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Introduction: Chlamydia trachomatis infection is among the STDs that are known to increase the risk of HIV infection. The present study aims to determine the seroprevalence of C. trachomatis among HIV positive women in Ilorin and Offa, Kwara State, North Central Nigeria. Methods: Serum samples from 400 HIV positive women attending the HAART Clinic in Offa and the Ilorin General Hospital in Kwara State, Nigeria, were screened using Enzyme Linked Immunosorbent Assay (ELISA), utilizing the immunocomb Chlamydia IgG test kit (Calbiotech, El Cajon, CA, USA) to check for the existence of anti-C. trachomatis antibodies. Result: Anti-C. trachomatis antibodies were present in 92 (23.0%) of the 400 HIV positive women samples. There was a higher prevalence among the age group 36-40 years. Hence, age groupings were statistically and significantly associated (p=0.001) with the seroprevalence of C. trachomatis among HIV positive women. Married HIV positive women (60.9%) had the highest prevalence of C. trachomatis, with a statistically significant association (p=0.001). There was a statistically significant association between the number of sexual partner(s) (p=0.001) and the seroprevalence of C. trachomatis among HIV positive women. Conclusions: The high frequency confirms the necessity for comprehensive sexual education among young adults and routine testing for anti-C. trachomatis. It reflects the endemicity of the infection in Ilorin and Offa Kwara State, Nigeria.

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Background: Burnout is a psychological syndrome resulting from exposure to chronic work-related stress. There are, however, a few works of literature on burnout among trainee doctors in Nigeria. Aim: To determine the prevalence of burnout and its predictors among resident doctors across 16 medical specialties and/or subspecialties. Setting: The University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria. Methods: A cross-sectional study was conducted among 176 resident doctors between October 2020 and January 2021. The survey included the Proforma and Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS MP). Results: The mean age of participants was 35.10 (SD 4.07) years. The prevalence of burnout was 21.6% for high emotional exhaustion (EE), 13.6% for high depersonalization (DP), and 30.7% for low personal accomplishment (PA). Being a younger resident doctor aged 31-35 (OR = 3.715, 95% CI [1.270 - 10.871]) was the only significant predictor for the EE. Predictors of DP included the age group 31-35 years (OR = 7.143, 95% CI [2.297 - 22.216]), duty hours >50 hours per week (OR = 2.984, 95% CI [1.203 - 7.401]), and presence of work-related stress (OR = 3.701, 95% CI [1.315 - 10.421]). A good relationship with colleagues negatively predicted low PA (OR = 0.221, 95% CI [0.086 - 0.572]). Conclusion: High levels of burnout are prevalent among resident doctors, comparable to international studies. Therefore, the government and other relevant stakeholders must drive legislation and formulate policies toward addressing the work-related factors associated with burnout in the Nigerian healthcare industry. Contribution: This study highlighted the determinants of burnout among Nigerian resident doctors, which necessitates targeted interventions to address them.

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Background: Respiratory diseases constitute a significant cause of morbidity globally. There is limited information on the epidemiology of respiratory diseases in North Central Nigeria particularly with the changing trend in risk factors. Aim: This study aimed at evaluating the pattern and morbidity related to respiratory diseases among adult outpatients attending a chest clinic in a tertiary healthcare facility, especially with increasing environmental pollution and biomass exposure globally. Patients And Methods: This was a retrospective review of the case records of 338 newly referred patients seen in the chest clinic of the University of Ilorin Teaching Hospital (UITH) with respiratory illnesses over a 2-year period (January 2017-December 2018). Results: The mean age of the recruited patients was 47.6 ± 19.8 years with a male to female ratio of 1.1:1. Microbiologically confirmed tuberculosis (30.2%), chronic obstructive pulmonary disease (COPD) (24.3%), and bronchial asthma (17.8%) were the commonest conditions managed in the clinic. Overall, noncommunicable respiratory diseases (61.2%) constituted a larger proportion of cases when compared to infective respiratory conditions. Almost 90% of the patients were never smokers. Systemic hypertension (15.1%) and human immunodeficiency virus infection (3.6%) were the commonest comorbid illnesses. Conclusion: Although tuberculosis constituted the most observed single condition, noncommunicable respiratory diseases predominated cumulatively among the new cases seen in the chest clinic of UITH, Ilorin. This raises the need for significant attention in terms of prevention and management of noncommunicable respiratory diseases, which appear to be on the uprising.

