Rural-Urban Differences in Risk Factors for Prediabetes and Undiagnosed Diabetes Among Adult Dwellers in Selected Yoruba-Speaking Parts of Nigeria: A Glycated Haemoglobin-Based Population Screening.

BACKGROUND AND OBJECTIVES: Prevalence of prediabetes and undiagnosed diabetes are different in rural and urban dwellings, with varying driving factors. This study aimed to determine the differences in risk factors of prediabetes and undiagnosed diabetes among Yoruba speaking adult dwellers in selected rural and urban communities in Nigeria using haemoglobin A1c. METHODS: A cross-sectional study was conducted in five selected states in Southwestern Nigeria. Using a multistage sampling technique, 2,537 participants with no prior diagnosis of prediabetes or diabetes mellitus (DM) were enrolled and their glycated haemoglobin (HbA1c) determined. Descriptive statistics, univariate and multiple logistic regression analysis was used to determine the prevalence and risk factors of prediabetes and diabetes at 5% level of significance. RESULTS: Increased age, sex, family history of diabetes, being married, participants' history of hypertension, cardiovascular disease and Gestational Diabetes Mellitus (GDM) or delivery of big babies, BMI, systolic and diastolic blood pressure were significantly associated with prediabetes and diabetes in both urban and rural areas. However, adjusted odds ratio showed that family history of diabetes (2.14, 95% CI: 1.26-3.61 versus 1.36, 95% CI: 1.00-1.85) and past GDM among women (2.67, 95% CI: 0.62, 11.39 versus 1.32, 95% CI: 0.61, 2.89) clearly predict dysglycaemia in the rural compared to urban participants, respectively. CONCLUSIONS: Family history of diabetes and past GDM disproportionately predict dysglycaemia in rural compared to urban participants. Periodic screening for dysglycaemia and public health education, especially in child-bearing women, are necessary measures to reduce the burden of dysglycaemia in Nigeria.

CONTEXTE ET OBJECTIFS: La prévalence du prédiabète et du diabète non diagnostiqué diffère entre les zones rurales et urbaines, avec des facteurs déterminants variés. Cette étude visait à déterminer les différences dans les facteurs de risque du prédiabète et du diabète non diagnostiqué chez les adultes yoruba-parlants vivant dans des communautés rurales et urbaines sélectionnées au Nigeria, en utilisant l'hémoglobine A1c. MÉTHODES: Une étude transversale a été menée dans cinq États sélectionnés du sud-ouest du Nigeria. Utilisant une échantillonnage en plusieurs étapes, 2 537 participants sans diagnostic antérieur de prédiabète ou de diabète sucré (DS) ont été recrutés et leur hémoglobine glyquée (HbA1c) déterminée. Des statistiques descriptives, ainsi que des analyses de régression logistique univariée et multivariée, ont été utilisées pour déterminer la prévalence et les facteurs de risque du prédiabète et du diabète à un seuil de signification de 5 %. RÉSULTATS: L'augmentation de l'âge, le sexe, les antécédents familiaux de diabète, le mariage, les antécédents d'hypertension, de maladie cardiovasculaire et de diabète gestationnel (DG) ou l'accouchement de gros bébés, l'IMC, la pression artérielle systolique et diastolique étaient significativement associés au prédiabète et au diabète dans les zones urbaines et rurales. Cependant, les odds ratio ajustés ont montré que les antécédents familiaux de diabète (2,14, IC à 95 % : 1,26-3,61 contre 1,36, IC à 95 % : 1,00-1,85) et les antécédents de DG chez les femmes (2,67, IC à 95 %: 0,62, 11,39 contre 1,32, IC à 95 % : 0,61, 2,89) prédisent clairement la dysglycémie en milieu rural par rapport aux participants urbains, respectivement. CONCLUSIONS: Les antécédents familiaux de diabète et les antécédents de DG prédisent de manière disproportionnée la dysglycémie en milieu rural par rapport au milieu urbain. Un dépistage périodique de la dysglycémie et une éducation sanitaire, en particulier chez les femmes en âge de procréer, sont des mesures nécessaires pour réduire le fardeau de la dysglycémie au Nigeria. MOTS-CLÉS: Prédiabète, diabète non diagnostiqué, Facteurs de risque, Rural-urbain, Différences, Basé sur l'hémoglobine glyquée, Nigeria.

Determinants of Choice of Facility-Based Delivery among Mothers in Kwara State, Nigeria.

