Showing papers by "University of Nigeria, Nsukka published in 2010"

Hypertension, diabetes and overweight: looming legacies of the Biafran famine.

Abstract: Background Sub-Saharan Africa is facing rapidly increasing prevalences of cardiovascular disease, obesity, diabetes and hypertension. Previous and ongoing undernutrition among pregnant women may contribute to this development as suggested by epidemiological studies from high income countries linking undernutrition in fetal life with increased burden of non-communicable diseases in later life. We undertook to study the risks for hypertension, glucose intolerance and overweight forty years after fetal exposure to famine afflicted Biafra during the Nigerian civil war (1967–1970). Methods and Findings Cohort study performed in June 27–July 31, 2009 in Enugu, Nigeria. Adults (n = 1,339) born before (1965–67), during (1968–January 1970), or after (1971–73) the years of famine were included. Blood pressure (BP), random plasma glucose (p-glucose) and anthropometrics, as well as prevalence of hypertension (BP>140/90 mmHg), impaired glucose tolerance (IGT; p-glucose 7.8–11.0 mmol/l), diabetes (DM; p-glucose ≥11.1 mmol/l), or overweight (BMI>25 kg/m2) were compared between the three groups. Fetal-infant exposure to famine was associated with elevated systolic (+7 mmHg; p<0.001) and diastolic (+5 mmHg; p<0.001) BP, increased p-glucose (+0.3 mmol/L; p<0.05) and waist circumference (+3cm, p<0.001), increased risk of systolic hypertension (adjusted OR 2.87; 95% CI 1.90–4.34), IGT (OR 1.65; 95% CI 1.02–2.69) and overweight (OR 1.41; 95% CI 1.03–1.93) as compared to people born after the famine. Limitations of this study include the lack of birth weight data and the inability to separate effects of fetal and infant famine. Conclusions Fetal and infant undernutrition is associated with significantly increased risk of hypertension and impaired glucose tolerance in 40-year-old Nigerians. Prevention of undernutrition during pregnancy and in infancy should therefore be given high priority in health, education, and economic agendas.

Towards universal Kangaroo Mother Care: recommendations and report from the First European conference and Seventh International Workshop on Kangaroo Mother Care.

Abstract: The hallmark of Kangaroo Mother Care (KMC) is the kangaroo position: the infant is cared for skin-to-skin vertically between the mother's breasts and below her clothes, 24 h/day, with father/substitute(s) participating as KMC providers. Intermittent KMC (for short periods once or a few times per day, for a variable number of days) is commonly employed in high-tech neonatal intensive care units. These two modalities should be regarded as a progressive adaptation of the mother-infant dyad, ideally towards continuous KMC, starting gradually and progressively with intermittent KMC. The other components in KMC are exclusive breastfeeding (ideally) and early discharge in kangaroo position with strict follow-up. Current evidence allows the following general statements about KMC in affluent and low-income settings: KMC enhances bonding and attachment; reduces maternal postpartum depression symptoms; enhances infant physiologic stability and reduces pain, increases parental sensitivity to infant cues; contributes to the establishment and longer duration of breastfeeding and has positive effects on infant development and infant/parent interaction. Therefore, intrapartum and postnatal care in all types of settings should adhere to a paradigm of nonseparation of infants and their mothers/families. Preterm/low-birth-weight infants should be regarded as extero-gestational foetuses needing skin-to-skin contact to promote maturation. Conclusion: Kangaroo Mother Care should begin as soon as possible after birth, be applied as continuous skin-to-skin contact to the extent that this is possible and appropriate and continue for as long as appropriate.

Willingness to pay for rapid diagnostic tests for the diagnosis and treatment of malaria in southeast Nigeria: ex post and ex ante

