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A review of the current diphtheria outbreaks
No full textCorynebacterium diphtheriae is responsible for both endemic and epidemic diphtheria. The predisposing factor for this disease is the failure to immunize during childhood. Humans are the only hosts of the organism and is present in the upper respiratory tract. The organism is transmitted via airborne route and can cause respiratory obstruction and heart failure because of the exotoxin it produces. There is presently a resurgence of diphtheria outbreaks in Nigeria. The Nigeria Center for Disease Control (NCDC) was notified of suspected diphtheria outbreaks in Lagos and Kano States, Nigeria, in December 2022 and has been issuing monthly reports since that time. This review of the diphtheria outbreaks following online database searches on PubMed and Google Scholar as well as the NCDC/WHO websites and grey literatures, describes the current trend of the outbreaks globally, elucidated the different strains of Corynebacterium responsible for the outbreaks, identified the recent vaccine formulation developed to tackle the outbreaks, and provide information on vaccine delivery and efficacy studies in the country and globally.
French title: Un examen des épidémies actuelles de diphtérie
Corynebacterium diphtheriae est responsable à la fois de la diphtérie endémique et épidémique. Le facteur prédisposant à cette maladie est l'absence de vaccination pendant l'enfance. Les humains sont les seuls hôtes de l'organisme et sont présents dans les voies respiratoires supérieures. L'organisme est transmis par voie aérienne et peut provoquer une obstruction respiratoire et une insuffisance cardiaque en raison de l'exotoxine qu'il produit. Il y a actuellement une recrudescence des épidémies de diphtérie au Nigeria. Le Centre Nigérian de Contrôle des Maladies (NCDC) a été informé des épidémies présumées de diphtérie dans les États de Lagos et de Kano, au Nigéria, en décembre 2022 et publie depuis lors des rapports mensuels. Cet examen des épidémies de diphtérie à la suite de recherches dans les bases de données en ligne sur PubMed et Google Scholar ainsi que sur les sites Web et les littératures grises du NCDC/OMS, décrit la tendance actuelle des épidémies dans le monde, a élucidé les différentes souches de Corynebacterium responsables des épidémies, identifié les récentes la formulation de vaccins développée pour lutter contre les épidémies et fournir des informations sur l'administration des vaccins et les études d'efficacité dans le pays et dans le monde. 
Determinants of COVID-19 vaccine acceptance amongst doctors practising in Cross River State, Nigeria
No full textBackground: COVID-19 vaccine is one of the most effective public health intervention approaches for prevention of COVID-19. Despite its well-known efficacy and safety, significant proportion of frontline COVID-19 healthcare workers remain hesitant about accepting the vaccine for whatever reasons. This study aimed to determine acceptance rate and determinants of vaccine refusal among doctors in Cross River State, Nigeria.
Methodology: This was a cross-sectional survey of doctors using structured online questionnaire administered via the WhatsApp platform of the medical doctors’ association, in order to assess their rate of acceptance of COVID-19 vaccines, and reasons for vaccine refusal. The predictors of vaccine acceptance were analysed by univariate and multivariate logistic regression analyses.
Results: Of the 443 medical doctors targeted on the WhatsApp platform, 164 responded to the questionnaire survey, giving a response rate of 37.0% (164/443). The mean age of the respondents is 38 ±6.28 years, 91 (55.5%) are 38 years old and above, 97 (59.1%) are males and 67 (40.9%) are females, giving a male-to-female ratio of 1.4:1. The greater proportion of the respondents are physicians (70/148, 47.3%) and about three-quarter of the participants (127/164, 77.4%) had received COVID-19 vaccine. The proportion of physicians who had received COVID-19 vaccine (57/70, 81.4%) was more than the proportion of general practitioners (31/42, 73.8%) and surgeons (24/35, 68.6%). Low perceived benefit of vaccination was the main reason given for COVID-19 vaccine refusal (45.9%, 17/37). No significant association was found between vaccine refusal and suspected predictors (p>0.05).
