Acceptability of an Orange-Flavoured Zinc Sulphate Dispersible Tablet in the Management of Acute Diarrhoea in Under-five Children in Lagos, Nigeria.

BACKGROUND: Acute diarrhoea is a significant cause of morbidity and mortality in children under five, especially in subSaharan Africa. The WHO recommends using oral rehydration solution (ORS) and zinc therapy for its management, but the metallic taste of zinc often hinders adherence. METHOD: This prospective open-label intervention study took place at three health facilities in Lagos, Southwest Nigeria, involving children aged 3 to 59 months with acute diarrhoea. Sociodemographic and diarrhoea-related data were obtained. Palatability was assessed using a 5-point hedonic scale, and adherence was determined by the proportion of prescribed zinc sulfate tablets consumed. Caregivers received a 10-day supply of the study drug and ORS sachets for each child, along with participant diaries for tracking drug intake, palatability scores, and adverse events. Follow-up was conducted on Days 3 and 7, and diaries were collected between Days 10 and 14. RESULTS: Out of the 294 participants, most caregivers were mothers (86.0%), had at least a secondary education (88.1%), and were employed (70.7%). The majority of children were male (54.2%), and under 18 months old (52.2%). The average palatability score was 2.65 (±0.78), with no significant differences based on age or gender. Mean adherence was 93.03%, with 89.3% achieving ≥80% adherence, and adherence did not significantly differ by age or gender. The only reported adverse event, vomiting, decreased from 18.8% on Day 1 to 0.5% on Day 10. CONCLUSION: The study indicates that the orange-flavored dispersible zinc sulfate tablet is well-accepted by children aged 3 to 59 months with acute diarrhoea in Lagos, Nigeria.

CONTEXTE: La diarrhée aiguë est une cause significative de morbidité et de mortalité chez les enfants de moins de cinq ans, en particulier en Afrique subsaharienne. L'OMS recommande l'utilisation de la solution de réhydratation orale (SRO) et de la thérapie au zinc pour sa prise en charge, mais le goût métallique du zinc entrave souvent l'observance. MÉTHODE: L'étude d'intervention prospective à ciel ouvert a eu lieu dans trois établissements de santé à Lagos, dans le sud-ouest du Nigeria, impliquant des enfants de 3 à 59 mois souffrant de diarrhée aiguë. Des données sociodémographiques et liées à la diarrhée ont été obtenues. La palatabilité a été évaluée à l'aide d'une échelle hédonique à 5 points, et l'observance a été déterminée par la proportion de comprimés de sulfate de zinc prescrits consommés. Les aidants ont reçu une provision de 10 jours du médicament de l'étude et des sachets de SRO pour chaque enfant, ainsi que des journaux de suivi pour noter la prise du médicament, les scores de palatabilité et les événements indésirables. Un suivi a été effectué aux jours 3 et 7, et les journaux ont été collectés entre les jours 10 et 14. RÉSULTATS: Sur les 294 participants, la plupart des aidants étaient des mères (86,0%), avaient au moins une éducation secondaire (88,1%), et étaient employées (70,7%). La majorité des enfants étaient de sexe masculin (54,2%) et avaient moins de 18 mois (52,2%). La note moyenne de palatabilité était de 2,65 (±0,78), sans différences significatives en fonction de l'âge ou du sexe. L'observance moyenne était de 93,03%, avec 89,3% atteignant une observance ≥ 80%, et l'observance ne différait pas de manière significative en fonction de l'âge ou du sexe. Le seul événement indésirable signalé, les vomissements, est passé de 18,8% le jour 1 à 0,5% le jour 10. CONCLUSION: L'étude indique que le comprimé de sulfate de zinc dispersible à l'arôme d'orange est bien accepté par les enfants de 3 à 59 mois souffrant de diarrhée aiguë à Lagos, au Nigeria. MOTS-CLÉS: Diarrhée, moins de cinq ans, Enfants, Arôme d'orange, Comprimés de zinc, Palatabilité, Acceptabilité, Échelle hédonique, Lagos, Nigeria.