Abstract: Background: The introduction of rapid diagnostic tests (RDTs) has improved the diagnosis and treatment of malaria. However, any successful control of malaria will depend on socio-economic factors that influence its management in the community. Willingness to pay (WTP) is important because consumer responses to prices will influence utilization of services and revenues collected. Also the consumer’s attitude can influence monetary valuation with respect to different conditions ex post and ex ante. Methods: WTP for RDT for Malaria was assessed by the contingent valuation method using a bidding game approach in rural and urban communities in southeast Nigeria. The ex post WTP was assessed at the health centers on 618 patients immediately following diagnosis of malaria with RDT and the ex ante WTP was assessed by household interviews on 1020 householders with a prior history of malaria. Results: For the ex ante WTP, 51% of the respondents in urban and 24.7% in rural areas were willing to pay for RDT. The mean WTP (235.49 naira) in urban is higher than WTP (182.05 Naira) in rural areas. For the ex post WTP, 89 and 90.7% of the respondents in urban and rural areas respectively were WTP. The mean WTP (372.30 naira) in urban is also higher than (296.28 naira) in rural areas. For the ex post scenario, the lower two Social Economic Status (SES) quartiles were more willing to pay and the mean WTP is higher than the higher two SES while in the ex ante scenario, the higher two SES quartiles were more WTP and with a higher WTP than the lower two SES quartile. Ex ante and ex post WTP were directly dependent on costs. Conclusion: The ex post WTP is higher than the ex ante WTP and both are greater than the current cost of RDTs. Urban dwellers were more willing to pay than the rural dwellers. The mean WTP should be considered when designing suitable financial strategies for making RDTs available to communities.

Atherogenic index of plasma as useful predictor of cardiovascular risk among postmenopausal women in Enugu, Nigeria

Abstract: Background: Menopausal health in our environment has received little attention. As an independent risk factor for dyslipidaemia, the degree and pattern of derangement, though difficult to assess may adversely affect the cardiovascular health of our women. Objectives: To estimate the serum lipid profile and the atherogenic index of plasma in normal post menopausal women. Methods: This is a cross sectional study involving 80 apparently healthy women voluntarily recruited from staff of the University of Nigeria and the Teaching Hospital (UNTH) located in Enugu. They include 50 postmenopausal subjects aged between 50 and 70 years and 30 premenopausal controls aged between 25 and 49 years. Total cholesterol (TC), and the various subfractions ;high density lipoprotein cholesterol (HDL-C), very low density lipoprotein cholesterol (VLDL-C), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were determined. Atherogenic index of plasma (AIP); log (TG/HDL-C) was calculated. Results: There were statistically significant increases (P as the duration of menopause increased. Conclusion: Menopause, no doubt alters lipid profile. A triglyceride based index (AIP) can significantly add value when assessing the risk of developing atherosclerosis in Nigeria. Key Words: Lipid profile, atherogenic index of plasma (AIP), postmenopausal women, dyslipidaemia, atherosclerosis

A community-based study of hypertension and cardio-metabolic syndrome in semi-urban and rural communities in Nigeria

Abstract: Background: The prevalence of cardio-metabolic syndrome (CMS) is increasing worldwide. In people of African descent, there is higher prevalence of hypertension and complications than other races. Bearing in mind these facts, we looked at the CMS in the general population and the population with hypertension. Using the new International Diabetes Federation (IDF) definitions of CMS, we studied its prevalence in semi-urban and rural communities in South-east Nigeria in relation to hypertension. Method: This is a cross sectional population based study involving 1458 adults aged from 25 to 64 years. Diagnosis of CMS was based on the new IDF criteria using the anthropometric measurements for Europids as there is none yet for blacks. Hypertension was defined according to the WHO/ISH criteria. Results: The overall prevalence of CMS was 18.0% in the semi-urban community as against 10.0% in the rural community increasing to 34.7% and 24.7% respectively in the population with hypertension. The prevalence of co-morbidities - hyperglycaemia, abdominal obesity, and hypertriglceridaemia were 13.9%, 41.1% and 23.9% while in the hypertensive populations they were 21.2%, 55.0% and 31.3% in the general population in both communities combined. Except for low HDL cholesterol, every other co-morbidity was higher in hypertensive population than the general population. Conclusion: The high prevalence of CMS in the semi-urban population especially for the population with hypertension underscores the double burden of disease in developing countries. The lesson is while infections and infestations are being tackled in these countries the non-communicable diseases should not be neglected.

Willingness to pay for community-based health insurance in Nigeria: do economic status and place of residence matter?

