Acceptability of an Orange-Flavoured Zinc Sulphate Dispersible Tablet in the Management of Acute Diarrhoea in Under-five Children in Lagos, Nigeria.

BACKGROUND: Acute diarrhoea is a significant cause of morbidity and mortality in children under five, especially in subSaharan Africa. The WHO recommends using oral rehydration solution (ORS) and zinc therapy for its management, but the metallic taste of zinc often hinders adherence. METHOD: This prospective open-label intervention study took place at three health facilities in Lagos, Southwest Nigeria, involving children aged 3 to 59 months with acute diarrhoea. Sociodemographic and diarrhoea-related data were obtained. Palatability was assessed using a 5-point hedonic scale, and adherence was determined by the proportion of prescribed zinc sulfate tablets consumed. Caregivers received a 10-day supply of the study drug and ORS sachets for each child, along with participant diaries for tracking drug intake, palatability scores, and adverse events. Follow-up was conducted on Days 3 and 7, and diaries were collected between Days 10 and 14. RESULTS: Out of the 294 participants, most caregivers were mothers (86.0%), had at least a secondary education (88.1%), and were employed (70.7%). The majority of children were male (54.2%), and under 18 months old (52.2%). The average palatability score was 2.65 (±0.78), with no significant differences based on age or gender. Mean adherence was 93.03%, with 89.3% achieving ≥80% adherence, and adherence did not significantly differ by age or gender. The only reported adverse event, vomiting, decreased from 18.8% on Day 1 to 0.5% on Day 10. CONCLUSION: The study indicates that the orange-flavored dispersible zinc sulfate tablet is well-accepted by children aged 3 to 59 months with acute diarrhoea in Lagos, Nigeria.

CONTEXTE: La diarrhée aiguë est une cause significative de morbidité et de mortalité chez les enfants de moins de cinq ans, en particulier en Afrique subsaharienne. L'OMS recommande l'utilisation de la solution de réhydratation orale (SRO) et de la thérapie au zinc pour sa prise en charge, mais le goût métallique du zinc entrave souvent l'observance. MÉTHODE: L'étude d'intervention prospective à ciel ouvert a eu lieu dans trois établissements de santé à Lagos, dans le sud-ouest du Nigeria, impliquant des enfants de 3 à 59 mois souffrant de diarrhée aiguë. Des données sociodémographiques et liées à la diarrhée ont été obtenues. La palatabilité a été évaluée à l'aide d'une échelle hédonique à 5 points, et l'observance a été déterminée par la proportion de comprimés de sulfate de zinc prescrits consommés. Les aidants ont reçu une provision de 10 jours du médicament de l'étude et des sachets de SRO pour chaque enfant, ainsi que des journaux de suivi pour noter la prise du médicament, les scores de palatabilité et les événements indésirables. Un suivi a été effectué aux jours 3 et 7, et les journaux ont été collectés entre les jours 10 et 14. RÉSULTATS: Sur les 294 participants, la plupart des aidants étaient des mères (86,0%), avaient au moins une éducation secondaire (88,1%), et étaient employées (70,7%). La majorité des enfants étaient de sexe masculin (54,2%) et avaient moins de 18 mois (52,2%). La note moyenne de palatabilité était de 2,65 (±0,78), sans différences significatives en fonction de l'âge ou du sexe. L'observance moyenne était de 93,03%, avec 89,3% atteignant une observance ≥ 80%, et l'observance ne différait pas de manière significative en fonction de l'âge ou du sexe. Le seul événement indésirable signalé, les vomissements, est passé de 18,8% le jour 1 à 0,5% le jour 10. CONCLUSION: L'étude indique que le comprimé de sulfate de zinc dispersible à l'arôme d'orange est bien accepté par les enfants de 3 à 59 mois souffrant de diarrhée aiguë à Lagos, au Nigeria. MOTS-CLÉS: Diarrhée, moins de cinq ans, Enfants, Arôme d'orange, Comprimés de zinc, Palatabilité, Acceptabilité, Échelle hédonique, Lagos, Nigeria.

Research Participation and Feedback: Perception of Adolescents and Young Adults Living with HIV in Lagos, Nigeria.

BACKGROUND: Evidence-based research remains the cornerstone in changing the narrative of wholesome health among Adolescents and Young Adults Living with HIV (AYALHIV). However, little is known about the perceptions of AYALHIV in research participation and outcomes, in low- and middle-income countries, especially in sub-Saharan Africa. This study describes the perception of AYALHIV in research participation and outcome in Lagos, Nigeria. METHODS: The study population was drawn from a cohort of participants in a cross-sectional study at the Nigerian Institute of Medical Research. The survey questions were on perceptions of the importance of research participation, the frequency, understanding of participation in research, the interest in the outcome, the knowledge of the interpretation of the outcome and the willingness to participate in future studies. Data obtained was analyzed using SPSS version 26.0. RESULTS: The mean age of the AYALHIV was 15.7(±3.1) years, with a male-to-female ratio of (0.8:1), and 85.7% on antiretroviral drugs for at least five years. Seventy-two percent (46/63) have been involved in previous studies at least once, with only 27% (17/63) informed on the outcome of the research they have ever participated. Only 30% (19) of participants understood they were involved in research, with 92% interested in the study outcome. 87.3% (55) will request more information before participating in future research activities. CONCLUSION: Educating AYALHIV on research participation is important in promoting concerted efforts by researchers towards improving engagement, patient-centred care, and research dissemination.

