Student's Journal of Health Research Africa
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KNOWLEDGE AND PERCEPTION OF MALNUTRITION AND ITS EFFECT ON UNDER-FIVE CHILDREN AMONG MOTHERS ATTENDING PRIMARY HEALTH CENTERS IN SAGAMU LOCAL GOVERNMENT AREA, OGUN STATE: A CROSS-SECTIONAL STUDY
Get PDFBackground
Childhood malnutrition remains a global challenge and the most prevalent nutritional problem in developing countries, including Nigeria. This study assessed the knowledge and perception of malnutrition and its effect on under-five children among mothers attending primary health centers in the Sagamu Local Government Area of Ogun State, Nigeria.
Method
The study adopted a cross-sectional quantitative design and used a multi-stage sampling technique to select sixty-one mothers from the three selected primary health centers in Sagamu LGA. A researcher-developed questionnaire was used for the collection of data from participants. Data was collected, coded, and analyzed using Statistical Package for the Social Sciences (SPSS) 23. Descriptive and inferential statistics were used to present the findings from the study, and all were tested at the level of 0.05 significance
Results
The result shows that the majority of the mothers were between the ages of 18 and 28 years (44.9%), attained tertiary education (73.5%), were from Yoruba land (65.3%), were Christian (75.5%), and most had one to three children (80.6%). Mothers had high knowledge of malnutrition 138(91.8%), and high knowledge of the effects of malnutrition 144 (95.8%). The result also revealed a significant relationship between respondent's knowledge of malnutrition and the effects of malnutrition (p= 0.001), level of education and knowledge of malnutrition (p= 0.000), and between the knowledge of malnutrition and perception of malnutrition in under-five children (p= 0.006)
Conclusion
The study concludes that the Majority of the mothers demonstrated high knowledge of malnutrition and good knowledge of its effects, and it established a positive relationship between knowledge and perception of malnutrition in children under five.
Recommendation
Therefore, the study recommended that training programs should be done periodically for mothers to ensure they are abreast with the proper knowledge and ways to prevent malnutrition in their under-five children
Patient satisfaction with Tuberculosis treatment services at Kawaala Health Centre III, Kampala, Uganda, January-June 2017: A cross-sectional study.
Get PDFIntroduction
Supervised treatment of TB in an urban setting (Urban Directly Observed Therapy) is part of a support package that is sensitive and supportive of patients’ needs. Patient satisfaction with DOT is one of the measures to support patient adherence and treatment completion, thus its importance to treatment outcomes. Assessing patient satisfaction with urban DOT and applicability of the service quality tool (SERVQUAL) hasn’t been done, and so, there is insufficient knowledge for implementers of the strategy. We determined the level of patient satisfaction and applicability of the tool at Kawaala Health Centre III, Rubaga division, Kampala, Uganda.
Methods
We conducted a cross-sectional study in June 2017 and collected quantitative data using the SERVQUAL tool. We used factor analysis and reliability testing to determine the tool’s applicability among TB patients and mean score analysis to determine the level of patient satisfaction. Patients aged ≥18 years with confirmed smear-positive pulmonary tuberculosis (PTB) and on treatment under Urban DOT at Kawaala Health center III were included in the study.
Results
We found the SERVQUAL tool to have Cronbach's alpha coefficients of 0.83 for expectations and 0.76 for perceptions. A quality gap of -0.46 was also found.
Conclusion
The tool applies to TB patients in a Ugandan urban setting. Forty-six percent of patients were dissatisfied with tuberculosis treatment services. We recommend improvement in the dimensions of urban DOT components, reliability, and responsiveness.
Recommendation
Effective diagnostics, such as a functional genexpert machine, should be explored to improve service delivery
Vitamin B12 deficiency presenting with syringomyelia. Case report.
