Abstract 1215: Epidemiology of breast malignancies in sub-Saharan Africa: A ten-year retrospective evaluation of 2,419 patients at a major tertiary institution in Southwestern Nigeria

Background:Despite demonstrating global concerns about infection in the workplace, very little research has explored how co-workers react to those living with HIV in the workplace in sub-Saharan Africa. This study aimed to assess the level of stigmatising attitude towards co-workers living with HIV in the workplace.Methods:The study was a descriptive cross-sectional survey involving 403 respondents. They were recruited from selected companies through a multistage sampling technique. Survey was carried out using pre-tested semi-structured questionnaires. Data were analyzed using the Statistical Package for the Social Sciences to generate frequencies, cross tabulations of variables at 5% level of significance. Logistic regression model was used to determine the predictors at 95% confidence intervals.Results:Mean age of respondents was 32.9 ± 9.4 years with 86.1% being females. Overall, slightly below two-third (63.0%) had good knowledge on transmission of HIV/AIDS while 218 (54.1%) respondents had a high stigmatising attitude towards co-workers with HIV in the workplace. More female respondents (69.6%) demonstrated high stigmatising attitudes towards co-workers with HIV in the workplace (p = 0.012). Female workers were twice more likely to have high stigmatising attitudes towards co-worker with HIV [OR 2.1 (95% CI: 1.13 – 3.83)].Conclusion:Stigma towards people living with HIV/AIDs is still very persistent in different settings. Good knowledge amongst our participants about HIV/AIDs did not translate to low stigmatising attitudes among workers. Concerted efforts and trainings on the transmission of HIV/AIDs are essential to reduce stigma that is still very prevalent in workplace settings.

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Presence of additional P. vivax malaria in Duffy negative individuals from Southwestern Nigeria: Short Report

10.21203/rs.3.rs-15945/v1 ◽

2020 ◽

Author(s):

MARY Aigbiremo OBOH ◽

Upasana Shyamsunder Singh ◽

Daouda Ndiaye ◽

Aida Sadikh Badiane ◽

Nazia Anwar Ali ◽

...

Keyword(s):

Vivax Malaria ◽

National Level ◽

Sub Saharan Africa ◽

Diagnostic Tools ◽

Short Report ◽

Southwestern Nigeria ◽

Malaria Epidemiology ◽

High Prevalence ◽

Sub Saharan ◽

Duffy Negative

Abstract Background Malaria in sub-Saharan Africa (sSA) is thought to be hugely caused by Plasmodium falciparum . Recently, growing reports of cases due to P. ovale , P. malariae , and P. vivax have been significantly reported to play a role in malaria epidemiology in sSA. This in fact is due to the usage of very sensitive diagnostic tools (e.g. PCR) which have highlighted the underestimation of non-falciparum malaria in this sub-region. P. vivax was historically thought to be absent in sSA due to the high prevalence of the Duffy null antigen in individuals residing in this sub-continent. For example, recent studies reporting the detection of vivax malaria in Duffy-negative individuals from Mali, Mauritania, Cameroon to mention a few challenges this notion.Methods Following our earlier report of P. vivax in Duffy-negative individuals, we have collected and assessed RDT and/or microscope malaria positive samples following the conventional PCR method and DNA sequencing to confirm both single/mixed infections as well as the Duffy status of the individuals.Results Amplification of Plasmodium gDNA was possible in 59.9% (145/242) of the evaluated isolates and as expected P. falciparum was the most predominant (91.7%) species identified. Interestingly, four P. vivax isolates were identified either as single (3) or mixed (1 – P. falciparum / P. vivax ) infection. Sequencing results confirmed, all vivax isolates as truly vivax malaria and their Duffy status to be that of the Duffy-negative genotype.Conclusion Identification of more vivax isolates among these Duffy-negative individuals from Nigeria, substantiate the expanding body of evidence on the ability of P. vivax to infect RBCs that do not express the DARC gene. Hence, such genetic-epidemiological study should be conducted at the national level in order to evaluate the actual burden of P. vivax in the country.