Abstract: Objective We examine socio-economic status (SES) and geographic differences in willingness of respondents to pay for community-based health insurance (CBHI). Methods The study took place in Anambra and Enugu states, south-east Nigeria. It involved a rural, an urban and a semi-urban community in each of the two states. A pre-tested interviewer-administered questionnaire was used to collect information from a total of 3070 households selected by simple random sampling. Contingent valuation was used to elicit willingness to pay (WTP) using the bidding game format. Data were examined for correlation between SES and geographic locations with WTP. Log ordinary least squares (OLS) was used to examine the construct validity of elicited WTP. Results Generally, less than 40% of the respondents were willing to pay for CBHI membership for themselves or other household members. The proportions of people who were willing to pay were much lower in the rural communities, at less than 7%. The average that respondents were willing to pay as a monthly premium for themselves ranged from 250 Naira (US$1.7) in a rural community to 343 Naira (US$2.9) in an urban community. The higher the SES group, the higher the stated WTP amount. Similarly, the urbanites stated higher WTP compared with peri-urban and rural dwellers. Males and people with more education stated higher WTP values than females and those with less education. Log OLS also showed that previously paying out-of-pocket for health care was negatively related to WTP. Previously paying for health care using any health insurance mechanism was positively related to WTP. Conclusion Economic status and place of residence amongst other factors matter in peoples’ WTP for CBHI membership. Consumer awareness has to be created about the benefits of CBHI, especially in rural areas, and the amount to be paid has to be augmented with other means of financing (e.g. government and/or donor subsidies) to ensure success and sustainability of CBHI schemes.

Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria.

Abstract: Out-of-pocket spending (OOPS) is the major payment strategy for healthcare in Nigeria. Hence, the paper assessed the determinants socio-economic status (SES) of OOPS and strategies for coping with payments for healthcare in urban, semi-urban and rural areas of southeast Nigeria. This paper provides information that would be required to improve financial accessibility and equity in financing within the public health care system. The study areas were three rural and three urban areas from Ebonyi and Enugu states in South-east Nigeria. Cross-sectional survey using interviewer-administered questionnaires to randomly selected householders was the study tool. A socio-economic status (SES) index that was developed using principal components analysis was used to examine levels of inequity in OOPS and regression analysis was used to examine the determinants of use of OOPS. All the SES groups equally sought healthcare when they needed to. However, the poorest households were most likely to use low level and informal providers such as traditional healers, whilst the least poor households were more likely to use the services of higher level and formal providers such as health centres and hospitals. The better-off SES more than worse-off SES groups used OOPS to pay for healthcare. The use of own money was the commonest payment-coping mechanism in the three communities. The sales of movable household assets or land were not commonly used as payment-coping mechanisms. Decreasing SES was associated with increased sale of household assets to cope with payment for healthcare in one of the communities. Fee exemptions and subsidies were almost non-existent as coping mechanisms in this study There is the need to reduce OOPS and channel and improve equity in healthcare financing by designing and implementing payment strategies that will assure financial risk protection of the poor such pre-payment mechanisms with government paying for the poor.

Lead removal from wastewater using fluted pumpkin seed shell activated carbon: Adsorption modeling and kinetics

Abstract: Activated carbon produced from fluted pumpkin (Telfairia occidentalis) seed shell was utilized for the removal of lead (II) ion from simulated wastewater. Adsorption tests were carried out in series of batch adsorption experiments. Several kinetic models (Bhattacharya-Venkobacher, Elovich, pseudo first and second order, intra-particle and film diffusion) were tasted for conformity to the experimental data obtained. The Langmuir and Freundlich adsorption models were also used to test the data. The amount of lead (II) ion adsorbed at equilibrium from a 200 mg/L solute concentration was 14.286 mg/g. The experimental data conform very well to the pseudo-second order equation where equilibrium adsorption capacities increased with increasing initial lead (II) concentration. The rate of the adsorption process was controlled by the film (boundary layer) diffusion as the film diffusion co-efficient values obtained from data analysis were of the order of 10 6cm2/s. From the plots, the linear regression coefficient (R2) of the Langmuir model was higher than that of the Freundlich: the adsorption isotherm obeyed the Langmuir model better than the Freundlich model.

The impact of pre-menarcheal training on menstrual practices and hygiene of Nigerian school girls.