Conclusion: Our study revealed high rate of COVID-19 vaccine acceptance among medical doctors especially among the physicians, with the surgeons showing lowest acceptance rate. A significant proportion would not take vaccine because they perceived it lacks much benefits. To raise vaccine acceptance among doctors, more efforts on vaccine literacy that would target doctors from all sub-specialties especially surgeons and incorporate vaccine benefits should be made
Factors influencing contraceptive use among women of reproductive age in plantation farming communities in South-South Nigeria
No full textThe use of contraceptives by women of reproductive age remains one of the cost-effective ways of reducing maternal, infant, and child mortality and achieving a decline in the high fertility rate in the country. This was a descriptive cross-sectional study aimed to assess the association between the location of residence, occupation, and education level and the current use of contraceptives among women of reproductive age resident in plantation farming communities in South-south Nigeria. The test of associations between the dependent and independent variables and covariates was conducted using the Likelihood ratio Chi-square as appropriate. Multiple logistic regressions using the best-fit option of covariate selection were done with the use of contraceptives as the dependent variable. Of the 609 participants recruited, 189 (31.03%) were currently using a contraceptive. Women with secondary education were less likely to use contraceptives compared to the none educated [AOR=0.07; CL: 0.013-0.39]. Location and age were also significant predictors of the use of contraceptives by women in plantation farming communities in Nigeria. Deliberate and purposeful targeting of women and girls of reproductive age in plantation farming communities should be prioritized in the universal access to contraceptive use.
L'utilisation de contraceptifs par les femmes en âge de procréer reste l'un des moyens rentables de réduire la mortalité maternelle, infantile et juvénile et de parvenir à une baisse du taux de fécondité élevé dans le pays. Il s'agissait d'une étude transversale descriptive visant à évaluer l'association entre le lieu de résidence, la profession et le niveau d'éducation et l'utilisation actuelle de contraceptifs chez les femmes en âge de procréer résidant dans les communautés agricoles des plantations du sud-sud du Nigeria. Le test des associations entre les variables dépendantes et indépendantes et les covariables a été effectué en utilisant le rapport de vraisemblance Chi-carré, le cas échéant. Des régressions logistiques multiples utilisant l'option la plus adaptée de la sélection des covariables ont été effectuées avec l'utilisation de contraceptifs comme variable dépendante. Sur les 609 participants recrutés, 189 (31,03%) utilisaient actuellement un contraceptif. Les femmes ayant fait des études secondaires étaient moins susceptibles d'utiliser des contraceptifs que les femmes sans instruction [AOR = 0,07 ; CL : 0,013-0,39]. Le lieu et l'âge étaient également des prédicteurs significatifs de l'utilisation de contraceptifs par les femmes dans les communautés agricoles des plantations au Nigeria. Le ciblage délibéré et délibéré des femmes et des filles en âge de procréer dans les communautés agricoles des plantations devrait être une priorité dans l'accès universel à l'utilisation des contraceptifs. 
The Influence of Parallel Reporting Systems on Data Quality and Information Use in Northwest Ethiopia: A Qualitative Study
No full textBackground: Ethiopia utilises the district health information system for health information management. However, the lower level health structure seems inaccurate in comparison to the parallel reporting system, with limited evidence on its effect on data quality and information use. Therefore, the present study aimed to assess the influence of a parallel reporting system on data quality and information use at the lower level structures of the Amhara region, Northwest Ethiopia.Methods: The study was conducted in five districts of the Amhara region using an explanatory case study design. Twenty respondents were interviewed from the 1st – 30th April 2021, using a semi-structured key informant interview (KII) guide with multiple probes to explore relevant information. The data was transcribed into English and transferred to the Open-Code 4.02 software for analysis. Textual data were coded, and themes were identified from the synthesis. Inductive thematic analysis was applied to identify the relationships among the emerging themes in order to draw a relevant conclusion.Results: Five themes were emerged from the analysis, including the current practice of parallel reporting, a program area of parallel reporting, the influence of parallel reporting, reasons for parallel reporting, and means to avoid parallel reporting. Likewise, parallel reporting was done at the district level and at the point of service delivery. The respondents described maternal and child health programs often using parallel reporting. Parallel reporting was described as having undesirable impacts on routinely collected health data quality and use. Moreover, it increases the work burden; and affects service quality, the the satisfaction levels of clients and staff, and the overall efficiency. The main reasons for practicing parallel reporting were: missing important data elements in DHIS2, single language, varying stakeholders’ interests, and lack of conducting a partner forum.Conclusion and implication: Against the national health information system’s guiding principles and vision, parallel reporting is practiced at the lower health system levels for various programs. Therefore, a corrective measure should be taken to achieve the country’s information revolution (IR) agenda. To avoid parallel reporting mechanisms, it is recommended that regular partner forums at the district level must be strengthened, important data elements should be incorporated into the DHIS 2, and additional language platforms should be be included in the DHIS2 system
