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Objective: To describe the Factors to Effective Clinical Experience and Willingness to pursue Career in Rural Health Facilities among Nursing Students on Clinical Placement in southeast Nigeria. Methods: The study was conducted among 48 rural health centres and general hospitals with 528 respondents from different higher institutions of learning serving in these health facilities for their clinical experience. The study applied survey design and utilized questionnaire instrument for data collection. Results: Majority of the students (60%) agreed that their school lacked functional practical demonstration laboratory for students' clinical practice, 66.7% agreed that their school lab lacked large space for all the students to observe what is being taught, 79.9% that their school lab lacked enough equipment that can enable many students to practice procedures; majority of the students (79.9%) answered that the hospitals where they are on clinical placement lacked enough equipment needed for the students on each shift of practice, 59.9% agreed that student/client ratio in each ward during clinical experience periods was not enough for students' practice under supervision, while 73.3% indicated that their school lacked library with current nursing texts for references. Personal, socioeconomic and institutional factors explain the 76% of the variance of effective clinical experience and the 52% of the variance of the willingness to work in rural health facilities in the future if offered employment. Conclusion: The factors surrounding effective clinical experience in rural healthcare facilities in southeastern Nigeria are unfavorable and could discourage future nurses from working there. It is necessary to implement strategies to improve the management of these centers in order to promote the perspective of improving sustainable rural health in this region.

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INTRODUCTION: Cardiac surgery requiring cardiopulmonary bypass had been unavailable in Northern Nigeria and the federal capital territory of Nigeria regularly. Several attempts in the past at setting up this service in a self-sustaining manner in Northern Nigeria had failed. This paper is a contrasting response to an earlier publication that emphasized the less-than-desirable role played by international cardiac surgery missions in the evolution of a sustainable open-heart surgery program in Nigeria. METHODS: The cardiothoracic unit of Federal Medical Centre, Abuja, was established on March 1, 2021, but could not conduct safe open-heart surgery. The model and strategies employed in commencing open-heart surgeries, including the choice of personnel training within the country and focused collaboration with foreign missions, are discussed. We also report the first seven patients to undergo cardiac surgery under cardiopulmonary bypass in our government-run hospital as well as the transition from foreign missions to local team operations. RESULTS: Seven patients were operated on within the first six months of setting up with high levels of skill transfer and local team participation, culminating in one of the operations entirely carried out by the local team of personnel. All outcomes were good at an average of one-year follow-up. CONCLUSION: In resource-constrained government-run hospitals, a functional, safe cardiac surgery unit can be set up by implementing well-planned strategies to mitigate encountered peculiar challenges. Furthermore, with properly harnessed foreign missions, a prior-trained local team of personnel can achieve independence and become a self-sustaining cardiac surgery unit within the shortest possible time.

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Objective. To describe the Factors to Effective Clinical Experience and Willingness to pursue Career in Rural Health Facilities among Nursing Students on Clinical Placement in southeast Nigeria. Methods. The study was conducted among 48 rural health centres and general hospitals with 528 respondents from different higher institutions of learning serving in these health facilities for their clinical experience. The study applied survey design and utilized questionnaire instrument for data collection. Results. Majority of the students (60%) agreed that their school lacked functional practical demonstration laboratory for students' clinical practice, 66.7% agreed that their school lab lacked large space for all the students to observe what is being taught, 79.9% that their school lab lacked enough equipment that can enable many students to practice procedures; majority of the students (79.9%) answered that the hospitals where they are on clinical placement lacked enough equipment needed for the students on each shift of practice, 59.9% agreed that student/client ratio in each ward during clinical experience periods was not enough for students' practice under supervision, while 73.3% indicated that their school lacked library with current nursing texts for references. Personal, socioeconomic and institutional factors explain the 76% of the variance of effective clinical experience and the 52% of the variance of the willingness to work in rural health facilities in the future if offered employment. Conclusion. The factors surrounding effective clinical experience in rural healthcare facilities in southeastern Nigeria are unfavorable and could discourage future nurses from working there. It is necessary to implement strategies to improve the management of these centers in order to promote the perspective of improving sustainable rural health in this region.