Abstract: Background: The menstrual practices of adolescents derive largely from health issues associated with their adjustment to reproductive life. The objective of the study was to assess the effect of pre-menarcheal training on the menstrual and hygiene practices of Nigerian school girls. Methods: A cross-sectional questionnaire-based survey of randomly selected post-menarcheal school girls using a pre-tested, semi-structured questionnaire was done. Results: The mean age of the school girls was 14.9 ± 1.7 years. Pre-menarcheal training was given to 273 (55.2%) of them. Mothers (74.7%) were the more common source of information. Inappropriate experience of menarche, adverse effect of menstruation on schooling and social life and the use of unhygienic menstrual absorbents were common in girls who had no pre-menarcheal training than those who did. Conclusion: Lack of timely information results in inappropriate menstrual experiences and poor menstrual hygiene practices. Ways to promote menstrual education and hygiene practices are suggested.

Low HDL-cholesterol with normal triglyceride levels is the most common lipid pattern in West Africans and African Americans with Metabolic Syndrome: Implications for cardiovascular disease prevention

Abstract: Summary Background Although designed to predict cardiovascular disease and type 2 diabetes mellitus, the Metabolic Syndrome (MetSyn) under-predicts these conditions in African Americans (AA). Failure of MetSyn in AA is often attributed to their relative absence of hypertriglyceridemia. It is unknown if the African experience with MetSyn will be similar or different to that in AA. Focusing on the lipid profile, our goal was to determine in West Africans (WA) and AA the pattern of variables that leads to the diagnosis of the MetSyn. Methods Cross-sectional analysis of 1296 subjects (364 WA, 44% male, 932 AA, 46% male). WA were from urban centers in Nigeria and Ghana and enrolled in the Africa America Diabetes Mellitus Study. AA lived in Washington, DC and participated in the Howard University Family Study. Results The prevalence of MetSyn was different in WA women and men: 42% vs.19%, P P Conclusions Elevated triglyceride levels were uncommon in both WA and AA with MetSyn. As the relative absence of hypertriglyceridemia is associated with a lack of efficacy of MetSyn in AA, caution is warranted in diagnosing MetSyn in WA, the ancestral population of AA. Prospective studies are necessary to determine if an ethnic-specific reformulation of the MetSyn scoring system for lipids might optimize risk identification in black populations.

A Cross-Sectional Survey on Parasites of Chickens in Selected Villages in the Subhumid Zones of South-Eastern Nigeria

Abstract: A study was carried out to identify and estimate the prevalence of ecto- and endoparasites of village chicken between April and July 2008 in three local councils of Enugu state, Nigeria. A total of 1038 chickens comprising of 468 chicks, 207 growers and 363 adults were examined during the house to house survey for ectoparasites, gastrointestinal helminths and coccidia infections. Our finding showed that 41% were infected with ectoparasites with lice, fleas, and mites having prevalence rates of 62.2%, 35.7% and 2.1%, respectively. Helminths and coccidia had prevalence of 35.5% each. Among the helminths Ascaridia, galli was the most dominant species (17.2%). Generally, there was a significantly higher helminth infestation relative to the ectoparasites (P < .05), high prevalence of mixed infections and absence of tick infestation. Parasitism could be big constraint to production in the study area and we recommend a sustainable control strategy.

Factors associated with urinary schistosomiasis in two peri-urban communities in south-western Nigeria.

Abstract: In Nigeria, there is only very limited epidemiological information on which the control of human urinary schistosomiasis could be based. In a cross-sectional study, therefore, the prevalences and intensities of, and risk factors for, human infection with Schistosoma haematobium infection were explored in two endemic peri-urban villages in the south-western state of Osun. The villagers' knowledge about the infection and demographic, socio-economic and environmental variables were recorded using a structured questionnaire. Of the 1023 individuals who were investigated, 634 (62.0%) were found infected, with a mean (S.D.) overall intensity of 114.2 (327.7) eggs/10 ml urine. The subjects aged 10-14 years had both the highest prevalence (83.6%) and the highest mean (S.D.) intensity of infection [196.67 (411.7) eggs/10 ml urine]. Most (70.0%) of the subjects appeared to have no knowledge of the transmission of S. haematobium. The results of multivariate regression analysis indicated that infection and moderate-heavy infection (i.e. >50 eggs/10 ml urine) were both associated with: a low family income, of

Delays in presentation and treatment of breast cancer in Enugu, Nigeria.