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BACKGROUND: The irregular sickle cells can block blood vessels, causing tissue and organ damage and in most cases presented with pain as a result of organ ischemia. Ultrasonography is an easily available instrument for investigating abdominal organs which are most commonly affected by sickle cell disease (SCD). This study was aimed to assessing liver, gall bladder, spleen, and kidney in children with SCD in Ilorin, Kwara State. METHODS: A prospective cross-sectional study was conducted among children with SCD in Ilorin from September 2017 to April 2018. An ethical approval was obtained from the Human Research and Ethics Committee of the Kwara State Ministry of Health. In this study, 106 children with SCD and 106 normal children for control were included. Abdominal ultrasound scan was performed on all the selected subjects and the findings were recorded on the data capture sheet. Descriptive and inferential statistic was used in the data analysis, SPSS version 20 was used and the P = 0.05. RESULTS: In the children with SCD, hepatomegaly was found in 45 (42.5%), 29 (27.4%) had coarse echo pattern of liver and 16 (15.1%) had hyperechoic liver, 5 (4.7%) had gallbladder stone, 2 (1.9%) had gallbladder sludge, and 6 (5.6%) had thickened gallbladder wall. Twenty-five (23.6%) had splenomegaly, and 7 (6.6%) had autosplenectomy. Four (3.8%) showed reduced corticomedullary differentiation in each kidney, five (4.7%) in each kidney had mild calyceal dilatation. One (0.9%) had mild calyceal dilatation with reduced corticomedullary differentiation with accompanying loss of renal sinus fat. CONCLUSION: Abdominal ultrasound imaging for patients with SCD showed a high incidence of abdominal abnormalities, especially in solid organs such as liver, kidney, and spleen.

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INTRODUCTION: Latent Tuberculosis Infection (LTBI) screening is recommended for individuals with a known risk factor for progression to active disease especially in the setting of HIV infection. This will ensure early diagnosis and prompt treatment. The purpose of our study was to compare tuberculin skin test (TST) with Interferon Gamma Release Assay (IGRA) in the diagnosis of LTBI among patients with known HIV infection at University of Ilorin Teaching Hospital (UITH), Ilorin. METHODS: this was a hospital based cross-sectional study at the Highly Active Antiretroviral therapy (HAART) Clinic and medical wards of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 282 consenting patients with HIV infection were recruited. Sociodemographic and clinical information was obtained using a well-structured questionnaire. The screening for LTBI was done using Tuberculin skin test (TST) and Interferon Gamma release assay (IGRA). RESULTS: the prevalence of LTBI among HIV infected patients was 40.6% and 53.1% using TST and QFT-IT respectively, while the overall prevalence considering positivity to either of the test was 66%. There was mild agreement (κ: 0.218) between TST and QFT-IT in the diagnosis of LTBI among patients with HIV infection. The association between CD4 count and TST was not statistically significant (p value = 0.388) but there was strong association between CD4 cell count and QFT results (p = 0.001). CONCLUSION: the prevalence of LTBI is quite high among patients with HIV infection in our locality. There is a need to encourage screening of at-risk individuals to forestall the morbidity and mortality associated with TB in this population.