Objetivo. Describir la experiencia clínica efectiva entre los estudiantes de enfermería en prácticas clínicas en las instalaciones sanitarias rurales en el sudeste de Nigeria. Métodos. Este estudio descriptivo se llevó a cabo entre 48 centros de salud rurales y hospitales generales con 528 encuestados de diferentes instituciones de enseñanza superior que prestaban servicio en estas instalaciones sanitarias para su experiencia clínica. Resultados. 60% de los estudiantes comentaron que su centro carecía de un laboratorio de simulación para las prácticas clínicas de los estudiantes, el 66.7% indicó que el laboratorio de su centro carecía de un espacio para que todos los estudiantes pudieran observar lo que se enseñaba. Un 79.9% indicó que el laboratorio de su centro no disponía de equipos suficientes para practicar los procedimientos, y otro porcentaje igual (79.9%) manifestaron que los hospitales carecían del equipo necesario para realizar adecuadamente las prácticas clínicas. El 59.9% indicaron que la razón de estudiantes por paciente en cada sala durante los periodos de experiencia clínica era insuficiente para que los estudiantes realizaran prácticas bajo supervisión, y el 73.3% indicaron que los recursos de la biblioteca en textos de enfermería eran insuficientes para sus necesidades. Los factores personales, socioeconómicos e institucionales explican el 76% de la varianza en la experiencia clínica efectiva y el 52% en la disposición a trabajar en centros sanitarios rurales en el futuro. Conclusión. Los factores que rodean la experiencia clínica efectiva en los centros sanitarios rurales del sudeste de Nigeria son desfavorables y podrían desanimar a los futuros enfermeros a trabajar en ellos. Es necesario implementar estrategias de mejoramiento de la gestión de estos centros con el fin de impulsar la perspectiva de mejorar la salud rural sostenible en esta región.

Objetivo. Descrever a experiência clínica eficaz entre estudantes de enfermagem em estágios clínicos em unidades de saúde rurais no sudeste da Nigéria (África). Métodos. Este estudo descritivo foi realizado em 48 centros de saúde rurais e hospitais gerais com 528 entrevistados de diferentes instituições de ensino superior que atendem essas unidades de saúde pela sua experiência clínica. Resultados. 60% dos alunos comentaram que seu centro não possuía laboratório de simulação para as práticas clínicas dos alunos, 66.7% indicaram que o laboratório de seu centro carecia de espaço para que todos os alunos pudessem observar o que estava sendo ensinado. 79.9% indicaram que o laboratório do seu centro não possuía equipamentos suficientes para a realização dos procedimentos e outro percentual igual (79.9%) afirmou que os hospitais não possuíam os equipamentos necessários para a realização adequada das práticas clínicas. 59.9% indicaram que a proporção de estudantes por pacientes em cada sala durante os períodos de experiência clínica era insuficiente para que os estudantes realizassem as práticas sob supervisão e 73.3% indicaram que os recursos da biblioteca em textos de enfermagem eram insuficientes para suas necessidades. Fatores pessoais, socioeconómicos e institucionais explicam 76% da variação na experiência clínica efetiva e 52% na vontade de trabalhar em centros de saúde rurais no futuro. Conclusão. Os fatores que rodeiam a experiência clínica eficaz em unidades de saúde rurais no sudeste da Nigéria são desfavoráveis e podem desencorajar futuros enfermeiros de trabalhar lá. É necessário implementar estratégias para melhorar a gestão destes centros, a fim de promover a perspectiva de melhorar a saúde rural sustentável nesta região.

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BACKGROUND: Breast cancer remains a complex disease and leading cause of cancer-related death in Nigerian women. Recently, the role of nutrition has been highlighted in the etiology of breast cancer. METHODS: The aim of this research was to evaluate the nutrition-related knowledge, attitude, and practices of female university students. We also investigated the correlation between their demographic characteristics and their knowledge and attitudes of the survey participants. A descriptive cross-sectional study was carried out among female students at the Federal University of Oye (FUOYE), Nigeria. Participants completed self-administered questionnaires designed to assess their knowledge, attitude, and practices concerning cancer prevention. Statistical analysis was performed using SPSS 20, and significance was set at p < 0.05. RESULTS: Out of the 402 students who received the questionnaire, 300 completed it. The average age of the participants was 21.26 years with a standard deviation of 2.68. There was generally limited knowledge regarding breast cancer risk factors, with 45% of participants citing family history as the most recognized risk factor. Overall, knowledge level was influenced by the participants' permanent place of residence and course of study. Attitudes towards the impact of maternal and paternal nutrition on breast cancer prevention were notably low. Additionally, less than half of the participants demonstrated good dietary practices. CONCLUSION: This study revealed low levels of nutrition-related knowledge concerning cancer prevention, accompanied by poor dietary habits among the participants. These results suggest a possible link between inadequate knowledge about breast cancer prevention and the observed poor dietary practices among the participants. The frequent consumption of unhealthy foods among the participants may be a pointer to higher risk of breast cancer in the future, emphasizing a need for health education targeted at this group.

