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Background: Cognitive assessment is a key component of clinical evaluations for patients with dementia and Alzheimer's disease in primary health care (PHC) settings. The need for well-validated, culturally appropriate, and easy-to-use assessments is especially urgent in low- and middle-income countries (LMICs) that are experiencing rapid growth in their older adult populations. Objective: To examine the feasibility and demographic determinants of performance for a tablet-based cognitive assessment tool (TabCAT) battery, which includes subtests for four cognitive domains, among older PHC patients in southeastNigeria. Methods: A cross-sectional mixed-method descriptive study evaluating the useability and performance of TabCAT. Results: We enrolled 207 participants (mean age of 64.7±13.5 years; 52% with only primary, 41% secondary, and 7% tertiary education). Most (91%) who initiated the assessment were able to complete it, requiring 10-15 minutes to complete. More years of education was associated with better test scores across all tests (p < 0.001). Living in a rural location was also associated with better performance (p < 0.05). Male compared to female sex did not associate with performance on any of the tests (all ps > 0.05). Conclusions: Tablet-based cognitive assessment was feasible in rural and urban settings of Nigeria. Better performance on cognitive subtests linked to more education and residing in a rural area; however, sex did not predict performance. Digital cognitive assessment tools hold potential for widespread use in healthcare and educational contexts, particularly in regions with varying levels of urbanization and educational access.

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Objective: The aging population in developing countries demands parallel improvements in brain health assessment services to mitigate stigma, promote healthy aging, and diagnose cognitive impairments including dementia in primary health care (PHC) facilities. The lack of culturally appropriate cognitive assessment tools in PHC facilities delays early detection. This study aims to culturally adapt a brief digital cognitive assessment tool for PHC professionals in Southeast Nigeria. Method: A total of 30 participants (15 healthcare workers HCW and 15 community members) were selected to be culturally representative of the community. We completed focus groups and pilot testing to evaluate and refine the Brain Health Assessment (BHA) a subset of tools from the Tablet-based Cognitive Assessment Tool (TabCAT) known to be sensitive to cognitive impairment in other settings. We examined BHA subtests across local languages (Pidgin and Igbo) spoken at two geriatric clinics in Anambra State Southeast Nigeria. Results: Following structured approaches in focus groups, adaptations were made to the Favorites (memory) and Line Length (visuospatial) subtests based on their input. Participants found the new adaptations to have good construct validity for the region. Conclusions: The BHA subtests showed content validity for future work needed to validate the tool for detecting early cognitive changes associated with dementia and Alzheimer's disease in PHC settings. The use of culturally adapted and concise digital cognitive assessment tools relevant to healthcare professionals in Southeast Nigeria's PHCs is advocated.

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Objectives: Primary health care remains the widely available first point of medical care in Nigeria and in other low- and middle-income countries. Recognizing the rising prevalence of dementia in these settings, primary healthcare providers should be trained on cognitive assessment. However, little is known about the current Nigerian primary healthcare providers' knowledge of dementia, cognitive assessment tools, and use in elderly populations. The aim of this study was to evaluate primary healthcare providers' knowledge of dementia and cognitive assessment tools in Southeast Nigeria in preparation for the introduction of digital tablet-based assessment tool. Methods: This is a cross-sectional mixed method descriptive pilot survey carried out in a comprehensive healthcare center affiliated with Nnamdi Azikiwe University Teaching Hospital. Fifty healthcare workers participated. Convenience sampling was employed involving all consenting primary healthcare providers in comprehensive healthcare center-Nnamdi Azikiwe University Teaching Hospital. A structured questionnaire was distributed for generation of both qualitative and quantitative data. Result: The mean age of the 50 primary healthcare providers was 36.6 years, with females constituting 80%. Mean practice duration was 10.8 years. Their response on the mean age at which patients may need a cognitive assessment was reported as 52.8 years. Primary healthcare providers reported that dementia is associated with memory loss and can be genetically inherited. None of the respondents were familiar with Montreal cognitive assessment, or any form of tablet-based cognitive assessment tool. Most (86%) knew about the mini mental state examination. Conclusion: Primary healthcare providers are deficient in knowledge of dementia Alzheimer's or cognitive assessment tools, and so they do not routinely carryout cognitive screening in elderly patients during clinic visits. It is important to train all cadres of primary healthcare staff on the use and benefit of cognitive assessment using culturally validated user-friendly tool to improve quality of care for the elderly population.