BACKGROUND: Nigeria has the highest number of maternal deaths in the world, which is a major public health problem. One of the major contributory factors is high prevalence of unskilled birth attendance from low facility delivery. However, the reasons for and against facility delivery are complex and not fully understood. OBJECTIVE: The objective of this study was to identify the facilitators and barriers to facility based deliveries (FBD) among mothers in Kwara state, Nigeria. METHODS: The study was carried out among 495 mothers that delivered in the five years prior to the study in three selected communities from the three senatorial districts of Kwara state using mixed methods. The study design consisted of a cross-sectional study with mixed data collection involving qualitative and quantitative methods. Multistage sampling technique was employed. Primary outcome measures were place of delivery, reasons for and against FBD. RESULTS: Of the 495 respondents that had their last delivery during the study period, 410 respondents delivered in the hospital (83%). Common reasons for hospital delivery were ease and convenience (87.1%), safe delivery (73.6%) and faith in healthcare providers (22.4%). The common barriers to FBD included high cost of hospital delivery (85.9%), sudden birth (58.8%) and distance (18.8%). Other important barriers were availability of cheaper alternatives (traditional birth attendants and community health extension workers practising at home), unavailability of community health insurance and lack of family support. Parity, level of education of respondents and husband had significant influence on choice of delivery (p<0.05). CONCLUSION: These findings provided a good insight into the reasons for and against facility delivery among Kwara women, which can assist policy makers and program interventions that can improve facility deliveries and ultimately improve skilled birth attendance, reduce maternal and newborn morbidity and mortality.

CONTEXTE: Le Nigeria compte le plus grand nombre de décès maternels au monde, ce qui constitue un problème majeur de santé publique. L'un des principaux facteurs contributifs est la forte prévalence de l'assistance à l'accouchement non qualifiée due à un accouchement dans des établissements de faible qualité. Cependant, les raisons pour et contre la prestation en établissement sont complexes et ne sont pas entièrement comprises. OBJECTIF: L'objectif de cette étude était d'identifier les facilitateurs et les obstacles aux accouchements en établissement (FBD) chez les mères de l'État de Kwara, au Nigeria. METHODES: L'étude a été menée auprès de 495 mères qui ont accouché au cours des cinq dernières années précédant l'étude dans trois communautés sélectionnées des trois districts sénatoriaux de l'État de Kwara en utilisant des méthodes mixtes. La conception de l'étude consistait en un entretien avec des informateurs clés et une étude transversale avec une collecte de données mixte impliquant des méthodes qualitatives et quantitatives. La technique d'échantillonnage à plusieurs degrés a été employée. Les principaux critères de jugement étaient le lieu d'accouchement, les raisons pour et contre le FBD. RESULTATS: Parmi les 495 répondantes qui ont eu leur dernier accouchement au cours de la période d'étude, 410 répondantes ont accouché à l'hôpital (83 %). Les raisons courantes de l'accouchement à l'hôpital étaient la facilité et la commodité (87,1 %), la sécurité de l'accouchement (73,6 %) et la confiance dans les prestataires de soins de santé (22,4 %). Les obstacles courants à la FBD comprenaient le coût élevé de l'accouchement à l'hôpital (85,9 %), l'accouchement soudain (58,8 %) et la distance (18,8 %). D'autres obstacles importants étaient la disponibilité d'alternatives moins chères (accoucheuses traditionnelles et agents de vulgarisation de la santé communautaire exerçant à domicile), l'absence d'assurance maladie communautaire et le manque de soutien familial. La parité, le niveau d'éducation des répondants et le mari ont une influence significative sur le choix de l'accouchement (p<0,05). CONCLUSION: Ces résultats ont fourni un bon aperçu des raisons pour et contre l'accouchement en établissement chez les femmes Kwara, ce qui peut aider les décideurs politiques et les interventions de programme qui peuvent améliorer les accouchements en établissement et, en fin de compte, améliorer l'assistance qualifiée à l'accouchement, réduire la morbidité et la mortalité maternelles et néonatales. Mots clés: Prestation en établissement; Facilitateurs; Barrières; État de Kwara; Nigeria.

Low Immunization Completion among Under-Five Children: Are Underserved Nomadic and Farming Communities in a North Central State of Nigeria doing Better?

