Comparative serologic profiles of hepatitis B Virus (HBV) between HIV/HBV co-infected and Hbv mono-infected patients in Ile-Ife, Nigeria.

Hepatitis B virus (HBV) infects about 2 billion people globally and accounts for mortality of about 800,000 from liver cirrhosis and hepatocellular carcinoma. Sub-Saharan Africa accounts for 70% of the Human Immunodeficiency Virus (HIV) global burden. HIV/HBV co-infection results in the early development of HBV complications, alterations of serological biomarkers of HBV. Two hundred and fifty patients with HIV/AIDS were screened for HBV and 20 (8%) were identified. The same number of HBV mono-infected individuals were recruited into the study and subsequently, HBV serological profiles which include HBsAg, HBsAb, HBeAg, HBeAb, HBcAbIgM, and HBcAbIgG were assayed using HBV ELISA kits. Mean age of patients in the HBV/HIV cohort was 45.5 years while the HBV mono-infected infected cohort was 30.5 years. The majority of the HBV/HIV co-infected individuals were females (85%). The frequency of HBeAg among HIV/HBV co-infected cohort was 25% and 15% for HBV mono-infected, while the frequency of HBeAb was higher (60%) among the cohort of HBV/HIV co-infected patients in comparison with the HBV mono-infected cohorts (50%). Two patients among the HIV/HBV co-infected cohort have the isolated anti-HBcAg serologic pattern. The study broadened the available evidence of comparative serologic profiles of Hepatitis B virus between cohorts of HBV/HIV co-infected individuals and HBV mono-infected patients in Nigeria.

Hepatobiliary Ultrasonographic Abnormalities in Adult Patients with Sickle Cell Anaemia in Steady State in Ile-Ife, Nigeria.

BACKGROUND: Sickle cell anaemia (SCA) is associated with structural manifestations in the hepatobiliary axis. This study aimed to investigate the hepatobiliary ultrasonographic abnormalities in adult patients with sickle cell anaemia in steady state attending the Haematology clinic of a federal tertiary health institution in Ile-Ife, Nigeria. MATERIAL/METHODS: Basic demographic data as well as right upper abdominal quadrant ultrasonography of 50 consecutive sickle cell anaemia patients were compared with those of 50 age- and sex-matched subjects with HbAA as controls. RESULTS: Each of the study groups (patients and controls) comprised of 21 (42%) males and 29 (58%) females. The age range of the patients was 18-45 years with a mean (±SD) of 27.6±7.607 years, while that of the controls was 21-43 years with a mean (±SD) of 28.0±5.079 years (p=0.746). Amongst the patients, 32 (64%) had hepatomegaly, 15 (30%) cholelithiasis and 3 (6%) biliary sludge. Fourteen (28%) of the patients had normal hepatobiliary ultrasound findings. In the control group, one (2%) person had cholelithiasis, one (2%) biliary sludge, one (2%) fatty liver and none hepatomegaly. Forty-seven (94%) of the controls had normal hepatobiliary ultrasound findings. There was a statistically significant difference in the prevalence of hepatomegaly and cholelithiasis between the patients and controls (p value <0.001 for both comparisons). CONCLUSIONS: In this study, hepatomegaly, cholelithiasis and biliary sludge were the most common hepatobiliary ultrasound findings in patients with sickle cell anaemia. Ultrasonography is a useful tool for assessing hepatobiliary abnormalities in patients with sickle cell anaemia.

Histopathological Outcome of Colonoscopic Biopsies in a Tertiary Hospital in Southwestern Nigeria: A 7-Year Retrospective Study.

