Ahmadu Bello University Teaching Hospital Research Articles

Comparative effectiveness of low-level laser therapy versus muscle energy technique among diabetic patients with frozen shoulder: a study protocol for a parallel group randomised controlled trial

BackgroundDiabetes mellitus is one of the fastest-growing health challenges of the twenty-first century with multifactorial impact including high rates of morbidity and mortality as well as increased healthcare costs. It is associated with musculoskeletal complications, with frozen shoulder being commonly reported. While low-level laser therapy (LLLT) and muscle energy technique (MET) are commonly used to manage this condition, there remains a lack of agreement on the most effective approach, with limited research available on their comparative efficacy.ObjectivesTo evaluate the comparative effectiveness of LLLT versus MET among diabetic patients with frozen shoulder.MethodsThis is a single-centre, prospective, single-blind, randomised controlled trial with three parallel groups to be conducted at Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria. Sixty diabetic patients with frozen shoulder will be randomly assigned into LLLT group, MET group, or control group in a 1:1:1 ratio. All the groups will receive treatment three times weekly for 8 weeks. The primary outcome will be shoulder function and the secondary outcomes will include pain intensity, shoulder ROM, interleukin-6 (IL-6), depression, anxiety, and quality of life (QoL). All outcomes will be assessed at baseline, at post 8-week intervention, and at 3 months follow-up.DiscussionThis will be the first randomised controlled trial to evaluate the comparative effectiveness of LLLT versus MET on both clinical and psychological parameters among diabetic patients with frozen shoulder. The findings of the study may provide evidence on the efficacy of these interventions and most likely, the optimal treatment approach for frozen shoulder related to diabetes, which may guide clinical practice.Trial Registration: Pan African Clinical Trials Registry (PACTR202208562111554). Registered on August 10, 2022.

Comparison of trans-vaginal ultrasound cervical length measurement and Bishop score in predicting successful labour induction in term pregnancies at Ahmadu Bello University Teaching Hospital Zaria

The goal of induction of labour (IOL) is to achieve successful vaginal delivery and reduce caesarean section (CS). The gold standard method for assessing cervical status has been the use of the Bishop score (BS) which is not flawless leading to unnecessary intervention. Trans-vaginal ultrasound cervical length (CL) measurement has been compared with BS in predicting successful IOL. The objective of this study was to compare CL and BS in predicting successful IOL at Ahmadu Bello University Teaching Hospital. It was a cross sectional comparative study design conducted among pregnant women at 37-42 weeks of gestation slated for IOL between November 2017 to November 2018. Eighty-seven (87) women were recruited as participants. Each participant, had a trans-vaginal ultrasound (TVS) CL measured and each was followed by a digital cervical assessment using BS. Relevant data obtained was analysed using SPSS version 23. The significance level was considered at P< 0.05 IOL was successful in 66.2% (47) of the participants, while 15% (13) had CS. The receiver operating characteristic curve (ROC) demonstrated a better performance of the BS (AUC= 0.556, P= 0.433, CI= 0.426-0.673, PPV=52.8%) in predicting successful IOL than the TVS-CL measurement (AUC= 0.446, P=0.391, CI= 0.317-0.574) PPV=60.2%). Results further showed that the best cut off values for favourability for IOL for TVS-CL and BS were ≤2.5 cm and ≥5 respectively. The most important component of the BS predictive of successful IOL was cervical dilatation (OR= 0.603, P=0.011). TVS-CL did not demonstrate a diagnostic accuracy in predicting successful IOL in term pregnancies compared to BS.

Abstract 2158: Emerging epidemiological cancer trends among West African adults in Zaria, Nigeria (1972 to 2022)