Background: The recent drop in immunization coverage in Nigeria has left more than 3.25 million children unimmunized and has risen concern over immunization completion among the under-five children. More so among underserved communities of pastoralist nomads and farmers that were isolated from immunization services because of operational and sociocultural factors. Materials and Methods: A cross-sectional analytical (comparative analysis) study was carried out among 550 eligible caregivers of under-five children in nomadic and farming communities in Niger State, Nigeria. The mothers and caregivers paired with under-five children were recruited into the study using a multistage sampling technique. Data was collected using a validated interviewer-administered questionnaire. Data was analyzed with the statistical software package (version 23). Results: More than half of the under-five children studied were males in both the nomadic (57.5%) and farming (52.0%) communities. The aggregated score of immunization knowledge was significantly (P < 0.001) better (Good 44.4%; Fair 49.8%) among farmers compared to their nomads' counterpart (Good 21.1%; Fair 43.6%). Conversely, almost all the respondents (98.2%) in nomadic community significantly had a good overall perception of childhood immunization compared to 77.1% in the farming community. More farmers' children (99.6%) had received immunization compared to 92.4% of the nomads' children. About 87.3% of farmers compared to 76% of the nomads' (76.0%) children reported immunization completion. About 50.5% of the farmers' and 41.4% of the nomads' children have achieved immunization on card inspection. Conclusion: This study revealed that average immunization completion reported among under-five children in both farming and nomadic communities is higher than the national average. It is recommended that more strategies are needed to intensify immunization campaigns targeted at populations in Nigeria.

The Indirect Victims of COVID-19: Perception of Non-COVID-19 Patients about the Effect of Closure of the Medical Outpatient Services on their Health.

BACKGROUND: In order to reduce COVID-19 transmission and protect healthcare workers, the outpatient departments (OPDs) in many hospitals worldwide were closed down in the early days of the pandemic. Patients being managed for chronic medical illnesses who subsequently suffered reduced access to healthcare have been described as "the patients left behind". AIM: The study aimed at assessing the impact of the closure of the Medical OPD in University of Ilorin Teaching Hospital (UITH) on the health and perceived well-being of patients with chronic medical illnesses. METHODS: A cross-sectional study of 180 patients with chronic medical illnesses attending the MOPD in UITH. RESULTS: Mean age of participants was 50.2±18.2years, 92 (51.1%) were male, median duration of attending MOPD was 21 months (IQR 12-36). 92 patients (51.1%) perceived a negative affectation of their well-being by the closure of MOPD. Being >50 years was associated with a perception of negative affectation of well-being (P=0.042). 140 patients (77.8%) had clinic appointments that fell within the period under review. 67(69.3%) of the 97 patients who had medical complaints during the period could not reach a doctor and this was associated with a perception of negative affectation of their wellbeing. The commonest action they took was to do nothing (28.3%), three (4.5%) resorted to herbal concoctions. 19 (29.9%) felt their complaints were urgent. CONCLUSION: Our study identifies that patients with chronic medical illness are potential victims of COVID-19 related disruption of healthcare services. Healthcare managers in Nigeria must develop alternatives such as telemedicine that sustain face-to-face medical interaction during eventualities.

CONTEXTE: Afin de réduire la transmission de la COVID-19 et protéger les travailleurs de la santé, les services ambulatoires (OPD) dans de nombreux hôpitaux dans le monde ont été fermés dans les premiers jours de l'Pandémie. Patients pris en charge pour des maladies chroniques quipar la suite souffert d'un accès réduit aux soins de santé ont été décrit comme "les patients laissés pour compte". OBJECTIF: L'étude visait à évaluer l'impact de la fermeture de l'OPD médical à l'hôpital universitaire d'Ilorin (UITH) la santé et le bien-être perçu des patients atteints de chroniquesMaladies. MÉTHODES: Une étude transversale de 180 patients atteints de chroniques maladies médicales fréquentant le MOPD à l'UITH. RÉSULTATS: L'âge moyen des participants était de 50.2 ±18.2 ans, 92 ans(51.1 %) étaient des hommes, la durée médiane de la participation au MOPD était de 21mois (IQR 12-36). 92 patients (51.1 %) ont perçu un résultat negative l'affectation de leur bien-être par la fermeture du MOPD. Être >50ans était associée à une perception d'affectation négative de bien-être (P= 0.042). 140 patients (77.8 %) avaient des rendez-vous à la clinique qui s'inscrivait dans la période considérée. 67 (69.3 %) des 97 patients qui ont eu des problèmes médicaux au cours de la période n'ont pas pu atteindre un et cela était associé à une perception d'affectation negative de leur bien-être. L'action la plus courante qu'ils ont prise était de ne rien faire (28.3%), deux (4.5%) ont eu recours à des concoctions à base de plantes. 19 (29.9 %) ont ressenti leurs plaintes étaient urgentes. CONCLUSION: Notre étude identifie que les patients atteints demaladie chronique les maladies médicales sont des victimes potentielles des perturbations liées à la COVID-19des services de santé. Les gestionnaires de soins de santé au Nigeria doivent se developper des solutions de rechange comme la télémédecine qui soutiennent la médecine en personne interaction lors d'éventualités. Mots-clés: Maladie COVID-19, Maladies chroniques, COVID-19 fermeture connexe des services médicaux ambulatoires, perception.

