How resilient are farmers in Africa to climate shocks? A case study of Nigerian farmers.

Agriculture in sub-Saharan Africa remains highly vulnerable to climate related shocks, since most production relies on rainfall. It is important to accurately measure the resilience of farmers and farming communities to weather variabilities, for both government policy and farmer management responses. This paper develops a Resilience Index Framework, which is further used to assess the resilience of farmers to climate shocks in Nigeria. We conceptualized our Resilience Index (RI) in this study to be a composite function of 60 indicators encompassing four resilience domains namely, Economic & Financial Resilience (ER); Technical-know-how Resilience (TR); Social Resilience (SR); and Physical Resilience (PR). A three-stage standardization approach to construct the resilience index is taken in this study. In the first stage, each indicator is standardized. In the second stage, the resilience domain is computed by averaging the corresponding standardized indicators. In the final stage, the composite RI is computed by estimating the weighted average of all the resilience domains. The study uses the baseline survey data collected between 2021 and 2022 from a total of 5954 farmers in the rainforest, derived and guinea savannah agroecological zones of Nigeria. The result of the study shows that the majority (96.5%) of the farmers are less resilient to climate shocks, with only 0.9% economically & financially resilient, 1.4% socially resilient, 31.4% technically resilient, and 18.5% physically resilient. Finally, some recommend steps to be taken by the government and relevant stakeholders to improve the resilience of farmers through provision of good infrastructural facilities and subsidized improved resistant seed varieties are proposed.

Diphtheria in two Nigerian Hospitals: What is New and the Implications for Control.

We recorded three cases of faucial Diphtheria in two Nigerian hospitals between 2021 and 2022. Hitherto, no infections were documented in these hospitals in the prior ten years. All infected children missed their routine childhood vaccinations and presented with reduced feeding, a bull neck and a light yellowish throat or tonsillar pseudo-membrane. Outcome was fatal in the first case after two weeks of antibiotic treatment. Diphtheria anti-toxoids (DAT); were not available at this time in Osun state, Nigeria. Outcome was good in the other two children following treatment with antibiotics and compatible plasma transfusion as an alternative for DAT. The predominant contrasting colour of our reported pseudo-membrane compared to the grey colour dominantly well-known is highlighted. We also proffer Plasma transfusion as an alternative to DAT when unavailable. Disease resurgence from the other associated missed pentavalent vaccines is a potential risk.

Nous avons enregistré trois cas de diphtérie fauve dans deux hôpitaux nigérians entre 2021 et 2022. Jusqu'à présent, aucune infection n'avait été documentée dans ces hôpitaux au cours des dix années précédentes. Tous les enfants infectés n'avaient pas reçu les vaccinations infantiles de routine et présentaient une alimentation réduite, un cou de taureau et une gorge légèrement jaunâtre ou une pseudo-membrane amygdalienne. L'issue a été fatale dans le premier cas après deux semaines de traitement antibiotique. Les antitoxines diphtériques (DAT) n'étaient pas disponibles à cette époque dans l'État d'Osun, au Nigeria. L'évolution a été bonne chez les deux autres enfants après un traitement antibiotique et une transfusion de plasma compatible en remplacement des DAT. La couleur contrastante prédominante de la pseudo-membrane que nous avons rapportée, comparée à la couleur grise dominante bien connue, est mise en évidence. Nous proposons également la transfusion de plasma comme alternative à la DAT lorsqu'elle n'est pas disponible. La résurgence de la maladie à partir des autres vaccins pentavalents manqués associés est un risque potentiel. Mots clés: Pédiatrie, diphtérie, maladie infectieuse évitable par la vaccination, ré-émergence.

Influence of social disadvantage among children admitted to the pediatric emergency unit of a tertiary Hospital in Nigeria.

