Prevalence of Extra-pulmonary Tuberculosis among Patients Diagnosed with Tuberculosis in a Tertiary Hospital in Bauchi, Northeastern Nigeria - A Five-Year Review.

BACKGROUND: Extra- pulmonary tuberculosis ( EPTB) contributes to the burden of Tuberculosis (TB) especially in developing countries. Despite this fact, information on the prevalence of EPTB is scarce. The aim of this study is to determine the five-year prevalence of EPTB among patients diagnosed with tuberculosis (TB) that attended and received treatment for TB at directly observed treatment short course (DOTS) clinic of Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), Bauchi, North-eastern Nigeria. METHODOLOGY: This is a retrospective review of all patients' records diagnosed with TB that attended and received treatment at the TB DOTS clinic of ATBUTH, Bauchi from January, 2017 to December, 2021. Extracted data was analyzed using IBM SPSS version 23.0 software. RESULT: There were 676 patients comprising of 389 (57.5%) males and 287 (42.5%) females and out of these, 208 had EPTB. The estimated five-year prevalence of EPTB in the studied cases was 30.8%. Tuberculosis of the spine was the predominant form of EPTB in this study with 117 (56.3%) cases. This was followed by TB Lymph nodes 40 (19.2%), TB Abdomen 36 (17.3%), TB Pleura 6 (2.9%), TB Pericardium 3 (1.4%), 2 (1.0%) each of TB Breast and CNS, and 1 (0.5%) each of TB Testicle and Upper arm. Seventy-eight (11.5%) patients were HIV positive, 549 (81.2%) were HIV-negative and the HIV status of 49 (7.2%) patients was unknown. CONCLUSION: The study showed prevalence of EPTB is still high as reported in some literature. Tuberculosis of spine was the commonest form of EPTB. These findings underscore the need for continued screening of EPTB to reduce the burden of TB in resource-poor countries.

CONTEXTE: La tuberculose extra-pulmonaire (TEP) contribue au fardeau de la tuberculose (TB), en particulier dans les pays en développement. Malgré ce fait, les informations sur la prévalence de la TEP sont rares. Le but de cette étude est de déterminer la prévalence sur cinq ans de la TEP chez les patients diagnostiqués avec la tuberculose (TB) qui ont fréquenté et reçu un traitement pour la TB au centre de traitement de courte durée sous observation directe (DOTS) de l'hôpital universitaire Abubakar Tafawa Balewa (ATBUTH), Bauchi, Nord-Est du Nigéria. MÉTHODOLOGIE: Il s'agit d'une revue rétrospective de tous les dossiers des patients diagnostiqués avec la TB qui ont fréquenté et reçu un traitement au centre de traitement DOTS de l'ATBUTH, Bauchi, de janvier 2017 à décembre 2021. Les données extraites ont été analysées à l'aide du logiciel IBM SPSS version 23.0. RÉSULTAT: Il y avait 676 patients comprenant 389 (57,5%) hommes et 287 (42,5%) femmes, dont 208 avaient une TEP. La prévalence estimée sur cinq ans de la TEP dans les cas étudiés était de 30,8%. La tuberculose de la colonne vertébrale était la forme prédominante de TEP dans cette étude avec 117 (56,3%) cas. Cela a été suivi par la TB des ganglions lymphatiques 40 (19,2%), la TB abdominale 36 (17,3%), la TB pleurale 6 (2,9%), la TB péricardique 3 (1,4%), 2 (1,0%) cas chacun de TB du sein et du SNC, et 1 (0,5%) cas chacun de TB testiculaire et du bras supérieur. Soixante-dix-huit (11,5%) patients étaient séropositifs, 549 (81,2%) étaient séronégatifs et le statut VIH de 49 (7,2%) patients était inconnu. CONCLUSION: L'étude a montré que la prévalence de la TEP est encore élevée, comme le rapporte certaines littératures. La tuberculose de la colonne vertébrale était la forme la plus courante de TEP. Ces résultats soulignent la nécessité de poursuivre le dépistage de la TEP pour réduire le fardeau de la TB dans les pays à ressources limitées. MOTS CLÉS: Tuberculose Extra-Pulmonaire, Prévalence, Bauchi, Nord-Est du Nigéria.

Risk Factors Associated with Under Five Children Mortality in Northeast Nigeria; A Retrospective Analysis of National Demographic and Health Survey Data.

BACKGROUND: Under-five children mortality rate (U5MR) remains a crucial indicator of a nation's child healthcare and socioeconomic development. This study aims to identify and quantify significant maternal, child, family, and environmental risk factors contributing to under-five mortalities in the Northeast geopolitical zone of Nigeria. METHODS: Retrospective analysis of secondary data from the 2018 National Demographic and Health Survey (NDHS) in six northeastern Nigerian states. Maternal factors (age, education, health-seeking behavior), child variables (weight, sex, vaccination status), family factors, and environmental factors (water source, residence, wealth index) were analyzed to determine their association with the under-five mortality rate (U5MR). Logistic regression models and population-attributable risk estimates were used to identify key contributors to U5MR in the region. RESULTS: A total of 26,293 mothers were surveyed, of which the majority (93.6%) were married, employed (70.7%), and had no insurance (99%). Most of the mothers were above 35 years of age, uneducated and with first birth between ages 15-19. Adjusted odds ratios show unmarried mothers 1.67 (P=0.015), small birth size 1.37 (P=0.022), never breastfeeding 1.83 (P=0.000), short birth intervals 1.50 (0.005), higher parity 1.5 (P=0.005), lack of any family planning method 1.43(P=0.040), twin siblings 3.95 (P=0.000) and place of residence 1.21 (P=0.000) were associated with higher U5MR odds ratios. Maternal age 21-25 years showed a protective effect AOR 0.59 (95% CI: 0.36-0.98, P=0.040) and age > 31 years AOR 0.44 (95% CI: 0.24-0.81, P=0.009). CONCLUSION: This study provides crucial insights into the multifaceted determinants of under-5 mortality in Northeast Nigeria. The findings underscore the importance of tailored interventions addressing maternal, child, and family factors to improve child health outcomes in the region.