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BACKGROUND: Severe malaria is a significant cause of morbidity and mortality in Nigeria and concomitant bacteraemia may potentially worsen clinical outcomes. (Duration of admission, Mortality, Fever clearance time and Coma recovery time). OBJECTIVES: This study aimed at identifying the proportion of children with severe malaria who had concomitant bacteraemia, the pathogens implicated and their drug sensitivity pattern, predictors of bacterial co-infection and its effect on treatment outcome. METHODS: This was a hospital-based cross-sectional study at the Emergency Paediatric Unit of the University of Ilorin Teaching Hospital, Nigeria. The subjects were children aged 6 months to 14 years with severe malaria and microscopy confirmed parasitemia at admission. All subjects had blood culture samples drawn at admission for identification of bacterial isolates. Relevant clinical and laboratory parameters were recorded on case proformas. RESULTS: A total of 944 children were admitted into the Emergency Paediatric Unit during the study period with 176 (18.6%) managed for severe malaria. Of the 176 children with severe malaria, 41 (23.3%) had concomitant bacteraemia. Gram positive bacteria were the most common (70.7%) isolates with Staphylococcus aureus being the most predominant (65.9%). The bacterial isolates were mostly sensitive to Ciprofloxacin. Children with concomitant bacteraemia had a longer duration of admission (p = 0.028) and longer fever clearance time (p=0.015). Increasing duration of coma before presentation was the single independent predictor of bacteraemia (p= 0.010). CONCLUSION: Severe malaria constituted a significant cause of admissions in UITH with approximately a fourth of the subjects having bacterial co-infection and this was associated with a worse prognosis (longer duration of admission and fever clearance time). Increased duration of coma prior to admission was the only predictor of the presence of bacteraemia in children with severe malaria. This highlights the importance of investigating for concomitant bacteraemia, especially in children presenting with coma.

CONTEXTE: Le paludisme grave est une cause importante de morbidité et mortalité au Nigéria et bactériémie concomitante peut potentiellement aggraver les résultats cliniques. (Durée de admission, mortalité, temps d'élimination de la fièvre et rétablissement dans le coma temps). OBJECTIFS: Cette étude visait à identifier la proportion de les enfants atteints de paludisme sévère qui ont eu une bactériémie concomitante, les agents pathogènes impliqués et leur schéma de sensibilité aux médicaments, prédicteurs de la co-infection bactérienne et de son effet sur le traitement résultat. MÉTHODES: Il s'agissait d'une étude transversale en milieu hospitalier l'Unité de pédiatrie d'urgence de l'Université d'Ilorin Hôpital universitaire, Nigéria. Les sujets étaient des enfants de 6 ans mois à 14 ans avec paludisme sévère et microscopie confirmée parasitémie à l'admission. Tous les sujets avaient des échantillons d'hémoculture prélevé à l'admission pour l'identification des isolats bactériens. Les paramètres cliniques et de laboratoire pertinents ont été enregistrés sur formulaires de cas. RÉSULTATS: Au total, 944 enfants ont été admis dans le Unité pédiatrique d'urgence pendant la période d'étude avec 176 (18,6%) pris en charge pour le paludisme grave. Sur les 176 enfants avec paludisme sévère, 41 (23,3%) avaient une bactériémie concomitante. Gramme les bactéries positives étaient les isolats les plus courants (70,7%) avec Staphylococcus aureus étant le plus prédominant (65,9%). Les isolats bactériens étaient pour la plupart sensibles à la ciprofloxacine. Les enfants atteints de bactériémie concomitante avaient une durée plus longue d'admission (p = 0,028) et un temps d'élimination de la fièvre plus long (p = 0,015). L'augmentation de la durée du coma avant la présentation était la seule prédicteur indépendant de bactériémie (p = 0,010). CONCLUSION: Le paludisme sévère constituait une cause importante des admissions à l'UITH avec environ un quart des sujets avoir une co-infection bactérienne et cela a été associé à une pronostic (durée d'admission plus longue et élimination de la fièvre temps). L'augmentation de la durée du coma avant l'admission était la seul prédicteur de la présence de bactériémie chez les enfants paludisme grave. Cela souligne l'importance d'enquêter sur en cas de bactériémie concomitante, en particulier chez les enfants présentant avec coma.

