Knowledge of heat waves and practice of protective measures against it in a rural West African

Background

Heat wave has a direct linkage to global climate change and is associated with increased morbidity and mortality. Between March and May 2019, Nigeria experienced severe heat waves. Understanding heat waves provides an opportunity for individuals to proactively take measures to prevent its negative health impacts. However, illiteracy levels in rural Sub-Saharan Africa are higher than in urban areas.This study was therefore conducted to assess knowledge of heat waves and practice of protective measures against it in an affected rural community of Nigeria.

Methods

A cross-sectional, community based descriptive study conducted among household heads in Nasarawan Buhari, a rural agrarian community in Nigeria. An interviewer-administered questionnaire was used to collect data from 104 household heads, selected using systematic random sampling technique. Data was analyzed using SPSS (version 20).

Results

A majority of the respondents were males (79.8%) and most of them (89.4%) had poor knowledge of heat waves. Farming occupation was significantly associated with knowledge of heat waves (P = 0.025). Awareness of measures needed to protect against the negative health impacts of heat waves was also poor. Hence fluid intake and cold showers were the only protective measures used by majority of respondents to reduce effect of the extreme heat.

Conclusions

Both knowledge of heat waves and practice of protective measures against it were poor among respondents. A health education intervention on heat waves and how to prevent its negative health impacts was conducted in the community.

Key messages

Due to poor knowledge of heat waves and its negative health effects, practice of protective measures against it was poor among respondents. There is need for more public health response to address this rural public health challenge.

Performance of metakaolin based geopolymer concrete at elevated temperature

Due to the carbon dioxide emission arising from the production of cement, alternative concrete that is environmentally friendly such as metakaolin geopolymer concrete have been developed. However, the performance of metakaolin based geopolymer concrete (MKGC) when exposed to aggressive environment particularly elevated temperature has not been investigated. Therefore, this paper assessed the performance of MKGC exposed to elevated temperatures. MKGC cube specimens of grade 25 were produced using a mix ratio of 1:1.58:3.71.After preparing the specimens, they were placed in an electric oven at a temperature of 60oC for 24 hours. Thereafter, the specimens were stored in the laboratory at ambient temperature for 28 days. The specimens were then exposed to elevated temperatures of 200, 400, 600 and 800oC. After exposure to elevated temperatures, the MKGC specimens were subjected to compressive strength, water absorption and abrasion resistance tests. Results show that at 600 and 800oC, the MKGC lost a compressive strength of 59.69% and 71.71% respectively. Higher water absorption and lower abrasion resistance were also observed. Keywords: Cement, Compressive Strength, Metakaolin Concrete, Elevated Temperature.

Health Education Intervention as an Effective Means for Prevention of Respiratory Infections Among Hajj Pilgrims: A Review

The prevalence of respiratory illness has continued to surge among Hajj pilgrims from different countries despite having some practices of preventive measures. Respiratory illnesses during Hajj could be due to many reasons and many factors that promote disease spread. These factors include overcrowding, cigarette smoking, and direct contact with infectious agents particularly viruses promote the spread of respiratory infections. However, due to the longer duration of the pilgrimage, there are high chances of pilgrims contracting various respiratory illnesses due to exposure to respiratory pathogens. Hajj pilgrims' knowledge, attitudes, and practices toward respiratory tract infections are used as the determinant of the effectiveness of the health education interventions. Knowledge and application of basic hygiene principles, use of face masks, following cough etiquettes, engaging in social distancing, and engaging in other measures are highly important. In this paper, we reviewed the various effective intervention strategies implemented to help prevent respiratory tract infections during Hajj.

Assessment of health-related quality of life of chronic kidney disease patients in aminu kano teaching hospital, Kano

Background

The prevalence of chronic kidney disease (CKD) is increasing globally. Recently, the concept of Health-Related Quality of Life (HRQOL) is receiving attention as a measure of treatment outcome in addition to traditional morbidity and mortality rates.

Objective

To assess the HRQOL of CKD patients stages 1-5 using the Kidney Disease Quality of Life questionnaire (KDQOL).

Methodology

The study was a cross-sectional study of CKD patients at a teaching hospital in north-western Nigeria during the study period. The quality of life, sociodemographic, clinical, and laboratory variables were assessed using a pro forma and the KDQOL questionnaire during regular clinic visits/dialysis sessions. Age and sex-matched healthy volunteers without evidence of renal disease were recruited from the hospital environment into a comparison group.

Results

A total of 150 subjects with CKD and 150 individuals in the comparison group completed the study with 77 males and 73 females for both groups. The mean ± standard deviation (SD) ages of the CKD and comparison group was 52.83 ± 14.21 and 52.43 ± 14.50 years, respectively. Subjects in the comparison group had higher physical composite summary (PCS) and mental composite summary (MCS) scores than individuals with CKD (P value < 0.05). Subjects with CKD showed a progressive decline in the scores of all HRQOL domains with advancing CKD stages (P value < 0.05).