Background: Social disadvantage has an influence on the health of individuals. In developed countries, the prevalence, pattern of social disadvantage, and the outcome of admissions in socially disadvantaged children are under-studied. Aim: To determine the prevalence of social disadvantage, pattern of diseases, and illness outcomes among socially disadvantaged children. Patients and Methods: This was a prospective hospital-based study involving 400 patients who presented at the pediatric emergency unit (PEU) of a tertiary hospital in Southwest Nigeria. Information on socio-demography and history of illness was obtained from consecutive children using a proforma. The data was analyzed using SPSS version 20. Results: The 400 participants comprised 276 male and 124 female giving a ratio of 2.2:1. Their age range was 1-14 years; the mean ± SD age was 4.6 ± 2.3. Three hundred (75%) of the children were socially disadvantaged. The social factors associated with social disadvantage were low income, unemployment of mothers, polygamous setting, single parenting, rural residence, and low registration for health insurance. There was a significant association between social disadvantage and the development of malaria (P = 0.03), pneumonia (P = 0.01), septicemia (P = 0.03), diarrhea diseases (P = 0.04), neonatal jaundice (P = 0.04), meningitis (P = 0.04), and protein-energy malnutrition (P = 0.003). Death was significantly worse among the children who are socially disadvantaged (P = 0.0001). Conclusion: Many children admitted to the PEU in Osogbo are socially disadvantaged. Children of low-income parents, unemployed mother, single parent, residents of rural places, and those without health insurance are more vulnerable to developing infectious disease as well as neonatal jaundice and protein-energy malnutrition. Socially disadvantage increases the risk of poor illness outcome (death).

Muco-Cutaneous Infections in HIV Infected Children at a Nigerian Tertiary Hospital.

BACKGROUND: Studies on mucous infections in HIV infected children are sparse. Cutaneous infections though common, vary in pattern and prevalence over time and location. OBJECTIVES: To provide updates on the prevalence and pattern of muco-cutaneous infections among HIV infected children attending a Nigerian tertiary hospital and identify neglected muco-cutaneous infections. METHODS: Consecutive HIV infected children seen over a 5-year period were studied. Relevant information on the subjects, HIV and presence or absence of skin infections was obtained. Data was analysed with SPSS version 16 software. RESULTS: One hundred and thirty-two children were studied with ages ranging between 3 months and 17 years of which 68(51.5%) were boys and 64(48.5%) girls. Of the 132 children 64(48.5%) had muco-cutaneous infections, comprising 50(78.1%) cutaneous and 14(21.9%) mucous infections. Superficial fungal, viral, bacterial and parasitic infections were recorded in 45(34.1%), 18(26.6%), 12(9.1%) children and 1 (0.8%) child respectively. Thirty-six (56.2%) of the 64 children with muco-cutaneous infection were unaware of their skin infection prior to consultation. The rates of skin infection were significantly higher amongst children with advanced HIV disease, children whose caregivers had skin disease and children whose parents had no formal education and educational attainments limited to the primary school.(p< 0.05). Presence of phlyctenular conjunctivitis in a child with hitherto undiagnosed tuberculosis was recorded. CONCLUSION: Muco-cutaneous infections are common disease conditions of HIV infected children. Awareness of muco cutaneous infections amongst those infected is poor. Interventions mitigating associated factors are expected to reduce the burden of this disease.

CONTEXTE: Études sur les infections muqueuses chez les personnes infectées par le VIH les enfants sont clairsemés. Les infections cutanées, bien que courantes, varient en le modèle et la prévalence au fil du temps et de l'emplacement. OBJECTIFS: Fournir des mises à jour sur la prévalence et la tendance des infections muco-cutanées chez les enfants infectés par le VIH fréquentant un hôpital tertiaire nigérian et identifier les muco-cutanés négligés Infections. MÉTHODES: Enfants infectés par le VIH consécutifs vus pendant 5 ans période ont été étudiés. Informations pertinentes sur les sujets, le VIH et la présence ou l'absence d'infections cutanées a été obtenue. Les données ont été analyses avec le logiciel SPSS version 16. RÉSULTATS: Cent trente-deux enfants ont été étudiés avec âges compris entre 3 mois et 17 ans, dont 68 (51.5 %) étaient des garçons et 64 (48.5 %) des filles. Sur les 132 enfants, 64 (48.5 %) avaient infections muco-cutanées, comprenant 50 (78.1 %) cutanés et 14 (21.9 %) infections muqueuses. Fongique superficiel, viral, bactérien et des infections parasitaires ont été enregistrées chez 45 (34.1 %), 18 (26.6 %), 12 (9.1 %)enfants et 1 (0.8%) enfant respectivement. Trentesix (56.2 %) des 64 enfants atteints d'une infection muco-cutanée n'étaient pas au courant de leur infection cutanée avant la consultation. Les taux d'infection cutanée étaient significativement plus élevé chez les enfants atteints d'une maladie à VIH avancée,les enfants dont les soignants avaient une maladie de la peau et les enfants dont les parentsn'avaient pas d'éducation formelle et de niveau de scolarité limité à l'école primaire. (p< 0.05). Présence de conjonctivite phlycténulaire chez un enfant atteint de tuberculose jusqu'alors non diagnostiquée a été enregistré. CONCLUSION: Les infections muco-cutanées sont des maladies courantes les conditions des enfants infectés par le VIH. Sensibilisation à la muqueuse-cutanéeles infections parmi les personnes infectées sont faibles. Interventions atténuantes on s'attend à ce que les facteurs associés réduisent le fardeau de cette maladie. Mots-clés: Pédiatrie, Infectieux, Dermatoses, Humain virus de l'Immuno déficience.