Mid-term impact of home-based follow-up care on health-related quality of life of hypertensive patients at a teaching hospital in Ilorin, Nigeria.

BACKGROUND: Health-related quality of life (HRQoL) is an important clinical outcome assessment in hypertension management, given the lifelong (chronicity) nature and the need for daily self-management for hypertensive patents. Of some of the studies that implemented home-based interventions on hypertension globally, the HRQoL is rarely used as a primary outcome measure. This study developed, implemented, and assessed the impact of home-based follow-up care (HBFC) on HRQoL of hypertensive patients attending outpatients' clinics in Ilorin, Nigeria. MATERIALS AND METHODS: A total of 149 and 150 patients were randomized to intervention and usual care (control) groups, respectively. A 12-month task-shifting (nurse-driven) HBFC intervention was administered to intervention group. The mid-term impact of intervention on HRQoL was assessed after 6 months intervention. Data were analyzed with intention-to-treat principle. Treatment effects were measured with the t-tests, analysis of covariance, and multivariate analysis of covariance analysis. Significant levels were set at P < 0.05 and 95% confidence interval. RESULTS: The between-group treatment effect was not statistically significant (P > 0.05), whereas the within-group treatment effects were statistically significant for both the intervention and control arms (P < 0.05) at 6 months. After controlling for age and baseline HRQoL, the intervention group had an improved physical component of HRQoL than the control group. The intervention group also had statistically significant improvement in blood pressure control, medication adherence, and symptom counts (P < 0.05). CONCLUSION: The HBFC intervention for hypertensive patients impacted positively on physical component of HRQoL after controlling for baseline HRQoL and age of the patients at 6 months post-intervention.

Willingness to support antenatal blood donation among married men in a Metropolitan City in North-central Nigeria.

AIMS AND OBJECTIVES: Improving blood availability through voluntary or compulsory antenatal blood donation is pivotal to reducing maternal morbidity and mortality in developing countries. Willingness to donate blood is adjudged to be an important step to the actual practice of donating blood. This study aimed to determine the knowledge, attitude and willingness of men towards antenatal blood donation. PATIENTS AND METHODS: This was a descriptive cross-sectional study. A multi-stage sampling technique was used to recruit 500 married men into the study using interviewer-administered questionnaire. Data analysis was done using SPSS version 16 software package. Pearson's Chi-squared test was used to test for significant associations between variables. A P < 0.05 was considered as statistically significant. RESULTS: More than half 300 (60%) of the respondents had good knowledge of antenatal blood donation in general. Majority (85.8%) of the respondents were willing to support voluntary blood donation. The overall attitude to blood donation was positive in 77.8% of the respondents. A significantly higher proportion 268 (89.3%) of respondents with good knowledge of antenatal blood donation were willing to donate blood (P = 0.0006). CONCLUSIONS: The majority have good knowledge and positive attitude towards antenatal blood donation. However, there is need to urgently transform this positive attitude to action through continual public enlightenment to reduce maternal morbidity and mortality.

Self-reported sleep parameters among secondary school teenagers in middle-belt Nigeria.