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ABSTRACT Introduction: Cardiac surgery requiring cardiopulmonary bypass had been unavailable in Northern Nigeria and the federal capital territory of Nigeria regularly. Several attempts in the past at setting up this service in a self-sustaining manner in Northern Nigeria had failed. This paper is a contrasting response to an earlier publication that emphasized the less-than-desirable role played by international cardiac surgery missions in the evolution of a sustainable open-heart surgery program in Nigeria. Methods: The cardiothoracic unit of Federal Medical Centre, Abuja, was established on March 1, 2021, but could not conduct safe open-heart surgery. The model and strategies employed in commencing open-heart surgeries, including the choice of personnel training within the country and focused collaboration with foreign missions, are discussed. We also report the first seven patients to undergo cardiac surgery under cardiopulmonary bypass in our government-run hospital as well as the transition from foreign missions to local team operations. Results: Seven patients were operated on within the first six months of setting up with high levels of skill transfer and local team participation, culminating in one of the operations entirely carried out by the local team of personnel. All outcomes were good at an average of one-year follow-up. Conclusion: In resource-constrained government-run hospitals, a functional, safe cardiac surgery unit can be set up by implementing well-planned strategies to mitigate encountered peculiar challenges. Furthermore, with properly harnessed foreign missions, a prior-trained local team of personnel can achieve independence and become a self-sustaining cardiac surgery unit within the shortest possible time.

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In Bauchi State, northern Nigeria, communities recognise short birth interval (kunika in the Hausa language) as harmful, but family planning is a sensitive topic. This paper describes the development of a culturally safe way to communicate about kunika in a conservative Muslim setting. The objective was to co-design culturally safe communication material, based on local knowledge about short birth interval, to share with women and men in households.Six community co-design groups of women and six of men (total 96 participants) reviewed summaries of their previously created maps of perceived local causes of kunika, categorised as frequent sex, family dynamics and non-use of contraception. They advised how these causes could be discussed effectively and acceptably with women and their husbands in households and suggested storylines for three short video docudramas about the prevention of kunika. The research team created the docudramas with a local producer and fieldworkers piloted their use in households.The design groups advised that communication materials should focus on child spacing rather than on limitation of family size. Even sensitive issues could be covered. People would not change their sexual behaviour but could be advised to use contraceptives to prevent kunika. The groups approved the final videos and six focus groups of visited women and men reported they were acceptable and helpful. Community co-design of communication about kunika was feasible and led to videos about a sensitive topic that were acceptable to ordinary men and women in communities in Bauchi.

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Aim: Globally, one of the leading causes of preventable blindness is primary open-angle glaucoma (POAG). The study assessed the clinical presentations of POAG patients attending an eye center in Abuja, Nigeria. Materials and methods: Records of 188 eyes, collected from 94 patients diagnosed with POAG for a period of 1 year at the eye center, were reviewed. Clinical records, including age, gender, visual acuity (VA), central cornea thickness (CCT), intraocular pressure (IOP), cup-to-disk ratios, and retinal nerve fiber layer (RNFL) thickness of the participants, were extracted and analyzed. Results: The majority of the participants were males (56.4%) and adults (57.4%), most of whom had normal VA (>70% in each eye). Our analysis revealed normal average estimates of RNFL thickness, IOP, and CCT among the participants. Females had thicker RNFL compared to males (p = 0.02). Although CCT decreased with age (r = -0.28, p = 0.005), there was no such link between IOP and CCT (r = 0.09, p = 0.38). Conclusion: Central cornea thickness (CCT), RNFL thickness, and IOP in isolation should not be used as early indicators for POAG; rather, a combination of these and other indices is recommended. Early detection through active screening and treatment in the community for at-risk groups is highly advised. How to cite this article: Ezinne NE, Kwarteng MA, Ekemiri KK, et al. Clinical Profile of Primary Open-angle Glaucoma Patients at an Eye Center in Nigeria. J Curr Glaucoma Pract 2023;17(3):113-117.

