Iron deficiency-related symptoms in non-anemic whole blood donors.

INTRODUCTION: Whole blood donors are at increased risk for iron deficiency (ID). ID anemia is associated with several symptoms, such as fatigue, cognitive dysfunction, pica, and restless leg syndrome (RLS). However, it is unclear if these symptoms also occur when a donor has developed ID without anemia. This study aims to determine whether non-anemic ID (NAID) is associated with the occurrence of ID-related symptoms. STUDY DESIGNS AND METHODS: We combined data from three studies in whole blood donors (i.e., Donor Insight-III, FIND'EM, and FORTE) to create a substantial sample size (N = 12,143). The self-reported occurrence and severity of ID-related symptoms, such as physical and mental health, fatigue, cognitive functioning, pica, and RLS, was measured using validated questionnaires. Associations were studied using logistic regression modeling with ID-related symptoms derived from the questionnaires as the dependent variable and ferritin level group (0-15 µg/L, 15-30 µg/L, and >30 µg/L) as explanatory variable. RESULTS: After applying inclusion and exclusion criteria, 9829 donors were eligible for analysis. In the models corrected for age, body mass index, Hb level, and cohort, only fatigue was shown to be associated with ferritin levels in men, showing lower odds (OR 1.41, 95% CI 1.11-1.79) for fatigue with higher ferritin levels. CONCLUSION: In these studies, NAID was only associated with self-reported fatigue in male donors. Although selection bias may have led to underestimated associations, ferritin measurements in donors should be primarily considered as a measure to prevent anemia, rather than to prevent or mitigate NAID-related symptoms.

Plasmid-Mediated Fluoroquinolone Resistance among Enterobacterales in Africa: Systematic Review.

INTRODUCTION: According to the World Health Organization, antimicrobial resistance (AMR) is a silent global pandemic that plagues everyone. It makes therapy of infectious diseases more difficult and eventually increases morbidity and mortality. AIM: The purpose of this work is to examine existing data on plasmid-mediated quinolone resistance (PMQR), to assess the prevalence of PMQR genes in Enterobacterales, and to determine any knowledge gaps from sub-Saharan Africa. METHODOLOGY: The Preferred Reporting Items of Systematic Reviews and Meta-analyses (PRISMA) standard was followed when conducting this systematic review. The main internet databases examined for pertinent publications were PubMed, Google Scholar, and Ajol. A set of qualifying criteria were used to evaluate the qualified articles. Using the eligibility criteria, 56 full-text articles were chosen for screening. RESULT: Thirty-two (32) articles with the majority originating from West and North Africa and only one article reporting a study carried out in Central Africa were selected for this review. Escherichia coli and Ciprofloxacin were the most reported Enterobacterales and Quinolone respectively. The PMQR genes include qnr (qnrA,qnrB, qnrC, qnrD, and qnrS), aac (6') Ib, aac (6') Ib-cr, oqxAB and qepA gene. The most prevalent PMQR gene is the aac (6') Ib-cr gene (32%) followed by qnrS (26%). CONCLUSION: This study highlighted the requirement for an efficient antimicrobial resistance surveillance system in the continent and revealed a significant incidence of PMQR genes.

INTRODUCTION: Selon l'Organisation mondiale de la santé, la résistance aux antimicrobiens (RAM) est une pandémie mondiale silencieuse qui touche tout le monde. Elle rend le traitement des maladies infectieuses plus difficile et finit par augmenter la morbidité et la mortalité. OBJECTIF: L'objectif de ce travail est d'examiner les données existantes sur la résistance plasmidique aux quinolones (PMQR), d'évaluer la prévalence des gènes PMQR chez les Enterobacterales et de déterminer d'éventuelles lacunes de connaissances en Afrique subsaharienne. MÉTHODOLOGIE: La norme Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) a été suivie lors de la réalisation de cette revue systématique. Les principales bases de données Internet examinées pour des publications pertinentes étaient PubMed, Google Scholar et Ajol. Un ensemble de critères d'admissibilité a été utilisé pour évaluer les articles qualifiés. En utilisant les critères d'éligibilité, 56 articles en texte intégral ont été choisis pour le dépistage. RÉSULTAT: Trente-deux (32) articles, dont la majorité provient d'Afrique de l'Ouest et du Nord, et un seul article rapportant une étude menée en Afrique centrale, ont été sélectionnés pour cette revue. Escherichia coli et la ciprofloxacine étaient les Enterobacterales et les quinolones les plus signalées respectivement. Les gènes PMQR comprennent les gènes qnr (qnrA, qnrB, qnrC, qnrD et qnrS), aac (6 ') Ib, aac (6 ') Ib-cr, oqxAB et qepA. Le gène PMQR le plus prévalent est le gène aac (6 ') Ib-cr (32 %), suivi de qnrS (26 %). CONCLUSION: Cette étude a souligné la nécessité d'un système efficace de surveillance de la résistance aux antimicrobiens sur le continen`t et a révélé une incidence significative des gènes PMQR. MOTS-CLÉS: Enterobacterales, Escherichia coli, Quinolone, Ciprofloxacine, PMQR, "aac(6')-Ib", "aac(6')-Ib-cr", "qnr", "qepA", "oqxAB", "résistance aux antibiotiques".