CONTEXTE: Le taux de mortalité des enfants de moins de cinq ans (U5MR) reste un indicateur crucial des soins de santé pour les enfants et du développement socio-économique d'une nation. Cette étude vise à identifier et à quantifier les facteurs de risque significatifs liés à la mère, à l'enfant, à la famille et à l'environnement, contribuant à la mortalité des enfants de moins de cinq ans dans la zone géopolitique du nord-est du Nigéria. MÉTHODES: Analyse rétrospective des données secondaires de l'Enquête Démographique et de Santé Nationale (EDSN) de 2018 dans six États du nordest du Nigéria. Les facteurs maternels (âge, éducation, comportement de recherche de soins), les variables de l'enfant (poids, sexe, statut vaccinal), les facteurs familiaux et les facteurs environnementaux (source d'eau, résidence, indice de richesse) ont été analysés pour déterminer leur association avec le taux de mortalité des enfants de moins de cinq ans (U5MR). Des modèles de régression logistique et des estimations du risque attribuable à la population ont été utilisés pour identifier les principaux contributeurs à l'U5MR dans la région. RÉSULTATS: Un total de 26 293 mères ont été interrogées, dont la majorité (93,6%) étaient mariées, employées (70,7%) et n'avaient pas d'assurance (99%). La plupart des mères avaient plus de 35 ans, n'étaient pas éduquées et avaient eu leur premier enfant entre 15 et 19 ans. Les ratios de cotes ajustés montrent que les mères non mariées (1,67, P=0,015), la petite taille à la naissance (1,37, P=0,022), l'absence d'allaitement (1,83, P=0,000), les intervalles de naissance courts (1,50, P=0,005), une parité élevée (1,5, P=0,005), l'absence de méthode de planification familiale (1,43, P=0,040), les jumeaux (3,95, P=0,000) et le lieu de résidence (1,21, P=0,000) étaient associés à des ratios de cotes plus élevés de l'U5MR. L'âge maternel de 21 à 25 ans a montré un effet protecteur AOR 0,59 (95% CI : 0,36-0,98, P=0,040) et l'âge > 31 ans AOR 0,44 (95% CI : 0,24-0,81, P=0,009). CONCLUSION: Cette étude fournit des informations cruciales sur les déterminants multifactoriels de la mortalité des enfants de moins de cinq ans dans le nord-est du Nigéria. Les résultats soulignent l'importance d'interventions adaptées abordant les facteurs liés à la mère, à l'enfant et à la famille pour améliorer les résultats de santé des enfants dans la région. MOTS-CLÉS: Mortalité des enfants de moins de cinq ans, Facteurs de risque,Nord-Est du Nigéria, Santé des enfants.

Infection Prevention and Control: Baseline Knowledge and Practices of TBAs in Rural Kano, Northwestern Nigeria.

BACKGROUND: Maternal infections remain a significant contributor to maternal mortality worldwide. Majority of births in northern Nigeria occur at home and are attended by Traditional Birth Attendants (TBAs). Little has been documented about their knowledge and practice on infection prevention and control practices in Kano, northern Nigeria. OBJECTIVES: This study evaluated the level as well as factors associated with TBAs' infection prevention and control knowledge and practices. METHODS: The study is the baseline phase of a quasi-experimental study, conducted in a rural LGA in Kano State, Nigeria. Using an adapted tool, 163 eligible TBAs were surveyed. Knowledge and practice of IPC were scored, aggregated, and dichotomized into good or poor. Binary logistic regression analysis was used to predict knowledge and practice of IPC. RESULTS: Majority (79.1%) of the TBAs exhibited poor IPC knowledge but many (78.5%) reported good practice. Good knowledge of IPC was predicted by the TBAs' age: a six-fold increased likelihood (AOR=6.25, 95% CI: 1.02- 38.53) and almost five-fold increased likelihood (AOR=4.75, 95% CI: 1.39- 16.24) for those in their second and fourth decades of life. TBAs who reported poor practice of IPC were 83% less likely (AOR=0.17, 95% CI: 0.03- 0.92) to have good knowledge of IPC. TBAs' practice was only linked to previous training (AOR=0.17, 95% CI: 0.04- 0.76). CONCLUSION: TBAs knowledge of IPC was low although reported practice was good. The need for tailored training interventions to enhance knowledge and skills for safe delivery care is paramount to improve maternal and neonatal outcomes.

