan, southwestern Nigeria. Methodology: A cross-sectional study. Adults aged ≥ 18 years who had received the Astra-Zeneca/Oxford COVID-19 vaccine at selected COVID-19 vaccination centres across three Local Government Areas in Ibadan, SW Nigeria were interviewed by means of a structured questionnaire to determine the spectrum of adverse events following immunisation (AEFI). Results: We enrolled 369 adults; 179 males and 190 females, with a mean of age of 37.8 ±12.0 years. Three hundred and thirty-two (90.0%) of the subjects experienced one or more AEFI. Of the total AEFIs reported, the most frequent were headache 225 (21.1%), fatigue/tiredness 186 (17.4%), pain at the injection site 99 (9.3%) and myalgia 97(9.1%). Nine in ten (96.4%) of these AEFIs occurred within 48 hours post-vaccination. Higher severity of adverse events score (p=0.049) and multiple AEFIs (p=0.01) were associated with the first dose of the vaccine. There were severe AEFI in 1.2 % (95% CI: 0.3-.9.0%) of the respondents. Presumed or confirmed COVID 19 infection before vaccination increased the odds of AEFI (OR 7.0, 95% CI: 1.8-27.8). Conclusion: Our study showed a high frequency of AEFI among recipients of the Astra Zenecca/Oxford vaccine in Ibadan. Majority of the AEFIs are mild and self-limiting. Previous infection with COVID-19 appears to increase the risk of AEFI.

Oxidative stress indices in ASD children in Sub-Sahara Africa.

BACKGROUND: The pathogenesis of autism spectrum disorder (ASD) remains a medical challenge even in the developed world. Although genetics and epigenetic factors have been variously indicted as major causes of the disorder, development of oxidative stress especially in the formative years of children has equally gained prominence as an etiological basis of the disorder. Oxidative stress is characterized by the production of excessive amounts of free radicals, decreased levels of antioxidants with the attendant imbalance in oxidant/antioxidant ratio. This study was designed to determine the levels of essential metals [magnesium (Mg), zinc (Zn), and copper (Cu)] and toxic metal, lead (Pb), and generation of oxidative stress by their abnormal interaction. METHOD: Twenty-five children clinically diagnosed for ASD according to DSM-IV-TR and 25 neuro-typical (NT) children (controls), (aged 5.96 ± 1.40 years and 6.18 ± 2.59 years respectively) were recruited for this study. Essential and toxic metals were analyzed using induction-coupled plasma-mass spectrometry (ICP-MS); oxidative stress markers [malondialdehyde (MDA), total plasma peroxidase (TPP), and total antioxidant capacity (TAC)] were determined using appropriate biochemical methods. Oxidative stress index (OSI) was calculated. RESULTS: The levels of TPP and TAC were significantly reduced while MDA was higher in ASD compared to NT. Although OSI was higher in ASD, the difference was not significant. Pb (lead) concentration was significantly increased while Mg, Zn, and Cu levels were reduced significantly in ASD compared to NT. A significant negative correlation between Mg and OSI (r = - 0.438; p = 0.029) was observed in NT. CONCLUSION: Reduction in Zn and Mg levels with a concurrent increase in Pb in children with ASD in this study may be the basis of inadequate TAC manifesting as increased MDA and reduced TPP levels. The attendant imbalance in oxidant/antioxidant ratio may result in abnormality in neuronal transduction leading to the abnormal cognitive and speech functions characteristic of ASD.

Cranial magnetic resonance imaging findings in kwashiorkor.

Protein energy malnutrition (PEM) is an important public health problem in the developing countries, although it is becoming uncommon in South West Nigeria. Cerebral changes have been associated with severe PEM. This study evaluated the neurological changes using Magnetic Resonance Imaging (MRI) in Ibadan south west Nigeria. The 5 children evaluated had a median age of 16 months and all the children had brain changes compatible with cerebral atrophy. In addition two of the children had periventricular white matter changes, while one these two had mega cisterna magna in addition. Though this study did not re-evaluate the brains of these children after nutritional rehabilitation, it is possible that changes are reversible as demonstrated in earlier studies.

Positive and inverse correlation of blood lead level with erythrocyte acetylcholinesterase and intelligence quotient in children: implications for neurotoxicity.

Blood lead level (BLL) is insufficiently sensitive for early detection of Lead-induced neurotoxicity (LIN). This study determined the possible role of the combination of BLL, intelligent quotient (IQ) and erythrocyte acetylcholinesterase (AChE) activity in the early detection of LIN in Children. Apparently healthy children (n=309) from eight public primary schools in Ibadan, Nigeria were recruited and classified into: children with Elevated BLL (EBLL) and children with Acceptable BLL (control) based on CDC cut-off for childhood lead exposure. Neurological indices (speech, memory, cranial nerves and cerebellar functions), IQ, BLL and erythrocyte AChE activity were assessed using standard methods, Standard Progressive Matrices, AAS and HPLC respectively. Statistical analysis involved Student's t-test, Pearson's correlation and multivariate regression. p<0.05 was considered significant. There were 169 (54.7%) children with EBLL while there were 140 (45.3%) control children. Both groups exhibited normal speech, memory, cranial nerves and cerebellar functions. However, IQ was lower in EBLL children (85.9±11.6) compared with control (91.5±14.0) while BLL and AChE activity were higher in EBLL children (0.4±0.1 µmol/l; 117.5±25.5 µkat/l) compared with control (0.2±0.0 µmol/l; 59.4±10.2 µkat/l). BLL showed inverse correlation with IQ (r=-0.134, p=0.019) but positive correlation with AChE (r=0.978, p≤0.001). 16.2% of the observed variation in BLL could be accounted for by AChE using the equation; [BLL=-0.007+0.003 AChE] p<0.05. Elevated blood lead level is prevalent among the school children and appears to have adverse effect on their IQ. Erythrocyte AChE could be a promising marker for early recognition of significant environmental lead exposure and lead-induced neurotoxicity in children.