Alleged rape: an analysis of management of cases seen at specialist hospital Gombe, Nigeria.

The aim of this study was to determine how patients who presented following sexual assault were managed at a secondary health facility in Gombe, Nigeria. The case notes of patient who presented at the Accident and Emergency Unit of State Specialist Hospital Gombe after serious sexual assault from August 1 2016 to July 30 2018 were retrieved and the data were entered into SPSS Version 20 (SPSS Inc., Chicago, IL) and summarised as proportions. Of the 15,613 patients who presented, 277 were alleged rapes which constituted 1.77% of presentations. Two hundred and one of the patients were females with a total of 2341 admissions at the gynaecological ward representing 8.6%. One hundred and seventy one (67%) of the patients did not receive any form of care, 127 (54.0%) were not given antibiotics prophylaxis against STIs, 117 (42%) did not receive post-exposure prophylaxis for HIV/AIDS and 80% of the women between the ages of 15-45 had emergency contraception. One hundred and ninety seven (71.1%) did not receive any psychological support. Rape is common. Measures should be put in place to improve the clinical management of survivors.Impact statementWhat is already known on this subject? Rape is common in Gombe, Nigeria, and a standard management protocol has been developed with a view to reduce the adverse consequences associated with it.What the results of this study add? The results of this study show that survivors of rape in the developing countries like ours do not receive adequate clinical and psychological care when they present at the hospital.What the implications are of these findings for clinical practice and/or further research? Given the results, there is the need for physicians managing rape cases to pay attention to details so as to minimise both immediate and long-term complications associated with rape.

Trends and Burden of Hepatitis B Viral Infection in Children and Adults in a Tertiary Health Facility in North East Nigeria Over a Fifteen-year Period.

BACKGROUND: Hepatitis B infection is endemic in Nigeria where greater than six percent of the general population are chronic carriers. Transmission predominantly occurs in infants and children when compared with adults. Viral hepatitis deaths are mostly due to chronic liver disease. Routine immunization against hepatitis B virus infection in Nigeria is still low. AIMS: We planned to describe the burden and trend of hepatitis B viral infection at Federal Teaching Hospital, Gombe. METHODOLOGY: This study was a retrospective cross-sectional descriptive study. The results of all hepatitis B surface antigen (HBsAg) tests using rapid chromatographic immunoassay performed at the Federal Teaching Hospital, Gombe (FTHG), Nigeria from January 2000 to December 2014 were retrieved and analyzed. RESULTS: Between 2000 and 2014, 23,611 individuals ranging from 2 months to 98 years of age were tested for HBsAg. A total of 13,136 (55.6%) were males and 10,475 (44.4%) were females. Among individuals tested for hepatitis B surface antigen, 18.9% (4,456) were positive. A total of 70.6% (3,147) were males and 29.4% (11,239) were females. Male sex was significantly associated with HBsAg positivity (P < 0.001). The mean HBsAg prevalence over the 15-year periods among males and females were 22% and 12%, respectively (P < 0.001). The mean yearly HBV prevalence was 17.5%, 17.2%, 19.6%, 15.5%, and 4.4% among age-groups 0-18 years, 19-25 years, 26-45 years, 56-65 years, and >65 years, respectively (P = 0.132). The proportion of HBsAg-positive individuals was highest in the year 2012 (28.7%) and lowest in 2014 (1.8%). CONCLUSION: There was an increasing trend in HBV testing and diagnosis in children and adults in our facility over the last 15 years. Health facility capacity for HBV treatment and care requires strengthening.

Are roadside petrol dispensers at risk of oxidative stress? a study from gombe, North East Nigeria.