CONTEXTE: Les infections maternelles restent une contribution significative à la mortalité maternelle dans le monde. La majorité des accouchements dans le nord du Nigeria ont lieu à domicile et sont assistés par des TBA. Peu de choses ont été documentées sur leurs connaissances et leurs pratiques en matière de prévention et de contrôle des infections à Kano, dans le nord du Nigeria. OBJECTIFS: Cette étude a évalué le niveau de connaissances et de pratiques des TBA en matière de prévention et de contrôle des infections, ainsi que les facteurs associés. MÉTHODES: L'étude est la phase de base d'une étude quasiexpérimentale, menée dans une LGA rurale de l'État de Kano, au Nigeria. En utilisant un outil adapté, 163 TBA éligibles ont été interrogés. Les connaissances et les pratiques en matière de PCI ont été évaluées, agrégées et dichotomisées en bonnes ou mauvaises. Une analyse de régression logistique binaire a été utilisée pour prédire les connaissances et les pratiques en matière de PCI. RÉSULTATS: La majorité (79,1 %) des TBA présentaient des connaissances médiocres en PCI, mais beaucoup (78,5 %) ont déclaré avoir de bonnes pratiques. De bonnes connaissances en PCI étaient prédites par l'âge des TBA : une probabilité multipliée par six (AOR=6,25, IC à 95 % : 1,02-38,53) et presque multipliée par cinq (AOR=4,75, IC à 95 % : 1,39-16,24) pour ceux dans leur deuxième et quatrième décennies de vie. Les TBA qui ont déclaré une mauvaise pratique de la PCI étaient 83 % moins susceptibles (AOR=0,17, IC à 95 % : 0,03-0,92) d'avoir de bonnes connaissances en PCI. La pratique des TBA était uniquement liée à une formation antérieure (AOR=0,17, IC à 95 % : 0,04­0,76). CONCLUSION: Les connaissances des TBA en matière de PCI étaient faibles bien que les pratiques déclarées étaient bonnes. La nécessité d'interventions de formation sur mesure pour améliorer les connaissances et les compétences en matière de soins de l'accouchement sécurisés est primordiale pour améliorer les résultats maternels et néonatals. MOTS-CLÉS: Accoucheuses Traditionnelles, Mortalité Maternelle, Infection Maternelle, Nigeria.

Detection and genetic characterization of orf virus from sheep and goats in Nigeria.

Orf is a contagious, viral epitheliotropic disease of small ruminants. We investigated the molecular epidemiology of orf virus (ORFV) in breeds of small ruminants to determine the evolutionary diversity in Nigeria. Out of 54 small ruminants screened, the number of animals that were positive for ORFV in the three locations were 25. The distribution of positive animals by location were FCT 45.0% (n = 9/20), Oyo State 42.9% (6/14), and Plateau State 50.0% (n = 10/20). ORFV sequences from this study clustered with viruses detected in Taiwan, Iran, USA, and France. Our findings highlight the risk of transmission across geographic boundaries in Nigeria and West Africa, and reinforces the need for increased surveillance to prevent and control spread. Comprehensive characterization of ORFV in small ruminants as well as in humans in Nigeria is required to better elucidate the epidemiological dynamics and the virus evolution.

Serum Immunoglobulin E Level and Its Relationship with Eosinophil Count among Patients with Allergic Rhinitis in Tertiary Hospital in Bauchi, Northeastern Nigeria: A Cross-Sectional Study.

BACKGROUND: Allergic rhinitis is an immunoglobulin E-mediated hypersensitivity disease of the mucous membrane of the nasal airway. There is a paucity of information regarding serum immunoglobulin E level and its relationship with eosinophil count among patients with allergic rhinitis in our facility and Northeastern Nigeria. AIM: To determine serum immunoglobulin E level and its relationship with eosinophil count among patients with allergic rhinitis. METHODOLOGY: It was a cross-sectional study of consecutive patients diagnosed with allergic rhinitis that were recruited from the ear, nose, and throat surgery and respiratory medicine clinics of ATBUTH, Bauchi, Bauchi State, Northeastern Nigeria, from January 01, 2022, to May 31, 2023. Five milliliters of blood were analyzed for immunoglobulin E estimation using an immunoglobulin E ELISA kit and determination of eosinophil count using pack five hematologic autoanalyzer. Extracted data were analyzed using IBM SPSS version 23.0 software. RESULT: There were 61 patients studied comprising 22 (36.1%) males and 39 (63.9%) females with a male-to-female ratio of 1:1.7. Their ages range from 18 to 77 years old. The mean age, serum IgE level, and eosinophil counts of all three patients were 38.65 ± 14.34 years, 371.24 ± 82.63 IU/ml, and 3.35 ± 2.87%, respectively. All (100%) participants had raised serum IgE levels, and 88.5% had normal eosinophil count. There was no significant correlation between the serum IgE level and eosinophil counts (r = -0.206; P = 0.112). CONCLUSION: All of the participants had a high serum IgE level. There was no significant association between serum IgE and eosinophil count.

MOBILE PHONE UTILIZATION FOR ENHANCING CHILD HEALTH: KNOWLEDGE, ATTITUDES AND PRACTICE OF MOTHERS IN FEDERAL TEACHING HOSPITAL, GOMBE.