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Consumer preferences for organic vegetables in southwestern Nigeria: A choice experiment approach

African Journal of Agricultural and Resource Economics ◽

10.53936/afjare.2021.16(2).01 ◽

2021 ◽

Vol 16 (1) ◽

pp. 1-13

Author(s):

Joseph Akinwehinmi ◽

◽

Taye Amos ◽

Kolawole Ogundari ◽

◽

...

Keyword(s):

Choice Experiment ◽

Consumer Preferences ◽

Mixed Logit ◽

Third Party ◽

Sub Saharan Africa ◽

Southwestern Nigeria ◽

Mixed Logit Models ◽

Guarantee System ◽

Sub Saharan ◽

Safe Food

In sub-Saharan Africa, identifying estimates of consumers’ preferences and willingness to pay (WTP) for safe food continues to receive attention in the literature. Using experimental data from Nigeria, we examined the source of heterogeneities in preference and WTP for organically produced food. The subjective valuation by consumers of certification in relation to third-party certification and the participatory guarantee system (PGS) was also investigated. A sample of 196 households subjected to a discrete choice experiment yielded 1 764 observations that were analysed using the generalised multinomial logit and mixed logit models. The results reveal a strong preference for food safety in terms of reducing chemical residue, which dominated the respondents’ preference and WTP patterns. Concerning certification attributes, consumers were positively disposed to third-party certification, but showed no significant preference for the PGS form of certification. Significant heterogeneities in preference were due mainly to age and awareness of organic products. We suggest that policies should focus on consumers’ understanding of organic food, third-party certification, and organic agriculture

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Presence of additional P. vivax malaria in Duffy negative individuals from Southwestern Nigeria

10.1101/19009837 ◽

2019 ◽

Author(s):

Mary Aigbiremo Oboh ◽

Upasana Shyamsunder Singh ◽

Daouda Nidaye ◽

Aida S. Badiane ◽

Anwar Ali ◽

...

Keyword(s):

Plasmodium Falciparum ◽

Vivax Malaria ◽

National Level ◽

Sub Saharan Africa ◽

Mixed Infections ◽

Southwestern Nigeria ◽

High Prevalence ◽

Pcr Method ◽

Sub Saharan ◽

Duffy Negative

AbstractMalaria in sub-Saharan Africa (sSA) is thought to be hugely caused by Plasmodium falciparum and very infrequently by P. ovale, P. malariae, with P. vivax not even being considered to be of any significant role. However, with the availability of very sensitive diagnostic tool, it has become more clear that, the percentage of non-falciparum malaria in this sub-region has been underestimated. P. vivax was historically thought to be absent in sSA due to the high prevalence of the Duffy null antigen in individuals residing here. Nevertheless, recent studies reporting the detection of vivax malaria in Duffy-negative individuals challenges this notion. Following our earlier report of P. vivax in Duffy-negative individuals, we have re-assessed all previous samples following the classical PCR method and sequencing to confirm both single/mixed infections as well as the Duffy status of the individuals.Interestingly, fifteen additional Plasmodium infections were detected, representing 5.9% in prevalence from our earlier work. In addition, P. vivax represents 26.7% (4/15) of the new isolates collected in Nigeria. Sequencing results confirmed, all vivax isolates as truly vivax malaria and their Duffy status to be that of the Duffy-negative genotype. The identification of more vivax isolates among these Duffy-negative individuals from Nigeria, substantiate the expanding body of evidence of the ability of P. vivax to infect RBCs that do not express the DARC gene. Hence, such geno-epidemiological study should be conducted at the national level in order to evaluate the actual burden of P. vivax in the country.

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Profile and outcomes of hospitalized patients with COVID-19 at a tertiary institution hospital in Ghana

Ghana Medical Journal ◽

10.4314/gmj.v54i4s.7 ◽

2020 ◽

Vol 54 (4s) ◽

pp. 39-45

Author(s):

Nana K. Ayisi-Boateng ◽

Michael Owusu ◽

Phyllis Tawiah ◽

Brenda A. Ampah ◽

Augustina A. Sylverken ◽

...

