Annals of African Medicine
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   2014| July-September  | Volume 13 | Issue 3  
    Online since June 12, 2014

 
 
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ORIGINAL ARTICLES
Progress toward elimination of malaria in Nigeria: Uptake of artemisinin-based combination therapies for the treatment of malaria in households in Benin City
Obehi Aituaje Akoria, Isibor James Arhuidese
July-September 2014, 13(3):104-113
DOI:10.4103/1596-3519.134383  PMID:24923369
Background: The Roll Back Malaria (RBM) Partnership converged in Abuja in 2000. In 2005, Nigeria adopted artemisinin-based combination therapies (ACTs) as first-line therapy for uncomplicated malaria. It was determined that by 2010, 80% of persons with malaria would be effectively treated. Objectives: To describe household practices for malaria treatment in Benin City; to explore demographic characteristics that may influence use of ACTs. Materials and Methods: Multistage sampling technique was used to select households from each of the three local government areas in Benin City. Adult respondents were interviewed. Household reference persons (HRPs) were defined by International Labour Organization categories. Data were collected between December 2009 and February 2010 and were analyzed using Statistical Package for the Social Sciences Version 16.0, at a significance level of P < 0.05 (2-tailed). Results: Of the 240 households selected, 217 were accessible, and respondents from 90% of these recalled the most recent episode (s) of malaria. One-third of malaria episodes had occurred in children younger than 5 years. ACTs were used in 4.9% of households; sulfadoxine-pyrimethamine was the chief non-ACT antimalarial, followed by artemisinin monotherapies. Patent medicine stores were the most common sources of antimalarial medicines (38.2%), followed by private hospitals (20.3%) and private pharmacies (10.6%). Only 8.3% of households got their medicines from government hospitals. Having a HRP in managerial or professional categories was associated with a 6 times higher odds of using ACTs, compared to other occupational categories [odds ratio (OR) 5.8; confidence interval (CI) 1.470-20.758, P = 0.016]. Fathers' tertiary or higher education was significantly associated with ACT use, but not mothers' (OR 0.054, CI 0.006-0.510; P = 0.011 and OR 0.905, CI 0.195-4.198; P = 0.898, respectively). Conclusion: Ten years after the historic Abuja meeting, only 5% of households in Benin City used ACTs for the treatment of malaria, sourcing medicines chiefly from patent medicine stores and private hospitals. Fathers' level of education was significantly associated with ACT use. Interventions to eliminate malaria from Nigeria should mainstream the men folk and health care providers outside government hospitals, in line with the Nigerian reality.
  11,458 39 -
Condom use among people living with HIV/AIDS attending Abejukolo General Hospital in Kogi State, North Central Nigeria
Adekunle G. Salaudeen, Omotosho I. Musa, Austin Ojotule, Ayodeji S. Yusuf, Kabir A. Durowade, Lukman O. Omokanye
July-September 2014, 13(3):99-103
DOI:10.4103/1596-3519.134378  PMID:24923368
Background: Condom programming is an integral component in a range of HIV/AIDS prevention strategies and with repeated sexual contact among HIV-discordant couples, 98-100% of those who used latex condoms correctly and consistently did not become infected. The objective of this study is to determine condom use among people living with HIV/AIDS (PLWHA). Methods: This is a cross-sectional survey carried out among 231 PLWHA and receiving care and treatment at General Hospital Abejukolo in Kogi State, Nigeria. The research instrument was interviewer-administered questionnaire. The data obtained were analysed using EPI-INFO version 3.4.1 software and P-value of < 0.05 was significant for the study. Results: About three-quarters (70.6%) of the respondents had ever used condom. Reasons given by respondents who did not use condom were: Desire for children (39.7%), and reduction of sexual pleasure (17.7%) and partner preference. More than half (56.0%) of the respondents with multiple partners did not use condom. About half 119 (51.5%) have used condom in the last sexual encounter. Gender, literacy level and disclosure of HIV status to partners significantly influence condom use during sexual intercourse. Conclusion: The poor uptake of condom among PLWHA underscores the need for government and other stakeholders in the management of HIV/AIDS to provide more enlightenment opportunities to address the gaps in condom use and disclosure of HIV status to partners.