Introduction: Globally e-health interventions have expanded significantly and despite huge mobile phone penetration in Nigeria, its deployment in health remains largely unexplored. Objective: To establish the use of mobile phones for health by mothers of children admitted in the paediatric wards of Federal Teaching Hospital, Gombe. Methodology: Three hundred and eighteen structured questionnaires were administered to mothers of children on admission in the paediatric medical ward, emergency paediatric ward, and the special care babies unit over 10 weeks. Results: There were 96.7% (298/308) between 16 and 45 years; 35.1% and 33.8% of mothers had tertiary and secondary level education respectively, 89.3% (275) were married, 65.9% had monogamous marriages; 75.4.% (212/281) of mothers had 1-4 children 94.5% of mothers possessed a mobile phone, 68.5%(139/203) accessed the internet daily, 69.5% (210/302) had access to the internet, 77.5% (203/262) belonged to a social media platform, 64.7% mothers used internet for health, 81% of mothers with tertiary education accessed the internet for health (p<0.05), 66.7% (148/222) have used their phones for healthcare consultation, 54.9%(157/286) have called a healthcare worker which was highest among tertiary-educated mothers (p<0.05), and 88.5% would preferably call a doctor. Symptoms that necessitated the phone call were diarrhoea, convulsions, excessive crying, and vomiting. 59.3% preferred to call healthcare workers anytime, 27% at night. 36% received a prescription 35% were advised and 27% were referred. 87% were satisfied with the healthcare response via phone. 23% have children with chronic illness and 97.3% (291/299) would like to have a Paediatric call Centre for their children's health. Conclusion: Higher maternal education enhanced the use of mobile phones for child health.

CASE FATALITY RATE OF CHILDHOOD TUBERCULOSIS: EXPERIENCE FROM FEDERAL TEACHING HOSPITAL GOMBE: A TWO DECADE REVIEW.

Introduction: Tuberculosis (TB) was the leading cause of death from an infectious agent worldwide, until the Coronavirus (COVID-19) pandemic, ranking above HIV/AIDS. Nigeria ranks 6th among the 30 TB high-burden countries (TB, TB/HIV, DRTB) and 1st in Africa. The estimated case fatality rate (CFR) of TB in Sub-Sahara Africa (SSA) is 15%. Objective: To review the Tuberculosis case fatality rate (TCFR) in children diagnosed with TB from 2000-2019 in Federal Teaching Hospital Gombe. Methodology: All cases of Tuberculosis (TB) diagnosed in children using ICD 10 classification were retrieved and analyzed. These included deaths from TB. The mainstay of TB diagnosis was clinical using TB Score (81%), Gene Xpert was 7%, and AFB was 10%. Results: 26,716 children were admitted; 383 had TB out of which 208(54.3%) were males and 175 (45.7%) females. TB constituted 1.4% of Paediatric admissions. Children 0 -5 years constituted 46.7% (179/383) of cases and 11 - 18 years were 31.3% (120/383). Fulani, Hausa, and Tangale constituted 43.6% (167), 21.1% (81), and 6.8% (26) of TB cases respectively. TB admissions were highest between 2015 and 2019 (31.8%). TB adenitis was the most common extrapulmonary TB. Tuberculosis/HIV co-infection accounted for 103(27%), out of which 74% (44) died. Overall TCFR was 15.6%; TCFR was 16.3% in males and 14.8% in females. The TCFR was 46.7% in 0-5yrs; 15% in 6-9yrs and 38.3% in 10-18yrs.Fulani had the highest CFR (11.9%). Tuberculosis CFR was highest between 2010-2014 (30.0%) and lowest in 2005-2009 (21.6%). Conclusion: The Tuberculosis CFR is comparable to SSA CFR.

REVEALING THE VARIED REALITY OF MALARIA-RELATED DEATHS IN CHILDREN ACROSS GENDER, AGE, AND ETHNICITY IN FEDERAL TEACHING HOSPITAL GOMBE OVER 20 YEARS: AN ESSENTIAL EPIDEMIOLOGIC IMPERATIVE.

Introduction: Nigeria recorded 31% of 619,000 malaria deaths globally and accounts for 25-30% of all childhood mortality in the country. Few studies in Nigeria, have reported malaria's case fatality rate over a long period. Objective: To determine Malaria Case Fatality Rate among Children admitted from 2000-2019. Methodology: All severe malaria cases and deaths amongst children aged 0-18 over the last two decades were analysed using ICD-10. The diagnosis was based on clinical and microscopic findings. Results: 26,716 children were admitted, 2494 (9.3%) were diagnosed with malaria and 209 died. Malaria constituted 5.3% (209/3956) of all childhood mortality. Males constituted 58.9 % (1468/2494) while 65% (1642/2494) were aged 0-5 years. Of the malaria admissions, Fulani and Hausa constituted 948(38%) and 438(17.6%) respectively. Admissions were highest in October (15%) and in 2012 (9.6%). The overall malaria CFR was 8.3%; 8.8% in Females (91/1026) and 8.03% in Males P-value <0.05 (X2=54.735); 8.6% in children aged 0-5years, 8.2% in 6-10 years and 7.4% in 11-18 years, P-value <0.05 (X2=893.164). CFR was highest in April (11.4%)and lowest in November (5.2%). Kanuri and Igbo had CFR of 70% and 38.4% respectively while it was lowest in Tera tribe (4.3%), P-value<0.05. The CFR was highest in the year 2004 (22%), 3.5% in 2000 and 2006. Over the years, case fatality rate was 15.9% between 2000-2004, 6.1% from 2005-2009. Between 2010-2015, it was 7.3% and 8.5% from 2016-2019. Conclusion: This study revealed the deadly reality of severe malaria with increased CFR among females, aged 0-5 and the Kanuri tribe.

EPIDEMIOLOGIC TREND AND CASE FATALITY OF CHILDHOOD TETANUS IN FEDERAL TEACHING HOSPITAL GOMBE; A 20YEARS REVIEW.