The profile of Black South African men diagnosed with prostate cancer in the Free State, South Africa
No full textBackground: Prostate cancer (PCa) ranks high in terms of morbidity and mortality, especially in Africa. Prostate-specific antigen (PSA) screening remains a practical method of screening for and thereby detecting PCa early, especially among African men who are more negatively affected. Modifiable risk factors for PCa are mostly behavioural and lifestyle. Understanding communityspecific determinants is important when developing health promotion interventions.Objective: This study aimed to determine the profile of African men with PCa in the Free State, South Africa.Method: A cross-sectional descriptive study was conducted using case record information and self-administered questionnaires among 341 African men with PCa attending the oncology and urology clinics of a tertiary hospital.Result: Participants’ median age at diagnosis was 66 years. Only 76 (22.3%) participants had ever heard of PCa prior to being diagnosed with the disease, 36 (47.4%) of whom had ever had screening performed. The majority (n = 298, 87.4%) were symptomatic; < 50% sought medical help within six months. At diagnosis, 133 (39.0%) men presented with stage T3 or T4 disease, 75 (22.0%) with metastatic disease and 84 (24.6%) with Gleason score ≥ 8. Factors associated with advanced and high-grade disease included smoking, decreased sunlight exposure and physical activity, relatively increased ingestion of dairy products and red meat. Factors associated with early stage and low-grade disease included relatively increased ingestion of fruits, vegetables and fish.Conclusion: Advanced and high-grade PCa disease is not uncommon among men ≥ 60 years in this study setting. Certain modifiable risk factors associated with advanced disease were established in this study. The majority had lower urinary tract symptoms (LUTS) prior to PCa diagnosis, but they were of poor health-seeking behaviour. Although there seems not to be a systematic delay in the definitive diagnosis and initiation of treatment for PCa, there is a need to improve on health education and awareness in the study setting
Current norms and practices in using a seizure diary for managing epilepsy: A scoping review
No full textBackground: Epilepsy is a chronic and debilitating condition affecting people of all ages in many nations. Healthcare practitioners look for effective ways to track patients’ seizures, and a seizure diary is one of the methods used. This scoping review sought to identify current norms and practices for using seizure diaries to manage epilepsy.
Method: A scoping review was performed by screening relevant studies and identifying themes, categories and subcategories.
Results: A total of 1125 articles were identified from the database; 46 full-text articles were assessed for eligibility, of which 23 articles were selected. The majority (48%) of the studies were prospective studies. The majority (65%) of the articles were studies conducted in the United States. The themes identified were types of seizure diaries used in clinical practice, contents and structure of a standardised seizure diary, the use and efficacy of seizure diaries in medicine and challenges relating to using a seizure diary for patient management.
Conclusion: The study revealed that a seizure diary remains a relevant tool in managing epilepsy. The two forms of diaries in use are electronic and paper-based diaries. The high cost of data and the expensive devices required to access electronic diaries make it unsuitable in a resource-limited setting. Despite its disadvantages, imperfections and inadequacies, the paper-based diary is still relevant for managing patients with epilepsy in resource-limited settings.
Contribution: This study reviewed the literature to find the current norms and practices in using seizure diaries. The benefits of the different formats were emphasised. 
The outbreak of monkeypox: A clinical overview
No full textThe development of new zoonotic diseases such as coronavirus disease 2019 (COVID-19) and monkeypox that can cause epidemics and high mortality rates have significantly threatened global health security. However, the increasing number of people with no immunity to poxvirus because of the end of the smallpox vaccination programme has created a vulnerable population for the monkeypox outbreak. On 23 July 2022, it was announced that the World Health Organization’s director-general has determined that the multicountry outbreak of monkeypox constitutes a Public Health Emergency of International Concern. The monkeypox virus is an orthopoxvirus that causes a disease with symptoms similar to smallpox but less severe. Many unanswered questions remain regarding monkeypox’s pathogenesis, transmission and host reservoir. There is currently no evidence that transmission by individuals can sustain zoonotic infections during human-to-human transmissions; the continued emergence of these pathogens highlights the interconnectedness of animals and humans. The increasing number of monkeypox cases outside the endemic region has highlighted the need for effective global capacity building to prevent the spread of the disease and its impact on global health security. The priority now is to stop the spread of the disease and protect frontline healthcare workers and the most vulnerable individuals. This article aims to comprehensively analyse the various aspects of the transmission and epidemiology of monkeypox. It also explores possible diagnostic techniques, therapeutics and prevention strategies. A key recommendation is that primary care and public health professionals are expected to increase their efforts to be vigilant and contain any potential outbreaks. 