Abstract Cancer incidence and mortality rates in Africa are increasing, with sub-Saharan Africa reporting 2.7-fold higher fatality than global averages. The incidence of cancer in Africa in 2020 was about 1.1 million new cases, with 711,000 deaths, indicating a mortality-to-incidence ratio (MIR) of 0.64. These cancer challenges in Africa necessitate a concerted approach towards effective cancer control and management. Here, we present an extensive report of emerging epidemiological cancer trends among West African adults seen between 1972-2022 in Zaria, Nigeria. We used the Zaria cancer registry of the Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Nigeria to obtain information on histologically diagnosed cancers from January 1st, 1972 to December 31, 2022. Records in the Zaria registry are indexed into a register paper-based and 2008 and transferred by CanReg4 software on the computer. We used WHO classification of tumors (WHO Blue Book) 5th edition to classify all the abstracted cancers for the purpose of this study. Time-trend analyses were performed by utilizing linear regression models. In the analysis of the Zaria cancer registry, 12,114 adults (42.2% male, 57.8% female) were diagnosed with histologically confirmed cancer between 1972 - 2022. The most common diagnosis among male cancer patients was prostate cancer, comprising a quarter of all cases. The median age of diagnosis for prostate cancer was 65 years, with an interquartile range (IQR) of 60 and 70. Among female cancer patients, the most common diagnoses were cervical cancer and breast cancer, together comprising 68.2% of all cases. Median age at diagnosis were 45 (IQR, 40-56) and 42 (IQR, 35-50), respectively. In time-trend analyses, the total number of new cancer cases diagnosed at ABUTH from 1972 to 2022 increased over time (p<0.001). In the analyses of individual cancers, those in which the number of new cases increased over time were neoplasms of the bones and joints, breast, cervix, prostate, colorectum and stomach, head and neck (p<0.001); esophagus (p=0.006); eye and orbit and soft tissue (p=0.002); and ovary (p=0.005). Cancers in which the number of new cases decreased over time were Hodgkin lymphoma, Non-Hodgkin lymphoma, melanoma of the skin, and non-melanoma cancer of the skin (p<0.001). The number of new adult cancer diagnoses recorded in the Zaria cancer registry have increased over time from 1972 to 2022. Prostate cancer accounted for a quarter of all cancer cases among males, whereas cervical cancer and breast cancer accounted for nearly 70% of all cases among females. Westernization with associated change in dietary habits, physical inactivity, obesity and reproductive behaviors and changes in the population size and life expectancy may be attributable factors to change in cancer in Zaria. Better understanding of these factors will inform cancer prevention and control strategies. Citation Format: Faruk Mohammed, David J. Lee, Katy Graef, Abdulmumini Hassan Rafindadi, Sani Ibrahim, Sirajo Mohammed Aminu, Ahmed Adamu, Adamu Abdullahi, Aishatu Maude Suleiman, Abdullahi Mohammed, John Idoko, Abdulkadir Lawal Rafindadi, Danladi Amodu Ameh, Bello Ahmad Kumo, Ahmad Bello, Abdullahi Jubril Randawa, Oguntayo Olanrewaju Adekunle, Usman Mohammed Aminu, Muhammad Manko, Olasinde Tajudeen Tajudeen, Lazarus M. Yusufu, Mohammed Dauda Maigatari, Lawal Khalid, Dahiru Ismail, Aliyu Ahmed Babadoko, Ahmed Tijjani Lawal, Abdullahi Alfa Mohammed, Yahaya Ukwenya, Ahmed Mai, Maitama Yusuf Hussaini, Anisah Yahaya, Caitlin Bishop, Jennifer Dent, Timothy R. Rebbeck, Yawale Iliyasu. Emerging epidemiological cancer trends among West African adults in Zaria, Nigeria (1972 to 2022) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2158.

Molecular characterization of antimicrobial resistance and virulence factors in coagulase – negative staphylococci nasal isolates among adult patients in a tertiary hospital in North-Western Nigeria

Coagulase-negative staphylococci are harmless microorganisms that can become pathogenic when the host resistance is impaired. Their ability to exhibit multidrug-resistance and form biofilm limit treatment options and contributes to the health and financial burden on health care systems worldwide. This study aimed to provide data on the acquisition and expression of genetic elements associated with resistance and virulence in the organisms from nasal colonization of adults admitted to a University Teaching Hospital in Nigeria. One hundred and twenty-three presumptive staphylococci isolates were obtained from the medical microbiology laboratory of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. The isolates were characterized, and the antibiotics susceptibility pattern assessed. Biofilm formation was evaluated by the micro-titre plate method, and polymerase chain reaction was used to detect resistance genes (mecA and ermB), virulence gene (psm-mec) and adhesin genes, (icaAB, icaC and icaD) in the isolates. Out of the 60 coagulase-negative staphylococci isolates, 50 (83.3%) were strong biofilm formers, 5 (8.3%) were moderate biofilm formers and 5 (8.3%) were weak biofilm formers. For the 14 isolates that were characterized by PCR, mecA and ermB resistance genes were detected in 78% and 71% of the isolates respectively. Twenty-one percent had psm-mec virulence gene while biofilm adhesin genes, icaAB and icaD were detected in 36% and 57% respectively, icaC gene was not detected. This study confirmed formation of biofilm, carriage of resistance and virulence genes which have been shown to play a role in pathogenesis. This study shows the necessity of the periodical monitoring of the drug resistance pattern and virulence factors of coagulase-negative staphylococci.