Abstract: To assess the delays and define the causes of delay in presentation and treatment of breast cancer patients inEnugu,Nigeria. Across-sectional survey of breast cancer patients using a semi structured questionnaire. SurgicalOncology unit,University ofNigeriaTeachingHospitalEnugu, (UNTH-E),Nigeria. 164 consecutively presenting breast cancer patients seen between June 1999 andMay 2005. Most of the patients (82.3%) reported for initial evaluation at a modern health facility while 17.5% reported first toAlternative practitioners. Forty six patients (26.4%) presented within a month of noticing the symptoms while 72 (45.3%) delayed more than 3 months. In contrast, 18 (17%) were seen at the site of definitive treatment within one month of seeking help at the initial hospital while 73.4% had a delay of more than 3months after the initial hospital contact. Institutional or physician induced delayswere present in 46.2% of the caseswhile patient related delayswere present in 79.2% of cases.Only use of alternative practitioners for initial treatmentwas significantly related to delays ofmore than threemonths before presentation (p= 0.017). For breast cancer prevention programs in Nigeria to succeed, they must in addition to breast awareness and screening programs, address the institutional bottlenecks, the dearth of knowledge among primary care physicians and improve referrals fromalternative practitioners and prayer houses. Keywords: Breast cancer, delayed presentation, treatment,Nigeria.

Prevalence, awareness, treatment and control of hypertension in a nigerian population

Abstract: Hypertension is a major public health problem. Due to paucity of data, the burden of hypertension in Nigeria might be underestimated. Estimating the prevalence of hypertension in populations of Nigeria would be useful in efforts to control hypertension and prevent its consequences. This survey aimed to assess the prevalence, detection, treatment and control of hypertension in Nsukka, a city located in South-Eastern Nigeria. Hypertension prevalence, awareness, treatment, and control (outcomes) were examined in 756 adult participants (364 men and 392 women) aged 18 years and above. Blood pressure (BP) of the participants was measured and they also answered a detailed questionnaire. Hypertension was defined as BP ≥ 140 for systolic BP and or ≥ 90 mm Hg for diastolic BP or being on antihypertensive therapy. Prevalence of hypertension was 21.1%. Men had higher prevalence of high BP compared to women. Systolic and diastolic BP increased with age in both men and women. Detection of high BP in participants with raised blood pressure was 40.3% and 24.7% for males and females respectively. Only 23.7% and 17.5% of males and females respectively with high BP were on antihypertensive treatment while 5.0% of males and 17.5% of females with hypertension were controlled. Prevalence of hypertension was comparable with other studies in Nigeria and Africa. The results showed a poor detection, treatment and control of hypertension. This underscores the need for comprehensive evaluation of the prevalence of hypertension and other cardiovascular diseases in Nigeria.

Aetiology of Diarrhoea and Virulence Properties of Diarrhoeagenic Escherichia coli among Patients and Healthy Subjects in Southeast Nigeria

Abstract: Diarrhoeal diseases are one of the most important causes of illness and death all over the world. In Nigeria, the aetiology of diarrhoeagenic bacteria and the virulence of various Escherichia coli pathotypes have not been well-studied because most currently-published data were from the southwestern axis of the country. In total, 520 stool samples were collected from infants, young children, and other age-groups with acute diarrhoeal diseases in Enugu and Onitsha, southeastern Nigeria. Stool samples were collected from 250 apparently-healthy individuals, with similar age distribution and locality, who were considered control subjects. The stool samples were screened for diarrhea-causing bacterial agents. E. coli strains were isolated from both the groups and were examined by polymerase chain reaction (PCR) for 16 virulence genes. Of the 520 stool samples in the diarrhoea group, 119 (44.74%) were E. coli. Fifty (49.02%) were enteropathogenic E. coli (EPEC), 22 (21.57%) were enterotoxigenic E. coli (ETEC) while 7.84% was enteroaggregative E. coli (EAEC). Sex had no effect on the distribution of diarrhoeagenic bacteria, except for EIEC. The E. coli strains isolated from the diarrhoea and healthy asymptomatic age-matched control groups examined by PCR for 16 virulence genes indicate that the detection of EAEC, ETEC, EPEC, and EIEC was significantly associated with diarrhoea (p=0.0002). The study confirmed that several bacterial pathogens, such as E. coli, play an important role in the aetiology of acute diarrhoea in southeastern Nigeria. A routine surveillance, especially for diarrhoeagenic E. coli, would be useful in identifying outbreaks and help identify the potential reservoirs and transmission routes.