BACKGROUND AND AIM: Colonoscopy with histopathological analysis of mucosal biopsy samples remains the gold standard procedure for diagnosing lower gastrointestinal disorders. This study aimed to determine the pattern of histopathological findings of mucosal biopsies obtained at colonoscopy over a 7-year period and to correlate the histological findings with the clinical profile of the patients. METHODS: This was a retrospective study conducted in a healthcare facility in southwestern Nigeria. The Histology reports from January 1, 2016, to December 31, 2022, were retrieved from the histopathology department of the institution to obtain the following information for analysis: age, gender, year of the test, presenting complaint, provisional clinical diagnosis, colonoscopy diagnosis, and histological diagnosis. RESULTS: The data of a total number of 81 patients were analyzed; 51 males (63.0%) and 30 females (37.0%) with a male-to-female ratio of 1.7-1. The age range of the patients was 30-86 years with a mean (±standard deviations) age of 59.87 ± 14.44. The most common indication for colonoscopy was hematochezia (23 (28.4%)) followed by change in bowel habit (16 [19.8%]), constipation (11 [13.6%]), and tenesmus (10 [12.3%]). Large bowel masses suggestive of cancers were the most common colonoscopy finding in the study subjects (36 [44.4%]). Colorectal cancer was the most common histologic abnormality in the study subjects (26 [32.1%]) followed by chronic nonspecific colitis (8 [9.9%]), polyps (7 [8.6%]), adenomas (5 [6.2%]) and acute on chronic colitis (5 [6.2%]). Twenty-two (27.2%) patients had normal histologic findings. Patients aged between 45 and 64 years had the highest prevalence of colorectal cancer (13 [50.0%]). CONCLUSION: Colorectal cancer was the most common histopathological finding in this study and the patients were mostly within the middle-age group. Early screening colonoscopy is therefore recommended and histopathological analysis of the mucosal specimens obtained is essential for early detection of premalignant lesions.

Résumé Contexte et Objectif:La coloscopie avec analyse histopathologique d'échantillons de biopsie muqueuse reste la procédure de référence pour diagnostiquer les troubles gastro-intestinaux inférieurs. Cette étude visait à déterminer le schéma des résultats histopathologiques des biopsies muqueuses obtenues à la coloscopie sur une période de sept ans et à corréler les résultats histologiques avec le profil clinique des patients.Méthodes:Il s'agissait d'une étude rétrospective menée dans un établissement de santé du sud-ouest du Nigeria. Les rapports d'histologie du 1er janvier 2016 au 31 décembre 2022 ont été récupérés auprès du service d'histopathologie de l'établissement afin d'obtenir les informations suivantes pour analyse : âge, sexe, année du test, plainte présentée, diagnostic clinique provisoire, diagnostic de coloscopie et diagnostic histologique.Résultats:Les données d'un nombre total de 81 patients ont été analysées; 51 hommes (63,0 %) et 30 femmes (37,0 %) avec un ratio hommes/femmes de 1,7 pour 1. La tranche d'âge des patients était de 30 à 86 ans avec un âge moyen (± ET) de 59,87 ± 14,44. L'indication la plus fréquente de la coloscopie était l'hématochézie (23 (28,4 %)), suivie de la modification du transit intestinal (16 (19,8 %)), de la constipation (11 (13,6 %)) et du ténesme (10 (12,3 %)). Les masses du gros intestin évocatrices de cancers étaient la constatation la plus fréquente de la coloscopie chez les sujets de l'étude (36 (44,4 %)). Le cancer colorectal était l'anomalie histologique la plus fréquente chez les sujets de l'étude (26 (32,1%)) suivi de la colite chronique non spécifique (8 (9,9%)), des polypes (7 (8,6%)), des adénomes (5 (6,2%)) et aigu sur la colite chronique (5 (6,2 %)). Vingt-deux (27,2 %) patients avaient des résultats histologiques normaux. Les patients âgés de 45 à 64 ans avaient la prévalence la plus élevée de cancer colorectal (13 (50,0 %)).Conclusion:Le cancer colorectal était la découverte histopathologique la plus courante dans cette étude et les patients appartenaient principalement au groupe d'âge moyen. Une coloscopie de dépistage précoce est donc recommandée et l'analyse histopathologique des échantillons de muqueuses obtenus est essentielle pour la détection précoce des lésions pré-malignes.

Asymptomatic bacteriuria in patients with type 2 diabetes mellitus in rural southwestern Nigeria: a cross-sectional study.