Musculoskeletal disorders and their associated factors among individuals with diabetes mellitus in northwest Nigeria.

Diabetes mellitus (DM) is a growing public health problem causing a significant amount of disability and mortality in Nigeria. Musculoskeletal disorders (MSDs) are common complications associated with DM. However, studies on the prevalence of MSDs and their associated factors are limited in Nigeria, particularly in the northwest region. The purpose of this study was to determine the prevalence of MSDs and their associated factors among individuals with DM in northwest, Nigeria. A retrospective cross-sectional survey of medical case records of all consecutive patients with DM attending a diabetic clinic in Ahmadu Bello University Teaching Hospital, Zaria was conducted between February 2015 and September 2021. Data on sociodemographic and clinical variables was collected using a researcher-designed questionnaire and analysed using descriptive statistics and logistic regression models. Four hundred eighty-nine cases (170 men [34.8%], 319 females [65.2%]; mean age: 51.4 ±12.3 years) were analysed. The majority of the participants had type 2 DM (96.7%), with a mean DM duration of 7.02 ±5.05 years. The overall prevalence of MSDs was 32.7%, with the highest prevalence found for lumbosacral spondylosis (11%) followed by knee osteoarthritis (8.4%). Among the different potential predictors examined, only duration of DM was significantly associated with overall MSDs (AOR: 1.76, 95% CI: 1.04-2.98; p = 0.035) whereas both duration of DM (AOR: 2.64, 95% CI: 1.19-5.89; p = 0.018) and body mass index (AOR: 7.461, 95% CI: 1.33-43.8; p = 0.023) were significantly associated with lumbosacral spondylosis. Approximately one-third of the study participants had MSDs, with lumbosacral spondylosis being the most frequently occurring disorder. Being obese and having a longer duration of DM were associated with MSDs. Clinicians in Nigeria need to pay attention to MSDs and related factors in DM patients by conducting routine assessments and implementing early treatment.

Detection of Aerobic Vaginitis and Antibiogram of its Implicating Bacteria among Women with Suspected Cases of Vaginitis in Obstetrics and Gynecology Clinics, Ahmadu Bello Teaching Hospital, Shika, Zaria-Nigeria

Aerobic vaginitis (AV) is a condition caused by aerobic bacteria, posing significant risks to women's health, particularly during pregnancy. Misdiagnosis and treatment challenges stem from widespread multidrug-resistant bacteria. This study aimed to diagnose aerobic vaginitis (AV) and assess antibiotic susceptibility patterns of the implicated bacteria in vaginitis among women attending Ahmadu Bello University Teaching Hospital's Obstetrics and Gynecology Clinics in Zaria, Nigeria. A total of 100 high vaginal swab (HVS) samples were collected and subjected to bacterial isolation, identification, and antibiotic susceptibility testing using cultural and biochemical methods, and the agar disc diffusion method, respectively. Results indicated 23% positivity for AV, with the highest prevalence observed in the 41-50 age group (50.0%) and the lowest in the 21-30 age group (7.3%), revealing a significant association between age and AV (p<0.05). While third-trimester pregnant women displayed a higher AV rate (32.0%) than those in their second trimester (0%), no significant association was found between gestational periods and AV (p>0.05). Symptomatically, painful intercourse correlated with a 28.0% AV rate, while vaginal itching showed an 18.5% rate, though lacking a symptom-AV relationship (p>0.05). Notably, condom use during sexual intercourse exhibited a higher AV rate (63.6%) than non-users (18.0%). AV prevalence was notably higher among women with a history of miscarriage (62.5%) compared to those without (15.5%), showing a significant association between risk factors and AV (p<0.05). Klebsiella species (47.8%) and Escherichia coli (30.4%) were the primary AV-associated bacteria, with Klebsiella spp. showing high resistance to Ceftriaxone and Ampicillin (100%). These findings underscore the importance of accurate AV diagnosis to avert adverse outcomes like miscarriage and postpartum complications and highlight the need to reconsider Ceftriaxone and Ampicillin usage in AV treatment.