Introduction: Tetanus is a vaccine-preventable disease, it remains a significant cause of morbidity and mortality in both neonatal and post-neonatal periods, especially in developing countries with limited health facilities and inadequate vaccination. The overall case fatality rate (CFR) is 13.2% globally, highest in the neonatal period and in sub-Saharan Africa. CFR is 64%, 47%, and 43% in Nigeria, Uganda, and Tanzania respectively. Objectives: To determine the Case Fatality Rate of Childhood tetanus in FTHG from 2000-2019. Methodology: All cases and deaths from tetanus amongst children aged 0-18 years in paediatric medical ward of FTHG over the last two decades diagnosed clinically and classified using ICD-10 were analysed. Results: 95 cases of tetanus out of 26,716 total admissions constituting 0.004%. There were 49 tetanus deaths out of 3956 total childhood deaths (0.012%) over the study period. Males constituted 66% (63/95). 30% (28/95) were aged 0-28 days; 23.1% (22/95) were adolescents. Fulani and Hausa constituted 37% (34/95) and 31% (29/95) respectively. Admission was highest in the dry season 52% (50/95 %). The overall tetanus CFR was 51.6%; 78% of deaths were in males (38/49), 30% in neonates, and 23% in adolescents. CFR was highest during the dry season (67.3%). Hausa and Fulani had CFR of 51% and 40% respectively. P-value <0.05 The CFR was 88% between 2000-2004, 72% from 2005-2009, 71% between 2010-2014 and 33% from 2015-2019. Conclusion: Tetanus CFR is still high among neonates and adolescents. Maternal tetanus vaccine and booster doses in children need strengthening.

IN-PATIENT PNEUMONIA BURDEN AND CASE FATALITY RATES IN CHILDREN OVER TWO DECADES IN FEDERAL TEACHING HOSPITAL, GOMBE (FTHG).

Introduction: Pneumonia is the leading cause of death among children globally accounting for an estimated 1.2 million (18%) total deaths annually. The number of childhood-related deaths from pneumonia is approximately 2000-fold higher in developing than in developed countries. Nigeria contributes the highest of pneumonia-related deaths globally. Objectives: To determine the case fatality rates (CFR) of pneumonia from 2000-2019 in paediatric ward, FTHG. Methodology: All cases of pneumonia admissions and deaths in patients aged 0-18 years, using ICD-10 classification, were retrieved and analysed. The mainstay of diagnosis is clinical and/or radiographic features. Results: A total of 26,716 children were admitted during this period, 1151 had pneumonia (4.3%) and 118 died. Males constituted 647 (56.2%) and females 43.8% of the total pneumonia admissions. Children aged 0-5 years had the highest pneumonia admissions, followed by 6-9 years. Admissions were highest in the wet than the dry season. Pneumonia CFR was 10.2%; 10.9% in females and 9.7% in males. Under-5 constituted 84% (969/1151) of pneumonia admission with a CFR of 9.3%. CFR were 10.3% and 21% in 6-10 years, and 11-18 years respectively. The CFR between2000-2004 was 14.1%, 2005-2009:21.1%, 2010-2014:10.2% and 2015-2019:7.2%. Kanuri had the highest CFR of 56.2%.(P <0.05) Other ethnic groups were 29.4% in Waja, 25% in Tula, 21.4% in Igbo, 16.6% in Yoruba, 12.1% in Tangale, 10.2% in Hausa, 8.8%in Bolewa and 8.3% in Fulani. The CFR was highest in February20.2%. Conclusion: Pneumonia Case fatality is high.

Cord Blood Thyroid Stimulating Hormone Values in Healthy Term Babies delivered at Abubakar Tafawa Balewa University Teaching Hospital Bauchi, Northeastern Nigeria.

BACKGROUND: Congenital hypothyroidism is one of the most common preventable causes of mental retardation and clinical manifestations are often subtle or absent at birth and hence the need for screening. Implementation of newborn screening requires local normative values. OBJECTIVES: To determine the normative values of cord Thyroid Stimulating Hormone (TSH) among term babies in Bauchi, Northeast Nigeria and compare it with that from other centers in Nigeria. METHODOLOGY: Cord blood samples from 200 term babies were analyzed for TSH by Fluorescence Immunoassay technique in this descriptive cross-sectional study. A cut-off of >20 µIU/ml was used for recall. The mean and range were determined and compared with those of previous local studies using t-test. Impact of some maternal and infant factors on TSH was also assessed. RESULTS: The overall mean (SD) cord TSH was 3.74 (±1.99) µIU/ ml and the range was 0.73 to 15.22 µIU/ml (2.5th to 97.5th centile) and none had TSH > 20 µIU/ml and hence our recall rate was 0%. The mean cord TSH was comparable to that reported by a lone local multicenter study (p = 0.120) but significantly different from that of 3 other local studies (p < 0.001). There was also no significant difference between the means of different gender, birth weight groups, mode of delivery, socio-economic classes, maternal age and parity. CONCLUSION: The Cord blood TSH level of most term newborn in Bauchi, similar to other Nigerian studies, is < 10 µIU/ml with a few but significant percentage recording cord TSH level > 10 µIU/ml. Gender, birth weight, mode of delivery, socio-economic class, maternal age and parity were not significantly related to cord TSH level. The mean blood TSH values from different studies across the country tend to vary based on the assay technique. We recommend a nationwide multicenter study with a much larger sample size, lower cutoff value for recall and a unified sample processing laboratory if national normative values are to be developed.