Conclusions

The results suggest that subjects with CKD have worse HRQOL domain scores when compared to the normal population and these scores progressively worsened with advancing CKD stages.

Kick Out Cancer Campaign

Amount raised: N17,307,000 Background and context: The power of games for social change is well documented. Football, the world's most popular game is a common passion shared by most Nigerians across all divides. It defies all barriers and unites people globally. Beyond the potential for cancer awareness creation using football games, it can also be used to raise funds for cancer course. Aim: The aim was to increase cancer awareness via community participation and involvement as well as raise funds for cancer patients. To encourage the population to engage in healthy lifestyles and physical activities in lowering the risks of cancer. Strategy/Tactics: We partnered with the League Management Company- Nigeria Professional Football League and the Nigerian Football Federation (NFF) for technical support to portray a tone of professionalism in our novelty football tournament. We worked a long side with expert active, retired, Nigerian and international professional footballers as well as artists to bring out in mass fans and the community at large toward achieving our goals. Radio and television jingles were made to ensure maximum reach out to the masses. Social media hype was done where some selected players called on to their fans to get involved. An awareness 5-km walk was organized where kits (T-shirts, face caps, wrist bands) were sold in addition to the tickets for the tournament. Footballers signed on various T-shirts which were auctioned during the tournament as well as arts and jewelry. Program process: Active and retired footballers were engaged as well as prominent local artist to bring out crowd in mass crowd that benefitted in this campaign. All transactions made were through the foundation's account for credibility. Costs and returns: Costs: media and logistics - N1,000,000, walk kits and jerseys - N1,500,000, food and refreshments - N1,300,000, security - N200,000, event planners - N300,000, kids corner - N500,000. Total N4,800,000 Returns: tickets and coupon sales - N1,057,000, walk kits sold - N 3,050,000, players registration - N200,000, teams registration - N4,000,000, stands sold - N250,000, auctioned art - 1,000,000, auctioned jerseys - N1,500,000, auctioned jewelry - 250,000, donations received - N10,800,000. Total N22,107,000 What was learned: A lot can be achieved collectively as a community in reducing the burden of costs in the treatment of cancer.

Awareness and Utilization: Prevention of Mother-to-Child Transmission (PMTCT) Services among Primigravid Women attending Primary Health Care Facilities in Zaria, North-Western Nigeria

BACKGROUND

Nigeria with an estimated population of 193 million is Second to South Africa in the number of people living with Human Immune Deficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) worldwide, representing 9% of the global burden of the disease. The objective of this study is to determine the awareness, knowledge and utilization of PMTCT services before first pregnancy in the study population, which is a critical prong 1 PMTCT strategy to prevent and control the vertical transmission of this pandemic infection.

METHODS

An analytical cross-sectional study conducted in February-April 2016 among 300 Primigravid women selected by the cluster sampling technique from six Primary Health Care (PHC) facilities that offered PMTCT services out of a list of 25 PHC facilities in Zaria LGA at the time of the survey. Data were collected using interviewer administered, closed ended questionnaire. Bivariate and multivariate logistic regression analyses were done using the IBM SPSS version 20 and the Stata Corp STATA SE 14 to determine variables that were significantly associated with respondents' utilization of the PMTCT services. The level of significance was set at p<0.05.

RESULTS

The mean age of the respondents and mean gestational age at booking were 21.1+3.54 years and 21.68 + 6.74 weeks, respectively. One-fifth of the respondents were not aware of any HIV preventive method, 81(27%) did not know that HIV can be transmitted from the mother to the fetus, 83 (27.7%) believed that transmission was by witchcraft, while 76%, 64% and 45% opined that use of condom, faithfulness to an HIV negative sexual partner and abstinence respectively were protective measures. Only 62(20.7%) were ever tested for HIV infection and 7(2.3%) of these were HIV positive. There were significant association between respondent age, awareness, perception and knowledge of MTCT, gestational age at booking, family setting and the prior utilization of PMTCT services (p<0.05).

CONCLUSION

The awareness and utilization of PMTCT services before pregnancy was poor. There was a need to scale up programmes to improve the uptake of PMTCT services before pregnancy toward attaining the sustainable development goal 3.3.

Factors Affecting Technical Efficiency of Rubber Smallholders in Negeri Sembilan, Malaysia

The main objective of the study was to figure out, identify and analyse the technical efficiency of rubber smallholders’ production in Negeri Sembilan, Malaysia. Multi-stage data collection procedures, comprising both purposive and random sampling techniques, were used. Using structured questionnaires, farm-level information with cross sectional data from five districts of Negeri Sembilan, were employed in the study. A parametric Stochastic Frontier Analysis (SFA), with a transcendental logarithmic (Translog) functional form, was used in the study. The descriptive statistics results revealed that, the mean rubber yield was 5465 kg while that of the seven inputs used include 1.2 ha, 602.7, 2.33, 363.6 kg, 13.0 lit, 13.2 man days and 2.47 respectively for farm size, task, farm tools, fertilizer, herbicides, labour and rubber clones.The inferential statistics showed that, the mean technical efficiency was found to be 0.73 with a standard deviation of 0.089. Thus, this translates that 27% accounted for technical inefficiency. Both the sigma square and gamma coefficients were found to be statistically significant at 1% level. The Log Likelihood Function (LLF) and the Log Rati (LR) test were found to be respectively 167.7 and 34.07. The results further revealed that, although none of the farms were found to be on the frontier, however, 9 farms were very near the frontier with efficiency score range between 0.90-0.99. And twenty (20) firms have range 0.80-0.90. Race, Tapping experience, household number and extension agent’s visits were found to be technically significant and are thus critical in determining technical efficiency of rubber smallholders in Negeri Sembilan, Malaysia.