Socio-demographic and food insecurity associated with adherence to antiretroviral therapy among HIV adults in Ahmadu Bello University teaching hospital Zaria, Kaduna State Nigeria

Background: Socio-demographic characteristics may have an impact on HIV-positive people's prognosis and survival. In addition, food insecurity could make it harder for HIV patients to stick to their treatment plans as effectively as possible.Objective: This research aimed to determine the association between socio-demographic and food insecurity with adherence to antiretroviral therapy among people living with HIV on ART in Ahmadu Bello University Teaching Hospital Zaria, Kaduna State, Nigeria.Method: Using a cross-sectional design, a systematic random sampling method was used to select respondents aged 18–64 years on antiretroviral therapy for at least six months at Ahmadu Bello University Teaching Hospital Zaria, Kaduna State, Nigeria, outpatients of the President's Emergency Plan for AIDS Relief clinic. Socio-demographic, food insecurity status and adherence to ART was obtained using self-administered questionnaire. Descriptive statistics, chi-square test, and multiple logistic regression were used for data analysis.Results: Among the 385 people who took part in the study, about 67.5% of females and 32.5% of males took part in the survey, respectively. About 54% of adults adhered to ART. The majority of the respondents (87.0%) had a low level of food security. Food insecurity (OR = 1.2, p = <0.05), government employment (OR = 2.842, p = <0.01), self-employment (OR = 2.6, p = <0.001), and being divorced or widowed (OR = 2.0, p = <0.01) were all significantly associated with ART adherence.Conclusion: Food insecurity, employment, and marital status influenced adherence to ART. As a result, health care providers and HIV control programme implementers must continually emphasis and encourage strict adherence.

An intervention study investigating the effectiveness of contextualizing multimodal strategy on improving hand hygiene at a tertiary hospital in Nigeria.

Hand hygiene (HH) is a proven low-cost means to curtail the problem of hospital-acquired infection (HAI). However, a low HH compliance rate of 17.1% was found among surgical health workers at Ahmadu Bello University Teaching Hospital (ABUTH) in Zaria, Nigeria. This was an intervention study conducted utilizing mixed methods to investigate the effectiveness of the World Health Organization (WHO) multimodal strategy to improve the HH compliance rate of doctors at ABUTH Zaria. The study was conducted between June and August 2022 and included delivering a behavioural change HH workshop to doctors followed by data collection in the surgical wards that had received environmental modification through the provision of an alcohol-based hand rub (ABHR), HH posters and nurses for visual and/or verbal reminders. The cumulative HH compliance rate was 69% (n=1774) and was significantly different from the baseline HH compliance rate of 17.1% (confidence interval 45.5 to 57.7, p<0.001). Observed HH was highest in the ward with both visual and verbal reminders (78%) and lowest (59%) where neither visual nor verbal reminders were provided (n=444 per ward). All respondents reported motivation to perform HH with the presence of ABHR. The WHO multimodal strategy is good for enhancing HH among health workers in the context of low- and middle-income countries. More research is needed to understand how much of a reduction in HAI is directly associated with efficient HH by health workers.

Prevalence and pattern of sensorineural hearing loss among children and adolescents with sickle cell disease in a tertiary health facility, Northwest Nigeria

