Phenotypic Detection of Extended-Spectrum ß-lactamase Produced by Escherichia coli Isolates from Health facilities in Otukpo, Benue State Nigeria

Beta-lactamase production by Escherichia coli and other bacteria is one of the most important mechanism of resistance to beta-lactam antibiotics such as Penicillins and Cephalosporins which are the most commonly used antibiotics in the treatment of bacterial infections in Hospitals. Resistance to antibiotics is emerging worldwide as a threat to human health resulting in limitations of therapeutic options. Susceptibility tests of microorganisms to antimicrobial agents do not reveal production of Extended-Spectrum ß-lactamase, hence the need to detect their presence by phenotypic or molecular techniques. This study is aimed at determining the prevalence of ESBL-production by Escherichia coli isolates from clinical samples collected from some selected health facilities in Otukpo, using phenotypic detection. Four hundred (400) specimens were collected from four different health facilities in Otukpo. Specimens collected included urine, blood, stool and wound swabs from 222 females and 178 males. Standard microbiological methods were employed for isolation, identification and characterization of Escherichia coli isolates from these specimens. Antibiotic susceptibility of the E. coli isolates was determined using Kirby-Bauer disc diffusion method while double disc synergy test (DDST) was used for ESBL production. Sixty-eight, (17%) of the 400 specimens tested for ESBL production were positive. Isolates from stool 22(22.7%) had the highest prevalence of ESBL-producing E. coli, followed by isolates from blood 4(21.4%). Urine isolates had the least prevalence 31(13.8%). Isolates from female subjects, 38(17.1%) had higher positivity rate than their male counterpart 30(16.9%). Otukpo General Hospital had the highest prevalence 20(20.0%) of ESBL followed by Otia Hospital 18(18.0%). Comprehensive health center, Otukpo had the least prevalence 14(14.0%). There is a high prevalence of ESBL production by Escherichia coli isolated from health facilities in Otukpo. Routine drug resistance surveillance therefore has become necessary to guide the appropriate and judicious antibiotic use.

Assessment of Sexual and Reproductive Health Knowledge of Adolescents in Makurdi, Benue State, Nigeria

In Nigeria, National data indicates that the age group 15 to 24 years contributes the highest (40%) to all reported new cases of HIV and not much is been done to understand and address adolescent sexual and reproductive health (ASRH) concerns. New evidences are required to design cost effective programs on ASRH. This study was aimed at assessing in-school adolescents' knowledge on SRH and associated factors. The study was a cross sectional Study conducted among 250 adolescents in secondary schools in Makurdi selected through multi-stage sampling technique. Pretested, self-administered questionnaire was used to collect data. Knowledge was assessed via an 18-point knowledge scale and the data was analyzed using the Statistical Package for Social Science (SPSS) version 21 software. The mean age of the respondents was 15.15±1.82 years. More than half of the respondents had good knowledge of ASRH (56.8%) while 43.2% had poor knowledge. The main sources of information on Sexually Transmitted Infections (STI) were Parents (90.8%), School Teacher (82.4%), Friends (35.2%) and Social Media (34.4%). Respondents in the senior classes were more knowledgeable about SRH while age and having a girl/boyfriend affected their knowledge. In conclusion, on the adolescents' knowledge on ASRH, more than half of them had good knowledge, however more measures need to be put in place to reach the adolescent population with poor knowledge which will ultimately help to prevent risky sexual behaviors.

Histopathological Review and Distribution of Granulomatous Inflammatory Disorders in Makurdi, North Central Nigeria

Granulomatous inflammation is a pattern of chronic inflammation characterized by the presence of granulomas consisting of microscopic aggregates of macrophages transformed into epithelioid cells surrounding by a collar of lymphocytes and occasioned plasma cells. The study aimed to determine the distribution by tissue site, histological patterns of granulomatous inflammatory disorders in Benue State University Teaching Hospital (BSUTH), Makurdi over a 5-year period. This was a 5 year (March 2013 – February 2018) retrospective study of all cases diagnosed as granulomatous inflammatory disorders on Haematoxylin and Eosin-stained sections at the Anatomical pathology Department. Ziehl-Neelsen special stain was also done on all specimens. A total of two hundred and thirty-six (236) cases of granulomatous inflammatory disorders were diagnosed, analysed and categorized based on the tissue site, on Haematoxylin and Eosin-stained sections; Ziehl-Neelsen special stain was done on all cases. The most common sites were cervical lymph nodes, appendix, skin, testicular tissues etc with the Eyelid been the least common site.