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BACKGROUND: Pulmonary tuberculosis (PTB) contributes significantly to morbidity and mortality worldwide, and despite microbiological cure for the disease, many patients still demonstrate residual respiratory symptoms and spirometric abnormalities. AIM AND OBJECTIVES: The study aimed at identifying the prevalence, pattern and factors associated with spirometric abnormalities in patients successfully treated for PTB in Ilorin, Nigeria. MATERIALS AND METHODS: This was a hospital-based cross-sectional study at the pulmonary outpatient clinics of the University of Ilorin Teaching Hospital and Kwara State Specialist Hospital, Sobi, Ilorin. A total of 308 consenting patients who had been certified microbiologically cured for bacteriologically confirmed PTB in the preceding 3 years had assessment of residual pulmonary symptoms, spirometry and plain chest radiograph. RESULTS: The prevalence of abnormal spirometry following treatment for PTB was 72.1% (confidence interval: 0.6682-0.7695), with restrictive pattern being the predominant abnormality (42.2%). Over half of the patients (56.5%) had at least one residual respiratory symptom. The significant predictors of abnormal spirometry were PTB retreatment (adjusted odds ratio [aOR] = 6.918; P = 0.012), increasing modified Medical Research Council dyspnoea scores (aOR = 7.935; P = 0.008) and increasing radiologic scores (aOR = 4.679; P ≤ 0.001) after treatment. CONCLUSION: There is significant residual lung function impairment in majority of the individuals successfully treated for PTB in Ilorin. This highlights the need for spirometric assessment and follow-up after treatment.

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OBJECTIVE: The current study aimed to determine the prevalence, infection burden, and risk factors associated with the occurrence of gastrointestinal (GI) parasites in different avian species in Ilorin, Nigeria. MATERIALS AND METHODS: This study was conducted in Ilorin, involving 597 fecal samples and GI tracts from a variety of sold and slaughtered avian species. The study was conducted between September 2017 and February 2018. Fecal samples were examined using floatation technique, while the GI tracts were examined for gross helminths and its content were subjected to the direct wet mount examination. Data were analyzed using percentages (descriptive) and the Chi-square (१) test (inferential). p < 0.05 was considered significant for all analysis. RESULTS: Ten GI parasites were detected with Eimeria species (32.83%), Ascaridia galli (30.15%) and Heterakis gallinarum (24.79%) as the most prevalent ones. Multiple parasites co-infection was recorded in all the avian species: broilers (77.78%), layers (33.33%), cockerels (45.16%), indigenous chickens (17.91%), ducks (69.70%), pigeons (94.12%), turkeys (47.83%), and guinea fowls (77.36%). Pigeons (100.00%) and turkeys (95.65%) were the most infected avian species. Age, sex, and avian types were significantly (p < 0.05) associated with the occurrence of GI parasites infection. CONCLUSION: This study gives a reflection of the GI parasites fauna of avian species in Nigeria. The GI parasites are endemic among different avian species in Ilorin, North Central Nigeria. Knowledge on the epidemiology of these parasites is important in instituting a good preventive and control measures against GI parasites, so as to have maximum production and reproduction effects in the poultry industry.

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BACKGROUND: Harmful wastes and other dangerous industrial by-products constitute major sources of environmental pollutants in Nigeria. Industrial pollutants discharged into the environment contain organic and inorganic pollutants in dissolved, suspended and insoluble forms. Fishes are known for their innate potential to bioaccumulate heavy metals in their muscles and various organs. OBJECTIVES: The present study aimed to assess the bioaccumulation status of heavy metals in selected organs and tissues of African catfish in Asa River, Ilorin, Kwara State, Nigeria. METHODS: Three sampling points (A (upstream), B (point of discharge) and C (downstream)) were selected in relation to industrial effluents that enter the river. African catfish were randomly harvested from each site using fishing nets at the three sampling points. The samples were digested and subjected to atomic absorption spectrophotometric analysis. Statistical analysis of data was carried out using the Statistical Package for the Social Sciences (SPSS) version 20 and two-way analysis of variance (ANOVA) to compare data among sites and organs. RESULTS: The present study found that the bioaccumulation level of heavy metals in selected organs and tissues of African catfish in Asa River, Ilorin, Kwara State, Nigeria was very high and the level of accumulation of heavy metals increased downstream. Accumulations were much higher during the dry season (especially in the month of February) and relatively low during the peak of the rainy season. CONCLUSIONS: Heavy metals at elevated levels in the aquatic environment can accumulate in fish tissues and organ, and therefore fish from the Asa River are not fit for human consumption. COMPETING INTERESTS: The authors declare no competing financial interests.