Sickle Cell Disease (SCD) can result in painful vascular occlusion crises, anoxia, and ischemia, which can occasionally cause damage to tissues and organs, including the auditory system, particularly the blood-rich cochlea. Despite being underreported, Sensorineural Hearing Loss (SNHL) is a well-known consequence of SCD globally. The study’s objective was to determine the prevalence and pattern of hearing loss in children and adolescents aged 5 to 16 years old with SCD who were in steady state and were seen at the hematology and pediatric outpatient clinics at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria. A prospective hospital-based case-control study was conducted with 125 children with SCD in steady state, aged 5 to 16, who were enrolled in the hematology clinic at the Ahmadu Bello University Teaching Hospital in Zaria, Nigeria, and 125 ‘age- and sex-matched healthy controls, who were selected from the ABUTH’s pediatric outpatient clinics. An organized questionnaire was used to collect fundamental data on the sociodemographic characteristics and medical history of the participants and controls. In a sound-treated booth, the participant’s hearing was evaluated using tympanometry and pure tone audiometry. Overall, 68 (54.4%) and 57 (45.6%) out of the 125 assessed participants were male and female, respectively, with a male-to-female ratio of 1.2:1 and the mean age 10.17±3.55 years. Due to age-sex matching, the subject’s age and sex distributions match those of the controls. Children with SCD experienced bilateral SNHL ≥25 dB in 32/125 (25.6%) cases (21 males;11 females). The control group, which had a HbAA phenotype that was normal, did not exhibit any hearing loss. 21/32 (65.6%) of the participants had mild (26-40 dB) hearing loss, and SNHL occurred more frequently in males (21/32 (65.6%) than in females (11/32 (34.4%). In comparison to 3(9.4%) HbSC and 1(3.1%) HbSS+F, SNHL was more common in individuals with 28(87.5%) HbSS phenotypes. While diverse frequencies were impacted in the affected participants, there was no consistency in the frequency pattern of hearing loss. The current study showed that SNHL is a frequent complication in children and adolescents with SCD. About 25% of children and adolescents with SCD experienced SNHL, which disproportionately affected males. Frequent audiometry should be carried out to check the children’s hearing levels and identify any early hearing losses so that interventions can be made to perhaps prevent associated speech and language issues that might cause educational challenges.

Association between Socio-Demographics and Clinical Profile with Therapy Options Received by Cervical Cancer Patients in Two Nigerian Tertiary Hospitals

This study was conducted to determine the associations between the socio-demographics, clinical profile and therapy options received by cervical cancer (CC) patients in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto and Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. The study used a prospective longitudinal design with retrieved data for 157 eligible CC patients. Pearson’s correlation was used to test for association between patients’ socio-demographics, clinical characteristics and number of therapy options received while comparisons of proportions were carried out using Pearson’s Chi square. Results show that the mean age of the patients was 50.7±9.0 years and 43.3% of patients earned less than ₦50,000.00 per month. The results also reveal most of the 47.1% of patients presented with clinical stage III. Per Vaginal Bleeding (PVB) was the symptoms recorded for 88.5% of the patients while most patients (49.7%) received Chemotherapy (CT) as the major therapy option. There were significant associations between the level of income, (r=0.412, p&lt;0.001), baseline number of symptoms, (r=0.200, p=0.012), number of symptoms after therapy, (r= -0.584, p&lt;0.001) and the number of therapies received by the patients. Clinical disease-stage, baseline number of symptoms and level of income were found to be associated with the therapy options received by the patients.

Health-related quality of life associated with different cervical cancer therapies received by patients in two Nigerian tertiary hospitals.

There are important consequences from cervical cancer (CC) disease and its treatment among survivors, especially the impact on quality of life (QoL). To evaluate the health-related QoL associated with different CC therapies received by patients in two Nigerian tertiary hospitals. This study employed a prospective longitudinal design. It was conducted at Usmanu Danfodiyo University Teaching Hospital, Sokoto and Ahmadu Bello University Teaching Hospital Zaria, North-Western Nigeria. Data of all the 157 eligible CC patients were collected at baseline and after therapy. Data analysis was done with appropriate descriptive and inferential statistics using SPSS V. 20 for windows. P<0.05 was considered statistically significant. Chemotherapy (CT) was the major therapy option received by 78(49.7%) of the patients. Patients who received chemoradiation therapy (CRT) and adjuvant chemotherapy (CTS) had the highest increase in mean overall health-related QoL of 0.138 (t=8.456, p<0.001) and 0.138 (t=6.489, p<0.001) higher than their respective baseline scores. Patients who received CT had the least increase in mean overall health-related QoL of 0.095 (t=4.574, p<0.001) from baseline. Chemoradiation therapy and adjuvant chemotherapy were associated with highest increase in mean overall health-related QoL. Chemotherapy was associated with the least increase in mean overall health-related QoL.