Get PDFBackground:
Syringomyelia is characterized by the formation of a cyst or cavity (syrinx) within the spinal cord. It is typically associated with Chiari malformation, trauma, or other spinal cord abnormalities. Vitamin B12 deficiency can lead to various neurological and haematological manifestations, including myelopathy, neuropathy, cognitive impairment, and macrocytic anemia. This case highlights a rare or underreported association between vitamin B12 deficiency and syringomyelia.
Case presentation:
A 22-year-old young male, a vegetarian, presented with progressive gait disturbances for the last 4 months. He also had a history of imbalance on standing with closed eyes, with increased gait difficulty in the dark. There was also a history of numbness and paraesthesia of both upper and lower limbs. The neurological examination showed spasticity of both lower limbs, hyperreflexia, and gait ataxia with normal bulk and power, and increased deep tendon reflexes and absent bilateral ankle jerks. The plantar were flexors on both sides. Romberg’s test was positive. Blood investigation revealed pancytopenia (haemoglobin-4.6, total leucocyte count- 3900, Platelet count-62,000) with raised MCV- 118 fL. Serum vitamin B12 was found to be low (78 pg/ml) with elevated homocysteine levels (27 umol/l). MRI revealed prominence of the central canal in the cervical spinal cord at the C2-C3 vertebral level. The nerve conduction study showed inexcitable bilateral sural nerves. He was treated with intramuscular vitamin B12 injections. He was given 1000 μg of methylcobalamin initially daily for a week and then weekly for a month, and once-monthly injections for 6 months. After 9 months, he significantly recovered to his near-normal physical capacity with a normal gait. There was also almost complete regression of the syrinx cavity.
Conclusion:
Syrinx formation secondary to B12 deficiency is rarely reported in the literature. This case highlights the importance of treating the underlying vitamin B12 deficiency before planning for any interventional procedure
A scoping review of family caregivers' experiences in caring for patients with kidney failure undergoing haemodialysis: evidence from Sub-Saharan Africa.
Get PDFBackgroundKidney failure (KF) poses a significant burden and role changes on family caregivers who provide essential support to patients undergoing haemodialysis.
ObjectiveThis scoping review synthesises available evidence on the caring experiences, challenges, and support needs of family caregivers of patients with kidney failure receiving haemodialysis treatment in Sub-Saharan Africa.
Charting MethodsTwo reviewers independently selected articles based on the agreed search strategy and inclusion criteria. Following the selection process, both reviewers independently extracted data from the included studies to ensure accuracy and reliability of the findings.
Eligibility CriteriaThe review included qualitative primary studies written in English that focused on family caregivers of patients with kidney failure receiving haemodialysis in Sub-Saharan Africa.
Sources of EvidenceLiterature was searched across three relevant databases: PubMed, Medline, and ScienceDirect. The search strategy was designed to capture studies examining the experiences of family caregivers in the Sub-Saharan African context.
ResultsThe final review included two qualitative studies conducted in Rwanda and Tanzania between 2021 and 2025. Analysis of these studies revealed four major themes: healthcare provider-family caregiver interactions, challenges within the healthcare system and accessibility of dialysis treatment, the multidimensional impact of long-term caregiving, and coping mechanisms and adaptation strategies.
ConclusionsFamily caregivers experience significant physical, emotional, social, and financial burdens while caring for kidney failure patients. Healthcare systems in Sub-Saharan Africa need to develop comprehensive support frameworks that address the needs of caregivers and improve patient outcomes.
RecommendationsHealthcare providers should prioritise the implementation of family-centred care training programs and establish structured communication protocols with caregivers
Are serum thyroid hormone, parathormone, calcium, and vitamin D levels associated with lumbar spine degeneration? A cross-sectional observational clinical study.
Get PDFBackground
Lumbar spine degeneration (LSD) is a major contributor to chronic low back pain, particularly among older adults, leading to reduced quality of life and functional impairment. While mechanical stress and aging are established contributors, the role of systemic metabolic and hormonal factors remains inadequately explored. This study evaluated the association of serum vitamin D, calcium, parathormone (PTH), and thyroid hormones with lumbar spine degeneration.