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The objective of this research was to develop and assess the validity of a scale to measure perceived abortion self-efficacy (PASE). Perceived abortion self-efficacy is defined as an individual's perceived confidence in their ability to carry out the tasks necessary to end a pregnancy safely and successfully. During the first phase of this study between February and April 2018, we conducted qualitative research using in-depth interviews and focus group discussions with women in Bolivia, Nepal, and Nigeria to explore domains of PASE. Using the qualitative data, we prepared a draft set of measures with 31 items. In October and November 2018, the second phase of the study included field testing 31 draft items with a convenience sample of approximately 1200 women across the three study countries. Exploratory factor analysis was conducted to identify an appropriate scale structure, resulting in a 15-item, 3-factor model. The three factors represent the concepts of enlisting social resources, accessing information and care, and resilience. In the third and final phase in September and October 2019, the validity of the 15 scale items was assessed. The scale was administered to a new sample of approximately 400 women in each country. Confirmatory factor analyses were conducted to test model fit for the scale structure identified during the second phase. The results from this study suggest that the final PASE scale has considerable potential to be a valid measure of PASE. The new 15-item PASE scale presented in this paper can be used to evaluate programmes or interventions designed to improve women's PASE and to assess the state of PASE in populations.

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Background: Achieving climate targets will require a rapid transition to clean energy. However, renewable energy (RE) firms face financial, policy, and economic barriers to mobilizing sufficient investment in low-carbon technologies, especially in low- and middle-income countries. Here, we analyze the challenges and successes of financing the energy transition in Nigeria and Brazil using three empirically grounded levers: financing environments, channels, and instruments. Results: While Brazil has leveraged innovative policy instruments to mobilize large-scale investment in RE, policy uncertainty and weak financing mechanisms have hindered RE investments in Nigeria. Specifically, Brazil's energy transition has been driven by catalytic finance from the Brazilian Development Bank (BNDES). In contrast, bilateral agencies and multilateral development banks (MDBs) have been the largest financiers of renewables in Nigeria. Policy instruments and public-private partnerships need to be redesigned to attract finance and scale market opportunities for RE project developers in Nigeria. Conclusions: We conclude that robust policy frameworks, a dynamic public bank, strategic deployment of blended finance, and diversification of financing instruments would be essential to accelerate RE investment in Nigeria. Considering the crucial role of donors and MDBs in Nigeria, we propose a multi-stakeholder model to consolidate climate finance and facilitate the country's energy transition.

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INTRODUCTION: The aim of this study was to examine the effect of group cognitive-behavioral therapy (GCBT) on pathological internet use (PIU). METHOD: The study applied a group randomized controlled trial design to assign participants to intervention and control groups. A total of 40 college students aged 18 to 30 who were pathological internet users (PIUs) participated in this study and were randomly assigned to treatment and control groups. Participants completed a self-report scale entitled the Problematic Internet Use Scale (PIUS) at three time points. The intervention lasted 8 weeks. The data collected were statistically analyzed using repeated-measures analysis of variance (ANOVA). RESULTS: The results showed that GCBT has significant efficacy, decreasing the symptoms of PIU among the GCBT participants compared to those in the control group and that the improvements were maintained at follow-up. We also found a significant interaction effect by time for PIU. CONCLUSION: From the study findings, we can conclude that GCBT has significant benefit for mitigating the severity of PIU in college students. Therefore, mental health professionals are encouraged to explore the benefits of GCBT in treating symptoms associated with PIU in school settings and beyond.

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Abstract Introduction The aim of this study was to examine the effect of group cognitive-behavioral therapy (GCBT) on pathological internet use (PIU). Method The study applied a group randomized controlled trial design to assign participants to intervention and control groups. A total of 40 college students aged 18 to 30 who were pathological internet users (PIUs) participated in this study and were randomly assigned to treatment and control groups. Participants completed a self-report scale entitled the Problematic Internet Use Scale (PIUS) at three time points. The intervention lasted 8 weeks. The data collected were statistically analyzed using repeated-measures analysis of variance (ANOVA). Results The results showed that GCBT has significant efficacy, decreasing the symptoms of PIU among the GCBT participants compared to those in the control group and that the improvements were maintained at follow-up. We also found a significant interaction effect by time for PIU. Conclusion From the study findings, we can conclude that GCBT has significant benefit for mitigating the severity of PIU in college students. Therefore, mental health professionals are encouraged to explore the benefits of GCBT in treating symptoms associated with PIU in school settings and beyond.