Causes and Pattern of Eye Diseases in Children Attending the Paediatric Eye Unit of Ahmadu Bello University Teaching Hospital, Shika, Zaria

Aim: The purpose was to determine the causes and pattern of eye diseases in children 0-15 years of age who attended the paediatric unit of the Ophthalmology department Ahmadu Bello University Teaching Hospital Shika, Zaria with a view of obtaining data for planning of children eye care. Methods: This was a descriptive cross-sectional study. All children that met the inclusion criteria were recruited. Subjects had visual acuity assessments as appropriate for age. Anterior segment examination was done using a loupe or slit lamp biomicroscope as appropriate while posterior segment was examined by direct ophthalmoscopy. Manual refraction was done using streak retinoscope (cycloplegic refraction when required). Results: A total of 12,516 patients attended the Ophthalmology out-patient clinic of the hospital during the 30- month study period (May 2014- October 2016), 1,760 old and new patients (14.1%) were patients 0-15 years of age (study population). A total of 448 children were recruited for the study. The male to female ratio M:F was 1.3:1. Allergic conjunctivitis 181 (40.4%), refractive error 42 (9.4%) and infective conjunctivitis 39 (8.7%) were the most common ocular disorders seen. The prevalence of visual impairment was 34.4%. Trauma was the most common cause of uniocular visual impairment. The proportion of blind eyes was 3.1% (n=12). Conclusions: Majority of the ocular disorders seen among the children were treatable causes of visual impairment. Public health education is necessary to create awareness on the causes of blindness. However, there was no statistically significant difference in the ocular disorders with respect to age and gender of the children.

Causes and Pattern of Eye Diseases in Children Attending the Pediatric Eye Unit of Ahmadu Bello University Teaching Hospital, Shika, Zaria

Aim: The purpose was to determine the causes and pattern of eye diseases in children 0-15 years of age who attended the paediatric unit of the Ophthalmology department Ahmadu Bello University Teaching Hospital Shika, Zaria with a view of obtaining data for planning of children eye care. Method: This was a descriptive cross-sectional study. All children that met the inclusion criteria were recruited. Subjects had visual acuity assessments as appropriate for age. Anterior segment examination was done using a loupe or slit lamp biomicroscope as appropriate while posterior segment was examined by direct ophthalmoscopy. Manual refraction was done using streak retinoscope (cycloplegic refraction when required). Result: A total of 12,516 patients attended the Ophthalmology out-patient clinic of the hospital during the 30- month study period (May 2014- Oct. 2016), 1,760 old and new patients (14.1%) were patients 0- 15 years of age (study population). A total of 448 children were recruited for the study. The male to female ratio M: F was 1.3:1. Allergic conjunctivitis 181 (40.4%), refractive error 42 (9.4%) and infective conjunctivitis 39 (8.7%) were the most common ocular disorders seen. The prevalence of visual impairment was 34.4%. Trauma was the most common cause of uniocular visual impairment. The proportion of blind eyes was 3.1% (n=12). Conclusion: Majority of the ocular disorders seen among the children were treatable causes of visual impairment. Public health education is necessary to create awareness on the causes of blindness. However, there was no statistically significant difference in the ocular disorders with respect to age and gender of the children.

Influence of pregnancy and lactation on vitamin D serum levels and antioxidant status in randomized women in Zaria.

Pregnancy and lactation are normal physiological conditions that tend to influence numerous biological processes. The aim of this study was to identify the impact of pregnancy and lactation on serum vitamin D level and antioxidant status in some women in Zaria, Nigeria. A cross‑sectional descriptive study conducted at Ahmadu Bello University Teaching Hospital, Zaria for a period of three (3) months. Blood samples were collected, serum catalase, superoxide dismutase, lipid peroxidation and vitamin D, were determined using standard methods. Data were presented as mean ± SD, analysis was performed using one-way ANOVA and Pearson's correlation analysis. Values were considered significant at p ≤ 0.05. There was a significant difference (p < 0.01) serum malondialdehyde level, superoxide dismutase activity and glutathione peroxidase activity during the various trimesters of pregnancy and lactating group. However, the levels of these markers were highest in the lactating group. Furthermore, serum level of vitamin D and catalase activity was highest in the 2nd trimester and lowest in the control and lactating group respectively. Pregnancy and lactation altered serum level of Vitamin D, CAT, SOD, MDA and GPx suggesting a variation in oxidative stress at different trimester of pregnancy and lactation. Key words: Pregnancy, lactation, oxidative stress, vitamin D.