BACKGROUND: Available evidences seem to suggest increasing trend in sleep deficit among teenagers worldwide, and there is limited information on this among Nigerian teenagers. This study was carried out to determine the basic sleep schedule and sleep duration among schooling teenagers in Ilorin, Nigeria. METHODS: This is a descriptive cross-sectional study conducted among 20 selected public secondary schools in Ilorin, Nigeria. A multistage sampling technique was used to randomly select participating schools. RESULT: A total of 1033 students participated in the study; of these 47.3% were males and 51.7% females. Students mean age (standard deviation) was 15.3 ± 1.6 years with a range of 12-19 years. Majority (76.2%) of participants co-share bed with at least one person and some (23.8%) slept alone in bed. The three leading reasons given for going to bed were: Tiredness - 31.1%, completion of house assignment - 20.5%, and parental directive - 12.4%. 10% of teenagers do make regular phone calls at night and 5.5% surf internet and use computers at night. Regular habits of daytime sleepiness were reported by 8.2% of study participants. Students' mean sleep duration during school days was 9.33 ± 2.29 h compared to 10.09 ± 1.32 h at weekend (P < 0.05). The duration of night time sleep was adequate (>9 h) in 41% of students; borderline (8-9 h) in 44.3% while 13.3% of the students had insufficient nighttime sleep duration (<8 h) P < 0.05. CONCLUSION: A substantial number of students had borderline nighttime sleep duration and so had potentials to transit into the problematic insufficient range. To prevent this, there is a need to educate schooling teenagers on the dangers associated with prolonged sleep insufficiency.

Energy value of wheat, barley, and wheat dried distillers grains with solubles for broiler chickens determined using the regression method.

The energy value of wheat, barley, and 2 samples of wheat dried distillers grains with solubles (WDDGS) for broiler chickens were determined in 2 experiments with Ross 708 broiler chickens from d 15 to 22 posthatch. The birds were fed a standard broiler starter diet from d 1 to 15 posthatch. In each experiment, 320 birds were grouped by weight into 8 blocks of 5 cages with 8 birds per cage and assigned to 5 diets. There were 5 diets in each experiment consisting of a corn-soybean meal reference diet (RD) and 4 test diets (TD). The TD consisted of each of the 2 WDDGS samples (experiment 1), wheat, or barley (experiment 2) that partly replaced the energy sources in the RD at 100 or 200 g/kg such that the same ratios were maintained for all energy ingredients across all experimental diets. The ileal digestible energy (IDE), ME, and MEn of the WDDGS samples, wheat, and barley were determined by the regression method. Dry matter of WDDGS1, WDDGS2, wheat, and barley were 939, 947, 899, and 890 g/kg, respectively; the gross energies were 4,838; 4,825; 4,456; and 4,567 kcal/kg of DM, respectively. Addition of WDDGS to the RD in experiment 1 linearly decreased (P<0.01) ileal nitrogen and energy digestibilities, total tract utilization of DM, energy and nitrogen, as well as ME and MEn of the TD. In experiment 2, IDE, ME, and MEn in the TD decreased (P<0.01) with increasing levels of barley in the diets, but wheat inclusion had no effect on the IDE, ME, and MEn of the diets. Wheat inclusion linearly improved (P<0.05) DM and energy utilization in TD. The DE, ME, and MEn of the test ingredients were determined by the regression method in which the test ingredient contribution to DE, ME, and MEn in kilocalories was regressed against the amount of test ingredient in grams. The IDE were 2,001 and 1,831 kcal/kg of DM for WDDGS1 and WDDGS2, respectively. The respective ME and MEn values were 2,644 and 2,464 kcal/kg of DM for WDDGS1 and 2,215 and 2,092 kcal/kg of DM for WDDGS2. The respective IDE, ME, and MEn of wheat for broiler chickens were 3,413; 3,713; and 3,372 kcal/kg of DM. The barley sample evaluated contained 2,364 kcal of IDE, 2,894 kcal of ME, and 2,841 kcal of MEn/kg of DM for broiler chickens.

Psychosocial factors associated with psychiatric morbidity in higher institution students in Nigeria

Introduction: Mental health disorders in undergraduates are often undetected and may predispose to other academic and social complications. The objective of the study is to determine the prevalence of probable psychiatric morbidity among students of University of Ilorin, Nigeria and the psycho-social factors that are associated with psychiatric morbidity in them. Methods: Socio-demographic questionnaire and the 12-item General health questionnaire (GHQ-12) were administered to 3,300 undergraduate students to assess psychosocial variables and psychiatric morbidity respectively. Results: About 23.5% of respondents scored >3 using the GHQ-12 questionnaire, signifying a likehood of psychiatric morbidity. Students from polygamous families were 1.3 times more likely to have GHQ scores of >3 than those from monogamous (OR=1.276, P=0.026). Those who had unemployed fathers were twice more likely to have a GHQ > 3 than those with employed fathers. (OR=2.084, P=0.005).Those who lived in houses with shared toilet facilities were 1.3 times more likely to have GHQ >3 (OR=1.310, P=0.028) Conclusion: This study calls for a careful consideration and modification of the various psychosocial factors associated with pschiatric morbidity in order to ensure a mentally healthy and vibrant student community