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OBJECTIVE: The aim of this analysis was to identify alcohol consumption clusters for adolescents and early adults according to attitudes to drinking, motivations against drinking and perceptions associated with alcohol. METHOD: Interviews were undertaken with people aged 18-34 years old living in four cities in different regions of the world. Multistage random sampling was consistent across the four cities (Ilorin (Nigeria), Wuhan (China), Montevideo (Uruguay) and Moscow (Russia)). The questionnaire was forward and back translated into relevant languages and face-to-face interviewing undertaken. The data were weighted to the population of each city. In total 6235 structured interviews were undertaken (1391 in Ilorin, 1600 in Montevideo, 1604 in Moscow and 1640 in Wuhan). Questions regarding motivation against alcohol consumption (14 items), assessing perceptions (3 items) and attitudes to drinking in certain situations (8 items) were asked of all respondents including abstainers. Factor analysis was initially undertaken to identify highly related correlated variables. RESULTS: Cluster analysis provided a variety of clusters (Ilorin (3 clusters), Montevideo (5), Moscow (4) and Wuhan (4)). At least one cluster in each city was dominated by abstainers and another by heavy episodic drinkers. Variations by city and alcohol consumption patterns existed in regards to variables included. CONCLUSION: This analysis detailed the city specific motivations against drinking alcohol, and the attitudes towards alcohol consumption. Differences highlight the influence of country/city specific culture, customs, laws, societal norms and traditions.

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BACKGROUND: Heavy episodic drinking (HED) can have health and social consequences. This study assesses the associations between HED and demographic, socioeconomic, motivation and effects indicators for people aged 18⁻34 years old living in four cities in different regions of the world. METHOD: Multistage random sampling was consistent across the four cities (Ilorin (Nigeria), Wuhan (China), Montevideo (Uruguay) and Moscow (Russia)). The questionnaire was forward/back translated and face-to-face interviewing was undertaken. A total of 6235 interviews were undertaken in 2014. Separate univariable and multivariable modelling was undertaken to determine the best predictors of HED. RESULTS: HED prevalence was 9.0%. The best predictors differed for each city. The higher probability of HED in the final models included beliefs that they have reached adulthood, feeling relaxed as an effect of drinking alcohol, and forgetting problems as an effect of drinking alcohol. Lower probability of HED was associated with not being interested in alcohol as a reason for limiting alcohol, and the belief that drinking alcohol is too expensive or a waste of money. CONCLUSION: Although some indicators were common across the four cities, the variables included in the final models predominantly differed from city to city. The need for country-specific prevention and early intervention programs are warranted.

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BACKGROUND: Health-related quality of life (HRQoL) is an important clinical outcome assessment in hypertension management, given the lifelong (chronicity) nature and the need for daily self-management for hypertensive patents. Of some of the studies that implemented home-based interventions on hypertension globally, the HRQoL is rarely used as a primary outcome measure. This study developed, implemented, and assessed the impact of home-based follow-up care (HBFC) on HRQoL of hypertensive patients attending outpatients' clinics in Ilorin, Nigeria. MATERIALS AND METHODS: A total of 149 and 150 patients were randomized to intervention and usual care (control) groups, respectively. A 12-month task-shifting (nurse-driven) HBFC intervention was administered to intervention group. The mid-term impact of intervention on HRQoL was assessed after 6 months intervention. Data were analyzed with intention-to-treat principle. Treatment effects were measured with the t-tests, analysis of covariance, and multivariate analysis of covariance analysis. Significant levels were set at P < 0.05 and 95% confidence interval. RESULTS: The between-group treatment effect was not statistically significant (P > 0.05), whereas the within-group treatment effects were statistically significant for both the intervention and control arms (P < 0.05) at 6 months. After controlling for age and baseline HRQoL, the intervention group had an improved physical component of HRQoL than the control group. The intervention group also had statistically significant improvement in blood pressure control, medication adherence, and symptom counts (P < 0.05). CONCLUSION: The HBFC intervention for hypertensive patients impacted positively on physical component of HRQoL after controlling for baseline HRQoL and age of the patients at 6 months post-intervention.