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Brain is the most vulnerable organ in the body to the ageing processes which operates at variable levels between organs and species. In this study we examine brains histopathologically for architectural changes in four Nigerian cattle breeds. Brains from 246 cattle (Bunaji=80, Muturu=78, Rahaji=62 and Sokoto Gudali=26), aged 1­≥12years were examined at 8 different neuroanatomical locations. All the cattle used were obtained from Abattoir in Ibadan, Nigeria. They were examined at ante-mortem and those without clinical signs suggestive of neurological disease were sampled. Major changes observed were intracellular accumulation of substances (61.4%), neuronal and or axonal degenerations and loss (51.6%), perivascular cuffing (50.0%), extracellular accumulation of substances (29.7%), hypercellularity (19.1%) and spongy state (0.4%), malacia (0.0%), demyelination (0.0%) in 233 cattle. Intraneuronal vacuolations (35%), lipofuscin accumulation (42%), axonal spheroids (50%), inflammatory changes (50%), and brain sand (22%). Although perivascular cuffing was high, there was low incidence of lymphocytic infiltration in the pineal gland in both sexes. Intracellular accumulation of substances, neuronal and or axonal degenerations and loss, and extracellular accumulation of substances display levels of significant changes with age (p<0.0001). Changes starts at the age of 2 years in life in these breeds of cattle due probably to the adverse stress exerted by the tropical climate. The description of histological findings in the brain of symptomless cattle in the present study provides a useful background for diagnostic bovine neuropathology in the tropics.(AU)

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INTRODUCTION: Geriatrics, a specialized medical branch focusing on the health and well-being of older individuals, has gained increasing attention due to the global demographic shift towards an aging population. Despite the significant growth of the older adult population in Nigeria, limited empirical studies hinder the translation of research findings into health and well-being improvements for older adults in the region. OBJECTIVE: This systematic review will synthesize geriatrics research conducted in Nigeria over the past 6 decades, identifying temporal patterns and research priorities. METHODS: Four electronic databases will be searched to identify studies from published and grey literature on geriatrics in Nigeria between 1960 and 2023 and will be reviewed from inception to 2023: PubMed, MEDLINE, Google Scholar, and African Journal Online. The population of interest is older adults aged ≥60 years. The review team comprises primary investigators, content experts, and a subject librarian. Data extraction and analysis will be conducted independently by review authors, and statistical analysis will be performed by experts. EXPECTED RESULTS: Depending on the results, we anticipate that this systematic review will help clarify the state of geriatrics studies and services in Nigeria. RELEVANCE: The review will fill research gaps to inform policy directives and interventions in geriatric care by developing evidence-based clinical and policy documents to improve the health and well-being of older adults in Nigeria. (AU)

INTRODUÇÃO: A geriatria, um ramo médico especializado com foco na saúde e no bem-estar dos indivíduos mais velhos, tem ganhado cada vez mais atenção por conta de uma mudança demográfica global diante do envelhecimento da população. Apesar do crescimento significativo da população idosa na Nigéria, estudos empíricos limitados dificultam a tradução dos resultados das pesquisas em melhorias na saúde e no bem-estar dos idosos na região. OBJETIVO: Esta revisão sistemática visa sintetizar a pesquisa em geriatria realizada na Nigéria nas últimas seis décadas, identificar padrões temporais e prioridades de investigação. METODOLOGIA: Pesquisas foram realizadas em quatro bases de dados eletrônicas (PubMed, Medical Literature Analysis and Retrieval System Online - MEDLINE, Google Scholar e African Journal Online - AJOL) para identificar estudos sobre geriatria na Nigéria, englobando literatura publicada e literatura cinzenta entre 1960 e 2023. Esses estudos foram revisados desde o início até 2023. A população de interesse é de idosos com idade ≥60 anos. A equipe de revisão é composta de investigadores principais, especialistas em conteúdo e um bibliotecário especializado no assunto. A extração e a análise de dados foram conduzidas de forma independente pelos autores da revisão, e a análise estatística foi realizada por especialistas. RESULTADOS ESPERADOS: Dependendo dos resultados, prevemos que esta revisão sistemática contribuirá para a compreensão do estado dos estudos e serviços de geriatria na Nigéria. RELEVÂNCIA: A revisão irá, através do desenvolvimento de documentos clínicos e políticas baseados em evidências, preencher lacunas das pesquisas que informam as diretivas políticas e as intervenções nos cuidados geriátricos, para assim melhorar a saúde e o bem-estar dos idosos na Nigéria.