Methods
This cross-sectional observational study was conducted at Dharanidhar Medical College and Hospital, Keonjhar. A total of 100 participants aged ≥50 years were enrolled, comprising 50 patients with clinically and radiographically confirmed lumbar spine degeneration and 50 age- and sex-matched controls without spinal degeneration. The study population included 55 males and 45 females, with the majority belonging to the 60–69-year age group. Serum levels of 25-hydroxyvitamin D, total calcium, intact PTH, thyroid-stimulating hormone (TSH), and free thyroxine (free T4) were measured. Statistical analysis was performed using appropriate parametric and non-parametric tests, with p < 0.05 considered significant.
Results
Patients with lumbar spine degeneration demonstrated significantly lower mean serum vitamin D (18.5 ± 4.2 ng/mL) and calcium levels (8.2 ± 0.6 mg/dL) compared to controls (32.1 ± 3.5 ng/mL and 9.1 ± 0.5 mg/dL, respectively; p < 0.001). Serum PTH levels were significantly higher in the LSD group (75 ± 12 pg/mL) than in controls (40 ± 8 pg/mL; p < 0.001). No statistically significant differences were observed in TSH or free T4 levels between the two groups.
Conclusion
Vitamin D deficiency, hypocalcemia, and secondary hyperparathyroidism are significantly associated with lumbar spine degeneration, whereas thyroid hormone levels are not.
Recommendations
Early correction of these metabolic abnormalities may help improve spinal health and potentially slow degenerative progression. Further longitudinal and interventional studies are warranted to establish causality and therapeutic benefit
Correlation of Tonsillar Size with Severity of Obstructive Sleep Apnea (OSA) in Adult Patients
Get PDFBackground:Obstructive sleep apnea (OSA) is a common disorder marked by recurrent upper airway obstruction during sleep. To evaluate the distribution of tonsillar size in adult patients with OSA and analyze its correlation with disease severity as measured by the apnea–hypopnea index (AHI).
Methods:
This prospective observational study was conducted on 50 adult patients diagnosed with OSA. Tonsillar size was graded using the Brodsky classification (Grade I–IV). Severity of OSA was determined according to AHI values obtained from overnight polysomnography: mild (5–14), moderate (15–29), and severe (≥30). Correlations between tonsillar grade and OSA severity were assessed, and mean AHI scores were compared across tonsillar grades. Statistical significance was set at p < 0.05.
Results:
The tonsillar size distribution showed that Grade II (28%) and Grade III (32%) hypertrophy were the most frequent, while Grades I and IV were observed in 20% each (Table 1). Among patients, 15 (30%) had mild OSA, 18 (36%) moderate OSA, and 17 (34%) severe OSA (Table 2). Significant correlations were found between tonsillar grade and OSA severity: Grade I was predominantly associated with mild OSA, while Grade IV was strongly correlated with severe OSA (p = 0.001) (Table 3). Mean AHI increased progressively with higher tonsillar grades: 9.5 ± 2.1 (Grade I), 16.8 ± 3.2 (Grade II), 27.5 ± 4.6 (Grade III), and 35.2 ± 6.1 (Grade IV) (Table 4).
Conclusion:
Increasing tonsillar size is directly associated with greater OSA severity in adults. Tonsillar hypertrophy, particularly Grades III and IV, strongly predicts moderate to severe OSA. Integrating tonsillar assessment into clinical evaluation may enhance risk stratification and guide treatment decisions.
Recommendation:
Routine tonsillar grading should be incorporated into OSA evaluation to improve risk prediction and guide timely surgical or non-surgical interventions
Phenotypic and genotypic characterization of vancomycin-resistant enterococcus isolates from clinical specimens: A cross-sectional study.
Get PDFBackgroundEnterococci are Gram-positive bacteria that form part of the human gut flora but have emerged as significant nosocomial pathogens. The increasing prevalence of vancomycin-resistant enterococci (VRE) poses major therapeutic and infection-control challenges. This study aimed to determine the prevalence of vancomycin resistance among clinical Enterococcus isolates and to characterize the associated phenotypic and genotypic resistance profiles.