Pattern of Blood Donation and Transfusion Transmissible Infections in a Hospital-Based Blood Transfusion Service in Lagos, Nigeria.

BACKGROUND: Blood transfusion therapy remains a mainstay in the care of many tropical diseases. Blood supply in sub-Saharan Africa (SSA) including Nigeria is still a challenge in terms of perennial blood shortages and transfusion transmissible infections (TTI). This study aimed to describe blood donation patterns and compare the rates of TTIs among types of blood donors seen at LUTH. STUDY METHOD: A 6-year retrospective review of data on donor types and pattern of TTIs at LUTH transfusion service. TTI rates and odd ratios (OR) of TTI positivity amongst VNRD versus FRD were computed at 95% confidence intervals. Proportion of TTI sero-positivity was also compared between the VNRD and FRD groups. RESULTS: A total of 53,319 blood donors were observed over the study period, with average of 8886.5 donors per year. VNRDs accounted for 12.3% (6533/53,319), while FRDs accounted for 87.7% (46,789/53,319) of all donors. The proportion of VNRDs ranged from 5.1% to 20.8%. The overall prevalence of TTIs over the 6-year period for all donors was 1.34% for HIV, 5.79% for HBV, 2.23% for HCV and 0.88% for syphilis. Sero-positivity rates for HIV, HBV, HCV, and syphilis was statistically significantly lower among VNRD compared to FRDs. CONCLUSION: There exists a lot of room for improvement in our blood donation practices to improve blood stock and transfusion safety. A more aggressive strategic effort needs to be directed towards achieving a target of 100% voluntary blood donor base through partnerships, advocacy, more financing and resource allocation, and other proven initiatives.

CONTEXTE: La thérapie de transfusion sanguine reste un pilier dans le traitement de nombreuses maladies tropicales. L'approvisionnement en sang en Afrique subsaharienne (ASS), y compris au Nigeria, reste un défi en termes de pénurie de sang et d'infections transmissibles par transfusion (ITT). Cette étude visait à décrire les habitudes de don du sang et à comparer les taux d'ITT parmi les types de donneurs de sang vus au LUTH. MÉTHODE DE L'ÉTUDE: Un examen rétrospectif sur 6 ans des données sur les types de donneurs et les tendances des ITT au service de transfusion du LUTH. Les taux d'ITT et les odd ratios (OR) de positivité de l'ITT parmi les VNRD par rapport aux FRD ont été calculés avec des intervalles de confiance de 95%. La proportion de séropositivité à l'ITT a également été comparée entre les groupes VNRD et FRD. RÉSULTATS: Un total de 53 319 donneurs de sang ont été observés au cours de la période d'étude, avec une moyenne de 8886,5 donneurs par an. Les DVNR représentaient 12,3 % (6533/53 319), tandis que les DRF représentaient 87,7 % (46 789/53 319) de tous les donneurs. La proportion de DVNRD variait de 5,1 % à 20,8 %. La prévalence globale des ITT sur la période de 6 ans pour l'ensemble des donneurs était de 1,34 % pour le VIH, 5,79 % pour le VHB, 2,23 % pour le VHC et 0,88 % pour la syphilis. Les taux de séropositivité pour le VIH, le VHB, le VHC et la syphilis étaient statistiquement significativement plus faibles chez les VNRD que chez les FRD. CONCLUSION: Il existe une grande marge d'amélioration dans nos pratiques de don de sang pour améliorer la sécurité des stocks de sang et des transfusions. Un effort stratégique plus agressif doit être déployé pour atteindre l'objectif de 100 % de donneurs de sang volontaires par le biais de partenariats, d'actions de sensibilisation, d'un financement et d'une allocation de ressources accrus et d'autres initiatives éprouvées. MOTS CLÉS: Transfusion, Infections transmises par transfusion, Nigeria, donneurs de sang, Lagos, Afrique sub-saharienne.