CONTEXTE: La recherche fondée sur des données probantes reste la pierre angulaire du changement du discours sur la santé saine chez les adolescents et les jeunes adultes vivant avec le VIH (AYALHIV). Cependant, on sait peu de choses sur les perceptions de l'AYALHIV dans la participation et les résultats de la recherche, dans les pays à revenu faible et intermédiaire, en particulier en Afrique subsaharienne. Cette étude décrit la perception d'AYALHIV dans la participation et les résultats de la recherche à Lagos, au Nigéria. METHODES: La population m'étudiée a été tirée d'une cohorte de participants à une étude transversale menée à l'Institut nigérian de recherche médicale. Les questions de l'enquête portaient sur les perceptions de l'importance de la participation à la recherche, la fréquence, la compréhension de la participation à la recherche, l'intérêt pour les résultats, la connaissance de l'interprétation des résultats et la volonté de participer à des études futures. Les données obtenues ont été analysées à l'aide de SPSS version 26.0. RESULTATS: L'âge moyen des AYALHIV était de 15,7 (± 3,1) ans, avec un ratio hommes/femmes de (0,8 : 1) et 85,7 % prenaient des médicaments antirétroviraux depuis au moins cinq ans. Soixantedouze pour cent (46/63) ont participé à des études antérieures au moins une fois, et seulement 27 % (17/63) sont informés des résultats de la recherche à laquelle ils ont déjà participé. Seulement 30 % (19) des participants comprenaient qu'ils étaient impliqués dans la recherche, et 92 % d'entre eux étaient intéressés par les résultats de l'étude. 87,3 % (55) demanderont plus d'informations avant de participer à de futures activités de recherche. CONCLUSION: Éduquer AYALHIV sur la participation à la recherche est important pour promouvoir les efforts concertés des chercheurs en vue d'améliorer l'engagement, les soins centrés sur le patient et la diffusion de la recherche. MOTS CLES: VIH, Adolescent, Jeunes adultes, Perception, Recherche.

Intimate Partner Violence and Risk Factors among Women during the COVID-19 Movement Restriction in Nigeria: An Online Survey.

BACKGROUND: The rapid spread of the SARS-CoV-2 infection in the absence of treatment or the presence of vaccines is forcing nations to respond with strong preventive measures ranging from mitigation, containment, and in extreme cases, quarantines. While these measures are a useful measure of infection control, they can lead to significant social, economic, and psychological consequences. This study sought to establish the prevalence and risk factors of intimate partner violence during the COVID-19 movement restriction in Nigeria among girls and women. METHODS: An online-based questionnaire survey using Google Forms was conducted over four weeks among girls and women aged 15 years and above. Data analysis was performed using SPSS version 20, and logistic regression was used to determine risk factors for IPV experience during the lockdown. RESULTS: Overall, 32.8% of respondents reported ever experiencing IPV, and 42.5% experienced IPV during the lockdown. Verbal (35.1%) and psychological (24.1%) violence were the commonest forms of violence in the study. There was considerable overlap between the various forms of IPV in the study. Age less than 35 years (aOR = 1.3; CI = 1.2 - 1.4), resident in the northeast region (aOR=1.6; CI=1.41.9), alcohol (aOR=1.3;CI=1.2-1.5) and substance (aOR = 1.5; CI = 1.3 - 1.8) use, average family monthly income < $100 (aOR = 1.4;CI=1.2 - 1.5), daily or weekly income (aOR = 2.7; CI = 2.5-3.1) had an increased association with IPV during the lockdown, residency in the southeast region had lower odds of experiencing IPV (aOR=.0.5; CI = 0.3-0.8). CONCLUSION: The reported lockdown prevalence of IPV was 42.8%, with verbal and psychological violence being the most prevalent form of IPV. Age less than 35 years, resident in northeast and southeast, use of alcohol or substances, average family monthly income < $100, and partner being a daily-weekly earner was associated with IPV experience. Policymakers in the future should consider the consequences, including IPV, before issuing such an order.