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BACKGROUND: Scavengers, due to the nature of their work, are at risk of various occupational hazards while sorting for materials for recycling and sale. They are exposed to blood borne infections such as hepatitis B virus (HBV) infection from injuries from sharps and contact with discarded materials due to non-compliance with standard precautions. OBJECTIVE: The present study assessed the prevalence of HBV and compliance with safety precautions among scavengers in Ilorin Metropolis, Kwara State, Nigeria. METHODS: A cross-sectional study was conducted among 236 scavengers (comprised of scavengers dealing with biomedical wastes and those that were not) using structured questionnaires during the first stage of the study and a second testing stage. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 20.0 for descriptive and inferential statistics at a 5% level of significance. RESULTS: The prevalence of HBV infection among the scavengers was found to be 17.4%, indicating that scavengers are at high risk of HBV infection. There was a significant difference in the prevalence of HBV among scavengers that handled biomedical wastes and those that did not. The majority of the scavengers (74.2%) did not have knowledge of or use standard precautions such as personal protective equipment (PPE). The level of injuries was considerably high and the treatment of injuries among scavengers illustrated their lack of awareness of the hazards involved in their occupations, as the majority of respondents (51.3%) engaged in self-treatment of occupational injuries. CONCLUSIONS: The probable pathway for virus transmission was waste handling, especially biomedical waste, which is mostly handled with bare hands without standard safety precautions. Vaccination against HBV, proper personal hygiene practices, regular training in occupational safety, monitoring by regulatory agencies and inclusion of scavengers in a mandatory health insurance scheme are recommended to control the risk of HBV infection among scavengers. INFORMED CONSENT: Obtained. ETHICAL APPROVAL: This study was approved by the Kwara State Ministry of Health Ethical Review Committee. Permission was also granted by the scrap dealers association through the Kwara State Environmental Protection Agency that oversees issues relating to the environment and public health in the state. COMPETING INTERESTS: The authors declare no competing financial interests.

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Oral diseases have been shown to negatively affect pregnancy outcomes, yet, routine oral health care is not a component of the antenatal care package in Nigeria. This study was designed to describe the pattern of the oral conditions in pregnancy compared to the non-pregnant controls. Two hundred and twenty-five pregnant women and 166 non-pregnant controls were studied from two healthcare facilities in Ilorin. Oral-related complaints were assessed in the pregnant population while both of the groups had an oral cavity examination. The mean age of the respondents was 28.24 years ±4.77 and 80% had at least a secondary school level of education. The prevalence of oral complaints among the pregnant women was 19.1%. Gingivitis was more common among the pregnant women than the non-pregnant women, and more demonstrable on examination. Oral healthcare should be a component of the antenatal care in our environment. Impact statement What is already known on this subject? Women experience oral disorders in pregnancy, which may be worsened by the physiological changes in pregnancy. What do the results of this study add? This study has demonstrated a higher prevalence of gingivitis in the pregnant women than in the non-pregnant women on oral examination. The signs of gingivitis were higher than its related complaints. What are the implications of these findings for clinical practice and/or further research? Therefore, dental care and an examination should be part of a routine antenatal care package to prevent the unwanted pregnancy outcomes that are related to oral disorders.

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Human T-cell lymphotropic virus types I/II (HTLV-I/II) is endemic in some parts of the world including Nigeria. Reported prevalence rates in Nigeria have largely focused on blood donors. This study aims at determining the prevalence of HTLV infection among pregnant women in Ilorin North-central Nigeria. Serum samples from 276 pregnant women who were antenatal clinic attendees at General and Civil Service Hospitals in Ilorin were tested for the presence of HTLV-I/II antibodies using Enzyme Linked Immunosorbent Assay test kits from Diagnostic Automation INC., USA. Out of the 276 women tested, 3 tested positive giving a prevalence rate of 1.1%. The result was analyzed on the basis of age, marital status, nature of family, educational status, occupation, religion, parity, and gestational stage of the women. There was no statistical association of HTLV positivity with any of the variables. Although relatively lower than prevalence rate recorded among similar study groups in other parts of the country, the 1.1% prevalence in this study underscores the need for proper education and creation of awareness among antenatal clinic attendees, so as to reduce viral transmission and incidence of HTLV-related diseases.