Ten-Year Review of Paediatric Endocrine Disorders at Uniosun Teaching Hospital, Osogbo, Nigeria.

BACKGROUND: Paediatric endocrinology is a nascent subspecialty in Nigeria.Previous reports suggest a poor awareness of paediatric endocrine disorders resulting in late presentation, missed diagnosis and unnecessary death. OBJECTIVES: The study aims to report the prevalence of paediatric endocrine disorders at UNIOSUN Teaching Hospital (UTH) and to provide essential information to enhance early presentation and management. METHODS: This is a 10-year retrospective study of all children managed for paediatric endocrine disorders at UTH from March 2010 to March 2020. Relevant data were extracted from patients' records, entered into and analyzed with SPSS. RESULTS: Forty (0.42%) of 9,520 new consultations at UTH paediatric specialist clinic during the study period had endocrine disorders. There were 13 males and 27 females (M:F=1:2), with ages ranging from 1 month to 15.5years and 23 (57.5%) of them were under the age of 5 years. The four most common endocrine disorders were Rickets (45%), Diabetes (15%), Thyroid disorders (15%) and disorders of puberty (12.5%). There was a progressive yearly increase in the number of paediatric endocrine cases seen. At the time of this report, 34 (85%) of the patients were alive and doing very well, 5 (12.5%) has been lost to follow up and 1 (2.5%) mortality was recorded. CONCLUSION: Rickets, diabetes, thyroid disorders and disorders of puberty are the four leading paediatric endocrine disorders seen at UTH. Attrition is a notable challenge in paediatric endocrine disorders. Reasons for attrition and ways to terminate these challenges need to be identified and put into practice.

CONTEXTE: L'endocrinologie pédiatrique est une surspécialité naissante au Nigéria. Les rapports precedents suggèrent une mauvaise connaissance générale des troubles endocriniens pédiatriques entraînant une présentation tardive, un diagnostic manqué et une mort inutile. OBJECTIFS: L'étude vise à examiner la prévalence des troubles endocriniens pédiatriques au UTH et à fournir des informations essentielles pour améliorer la présentation et la prise en charge précoces. METHODES: Il s'agit d'une etude rétrospective de 10 ans de tous les enfants pris en charge pour des troubles endocriniens pédiatriques au UTH de mars 2010 à mars 2020. Les données pertinentes ont été extraites des dossiers des patients, entrées et analysées avec SPSS. RESULTATS: Quarante (0,42%) des 9 520 nouvelles consultations à la Clinique pédiatrique spécialisée UTH au cours de la période d'étude présentaient des troubles endocriniens. Il y avait 13 hommes et 27 femmes (M: F = 1: 2), âgés de 1 mois à 15,5 ans et 23 (57,5%) d'entre eux avaient moins de 5 ans. Les quatre troubles endocriniens les plus courants au UTH étaient le rachitisme (45%), le diabète (15%), les troubles thyroïdiens (15%) et les troubles de la puberté (12,5%). Il y avaitune augmentation annuelle régulière du nombre de cas endocriniens pédiatriques observés. Trente-quatre (85%) des patients sont vivants et se portent très bien, 5 (12,5%) ont été perdus de vue et 1 mortalité (2,5%) a été enregistrée. CONCLUSION: le rachitisme, le diabète, les troubles thyroïdiens et les troubles de la puberté sont les quatre principaux troubles endocriniens pédiatriques observés au UTH. L'attrition est un défi notable dans les troubles endocriniens pédiatriques. Les raisons de l'attrition et les moyens de mettre fin à ce défi doivent être identifiés et mis en pratique. MOTS CLÉS: Pédiatrie, troubles endocriniens, sensibilisation, rachitisme, diabète, Nigéria.