CONTEXTE: La propagation rapide de l'infection par le CoV-2 du SRAS en l'absence de traitement ou présence de vaccins oblige les nations à réagir par des mesures préventives fortes allant de l'atténuation à l'endiguement et, dans les cas extrêmes, à la mise en quarantaine. Bien que ces mesures soient utiles pour contrôler l'infection, elles peuvent avoir des conséquences sociales, économiques et psychologiques importantes. Cette étude visait à établir la prévalence et les facteurs de risque de la violence exercée par le partenaire intime au cours de la restriction de mouvement du COVID-19 au Nigeria, chez les filles et les femmes. MÉTHODES: Une enquête par questionnaire en ligne utilisant google form a été menée pendant quatre semaines auprès de filles et de femmes âgées de 15 ans et plus. L'analyse des données a été réalisée à l'aide de la version 20 de SPSS et une régression logistique a été utilisée pour déterminer les facteurs de risque de violence conjugale pendant la période de restriction. RÉSULTATS: Dans l'ensemble, 32,8 % des personnes interrogées ont déclaré avoir déjà subi des VPI, et 42,5 % ont subi des VPI pendant l'enfermement. La violence verbale (35,1 %) et la violence psychologique (24,1 %) étaient les formes de violence les plus courantes dans l'étude. Il y avait un chevauchement considérable entre les différentes formes de VPI dans l'étude. L'âge inférieur à 35 ans (aOR=1,3 ; CI= 1,2 - 1,4), la résidence dans la région nord-est (aOR=1,6; CI=1,4-1,9), la consommation d'alcool (aOR=1,3; CI=1,2 - 1,5) et de substances (aOR=1,5 ; CI = 1,3 - 1,8), le revenu mensuel moyen de la famille < 100 $ (aOR=1. 4 ; IC = 1,2 - 1,5), le revenu quotidien ou hebdomadaire (aOR = 2,7 ; IC = 2,5-3,1) était davantage associé à la VPI pendant le lockdown, la résidence dans la région du sud-est avait moins de chances d'être victime de VPI (aOR = 0,0,5 ; IC = 0,3-0,8). CONCLUSION: La prévalence de la VPI pendant le lockdown était de 42,8 %, la violence verbale et psychologique étant la forme de VPI la plus répandue. L'âge inférieur à 35 and, le fait de résider dans le nord-est et le sud-est, la consommation d'alcool ou de substances, le revenu mensuel moyen de la famille inférieur à 100 dollars et le fait que le partenaire gagne sa vie toutes les semaines étaient associés à l'expérience de la VPI. À l'avenir, les décideurs politiques devraient prendre en compte les conséquences, y compris la VPI, avant d'émettre un tel ordre. Mots-clés: Violence entre partenaires intimes, COVID-19, Lockdowns, Nigeria, Violence fondée sur le genre.

Preliminary Study on Open Labelled Randomized Controlled Trial of the Safety and Efficacy of Hydroxychloroquine and Chloroquine Phosphate for the Treatment of Persons Infected with 2019 Coronavirus Disease in Nigeria.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a causative agent of COVID-19 is a leading cause of ill-health and deaths worldwide. Currently, COVID-19 has no known widely approved therapeutics. Thus, the need for effective treatment. OBJECTIVES: We investigated the safety and efficacy of two (2) therapeutic agents; chloroquine phosphate (CQ), 2- hydroxychloroquine (HCQ) and a control (standard supportive therapy) among hospitalized adults with COVID-19. METHODS: The clinical trial was done in accordance to the World Health Organization master protocol for investigational therapeutics for COVID-19. Atotal of 40 participants with laboratory-confirmed positive COVID-19 were enrolled. Blood samples and oropharyngeal (OP) swabs were obtained on days 1,3,15 and 29 for safety and efficacy assessments. RESULTS: The baseline demographics showed that the median ages in years (range) were 45 (31-57) in CQ, 45 (36.5-60.5) in HCQ, 43 (39.5-67.0) and 44.5 (25.3-51.3) in the control (P<0.042).At randomization, seven (7) participants were asymptomatic, thirty-three (33) had mild symptoms, eight (8) had moderate symptoms while three (3) had severe symptoms. The average day of conversion to negative COVID-19 was 15.5 days for CQ, 16 days for HCQ and 18 days for the control(P=0.036). CONCLUSION: The safety assessment revealed no adverse effect of the drugs in COVID-19 patients after treatment. These findings proved that chloroquine and hydroxychloroquine are effective for the treatment of COVID-19 among hospitalized adults. It also confirmed that they are safe.

CONTEXTE: Le coronavirus du syndrome respiratoire aigu sévère 2 (SARS-CoV-2),agentcausaldelaCOVID-19, est l'unedes principales causes demaladie et de décès dans le monde. À l'heure actuelle, il n'existe aucun traitement largement approuvé pour la COVID-19. Ainsi, ilya un besoin de traitement efficace. OBJECTIFS: Nous avons étudié l'innocuité et l'efficacité de deux (2) agents thérapeutiques, le phosphate de chloroquine (CQ) et l'hydroxychloroquine (HCQ), ainsi qu'un groupe témoin (traitement de soutien standard) chez des adultes hospitalisés atteints de la COVID-19.MÉTHODES: L'essai clinique a été mené conformément au protocole maître de l'Organisation mondiale de la santé pour les thérapeutiques à l'étude de la COVID-19. Au total, 40 participants atteints de la COVID-19, confirmée en laboratoire, ont été in scrits. Des échantillons de sang et des prélèvements oropharyngés (PO) ont été effectuésauxjours1,3,15et29pourévaluerl'innocuitéetl'efficacité. RÉSULTATS: Les données démographiques initiales ont révélé que l'âge médian en années (plage) était de 45 (31-57) pour le groupe CQ, de 45 (36,5-60,5) pour le groupe HCQ, de 43 (39,5-67,0) et de 44,5 (25,3-51,3) pour le groupe témoin (P<0,042). À la randomisation, sept (7) participants étaient asymptomatiques, trente-trois (33) présentaient des symptômes bénins, huit(8) avaient des symptômes modérés, tandis que trois(3) avaient des symptômes graves. Le jour moyende conversionentest COVID-19 négatif était de 15,5 jours pour le groupe CQ, de 16 jours pour le groupe HCQ et de 18 jours pourle groupe témoin (P=0,036). CONCLUSION: L'évaluation de la sécurité n'a révélé aucun effet indésirable des médicaments chez les patients atteints de la COVID-19 après le traitement. Ces conclusions ont prouvé que la chloroquine et l'hydroxychloroquine sont efficaces pour le traitement de la COVID-19 chez les adultes hospitalisés. Cela a également confirmé qu' ilssont sûrs. Mots-clés: COVID-19, SARS-CoV-2, essai clinique, innocuité, efficacité, thérapeutiques.