Oral health seeking behaviour among patients attending outpatient clinic in University of Ilorin teaching hospital (UITH) Ilorin

Introduction: In sub ­ Saharan Africa, oral health services are greatly hampered by low availability and poor accessibility to health care and these are various interrelated factors responsible. This study determined the factors that influence oral health seeking behavior among patients attending outpatients' clinic. Methodology: A total of 460patients were selected into the study from the outpatients' clinic using systematic random sampling. Data was collected and was analyzed using SPSS 17. The significant level was set at 0.05 Results: Of the 97.3% of the respondents with awareness of oral health facility, 90.9% of them had oral health facility within 5km distance. The commonest complaint was toothache. Majority of the respondents (88.2%) accessed orthodox oral health services mostly for teeth extraction (61.3%). There was statistically significant difference between the awareness of Oral health facility and closeness to residence. Conclusion: Age, awareness and attitude have positive effect on health seeking behavior of patients.

Regression and direct methods do not give different estimates of digestible and metabolizable energy values of barley, sorghum, and wheat for pigs.

Direct or indirect methods can be used to determine the DE and ME of feed ingredients for pigs. In situations when only the indirect approach is suitable, the regression method presents a robust indirect approach. Three experiments were conducted to compare the direct and regression methods for determining the DE and ME values of barley, sorghum, and wheat for pigs. In each experiment, 24 barrows with an average initial BW of 31, 32, and 33 kg were assigned to 4 diets in a randomized complete block design. The 4 diets consisted of 969 g barley, sorghum, or wheat/kg plus minerals and vitamins for the direct method; a corn-soybean meal reference diet (RD); the RD + 300 g barley, sorghum, or wheat/kg; and the RD + 600 g barley, sorghum, or wheat/kg. The 3 corn-soybean meal diets were used for the regression method. Each diet was fed to 6 barrows in individual metabolism crates for a 5-d acclimation followed by a 5-d period of total but separate collection of feces and urine in each experiment. Graded substitution of barley or wheat, but not sorghum, into the RD linearly reduced ( < 0.05) dietary DE and ME. The direct method-derived DE and ME for barley were 3,669 and 3,593 kcal/kg DM, respectively. The regressions of barley contribution to DE and ME in kilocalories against the quantity of barley DMI in kilograms generated 3,746 kcal DE/kg DM and 3,647 kcal ME/kg DM. The DE and ME for sorghum by the direct method were 4,097 and 4,042 kcal/kg DM, respectively; the corresponding regression-derived estimates were 4,145 and 4,066 kcal/kg DM. Using the direct method, energy values for wheat were 3,953 kcal DE/kg DM and 3,889 kcal ME/kg DM. The regressions of wheat contribution to DE and ME in kilocalories against the quantity of wheat DMI in kilograms generated 3,960 kcal DE/kg DM and 3,874 kcal ME/kg DM. The DE and ME of barley using the direct method were not different (0.3 < < 0.4) from those obtained using the regression method (3,669 vs. 3,746 and 3,593 vs. 3,647 kcal/kg DM, respectively). The direct method-derived DE and ME of sorghum were not different (0.5 < < 0.7) from those obtained using the regression method (4,097 vs. 4,145 and 4,042 vs. 4,066 kcal/kg DM, respectively). The direct method- and regression method-derived DE (3,953 and 3,960 kcal/kg DM, respectively) and ME (3,889 and 3,874 kcal/kg DM, respectively) of wheat were not different (0.8 < < 0.9). Results of these 3 experiments suggest that regression and direct methods do not give different estimates of DE and ME in barley, sorghum, and wheat for pigs.

Dermatology Quality of Life Impairments among Newly Diagnosed HIV/AIDS-Infected Patients in the University of Ilorin Teaching Hospital (Uith), Ilorin, Nigeria.

The study sought to describe the quality-of-life impairments in newly diagnosed HIV/AIDS-infected adult patients with cutaneous lesions. This was a hospital-based, cross-sectional, descriptive study of 160 newly diagnosed HIV/AIDS-infected adult patients attending the HIV/AIDS clinic of University of Ilorin Teaching Hospital (UITH). Systemic random sampling technique was used in recruiting respondents for the study. The Dermatology Life Quality Index (DLQI) was used to gauge the quality-of-life impairments. The study showed high prevalence of cutaneous lesions in HIV/AIDS-infected patients. Majority of the respondents (83.7%) scored more than 10 in DLQI score. This signifies that the skin lesions had large negative effects on their quality of life. The assessment of the impact of dermatoses on patients' quality of life is important for clinical management. It is pertinent to detect patients at higher risk of experiencing worse quality of life in order to treat them holistically.