BACKGROUND: L'hypothyroïdie congénitale est l'une des causes évitables les plus courantes de retard mental et les manifestations cliniques sont souvent subtiles ou absentes à la naissance, d'où la nécessité d'un dépistage. La mise en œuvre du dépistage néonatal nécessite des valeurs normatives locales. OBJECTIFS: Déterminer les valeurs normatives de l'hormone stimulatrice de la thyroïde (TSH) du cordon chez les bébés nés à terme à Bauchi, Nord-Est du Nigeria et les comparer à celles d'autres centres du Nigeria. MÉTHODOLOGIE: Des échantillons de sang ombilical de 200 bébés nés à terme ont été analysés pour la TSH par la technique d' étude descriptive transversale. Un seuil de >20 µUI/ml a été utilisé pour le rappel. La moyenne et l'intervalle ont été déterminés et comparés avec ceux des études locales précédentes en utilisant le test t. L'impact de certains facteurs maternels myet infantiles sur la TSH a également été évalué. RÉSULTATS: La moyenne globale (SD) de la TSH du cordon était de 3,74 (±1,99) µIU/ml et l'intervalle était de 0,73 à 15,22 µIU/ml (2,5 à 97,5 centiles) aucun n'avait une TSH > 20 µIU/ml et donc notre taux de rappel était de 0%. La moyenne de TSH au cordon était comparable à celle rapportée par une seule étude multicentrique locale unique (p = 0,120) mais significativement différente de celle de 3 autres études locales (p < 0,001). Il n'y avait pas non plus de différence significative entre les moyennes des différents sexes, groupes de poids de naissance, mode d'accouchement, classes socio d'accouchement, les classes socio-économiques, l'âge maternel et la parité. CONCLUSION: Le niveau de TSH dans le sang de cordon de la plupart des nouveau-nés à termede la plupart des nouveau-nés à terme à Bauchi, comme dans d'autres études nigérianes, est < 10 µUI/ml mais significatif, enregistrant un niveau de TSH du cordon > 10 µIU/ml. Le sexe, le poids à la naissance, le mode d'accouchement, la classe socio-économique maternelle et la parité n'étaient pas significativement liés au taux de TSH au cordon. Le site valeurs moyennes de la TSH sanguine provenant de différentes études dans le pays ont tendance à varier en fonction de la technique de dosage. Nous recommandons une étude nationale multicentrique avec une taille d'échantillon beaucoup plus grande, une valeur seuil pour le rappel et un laboratoire de traitement des échantillons unifié si des valeurs normatives nationales doivent être développées. Mots clés: Sang de cordon, Hormone de stimulation thyroïdienne, Bébés à terme.

Pre-grafting histological studies of skin grafts cryopreserved in α helix antarctic yeast oriented antifreeze peptide (Afp1m).

A number of living creatures in the Antarctic region have developed characteristic adaptation of cold weather by producing antifreeze proteins (AFP). Antifreeze peptide (Afp1m) fragment have been designed in the sequence of strings from native proteins. The objectives of this study were to assess the properties of Afp1m to cryopreserve skin graft at the temperature of -10 °C and -20 °C and to assess sub-zero injuries in Afp1m cryopreserved skin graft using light microscopic techniques. In the present study, a process was developed to cryopreserve Sprague-Dawley (SD) rat skin grafts with antifreeze peptide, Afp1m, α-helix peptide fragment derived from Glaciozyma antractica yeast. Its viability assessed by different microscopic techniques. This study also described the damages caused by subzero temperatures (-10 and -20 °C) on tissue cryopreserved in different concentrations of Afp1m (0.5, 1, 2, 5 and 10 mg/mL) for 72 h. Histological scores of epidermis, dermis and hypodermis of cryopreserved skin grafts showed highly significant difference (p < 0.01) among the different concentrations at -10 and -20 °C. In conclusion, the integrity of cryopreserved skin grafts with lower concentrations of Afp1m (0.5, 1 and 2 mg/mL) or at -20 °C was not maintained. The present study attested that Afp1m is a good cryoprotective agent for the cryopreservation of skin graft. Higher Afp1m concentrations (5 and 10 mg/mL) at -10 °C found to be suitable for the future in vivo study using (SD) rat skin grafts.

Clinical and laboratory profile of patients with epistaxis in Kano, Nigeria: A 10-year retrospective review.

BACKGROUND: Epistaxis is a common cause of otorhinolaryngological clinic visits and admissions into accident and emergency. Severe epistaxis could remarkably alter the hemodynamic milieu of individuals and results into significant morbidity and occasional mortality. AIMS: To review the clinical pattern and laboratory test results of individuals treated for epistaxis in a tertiary health care center in northern Nigeria. METHODS: This study was a 10-year retrospective review of patients managed for epistaxis in the department of otorhinolaryngology, Aminu Kano teaching hospital, Kano, Nigeria. Case files of patients were retrieved, reviewed, and clinical and laboratory data were extracted. The data were analyzed using Statistical Product and Service Solution version 23. RESULTS: A total of 256 were reviewed with 149 (58.2%) male and 107 (41.8%) female with M: F of 1.4:1. A mean age ± SD of 33.86 ± 20.06 years. Anterior epistaxis was the most prevalent, 126 (49.2%), and majority of the patients presented with severe epistaxis, 75 (29.3%). Most were treated with nasal packing, 93 (36.3%). Majority had abnormal full blood counts and clotting profile results, 158 (61.75) and 104 (40.6%), respectively. There was a significant association between patient's genotype and outcome. Anterior epistaxis and AA genotype were significant positive predictors of outcome. CONCLUSION: Coagulopathies, anaemia, and hemoglobinopathies are common findings among our patients with epistaxis.