Impact of SARS-CoV-2 Pandemic on Antiretroviral Access at a Large Treatment Centre in Lagos, Nigeria.

INTRODUCTION: The SARS-CoV-2 pandemic has ravaged the world with significant implications on the socio-economic and health status of individuals. Several measures were put in place to curtail the pandemic especially movement restrictions. The effect of this pandemic and the restriction measures could further compound the health needs of PLWHA. This study thus described the trend in access to HIV/AIDS care services before and during the COVID-19 induced lockdown and the possible consequences on their treatment outcome. METHODS: A secondary analysis of client data was carried out at the HIV clinic of the Nigerian Institute of Medical Research. The sociodemographic and clinical data [type of ART, duration on ART, clinical services 3-months before and during the COVID-19 induced Lockdown] were extracted from the electronic medical records. Data obtained was analyzed using the SPSS version 22.0. RESULTS: The median age of PLWHA was 45 years (IQR: 39-51), with the predominant age group being 25-49 years (65.4%). The majority were females (68.7%), married (59.5%), had at least secondary education (82.8%), and employed (81.5%). The median duration on ART was 102 months (IQR: 67-138) with the majority on non-Protease Inhibitor based regimen (77.7%). In the 3 months before the lockdown, there was an increase in drug pick-up of approximately 25% over the booked appointment compared to a decline of 40% when the lockdown was enacted. CONCLUSION: The significant decline in drug pick-up during the SARS-CoV-2 pandemic raises the need for measures to ensure continued access to drugs and care among PLWHA.

INTRODUCTION: La pandémie de SRAS-CoV-2 a ravagé le monde avec des implications significatives sur l'état socio- économique et sanitaire. Plusieurs mesures ont été mises en place pour freiner la pandémie, en particulier la restriction des déplacements. L'effet de cette pandémie et les mesures de restriction pourraient encore aggraver les besoins de santé des PVVIH. Cette étude décrit ainsi la tendance des services de soins du VIH / SIDA avant et pendant le verrouillage induit par le COVID-19 et les conséquences possibles sur l'issue de leur traitement. MÉTHODES: Une étude transversale parmi les PVVIH fréquentant la clinique VIH de l'Institut nigérian de recherche médicale. Les données sociodémographiques et cliniques [type de TAR, durée de la TAR, services cliniques 3 mois avant et pendant le verrouillage induit par COVID-19] ont été extraites des dossiers médicaux électroniques. Les données obtenues ont été analysées à l'aide de la version 22.0 de SPSS. RÉSULTATS: L'âge médian des PVVIH était de 45 ans (IQR (39-51), le groupe d'âge prédominant étant 25-49 ans (65,4%). La majorité étaient des femmes (68,7%), mariées (59,5%), avaient au moins secondaire (82,8%) et employé (81,5%). La durée médiane des TAR était de 102 mois (IQR: 67-138), la majorité sous traitement sans inhibiteur de protéase (77,7%). Au cours des 3 mois précédant le verrouillage , il y a eu une augmentation de la cueillette de médicaments d'environ 25% par rapport au rendez-vous réservé, comparativement à une baisse de 40% lorsque le verrouillage a été décrété. CONCLUSION: La baisse significative de la collecte de médicaments pendant la pandémie de SRAS-CoV-2 fait ressortir la nécessité de prendre des mesures pour assurer un accès continu aux médicaments et aux soins parmi les PVVIH. Mots Clés: SRAS-CoV-2, antirétroviral, COVID-19, ramassage de médicaments, VIH, verrouillage.

Challenges of Accessing Care in Art Clinic during COVID-19 Lockdown in Lagos.

