Is there still yaws in Nigeria? Active case search in endemic areas of southern Nigeria.

BACKGROUND: Yaws is a disease caused by the bacteria Treponema pallidum subspecies pertenue, which is most commonly seen among children below 15 years. In the twentieth century yaws was endemic in Nigeria but eradication strategies markedly reduced the disease burden. Currently there is minimal data on the ongoing transmission of yaws in Nigeria, despite reports of confirmed yaws cases in neighbouring West African countries. METHODS: We conducted both community and school-based active yaws case search among school-aged children in southeast Nigeria. Children were screened by trained community volunteers. Suspected yaws cases were clinically reviewed and tested using rapid diagnostic serological tests. RESULTS: Between February and May 2021, up to 28 trained community volunteers screened a total of 105,015 school children for yaws. Overall, 7,706 children with various skin lesions were identified. Eight (8) suspected cases of yaws were reported, reviewed and screened, but none was confirmed using rapid diagnostic tests. The four most common skin conditions identified were scabies (39%), papular urticaria (29%), tinea corporis (14%) and tinea capitis (12%). CONCLUSIONS: No case of yaws was confirmed in this large population of children in south-east Nigeria. Continuous community awareness and yaws case finding activities have been recommended across Nigeria.

Plain radiograghs of lumbar spine in patients with low back pain.

Low back pain (LBP) is a common presenting complaint in our hospital in Enugu Nigeria. Three hundred thirty-three radiographs of patients with LBP were studied. A lot of them had bony outgrowths (osteophytes) on the spine. Plain radiograph of the spine is useful in studying these patients' condition. INTRODUCTION: Low back pain (LBP) is one of the common symptoms which bring patients to hospital and ultimately to radiology department for medical assistance. Plain radiographs of lumbar spine are usually the initial imaging tools requested by clinicians. The objective of this study is to evaluate commonest finding in patients with LBP to guide physicians for improved management. METHODS: This work was a retrospective study. Plain films of these patients with LBP at the University of Nigeria Teaching Hospital, Enugu, were assessed by two radiologists. Findings documented and analyzed using IBM'S SPSS 22. Association was determined using chi-square with level of significance, p < 0.05. RESULTS: Total number of radiographs reviewed was 333. One hundred and eighty-three (55.0%) patients were females. Age ranged from 14 to 101 years. Mean age of 53.4 ± 15.9 years. Disc space was normal in majority (55.3%, 184/333) of patients; narrowing was observed in most others (43.2%, 144/333), about half of the narrowing occurring along with vacuum phenomenon. Osteophytes were commonest finding in a total of 284/333 (85.3%) existing alone or in combination with other findings. Proportion of patients with osteophytes was highest in sixth to eighth decade of life (98.8% of 61-80 age group), followed by 41-60 age group (92.9%). This association between age group and the presence of osteophytes was statistically significant (p < 0.000). Anterior vertebral body was affected in 85.0% (284/333) of patients. CONCLUSIONS: Osteophytes are common radiologic features in LBP. Anterior vertebral body is most affected. It is commoner in the older age group. Plain radiograph is an invaluable imaging tool in the management of LBP in this part of the world.

Prevalence of malaria in HIV positive and HIV negative pregnant women attending antenatal clinics in south eastern Nigeria.

INTRODUCTION: Globally, malaria in pregnancy is a public health challenge. Malaria and HIV are among the two most important diseases contributing to the global health burden of our time. HIV positive pregnant women are at increased risk of all the adverse outcomes of malaria in pregnancy. OBJECTIVE: The objective of this study was to compare malaria parasitaemia between HIV positive and HIV negative pregnant women attending antenatal clinics offering Preventing Maternal to Child Transmission (PMTCT) services in Enugu metropolis, south-eastern Nigeria. METHODS: A descriptive cross sectional study was conducted among 200 HIV positive and 200 HIV negative pregnant women attending antenatal clinics in Enugu. Two out of five hospitals that provide PMTCT services were selected through balloting. Finger pricked blood samples were collected and thick blood films were examined for malaria parasite using giemsa expert microscopy. A structured interviewer administered questionnaire was used for data collection. Data was analysed using SPSS version 22. RESULTS: The HIV positive pregnant women (152) (76%) and HIV negative women (137) (68.5%) studied were mostly in the age range of 25-34 years. Mean gestational age of HIV positive and HIV negative participants were 23.4±10.7 and 23.2±10.1 weeks respectively (P=0.001). The prevalence of malaria infection among HIV positive pregnant mothers was 81% (162/200) and 75% (150/200) among HIV negative pregnant women (P < 0.001). The HIV positive mothers had more moderate parasitaemia (86/200: 53.1%) compared to 43/200: 28.7% in HIV negative mothers (P<0.001). Even though more HIV positive mothers (54.5%) used insecticide treated nets ITNs during pregnancy compared to 41.5% in HIV negative mothers, moderate malaria parasitaemia was higher in HIV positive mothers. HIV positive nulliparous pregnant women had the highest rate of malaria parasitaemia (32/36: 88.9%). CONCLUSION: Moderate malaria parasitaemia was higher among HIV positive pregnant women. All malaria preventive strategies should be intensified in pregnancy as ITNs provided little protection.