Maternal near-miss and death among women with hypertensive disorders in pregnancy: a secondary analysis of the Nigeria Near-miss and Maternal Death Survey.

OBJECTIVE: To investigate life-threatening maternal complications related to hypertensive disorders of pregnancy (HDP) in Nigerian public tertiary hospitals. DESIGN: Secondary analysis of a nationwide cross-sectional study. SETTING: Forty-two tertiary hospitals. POPULATION: Women admitted for pregnancy, childbirth or puerperal complications. METHOD: All cases of severe maternal outcome (SMO: maternal near-miss or maternal death) due to HDP were prospectively identified using the WHO criteria over a 1-year period. MAIN OUTCOME MEASURES: Incidence of SMO, health service events, case fatality rate, and mortality index (% of maternal death/SMO). RESULTS: Out of 100 107 admissions for maternal complications, 6753 (6.8%) women had HDP. Pre-eclampsia (PE) (54.5%) and eclampsia (E) (30.4%) were the most common HDP recorded. SMO occurred in 587 women with HDP: 298 maternal near-misses and 289 maternal deaths. The majority (93%) of the women with SMO due to HDP were admitted in a critical condition. The median diagnosis-definitive intervention interval was over 4 hours in a quarter of women who died from HDP. For PE and E, case fatality rates were 1.9 and 10.4%, respectively, although both conditions had a similar mortality index of 49.3%. Lack of antenatal care and place of residence further than 5 km from the hospital were associated with maternal death. CONCLUSIONS: Severe maternal outcomes from HDP were due to late presentations and health system challenges. To reduce maternal deaths from HDP, health system strengthening that would engender early hospital presentation and prompt treatment is recommended. FUNDING: The original research that generated the data for this secondary analysis was funded by the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a co-sponsored programme executed by the World Health Organization (WHO). We have no other funding issue to declare for our study. TWEETABLE ABSTRACT: Eclampsia is the leading cause of maternal death in Nigerian hospitals.

Histological and mechanical evaluation of antifreeze peptide (Afp1m) cryopreserved skin grafts post transplantation in a rat model.

The objective of this study was to evaluate the use of Afp1m as a cryopreservative agent for skin by examining the transplanted skin histological architecture and mechanical properties following subzero cryopreservation. Thirty four (34) rats with an average weight of 208 ±â€¯31 g (mean ±â€¯SD), were used. Twenty four (n = 24) rats were equally divided into four groups: (i) immediate non-cryopreserved skin autografts (onto same site), (ii) immediate non-cryopreserved skin autografts (onto different sites), (iii) skin autografts cryopreserved with glycerol for 72 h and (iv) skin autografts cryopreserved with Afp1m for 72 h at -4 °C. Rounded shaped full-thickness 1.5-2.5 cm in diameter skin was excised from backs of rats for the autograft transplantation. Non-cryopreserved or cryopreserved auto skin graft were positioned onto the wound defects and stitched. Non-transplanted cryopreserved and non-cryopreserved skin strips from other ten rats (n = 10) were allowed for comparative biomechanical test. All skin grafts were subjected to histological and mechanical examinations at the end of day 21. Histological results revealed that tissue architecture especially the epidermal integrity and dermal-epidermal junction of the Afp1m cryopreserved skin grafts exhibited better histological appearance, good preservation of tissue architecture and structural integrity than glycerolized skin. However, there was no significant difference among these groups in other histological criteria. There were no significant differences among the 4 groups in skin graft mechanical properties namely maximum load. In conclusion, Afp1m were found to be able to preserve the microstructure as well as the viability and function of the skin destined for skin transplantation when was kept at -4 °C for 72 h.

Relationship between Physical Activity and Health Related Quality of Life among Pregnant Women.

The study aimed to investigate the association between health-related quality of life (HQoL) and physical activity (PA) among pregnant women. Sample of pregnant women (N= 398; mean age=27.86±5.15 years) were surveyed using the Pregnancy Physical Activity and Health Related Quality of Life (SF 12) Questionnaires. Spearman correlation coefficient and logistic regression analyses were used to determine the bivariate relationship and association between HQoL and PA intensities and domain respectively. Overall, sedentary behaviour was positively albeit tenuously related to HQoL (r=0.111, P <0.01) whereas sport/exercise was the only domain of PA tenuously associated with the Physical health of HQoL (r=0.142, p <0.01). Also, pregnant women with sufficient PA were 4 times likely to report good quality of life in physical component not in the mental component of HQoL (OR: 4.33, 95% CI: 1.36-13.80). In conclusion, sports/exercise may be an important domain of PA to target when delivering interventions to improve the physical wellbeing among pregnant women in Maiduguri, Nigeria.

A retroperitoneal extra-renal wilms' tumour: A case report.

Wilms' tumour originates predominantly in the renal tissue; in rare cases it can also arise from extra-renal sites accounting for 0.5-1% of cases of Wilms' tumours seen. A diagnosis of extra-renal Wilms' cannot be easily established with clinical and radiological features except when the histological facts are provided. Wilms' tumours arising from extra-renal sites may not be different in clinical features, protocol of treatment and outcome from a typical intra renal Wilms' tumour. A 2-year-old boy presented with an asymptomatic abdominal swelling for 3 months. Abdominal ultrasound and CT scans revealed an extra-renal mass. Intravenous urogram (IVU) showed prompt excretion bilaterally. Post excision histology of the tumour confirmed a Wilms' tumour.