OBJECTIVES: We aimed to identify the prevalence, bacterial isolates, antimicrobial susceptibility profile, and factors associated with asymptomatic bacteriuria (ASB) in patients with type 2 diabetes mellitus (T2DM) in rural southwestern Nigeria. METHODS: We performed a hospital-based cross-sectional study of patients with T2DM and ASB. Demographic and clinical data were collected using questionnaires. Urine samples were cultured using standard laboratory procedures, and bacterial colonies were isolated and antimicrobial sensitivity was performed using the disc diffusion technique. Relationships between variables were assessed using adjusted odds ratios (AORs) and 95% confidence intervals (CIs). RESULTS: Of the 280 participants, 73 (26.1%) had ASB (95% CI: 20.9%-31.2%). The most commonly identified isolate was E. coli (45/73; 61.7%), 100.0% of which were sensitive to cefuroxime but resistant to ciprofloxacin. Female sex (AOR, 6.132; 95% CI: 2.327-16.157), living below the poverty line (AOR, 2.066; 95% CI: 1.059-4.029), uncontrolled blood glucose (AOR, 2.097; 95% CI: 1.000-4.404), and a history of indwelling urethral catheterization (AOR, 14.521; 95% CI: 4.914-42.908) were associated with ASB. CONCLUSION: The findings suggest that cefuroxime should be used as an empirical treatment, pending urine culture and sensitivity, and that efforts should be made to prevent ASB in rural southwestern Nigeria.

Non-invasive assessment of hepatic fibrosis among patients with chronic hepatitis B virus infection in three tertiary hospitals in Nigeria.

Objective: This study aimed to assess hepatic fibrosis, using noninvasive tests, among patients with chronic hepatitis B virus infection in Nigeria. Methods: The study was a retrospective cross-sectional, hospital-based, multicentered study. The data of adult Nigerians who were aged 18 years and above who had been diagnosed with chronic hepatitis B infection and were not on treatment were extracted from three tertiary health institutions across Nigeria. Sociodemographic and relevant clinical data were obtained from the case notes of the patients. Fibrosis-4 and aspartate aminotransferase platelet ratio index scores were calculated to determine the presence and severity of liver fibrosis in the patients. The data obtained were analyzed using Statistical Package for the Social Sciences (version 25.0). A p-value of less than 0.05 was considered as statistically significant. Results: The data of a total of 234 patients were extracted for this study from across 3 tertiary hospitals in Nigeria. There were 132 (56.4%) males and 102 (43.6%) females in a ratio of 1.29:1 with a mean age of 37.92 ± 12.34 years. The fibrosis-4 score of the patients showed that 62.8% had "Normal/Mild Fibrosis," 25.6% had "Moderate Fibrosis," and 11.5% had "Severe Fibrosis/Cirrhosis." The aspartate aminotransferase platelet ratio index score of the patients showed that 64.1% had "No Fibrosis," 20.9% had "Mild Fibrosis," 6.4% had "Moderate Fibrosis," and 8.5% had "Severe Fibrosis/Cirrhosis." The median fibrosis-4 score of the patients was 1.18 (0.77-1.74), while the median aspartate aminotransferase platelet ratio index score was 0.40 (0.26-0.69). Liver ultrasonography detected cirrhosis in 8.5% of the patients. All the patients were not yet on treatment for hepatitis B infection. Conclusion: The prevalence of hepatic fibrosis is high among patients with chronic hepatitis B virus infection in Nigeria and a large number of these patients were not yet on therapy. Noninvasive assessment of hepatic fibrosis should be considered as a critical part of the work-up of patients with chronic hepatitis B infection.

Medical students' perceptions of the educational environment in a private medical school in Southwest Nigeria.

BACKGROUND: The educational environment plays a very important role in determining the overall performance of students. The aim of this study is to determine the perceptions of undergraduate medical students about their educational environment in a Nigerian university. MATERIALS AND METHODS: This was an observational, cross-sectional study conducted among final-year (600 level) undergraduate medical students. The Dundee Ready Education Environment Measure (DREEM) questionnaire was used for the study to assess the educational environment of the medical students. RESULTS: A total number of 100 final-year (600 level) undergraduate medical students participated in the study, out of which 27 (27.0%) were males and 73 (73.0%) were females with a male-to-female ratio of 0.37 to 1. The age range of the respondents was 21-30 years with a mean (±SD) of 23.54 (±1.403). The total mean DREEM score was 116.2/200. The total score of SPL domain was 30.2/48 (62.9%). The total score of SPT domain was 27.3/44 (62.0%), while that of SASP was 19.2/32 (60.0%). The total score of SPA domain was 26.6/48 (55.4%) and that of SSP was 13.1/28 (46.8%). For the SPL, SPT, SASP, and SPA domains, the score was above 50%. However, for the SSP domain the score was less than 50%. CONCLUSIONS: The total mean DREEM score in this study was 116.2/200, more positives than negatives, with the students' social perspective having the least domain score. There is a need to provide adequate social support system for medical students in general and particularly for those who get stressed.

