Seroprevalence of Coxiella burnetii in sheep flocks in Kaduna State, Northwestern Nigeria.

A cross-sectional study was carried out to determine the seroprevalence and risk factors of Q fever in sheep in the northern part of Kaduna State, Nigeria. This study aimed to determine Coxiella burnetii infection and its risk factors in sheep in Kaduna State. A total of 400 blood samples consisting of 259 samples from females and 141 from males were aseptically collected from the jugular vein of sheep from flocks in Kaduna State. The sera obtained were screened for Q fever using an indirect enzyme-linked immunosorbent assay (iELISA). The obtained data were analysed to determine whether there is a relationship between sex, age, and the animals tested. The analysis revealed that 8.0% of the sera was seropositive by iELISA. There was no significant difference in Q fever seropositivity in the study area according to the sex of sheep (P > 0.05). There was a statistically significant difference (P < 0.05) in Q fever seropositivity according to the age of sheep. This study indicated a high seroprevalence of Q fever mainly among female animals and older sheep. Further studies are required to determine the epizootiology of Q fever in the study area more precisely.

Acute flaccid paralysis (AFP) surveillance intensification for polio certification in Kaduna state, Nigeria: lessons learnt, 2015-2016.

BACKGROUND: Nigeria has made remarkable progress in its current efforts to interrupt wild poliovirus transmission despite the re-emergence of wild poliovirus in 2016. The gains made in Nigeria have been achieved through concerted efforts by governments at all levels, traditional leaders, health workers, caregivers, and development partners. The efforts have involved an elaborate plan, coordination, and effective implementation of routine immunization services, supplemental immunization activities, and acute flaccid paralysis (AFP) surveillance. METHODS: We conducted the following activities to strengthen AFP surveillance in Kaduna state: a monetary reward for all AFP cases reported by health workers or community informants and verified as "true" AFP by a World Health Organization (WHO) cluster coordinator; training and sensitization of surveillance officers, clinicians, and community informants; recruitment of more personnel and expansion of the surveillance network; and the involvement of special populations (nomadic, hard-to-reach, and border communities) and caregivers in stool sample collection. The paired t test was used to evaluate the impact of the different initiatives implemented in Kaduna state to intensify AFP surveillance in 2016. RESULTS: There was increased annualized non-polio AFP rate (ANPAFPR) in 21 out of 23 Local Government Areas (LGAs) of Kaduna state 6 months after implementation of different initiatives to intensify AFP surveillance. The AFP reported by the special population increased in 15 out of 23 LGAs. Statistical analyses of mean scores of ANPAFPR before and after the interventions using the paired t test revealed a significant difference in mean scores: mean = 19.7 (standard deviation (SD) = 16.1) per 100,000 < 15 years old in July-December 2015, compared with 38.0 (SD = 21.6) per 100,000 < 15 years old in January-June 2016 (p < 0.05). Likewise, analysis of silent wards using the paired t test showed a significant difference in mean scores: mean = 4.0 (SD = 2.1) in July-December 2015 compared with 2.4 (SD = 1.8) in January-June 2016 (p < 0.05). CONCLUSION: The different initiatives implemented in 23 LGAs of Kaduna state to intensify AFP surveillance may be responsible for the significant improvement in the AFP surveillance performance indicators in 2016.

Association Between Belief in Medicine and Adherence to Antiretroviral Therapy Among Human Immunodeficiency Virus Adults in Zaira, Kaduna State, Nigeria.