MethodologyA cross-sectional study was conducted in the Department of Microbiology, MKCG Medical College and Hospital, Berhampur, Odisha, from October 2017 to September 2019. One hundred non-duplicate Enterococcus isolates recovered from urine, blood, pus/wound swabs, and sterile body fluids were identified based on standard biochemical tests. Antimicrobial susceptibility was performed using the Kirby–Bauer disc diffusion method as per CLSI 2019 guidelines. Vancomycin resistance was screened on VRE agar and confirmed by MIC via E-test. Genotypic detection of vanA and vanB resistance genes was performed using multiplex real-time PCR. Basic demographic variables, including age and sex, were recorded.
ResultsOf the 100 isolates, 64% were E. faecalis, 31% were E. faecium, and 5% were E. durans. The mean age of affected patients was 38.6 years, with a female predominance (56%). The prevalence of VRE was 23%, with E. faecium accounting for most resistant isolates (69.6%). VRE isolates demonstrated high resistance to ampicillin (100%), ciprofloxacin (95.7%), high-level gentamicin (82.6%), and teicoplanin (78.3%), while all isolates remained susceptible to linezolid. All VRE isolates carried the vanA gene; vanB was not detected. Heteroresistance was identified in five isolates.
ConclusionvanA-mediated VRE is prevalent in hospital settings and associated with multidrug resistance.
Recommendation
Routine surveillance, molecular detection, and strengthened antimicrobial stewardship are essential to limit VRE dissemination
Diagnostic utility of pleural fluid/serum bilirubin ratio versus light’s criteria in differentiating exudative and transudative pleural effusions. A cross-sectional observational study.
Get PDFBackgroundDifferentiation between exudative and transudative pleural effusions is fundamental for guiding clinical management. Light’s criteria remain the standard, though reports suggest misclassification in certain cases, necessitating exploration of alternative biochemical markers.
ObjectivesTo evaluate the efficacy of the pleural fluid/serum bilirubin ratio in differentiating exudative from transudative pleural effusions in comparison with Light’s criteria.
MethodsA cross-sectional observational study was conducted on 60 patients with pleural effusion at a tertiary care center from January 2021 to June 2022. Patients underwent detailed clinical evaluation, radiological assessment, and biochemical analysis of pleural fluid and serum for protein, lactate dehydrogenase (LDH), and bilirubin. Ratios of pleural fluid to serum concentrations were calculated. Exudates and transudates were classified using clinical criteria, and diagnostic performance of Light’s criteria and bilirubin ratio was compared.
ResultsOf the 60 patients, 33 (55%) had exudative and 27 (45%) transudative effusions. Exudates were more common in males (57.5%) and in the age group 31–50 years, whereas transudates predominated among females and those aged 51–70 years. Tuberculosis (48.5%) and malignancy (36.4%) were the leading causes of exudates, while congestive cardiac failure (44.5%) and chronic liver disease (37%) were the main transudative etiologies. The mean pleural fluid/serum bilirubin ratio (0.74 vs. 0.32, p < 0.001) significantly differentiated exudates from transudates. Diagnostic accuracy was highest for the bilirubin ratio (96.67%) compared to Light’s criteria (95%), with superior specificity in identifying transudates.
ConclusionThe pleural fluid/serum bilirubin ratio is a simple, cost-effective, and reliable parameter, with diagnostic accuracy comparable to Light’s criteria.
RecommendationsThe bilirubin ratio can be used as an adjunct or alternative to Light’s criteria, especially in resource-limited settings, to minimize misclassification. Larger multicentric studies are recommended to validate its clinical utility and establish standardized cut-off values
Effect of telmisartan on metabolic syndrome components and cardiovascular protection: A prospective observational study.