Patterns of hepatitis b virus immune escape and pol/rt mutations across clinical cohorts of patients with genotypes a, e and occult hepatitis b infection in Nigeria: A multi-centre study.

Hepatitis B virus (HBV) immune escape and Pol/RT mutations account for HBV immunoprophylactic, therapeutic, and diagnostic failure globally. Little is known about circulating HBV immune escape and Pol/RT mutants in Nigeria. This study focused on narrowing the knowledge gap of the pattern and prevalence of the HBV mutants across clinical cohorts of infected patients in southwestern Nigeria. Ninety-five enrollees were purposively recruited across clinical cohorts of HBV-infected patients with HBsAg or anti-HBc positive serological outcome and occult HBV infection. Total DNA was extracted from patients' sera. HBV S and Pol gene-specific nested PCR amplification was carried out. The amplicons were further sequenced for serotypic, genotypic, phylogenetic, and mutational analysis. HBV S and Pol genes were amplified in 60 (63.2%) and 19 (20%) of HBV isolates, respectively. All the sixty HBV S gene and 14 of 19 Pol gene sequences were exploitable. The ayw4 serotype was predominant (95%) while ayw1 serotype was identified in 5% of isolates. Genotype E predominates in 95% of sequences, while genotype A, sub-genotype A3 was observed in 5%. Prevalence of HBV IEMs in the "a" determinant region was 29%. Commonest HBV IEM was S113T followed by G145A and D144E. The Pol/RT mutations rtV214A and rtI163V among others were identified in this study. This study provided data on the occurrence of existing and new HBV IEMs and Pol gene mutations in Nigeria.

The Pattern of Neurological Conditions in a Tertiary Institution in Nigeria: Six Years Experience in Ekiti State, Nigeria.

Background: Neurological disorders constitute major causes of morbidity, and globally, they are the leading causes of death. There is a dearth of neurologists in most African countries and the very few available ones are concentrated in urban areas. The cardiovascular and communicable risk factors responsible for most cases of acute and chronic neurological disorders are also prevalent in rural areas. Although patients from the neighbouring states attend the study centre, the majority are indigent. Therefore, there is a need to observe the pattern of these disorders in Ekiti, to appreciate the disease burden as it would help in the judicious allocation of human and other healthcare resources. Methodology: We reviewed the case files of patients seen at the neurology clinic and admitted via the emergency department into the Federal Teaching Hospital, Ido-Ekiti, over a period of 6 years (2016 to 2021). Results: A total of 881patients were seen during the study period, and they were mostly elderly male patients with chronic disorders in which stroke was the most common neurological disorder (44.9%) followed by seizure disorder (13.1%), and neurodegenerative disorders (9.9%). Tumors and myopathies were the least seen disorders. Conclusion: Health literacy on cardiovascular risk factors and even the distribution of manpower and material resources will help reduce the burden of neurological disorders among the attendees of the Ekiti tertiary health institution.

International health regulations and pre-travel health practices of international travelers at Nigerian airport: a cross-sectional study.