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Objectives: Routine dipstick urinalysis is a useful and inexpensive method for the early detection of asymptomatic diseases. Our study was carried out to detect the prevalence of urinary abnormalities among an apparently asymptomatic healthy female group and emphasize the value of routine dipstick urinalysis. Methods: A cross-sectional study was carried out among second to sixth (final)-year female medical students of Nnamdi Azikiwe University, Nnewi campus between 8 and 30 September 2019. A total of 100 subjects were enrolled. First-morning midstream urine samples were collected and promptly tested with dipstick strips. Subjects with abnormal findings were informed and treated appropriately. Results: In all, 54 (54%) of the subjects had urine abnormalities. Trace proteinuria was the commonest abnormality seen with a prevalence of 33%, followed by abnormal urine appearance (17%), leucocytes (14%), nitrites (8%) and urobilinogen (2%). Urine abnormalities were commoner in students who resided in the school hostel. Abnormal urine appearance was significantly associated with nitrites (0.003) and leucocytes (0.001). Conclusion: Routine dipstick urinalysis should be performed among students and apparently healthy individuals for early detection and diagnosis of renal diseases to facilitate quick interventions and prevent further progression.

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BACKGROUND: National tuberculosis (TB) programmes globally rely heavily on passive case finding for detecting TB in the community as advocated by the World Health Organization (WHO). TB case detection is low in Nigeria despite improvement in TB services and coverage. METHODS: A retrospective evaluation of an active case-finding intervention utilizing community-based approaches and targeted systematic TB screening in Ebonyi State, Nigeria was done. The analysis was performed using Epi Info. RESULTS: Using community-based and health-facility-based systematic screening strategies, 218,751 persons were screened, with 19.7% of them being presumptive TB cases. Among these, 23,729 (55.1%) submitted sputum samples for microscopy, and 764 (3.2%) had smear-positive TB. In addition, 683 individuals were diagnosed with other forms of TB using X-ray and clinical evaluation giving a total of 1447 all forms of TB cases. The overall number needed to screen (NNS) to find one person with all forms of TB through the project was 151. The NNS was 53 for general outpatients, 88 through contact tracing, and 110 among HIV-infected persons. CONCLUSIONS: Active case-finding strategies achieved good yields though early loss to follow-up was high. Active case finding is recommended for integration into national TB control policy and practice.

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BACKGROUND: This was a prospective study designed to evaluate the impact of thyroid function abnormalities on reproductive hormones during menstrual cycle in HIV infected females at Nnamdi Azikiwe University Teaching Hospital Nnewi, South-East Nigeria. METHODS: The study randomly recruited 35 Symptomatic HIV infected females and 35 Symptomatic HIV infected females on antiretroviral therapy (HAART) for not less than six weeks from an HIV clinic and 40 apparently heathy control females among the hospital staff of NAUTH Nnewi. They were all premenopausal females with regular menstrual cycle and aged between 15-45 years. Blood samples were collected at follicular and luteal phases of their menstrual cycle for assay of Thyroid indices (FT3, FT4 and TSH) and Reproductive indices (FSH, LH, Estrogen, Progesterone, Prolactin and Testosterone) using ELISA method. RESULTS: The result showed significantly higher FSH and LH but significantly lower progesterone (prog) and estrogen (E2) in the test females compared to control females at both phases of menstrual cycle (P<0.05). There was significantly lower FT3 but significantly higher TSH value in Symptomatic HIV females (P<0.05). FSH, LH and TSH values were significantly lowered while prog and FT3 were significantly higher in Symptomatic HIV on ART compared to Symptomatic HIV females (P<0.05). FT3, FT4, Prog and E2 were inversely correlated while FSH and LH were positively correlated with duration of HIV infection in HIV females (P<0.05 respectively). There was a direct correlation between CD4+ count and FT3 while inverse correlation was found between CD4+ count and TSH levels (P<0.05). DISCUSSION: The present study demonstrated hypothyroidism with a significant degree of primary hypogonadism in Symptomatic HIV infected females at both follicular and luteal phases of menstrual cycle which tends to normalize on treatments.