  4,961 43 1
Agents for facilitation of laryngeal mask airway insertion: A comparative study between thiopentone sodium and propofol
Janmejoy Sengupta, Mohua Sengupta, Tulsi Nag
July-September 2014, 13(3):124-129
DOI:10.4103/1596-3519.134405  PMID:24923372
Background: Development of endotracheal intubation to avoid deleterious effect on hemodynamic responses occurring during laryngoscopy and intubation compelled researchers to venture into alternative measures of airway management with subtle hemodynamic responses. This study was carried out to compare the conditions for laryngeal mask airways LMA insertion with widely used intravenous induction agents, thiopentone sodium and propofol, and also to compare the undesired responses occurring during LMA insertion with them. Materials and Methods: The study was prospective, randomized, and double blind. All patients selected were randomly allocated into two groups: Group 1 (propofol) and group II (thiopentone). Preinduction heart rate and blood pressure were recorded. Sixty healthy adult patients of either sex belonging to age group of 20-60 years and ASA grade I or II, to undergo surgery less than 1 h, were selected for the study-Patients were randomly allocated in two groups, 30 in each group. Premedication with midazolam 0.04 mg/kg and fentanyl 2 mg/kg done in both groups. Thereafter, group 1 was induced with 2 mg/kg of propofol and group 2 with 5 mg/kg of thiopentone sodium. Results: The study revealed that, ease of insertion of LMA, was statistically significantly greater in group 1 when compared with group 2 (P 0.05). The time required for successful insertion of LMA was lesser in group 1 patients (53.8 ± 7.77 s) than in group 2 patients (84.7 ± 16.54 s) (P 0.001). Conclusion: Severity of undesired responses were more in group 2, as incremental boluses of respective induction agents were required in 20% patients in thiopentone group compared to only 6% patients in propofol group and 13% of patients in thiopentone group required rescue succinylcholine.
  4,433 32 -
Macular volume and central foveal thickness measurements in normal eyes of healthy Nigerian adults using optical coherence tomography
Lawan Abdu, Rabi Yahaya Sani
July-September 2014, 13(3):134-137
DOI:10.4103/1596-3519.134417  PMID:24923374
Objective: To determine macular volume and central foveal thickness measurements in normal eyes of healthy Nigerian adults using Stratus optical coherence tomography. Subjects and Methods: Consenting 100 adults Nigerians with normal eyes were recruited and examined using Carl Zeiss Stratus Optical Coherence Tomographer (OCT) machine Model 3000 software version 4.0. A fast macular thickness map scan protocol was employed. Central fovea is defined as locus of intersection of the radial scans. A default setting of six lines at 6 mm was used. Data was analyzed using the paired t-test for independence and linear regression. Results: There were 200 eyes of 100 subjects with mean age of 36.4 + 11.7 years (M: F = 3.3:1). The mean macula volume was 6.79 + 0.392 μm 3 . It was 6.861 ± 0.297 in males, 6.496 ± 0.520 in females and was statistically higher in males than females (P = 0.000). The mean central foveal thickness (MCFT) was 149.58 ± 32.470 μm. It was 154.49 ± 34.652 μm in males and 133.33 ± 15.315 μm in females. MCFT was significantly higher in males than females (P = 0.000). Conclusion: Normal macular volume and central foveal thickness measurements in Nigerian adults is presented and is comparable to that of Indian and Chinese populations, but lower than reported in Caucasians.
  4,350 20 -
Analysis of computed tomography features of fungal sinusitis and their correlation with nasal endoscopy and histopathology findings
Kamini Gupta, Kavita Saggar
July-September 2014, 13(3):119-123
DOI:10.4103/1596-3519.134398  PMID:24923371
Objective: The purpose of this study was to analyze the computed tomography (CT) features of fungal sinusitis and to correlate them with nasal endoscopy and histopathological findings. Materials and Methods: Our study included 16 patients of either sex and any age group who presented in the otorhinolaryngology clinic at our hospital and had evidence of definite sinonasal disease on clinical evaluation. Multidetector CT was carried out on Somatom definition AS + 128 slice CT Machine by Siemens Germany Ltd. Axial sections were performed with the plane of data acquisition parallel to the hard palate and slice thickness of 3 mm, reconstructions at 0.75 mm in coronal and sagittal planes. Scanning parameters included 190 mA S, 120 KV and tube rotation time of 0.5 s. Provisional CT diagnosis was made in all cases and correlated with nasal endoscopy and histopathological findings. Results: Out of total 16 patients, 12 showed immunocompromised status and had infection with mucormycosis. Out of 12, 9 patients (75%) showed extension of disease beyond the sinonasal cavities and 4 (33.3%) showed evidence of bone destruction. All patients with candidiasis showed soft-tissue attenuation with hyperdense areas on CT scan. Nearly, 66.6% patients with aspergillosis showed soft-tissue attenuation with hyperdense areas and expansion of sinonasal cavities. Fifteen patients (93%) were proved to be of fungal sinusitis on histopathology. One patient of non-specific granulomatous infection showed bone destruction and mimicked fungal sinusitis on CT. Conclusions: In the present study, fungal sinusitis could be correctly diagnosed on CT with high accuracy. Thus, understanding the different CT findings of fungal sinusitis allows the radiologist to play a crucial role in the diagnosis and prompt treatment.