BACKGROUND: As the SARS-CoV-2 pandemic continues to ravage the world, its impact on the health systems and survival of people with chronic diseases especially People living with HIV [PLWH] could be undermined. It becomes relevant to assess the challenges PLWH face during this period to institute measures towards combating the negative effects of the pandemic. AIMS: This study aims to investigate the challenges faced by PLWH in accessing care during the lockdown period in Lagos, Nigeria. The study was a cross-sectional one involving PLWH aged 18 years and above who presented for care. An interviewer-administered questionnaire was used to obtain information on demographic characteristics, their knowledge about COVID-19 disease, and challenges experienced in accessing care during the COVID-19-induced lockdown. Ethical approval was obtained from the Institution Research Ethics Board (IRB) of NIMR. PATIENTS AND METHODS: Data generated from the survey was exported to Excel and analyzed using SPSS version 23.0. RESULTS: The mean age of PLWH who participated in the study was 42.2 (±12.2) years. The majority were female (74.3%), married (66.3%), employed (58.9%), and on less than $100 monthly income (80.5%). The commonest challenges experienced were psychological (78.5%), financial (68%) and food (40.7%). There were significant association among the income status, lack of food (OR: 2.5, CI: 1.4-4.5, P = 0.002), financial challenges (OR: 1.7, CI: 1.0-3.0, P = 0.048) and psychological challenges (OR; 1.8, CI: 1.0-3.5, P = 0.05). Ninety-five percent of participants believed SARS-COV-2 infection is a viral infection. CONCLUSIONS: PLWH faces a myriad of challenges that would have a significant impact on their overall well-being and the gains of HIV care.

Barriers and solutions to effective mentorship in health research and training institutions in Nigeria: Mentors, mentees, and organizational perspectives.

Aims and Background: Mentoring relationships and programs have become a subject of global interest and their relevance is high in the ever-evolving health system. In Nigeria, informal system of mentoring is largely practiced. To be able to institutionalize mentoring program, there is need to explore the various challenges of mentoring process and suggest potential approaches for effective mentor-mentee relationship in health research institutions in Nigeria. Subjects and Methods: The study was designed to explore the barriers and solutions to mentoring process from the perspectives of the mentor, mentee, and organization in health research and training institutions in Nigeria. A cross-sectional descriptive design was employed and the study was conducted among 21 health researchers drawn from 24 health research institutions across the 6 regions of Nigeria. The nominal group technique was adopted in the data collection process. Results: The most frequently reported mentor challenges were "lack of understanding of mentorship process" (84.2%) and "lack of capacity for mentoring" (78.9%), while those of mentee were "mentor preference" (73.7%) and "lack of freedom of expression" (47.4%). "Culture of selfishness/individualism" (84.2%) and "lack of formal relationship" (63.2%) were the most mentioned systemic challenges. Training on mentoring process and relationship was mentioned as the most frequent approach to overcoming challenges for the three perspectives. Conclusion: Significant mentorship challenges exist in the Nigerian health, academic and research institution. Systematic approaches to finding and implementing the appropriate solutions are needed to circumvent these bottlenecks.

Plasma L-Arginine in Sickle Cell Anaemia Patients in Crises and its Correlation with Markers of Severity of Disease.

INTRODUCTION/OBJECTIVES: Sickle Cell Anaemia (SCA) is a chronic haemolytic and inflammatory disorder characterized by repeated vaso-occlusive (VOC) and hyperhaemolytic crises (HC). These crises determine the quality of life of SCA patients. This study estimated the plasma L-arginine levels in SCApatients during crises (HC and VOC), and correlated these levels with the markers of inflammation in the patients. METHODS: A cross-sectional study comprising of 120 consenting adults (60 SCA patients and 60 HbAA controls). The SCA were grouped as SCA patients in VOC or SCA patients in HC and HbAA controls. All SCA patients presented at the emergency room or the daycare unit of Haematology Department, University College Hospital, Ibadan, Nigeria. Blood samples were collected and haematological parameters and plasma L-arginine levels were determined. RESULTS: There were 30 SCA patients in VOC, 30 SCA patients in HC, and 60 HbAA controls with age ranging from 18 to 58years. The controls had a higher haematocrit than the SCA patients (HbAA>SCA VOC> SCA HC, p<0.001) in each pair wise analysis. The VOC and the HC groups had higher mean White Blood Cell (WBC), platelet count, Absolute Neutrophil Count (ANC), Absolute Lymphocyte Count (ALC), Absolute Monocyte Count (AMC), and reticulocytes count than the HbAA controls. Similarly, the HC group had higher mean WBC, platelet count,ANC,ALC,AMC, and reticulocytes count, and a lower mean percentage irreversible sickle cell than the VOC group. The mean plasma L-arginine was significantly higher in the HbAA control group than those of SCA patients in crises (HbAA controls>SCAVOC>SCAHC, p < 0.001), and higher in the SCAVOC group than in the HC group. There was no significant correlation between plasma L-arginine levels, reticulocyte count, markers of VOC severity and markers of inflammations. CONCLUSION: The plasma L-arginine levels of SCA patients in VOC and HC were lower than those of the HbAA controls. The degree of reduction was however marked in patients in hyperhaemolytic crisis. There was no significant association between the plasma L-arginine levels and the markers of inflammation in the studied patients. The findings in this study buttress the need for consideration of L-arginine supplementation in patients with SCA, especially during acute hemolytic crises.