Assessment of Some Anthropometric Parameters of Repaired Unilateral Cleft Lips in Children at Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria

Cleft lip and palate are common congenital anomalies, and surgical outcome of cleft repair is difficult to evaluate due to the complex shape of the nose. In this study, some anthropometric parameters of repaired unilateral cleft lip were compared with those of non-cleft lip children by direct assessment with a view to establish the significance of these parameters in evaluating extent of cleft lip repairs.

P40 The effectiveness of contextualizing multimodal strategy on doctors to improve hand hygiene compliance in surgical wards at Ahmadu Bello University Teaching Hospital Zaria, Nigeria

Abstract Background Hospital acquired infection (HAI) is a major problem in healthcare delivery worldwide despite medical advances. A low HH compliance rate of 17.1% was found among surgical health workers at Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Nigeria. Although hand hygiene (HH) is a proven low-cost means to curtail HAI, low HH compliance is a global reality. The WHO multimodal strategy attempts to address low HH compliance within the frame of contextual realities. Methods This was an interventional study utilizing action research through a mixed method approach to investigate the effectiveness of employing a contextualized multimodal strategy to enhance the HH compliance rate of doctors at ABUTH Zaria. The study was from August to October 2022. A behavioural change campaign (BCC) HH workshop was carried out on doctors, and data collection followed immediately in the surgical wards (i.e. clusters) that had received environmental modification through the provision HH posters and nurses for visual and verbal reminders, respectively. The four clusters were: visual reminders only, verbal reminders only, visual and verbal reminders combined and neither visual nor verbal reminders (i.e. control). All clusters received an uninterrupted supply of alcohol-based hand rubs (ABHR) throughout the study period. The HH observation proforma for ‘five moments of HH’ template was used to collect the quantitative data through direct observation while qualitative data were by one-on-one interviews on doctors in surgical wards at ABUTH Zaria. Results The cumulative HH compliance rate by doctors was 69% (N = 1774). This was significantly different from the baseline HH compliance rate of 17.1% before this study’s intervention (P &amp;lt; 0.0001, C. I. 45.5% to 57.7%). HH was observed from doctors most in wards with both visual and verbal reminders (78%) while lowest (59%) where visual and verbal reminders were not provided, i.e. C4 (n = 444). Compared with the baseline HH compliance, all interventions were significant. However, compared with C4, visual reminders only (C1) had insignificant effect on influencing the HH practice of doctors while visual and verbal reminders combined. Verbal reminders only (C2) were found to be as effective as when combined with visual reminders (78%) as the difference was statistically insignificant (P = 0.4791, CI −3.5% to 7.5%, χ2 = 0.5). However, all doctors reported being motivated to perform HH by the presence of ABHR which was similar to the significance found even in the ward where no verbal or visual reminders (59%, n = 444) were used compared with the baseline (17%, n = 286) before this intervention study (P &amp;lt; 0.0001, CI 35% to 48%, χ2 = 125). All respondents reported hearing about the HH behavioural change workshop even though only one attended. Conclusions Continuous workshop on HH is necessary to sustain awareness of health workers on the importance of hand hygiene. The presence of ABHRs alone was enough motivation for doctors to perform HH but verbal reminders were significant in sustaining this positive attitude towards HH. A scaling of this intervention is needed in other departments so that staff can have changes made to their values towards healthcare delivery as well at ABUTH Zaria. Contextualizing the WHO multimodal strategy is an efficient and acceptable means of addressing the problem of low HH compliance.

A 5-year Retrospective Review Of Attention Deficit Hyperactivity Disorder In Children In Zaria, North West Nigeria