BACKGROUND: International Health Regulations (IHR) were developed by the World Health Organization (WHO) to curb the trans-border spread of epidemics. To our knowledge, no airport-based studies have assessed travelers' health practices against a combination of diseases subject to IHR 2005. Therefore, we aimed to generate and describe the baseline travelers' pre-travel health practices towards Cholera, Yellow Fever (YF), and Plague at Murtala Muhammed International Airport (MMIA) in Nigeria. METHODS: A cross-sectional study was employed to collect data from 486 international travelers using a multistage sampling technique. Pre-travel health practices (a combination of pre-travel consultation, pre-travel vaccination, and preventive measures against insect bites) were assessed using an interviewer-administered questionnaire. Logistic regression models were used to estimates the association between selected variables and pre-travel health practices. Statistical significance level was set at 5%. RESULTS: A total of 479 complete questionnaires were analyzed. The median age of respondents was 34.0 years Interquartile range (IQR) = 28.0, 44.0). Of the total respondents, 311 (64.3%) were aware of pre-travel health consultation and sources of information, amongst others, including friends/relatives in 180 (37.6%) travelers, social media/internet in 155 (32.4%) travelers, and health professionals in 102 (21.3%) travelers. Two hundred and seventy-one (56.6%) had pre-travel consultation, 156 (32.6%) had YF vaccination, and 226 (47.2%) were prepared to use preventive measures against insect bites. Only 10.6% had good pre-travel practices against the diseases subject to 2 International Health Regulations (IHR). Travelers with bachelor/college degrees, when compared to those with secondary/high education, had 2.91 times higher odds of having good practices when adjusting for other factors (95% C.I: 1.10, 7.70; p < 0.03). Also, those traveling to destinations endemic for YF infection, when compared to those who are not traveling to endemic countries/areas, had 48% lower odds of having good practices after adjusting for other factors (95% C.I: 1.41, 7.77; p < 0.01). CONCLUSIONS: Our study revealed a low prevalence of good pre-travel health practices among participants. Educational level and endemicity of YF at the destination were predictors of pre-travel health practices. Introducing topics on travelers' health into schools' curriculums may have a ripple positive effect on health practices among international travelers. Also, there is a need for public enlightenment programs on pre-travel health practices using social media platforms.

Exposure to patients' sample and prevalence of Hepatitis B and C virus infection among health-care workers in a Nigerian Tertiary Hospital.

Background: Hepatitis B and C lead to chronic disease in hundreds of millions of people and together constitute the most common cause of liver cirrhosis and cancer with attendant mortality. Objective: The objective of this study was to estimate the prevalence of hepatitis B and C virus infection among different categories of health-care workers, looking at the exposure to patients' samples and the prevalence rate among these categories of health workers. This will help to ascertain the risk and the need to pay more attention to preventive measures. Materials and Methods: This was a cross-sectional study conducted over a 2-year period among 217 health-care workers at the department of Haematology of the Federal Teaching Hospital, Ido-Ekiti, Nigeria. Respondents were randomly selected, and blood samples were taken for the hepatitis B and C screening. Data were analyzed using SPSS 20; bivariate analyses were done, and the level of statistical significance was set at P < 0.05. Results: A total of 13 (6.0%) tested positive for HBsAg. Analysis of the marital status of those that tested positive to Hepatitis B, revealed that the highest number (77%) was found among the married, while the singles and the divorced constitute 15.3% and 7.7% respectively. The nurses and nonhealth professionals (admin staff) constitute the highest positive yield of hepatitis B virus (HBV), followed by medical doctors and laboratory staff. The age of the respondent was found to have a statistically significant association with HBV serology (P < 0.05). Conclusion: There is a comparatively lower prevalence of HBsAg among the health-care workers who are directly exposed to patients' samples. The age of the respondent has a significant association with hepatitis B infection.

Résumé Contexte: L'hépatite B et C conduisent à des maladies chroniques chez des centaines de millions de personnes et constituent ensemble la cause la plus courante de cirrhose du foie et de cancer avec la mortalité des participants. Objectif: L'objectif de cette étude était d'estimer la prévalence de l'infection par le virus de l'hépatite B et du C entre différentes catégories de travailleurs de la santé, en examinant l'exposition aux échantillons des patients et le taux de prévalence entre ces catégories d'agents de santé. Cela aidera à déterminer le risque et la nécessité de prêter plus d'attention aux mesures préventives. Matériel et méthodes: Il s'agissait d'une étude transversale menée sur une période de 2 ans parmi 217 travailleurs de la santé au Département d'hématologie de l'hôpital fédéral universitaire, Ido - Ekiti, au Nigéria. Les répondants ont été sélectionnés au hasard et des échantillons de sang ont été prélevés pour le dépistage de l'hépatite B et du C. Les données ont été analysées à l'aide de SPSS 20; Des analyses bivariées ont été effectuées et le niveau de signification statistique a été fixé à p <0,05. Résultats: Un total de 13 (6,0%) ont été testés positifs pour HBSAG. L'analyse de l'état matrimonial de ceux qui se sont testés positifs à l'hépatite B, ont révélé que le nombre le plus élevé (77%) a été trouvé chez les mariés, tandis que les célibataires et les divorcés constituent respectivement 15,3% et 7,7%. Les infirmières et les professionnels de la santé (personnel administratif) constituent le plus élevé Rendement positif du virus de l'hépatite B (HBV), suivi des médecins et du personnel de laboratoire. L'âge du répondant s'est avéré avoir une association statistiquement significative avec la sérologie du VHB (p <0,05). Conclusion: Il existe une prévalence relativement plus faible de HBSAG chez les travailleurs de la santé qui sont directement exposés aux échantillons des patients. L'âge du répondant a une association significative avec l'infection à l'hépatite B. Mots-clés: Exposition, hépatite B et C, prévalence.