Keyword(s):

Case Fatality ◽

Hospitalized Patients ◽

Sub Saharan Africa ◽

University Hospital ◽

Tertiary Institution ◽

High Systolic Blood Pressure ◽

Kwame Nkrumah ◽

Treatment Centre ◽

Sub Saharan ◽

A Prospective Study

Background: In high-income countries, mortality related to hospitalized patients with the Coronavirus disease 2019 (COVID-19) is approximately 4-5%. However, data on COVID-19 admissions from sub-Saharan Africa are scanty.Objective: To describe the clinical profile and determinants of outcomes of patients with confirmed COVID-19 admitted at a hospital in Ghana.Methods: A prospective study involving 25 patients with real time polymerase chain reaction confirmed COVID-19 admitted to the treatment centre of the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana from 1st June to 27th July, 2020. They were managed and followed up for outcomes. Data were analysed descriptively, and predictors of mortality assessed using a multivariate logistic regression modelling.Results: The mean age of the patients was 59.3 ± 20.6 years, and 14 (56%) were males. The main symptoms at presentation were breathlessness (68%) followed by fever (56%). The cases were categorized as mild (6), moderate (6), severe (10) and critical (3). Hypertension was the commonest comorbidity present in 72% of patients. Medications used in patient management included dexamethasone (68%), azithromycin (96%), and hydroxychloroquine (4%). Five of 25 cases died (Case fatality ratio 20%). Increasing age and high systolic blood pressure were associated with mortality.Conclusion: Case fatality in this sample of hospitalized COVID-19 patients was high. Thorough clinical assessment, severity stratification, aggressive management of underlying co-morbidities and standardized protocols incountry might improve outcomes.

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Prevalence and Outcome of Obstructed Labour at a Tertiary Institution

INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH AND ANALYSIS ◽

10.47191/ijmra/v4-i9-11 ◽

2021 ◽

Vol 04 (09) ◽

Author(s):

Elizabeth Nionzima ◽

Keyword(s):

Caesarean Section ◽

Neonatal Intensive Care ◽

Mode Of Delivery ◽

Retrospective Chart Review ◽

Tertiary Hospital ◽

Sub Saharan Africa ◽

Tertiary Institution ◽

Obstructed Labour ◽

Sub Saharan ◽

Prolonged Hospital

Obstructed labour is a common preventable causes of both maternal and perinatal morbidity and mortality in developing countries affecting 3-6% labouring women globally and accounts for an estimated 8% of maternal deaths in Sub-Saharan Africa and South Asia. Objective: To determine the prevalence and outcome of obstructed labour in the Gynaecology and Obstetrics Department at a tertiary hospital in Northern Uganda. Method: This was a retrospective chart review of pregnant women admitted in labour and delivered by caesarean section from 1st January 2016 to 31st December 2017 at a Lira Regional Referral Hospital, a tertiary institution in Lango Sub region. Data was analysed using Statistical Package for Social Sciences version 16.0. Results: A total of 808 medical charts of mothers with obstructed labour were retrieved, evaluated and included in this review out of 12,189 deliveries during the study period, giving a prevalence of 6.6%. Majority (77%; 622/808) mothers admitted with diagnosis of obstructed were referred in from peripheral facilities. Over half (53.4%) of the women were in the age group of 20 to 29 years. Over 53%, were prime gravidae and were twice more likely to undergo C/S due to obstructed labour than multigravidas (OR 1.8; 95% CI 1.5-2.2). Only 49.2% had documented cause of obstructed labour, with Cephalo-pelvic disproportion being most common (17.5%), malposition/mal-presentation (14.6%), and macrosomia (3.6%). Partograph was used in only 46.6% (374) women who had obstructed labour. The commonest maternal complication observed were Sepsis (11%), PPH (5.2%), uterine rupture (4%) and burst abdomen (3%) which led to prolonged hospital stay and loss of fertility to some. Mode of delivery in the 808 reviewed charts was caesarean section, 90.3% of babies were born alive, while 8.5% (69) were born dead, (1.2%) had early neonatal, and 40.2% were referred Paediatric Neonatal Intensive Care Unit (NICU) because of low APGAR score. Conclusion: The prevalence of obstructed labour among women delivered by Caesarean section was high compared to the global average. Majority of the women were referrals from the peripheral health centres and associated with life threatening complications and even death. Young age and prime gravida is associated with obstructed labour and high caesarean section rates. The obstruction in multigravida could be due to secondary cephalo-pelvic disproportion as majority of the babies were in normal range weight. Low use of Partograph to monitor labour was evident among women who had obstructed.

