Causes of infant and under-five (under-5) morbidity and mortality among hospitalized patients in Southern Nigeria: A hospital based study

Background

Rate and pattern of under-five mortality is a reflection of a society's healthcare system and quality of life. This study is aimed at reviewing the causes of infants and under-five morbidity and mortality in Calabar, Southern Nigeria.

Methods

This study used retrospective descriptive cross-sectional design. We did a retrospective collation of data on under-five morbidity and mortality from 2012 to 2017 of under-five patients admitted or died while in admission in University of Calabar Teaching Hospital. The causes of morbidity and mortality were reported based on International Classification of Diseases 10 (ICD-10). The morbidity, mortality and fatality rates were computed.

Results

A total of 11,416 under-five admissions and 391 deaths were recorded within the study period giving a fatality rate of 3.4%. Age 1-4 years category represented 50.5% of the admissions while infants (<1 year) constitute majority of the deaths (64.7%). There were 5652 infant admissions and 253 infant deaths giving fatality rate of 4.5% within the study period. Males constituted majority (55.8%) of under-five morbidity whereas females constituted majority (51.2%) of the deaths. Conditions originating from perinatal period; and infectious and parasitic diseases were the leading broad cause of under-five mortality. Specific disease analysis showed sepsis/septicemia; congenital infectious and parasitic diseases; slow fetal growth, malnutrition and short gestation as the chief causes of both infant and under-five mortality.

Conclusion

The leading causes of under-five deaths in the studied population are amenable. Improved healthcare and antenatal will be of immense benefit.

COVID-19 in WHO African Region: Account and Correlation of Epidemiological Indices with Some Selected Health-related Metrics

BACKGROUND

The coronavirus disease 2019 (COVID-19) is a highly contagious and pathogenic viral disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Since it was first reported in Wuhan, China, it has spread across the continents. The study is aimed at describing epidemiological indices of COVID-19 as reported by the World Health Organization and to examine correlations with some country specific measures of general health status.

METHODS

Data from the WHO African region were extracted from World Health Organization, Global Health Security Index, Worldometer and World Bank databases, as at September 8, 2020. Other epidemiological indices were computed for the various countries. Epidemiological indices of COVID-19 were correlated with some selected health related metrics: Global Health Security index (GHSI) and current health expenditure (CHE). Pearson correlation was used to access the relationship between the health-related metrics and epidemiological indices.

RESULTS

Forty-seven (47) countries belonging to the WHO African region were evaluated. A total of 1,086,499 confirmed cases and 23,213 deaths were recorded giving a fatality rate of 2.1%. South Africa recorded the highest cumulative confirmed cases as well as deaths (Cases: 639,362; Deaths: 15,004) while Seychelles (Cases:135) and Eritrea/Seychelles (Deaths:0) had the least cumulative cases and deaths (135;0 and 330;0), respectively. South Africa recorded the highest attack rate (1127.67/100,000) while Republic of Tanzania recorded the least attack rate (0.78/100,000). The highest case fatality rate/ratio was observed in Chad (7.60%) while the least value was observed in Seychelles (0.0%). France was the most common country involved in travel history of index cases. Sporadic transmission was recorded in 3 countries, 9 countries had cluster of cases while the rest had community transmission. The first WHO African region country to record COVID-19 case was Algeria, while Comoros was the last. Significant positive correlation was found between COVID-19 case number/deaths and Global Health Security Index.

CONCLUSION

The WHO African region has had its own share of the pandemic with all the countries being affected. The trio of cluster cases, sporadic and community transmission were recorded with majority being community transmission.

Coping with COVID-19 pandemic in blood transfusion services in West Africa: the need to restrategize

Introduction

The West African region has been lagging in terms of the availability of, and accessibility to, safe blood. According to the 2016 World Health Organization (WHO) Global Status Report on Blood Safety and Availability, none of the West African countries met the WHO benchmark of 10 blood units per 1000 inhabitants. This study is aimed at discussing the blood transfusion status of West African countries in the pre-COVID-19 period and analyze the capacity to respond to the COVID-19 blood crisis, as well as to outline the panacea.

Methods

Secondary data were extracted from published reports, journal articles and web pages, reviewed and analyzed.

Result

All the West African countries have recorded confirmed COVID-19 cases and deaths. The confirmed cases have reached 55,697, with 1069 deaths and a fatality rate of 1.9%, as of June 17, 2020. The assessed countries lagged in most of the WHO benchmarks for effective blood transfusion services.

Conclusion

Blood transfusion services in the West African region lacked the basic benchmark practice and policy, are not coordinated and may find it hard to tackle the blood transfusion crisis created by the COVID-19 pandemic.

Correlative Study of Bone-related Biochemicals and Endocrine Changes in Perimenopausal Women in Enugu, Nigeria

BACKGROUND AND OBJECTIVE

Perimenopause is a physiological occurrence in women, and is characterized by endocrine and biochemical changes. During perimenopause phase, many derangements or abnormal health conditions start developing as a result of hormonal changes. These derangements in health conditions and biochemical changes lead to higher incidence of metabolic syndrome (MetS) occurrence with or without bone involvement. There is a scarcity of information on MetS in Enugu, Southern Nigeria and there is no available data on the correlation of selected bone-related biochemicals with endocrine parameters and MetS in perimenopausal women from the region.

