Staff risks stratification in preparation for COVID-19 in a tertiary healthcare facility in Nigeria.

INTRODUCTION: this report is a documentation of a staff risk stratification programme, undertaken in University of Benin Teaching Hospital, with outcomes, and the actions taken to protect staff. METHODS: an adapted risk stratification tool was circulated to all staff through their respective heads of departments/units. Staff were expected to voluntary assess their health and risk status in the context of COVID-19, using the tool. A central multi-disciplinary screening committee assessed submissions and invited staff who required further evaluation for physical interviews. Respondents were categorized into three risk/exposure groups from lowest to highest - A, B, and C, based on their individual health assessments, occupational exposures, and information obtained from direct interviews. RESULTS: the committee received submissions from 746 staff, representing 19.4% (about a fifth) of the hospital's 3,840 staff. One hundred and twenty two of these were invited for physical interviews, of whom 88 (72.1%) were categorized as high risk (Category C): pregnancy (53.4%); bronchial asthma (19.3%); hypertension (11.4%); cancer (3.4%) and sickle cell disease (2.3%); fractures and pulmonary tuberculosis (1%, respectively). These staff were recommended for redeployment from areas of high risk exposure to COVID-19. CONCLUSION: a management-driven risk assessment of hospital staff in preparation for the COVID-19 pandemic revealed that a fifth of staff assessed themselves as being vulnerable to adverse outcomes from exposure. It is our hope that similar risk stratification programmes will become standard practice in healthcare facilities during disease outbreaks, especially in Africa.

Metabolic Syndrome and Dyslipidemia among Nigerians with Lichen Planus: A Cross-Sectional Study.

BACKGROUND: Lichen planus (LP) is an inflammatory skin disease of unknown etiology associated with chronic inflammation, oxidative stress induction, and cardiovascular risk factors. OBJECTIVES: To document the prevalence of metabolic syndrome (MetS), dyslipidemia, and associated factors in Nigerian patients with LP. METHODS: A cross-sectional design was made to evaluate 90 patients with LP and 90 controls for MetS and dyslipidemia in two Nigerian teaching hospitals. Diagnosis of LP was made with the aid of histology, and MetS and dyslipidemia were diagnosed using the National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS: The prevalence of MetS was insignificantly higher in LP than in control (18.9% vs. 13.5, P = 0.311), and dyslipidemia was significantly associated with LP (60% vs. 40%, P = 0.007). LP was associated with higher mean of serum triglyceride (1.21 ± 0.34 vs. 1.08 ± 0.32 mmol/L, P = 0.003), low-density lipoprotein cholesterol (3.47 ± 0.89 vs. 3.12 ± 0.77 mmol/L, P = 0.007), and T-cholesterol (5.32 ± 0.88 vs. 4.92 ± 0.86, P = 0.002). LP patients with MetS were older (P < 0.001) and less likely to have Wickham's striae (P = 0.028) compared to those without MetS. Female LP patients were older (P = 0.047), obese (P = 0.043), and had insignificant increase in MetS prevalence compared to the males. Hypertrophic LP was more frequent in patients with dyslipidemia (63.0% vs. 27.8%, P = 0.002), and the family history of diabetes mellitus (DM) was an independent predictor of MetS in LP patients (odds ratio: 4.4, confidence interval: 1.0-19.1, P = 0.047). LIMITATION: Availability of fund is a significant factor that limited the sample size to the minimum required as always in a poor-resource setting. CONCLUSIONS: LP has an insignificant association with MetS and a significant association with dyslipidemia among Nigerians. The family history of DM is an independent predictor of MetS in LP patients. LP patients should be routinely screened for MetS and its components.

Packed cell volume Platelet count, PT, PTTK and Fibrinogen concentration of HIV positive patients on antiretroviral drugs.

OBJECTIVE: This is aimed at investigating some coagulation and haematologic profile of HIV positive patients on highly active antiretroviral therapy in patients attending clinic at the University of Benin Teaching Hospital. METHODS: This is a correlation study comprising fifty (50) HIV positive patients on HAART between 6 - 12 months as test subjects and fifty (50) HIV positive patients who have not began HAART as control subjects. Five millilitres of blood was withdrawn from each group by venepuncture into ethylene diaminetetracetic and sodium citrate anticoagulant containers. Platelet counts were estimated manually using ammonium oxalate solution, packed cell volume by the microhaematocrit method while Prothrombin Time (PT), Activated partial thrombroplastin time and fibrinogen concentration were done by methods described by Monica Chessbrough. RESULTS: This is presented as mean ± standard error of mean. There were reduction in PCV and platelet count between test and control subjects although not statistically significant (P> 0.05) while there was a significant increase in PT and PTTK between test and control groups (P<0.05). No significant change was observed in fibrinogen concentration in HIV patients on HAART and those not on HAART. CONCLUSION: HAART increases PT and PTTK in HIV infection.