Intimate Partner Violence and Risk Factors among Women during the COVID-19 Movement Restriction in Nigeria: An Online Survey.

BACKGROUND: The rapid spread of the SARS-CoV-2 infection in the absence of treatment or the presence of vaccines is forcing nations to respond with strong preventive measures ranging from mitigation, containment, and in extreme cases, quarantines. While these measures are a useful measure of infection control, they can lead to significant social, economic, and psychological consequences. This study sought to establish the prevalence and risk factors of intimate partner violence during the COVID-19 movement restriction in Nigeria among girls and women. METHODS: An online-based questionnaire survey using Google Forms was conducted over four weeks among girls and women aged 15 years and above. Data analysis was performed using SPSS version 20, and logistic regression was used to determine risk factors for IPV experience during the lockdown. RESULTS: Overall, 32.8% of respondents reported ever experiencing IPV, and 42.5% experienced IPV during the lockdown. Verbal (35.1%) and psychological (24.1%) violence were the commonest forms of violence in the study. There was considerable overlap between the various forms of IPV in the study. Age less than 35 years (aOR = 1.3; CI = 1.2 - 1.4), resident in the northeast region (aOR=1.6; CI=1.41.9), alcohol (aOR=1.3;CI=1.2-1.5) and substance (aOR = 1.5; CI = 1.3 - 1.8) use, average family monthly income < $100 (aOR = 1.4;CI=1.2 - 1.5), daily or weekly income (aOR = 2.7; CI = 2.5-3.1) had an increased association with IPV during the lockdown, residency in the southeast region had lower odds of experiencing IPV (aOR=.0.5; CI = 0.3-0.8). CONCLUSION: The reported lockdown prevalence of IPV was 42.8%, with verbal and psychological violence being the most prevalent form of IPV. Age less than 35 years, resident in northeast and southeast, use of alcohol or substances, average family monthly income < $100, and partner being a daily-weekly earner was associated with IPV experience. Policymakers in the future should consider the consequences, including IPV, before issuing such an order.

CONTEXTE: La propagation rapide de l'infection par le CoV-2 du SRAS en l'absence de traitement ou présence de vaccins oblige les nations à réagir par des mesures préventives fortes allant de l'atténuation à l'endiguement et, dans les cas extrêmes, à la mise en quarantaine. Bien que ces mesures soient utiles pour contrôler l'infection, elles peuvent avoir des conséquences sociales, économiques et psychologiques importantes. Cette étude visait à établir la prévalence et les facteurs de risque de la violence exercée par le partenaire intime au cours de la restriction de mouvement du COVID-19 au Nigeria, chez les filles et les femmes. MÉTHODES: Une enquête par questionnaire en ligne utilisant google form a été menée pendant quatre semaines auprès de filles et de femmes âgées de 15 ans et plus. L'analyse des données a été réalisée à l'aide de la version 20 de SPSS et une régression logistique a été utilisée pour déterminer les facteurs de risque de violence conjugale pendant la période de restriction. RÉSULTATS: Dans l'ensemble, 32,8 % des personnes interrogées ont déclaré avoir déjà subi des VPI, et 42,5 % ont subi des VPI pendant l'enfermement. La violence verbale (35,1 %) et la violence psychologique (24,1 %) étaient les formes de violence les plus courantes dans l'étude. Il y avait un chevauchement considérable entre les différentes formes de VPI dans l'étude. L'âge inférieur à 35 ans (aOR=1,3 ; CI= 1,2 - 1,4), la résidence dans la région nord-est (aOR=1,6; CI=1,4-1,9), la consommation d'alcool (aOR=1,3; CI=1,2 - 1,5) et de substances (aOR=1,5 ; CI = 1,3 - 1,8), le revenu mensuel moyen de la famille < 100 $ (aOR=1. 4 ; IC = 1,2 - 1,5), le revenu quotidien ou hebdomadaire (aOR = 2,7 ; IC = 2,5-3,1) était davantage associé à la VPI pendant le lockdown, la résidence dans la région du sud-est avait moins de chances d'être victime de VPI (aOR = 0,0,5 ; IC = 0,3-0,8). CONCLUSION: La prévalence de la VPI pendant le lockdown était de 42,8 %, la violence verbale et psychologique étant la forme de VPI la plus répandue. L'âge inférieur à 35 and, le fait de résider dans le nord-est et le sud-est, la consommation d'alcool ou de substances, le revenu mensuel moyen de la famille inférieur à 100 dollars et le fait que le partenaire gagne sa vie toutes les semaines étaient associés à l'expérience de la VPI. À l'avenir, les décideurs politiques devraient prendre en compte les conséquences, y compris la VPI, avant d'émettre un tel ordre. Mots-clés: Violence entre partenaires intimes, COVID-19, Lockdowns, Nigeria, Violence fondée sur le genre.