Direct and regression methods do not give different estimates of digestible and metabolizable energy of wheat for pigs.

Digestible and metabolizable energy contents of feed ingredients for pigs can be determined by direct or indirect methods. There are situations when only the indirect approach is suitable and the regression method is a robust indirect approach. This study was conducted to compare the direct and regression methods for determining the energy value of wheat for pigs. Twenty-four barrows with an average initial BW of 31 kg were assigned to 4 diets in a randomized complete block design. The 4 diets consisted of 969 g wheat/kg plus minerals and vitamins (sole wheat) for the direct method, corn (Zea mays)-soybean (Glycine max) meal reference diet (RD), RD + 300 g wheat/kg, and RD + 600 g wheat/kg. The 3 corn-soybean meal diets were used for the regression method and wheat replaced the energy-yielding ingredients, corn and soybean meal, so that the same ratio of corn and soybean meal across the experimental diets was maintained. The wheat used was analyzed to contain 883 g DM, 15.2 g N, and 3.94 Mcal GE/kg. Each diet was fed to 6 barrows in individual metabolism crates for a 5-d acclimation followed by a 5-d total but separate collection of feces and urine. The DE and ME for the sole wheat diet were 3.83 and 3.77 Mcal/kg DM, respectively. Because the sole wheat diet contained 969 g wheat/kg, these translate to 3.95 Mcal DE/kg DM and 3.89 Mcal ME/kg DM. The RD used for the regression approach yielded 4.00 Mcal DE and 3.91 Mcal ME/kg DM diet. Increasing levels of wheat in the RD linearly reduced (P < 0.05) DE and ME to 3.88 and 3.79 Mcal/kg DM diet, respectively. The regressions of wheat contribution to DE and ME in megacalories against the quantity of wheat DM intake in kilograms generated 3.96 Mcal DE and 3.88 Mcal ME/kg DM. In conclusion, values obtained for the DE and ME of wheat using the direct method (3.95 and 3.89 Mcal/kg DM) did not differ (0.78 < P < 0.89) from those obtained using the regression method (3.96 and 3.88 Mcal/kg DM).

Marker type but not concentration influenced apparent ileal amino acid digestibility in phytase-supplemented diets for broiler chickens and pigs.

Two experiments were conducted to investigate whether the choice of digestibility marker or marker concentration in corn-soybean meal diets influence apparent ileal AA digestibility (AIAAD) or the potential phytase-induced improvement in AIAAD in broiler chickens and pigs. One hundred ninety-two, 42-d-old, Ross 708 broilers were used in a 7-d study in Exp 1. The birds were allocated to 6 dietary treatments in a 2 × 3 factorial arrangement of treatments in a split-plot design. The factors were a combination of chromic oxide and titanium dioxide (0.3% or 0.5% of both markers, as-fed basis), and 3 levels of phytase inclusion [0, 500, or 1,000 phytase units (FTU)/kg]. In Exp. 2, 6 barrows fitted with a simple T-cannula at the distal ileum were allocated to 4 diets in a 6 × 4 Youden square design and 2 × 2 factorial arrangement of treatments. The factors were similar to Exp. 1, except the 500-FTU/kg phytase level was not used in Exp. 2. There were no marker type × marker concentration, phytase × marker type, or phytase × marker type × marker concentration interactions for any of the AA in either experiment. On average, AIAAD values calculated using Ti was greater (P < 0.05) than those calculated using Cr, regardless of the phytase inclusion level in both experiments. In Exp. 1, AIAAD values for His, Trp, Cys, and Pro were greater (P < 0.05) at the 0.3% than 0.5% marker concentration. The AIAAD values were consistently greater when calculated using Ti compared with Cr, irrespective of phytase level. It is concluded that the type of marker used does not influence whether a response to phytase supplementation, in terms of AIAAD, is observed.