Hepatitis B Vaccine Uptake among Voluntary Blood Donors in Jos: Implication on Blood Safety

Hepatitis B virus (HBV) is a transfusion-transmissible pathogen that poses a significant threat to blood safety. The virus' burden is high in the general population and among blood donors in Sub-Saharan Africa, leading to more donor rejection; blood discards, and increased risk of contamination of the blood supply. Hepatitis B Virus is vaccine-preventable; increased burden of infection may suggest a gap in vaccination. The study aimed to assess the level of hepatitis B virus vaccine uptake and identify factors affecting uptake of the vaccine among voluntary non remunerated blood donors (VNRBD) in Jos, Nigeria. A survey was conducted at the National Blood Transfusion Service (NBTS), Jos, among consenting VNRBD aged between 18 and 65 years from October to December 2020 using a structured questionnaire to collect information on vaccination status, socio-demographics and others. Of the 120 VNRBD interviewed, 36.7% received one or more doses of the HBV vaccine, while the majority (63.3%) were unvaccinated. Among the unvaccinated donors, 57.9% were unaware that HBV has a vaccine, 21.1% did not know where to get the vaccine, 7.9% had no time to get vaccinated; 3.9 % believed that there was no need to get vaccinated because they tested negative for the virus, while 9.2% gave no reason. Our study found a low uptake of HBV vaccine among VNRBD in our environment. We advocate for increased awareness and strong legislation to ensure universal access to the vaccine by Nigerians.

Risk of Exposure, Perception and Vaccination Status of Chronic Viral Hepatitis among Health Care Workers in Benue State, North Central Nigeria

Health care workers are high-risk group for contracting hepatitis B and C virus infections. Hepatitis B and C can be contracted in the hospital setting by needle prick injury, contact with blood (and body fluids) and during invasive medical procedures. This study aims to assess the risk of exposure, the concern or perception of healthcare workers about getting infected (with HBV and/or HCV) from the workplace and the level of HBV vaccination uptake among them. The study was carried out during a capacity building workshop organized for health care workers from all the Local Government Areas in Benue State. A self-administered questionnaire was distributed to 168 participants in attendance, after obtaining verbal consent. One hundred and thirty-eight (138) questionnaires were properly filled and returned, 115 (83.3%) have had needle prick injury, 127 (92%) have had blood spilling on them and 118 (85.5%) have been involved in the management of hepatitis patients. One hundred and nineteen (86.2%) were afraid of contracting hepatitis infection from their place of work, 133 (96.4%) were aware of hepatitis B vaccine for adult, 87 (63%) had received at least one dose of hepatitis B vaccine but only 56 (40.6%) received the complete three doses. Health care workers in Benue State are aware of the risk of contracting viral hepatitis at their workplace and are concerned about this risk. However, the uptake of hepatitis B vaccination among them remains poor.

Characterization of Electroencephalographic Findings at an Electrodiagnostic Unit of a Tertiary Hospital, North-central Nigeria

Electroencephalography (EEG) remains an important investigative tool in supporting the diagnosis and classification of various seizure types. We sought to examine and characterize the EEG findings from all patients referred for the procedure. This cross-sectional retrospective study was carried out at an EEG unit in Federal Medical Centre, Makurdi, Benue State, North Central Nigeria from May 2016 to December 2020. Relevant patients' information were extracted and analysed using SPSS version 21. A total of 484 patients were seen over the study period with age range of 1-87 years and median age of 23 years. They comprised of 254 (52.5%) male and 230 (47.5%) female. The psychiatrist and the Physicians/Neurologist referred most of them for EEG, 201 (41.5%) and 124 (25.6%) respectively. The most reported indication for EEG was clinical suspicion of seizure disorder 291 (60.1%), whilst some did not have a clear indication 111 (22.9%). About 417 (86.2%) of our patients had abnormal EEG finding out of which 414 (99.3%) were diagnostic of seizure disorder made up of generalized seizure in 255 (61.6%) and focal seizure in 159 (38.4%). About 237 (48.9%) of them were already on antiepileptic drugs (AEDs) at referral of which 190 (80.2%0 were taking carbamazepine. This study showed a high prevalence of abnormal EEG with most of them diagnostic of seizure disorder especially generalized seizure. They were mostly of younger age group with about half of them already on AEDs at referral, majority of who were sent by the Psychiatrist.