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Resumo Estudantes de medicina possuem diferentes opções de trajetórias acadêmicas ou profissionais após a graduação. Este estudo busca determinar as preferências de carreira entre graduandos de medicina e os fatores que contribuem para tal decisão. Pesquisa descritiva e transversal foi realizada com graduandos de medicina da Afe Babalola University, localizada em Ekiti State, Nigéria. Dados foram coletados por um questionário bem estruturado e analisados usando SPSS versão 21.0. A estatística descritiva inclui tabelas de frequência, gráficos, médias e desvios padrão. Um total de 100 graduandos participaram do estudo, dos quais 29 (29,0%) homens e 71 (71,0%) mulheres, com relação homem/mulher de 0,4 para 1. A faixa etária dos participantes foi de 21 a 30 anos, com média (±SD) de 23,5 (±1,4). Do total de participantes, 72% planejavam ingressar na pós-graduação após a faculdade de medicina, a maioria no Reino Unido, sendo o mestrado em Saúde Pública a qualificação de maior interesse. Da mesma forma, 76% dos entrevistados planejavam buscar uma bolsa de pós-graduação após a faculdade, também em sua maioria no Reino Unido. A especialidade mais procurada é Obstetrícia e Ginecologia (43%), seguida por Cirurgia (40%), Medicina de Família (34%), Medicina Comunitária (33%), Pediatria (25%) e Medicina Interna (23%), enquanto a especialidade menos procurada é Patologia Química (28%), seguida por Microbiologia Médica (27%) e Anatomia Mórbida (24%). O principal fator considerado para esta escolha é o interesse pessoal pela especialidade, seguido por perspectivas financeiras, estilo de vida confortável e horário de trabalho flexível. Mestrado em Saúde Pública e especialização em Obstetrícia e Ginecologia são as carreiras mais buscadas por graduandos de medicina, escolha majoritariamente pautada em seus interesses pessoais.

Abstract Medical students have many different options of academic and professional undertakings after graduation. The aim of this study is to determine the career preferences of students in their final year of medical school and to determine the factors that contributed for such decision. This is a descriptive cross-sectional study involving the final-year medical students of Afe Babalola University, Ekiti State, Nigeria. A well-structured questionnaire was used for data collection. The data was analysed using the Statistical Package for the Social Sciences (SPSS) version 21.0. Descriptive statistics included frequency tables, charts, means and standard deviations. A total number of 100 final-year medical students participated in the study, out of which 29 (29.0%) were males and 71 (71.0%) were females, with a male to female ratio of 0.4 to 1. The age range of the respondents was 21 to 30 years, with a mean(±SD) of 23.5(±1.4). 72% of the respondents planned to pursue a postgraduate academic qualification after graduating from medical school, mostly in the United Kingdom, and a Master of Public Health was the most sought qualification. Similarly, 76% of the respondents planned to pursue a postgraduate medical fellowship after medical school, also mostly in the United Kingdom. The specialty most sought-after is Obstetrics and Gynaecology (43%), followed by Surgery (40%), Family Medicine (34%), Community Medicine (33%), Paediatrics (25%), and Internal Medicine (23%) while the least sought-after specialty is Chemical pathology (28%), followed by Medical Microbiology (27%) and Morbid Anatomy (24%). The most important factor considered by the respondents in choosing a particular specialty is their personal interest in that specialty, followed by financial prospects, comfortable lifestyle, and flexible working hours. Master of Public Health degree and postgraduate fellowship in Obstetrics and Gynaecology specialty are the career preferences for most of the final-year medical students in this study, and this is largely informed by their personal interest in these fields.