Gomisin A inhibits hypoxia/reoxygenation induced myocardial cell injury by modulating TLR4 NF κB pathway
No full textPurpose: To determine the impact of Gomisin A (GomA) on myocardial cell damage caused by hypoxia/reoxygenation (H/R). Methods: Various methods, including MTT, western blot and flow cytometry were used to to assess the viability of H9c2 cardiomyocytes and cell apoptosis. Expression levels of various enzymes and cytokines, including superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA). Western blot was used to evaluate the expression levels of inducible nitric oxide synthase (iNOS), cyclooxygenase 2 (COX-2) and Toll-like receptor 4 (TLR4), as well as the phosphorylation of p65 and nuclear factor kappa B (NF-κB) inhibitor alpha (IκBα). Results: Low concentrations of GomA had no toxic effect on H9c2 cells. In H/R-stressed H9c2 cells, GomA increased cell viability and reduced cell apoptosis, suggesting that GomA inhibited H/R-induced cell apoptosis. Additionally, GomA alleviated H/R-induced oxidative stress and inflammation by increasing the expression of SOD and CAT, while decreasing the expression of MDA, iNOS, COX-2, TNF-α, IL-1β, and IL-6. GomA also suppressed the H/R-induced TLR4–NF-κB pathway by reducing the expression of TLR4 and the phosphorylation of p65 and IκBα. Conclusion: These results indicate that GomA is a potential candidate for the treatment of myocardial ischemia/reperfusion (MI/R) injury by increasing cell viability, reducing cell apoptosis, alleviating oxidative stress, and reducing inflammation by inhibiting TLR4–NF-κB pathway
Haematological and Histological Assessment of Clarias gariepinus Juveniles Exposed to Crude Extract of Albizia Chevalier Sawdust
No full textThe toxicity of Albizia chevalier sawdust extract was investigated with emphasis on histopathological and haematological effects on African catfish (Clarias gariepinus) juveniles. A static bioassay was conducted to determine the LC50 of Albizia chevalier sawdust extract to Clarias gariepinus juveniles. The fish were exposed to 55, 63.1, 67.6, and 73.9mI/L of Albizia chevalier sawdust extract. The result of the acute toxicity showed that the extract was toxic to the fish with an LC50 value of 54.42mI/L. The pH, DO and temperature values of the water in the different concentrations differed significantly from the control (p ≤ 0.05). Furthermore, the haematological assessment revealed that values of the blood parameters (WBC, RBC, HGB, HCT, PCV, LYM, MxM, NEUT and PLT) of fish in the different concentrations were significantly different from the control (p<0.05). Histopathological examinations of the gills and liver of Clarias gariepinus juvenile exposed to Albizia chevalier sawdust extract in the control showed normal gill and liver architecture. However, there were varying degrees of degenerative changes in the gills and liver of fish in different concentrations of the Albizia chevalier sawdust extract. The results of the study revealed that crude extract Albizia chevalier is toxic to fish organs and causes histopathological changes in the gills and liver and cause stress to the fish. Therefore indiscriminate discharge of sawdust by sawmills into the environment should be discouraged particularly into water bodies
Physicochemical and Heavy Metals Analysis of Different Brands of Sachet Water Sold in Benin City, Nigeria
No full textWater of good quality is essential for environmental and public health. In Nigeria, majority of the population rely on sachet/packed water for drinking purpose. This study was carried out to assess physico-chemical characteristics and levels of Fe, Zn, Cu, Pb and Mn in ten brands of sachet water sold in Benin City, Nigeria using standard methods. The lowest and highest values of the physico-chemical parameters were: pH (5.20 - 7.00), EC (10 - 170)µS/cm, turbidity (0.00 - 10.00)NTU TDS (5.30 - 90.10)mg/l, hardness (6.00 - 30.00)mg/l, chloride (7.06 - 21.18)mg/l, alkalinity (4.00 – 16.00)mg/l, nitrate (0.64 - 1.22)mg/l and phosphate (0.01 - 1.15)mg/l. They were all within the WHO permissible limits for drinking water except pH and turbidity that revealed a slight increase in concentrations in two brands, which could be indicative of high level of suspended solids and the presence of cations in the groundwater and could pose serious health threat to consumers. Therefore, proper treatment of water in the water packaging facilities and improved sanitary practices of workers and facilities in general are recommended. UNI data from heavy metals (Fe, Zn, Cu, Pb and Mn) analysis showed no evidence of contamination as they were all within their respective permissible limits of drinking water. It is therefore concluded that the sachet water brands sold in the study area are of good physical and chemical quality