BACKGROUND: Negative perceptions of antiretroviral treatment (ART)'s efficacy and consequences may operate as roadblocks to adherence. This research aimed to determine the association between belief in medicine and adherence to antiretroviral therapy among HIV adults on ART in Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria. METHOD: Using a cross-sectional design, a systematic random sampling method was used to select respondents aged 18-64 years on antiretroviral therapy for at least six months at Ahmadu Bello University Teaching Hospital, outpatients of the President's Emergency Plan for AIDS Relief Clinic. Socio-demographics, belief in medicine and adherence to ART were obtained using a self-administered questionnaire. Descriptive statistics, chi-square test, and multiple logistic regression were used for data analysis. RESULTS: Among the 385 people who took part in the study, about 67.5% were females and 32.5% were males. About 54% of adults adhered to ART. More than half (55.8%) of the respondents had negative perceptions (beliefs) of personal need for ART medication and about 42.3% of the respondents had more concerns about the potential negative effects of the ART medication. Government employment (odds ratio (OR) = 2.842, p = <0.01), self-employment (OR = 2.6, p = <0.001), and being divorced or widowed (OR = 2.0, p = <0.01), negative perceptions (beliefs) of personal need for the ART medication (adjusted OR (AOR) = 1.525, p=<0.01) and more concerns about the potential negative effects of the ART medication (AOR= 1.362, p = <0.05) were all significantly associated with ART adherence. CONCLUSION: Employment, marital status and belief in medicine were associated with adherence to ART. Therefore, during adherence counseling, healthcare personnel should address respondents' false views and fears regarding ART medication in order to strengthen proper information and the benefits of ART. This article was previously presented as a meeting poster at the 36th Scientific Conference of the Nutrition Society of Malaysia (7th and 8th September 2021).

Prevalence and Pattern of Hearing Loss among Young Adults in Tertiary Institutions with Habitual Headphone/Earphone Usage in Kaduna Metropolis.

Background: World Health Organisation estimates that 1.1 billion young people worldwide could be at risk of hearing loss due to unsafe listening practises and nearly half of the teenagers and young adults are exposed to unsafe levels of sound from the use of personal audio devices. Aim: This study aimed to determine the prevalence and pattern of hearing loss among students with habitual use of headphone/earphone in tertiary institutions in Kaduna. Participants and Methods: This was a prospective cross-sectional study of young adults with prolonged headphone/earphone usage in Kaduna and a group of nonheadphone/earphone users matched for age and sex as controls. Ethical approvals were obtained from relevant bodies and informed consent was also obtained from all participants. Data were obtained by clinical interview and audiometric evaluation of the participants and the data obtained were descriptively analysed using SPSS version 20.0. Frequency tables were generated and chi-square test and Student's t test were used to test for a possible association of variables. The level of significance was set at P < 0.05. Results: Two hundred and seventy-two prolonged headphone/earphone users with same number of controls participated in this study. The mean age for subjects and controls was 22.6 ± 3.4 and 23.2 ± 4.2, respectively. Using the better hearing ear, 48 and 20 of the subjects and controls, respectively, had hearing loss, giving a prevalence of 17.6% and 7.4% among the subjects and controls, respectively. Of the 48 subjects with hearing loss, 89.6% had a mild hearing loss. Majority, 91.7% had sensorineural hearing loss and the hearing loss was bilateral in all the participants (both subjects and controls). High frequencies were the most affected (64.6%). Conclusion: This study revealed that hearing impairment was more common among prolonged headphone/earphone users. In the majority of the prolonged headphone/earphone users, the hearing impairment was bilateral, mild, sensorineural, and mostly affects higher frequencies.

Adverse event following vaccine surveillance in Kaduna State, Northwestern Nigeria (January 2018 -June 2019): analysis of health facility´s records.

INTRODUCTION: Adverse Events Following Immunization (AEFI) are one of the main reasons for inadequate immunization coverage in Kaduna State, and AEFI underreporting serves as a barrier to achieving goals of global pharmaco-vigilance for vaccine. The purpose of this study is to estimate the completeness of variables in the AEFI line-listing forms, calculate AEFI reporting rates by Local Government Areas & vaccine type and profile the reported cases according to their reactions. METHODS: we conducted a descriptive, cross-sectional, retrospective study of primary surveillance records. We calculated AEFI reporting rates in the State and Local Government areas and AEFI Vaccine reaction rates to the various antigens. We used Binary logistic regression to determine the association between gender and vaccine reactions. RESULTS: seven thousand eight hundred and twenty-four (7,824) AEFI cases were reported. The completeness of variables on the filled AEFI line-list varied from 21% to 100%. The State had a high AEFI reporting rate of 9.09 per 10,000 administered doses. Fever (<38oC) was the main AEFI reaction. Severe AEFI cases accounted for only 0.89% of the total reported cases. Pentavalent vaccine was the suspect antigen responsible for the highest number of AEFI cases, with a vaccine reaction rate of 44.77 per 10,000 doses. The Zaria Local Government area had the highest AEFI reporting rate, while the Sanga Local Government area had the lowest AEFI reporting rate in the State. The difference between genders in the number of reported AEFI cases was not statistically significant (p>0.05). There were 35% higher odds of occurrence of bleeding among males than among females (aOR: 1.354; P-value: p=.012; 95% CI: 1.070-1.715; Nagelkerke-R2-: 0.003). The other reactions were not significantly related to gender. CONCLUSION: our study shows a higher occurrence of severe AEFI in subjects undergoing pentavalent vaccine. Thiscaused the highest incidence of AEFI. There was no significant association between gender and AEFI reactions.