Preliminary Study on Open Labelled Randomized Controlled Trial of the Safety and Efficacy of Hydroxychloroquine and Chloroquine Phosphate for the Treatment of Persons Infected with 2019 Coronavirus Disease in Nigeria.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a causative agent of COVID-19 is a leading cause of ill-health and deaths worldwide. Currently, COVID-19 has no known widely approved therapeutics. Thus, the need for effective treatment. OBJECTIVES: We investigated the safety and efficacy of two (2) therapeutic agents; chloroquine phosphate (CQ), 2- hydroxychloroquine (HCQ) and a control (standard supportive therapy) among hospitalized adults with COVID-19. METHODS: The clinical trial was done in accordance to the World Health Organization master protocol for investigational therapeutics for COVID-19. Atotal of 40 participants with laboratory-confirmed positive COVID-19 were enrolled. Blood samples and oropharyngeal (OP) swabs were obtained on days 1,3,15 and 29 for safety and efficacy assessments. RESULTS: The baseline demographics showed that the median ages in years (range) were 45 (31-57) in CQ, 45 (36.5-60.5) in HCQ, 43 (39.5-67.0) and 44.5 (25.3-51.3) in the control (P<0.042).At randomization, seven (7) participants were asymptomatic, thirty-three (33) had mild symptoms, eight (8) had moderate symptoms while three (3) had severe symptoms. The average day of conversion to negative COVID-19 was 15.5 days for CQ, 16 days for HCQ and 18 days for the control(P=0.036). CONCLUSION: The safety assessment revealed no adverse effect of the drugs in COVID-19 patients after treatment. These findings proved that chloroquine and hydroxychloroquine are effective for the treatment of COVID-19 among hospitalized adults. It also confirmed that they are safe.