Preferências de carreira entre graduandos de medicina no sudoeste da Nigéria / Career preferences of final-year medical students in south-west Nigeria

Resumo Estudantes de medicina possuem diferentes opções de trajetórias acadêmicas ou profissionais após a graduação. Este estudo busca determinar as preferências de carreira entre graduandos de medicina e os fatores que contribuem para tal decisão. Pesquisa descritiva e transversal foi realizada com graduandos de medicina da Afe Babalola University, localizada em Ekiti State, Nigéria. Dados foram coletados por um questionário bem estruturado e analisados usando SPSS versão 21.0. A estatística descritiva inclui tabelas de frequência, gráficos, médias e desvios padrão. Um total de 100 graduandos participaram do estudo, dos quais 29 (29,0%) homens e 71 (71,0%) mulheres, com relação homem/mulher de 0,4 para 1. A faixa etária dos participantes foi de 21 a 30 anos, com média (±SD) de 23,5 (±1,4). Do total de participantes, 72% planejavam ingressar na pós-graduação após a faculdade de medicina, a maioria no Reino Unido, sendo o mestrado em Saúde Pública a qualificação de maior interesse. Da mesma forma, 76% dos entrevistados planejavam buscar uma bolsa de pós-graduação após a faculdade, também em sua maioria no Reino Unido. A especialidade mais procurada é Obstetrícia e Ginecologia (43%), seguida por Cirurgia (40%), Medicina de Família (34%), Medicina Comunitária (33%), Pediatria (25%) e Medicina Interna (23%), enquanto a especialidade menos procurada é Patologia Química (28%), seguida por Microbiologia Médica (27%) e Anatomia Mórbida (24%). O principal fator considerado para esta escolha é o interesse pessoal pela especialidade, seguido por perspectivas financeiras, estilo de vida confortável e horário de trabalho flexível. Mestrado em Saúde Pública e especialização em Obstetrícia e Ginecologia são as carreiras mais buscadas por graduandos de medicina, escolha majoritariamente pautada em seus interesses pessoais.

Abstract Medical students have many different options of academic and professional undertakings after graduation. The aim of this study is to determine the career preferences of students in their final year of medical school and to determine the factors that contributed for such decision. This is a descriptive cross-sectional study involving the final-year medical students of Afe Babalola University, Ekiti State, Nigeria. A well-structured questionnaire was used for data collection. The data was analysed using the Statistical Package for the Social Sciences (SPSS) version 21.0. Descriptive statistics included frequency tables, charts, means and standard deviations. A total number of 100 final-year medical students participated in the study, out of which 29 (29.0%) were males and 71 (71.0%) were females, with a male to female ratio of 0.4 to 1. The age range of the respondents was 21 to 30 years, with a mean(±SD) of 23.5(±1.4). 72% of the respondents planned to pursue a postgraduate academic qualification after graduating from medical school, mostly in the United Kingdom, and a Master of Public Health was the most sought qualification. Similarly, 76% of the respondents planned to pursue a postgraduate medical fellowship after medical school, also mostly in the United Kingdom. The specialty most sought-after is Obstetrics and Gynaecology (43%), followed by Surgery (40%), Family Medicine (34%), Community Medicine (33%), Paediatrics (25%), and Internal Medicine (23%) while the least sought-after specialty is Chemical pathology (28%), followed by Medical Microbiology (27%) and Morbid Anatomy (24%). The most important factor considered by the respondents in choosing a particular specialty is their personal interest in that specialty, followed by financial prospects, comfortable lifestyle, and flexible working hours. Master of Public Health degree and postgraduate fellowship in Obstetrics and Gynaecology specialty are the career preferences for most of the final-year medical students in this study, and this is largely informed by their personal interest in these fields.