Physical properties of a sandy loam Ultisol as affected by tillage-mulch management practices and cropping systems.

Abstract: Evaluation of the impact of tillage-mulch practices under different cropping systems on soil physical properties is needed in southeastern Nigeria to identify those combinations with the potential of alleviating the physical constraints of the Ultisols predominant in the area. An investigation was carried out on a sandy loam soil at Nsukka to determine the effects of no-till (NT) and conventional tillage (CT) each with bare fallow (B) and mulch cover (M) on soil physical properties under three cropping systems [sole sorghum (Sorghum bicolor L. Moench), sole soybean (Glycine max L. Merrill), and sorghum-soybean intercrop]. The layout was a split-plot in randomized complete block design, with the tillage systems as the main plots and the mulch practices as the sub-plots. The treatments [no-till and bare (NTB), no-till with mulch (NTM), conventional tillage and bare (CTB) and conventional tillage with mulch (CTM)] were replicated four times. The selected key parameters evaluated after two years were density of earthworm casts, soil organic matter (SOM), bulk density (BD), total porosity (TP), pore size distribution (PSD), mean weight diameter (MWD), and saturated hydraulic conductivity (Ksat). Earthworm activity was significantly (P less than or equal to 0.001) higher with NT under the intercrop system. Values were generally very low for SOM (1.06-1.48%), moderate for BD (1.34-1.51 Mg m⁻³) and TP (46-52%), and low to moderate for MWD (1.1-2.9mm). The Ksat was within the slow to rapid range (8.1-57.0cm h⁻¹). Neither the tillage nor the mulch factors influenced SOM, BD, PSD, and MWD in the cropping systems. The TP was significantly (P less than or equal to 0.05) higher in the CT compared to the NT under the sole sorghum, where interaction showed higher value in the CTM compared to the rest. There was significant (P less than or equal to 0.05) enhancement of Ksat in the CT under the sole sorghum and the intercrop systems; whereas the value was significantly (P less than or equal to 0.01) higher in the bare fallow under the sole soybean. The cropping systems had more pronounced effect on the physical properties than the tillage-mulch management practices. All the measured parameters indicated significant (P less than or equal to 0.05) improvements under the sole soybean, except BD and MWD which were significantly (P less than or equal to 0.05) improved under the intercrop. Intercropping cereals and legumes on NT may be ideal for alleviating the soil's structural constraints.

Dermatophytosis in Western Africa: a review.

Abstract: Dermatophytic fungal infections are one of the most common infectious diseases in the world and are among the most commonly diagnosed skin diseases in Africa. They are caused by several dermatophyte species made up of three genera: Trichophyton, Microsporum and Epidermophyton. The pathogen spectrum and the clinical manifestations are totally different from those seen in other continents. The hot and humid environment in Africa is probably the major reason for their high prevalence. In this era of rapid movement from one continent to another and the increasing mobility of humans, agents of dermatophytic infections can no longer be said to be restricted within a given geographical area. This implies that an infection contracted in one part of the world may become manifest in another country where the etiological agent is not normally found. Therefore, updating our knowledge of the geographical distribution of the predominant causative agents of dermatophytosis will provide a better understanding of the risk factors and future epidemiologic trends. This review discusses the clinical signs and manifestations of dermatophytoses and attempts to summarize the current epidemiological trends on dermatomycosis of glabrous skin in Western Africa.

Anticonvulsant and anxiolytic evaluation of leaf extracts of Ocimum gratissimum, a culinary herb.

Abstract: Anticonvulsant and anxiolytic activities of leaf extracts and fraction of Ocimum gratissimum L. (Lamiaceae) were studied using seizures induced by pentylenetetrazol and open-field tests in mice. The results showed that the extracts and fraction increased the latency of tonic and tonic-clonic seizures and death and elicited 50% protection against mortality. In the open-field test, the extracts and fraction decreased the frequency of line crossing, center square entries, rearing against a wall and grooming, whereas grooming duration and freezing frequency and duration were increased. Acute toxicity test in mice gave an oral LD 50 greater than 5000 mg/kg for the methanol extract. These findings suggest that extracts of this plant possess anticonvulsant and anxiolytic-like properties.