  3,514 25 1
CASE REPORT
Posterior reversible encephalopathy syndrome in a adult female
O. I. Oyinloye, O. A. M. Adesiyun, M. O. Atobatele, A. A. Fawole
July-September 2014, 13(3):138-141
DOI:10.4103/1596-3519.134422  PMID:24923375
Posterior reversible encephalopathy syndrome is a clinico-neuroradiologic diagnosis, with rapidly evolving neurologic condition, characterized by headache, confusion, altered mental status, seizures, cortical blindness, lethargy, stupor, and occasionally, focal neurological signs accompanied by a typical computed tomography or magnetic resonance imaging pattern. With early recognition and treatment, complete resolution of symptoms occurs. Typical imaging findings characteristically involve the white matter bilaterally in the parieto-occipital regions. Atypical imaging finding of contrast enhancement of lesion can occur, but is less common. A 20-year-old primiparous lady presented with posterior reversible encephalopathy syndrome. To the best of our knowledge, this is the first documented case in Nigeria. This case-report highlights the importance of recognizing the salient imaging features in this lethal but reversible entity with prompt management.
  3,352 19 1
ORIGINAL ARTICLES
Substance dependence and mental health in northern Iran
Jabbar Heydari Fard, Mohammad Ali Heidari Gorji, Yadollah Jannati, Iraj Golikhatir, Farzad Bozorgi, Rezaali Mohammadpour, Ali Morad Heidari Gorji
July-September 2014, 13(3):114-118
DOI:10.4103/1596-3519.134389  PMID:24923370
Background: Today, substance dependence and illegal trading of narcotics is considered as a global issue. Since mental disorder has been reported in about 90% of the substance dependents, this study aimed at determining the rate of mental health in the substance dependents in Sari Township in 2011. Materials and Methods: In this study, 500 substance-dependent patients were selected using convenience sampling method. To collect data, SCL-90-R was used for the evaluation of their mental health and a demographic questionnaire was employed for identifying their personal information. The obtained data were analyzed by descriptive and inferential statistics using the SPSS software. Results: It was found that 90.4% of the participants were susceptible to mental disorder. Most of them suffered from depression, psychoticism, interpersonal sensitivity, anxiety, and paranoia. Also, there was significant relationship between the mental health of single, divorced and married addicts (P < 0.21). Conclusion: Due to the presence of mental disorder in the substance-dependent patients, it is recommended to help treat them by providing them with education, psychotherapy, and psychiatric medication.
  3,055 32 -
Pattern and outcome of surgical management of nasolachrymal duct obstruction in children: A five year review
Lawan Abdu, Abubakar Danjuma Salisu
July-September 2014, 13(3):130-133
DOI:10.4103/1596-3519.134412  PMID:24923373
Objective: To determine the pattern of naso-lachrymal duct obstruction (NLDO) and outcome of dacryocystorhinostomy (DCR) in children in Aminu Kano Teaching Hospital Kano, over a 5-year period. Patients and Methods: The clinic and theater registers were used to retrieve the records of all patients below the age of 15 years who presented with NLDO. The information obtained included age, sex, duration, and types of clinical signs at presentation cause of obstruction and outcome of DCR. Successful outcome is defined as patent naso-lachrymal duct 1 year after surgery. All the patients had external DCR with stent inserted into the lachrymal sac and anchored to the columella and left in situ for 6 weeks. Fortnightly for three visits then at 2 months intervals. At each visit, the patient had lachrymal punctal cannulation and irrigation with normal saline to ensure free drainage. Results: There were 17 patients, 9 males and 8 females (M: F = 1.1: 1). Two patients (11.8%) had bilateral disease and 15 (88.2%) were unilateral. The patients' ages ranged between 2 and 10 years. The commonest presenting features were tearing and discharge. In 14 patients (82%) tearing started from birth though patients presented much later. Congenital NLDO occurred in 82%, and in the remaining 18%, obstruction was caused by depressed nasal fracture. Fifteen patients (88%) had successful outcome of DCR at 1-year follow-up. The commonest complication noted was stent extrusion before 6 weeks in 17.6% of cases. Conclusion : NLDO was mostly of congenital origin and was characterized by delayed presentation. Patients have good outcome with external DCR.
  2,504 22 -
LETTERS TO THE EDITOR
Translation from research to clinical practice: Fostering improved patient care through microscopicobservation drug susceptibility for tuberculosis diagnosis in Nigeria
Dami Collier, Ernest Ochang, Ibidunni Bode-Sojobi, Oyin Oduyebo
July-September 2014, 13(3):142-144
DOI:10.4103/1596-3519.134427  PMID:24923377
  2,019 25 -
Dyslipidemia among HIV-infected patients
Somsri Wiwanitkit, Viroj Wiwanitkit
July-September 2014, 13(3):142-142
DOI:10.4103/1596-3519.134424  PMID:24923376
  1,792 26 -
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