CONTEXTE: Le coronavirus du syndrome respiratoire aigu sévère 2 (SARS-CoV-2),agentcausaldelaCOVID-19, est l'unedes principales causes demaladie et de décès dans le monde. À l'heure actuelle, il n'existe aucun traitement largement approuvé pour la COVID-19. Ainsi, ilya un besoin de traitement efficace. OBJECTIFS: Nous avons étudié l'innocuité et l'efficacité de deux (2) agents thérapeutiques, le phosphate de chloroquine (CQ) et l'hydroxychloroquine (HCQ), ainsi qu'un groupe témoin (traitement de soutien standard) chez des adultes hospitalisés atteints de la COVID-19.MÉTHODES: L'essai clinique a été mené conformément au protocole maître de l'Organisation mondiale de la santé pour les thérapeutiques à l'étude de la COVID-19. Au total, 40 participants atteints de la COVID-19, confirmée en laboratoire, ont été in scrits. Des échantillons de sang et des prélèvements oropharyngés (PO) ont été effectuésauxjours1,3,15et29pourévaluerl'innocuitéetl'efficacité. RÉSULTATS: Les données démographiques initiales ont révélé que l'âge médian en années (plage) était de 45 (31-57) pour le groupe CQ, de 45 (36,5-60,5) pour le groupe HCQ, de 43 (39,5-67,0) et de 44,5 (25,3-51,3) pour le groupe témoin (P<0,042). À la randomisation, sept (7) participants étaient asymptomatiques, trente-trois (33) présentaient des symptômes bénins, huit(8) avaient des symptômes modérés, tandis que trois(3) avaient des symptômes graves. Le jour moyende conversionentest COVID-19 négatif était de 15,5 jours pour le groupe CQ, de 16 jours pour le groupe HCQ et de 18 jours pourle groupe témoin (P=0,036). CONCLUSION: L'évaluation de la sécurité n'a révélé aucun effet indésirable des médicaments chez les patients atteints de la COVID-19 après le traitement. Ces conclusions ont prouvé que la chloroquine et l'hydroxychloroquine sont efficaces pour le traitement de la COVID-19 chez les adultes hospitalisés. Cela a également confirmé qu' ilssont sûrs. Mots-clés: COVID-19, SARS-CoV-2, essai clinique, innocuité, efficacité, thérapeutiques.

Impact of SARS-CoV-2 Pandemic on Antiretroviral Access at a Large Treatment Centre in Lagos, Nigeria.

INTRODUCTION: The SARS-CoV-2 pandemic has ravaged the world with significant implications on the socio-economic and health status of individuals. Several measures were put in place to curtail the pandemic especially movement restrictions. The effect of this pandemic and the restriction measures could further compound the health needs of PLWHA. This study thus described the trend in access to HIV/AIDS care services before and during the COVID-19 induced lockdown and the possible consequences on their treatment outcome. METHODS: A secondary analysis of client data was carried out at the HIV clinic of the Nigerian Institute of Medical Research. The sociodemographic and clinical data [type of ART, duration on ART, clinical services 3-months before and during the COVID-19 induced Lockdown] were extracted from the electronic medical records. Data obtained was analyzed using the SPSS version 22.0. RESULTS: The median age of PLWHA was 45 years (IQR: 39-51), with the predominant age group being 25-49 years (65.4%). The majority were females (68.7%), married (59.5%), had at least secondary education (82.8%), and employed (81.5%). The median duration on ART was 102 months (IQR: 67-138) with the majority on non-Protease Inhibitor based regimen (77.7%). In the 3 months before the lockdown, there was an increase in drug pick-up of approximately 25% over the booked appointment compared to a decline of 40% when the lockdown was enacted. CONCLUSION: The significant decline in drug pick-up during the SARS-CoV-2 pandemic raises the need for measures to ensure continued access to drugs and care among PLWHA.

INTRODUCTION: La pandémie de SRAS-CoV-2 a ravagé le monde avec des implications significatives sur l'état socio- économique et sanitaire. Plusieurs mesures ont été mises en place pour freiner la pandémie, en particulier la restriction des déplacements. L'effet de cette pandémie et les mesures de restriction pourraient encore aggraver les besoins de santé des PVVIH. Cette étude décrit ainsi la tendance des services de soins du VIH / SIDA avant et pendant le verrouillage induit par le COVID-19 et les conséquences possibles sur l'issue de leur traitement. MÉTHODES: Une étude transversale parmi les PVVIH fréquentant la clinique VIH de l'Institut nigérian de recherche médicale. Les données sociodémographiques et cliniques [type de TAR, durée de la TAR, services cliniques 3 mois avant et pendant le verrouillage induit par COVID-19] ont été extraites des dossiers médicaux électroniques. Les données obtenues ont été analysées à l'aide de la version 22.0 de SPSS. RÉSULTATS: L'âge médian des PVVIH était de 45 ans (IQR (39-51), le groupe d'âge prédominant étant 25-49 ans (65,4%). La majorité étaient des femmes (68,7%), mariées (59,5%), avaient au moins secondaire (82,8%) et employé (81,5%). La durée médiane des TAR était de 102 mois (IQR: 67-138), la majorité sous traitement sans inhibiteur de protéase (77,7%). Au cours des 3 mois précédant le verrouillage , il y a eu une augmentation de la cueillette de médicaments d'environ 25% par rapport au rendez-vous réservé, comparativement à une baisse de 40% lorsque le verrouillage a été décrété. CONCLUSION: La baisse significative de la collecte de médicaments pendant la pandémie de SRAS-CoV-2 fait ressortir la nécessité de prendre des mesures pour assurer un accès continu aux médicaments et aux soins parmi les PVVIH. Mots Clés: SRAS-CoV-2, antirétroviral, COVID-19, ramassage de médicaments, VIH, verrouillage.