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The Burden of Comorbidities in Cancer Patients in Southwestern Nigeria

Journal of Global Oncology ◽

10.1200/jgo.18.14400 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 61s-61s

Author(s):

O. Salako ◽

P. Okediji ◽

M. Habeeb ◽

O. Fatiregun ◽

O. Awofeso ◽

...

Keyword(s):

Cancer Patients ◽

Postoperative Mortality ◽

Sub Saharan Africa ◽

Noncommunicable Diseases ◽

Southwestern Nigeria ◽

Ulcer Disease ◽

Management Measures ◽

Increased Risk ◽

Sub Saharan ◽

High Index Of Suspicion

Background: Noncommunicable diseases (NCDs) in sub-Saharan Africa are a major cause of morbidity and mortality. There is especially a paucity of data on the burden of hypertension, diabetes mellitus and other NCDs coexisting with cancer in Nigerian cancer patients. Comorbidities influence the survival of patients with cancer; lead to presentation at advanced disease stages; and result in increased risk of treatment complications, higher rates of postoperative mortality, and a greater consumption of medical resources. Aim: To determine the magnitude and pattern of comorbidities in Nigerian cancer patients. Methods: This is a retrospective study, for which data were extracted from hospital records of patients presenting for oncology care between January 2015 and December 2016 in the Departments of Radiotherapy and Oncology of two tertiary health facilities in Lagos, Nigeria. Comorbidities were identified, ranked and weighted using the Charlson Comorbidity Index (CCI). Results: Eight hundred and forty-eight (848) cancer cases were identified, with breast (50.1%) and cervical (11.1%) cancers being the most prevalent. Comorbidities were present in 228 (26.9%) patients, and the most common comorbidities were hypertension (75.9%), diabetes (25.0%), and peptic ulcer disease (7.9%). Patients with prostate (41.5%), colorectal (34.0%), cervical (25.5%), nasopharyngeal (25.0%), and breast (24.0%) cancers are most likely to have comorbidities. The mean ages of patients with comorbidities and without was 60.1 ± 11.8 years and 52.5 ± 13.7 years respectively ( P < 0.0001). Hypertension-augmented CCI scores were 0 (15.6%), 1-3 (62.1%), 4-6 (21.7%), and ≥ 7 (0.6%). Patients with lower mean CCI scores were more likely to receive chemotherapy (2.2 ± 1.6 vs. 2.5 ± 1.9; P < 0.05) and/or surgery (2.1 ± 1.5 vs. 2.4 ± 1.7; P < 0.05). Conclusion: Comorbidities occur in at least one in four Nigerian cancer patients, and significantly influence the treatment outcome and prognosis of these patients. There is a need for a high index of suspicion and routine evaluation of cancer patients for comorbidities, with the aim of instituting appropriate and immediate multidisciplinary management measures where necessary.

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Risk factors for gametocyte carriage in uncomplicated falciparum malaria in children

Parasitology ◽

10.1017/s0031182004005669 ◽

2004 ◽

Vol 129 (3) ◽

pp. 255-262 ◽

Cited By ~ 36

Author(s):

A. SOWUNMI ◽

B. A. FATEYE ◽

A. A. ADEDEJI ◽

F. A. FEHINTOLA ◽

T. C. HAPPI

Keyword(s):