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BACKGROUND: Accurate laboratory diagnosis of suspected malaria is the hallmark to the control of the disease. AIM: The clinical proficiency of commercial Rapid Diagnostic test kits (RDTs) using nested PCR as quality control was evaluated among patients attending two public healthcare providing institutions in Ilorin, Kwara state, North-Central, Nigeria. METHOD: A cross-sectional evaluation of finger prick blood samples of volunteer patients were accessed for malaria parasites with pLDH, HRP2, Pf, Pf/PAN and nested PCR molecular assays. The data derived were analysed using standard formulae for diagnostic accuracy, and the obtained predictive values were subjected to a comparison with one-way analysis of variance (ANOVA). RESULT: Three hundred and sixty-eight (368) patients comprising 203 (55%) females and 165 (45%) males participated in this study. Routine microscopy revealed that 54 (32.7%) males and 80 (39.4%) was infected with Plasmodium falciparum. SD Bioline (pLDH) 47.4%; Carestart Malaria (HRP2) 49.8% recorded low sensitivities. Micropoint (pfPAN) 82.8% and Micropoint (Mal. Pf) 64.4% recorded a high sensitivity. SD Bioline (pLDH) 67.4%; Carestart Malaria (HRP2) 85.9%; Micropoint (PfPAN) 62.2% and Micropoint (Mal. Pf) 86.7% had high specificities. The positive predictive value (PPV) ranged from 67.7% to 85.94%, while the negative predictive values (NPV) of 64.4% for SD Bioline (pLDH); 86.7% for Carestart Malaria (HRP2); 89.3% for Micropoint (pfPAN) and 58.5% for Micropoint (Mal. Pf). Agarose gel analysis of P. falciparumssrRNA gene (206 bp) for 28 specimens containing 10% concordant and discordant samples showed that all 12 negative specimens for RDTs and routine microscopy were truly negative for nPCR. However, the remaining 16 specimens were positive for nPCR and showed discrepancies with routine microscopy and RDTs. Cohen's interrater diagnostic measure analysis revealed that the weighted kappa for the RDTs was moderate 0.417 (p=0.027), 95%CI (0.756, 0.078) and good for nPCR 0.720 (p < 0.001), 95%CI (0.963, 0.477). The area under the curve (AUC) specify that nPCR has been more effective than the RDTs (nPCRAUC = 0.875; p < 0.001 and RDTsAUC = 0.708; p = 0.063). CONCLUSION: A thorough large-scale quality control is advocated on all commercial RDTs being used in most sub-Saharan African countries. This is to avoid double jeopardy consequent upon misdiagnosis on unidentified positive cases serving as pool reservoir for the insect vector and cyclical infection and re-infection of the populace.

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BACKGROUND: Placenta previa, a major cause of obstetric hemorrhage, is potentially life-threatening to the mother and frequently results in high perinatal morbidity and mortality. METHODOLOGY: This is a retrospective study of all cases of placenta previa managed at the University of Ilorin Teaching Hospital over a 5-year from January 2011 to December 2015. A pro forma template was used to harvest information from case notes of patients involved in the study. RESULTS: There were a total of 10,250 deliveries over the 5-year study and 164 cases of placenta previa were managed during this period; giving an incidence of 1.6% of the total deliveries. Of these patients, 65.9% were unbooked while 34.1% were booked. 110 (67%) were above 30 years of age and 51.2% were grand multiparous women. The majority (81.7%) of the patients belonged to the low socioeconomic class. Painless vaginal bleeding (62.2%), intrapartum hemorrhage (22.6%), and abnormal lie presentation (8.5%) were the most common mode of presentation. Vaginal delivery occurred in (29.3%) of patients while 70. 7% were delivered through cesarean section. There was a significant association between patients' age, parity, booking status, and types of placenta previa (P < 0.05). Similarly, there was a significant association between gestational age at delivery, mode of delivery, intraoperative blood loss, and birth weight at delivery and types of placenta previa (P < 0.05). Perinatal mortality was 12.2%, 15.6% of babies had severe birth asphyxia, and there was no maternal mortality. CONCLUSION: From this study, the risk factors for placenta previa are advanced maternal age above 35 years, grand multiparity, and booking status. Early recognition, appropriate referral of these patients and availability of ultrasound facilities, blood transfusion facilities, improvement in neonatal facilities and trained personnel will go a long way in reducing the perinatal mortality from placenta previa.