Awareness and coverage of the national health insurance scheme among formal sector workers in Ilorin, Nigeria

A prepayment scheme for health through the National Health Insurance Scheme (NHIS) was commenced in Nigeria about ten years ago. Nigeria operates a federal system of government. Sub-national levels possess a high degree of autonomy in a number of sectors including health. It is important to assess the level of coverage of the scheme among the formal sector workers in Nigeria as a proxy to gauge the extent of coverage of the scheme and derive suitable lessons that could be used in its expansion. This is a cross-sectional; descriptive survey carried out among formal sector workers in Ilorin Kwara State; Nigeria. A stratified sampling technique was used to select study participants. A self-administered questionnaire was used to collect data from respondents. Data was analysed with the SPSS. Ethical approval to conduct the study was obtained from the Bowen University Teaching Hospital Research Ethics Committee. A total of 370 people participated in the study. Majority; (78.9%) of the respondents were aware of the NHIS; however only 13.5 % paid for health care services through the NHIS. Logistic regression analysis shows that respondents with post-secondary education (OR = 9.032; CI = 2.562 - 31.847; p = 0.001) and in federal civil service (OR = 2.679; CI = 1.036 - 6.929; p = 0.042) were over nine and three times more likely to be aware of the scheme than others. Coverage of the scheme among the respondents was unimpressive. A lot still need to be done to fast-track the expansion of the scheme among this sector of the population

Relationship between Age; Radiographic Normal Heart Size and Cardio-Thoracic Ratio in a Nigerian Population

Background: Cardio-vascular disease (CVD) is now on the increase. The precise diagnosis of CVD is of immense clinical importance to the cardiac surgeons; pathologist and also for cardiologists. However; information on normal values for various cardio-vascular structures in Nigeria; a country with the highest population of blacks in the world is sparse. In this regard the age-related radiographic sizes of a Nigerian cohort of patients with non-cardiogenic complaints or consultations were therefore assessed.Objectives: To evaluate the limits of normal cardiac size in our environment ; determine if there was a relationship between the age and size of the heart and to evaluate the relationship between sex and cardiac size and cardio-thoracic ratio.Design: A cross-sectional study.Setting: The Radiology department of University of Ilorin Teaching Hospital; Ilorin; North Central Nigeria between January to June 2012.Subjects: One Hundred patients were consecutively recruited and their chest radiographs examined after fulfilling the inclusion criteria.Results: Males accounted for 55% of the study population. The age range was 1 month to 73 years; (Mean = 29.3; SD =2.41668). The mean cardiac size was 11.7cm. The average cardiac size for adult males and females; were 11.6cm and 11.5cm respectively while that of thoracic size was 29.0cm and 26.8cm respectively. Correlation between age and cardiac size was 0.66; age and thoracic size was 0.64 and between cardiac size and thoracic size was 0.89. The paired sample t-test for age and cardiac size was less than 0.05 (p value 0.05).Conclusion: knowing the average values of cardiac size for adult males and females (11.6cm and 11.5cm) and thoracic size (29.0cm and 26.8cm) respectively from this study presents a base line for early detection of variation from normal cardiac measurements in this environment

Risk factors, threats and prevention of highly pathogenic avian influenza (HPAI) in African countries

Highly pathogenic avian influenza (HPAI) is a viral disease that affects the digestive; nervous and respiratory systems of all domestic and wild birds with high morbidity and mortality. It is highly contagious disease which can be fatal in humans. The avian influenza viruses (AIVs) are classified as types A; B and C with 15 subtypes of the type A. To date; all disease causing HPAI Viruses belong to H5 or H7 subtypes; and affect pigs and humans with the pigs serving as a mixing vehicle for re-assortment of the virus. The domestic ducks get infected without showing clinical signs and serve as a source of infection for domestic poultry. Outbreaks of HPAl in Europe; Asia and Turkey are reported to be associated; with the presence of wet lands and lakes where migratory birds rest. In some African countries like Nigeria; such wet lands exist with free flying wild birds and domestic ducks visiting and resting. The possible source of introduction into a country could be through importation or smuggling of infected poultry products across the borders and through migratory birds that fly through identified pathways. The status of HPAl in many African countries including Nigeria is still under investigation so that appropriate strategies / measures to prevent introduction of the disease into the country can be implemented and / or strengthened through restriction of importation of poultry and poultry products from high risk countries; effective disease surveillance; functional National Veterinary services; quarantine and community based participatory epidemiological system for HPAI surveillance and control. This article reviewed the global epidemiology and risk factors of HPAI infection in Nigeria and other African countries with emphasis on specific preventive measures that can reduce introduction of the virus into the country and the epidemiological surveillance for case detection / identification; screening and management. This review provides useful information and updates for health workers in tropical countries on the trends of AIVs and HPAI; diagnostic criteria using case definitions for both community and health facility levels and management protocols for confirmed cases as recommended by the World health Organization