An Epidemiological Study of Needlestick Injury among Healthcare Workers in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

BACKGROUND

Occupationally acquired infections are leading causes of morbidity and mortality among health care workers. The study aimed to determine knowledge, attitude and preventive practices of health care workers on needle stick injuries in Ahmadu Bello University Teaching Hospital, Zaria.

METHODS

This was a cross sectional descriptive study in which stratified sampling technique was used to sample respondents. Data was collected using structured, close ended self-administered questionnaire.

RESULTS

A total of 166 respondents completed the questionnaires out of 250 distributed questionnaires. Forty-three (25.9%) were males, 123 (74.1%) were females. The combined mean age was 40.9 ± 9.8 years. All the respondents were aware and knew of transmission of blood borne pathogens. Majority 116 (70.7%) had ever sustained injury while at work and 14 (8.8%) sustained injury in the last 3 months. The incidence of injury increases with work duration (c2= 17.88, p=0.001) and length of practice (c2=10.38, p=0.001). Eighty percent of respondents had received training on universal precautions. The commonest place of exposure was in the wards (65.6%) and circumstances of exposure were respectively sudden patient movements 21(19.3%) and recapping needle 20 (18.3%). Only 52 (43.3%) of respondents took appropriate measure (rinsing and disinfecting) the site after injury.

CONCLUSION

This study revealed the high risk health care workers are exposed to at work. There is urgent need to improve the safety of health care workers through continuing education and strict adherence to universal precautions. There is need to establish a surveillance system to monitor such incidents and provision of post-exposure prophylaxis to those accidentally exposed.

Nephrotic syndrome among children in Kano: a clinicopathological study

OBJECTIVE

To evaluate the clinicopathological features of children with nephrotic syndrome seen in a pediatric nephrology unit in northern Nigeria.

MATERIALS AND METHODS

All children less than 15 years of age who had nephrotic syndrome and who had been subjected to renal biopsy at Aminu Kano Teaching Hospital, Kano, were studied. Their histologic diagnoses were evaluated alongside clinical and other laboratory parameters.

RESULTS

Twenty children, 17 males and three females, were studied. These represented 55% of all children with nephrotic syndrome seen in the pediatric nephrology unit during the study period, the rest of which have never had renal biopsies. Peak age was 7-8 years (range 2.5-13 years). Fourteen of the 20 children (70%) had previously been on steroid treatment. Of these, 11 (55%) were classified to be steroid resistant and three (15%) were frequent relapsers. Six (30%) children were newly diagnosed with nephrotic syndrome and had not commenced steroid treatment. Hypertension was found in seven (35%) children. Sixteen children (80%) had microscopic hematuria on presentation. The most common histopathological diagnosis was focal glomerulosclerosis in nine (45%) children (segmental = 8; global = 1). Minimal change disease was found in four children (20%), membranoproliferative glomerulonephritis in three children (15%), membranous nephropathy in three children (15%), and diffuse mesangial hypercellularity in one child (5%). Of the six children who had renal biopsy before commencement of steroid treatment, three (50%) were found to have glomerulosclerosis.

CONCLUSION

Focal segmental glomerulosclerosis was the most common histological subtype diagnosed in Kano among children with nephrotic syndrome in this study.

New-onset diabetes after renal transplantation: a case series as seen in a Nigerian kidney transplant population

New-onset diabetes after transplantation (NODAT) is an important metabolic complication of transplantation because of its associated morbidity and mortality. Risk factors for NODAT include those known to cause diabetes mellitus in non-transplant patients as well as transplant-specific factors. This study was aimed at illustrating the presentation and management of NODAT in three kidney transplant recipients in our center and reviewing the literature. To our knowledge, this is the first report from Nigeria. Two of the patients were males of ages 60 and 36 years, respectively, while the third was a female aged 25 years. They were all receiving prednisolone, two were on tacrolimus, and one was on cyclosporine as part of their immunosuppressive regimens. They developed NODAT at varying times post transplant, ranging from 3 months to 6 years. Two patients were managed with oral hypoglycemic agents and one with insulin. One patient died of hemorrhagic stroke. We conclude that NODAT occurred in our kidney transplant recipients and recommend that physicians should have a high index of suspicion in order to make an early diagnosis and institute appropriate management to reduce morbidity and mortality.