BACKGROUND: Gasoline is one of the most frequently utilized chemicals whose use is on the increase. Exposure to the volatile constituents of gasoline generates free radicals leading to oxidative stress. This is associated with nucleic acid, lipids, and protein damages leading to chronic diseases including cancers. Occupational exposure to this product is of public health concern, especially in the developing countries where the awareness and enforcement of safety measures are not adequate. MATERIALS AND METHODS: Plasma level of total antioxidant status (TAS) was compared between 90 roadside dispensers of gasoline and 90 age- and sex-matched controls. TAS was measured using standard colorimetric method. RESULTS: The mean age of the exposed and control groups is 29.03 ± 3.7 and 29.24 ± 3.5 years, respectively. The mean plasma TAS level of the exposed (0.60 ± 0.33 mmol/L) was significantly (P < 0.001) lower than that of the controls (1.29 ± 0.25 mmol/L). CONCLUSION: Our data have demonstrated higher level of oxidative stress in roadside dispensers of gasoline compared to the controls. This is an indication that roadside gasoline dispensers are probably at greater risk of developing chronic diseases associated with increased oxidative stress. Antioxidant supplementation may be of benefit to the roadside gasoline dispensers. Legislation on roadside gasoline dispensing should be enforced to reduce the incidence of long-term complications from repeated exposures.

10 years of Vertigo Clinic at National Hospital Abuja, Nigeria: what have we learned?

The clinician's major role in management of the dizzy patient involves determining what dizziness is vertigo, and what vertigo is of central or peripheral origin. These demand attention to details of history, otolaryngological workup including vestibular assessment, and often use of diagnostic and management algorithms. There is paucity of published reports of the management outcomes of peripheral vestibular diseases from Africa. Two tertiary care otologist-led dedicated vertigo clinics are located in Abuja, Nigeria. A prospective, non-randomized study of patients presenting with features of peripheral vestibular diseases attending the National Hospital Abuja Nigeria (between May 2005 and April 2014) and CSR Otologics Specialist Clinics (May 2010 to April 2014) was carried out. Both institutions adopted the same diagnostic and management protocols. Data extracted from anonymized databases created for this study include age, sex, vertigo duration (acute <12 weeks, chronic >12 weeks), dizziness handicap inventory score at presentation and at subsequent visits, otological and vestibular findings, ice-water caloric testing results, other investigation outcomes, treatments offered and outcomes. 561/575 (97.5 %) of the cases recorded had peripheral vestibular disease. The male-to-female ratio was 290:271. The mean age of the subjects was 44.7 years. Duration of vertigo at presentation was acute in 278 subjects and chronic in 283 subjects. Identifiable clinical diagnostic groups include BPPV (n = 200), Meniere's disease (n = 189), cervicogenic vertigo (n = 35), labyrinthitis (n = 32), Migraine-associated vertigo (MAV) (n = 32), cholesteatoma/perilymph Fistula (n = 10), climacteric vertigo (n = 8) and unclassified vertigo (n = 55). Migraine-associated vertigo recorded the highest DHI score (95 % CI 75 ± 4.3), followed by cholesteatoma/perilymph fistula (95 % CI 72 ± 6.1) and labyrinthitis (95 % CI 62 ± 1.9). Pure tone audiometry (95 % CI 67.3 ± 3.43), followed by thyroid function tests (95 % CI 66.7 ± 23.55) and ice-water caloric testing (95 % CI 59.7 ± 2.69) were investigations with the highest yields. 86.5 % of cases were treated by either vestibular suppressant medications alone (n = 285) and/or particle repositioning maneuver (n = 200) with improvement in vertigo control (95 % CI 63.63 to 74.37 % and 62.59 to 75.41 %, respectively). Peripheral vestibular diseases constitute majority of cases of self-reported vertigo seen in our setting. Migraine-associated vertigo seen in our setting all have peripheral vestibular signs. Dedicated vertigo clinics could significantly improve the diagnostic and treatment yield in a resource-constrained setting like ours. Most cases can be managed using non-operative measures.

Audit of gynaecological laparoscopies in National Hospital Abuja, Nigeria.

