An evaluation of the impact of anti-rabies programs in Nigeria.

Rabies remains a significant public health problem in Africa with outbreaks reported in most countries. In Nigeria, the most populous country in Africa, rabies causes a significant public health burden partly due to uncoordinated efforts and the ineffectiveness of available anti-rabies programs. We aim to address the current efforts, and challenges associated with the available anti-rabies programs in Nigeria and provide recommendations to tackle these challenges. Results: The anti-rabies programs available in Nigeria are highlighted. They are sponsored by different bodies such as government parastatals, veterinary teaching hospitals, professional associations, nongovernmental associations, and students. These programs provide support to eradicate rabies but are not devoid of challenges. Recommendations are provided to the Nigerian government, bodies anchoring the anti-rabies programs, and health professionals to tackle the challenges hindering the effective impact of the programs. Conclusion: Anti-rabies programs in Nigeria are supported by individual and collaborative bodies. It is pertinent to hold on to these programs and create a comprehensive national program to achieve effective rabies eradication in Nigeria.

Etiology and characteristics of congestive heart failure in blacks.

In this study of 301 black patients with congestive heart failure (CHF), systemic hypertension is the most common cause of CHF and is the primary etiology of CHF in 61%. Left ventricular hypertrophy is highly prevalent and is seen in 63% of the patients who had an echocardiogram.

Efficacy and safety of iron sucrose for iron deficiency in patients with dialysis-associated anemia: North American clinical trial.

Iron sucrose has been used to provide intravenous (IV) iron therapy to patients outside the United States for more than 50 years. In a multicenter North American clinical trial, we determined the efficacy and safety of iron sucrose therapy in patients with dialysis-associated anemia, evidence of iron deficiency, and below-target hemoglobin (Hgb) levels despite epoetin therapy. Evidence of iron deficiency included a transferrin saturation (Tsat) less than 20% and ferritin level less than 300 ng/mL, and below-target Hgb levels included values less than 11.0 g/dL. We administered iron sucrose in 10 doses, each administered undiluted as 100 mg IV push over 5 minutes, without a prior test dose. We assessed efficacy by determining the subsequent change in Hgb, Tsat, and ferritin values. We assessed safety by recording blood pressure and adverse events after iron sucrose injection and comparing results with those for the same patients during an observation control period. Results showed a significant increase in Hgb level that was first evident after three doses of iron sucrose and persisted at least 5 weeks after the 10th dose. Tsat and ferritin levels also increased significantly and remained elevated. In 77 enrolled patients, including those with previous iron dextran sensitivity, other drug allergies, or concurrent angiotensin-converting enzyme inhibitor use, we saw no serious adverse drug reactions and no change in intradialytic blood pressure associated with iron sucrose administration. We conclude that iron sucrose injection administered as 1,000 mg in 10 divided doses by IV push without a prior test dose is safe and effective for the treatment of iron deficiency in patients with dialysis-associated anemia.