Variations in the prevalence of point (pre)hypertension in a Nigerian school-going adolescent population living in a semi-urban and an urban area

Abstract: Hypertension has been shown to start in early life and to track into adulthood. Detecting adolescents with hypertension and prehypertension will aid early intervention and reduce morbidity and mortality from the disorders. This study reports the point-prevalence of the two disorders in a semi-urban and an urban population of school-going adolescents in Nigeria. A total of 843 adolescents from two places of domicile were studied. Their blood pressures and anthropometric indices were measured using standard protocol. Point-hypertension and point-prehypertension were defined with respect to each subject's gender, age and height. The prevalence of the disorders was calculated and reported age-wise and nutritional status-wise. The prevalence of point-prehypertension in the semi-urban area was 22.2% (20.7% for girls and 23.1% for boys) while it was 25.0% (21.8% for girls and 29.2% for boys) in the urban area. The prevalence of point-hypertension was 4.6% (4.1% for girls and 4.8% for boys) in the semi-urban area and 17.5% (18.0% for girls and 16.9% for boys) in the urban area. Point-prehypertension was not detected among the thin subjects of both places of domicile. The prevalence of point-prehypertension was similar in both the urban and semi-urban areas among the subjects who had normal BMI-for-age, and over-weight/obese subjects respectively. From the semi-urban to the urban area, the prevalence of point-hypertension increased approximately 3-folds among thin and normal BMI-for-age subjects, and 10-folds among overweight/obese subjects. Systolic hypertension was more preponderant in both the semi-urban and urban areas. The prevalence of both disorders is considerably high in the studied populations. Urgent pediatric public health action is needed to address the situation.

Preferences for benefit packages for community-based health insurance: an exploratory study in Nigeria

Abstract: Background It is important that community-based health insurance (CBHI) schemes are designed in such a way as to ensure the relevance of the benefit packages to potential clients. Hence, this paper provides an understanding of the preferred benefit packages by different economic status groups as well as urban and rural dwellers for CBHI in Southeast Nigeria.

Performance of Recycled Asphalt Pavement as Coarse Aggregate in Concrete

Abstract: Recycled asphalt pavement (RAP) is the reclaimed and reprocessed pavement material containing asphalt and aggregate. Most RAP is recycled back into pavements, and as a result there is a general lack of data pertaining to the mechanical properties for RAP in other possible applications such as Portland cement concrete. In the present study, some mechanical properties of Portland cement concrete containing RAP as coarse aggregate were investigated in the laboratory. Six concrete mixes of widely differing water/cement ratios and mix proportions were made using RAP as coarse aggregate. The properties tested include the physical properties of the RAP aggregate, the compressive and flexural strengths of the concrete. These properties were compared with those of similar concretes made with natural gravel aggregate. Results of the tests suggest that the strength of concrete made from RAP is dependent on the bond strength of the “asphalt-mortar” (asphalt binder-sand-filler matrix) coatings on the aggregates and may not produce concrete with compressive strength above 25 MPa. However, for middle and low strength concrete, the material was found to compare favorably with natural gravel aggregate.

Examining appropriate diagnosis and treatment of malaria: availability and use of rapid diagnostic tests and artemisinin-based combination therapy in public and private health facilities in south east Nigeria.

Abstract: Background Rapid diagnostic tests (RDTs) and Artemisinin-based combination therapy (ACT) have been widely advocated by government and the international community as cost-effective tools for diagnosis and treatment of malaria. ACTs are now the first line treatment drug for malaria in Nigeria and RDTs have been introduced by the government to bridge the existing gaps in proper diagnosis. However, it is not known how readily available these RDTs and ACTs are in public and private health facilities and whether health workers are actually using them. Hence, this study investigated the levels of availability and use of RDTs and ACTs in these facilities.

Tracheobronchial foreign body aspiration in children: how reliable are clinical and radiological signs in the diagnosis?