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BACKGROUND: Poor municipal waste management, including waste treatment and disposal methods, threatens the environment and public health in most developing countries. Lack of proper municipal waste segregation and transportation techniques has increased the potential for the transmission of pathogens such as hepatitis B virus (HBV). OBJECTIVES: This study addressed issues relating to the potential risk of infectious diseases and prevalence of HBV among municipal waste workers and scavengers in Ilorin metropolis, Nigeria. METHODS: A cross-sectional study was conducted among municipal waste management workers and waste scavengers in Ilorin metropolis, Kwara State, Nigeria. A total of 120 respondents were administered questionnaires during the first stage of the study and participated in the second (testing) stage of the study. The prevalence of an HBV infection biological marker, the Australia antigen (HBsAg), and its association with exposure to waste, socio-demographic factors, and history of occupational injuries with sharp objects/needle sticks was examined. RESULTS: The prevalence of HBV infection among municipal waste management workers and waste scavengers was 2.6% and 16.67% respectively, indicating that scavengers were at higher risk of HBV infection. CONCLUSIONS: Lack of proper occupational health safety management among municipal waste management workers was a possible risk factor for HBV infection through injury with sharp instruments. The possible pathway of virus transmission was waste segregation, which is usually carried out with bare hands, and lack of hygiene and occupational safety during waste management activities. Therefore, vaccination against HBV, personal hygiene practices and regular training on occupational safety will help to control risk of HBV infection among municipal waste workers and scavengers.

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BACKGROUND: Childhood mortality and morbidity due to RSV is increasing. Our current study was aimed at determining the sero-prevalence rate of RSV IgG antibodies and investigates certain known risk factors for RSV disease severity in infants and pre-school children presenting with various forms of respiratory tract infections in Ilorin, Nigeria. MATERIALS AND METHODS: About 280, children and 30, aged matched controls were enrolled into the study at the specialist hospital Ilorin. Blood testing for anti RSV IgG was done using a commercial ELISA kit by IVD Research Inc® Carlsbad. California U.S.A. Information regarding Nutritional status, socio-economic status and other demographic variables were collected. RESULTS: A prevalence rate of 85.7% was recorded among tested children and 23.3%, in controls, across age groups and gender. A statistically significant difference in age groups were recorded among patients with LRTI, (p <0.05), age <1 41%, age 1 <5, 27.6%. This was also the case for children with SRTI (Pneumonia and Bronchiolitis), with age < 1yr, 9%, and 1 <5yr, 19.8%. Analysed risk factors for disease severity showed thatnutritional status of children were statistically significant for disease severity, p-value, 0.039 (Chi square test). CONCLUSIONS: We report a high level of exposure to RSV in infancy and early childhood among children from a representative population in a major central Nigerian City, further studies into neutralising antibody levels and subtype distribution of RSV are advocated.

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BACKGROUND: Endourology has revolutionized urological practices worldwide. This is not so in many urological centers in the West African sub-region. Although, some centers have made progress in the level of urological services that they offer; many of such centers provide rigid urethrocystoscopy services and only a few centers provide flexible urethrocystoscopy services. Flexible urethrocystoscopy has the advantage of being convenient as daycare procedure with no requirement for invasive forms of anaesthesia or the need for lithotomy position. In addition, skill transfer and acquisition is good. AIM & OBJECTIVES: We present our 2 year experience with outpatient flexible cystoscopy at the University of Ilorin Teaching Hospital, Ilorin. PATIENTS & METHODS: A review of the records of patients who had flexible cystoscopy at our outpatient endoscopy unit over a 2 year period was carried out. RESULTS: There were 39 patients (36 males and 3 females) with the age range of 25 -84 years and a mean of 58.5 years. The indications were both diagnostic and therapeutic. All the procedures were done under topical anesthesia. There were no complications noted. Consultants performed 80% of the cases while the remaining was performed by a senior registrar. The year 2 registrars from surgery and Obstetrics & Gyneacology assisted in most cases. CONCLUSION: Outpatient flexible urethrocystoscopy has positively improved endourological services in this centre with less invasive anesthesia, less morbidity and improved patient satisfaction. It has also enhanced training of residents doctors in lower urinary tract endoscopy.