INTRODUCTION / OBJECTIFS: La SCA est un mal hémolytique et inflammatoire chronique caractérisé par des crises vaso-occlusives (COV) et hyperhémolytiques (HC) répétées, qui déterminent la qualité de vie des patients atteints de SCA. L'étude a estimé les taux plasmatiques de L-arginine chez les patients atteints de SCA pendant les crises (HC et COV), et a mis en corrélation ces taux avec les marqueurs de l'inflammation chez les patients. MÉTHODES: Une étude transversale comprenant 120 adultes consentants (60 patients SCA et 60 contrôles HbAA) regroupés en patients SCA en COV; Patients SCA à HC (tous les patients SCA présentés à la salle d'urgence ou à l'unité de garde du département d'hématologie, University College Hospital, Ibadan, Nigéria); et contrôles HbAA. Des échantillons de sang ont été prélevés et les paramètres hématologiques et les taux de L-arginine ont été déterminés. RÉSULTATS: Il y avait 30 patients SCA en COV, 30 patients SCA en HC et 60 contrôles HbAA avec un âge allant de 18 à 58 ans. Les témoins avaient un hématocrite plus élevé que les patients SCA (HbAA> SCA VOC> SCAHC, p <0,001) dans chaque analyse par paire. Les groupes VOC et HC avaient des taux moyens de globules blancs, de plaquettes, d'ANC, d'ALC, d'AMC et de réticulocytes plus élevés que les témoins HbAA. De même, le groupe HC avait un nombre moyen de globules blancs, de plaquettes, d'ANC, d'ALC, d'AMC et de réticulocytes plus élevés, et un pourcentage moyen de de drépanocytose irréversible plus faible que le groupe COV. La L-arginine plasmatique moyenne était significativement plus élevée dans le groupe témoin HbAA que chez les patients SCA en crise (contrôles HbAA> SCA VOC> SCA HC, p <0,001), et plus élevée dans le groupe SCA VOC que dans le groupe HC, p <0,001. Il n'y avait pas de corrélation significative entre les taux de L-arginine, le nombre de réticulocytes, les marqueurs de gravité des COV et les marqueurs d'inflammations. CONCLUSION: Les taux plasmatiques de L-arginine chez les patients SCAen COV et HC étaient inférieurs à ceux des contrôles HbAA, et le degré de réduction est cependant marqué chez les patients en crise hyperhémolytique. Il n'y avait pas d'association significative entre les taux plasmatiques de L-arginine et les marqueurs de l'inflammation chez les patients étudiés. Les résultats de cette étude renforcent la nécessité d'envisager une supplémentation en L-arginine chez les patients atteints de SCA, en particulier pendant les crises hémolytiques aiguës. MOTS CLÉS: anémie falciforme, L-arginine, crise vaso-oclussive, crise hyperhémolytique.

Prevalence and Clinical Characteristics of Coronavirus Disease 2019 Seen at a Testing Centre in Lagos Nigeria.

BACKGROUND: The SARS-CoV-2 infection continues to ravage the global community since it was declared a pandemic. The socio-demographic and clinical characteristics defining the disease are mainly from Europe and Asia. The disease symptomatology is similar to the prevalent diseases in our environment, this could result in the delay in prompt identification and appropriate management of suspected cases toward combating community transmission. This study evaluates the prevalence, socio-demographic and clinical characteristics of positive cases of COVID -19. METHODS: This was a retrospective cohort study. Data on the socio-demographic, clinical characteristics and the results of the SARS-CoV-2 test of participants at the Nigerian Institute of Medical Research [NIMR] Modified Drive-through Centre for COVID-19 test sample collection over two months [24th February 2020- 27th April 2020] were retrieved from the electronic medical records (EMR). Data obtained were analyzed using SPSS version 22.0. RESULTS: A total number of 481 clients were evaluated in this review. The prevalence of SARS-CoV-2 infection in the population was 14.6%. The mean age of the positive cases was 42.2 [±15.9] years. The common symptoms reported by the positive cases were fever (40.0%), cough (32.9%), sore throat (17.1%) and running nose (15.7%). Fever depicted statistical significance with positive cases with the majority being of mild to moderate clinical severity. CONCLUSION: The prevalence of SARS-CoV-2 infection among this cohort was 14.6% with a male preponderance. Fever and sore throat were the variables that predicted SARS CoV-2 infection among our cohort.

Nutrient stability in mould-infested feed and mitigating effect of dietary supplemental vitamins in brown laying hens.