Abstract: Clin Otolaryngol 2010, 35, 479–485 Objectives: To evaluate the yield of clinical and radiological features in the diagnosis of suspected foreign body aspiration in children and to assess factors associated with delayed diagnosis of foreign body aspiration Study design and setting: Retrospective review of 10 years of experience in tertiary referral centre Participants: Data were extracted from clinical records of children who underwent rigid bronchoscopy for suspected foreign body aspiration at the University of Nigeria Teaching Hospital Enugu from 2000 to 2009 Main outcome measures: Clinical features and radiological findings were validated against bronchoscopic findings Results: Data of 103 children, (mean = 27 years, range =7 months to 14 years; 64% boys and 36% girls, were analysed Majority (73%) were under 3 years of age Foreign body aspiration was proven bronchoscopically in 85 (83%) patients The most common symptoms were sudden choking crisis (74%) and paroxysms of cough (73%) Independent predictors of proven foreign body aspiration were witnessed aspiration, choking crisis and unilateral decreased breath sounds in univariate (P = 0001, 72 h) was significantly more in younger children (t = 329; P = 0001), as well as in children with no history of witnessed aspiration, negative chest examination and radiological signs (P < 0001, P = 002 and P = 004 respectively) Conclusion: To prevent the delayed diagnosis, witnessed aspiration, choking crisis, unilateral decreased breath sounds and radiopaque objects should be checked in all suspected cases When history is doubtful, regardless of radiological findings, bronchoscopy can be strongly recommended in the presence of two factors

The effect of protest zeros on estimates of willingness to pay in healthcare contingent valuation analysis

Abstract: ’Protest zeros’ occur when respondents reject some aspect of the contingent valuation (CV) market scenario by reporting a zero value even though they place a positive value on the amenity being valued. This is inevitable even in the best-designed CV study, and, when excluded on an ad hoc basis, may cause a selection bias problem. This could affect the reliability of the willingness to pay (WTP) estimates obtained for preference assessment. Treatment of ‘protest zeros’ in general, and particularly in the context of developing countries, has been rather unsatisfactory. Most case studies employ the Heckman 2-step approach, which is much less robust to co-linearity problems than the Full Information Maximum Likelihood (FIML) estimator. The main objective of this article is to illustrate a sequential procedure to simultaneously deal with co-linearity and selectivity bias resulting from excluding ‘protest zeros’ in CV analysis. The sequential procedure involves different levels of estimation and diagnostics with the 2-step and FIML estimators; the duration of the procedure depends on the diagnostic test results at each stage of the estimations. The data used for the analysis were elicited using the conventional dichotomous choice buttressed with an open-ended follow-up question. The survey was designed to elicit households’ WTP for a proposed community-based malaria control scheme in rural Cameroon. In the application context, we found that the different levels of estimation and diagnostics resulted in reliable WTP estimates from the FIML approach, which would obviously have been overlooked in the absence of such diagnostics.

Comparative phytochemical and antimicrobial screening of some solvent extracts of Samanea saman (fabaceae or mimosaceae) pods

Abstract: Antimicrobial activity of distilled water (DE), methanol (ME), ethanol (EE) and ethyl acetate (EAE) extracts of Samanea saman pods was investigated by well-diffusion method against five pathogenic organisms: Bacillus subtilis (B. subtilis), Staphylococsus aureus (S. aureus), Escherichia coli (E. coli), Pseudomonas aeruginosa (P. aeruginosa) and Candida albicans (C. albicans). Only ME showed measurable inhibitory activity against both B. subtilis and S. aureus and at concentrations of 20 and 10 mg/ml whereas EAE inhibited only S. aureus at a concentration of 20 mg/ml. Qualitative phytochemical screening of the different solvent extracts of the S. saman pods indicated varied presence of the phytochemicals. However, acidic compounds, proteins and fats/oils were absent, but all the tested solvent extracts except DE showed moderate presence of reducing sugars. Furthermore, while ME and EAE indicated high presence of carbohydrates, DE and EE showed only moderate presence of carbohydrates. On comparison, ME has more of the secondary metabolites followed by EE and EAE and then, DE. The study apparently highlights the biochemical basis for possible use of the S. saman pods (especially the methanol extract) in ethno-medication. Key words: Samanea saman, fabeaceae, phytochemical, antimicrobial, ethno-medication, narrow spectrum.