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BACKGROUND: In some primary health care settings, even where the health services are not available, provisions are not made to ensure continuity of care. This study aimed to determine the availability and level of continuity of care for maternal health services in the primary health centers (PHCs) in Nnewi, Nigeria. METHODS: This was a cross-sectional survey. Using multistage sampling technique, 280 women utilizing maternal health services from four randomly selected public PHCs in Nnewi, Nigeria were chosen for the study. Data collection employed a mix of quantitative and qualitative methods. RESULTS: The mean ± standard deviation for age of the respondents was 29.2 ± 5.9 years. The facilities studied provided out-patient services, but the only in-patient services provided was for women who delivered or those in labor. None of the facilities is equipped to provide even basic essential obstetric care services. None had standardized a protocol for referring clients, referral forms, a transport system, or a community loan scheme in place. Forty-four (15.7%) women were referred for care outside of the PHCs for the following reasons: Lack of drugs and supplies (9.1%); lack of equipment (90.9%), lack of skilled personnel (45.5%) among others. CONCLUSIONS: This study showed that despite the unavailability of some services, appropriate strategies were not in place to ensure the coherent pattern of services within and between the PHCs and other levels of care. Delivery to the clients of comprehensive and integrated maternal health services, and efficient referral systems are thus recommended.

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Since the first seroprevalence survey in 1999, the HIV prevalence in Abia State has increased from 1.8% to 7.3% in 2010. The state is currently experiencing a generalized epidemic, with most transmission occurring through heterosexual low-risk sex. Drivers of the epidemic include low knowledge of HIV prevention, low risk perception, predominantly male factor-driven risky sexual behavior, and low condom use. This study reviewed the state HIV epidemic trend in relation to response, sought to identify the gaps between the epidemic and response, and recommended measures to strengthen the state response.

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BACKGROUND: This is a cross-sectional descriptive study aimed at assessing antenatal care service attendees' perception of quality of maternal healthcare (MHC) services in Anambra State, southeast Nigeria. MATERIALS AND METHODS: A total of 310 pregnant women utilising antenatal care (ANC) services in three purposively selected primary health centres (PHCs) in rural communities in Anambra State were studied. Reponses were elicited from the participants selected consecutively over a 4-month period, using a pre-tested, semi-structured interviewer-administered questionnaire on socio-demographic characteristics, utilisation and perception of MHC services. Data collected were analysed using SPSS version 17. RESULTS: Findings showed that utilisation of facility for both antenatal (97.0%; 95% CI, 94.4-98.4%) and natal services (92.7%; 95% CI 89.2-95.2%) were quite high. Generally, most of the women were satisfied with MHC services (89.7%). Most of them were satisfied with the staff attitude (85.1%), waiting time (84.1%) and cost of services (79.5%). Being ≥30 years (X (2) = 4.61, P = 0.032), married (X (2) = 9.70, P = 0.008) and multiparous (X (2) = 9.14, P = 0.028), as well as utilisation of formal health facility for antenatal (X (2) = 26.94, P = 0.000) and natal (X (2) = 33.42, P = 0.000) services were associated with satisfaction with maternal health services. CONCLUSIONS: The study showed high level of satisfaction with quality of maternal health services among antenatal attendees and highlights the need to strengthen interventions that increase uptake of formal MHC services.

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INTRODUCTION: Prevalence of adolescent sexual activity is on the increase globally, resulting in increased risk of adverse reproductive health outcomes among them. Sources of sex information are key factors that influence female adolescents' sexual decision-making. Consequently, this study is aimed at identifying adolescents' sources of sexuality information, and its likely effect on their sexual practices among in-school female adolescents in Osisioma LGA, in southeastern Nigeria. METHODOLOGY: A total of 304 girls selected by multi-stage sampling technique were studied. Responses were elicited from them using pretested, semi-structured, self administered questionnaire. Data were analyzed using MS Excel and Epi-6. FINDINGS: Primary and subsequent sources of sexuality information were mainly the media and peers. Families and schools mostly were not involved in provision of early sex education. Media and peer influence were predominantly negative. Female adolescents' knowledge of issues of sex was low. Premarital sex, early sexual initiation, and unprotected sex was common among them. Consequently, adverse implication of negative sexual behavior, such as unplanned pregnancies and induced abortion, was prevalent. CONCLUSION: The study highlights the need for increased roles of parents and teachers in early sexuality education of adolescent girls. This can be done by increasing capacity of parents to discuss sexuality issues with their children.

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