CONTEXT: The scope oflaparoscopy is increasing in contemporary gynaecological practice. There is scanty data on gynaecological laparoscopy in Nigeria. OBJECTIVE: To determine the rate, indications, perioperative characteristics and complications of gynaecological laparoscopy at National Hospital, Abuja. STUDY DESIGN, SETTING AND SUBJECTS: A retrospective review of gynaecological laparoscopies performed at the National Hospital, Abuja, Nigeria over a four year period (2001-2004). RESULTS: There were 58 gynaecological laparoscopies during the study period, and a rate of 28.7 laparoscopies per 1000 gynaecological operations. The incidence is low due to occasional logistic problems with the equipment and multiple strike actions by health workers. The procedure was done wholly for diagnostic purposes, the major indication being infertility in 88.9% of the patients. Majority (54.9%) of the patients had the procedure performed during the luteal phase of their menstrual cycle, as opposed to the proliferative phase. The procedure was performed by consultants or senior residents in 50 (98%) of the patients. All the patients had general anaesthesia for the laparoscopies. There was no major complication or operative mortality in the patients whose case folders were analysed. CONCLUSION: The gynaecological laparoscopy rate is low, at 28.7 per 1000 gynaecological operations; it was done mainly for elective and diagnostic purposes, the major indication being infertility and it was generally safe with absence of major perioperative or postoperative complications.

Valorization of Uncharred Dry Leaves of Ficus benjamina towards Cr (VI) removal from Water: Efficacy Influencing Factors and mechanism.

The potential of uncharred biomaterial derived from dry leaves of Ficusbenjamina (Family: Moraceae,local name: Weeping Fig) plant to remove Cr(VI) from aqueous samples was investigated. In the present work, treatment of dilute acids was used for activating the adsorption centres on the biomass instead of cumbersome charring process. The plant material was characterized using FT-IR, FE-SEM and EDX. Various influencing factors such as pH of equilibrating solution, contact time, Cr (VI) concentrations, adsorbent dose and temperature were optimized to obtain maximum sorption efficacy. The interactions among the biomaterial and Cr (VI) in water were studied by fitting the sorption data in four different adsorption isotherms. The data fitting and experimental evidences indicated formation of monolayer of Cr(VI) over the biomass surface. The process followed pseudo-second order kinetics and was thermodynamically spontaneous under laboratory conditions and reached equilibrium in 24 hours. Maximum adsorption capacity of 56.82 mg/g was obtained at the pH 2 when the concentration before adsorption was 200 mg L-1 of Cr(VI) with 24 hours of equilibration time and 2.50 g L-1 of dose of biomaterial at room temperature. The sorption efficiency was found to be better than many charred bio-based materials.

Seroprevalence of hepatitis B and C infection among the HIV-positive population in Abuja, Nigeria.

BACKGROUND: In Nigeria, it is estimated that 3.6% of the population were living with Human immunodeficiency virus in 2009, and the country had the world's second highest number of HIV/AIDS related deaths after South Africa. Viral hepatitis is also a major public health concern as hepatitis B virus (HBV) afflicts an estimated 350 million people, and hepatitis C virus (HCV) affects 150 million people worldwide. OBJECTIVES: We conducted a retrospective study of HBV and HCV seroprevalence among Nigerian population coming to our clinic in Abuja and receiving HIV/AIDS treatment. METHODS: In this cohort study, we collected medical data from 443 HIV-positive patients between September 2010 and May 2011. Standard enzyme immunoassays were used to determine the serological prevalence of hepatitis B (HBsAg) and C (anti-HCV antibody) among HIV-positive individuals. RESULTS: Among the HIV/AIDS positive individuals, we found that 35 patients were infected with hepatitis B virus (7.9%), 10 with hepatitis C virus (2.3%) and 3 with both hepatitis B and C viruses (0.7%). The overall hepatitis-HIV prevalence is 10.8%. The majority of the population infected was under 39 years of age (55%) and the same proportion of males and females was observed in all the studied categories (HIV, HIV + hepatitis B and/or C). Remarkably, an overall lower CD4 count was seen in the co-infected population (205 cells/µl versus 243 cells/µl), with the lowest seen for the triply infected individuals (97 cells/µl). CONCLUSIONS: Our findings underscore the importance of screening for hepatitis B and hepatitis C viruses in the HIV-infected population in developing countries, and particularly in sub-Saharan Africa, where the epidemics are still growing.

The distribution of ringworm infections among primary school children in Jos, Plateau State of Nigeria.

A survey was carried out on the distribution of ringworm infections among school children in four primary schools in Jos, Plateau State of Nigeria. Out of a total population of 6 987,237 (3.4%) were found to be infected by this disease. There was a high incidence of both scalp and foot ringworms among the infected children. Fourteen species of dermatophytes were isolated from the ringworm cases. The scalp ringworm had the highest number of fungal isolates. Trichophyton mentagrophyte and T. rubrum had the highest frequencies of occurrence. Some of the infected children were found to have nomadic parents who moved about with cattle.