Get PDFBackground
Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors including central obesity, hypertension, dyslipidaemia, and insulin resistance, which substantially increase the risk of diabetes mellitus and cardiovascular disease. .To evaluate the effect of telmisartan on the components of metabolic syndrome and its role in cardiovascular protection.
Methods
This prospective observational study included 100 patients with MetS, treated with telmisartan (40–80 mg daily) for 24 weeks. Blood pressure, fasting glucose, fasting insulin, HOMA-IR, lipid profile, waist circumference, and BMI were measured at baseline, 12 weeks, and 24 weeks. Cardiovascular protection was assessed by pulse wave velocity (PWV) and flow-mediated dilation (FMD). Data were analysed using paired t-tests, with p<0.05 considered significant.
Results
Telmisartan significantly reduced systolic (152.8 ± 12.6 to 132.6 ± 8.7 mmHg; p<0.001) and diastolic blood pressure (94.6 ± 8.1 to 82.3 ± 6.1 mmHg; p<0.001). Fasting glucose (118.6 ± 16.4 to 104.8 ± 12.7 mg/dL; p<0.01), fasting insulin (16.2 ± 4.8 to 11.7 ± 3.9 µU/mL; p<0.01), and HOMA-IR (4.8 ± 1.5 to 3.1 ± 1.1; p<0.01) improved significantly. Lipid profile showed reduced triglycerides and LDL-C, and increased HDL-C. Waist circumference and BMI decreased modestly (p<0.05). Cardiovascular protection markers improved, with reduced PWV (10.2 ± 1.8 to 8.7 ± 1.5 m/s; p<0.01) and increased FMD (6.4 ± 1.3% to 9.1 ± 1.6%; p<0.01). Telmisartan was well tolerated with only mild, transient adverse events.
Conclusion
Telmisartan effectively improves multiple components of metabolic syndrome while enhancing vascular function, thereby offering both metabolic and cardiovascular protection. Its dual ARB and PPAR-γ activity make it a valuable therapeutic option in high-risk MetS patients.
Recommendations
Telmisartan should be preferred in metabolic syndrome for simultaneous blood pressure control, improved insulin sensitivity, and enhanced cardiovascular protection
Prevalence and associated factors of obstructed labor among mothers delivered at a tertiary care hospital in Uganda: A descriptive retrospective cross-sectional study.
Get PDFBackground:
Obstructed labor (OL) is a major contributor to the high maternal and neonatal morbidity and mortality rates, especially in low and middle-income countries (LMICs) where structural barriers to accessing quality obstetric services are commonplace. This study aimed to document the magnitude of obstructed labor and its associated factors at a public regional referral hospital in Uganda.
Methods:
A descriptive retrospective cross-sectional study was conducted at Kayunga Regional Referral Hospital in Uganda that involved a review of 2,176 hospital records of mothers who delivered from 1st January to 31st December 2023. A pretested data extraction tool was used for data collection from the patient charts. A Multivariate Modified Poisson Regression model was employed to identify determinants of obstructed labor.
Results:
This study's prevalence of obstructed labor was 18.57% (405 out of 2176). Women referred from lower health facilities were likelier to experience OL, with a prevalence ratio of 1.83 (95% 1.43-2.34, p-value <0.001). Primipara mothers were 3 times more likely to encounter obstructed labor when compared to multigravidas (95% 1.94-6.35, p-value <0.001). Women of >42 weeks of gestation were 7 times more likely to encounter obstructed labor compared to those with 37-42 weeks (95% CI: 5.69-10.89, <0.001). The likelihood of encountering obstructed labor among mothers where a partograph was not used during labor was 3.55 times higher (95% CI: 2.68-4.70, p-value = <0.001) compared to those where a partograph was completed.
Conclusion:
The prevalence of obstructed labor is still high in LMICs. Referral from a lower health facility, parity, and partograph utilization were significantly associated with obstructed labor.
Recommendation:
Therefore, improving partograph use, training and equipping healthcare workers to diagnose OL, as well as early and timely interventions to prevent complications of OL, are recommended.