Background:Attention deficit hyperactivity disorder (ADHD) is characterized by inattention and/or hyperactivity-impulsivity that impair an individuals functioning and development. Children with ADHD are at risk of poor academic performance, dropping out of school, low self-esteem, teenage pregnancies, engaging in criminal behaviour, sustaining physical injuries and poor social skills. Objective: We carried out a 5- year retrospective review of cases of ADHD in our Paediatrics Neurology Clinic to determine the epidemiology, symptomatology and risk factors for ADHD in our setting. Materials and Methods: Case folders of all children with an established diagnosis of ADHD who were being seen at the paediatric neurology clinic of Ahmadu Bello University Teaching Hospital, Zaria from 1st January 2015 to 31st December 2019 were retrieved and relevant information such as sociodemographic characteristics, symptoms, age at presentation and perinatal or childhood central nervous system insult were extracted. Statistical analysis was done using Epi Info statistical software version 7. Results: A total of thirty (30) children were on follow-up for ADHD in the Paediatrics Neurology clinic of Ahmadu Bello University Teaching Hospital, Zaria during the study period. Twenty-four of them were males (80%) while 6 were females (20%). Their ages at presentation ranged from 2 to 15 years for boys (mean±SD =5.2 ±2.99) and from 2 to 5 years for girls (mean±SD =3.0 ±1.26). More than half (63.3% n= 19/30) were less than 5 years of age as at the time of first presentation to the clinic. Majority, (93.3% ,n= 28/30) had a history of CNS insult prior to onset of ADHD symptoms. Conclusion: Attention deficit hyperactivity disorder (ADHD) is increasingly being seen in environment, most cases occur in boys less than 5 years of age. Avoiding injuries to a childs central nervous system early in life can significantly decrease the likelihood of ADHD in them.

The prevalence of IGM antibodies to Zika virus in pregnant women in Northern Nigeria.

Zika virus (ZIKV) infection during pregnancy can result in severe outcomes for both the pregnant woman and the developing fetus. The objective of this study was to investigate the prevalence of Zika virus infection among pregnant women who sought healthcare services at Ahmadu Bello University Teaching Hospital. Serum samples were collected and analyzed using Enzyme Linked Immunoassay and RT-qPCR methods, while a structured questionnaire was used to gather relevant information about the participants. The results showed that 53 out of the 180 pregnant women tested positive for Anti-Zika IgM antibodies, which represents a 29.4% prevalence rate. Subsequent RT-qPCR analysis found that only 6 out of the 53 positive samples contained Zika virus RNA. Fever and headache were the most commonly reported symptoms related to the infection. These findings indicate a potential outbreak of Zika fever in Northern Nigeria emphasizing the importance for pregnant women to take precautions to avoid getting infected.

The use of trifluoromethyl tubercidin as a novel treatment of influenza in an overwhelmed health care setting: a correspondence

The use of trifluoromethyl tubercidin as a novel treatment of influenza in an overwhelmed health care setting: a correspondence

Association Between Belief in Medicine and Adherence to Antiretroviral Therapy Among Human Immunodeficiency Virus Adults in Zaira, Kaduna State, Nigeria.

Negative perceptions of antiretroviral treatment (ART)'s efficacy and consequences may operate as roadblocks to adherence. This research aimed to determine the association between belief in medicine and adherence to antiretroviral therapy among HIV adults on ART in Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria. Using a cross-sectional design, a systematic random sampling method was used to select respondents aged 18-64 years on antiretroviral therapy for at least six months at Ahmadu Bello University Teaching Hospital, outpatients of the President's Emergency Plan for AIDS Relief Clinic. Socio-demographics, belief in medicine and adherence to ART were obtained using a self-administered questionnaire. Descriptive statistics, chi-square test, and multiple logistic regression were used for data analysis. Among the 385 people who took part in the study, about 67.5% were females and 32.5% were males. About 54% of adults adhered to ART. More than half (55.8%) of the respondents had negative perceptions (beliefs) of personal need for ART medication and about 42.3% of the respondents had more concerns about the potential negative effects of the ART medication. Government employment (odds ratio (OR) = 2.842, p = <0.01), self-employment (OR = 2.6, p = <0.001), and being divorced or widowed (OR = 2.0, p = <0.01), negative perceptions (beliefs) of personal need for the ART medication (adjusted OR (AOR) = 1.525, p=<0.01) and more concerns about the potential negative effects of the ART medication (AOR= 1.362, p = <0.05) were all significantly associated with ART adherence. Employment, marital status and belief in medicine were associated with adherence to ART. Therefore, during adherence counseling, healthcare personnel should address respondents' false views and fears regarding ART medication in order to strengthen proper information and the benefits of ART. This article was previously presented as a meeting poster at the 36th Scientific Conference of the Nutrition Society of Malaysia (7th and 8th September 2021).