Improving Voluntary, Rights-Based Family Planning: Experience From Nigeria And Uganda.

BACKGROUND: Growing focus on the need for voluntary, rights-based family planning (VRBFP) has drawn attention to the lack of programs that adhere to the range of rights principles. This paper describes two first-of-their-kind interventions in Kaduna State, Nigeria and in Uganda in 2016-2017, accompanied by implementation research based on a conceptual framework that translates internationally agreed rights into family planning programming. METHODS: This paper describes the interventions, and profiles lessons learned about VRBFP implementation from both countries, as well as measured outcomes of VRBFP programming from Nigeria. RESULTS: The intervention components in both projects were similar. Both programs built provider and supervisor capacity in VRBFP using comparable curricula; developed facility-level action plans and supported action plan implementation; aimed to increase clients' rights literacy at the facility using posters and handouts; and established or strengthened health committee structures to support VRBFP. Through the interventions, rights literacy increased, and providers were able to see the benefits of taking a VRBFP approach to serving clients. The importance of ensuring a client focus and supporting clients to make their own family planning choices was reinforced. Providers recognized the importance of treating all clients, regardless of age or marital status, for example, with dignity. Privacy and confidentiality were enhanced. Recognition of what violations of rights are and the need to report and address them through strong accountability systems grew. Many lessons were shared across the two countries, including the need for rights literacy; attention to health systems issues; strong and supportive supervision; and the importance of working at multiple levels. Additionally, some unique lessons emanated from each country experience. CONCLUSION: The assessed feasibility and benefits of using VRBFP programming and outcome measures in both countries bode well for adoption of this approach in other geographies.

Spectrum of high risk human papillomavirus types in women in Kaduna State, Nigeria.

Context: Infection with oncogenic or high-risk human papillomavirus (hrHPV) types acts as carcinogens in the development of cervical cancer. Aim: The aim of the study was to detect the genotypes of some hrHPVs among women attending selected hospitals in Kaduna State, Nigeria. Settings and Design: Hospital-based and cross-sectional that involved the use of structured questionnaires to obtain sociodemographic and clinical data. Materials and Methods: Two hundred and seventy-six cervical scraping samples were screened for both HPV and squamous intraepithelial lesion (SIL) using enzyme-linked immunosorbent assay and conventional Pap smear, respectively. Samples positive for HPV antigen and SIL were subjected to polymerase chain reaction (PCR) to detect the viral type. Statistical Analysis Used: Data were analyzed using the frequency procedure of Statistical Analysis System version 9.2, at 0.05 level of significance and 95% confidence interval. Results: Of the 276 cervical scraping samples, only 24 (8.7%) were positive for HPV antigen, whereas 17 (6.2%) were positive for SIL. When thirty of these positive samples were subjected to PCR, the DNA of hrHPV was detected in 20 (66.6%) of the positive samples. The HPV types detected in the study were 16 (36.7%), 18 (40.0%), 31 (16.7%), and 45 (3.3%). Conclusion: The findings from this study have shown that there is a high possibility of detecting the DNA of hrHPV in women that are infected with HPV and those that have cervical dysplasia, which points out the possibility of these women developing cervical cancer.

Micro-planning for immunization in Kaduna State, Nigeria: Lessons learnt, 2017.