Challenges of Accessing Care in Art Clinic during COVID-19 Lockdown in Lagos.

BACKGROUND: As the SARS-CoV-2 pandemic continues to ravage the world, its impact on the health systems and survival of people with chronic diseases especially People living with HIV [PLWH] could be undermined. It becomes relevant to assess the challenges PLWH face during this period to institute measures towards combating the negative effects of the pandemic. AIMS: This study aims to investigate the challenges faced by PLWH in accessing care during the lockdown period in Lagos, Nigeria. The study was a cross-sectional one involving PLWH aged 18 years and above who presented for care. An interviewer-administered questionnaire was used to obtain information on demographic characteristics, their knowledge about COVID-19 disease, and challenges experienced in accessing care during the COVID-19-induced lockdown. Ethical approval was obtained from the Institution Research Ethics Board (IRB) of NIMR. PATIENTS AND METHODS: Data generated from the survey was exported to Excel and analyzed using SPSS version 23.0. RESULTS: The mean age of PLWH who participated in the study was 42.2 (±12.2) years. The majority were female (74.3%), married (66.3%), employed (58.9%), and on less than $100 monthly income (80.5%). The commonest challenges experienced were psychological (78.5%), financial (68%) and food (40.7%). There were significant association among the income status, lack of food (OR: 2.5, CI: 1.4-4.5, P = 0.002), financial challenges (OR: 1.7, CI: 1.0-3.0, P = 0.048) and psychological challenges (OR; 1.8, CI: 1.0-3.5, P = 0.05). Ninety-five percent of participants believed SARS-COV-2 infection is a viral infection. CONCLUSIONS: PLWH faces a myriad of challenges that would have a significant impact on their overall well-being and the gains of HIV care.

Prevalence and Clinical Characteristics of Coronavirus Disease 2019 Seen at a Testing Centre in Lagos Nigeria.

BACKGROUND: The SARS-CoV-2 infection continues to ravage the global community since it was declared a pandemic. The socio-demographic and clinical characteristics defining the disease are mainly from Europe and Asia. The disease symptomatology is similar to the prevalent diseases in our environment, this could result in the delay in prompt identification and appropriate management of suspected cases toward combating community transmission. This study evaluates the prevalence, socio-demographic and clinical characteristics of positive cases of COVID -19. METHODS: This was a retrospective cohort study. Data on the socio-demographic, clinical characteristics and the results of the SARS-CoV-2 test of participants at the Nigerian Institute of Medical Research [NIMR] Modified Drive-through Centre for COVID-19 test sample collection over two months [24th February 2020- 27th April 2020] were retrieved from the electronic medical records (EMR). Data obtained were analyzed using SPSS version 22.0. RESULTS: A total number of 481 clients were evaluated in this review. The prevalence of SARS-CoV-2 infection in the population was 14.6%. The mean age of the positive cases was 42.2 [±15.9] years. The common symptoms reported by the positive cases were fever (40.0%), cough (32.9%), sore throat (17.1%) and running nose (15.7%). Fever depicted statistical significance with positive cases with the majority being of mild to moderate clinical severity. CONCLUSION: The prevalence of SARS-CoV-2 infection among this cohort was 14.6% with a male preponderance. Fever and sore throat were the variables that predicted SARS CoV-2 infection among our cohort.