Risk Factors ◽

Antimalarial Drug ◽

Multiple Regression Model ◽

Sub Saharan Africa ◽

Asexual Parasite ◽

Southwestern Nigeria ◽

Gametocyte Carriage ◽

Duration Of Illness ◽

Increased Risk ◽

Sub Saharan

The risk factors associated with gametocytaemia at presentation and after treatment with different antimalarial drug regimens were evaluated in 767 children enrolled prospectively in 5 antimalarial drug trials between July 1996 and December 2002 in a hyperendemic area of southwestern Nigeria. The children were assigned to one of 6 treatment groups: chloroquine (CQ) only; pyrimethamine-sulfadoxine (PS) only; amodiaquine (AQ) only; CQ combined with chlorpheniramine (CQCP); or PS combined with CQ (CQPS) or AQ (AQPS). At enrolment, 115 (15%) of 767 children were gametocyte carriers. During follow-up, 15·6% of all patients (i.e. 120 patients) developed patent gametocytaemia, which in 85% (102 patients) had developed by day 7 following treatment. In a multiple regression model, 4 factors were found to be independent risk factors for the presence of gametocytaemia at enrolment: male gender (adjusted odds ratio [AOR]=0·55, 95% confidence interval [CI] 0·36–0·83,P=0·005), absence of fever (AOR=1·61, 95% CI 1·05–2·5,P=0·03), duration of illness >3 days (AOR=1·57, 95% CI 1·0–2·4,P=0·047), and asexual parasite densities less than 5000/μl (AOR=0·42, 95% CI 0·24–0·73,P=0·002). The presence of patent gametocytaemia at enrolment (AOR=0·04, 95% CI 0·02–0·07,P<0·001) and recrudescence of asexual parasites within 14 days were associated with the presence of gametocytaemia 7 or 14 days after enrolment (AOR=0·5, 95% CI 0·3–0·8,P=0·007). Delay in the time taken to clear the initial parasitaemia (>2 days) was associated with increased risk of subsequent gametocyte carriage. These findings may have implications for malaria control efforts in sub-Saharan Africa where control of the disease depends almost entirely on chemotherapy.

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RTS,S/AS01, a vaccine targeting pre-erythrocytic stages of Plasmodium falciparum

Emerging Topics in Life Sciences ◽

10.1042/etls20170101 ◽

2017 ◽

Vol 1 (6) ◽

pp. 533-537

Author(s):

Lorenz von Seidlein ◽

Borimas Hanboonkunupakarn ◽

Podjanee Jittmala ◽

Sasithon Pukrittayakamee

Keyword(s):

Protective Efficacy ◽

Age Groups ◽

Sub Saharan Africa ◽

Phase Iii ◽

European Medicines Agency ◽

Older Children ◽

Pivotal Phase ◽

Malaria Epidemiology ◽

Maximum Benefit ◽

Sub Saharan

RTS,S/AS01 is the most advanced vaccine to prevent malaria. It is safe and moderately effective. A large pivotal phase III trial in over 15 000 young children in sub-Saharan Africa completed in 2014 showed that the vaccine could protect around one-third of children (aged 5–17 months) and one-fourth of infants (aged 6–12 weeks) from uncomplicated falciparum malaria. The European Medicines Agency approved licensing and programmatic roll-out of the RTSS vaccine in malaria endemic countries in sub-Saharan Africa. WHO is planning further studies in a large Malaria Vaccine Implementation Programme, in more than 400 000 young African children. With the changing malaria epidemiology in Africa resulting in older children at risk, alternative modes of employment are under evaluation, for example the use of RTS,S/AS01 in older children as part of seasonal malaria prophylaxis. Another strategy is combining mass drug administrations with mass vaccine campaigns for all age groups in regional malaria elimination campaigns. A phase II trial is ongoing to evaluate the safety and immunogenicity of the RTSS in combination with antimalarial drugs in Thailand. Such novel approaches aim to extract the maximum benefit from the well-documented, short-lasting protective efficacy of RTS,S/AS01.

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Mortality and Society in Sub-Saharan Africa

Population Studies ◽

10.1080/0032472031000147416 ◽

1993 ◽

Vol 47 (3) ◽

pp. 555-556

Author(s):

Lado Ruzicka

Keyword(s):

Sub Saharan Africa ◽

Sub Saharan

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