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Background: Visual impairment (VI) is a public health problem that can affect an individual's social wellbeing. The study aims to determine the distribution and causes of vision impairment (VI) and blindness among patients at Nigerian Army Eye Centre Lagos, Nigeria. Method: An institutional cross-sectional study was conducted, and a systematic random sampling technique was used to enrol study participants from their medical records. Information about their demography, presenting visual acuity (VA), best corrected visual acuity and cause of VI and blindness, were retrieved. Result: A total of five hundred (500) medical records of patients aged from 4 to 96 years, with a mean age of 54.07 ± 21.43 years, were considered for the study. Among the participants, more than half were males (51.2%) and ≥60 years (53.0%). A large (47.2%) proportion of the patients had moderate VI at the time of presentation, followed by blindness (22.0%). The major cause of blindness was cataract, while glaucoma and refractive error were the major causes of VI. Blindness and VI were significantly associated with the type of VI before and after the provision of intervention (p < 0.05) across different age groups (children, youths, adults, elderly) with an adjusted p < 0.003 after an intervention. Conclusions: Cataracts, glaucoma and uncorrected refractive error (URE) were the major causes of VI and blindness in Lagos State. VI was more prevalent in males than females; however, there was no significant difference between the two proportions. The prevalence of VI among age groups was more significant for those 60 years and above. Early screening for the detection and management of cataract, URE and glaucoma is highly advised to reduce the burden of VI.

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BACKGROUND: There is evidence of an association between life events and psychosis in Europe, North America and Australasia, but few studies have examined this association in the rest of the world. AIMS: To test the association between exposure to life events and psychosis in catchment areas in India, Nigeria, and Trinidad and Tobago. METHOD: We conducted a population-based, matched case-control study of 194 participants in India, Nigeria, and Trinidad and Tobago. Cases were recruited through comprehensive population-based, case-finding strategies. The Harvard Trauma Questionnaire was used to measure life events. The Screening Schedule for Psychosis was used to screen for psychotic symptoms. The association between psychosis and having experienced life events (experienced or witnessed) was estimated by conditional logistic regression. RESULTS: There was no overall evidence of an association between psychosis and having experienced or witnessed life events (adjusted odds ratio 1.19, 95% CI 0.62-2.28). We found evidence of effect modification by site (P = 0.002), with stronger evidence of an association in India (adjusted odds ratio 1.56, 95% CI 1.03-2.34), inconclusive evidence in Nigeria (adjusted odds ratio 1.17, 95% CI 0.95-1.45) and evidence of an inverse association in Trinidad and Tobago (adjusted odds ratio 0.66, 95% CI 0.44-0.97). CONCLUSIONS: This study found no overall evidence of an association between witnessing or experiencing life events and psychotic disorder across three culturally and economically diverse countries. There was preliminary evidence that the association varies between settings.

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ABSTRACT Introduction: Prevalence of RhD negative phenotype in Nigeria is low; this leads to scarcity of RhD negative red cells for transfusion. Serological and molecular genotyping of RhD negative individuals for weak D types could reduce this scarcity. The aim of this study was to determine the serological prevalence and molecular types of weak D phenotypes among blood donors and pregnant women in Kano, Nigeria. Methods: A total of 4482 blood donors and pregnant women from three hospitals in Kano were recruited. An indirect antiglobulin test was used to determine weak D phenotypes. Molecular genotyping was performed on genomic DNA from whole blood amplified by polymerase chain reaction sequence-specific primers (PCR-SSP) with agarose gel electrophoresis. Results: The mean age of the participants was 26.50 ±5.79 years. The prevalence of the RhD negative phenotype was 4.2% (189/4482). Of the 189 RhD negative phenotypes, 20 (10.6%) were weak D positive. Molecular genotyping of the 20 Weak D positive phenotypes revealed 15 (75%) weak D type 4, of which 11 were due to the RHD*09.03 and RHD*DAR3 (T201R, F223V) polymorphisms and 4, due to RHD* 08.01 and RHD* DFV polymorphisms; 2 (10%) were due to the 602 C>G polymorphism, while the remaining 3 (15%) constituted partial D or other rare weak D types. Conclusion: The prevalence of weak D positive phenotypes is high in this study; weak D type 4 is the most common RhD genetic variant. Routine serologic weak D testing of RhD negative blood and molecular genotyping should be encouraged in resource-limited settings.

