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1.
Cureus ; 13(8): e17413, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34589324

ABSTRACT

Introduction Snakebites are common and constitute an important health problem in many countries of the world, with the greatest burden occurring in rural areas of Asia and Sub-Saharan Africa. They were classified by the World Health Organization as category A of neglected tropical diseases. Most studies on snake envenoming in Nigeria were among adult populations with few among children. This study assessed the prevalence and outcome of snakebite among children in Federal Medical Centre, Birnin Kebbi. Methods This was a four-year retrospective study in which the medical records of patients with managed snakebite were reviewed. A study proforma was used to obtain information on socio-demographic characteristics, site of the bite, features of envenoming, pre-hospitalization intervention, hospital treatment, length of hospitalization, and outcome of treatment of the patients. Results There were 19 snakebite cases out of 5,195 admissions during the period under review, giving a prevalence of 0.0037 (3.7/1000) with a male:female ratio of 2:1. The majority (66.7%) of the children were aged between 11 and 15 years and the mean (± SD) age of the study population was 10.5 (± 3.3) years. The lower limb was the site of bite in 10 (55.6%) of the patients and clinical features included local pain (100%), local swelling of varying magnitude (16 (88.9%)), spontaneous bleeding eight (44.4%) among others. Ten (55.65%) patients presented after four hours of bite and the mean (±SD) duration of hospitalization was 2.11 (±0.58) days. Most (77.8%) received at least one form of pre-hospital care while only 66.7% received polyvalent anti-snake venin. The case fatality rate was 5.6% while 55.6% of patients signed against medical advice. Conclusion There was a low hospital prevalence of snakebite in children in the present study location with associated low mortality but a high rate of discharge against medical advice. Most of the patients had a pre-hospital intervention and anti-snake venin is not readily accessible.

2.
PLoS One ; 13(6): e0199257, 2018.
Article in English | MEDLINE | ID: mdl-29920549

ABSTRACT

BACKGROUND: Nigeria reports high rates of mortality linked with recurring meningococcal meningitis outbreaks within the African meningitis belt. Few studies have thoroughly described the response to these outbreaks to provide strong and actionable public health messages. We describe how time delays affected the response to the 2016/2017 meningococcal meningitis outbreak in Nigeria. METHODS: Using data from Nigeria Centre for Disease Control (NCDC), National Primary Health Care Development Agency (NPHCDA), World Health Organisation (WHO), and situation reports of rapid response teams, we calculated attack and death rates of reported suspected meningococcal meningitis cases per week in Zamfara, Sokoto and Yobe states respectively, between epidemiological week 49 in 2016 and epidemiological week 25 in 2017. We identified when alert and epidemic thresholds were crossed and determined when the outbreak was detected and notified in each state. We examined response activities to the outbreak. RESULTS: There were 12,535 suspected meningococcal meningitis cases and 877 deaths (CFR: 7.0%) in the three states. It took an average time of three weeks before the outbreaks were detected and notified to NCDC. Four weeks after receiving notification, an integrated response coordinating centre was set up by NCDC and requests for vaccines were sent to International Coordinating Group (ICG) on vaccine provision. While it took ICG one week to approve the requests, it took an average of two weeks for approximately 41% of requested vaccines to arrive. On the average, it took nine weeks from the date the epidemic threshold was crossed to commencement of reactive vaccination in the three states. CONCLUSION: There were delays in detection and notification of the outbreak, in coordinating response activities, in requesting for vaccines and their arrival from ICG, and in initiating reactive vaccination. Reducing these delays in future outbreaks could help decrease the morbidity and mortality linked with meningococcal meningitis outbreaks.


Subject(s)
Disease Outbreaks , Meningitis, Meningococcal/epidemiology , Meningitis, Meningococcal/prevention & control , Neisseria meningitidis/pathogenicity , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Meningitis, Meningococcal/microbiology , Meningitis, Meningococcal/mortality , Mortality , Nigeria/epidemiology , Serogroup , Vaccines/therapeutic use , Young Adult
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