The Adequacy of Undergraduate Orthopaedic Education in Makurdi, North central Nigeria

A large number of patients seek help for musculoskeletal conditions. Students and doctors have been noted to have a poor cognitive mastery of the subject area. This study aims to determine the adequacy of orthopedic learning of final year medical students. Freedman and Bernstein’s validated basic cognitive examination was administered to final year medical students who had completed their orthopaedic surgery course work and clinical rotations. Overall scores and responses to the individual questions were analyzed using SPSS. The recommended passing score of 73.1 per cent was employed. Forty undergraduate medical students took part in the study. None of the students attained the passing score of ≥73.1%. The mean score was 21.2%. The students performed best in general orthopaedics with a mean score of 11.4%. They scored 5.3% and 4.6% in anatomy and trauma respectively. The final year undergraduate students had a poor knowledge of orthopaedics. Considering the huge burden of musculoskeletal complaints, further studies are needed to assess interventions that will lead to curriculum improvement in the school.

Reasons Pregnant Women seek Prenatal Sonographic Gender Disclosure in Makurdi, Nigeria

Fetal gender disclosure, a non-medical prenatal ultrasonography indication, although largely ethically unjustifiable, continues to grow and thrive in demand due to its request by pregnant women. The study aims at establishing the proportion of women who want to know fetal gender during prenatal ultrasound. This was twelve months` prospective study of all pregnant women, 16weeks and above who presented at our facility for antenatal ultrasound in Makurdi from 7th May 2019 to 6th May 2020. A structured questionnaire was used to obtain information on factors influencing their willingness to know the gender of their unborn children. The information collated was entered into statistical package for social science (SPSS) version 23.0 for analysis. P-values=0.005 was considered significant for the study population. Two hundred and fifty (250) pregnant women were recruited for the study. Majority of the women 233(93.2%) showed marked interest in knowing the gender of the fetus, while 17(6.8%) did not. The main reason for wanting to know the sex of the fetus was for easier choice of clothing and naming; whereas the main reason for not wanting sex disclosure was because any child is good. There was no statistically significant correlation between gender preferences and the other variables such as age, educational attainment, tribe and previous miscarriages (P=0.136, 0.485, 0.275 and 0.942 respectively). Majority of the women 233(93.2%) want fetal gender disclosure due to ease of choice of clothing and naming. The deliberate policy of non-disclosure on account of non-medical indication during prenatal ultrasonography is untenable in our environment.

Precocious Puberty: Case Report of a 3-year Old Girl

Precocious puberty is the onset of puberty before the age of 8 years in girls and 9 years in boys. There is a global trend towards earlier onset of puberty. The prevalence is not known in Nigeria. Precocious puberty has implications such as inappropriate body appearance, psychological effects and decreased final height. This is a rare case report of a 3-year-old girl who presents with precocious puberty. Investigations did not reveal the cause. Investigations and treatment are expensive and a challenge in a poor resource setting. Early diagnosis and treatment are recommended to reduce the complications associated with it.

Prevalence, Risk Factors and Outcome of Perinatal Asphyxia in Newborns at Benue State University Teaching Hospital Makurdi

Perinatal asphyxia is a global neonatal problem, which significantly contributes to both neonatal morbidity and mortality. This study was therefore undertaken to determine the prevalence, risk factors and outcomes of perinatal asphyxia in Makurdi, Nigeria. A retrospective review of clinical data of all newborns managed at the Special Care Baby Unit of the Benue State University Teaching Hospital over a 5 year period (January 2015-December 2019) was carried out using the research clinical data form. Maternal information including biodata, obstetric history, perinatal events as well as neonates' presentation and outcomes were reviewed. All inborn neonates with Apgar scores <7 at 5 min or out-born neonates with no recorded Apgar scores but with history of poor cry/inability to cry at birth were classified as asphyxiated. Out of the 1142 neonates admitted during the study period, 127 neonates had perinatal asphyxia with prevalence of 11.1%. Eighty-four (66.1%) of the newborns were males, while 43(33.9%) were females with male to female ratio of 1.95:1 Majority of the newborns(89.1%) were managed and discharged without early neurologic complications; eight survived with early neurologic complications, eight were discharged against medical advice, while 7 newborns died, giving a case fatality rate of 5.5%.Risk factors significantly associated were Meconium-stained amniotic fluid(P=0.002) ,fetal presentation (P=0.030),and birth attendants (P=0.001). The burden of perinatal asphyxia still persists in our environment. Associated factors in this study were meconium-stained liquor and unskilled birth attendants. Hence pregnant women should be encouraged to attend antenatal care and should ensure skilled birth attendants attend delivery with capacity to conduct safe delivery and institute neonatal resuscitation when necessary.