MATERIAL AND METHODS

We consecutively sampled 200 apparently healthy women, and categorized them into 120 perimenopausal women (age (!) = 50years) and a second group of 80 women in premenopause (age (!) = 35years). Measurement of anthropometric indices like blood pressure, height, weight and waist circumference were taken. Fasting blood samples were collected for the estimation of endocrine parameters (estradiol (E₂), follicle stimulating hormone (FSH), and luteinizing hormone (LH)) using enzyme linked immunosorbent assay (ELISA) technique. The lipid profile, fasting plasma glucose (FPG), uric acid, inorganic phosphate, calcium and alkaline phosphatase levels were determined using standard biochemical methods. The evaluation of MetS was carried out in the women using the three different criteria: World Health Organization (WHO), National Cholesterol Education Program- Adult Treatment Panel 111 (NCEP-ATP 111) and International Diabetes Federation (IDF). For statistical analysis, Student's t-test, Pearson correlation and Chi-square were used to compare categorical and continuous variables.

RESULTS

Calcium was predominantly high in the three criteria (p<0.05). LH and FSH showed a positive correlation with FPG while E₂ was negatively associated with FPG. Similarly, LH showed a positive association with inorganic phosphate while E₂ was negatively associated with alkaline phosphatase (p<0.05).

CONCLUSION

Perimenopausal women are at higher risk of developing osteoporosis than premenopausal women. This emphasizes the need for timely diagnosis of osteoporosis in perimenopausal women.

Combination of aqueous extracts of Curcuma longa (turmeric) and some calcium channel blockers synergistically improves CCl4-induced nephrotoxicity in albino rats

In the present study, special attention was drawn to CCl4-induced acute kidney injury (AKI) and how the nephrotoxicity could be treated or prevented by administration of aqueous extracts of Curcuma longa (AECL) alone or in combination with some calcium channel blockers. Thirty (30) male albino wister rats were grouped according to their weight into 6 groups (A-F) of 5 rats per group. Rats in groups A-D received CCl4 (0.4ml/kg b.wt, i.p) for 3 days. Group B received AECL (200mg/kg, oral), Group C received AECL and nifedipine (1mg/100g of rat, i.p), Group D received AECL and amlodipine (1mg/100g of rat, i.p), and group E received AECL alone with no CCl₄ challenge for 3 days. No treatment was administered to group F (Normal control). Serum renal biochemical parameters; MDA level and SOD activity in the kidney homogenates were measured. CCl₄ administration to the rats resulted to acute kidney injury with significantly increased Urea, Creatinine, K+ and MDA levels and decreased SOD activity (p<0.05, p<0.01 or p<0.001). The 3 days daily administration of AECL alone or plus nifedipine or amlodipine resulted in the attenuation of the CCl₄-induced kidney injury with significantly decreased Urea, Creatinine, K⁺ and MDA levels and increased SOD activity (p<0.05. p<0.01). Histopathological results showed a concomitant association with the biochemical findings. This study shows that the combination of the extract and some calcium channel blockers is synergistically nephroprotective and can be used to prevent acute renal injury.

Evaluation of Blood Oxidant/Antioxidant Changes and Testicular Toxicity after Subacute Exposure to Cadmium in Albino Rats: Therapeutic Effect of Nigella sativa Seed Extracts

AIM AND OBJECTIVE

Cells and tissues of the body are prone to oxidative damage as a result of an increased level of reactive oxygen species and nitrogen radical beyond the detoxifying ability of the endogenous antioxidant system. This study aimed to evaluate the ameliorative effect of methanolic extracts of Nigella sativa (MENS) against cadmium-induced blood oxidative stress and testicular toxicity in albino rats.

MATERIALS AND METHODS

Twenty-five (25) male albino rats, weighing (200 ± 20g), were randomly grouped into five groups (A-E). Group B (Negative Control) received intraperitoneal administration of cadmium chloride (CdCl₂, 5 mg/kg) only, group C received CdCl₂ and low dose MENS (300 mg/kg, oral), group D received CdCl₂ and high dose MENS (600 mg/kg, oral), group E (Positive control) received CdCl₂ and Vitamin C (200 mg/kg, oral), for 14 days. No treatment was administered to group A (Normal control). The oxidative state of the blood was assessed by measuring the blood levels or activities of MDA, CAT, GSH and SOD; while testicular injury was assessed by measuring serum testosterone level using ELISA. The testes were harvested for histopathological examination.

RESULTS

The results showed that cadmium induced a marked elevation in the level of MDA, and a decrease in SOD, CAT and GSH levels or activities (p<0.05 or p<0.01); but no significant alteration in the serum testosterone level was found (p>0.05); Histopathological studies on the testes showed that cadmium significantly induced testicular injury, which was however ameliorated by the seed extract of N. sativa.

CONCLUSION

We conclude that N. sativa seed extract is potentially testiculoprotective and attenuates oxidative stress against harmful chemical toxins such as cadmium.