Pregnancy, obstetric and neonatal outcomes in HIV positive Nigerian women.

While the effect of HIV infection on some maternal outcomes is well established, for some others there is conflicting information on possible association with HIV. In this study we investigated pregnancy and neonatal outcome of HIV positive women in large HIV treatment centre over a period of 84 months. They were managed according to the Nigerian PMTCT protocol. Adverse obstetric and neonatal outcome were observed in 48.3% HIV positives compared 30.3% to the negatives (OR: 2.08; CI: 1.84-2.34). Low birth weight ( OR:2.95; CI:1.95-3.1), preterm delivery (OR:2.05; CI:1.3-3.1), perinatal death (OR:1.9;CI:1.3-3.2), and spontaneous abortion (OR:1.37; CI:1.1-2.3) were factors found to be independently associated with HIV. Low CD4 count (OR: 2.45; CI: 1.34- 4.56) and opportunistic infections (OR: 2.11; CI: 1.56-3.45) were to be associated with adverse obstetric and neonatal outcome. This study confirms the association of HIV, severe immunosuppression and opportunistic infection and adverse obstetric and neonatal outcome.

Analyzing the impacts of three types of biochar on soil carbon fractions and physiochemical properties in a corn-soybean rotation.

Biochar is a solid material obtained when biomass is thermochemically converted in an oxygen-limited environment. In most previous studies, the impacts of biochar on soil properties and organic carbon (C) were investigated under controlled conditions, mainly laboratory incubation or greenhouse studies. This 2-year field study was conducted to evaluate the influence of biochar on selected soil physical and chemical properties and carbon and nitrogen fractions for two selected soil types (clay loam and a sandy loam soil) under a corn (Zea mays L.)-soybean (Glycine max L.) rotation. The three plant based biochar materials used for this study were corn stover (CS), ponderosa pine (Pinus ponderosa Lawson and C. Lawson) wood residue (PW), and switchgrass (Panicum virgatum L.) (SG). Data showed that CS and SG significantly increased the pH of acidic soil at the eroded landscape position but produced no significant change in soil pH at the depositional landscape position. The effects of biochar treatments on cold water extractable C (WSC) and nitrogen (WSN) fractions for the 0-7.5 cm depth were depended on biochar and soil type. Results suggested that alkaline biochars applied at 10 Mg ha-1 can increase the pH and WSC fraction of acidic sandy loam soil, but the 10 Mg ha-1 rate might be low to substantially improve physical properties and hot water extractable C and N fractions of soil. Application of higher rates of biochar and long-term monitoring is needed to quantify the benefits of biochar under field conditions on soils in different environmental conditions.

Incidence of and factors associated with meconium staining of the amniotic fluid in a Nigerian University Teaching Hospital.

This study was conducted to determine the incidence of meconium staining of the amniotic fluid (MSAF) and its associated factors in a Nigerian teaching hospital. Perinatal data on 80 consecutive live, singleton infants of booked mothers born through meconium-stained liquor from March - June 2003 were analysed and compared with babies born through clear liquor. The incidence of MSAF was 20.4% for 393 deliveries. The rate increased with gestational age: no case was found below 37 weeks (p = 0.001). Primiparity, prolonged rupture of fetal membranes and obstructed labour were more often associated with MSAF (p = 0.005, p = 0.0013 and p = 0.0000002, respectively) as were tachycardia or bradycardia and low Apgar scores (p = 0.0000001 and p = 0.046, respectively). It is concluded that meconium-staining is common. It is related to gestational maturity and stressful peripartum conditions and associated with adverse symptomatology in the fetus and newborn.