A 10-week study was conducted to assess the impact of mould infestation on nutrient stability of feed and the mitigating effect of supplemental tocopherol, retinol or a multivitamin on performance and hepatic histology of ISA Brown laying chickens. Two batches of corn were obtained: the aflasafe corn used in preparing control diet and corn with physical evidence of mould used in preparing diets 2 to 5 containing no supplemental vitamin, tocopherol, retinol or a branded multivitamin supplementations respectively. One hundred and fifty (150) laying chickens used were completely randomized into five dietary treatments with three replicates of 10 birds each. Results showed that there was gross instability in the nutrients of mouldy maize. The activities of the fungi depleted both protein and lipid contents by 11.54% and 12.72% respectively while crude fibre content rose by 31.7%. There was substantial drop in both retinol and tocopherol while aflatoxin content rose to 267 µg in mouldy corn and 118 µg in the mouldy diets. Feed intake was significantly (P < 0.05) reduced and consequently depressed (P < 0.05) egg production and feed efficiency. Egg quality differs (P < 0.05) in shell thickness and yolk colour. Proliferation of biliary duct epithelium, hepatic degeneration, cellular infiltration, hyper-cellularity or dilation of the sinusoidal spaces characterized livers of birds on mouldy corn diets while supplementation with vitamins subverted mycosis and aflatoxicosis as evidenced by normal-to-mild congestion of hepatocytes. It was concluded that mould contamination in feed compromised feed nutritive values, reduced bird performance and adversely impaired the liver of the experimental birds while tocopherol, retinol or a multivitamin supplementation relapses the damaging potential of mould and mycotoxin differently.

Drug resistance profiles of new- and previously treated patients with pulmonary tuberculosis in Ibadan, Nigeria.

BACKGROUND: Information on TB drug resistance profiles and its' associated risk factors are scarce in Nigeria despite the large burden of disease in the country. The study was designed to report drug resistance profiles of new- and previously treated patients with pulmonary tuberculosis (TB) in Ibadan, Nigeria. METHOD: Sputum from consenting pulmonary TB patients were collected and cultured for Mycobacterium tuberculosis (Mtb) at the TB laboratory of the University College Hospital, Ibadan, Nigeria using standard method. Mtb were stored and sent for drug susceptibility testing against first and second-line anti-TB drugs at the MRC Unit, The Gambia and at the Institute of Tropical Medicine, Antwerp, Belgium using BACTEC MGIT 960 and proportion method on solid medium respectively. RESULTS: Of 238 Mtb collected, 124 (52.1%) were viable, 102 (59.65%) non-viable while 12 (7.02%) were contaminated. About half (58.87%) of the Mtb were from previously treated patients, 40 (32.26%) were from new patients while treatment history of 1.1 (8.87%) were unknown. Forty-seven (37.90%) of the 124 Mtb. tested were multidrug resistant (MDR) out of which, 40 (85.10%) were from previously treated patients.. HIV prevalence was 8.69%. Of the 17 MDR-TB from previously treated cases tested for second-line drugs, four (23.53%) were resistant to fluoroquinolones or injectable agents, 13 (76.47%) were susceptible while none was resistant to both of these classes of drugs. CONCLUSION: MDR-TB in Ibadan already demonstrates resistance to second line anti-TB drugs hence management of MDR-TB patients should be strengthened to prevent emergence of extensively drug-resistant TB (XDR-TB).

Risk factors for pulmonary tuberculosis among health-care workers in Ibadan, Nigeria.

Data on TB infection control programs is limited in many of the TB high burden countries. We carried out a one-year cross sectional epidemiological study (January-December, 2008) to determine the prevalence of occupationally-acquired pulmonary tuberculosis (PTB) among Health- Care Workers (HCWs) in Ibadan, Nigeria. This information is important for planning preventive strategies. All consenting HCWs at two TB centres in Ibadan--the University College Hospital (UCH) and Jericho Chest Hospital were enrolled into the study. A well structured questionnaire was used to obtain information on socio-demographic characteristics of the subjects including their medical and social data. Three sputum samples collected from each subject were processed for acid-fast bacilli (AFB) and culture on selective medium. Isolates were confirmed as M. tuberculosis by standard biochemical tests. Of the 271 subjects recruited, nine (3.3%) had their sputum positive for AFB while six (2.2%) were positive for culture. Subjects aged 20 years and above, female gender and unskilled professionals had higher risk for occupationally-acquired PTB than those who were 20 years and below, male gender and skilled professionals (Odd Ratio OR = 1.9, 95% Confidence Interval, 95% CI = 0.23-16.3, Fisher's exact P = 0.37; OR = 1.1, 95% CI = 0.28-4.0, p = 0.01; OR = 1.05, 95% CI = 1.02-1.08, p = 3.43) respectively. Multivariate logistic regression analysis showed that subjects who received BCG vaccination were less likely to have occupationally-acquired PTB than those without vaccination (OR = 0.86, 95% CI = 0.20-3.6, p = 0.83 for microscopy; OR = 0.76, 95% CI = 0.13- 0.44, p = 0.76 for culture). Even though the risk for occupationally-acquired PTB was lower in subjects who had not spent up to two years in their units, the association was not statistically significant (OR = 0.84, 95% CI = 0.20-3.5, p = 0.82 for microscopy and OR = 1.21, 95% CI = 0.22-0.65, p = 0.82 for culture). There is a need to develop and implement affordable and cost-effective TB infection control strategies in Nigeria in order to reduce the burden of occupationally-acquired PTB in the country.