BACKGROUND: The OPV 3 coverage for Kaduna State, 12-23 months old children was 34.4%. The low OPV 3 coverage, due mainly to weak demand for routine antigens and the need to rapidly boost population immunity against the disabling Wild Polio Virus (WPV), led the Global Polio Eradication Initiatives (GPEI) to increase supplemental OPV campaigns in Kaduna State, despite the huge cost and great burden on personnel. The OPV campaigns, especially in high risk (low vaccine uptake, <80% OPV 3 coverage and high vaccines refusal rate) states of northern Nigeria with poliovirus transmission has resulted in overestimated denominators or target population, as the highest ever vaccinated is used to set OPV campaign targets. METHODS: We utilized a cross-sectional study that assessed the impacts and possible solutions to the challenges of overestimated denominators in immunization services planning, delivery and performance evaluation in Kaduna State, Nigeria. We used both descriptive and quantitative approaches. We enumerated households and obtained the target populations for routine immunization (<1 year), polio campaign (<5 years) and acute flaccid paralysis surveillance (<15 years). RESULTS: We found a significant difference in mean scores between the micro-planning and supplemental vaccination data on a number of <5 years (M = 102967, SD = 62405, micro-planning compared to M = 157716, SD = 72212, supplemental vaccination, p < 0.05). We also found a significant difference in mean scores between the micro-planning and projected census data on a number of <1 year (M = 26128, SD = 16828, micro-planning compared to M = 14154, SD = 4894, census, p < 0.05). CONCLUSION: Periodic household-based micro-planning, aided with the use of technology for validation remains a useful tool in addressing gaps in immunization planning, delivery and performance evaluation in developing countries, such as Nigeria with overestimated denominators.

Utilising the 'Getting to Outcomes®' Framework in Community Engagement for Development and Implementation of Sickle Cell Disease Newborn Screening in Kaduna State, Nigeria.

BACKGROUND: Sickle Cell Disease (SCD) has been designated by WHO as a public health problem in sub-Saharan Africa, and the development of newborn screening (NBS) is crucial to the reduction of high SCD morbidity and mortality. Strategies from the field of implementation science can be useful for supporting the translation of NBS evidence from high income countries to the unique cultural context of sub-Saharan Africa. One such strategy is community engagement at all levels of the healthcare system, and a widely-used implementation science framework, "Getting to Outcomes®" (GTO), which incorporates continuous multilevel evaluation by stakeholders about the quality of the implementation. OBJECTIVES: (1) to obtain critical information on potential barriers to NBS in the disparate ethnic groups and settings (rural and urban) in the healthcare system of Kaduna State in Nigeria; and, (2) to assist in the readiness assessment of Kaduna in the implementation of a sustainable NBS programme for SCD. METHODS: Needs assessment was conducted with stakeholder focus groups for two days in Kaduna state, Nigeria, in November 2017. RESULTS: The two-day focus group workshop had a total of 52 participants. Asking and answering the 10 GTO accountability questions provided a structured format to understand strengths and weaknesses in implementation. For example, we found a major communication gap between policy-makers and user groups. CONCLUSION: In a two-day community engagement workshop, stakeholders worked successfully together to address SCD issues, to engage with each other, to share knowledge, and to prepare to build NBS for SCD in the existing healthcare system.

Enhancing transit polio vaccination in collaboration with targeted stakeholders in Kaduna State, Nigeria: Lessons learnt: 2014-2015.

INTRODUCTION: In Kaduna State of Nigeria, the high influx of people from neighboring states with eligible children for polio vaccination represents a significant proportion of the target population. Many of these children are often missed by the vaccination team. The purpose of the study was to determine the contribution of targeted stakeholders in transit polio vaccination. METHODS: We used the trends of vaccinated children at transit points, motor parks and markets, well as total children vaccinated by transit teams in Chikun, Igabi and Sabon Gari Local Government Areas (LGAs) of Kaduna State, Nigeria, four rounds before and after the introduction of transit polio vaccination with targeted stakeholders in Kaduna State. RESULTS: A total of 87,502 under-5 children were vaccinated by the various transit teams in the three LGAs, which accounted for 3.2% of the total 2,781,162 children vaccinated by the three LGAs. For transit point vaccination, the number of vaccinated children increased from 1026 to 19,289 (302%), while motor park vaccination increased from 1289 to 4106 (318%) and market vaccination increased from 10,488 to 14,511 (138%), four rounds after the introduction of transit polio vaccination with targeted stakeholders. CONCLUSION: Engagement of targeted stakeholders significantly enhanced transit polio vaccination in Kaduna State, Nigeria.