A ten-year review of childhood obesity in a teaching hospital, South West Nigeria.

BACKGROUND: Obesity is an important cosmopolitan cause of morbidity in children and adolescence age groups. Information on obesity in this age group in Nigeria is scant. AIM: To determine the prevalence of obesity and the associated morbidities seen at the Paediatric Endocrinology clinic of Ekiti State University Teaching Hospital, South West, Nigeria. METHODS: A retrospective review of all obese children attending the Paediatric Endocrinology clinic. Sociodemographic and other information related to paediatric obesity and associated morbidities were extracted from the case notes. Data obtained was analyzed using Statistical Package for Social Sciences (SPSS) version 20. RESULTS: A total of 21 obese children attended the clinic in the 10 years of study. The 21 children were made of 14 (66.7%) girls and 7 (33.3%) boys, giving a 2:1 female to male ratio. The ages of the children ranged from 1 to 16 years with a mean age of 8.79 ± 4.35 years. Obesity was secondary to a nutritional cause in 16 (76.2%) of the cases and Type 1 diabetes mellitus, Type 2 diabetes mellitus, Cushing's syndrome, Iatrogenic Cushing's syndrome and post-meningitis in the remaining 1 (4.8%) case each. Seventeen (81%) of the children were from the higher socioeconomic class, and the remaining three (19.0%) from lower socioeconomic class. Four (19.0%) of the children had hypertension with their blood pressure (BP) above the 95th percentile for age and sex. Hypertension was more common among the higher socioeconomic group, children older than 10 years and the female gender. This association was not statistically significant. A greater proportion of children with body mass index (BMI) >30 had significantly higher rates of hypertension (P < 0.001). CONCLUSION: Obesity is a common disease condition amongst children attending paediatric endocrine clinic. Strategies to control obesity and progression of severity of obesity may have a place in reducing the prevalence of hypertension in obese children and adolescents.

Atopy in HIV-infected children attending the pediatric antiretroviral clinic of LAUTECH Teaching Hospital, Osogbo.

BACKGROUND: Atopy is poorly researched in HIV children living in the developing countries. There is no previous report on this subject in Nigeria and this pioneering study is undertaken to create an awareness of the burden of this disease among health practitioners. AIMS: The aim of this study was to document the atopic diseases present among HIV-infected children attending the antiretroviral (ARV) clinic of a Nigerian tertiary hospital. METHODS: Information was obtained from consecutive consenting caregiver/HIV-infected child attending the pediatric ARV clinic, by the use of a proforma specifically designed for the study. The data obtained were analyzed using Statistical Package for the Social Sciences (SPSS) software program, version 16.0. RESULTS: Seventy patients were studied and their ages ranged between 2 and 17 years. These 70 were constituted by 34 (48.6%) boys and 36 (51.4%) girls. Ten (14.3%) of the 70 studied, had atopic diseases. Nine (12.9%) patients had allergic conjunctivitis and 1 (1.4%) had allergic rhinitis. The single patient with allergic rhinitis also had bronchial asthma. No case of atopic eczema, or food allergy was recorded. Atopic disease conditions were more commonly recorded among the male sex and those whose parents have atopic diseases (P < 0.05). Atopic diseases were also more common among children without advanced HIV diseases and those with eosinophilia. Cosmetic and psychological embarrassment from eye discoloration and itching were the negative impacts on the quality of living. CONCLUSION: Allergic conjunctivitis is common in HIV-infected Nigerian children. Atopies are more common in boys and children with parental atopies.

Prevalence of anti-A and anti-B hemolysis among blood group O donors in Lagos.