Challenges of accessing care in art clinic during COVID-19 lockdown in Lagos

Background: As the SARS-CoV-2 pandemic continues to ravage the world, its impact on the health systems and survival of people with chronic diseases especially People living with HIV [PLWH] could be undermined. It becomes relevant to assess the challenges PLWH face during this period to institute measures towards combating the negative effects of the pandemic. Aims: This study aims to investigate the challenges faced by PLWH in accessing care during the lockdown period in Lagos, Nigeria. The study was a cross-sectional one involving PLWH aged 18 years and above who presented for care. An interviewer-administered questionnaire was used to obtain information on demographic characteristics, their knowledge about COVID-19 disease, and challenges experienced in accessing care during the COVID-19-induced lockdown. Ethical approval was obtained from the Institution Research Ethics Board (IRB) of NIMR. Patients and Methods: Data generated from the survey was exported to Excel and analyzed using SPSS version 23.0. Results: The mean age of PLWH who participated in the study was 42.2 (±12.2) years. The majority were female (74.3%), married (66.3%), employed (58.9%), and on less than $100 monthly income (80.5%). The commonest challenges experienced were psychological (78.5%), financial (68%) and food (40.7%). There were significant association among the income status, lack of food (OR: 2.5, CI: 1.4-4.5, P = 0.002), financial challenges (OR: 1.7, CI: 1.0­3.0, P = 0.048) and psychological challenges (OR; 1.8, CI: 1.0-3.5, P = 0.05). Ninety­five percent of participants believed SARS-COV-2 infection is a viral infection. Conclusions: PLWH faces a myriad of challenges that would have a significant impact on their overall well-being and the gains of HIV care.

Microbiological profile of bacterial conjunctivitis in ibadan, Nigeria.

OBJECTIVE: In bacterial conjunctivitis, clinical presentations are not diagnostic of the causative agent, therefore, microbiological analysis is mandatory for specific treatment option. This study was undertaken to determine the microbiology profile of bacterial conjunctivitis in our environment. METHODOLOGY: This is a laboratory-based study carried out in the Medical Microbiology Laboratory of University College Hospital, Ibadan, Nigeria. Conjunctival swabs collected from 365 patients with clinically diagnosed conjunctivitis, were analysed by standard bacteriological methods. RESULTS: Bacterial pathogens were detected in 342 (93.7%) conjunctival samples while 23(6.3%) were sterile. Of the pathogens, 256 (74.9%) were Staphylococcus aureus, 35(10.2%) Coagulase- negative staphylococci, 22 (6.4%) Pseudomonas aeruginosa , 11(3.2%) Escherichia coli, 7(2.1%) Klebsiella species, 5(1.5%) Streptococcus pneumoniae , 4(1.2%) Haemophilus influenzae, 1(0.3%) Proteus mirabilis, and 1(0.3%)Neisseria gonorrhoeae. The highest rate of conjunctivitis 96(26.3%) was found among infants and children (0-10years).Resistance rates to most of the tested antibiotics were high. However, 67% of them were susceptible to ceftriaxone while only 39.2% were susceptible to chloramphenicol. CONCLUSION: This study has recorded high antibiotic resistance in bacterial pathogens of conjunctivitis in this environment; therefore, determining the susceptibility pattern of these pathogens to available antibiotics is crucial to effective management of bacterial conjunctivitis.

Risk factors for pulmonary tuberculosis among health-care workers in Ibadan, Nigeria

Data on TB infection control programs is limited in many of the TB high burden countries. We carried out a one-year cross sectional epidemiological study (January-December, 2008) to determine the prevalence of occupationally-acquired pulmonary tuberculosis (PTB) among Health- Care Workers (HCWs) in Ibadan, Nigeria. This information is important for planning preventive strategies. All consenting HCWs at two TB centres in Ibadan--the University College Hospital (UCH) and Jericho Chest Hospital were enrolled into the study. A well structured questionnaire was used to obtain information on socio-demographic characteristics of the subjects including their medical and social data. Three sputum samples collected from each subject were processed for acid-fast bacilli (AFB) and culture on selective medium. Isolates were confirmed as M. tuberculosis by standard biochemical tests. Of the 271 subjects recruited, nine (3.3%) had their sputum positive for AFB while six (2.2%) were positive for culture. Subjects aged 20 years and above, female gender and unskilled professionals had higher risk for occupationally-acquired PTB than those who were 20 years and below, male gender and skilled professionals (Odd Ratio OR = 1.9, 95% Confidence Interval, 95% CI = 0.23-16.3, Fisher's exact P = 0.37; OR = 1.1, 95% CI = 0.28-4.0, p = 0.01; OR = 1.05, 95% CI = 1.02-1.08, p = 3.43) respectively. Multivariate logistic regression analysis showed that subjects who received BCG vaccination were less likely to have occupationally-acquired PTB than those without vaccination (OR = 0.86, 95% CI = 0.20-3.6, p = 0.83 for microscopy; OR = 0.76, 95% CI = 0.13- 0.44, p = 0.76 for culture). Even though the risk for occupationally-acquired PTB was lower in subjects who had not spent up to two years in their units, the association was not statistically significant (OR = 0.84, 95% CI = 0.20-3.5, p = 0.82 for microscopy and OR = 1.21, 95% CI = 0.22-0.65, p = 0.82 for culture). There is a need to develop and implement affordable and cost-effective TB infection control strategies in Nigeria in order to reduce the burden of occupationally-acquired PTB in the country