When getting there is not enough: a nationwide cross-sectional study of 998 maternal deaths and 1451 near-misses in public tertiary hospitals in a low-income country.

OBJECTIVE: To investigate the burden and causes of life-threatening maternal complications and the quality of emergency obstetric care in Nigerian public tertiary hospitals. DESIGN: Nationwide cross-sectional study. SETTING: Forty-two tertiary hospitals. POPULATION: Women admitted for pregnancy, childbirth and puerperal complications. METHODS: All cases of severe maternal outcome (SMO: maternal near-miss or maternal death) were prospectively identified using the WHO criteria over a 1-year period. MAIN OUTCOME MEASURES: Incidence and causes of SMO, health service events, case fatality rate, and mortality index (% of maternal death/SMO). RESULTS: Participating hospitals recorded 91 724 live births and 5910 stillbirths. A total of 2449 women had an SMO, including 1451 near-misses and 998 maternal deaths (2.7, 1.6 and 1.1% of live births, respectively). The majority (91.8%) of SMO cases were admitted in critical condition. Leading causes of SMO were pre-eclampsia/eclampsia (23.4%) and postpartum haemorrhage (14.4%). The overall mortality index for life-threatening conditions was 40.8%. For all SMOs, the median time between diagnosis and critical intervention was 60 minutes (IQR: 21-215 minutes) but in 21.9% of cases, it was over 4 hours. Late presentation (35.3%), lack of health insurance (17.5%) and non-availability of blood/blood products (12.7%) were the most frequent problems associated with deficiencies in care. CONCLUSIONS: Improving the chances of maternal survival would not only require timely application of life-saving interventions but also their safe, efficient and equitable use. Maternal mortality reduction strategies in Nigeria should address the deficiencies identified in tertiary hospital care and prioritise the prevention of severe complications at lower levels of care. TWEETABLE ABSTRACT: Of 998 maternal deaths and 1451 near-misses reported in a network of 42 Nigerian tertiary hospitals in 1 year.

Palliative care in patients who receive whole brain radiotherapy for brain metastases in Ahmadu Bello University Teaching Hospital, Zaria.

Background: Brain Metastases is a devastating complication of Cancer affecting 10-50% of patients with systemic disease. It by far outnumbers primary Brain tumor in a 10:1 ratio. Aims and Objective: To determine the age distribution, gender distribution, tumor of origin, commonest radiotherapy regimen and median survival of patients who received Whole Brain Radiotherapy for Brain Metastases. Materials and Methods: Between May 2006-May 2015 patients who received Whole Brain Radiotherapy for Brain Metastases for confirmed Brain Metastases were studied in a Retrospective study and evaluated with respect to age, gender, tumor of origin and radiotherapy regimen. Patients Case files and treatment files were reviewed and results were analyzed using SPSS version 20th Edition. Results: A total of 30 cases were reviewed. The age range of patients was between 16-70 years with a mean age of 43.5 years. Median age of 41.5 years. 83.4% of patients were female with remaining 16.7% males. The commonest tumor of origin was Breast Cancer (76.7%) followed by Lymphoma (6.7%),Lung (3.3%), Colon(3.3%), Endometrium(3.3%), Pancrease (3.3%), Paranasal Sinus (3.3%). Majority of patients 73.3% received 30Gy in 10# over 2 weeks. Median Survival is 3 months. The most common clinical presentation is Headache (46.6%). Conclusion: Most Patients presented at advanced stages of their diseases. The mean age of patients that received Whole Brain Radiotherapy were in the fifth decade of life. More Females than Males received Whole Brain Radiotherapy.

Unlocking Efficiency in Radio-Frequency Heating: Eigenfrequency Analysis for Resonance Identification and Propagation Enhancement in Nigerian Tar Sands.

Nigerian bituminous tar sands are among the world's largest deposits of bitumen and heavy oil. They are estimated to contain 38-40 billion barrels of heavy oil and bitumen, spanning approximately 120 km in length and 4-6 km in breadth. With global commitments to net zero emissions and various energy transition plans, improvements in the recovery methods for heavy oil and bitumen are being sought. To address this, renewable energy electrothermal enhanced oil recovery is considered an eco-friendly alternative. In our study, we introduce a novel Reservoir-Waveguide-Debye model. This model explores the enhancement of penetration for radio-frequency electromagnetic (EM) waves, which can be generated from renewable energy sources. These waves facilitate the viscosity reduction of heavy oil and bitumen. Through a comprehensive 2D numerical simulation employing the bulk properties of bituminous tar sands, we assess the propagation of EM fields within porous media. We utilize the industrial heating radio-frequency bandwidth of 1-60 MHz to conduct frequency domain investigations. Our analysis delves into propagation modes using eigenfrequency analysis, pinpointing the EM resonance of the tar sands. Furthermore, we investigate the impact of mesh refinement on the EM eigenfrequencies of porous media at both the microscale (400 µm) and macroscale (100 m in radial distance). Our results demonstrate the occurrence of resonance phenomena at complex eigenfrequencies around 27.12 and 54.24 MHz in both the microscale and macroscale models of the bituminous sands. This breakthrough research offers promising insights into harnessing renewable energy-driven EM waves for efficient thermal recovery processes in the Nigerian bituminous tar sands, thus fostering sustainable and eco-friendly energy solutions.