BACKGROUND: Group O donor blood is more readily available and is frequently used as universal red cell donor in our environment. The presence of hemolysins in the donors may however lead to hemolysis in the recipients. Attempts have been made to study the prevalence of hemolysins in various populations with results from our environment showing wide variation (20-80%). AIMS: To determine the prevalence and titer of anti-A and anti B hemolysins among blood donors at the Lagos University Teaching Hospital and compare results with that obtained elsewhere. Determine if the practice of transfusion of group O blood to nongroup O recipients is permissible in this environment. MATERIALS AND METHODS: Test for hemolysis was done using the standard tube method. Samples positive for hemolysis were then scored and titrated with the titers read visually and photometrically at 540 nm. RESULTS: Three hundred and fifty blood group O donors with age range 18-58 years and median age of 28 ΁ 8.4 years were enrolled in the study. The overall prevalence of anti-A and/or anti-B hemolysins obtained was 30.3%. Prevalence of anti-A and anti-B hemolysins only was 15.4% and 5.1% respectively whereas both anti-A and anti-B hemolysins were present in 9.7% donor samples. Though anti-A hemolysins were more prevalent than anti-B hemolysins, anti-B hemolysins had higher mean visual (6:7) and spectrophotometric titers (81:101). A visual titer of 8 and above which is considered significant was seen in 18.6% of donor samples. CONCLUSION: Anti-A and anti-B hemolysins exist in significant frequencies and titers among blood group O donors in Lagos. It is recommended that the use of group O donor blood for recipients who are non-O be discouraged. Clinical studies to determine the frequency and severity of hemolysis in non-group O recipients of blood group O are required.

Fatal scorpion sting in a child.

Fatal scorpion stings are rare in Nigeria. Hitherto, there has been no report from Nigeria of death following scorpion stings. This report is that of a 2-year-old boy who was stung by a scorpion while playing outside his home environment in Osogbo, South West Nigeria. He subsequently presented to the Children Emergency Unit of Ladoke Akintola University of Technology Teaching Hospital, Osogbo, in pain and with features of shock. He died within 2 h of admission despite all treatment given to relieve pain and manage shock. The case is reported in order to share the important lessons learned.

Preliminary study of effectiveness of aloe vera in scabies treatment.

In an open, non-comparative study carried out between August and December 2002 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, 5 patients with scabies were successfully treated with crude gel of Aloe vera; thereafter the efficacy of the extract was compared with that of benzoate lotion among 30 patients. Sixteen patients were treated with Aloe vera and 14 patients had benzyl benzoate lotion. Itching was still present in 3 patients in the benzyl benzoate group and in 2 patients in the Aloe vera group after 2 courses of treatment. The scabietic lesions virtually disappeared in all of them. None of these patients had any noticeable side effects. It is concluded that Aloe vera gel is as effective as benzyl benzoate in the treatment of scabies.

A gendered study of young adult contraceptive use at one university in KwaZulu-Natal.

This study explores contraceptive use among young adult male and female students (aged 18-25) who visit the campus clinic at a university in KwaZulu-Natal. Both a descriptive survey and face to face interviews were used for data collection. In this study, it is affirmed that gender stratification, societal attitudes, and misconceptions about contraceptive use play an important role in the attitudes of young adults, male and female towards contraception and its use. Evidence of this is the high use of condoms amongst both male and female students' compared with other available methods. Among female students this was highly attributed to personal convenience and comfort with condom use as an unmarried young woman. It was clear from the data collected that respondents themselves attached some stigma to being associated with the use of contraceptive pills or having to visit the clinic regularly for injections as young unmarried women. Male respondents affirmed the use of the condom, although this was hardly with the view of taking reproductive/contraceptive responsibility, but rather, it was attributed to the function of the condom as a safe sex method that offered protection against sexually transmitted diseases and infections. Also evident from the study was the fact that male respondents felt more comfortable with their sexual functioning than the female respondents. This was easily attributed to the role of societal gender stratification in an individual's life.

Essential oil composition of Piper guineense and its antimicrobial activity. Another chemotype from Nigeria.

The analysis of the essential oil of Piper guineense from Nigeria presents a new chemotype of constituents different from earlier reports with the absence of the usual myristicin. Ishwarane, a common constituent of Aristolochia indica and Bixa orellana, was also isolated from the essential oil of the fruit. The essential oil inhibited the growth of Pseudomonas aeruginosa UCH 655 strain at 5 mg/mL on which standard antibiotic drugs were ineffective.