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BACKGROUND: There is scarce information about the occurrence of extended-spectrum ß-lactamases (ESBLs) in Salmonella enterica serovar Typhi (S. Typhi) from patients with typhoid fever. OBJECTIVE: To study the antimicrobial resistance and ESBL encoding genes among S. Typhi isolates in aforesaid patients from Lagos, Nigeria. METHODS: S. Typhi isolates were collected from blood samples of typhoid fever patients from 4 academic medical centers in Lagos, Nigeria. The identification of isolates and their antibiotic susceptibility testing were performed by standard bacteriological techniques and disc diffusion method, respectively. The production of ESBLs was investigated using combination disk test (CDT) and polymerase chain reaction (PCR). RESULTS: A total of 27 S. Typhi isolates was collected. All isolates were susceptible to imipenem and nitrofurantoin. Fifteen (55.6%) isolates were multidrug-resistant (MDR). The CDT test showed 11 (40.7%) ESBL producer isolates. However, the PCR revealed a higher occurrence rate for ESBL producers (66.7%, n = 18/27). The ESBL genes were as follows: blaCTX-M (37.0%, n = 10/27), blaSHV (18.5%, n = 5/27), and blaTEM (44.4%, n = 12/27). All ESBL positive S. Typhi isolates were MDR. CONCLUSIONS: This study showed the emergence of ESBL-harboring S. Typhi in patients with typhoid fever from Nigeria.

Assuntos

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Globally, people self-manage their medication abortions without clinical assistance. Feminist activist collectives (accompaniment groups) support people through self-managed abortion with evidence-based guidance. We sought to understand the impact of COVID-19 and related restrictions on the need for and experiences of self-managed abortion with accompaniment support across varied legal and social contexts. Between May and October 2020, we conducted in-depth interviews with individuals who self-managed abortions with support from accompaniment groups during the pandemic in Argentina, Indonesia, Nigeria, and Venezuela. We conducted a thematic analysis to understand the impact of COVID-19 on participants' experiences with accompanied self-managed abortions. Across 43 in-depth interviews, participants in all four countries described how the COVID-19 pandemic created challenges at each step of their abortion process, from confirming the pregnancy, accessing abortion pills, finding a private, comfortable place, and verifying abortion completion. For most people, conditions related to the pandemic made it harder to self-manage an abortion; for a minority, being at home made aspects of the experience somewhat easier. Nonetheless, all participants reported feeling supported by accompaniment groups, and COVID-19 and related lockdowns reinforced their preference for accompaniment-supported self-managed abortion. These findings highlight the essential role that accompaniment groups play in ensuring access to high-quality abortion care in a multiplicity of settings, particularly during the COVID-19 pandemic. Efforts are needed to expand the reach of accompaniment groups to increase access to the high-quality abortion support they provide, filling a critical gap left by health systems and legal infrastructure.

Assuntos

RESUMO

ABSTRACT Background: There is scarce information about the occurrence of extended-spectrum β-lactamases (ESBLs) in Salmonella enterica serovar Typhi (S. Typhi) from patients with typhoid fever. Objective: To study the antimicrobial resistance and ESBL encoding genes among S. Typhi isolates in aforesaid patients from Lagos, Nigeria. Methods: S. Typhi isolates were collected from blood samples of typhoid fever patients from 4 academic medical centers in Lagos, Nigeria. The identification of isolates and their antibiotic susceptibility testing were performed by standard bacteriological techniques and disc diffusion method, respectively. The production of ESBLs was investigated using combination disk test (CDT) and polymerase chain reaction (PCR). Results: A total of 27 S. Typhi isolates was collected. All isolates were susceptible to imipenem and nitrofurantoin. Fifteen (55.6%) isolates were multidrug-resistant (MDR). The CDT test showed 11 (40.7%) ESBL producer isolates. However, the PCR revealed a higher occurrence rate for ESBL producers (66.7%, n = 18/27). The ESBL genes were as follows: blaCTX-M (37.0%, n = 10/27), blaSHV (18.5%, n = 5/27), and blaTEM (44.4%, n = 12/27). All ESBL positive S. Typhi isolates were MDR. Conclusions: This study showed the emergence of ESBL-harboring S. Typhi in patients with typhoid fever from Nigeria.