Bello University Teaching Hospital Zaria Research Articles

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.

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.

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.

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.

Assessment of Legibility of Handwritten Prescriptions and Adherence to W.H.O. Prescription Writing Guidelines in Ahmadu Bello University Teaching Hospital Zaria - Kaduna State, Nigeria.

Introduction: The issues of incorrectness and incompleteness for written prescriptions may result to dispensing errors and unintended outcomes of care. The objective of the study was to assess the legibility of handwritten prescriptions and adherence to W.H.O. prescription writing guidelines in Ahmadu Bello University Teaching Hospital Zaria. Method: A cross-sectional prospective study design was used, and existing prescriptions were sampled from selected in-patient and outpatient pharmacy units of Ahmadu Bello University Teaching Hospital Zaria. This was approved by the ethics and research committee of the institution. The prescriptions were then evaluated for quality based on the layout, legibility, and clarity of the details in the prescriptions and screened for medication errors. Result: The extent of prescribing drugs by generic name was (68.37%), the legibility percentage was moderate and the percentage of prescriptions in which details of the drug, route of administration, and duration of treatment were complete was 85.23%, 80.80%, and 82.40%, respectively. The doctor's signature (84.87%) was present in the prescriptions. Many of the prescribers did not use to indicate patients' weight, age, and clinic on prescriptions, these are deviations from good prescribing practices while total medication error was 38.01%. Conclusion: Prescribers have a duty of care to their patient and a professional duty to their colleagues (pharmacists) to ensure drug prescriptions are readily identifiable. Interventional techniques such as the use of printed or electronic prescriptions can improve the ease of interpreting information and reduce medication errors.

Knowledge and perception of medication errors among health care workers in Ahmadu Bello University Teaching Hospital Zaria, Kaduna State, North-west Nigeria.

Medication errors (MEs) are important, often overlooked forms of medical error that are associated with morbidity and mortality in health care settings. Among health care workers, knowledge, attitude and perception may affect reporting of MEs. The aim of this study was to determine the level of knowledge and perception of MEs among health care workers in Ahmadu Bello University Teaching Hospital, Zaria. A cross-sectional study was conducted among 138 health care workers selected randomly through a stratified sampling. Their responses were collected using pre-tested, self-administered questionnaires and analysed using the Statsitical Package for the Social Sciences. The numerical variables were summarised as means and standard deviations, whereas categorical variables were presented as frequencies and percentages. The Chi-square test was used to test for associations at P < 0.05. All the respondents heard of MEs and up to 108 (78.3%) correctly defined them. While only 121 (87.7%) respondents had fair to good knowledge about MEs, all of them had good perception of them. Major types of MEs known by the respondents were knowledge-based errors (79.7%), rule-based errors (52.9%), action-based errors (67.4%) and memory-based errors (55.8%). The causes of MEs identified were communication problems (88.4%), poor organizational knowledge transfer (63.8%), heavy workload (80.4%) and not reading instructions carefully (63.0%). There was no statistically significant association between the level of knowledge on MEs and sociodemographic characteristics of the respondents. Knowledge and perceptions of MEs were good among our respondents. Adequate mechanism (s) should be put in place to encourage the reporting of MEs whenever they occur to promote patient safety and improve health outcomes.

Evaluation of Some Selected Breast Cancer Classification Algorithms in Nigeria

Breast Cancer (BC) is a prevalent disease that affects mostly women in the world. According to the World Health Organization (WHO), BC represent about 25 percent of all cancers in women with 685 000 deaths in 2020. An early detection of this disease can greatly increase the chances of taking the right decision on a successful treatment plan. This resulted in the need of new research avenues most especially in a country like Nigeria where there is low awareness of the disease and late presentation of BC by patients is normal. To achieve this, Support Vector Machine (SVM), KN Neighbor (KNN) and Decision Tree (DT) was used on a local dataset obtained from Ahmadu Bello University Teaching Hospital Zaria to provide some effective diagnostic capabilities. The dataset was classified into three classes (Benign, Pre-malign and Malign) and the SVM obtained a good classification accuracy of (99.2%). Late presentation of breast cancer is normal because of low awareness of the disease in the country therefore more awareness of the disease is highly recommended and women above the age of 34 years should always go for the breast cancer screening at least once a year with or without sign, sickness or symptoms.

Nutritional status and serum vitamin A, protein and albumin levels in children six to fifty-nine months in Ahmadu Bello University Teaching Hospital Zaria

Background: Protein energy malnutrition (PEM) is a major public health problem in the tropical and subtropical regions of the world and often arises during protein and/or energy deficits due to nutritional inadequacy, poor socio-economic and environmental conditions and infections. Vitamin A deficiency (VAD) is an important health concern in severe malnutrition and has been found to be associated with significant morbidity and mortality. Children with PEM have greater deficiency of total protein and albumin and in severe cases the total protein may be reduced to about 50 per-cent. The objective of this study was to determine the serum vitamin A, total protein and albumin in malnourished children aged 6-59 months at Institute of Child Health Zaria.&#x0D; Methods: This study was a case control health- based descriptive study to determine the relationship between serum vitamin A, protein and albumin levels among children with Protein Energy Malnutrition and their controls at Institute of Child Health, Ahmadu Bello University Teaching Hospital (ABUTH) Zaria. Using systematic sampling method, a total of 132 children (cases and controls) between 6 and 59 months of age were selected for assessment of their serum vitamin A, protein and albumin. Serum vitamin A level was analyzed by high performance liquid chromatography while the total serum protein and albumin levels were analyzed on the Boerhringer Mannheim Automated Hitachi system 704 using the Biuret and colour change methods respectively.&#x0D; Results: The highest mean serum vitamin A (60.28±11.03μg/dl) and mean protein (61.24±10.12g/dl) among malnourished group were seen in marasmic –kwashiokor. For the controls, the mean serum protein is 62.96±5.99g/dl while the mean serum vitamin A is 59.44±13.90μg/dl. The overall mean serum protein for study group and controls were 50.2 4 ± 12.33μg/dl and 62.96±5.99g/dl respectively and the difference between them was statistically significant (p&lt;0.01) The highest mean retinol (60.28±11.03) and albumin (38.43±30.14g/dl) were recorded among the marasmic-kwashiorkor malnutrition, while for the controls, the mean retinol was 50.44±13.90μg/dl and the mean serum albumin was 37.62±40.98g/dl. The overall mean serum albumin for both study group and controls were37.17±12.22g/dl and 37.62±40.98g/dl respectively and the difference between them was statistically significant (p&lt;0.04).&#x0D; Conclusion: The serumprotein and albumin showed positive correlation with serum vitamin A levels. The highest mean serum vitamin A, protein and albumin was seen in marasmic-kwashiorkor among under-nourished children

A Cross-Sectional Study of Sialic Acids Level in Breast Cancer Patients Attending Ahmadu Bello University Teaching Hospital Zaria, North-Western Nigeria: Preliminary investigations and Implications on Disease Subtypes, Grade and Chemotherapy Courses

Abstract Due to the challenges associated with breast cancer prognosis, this study examined sialic acid levels based on subtypes, grades and therapeutic courses among breast cancer patients presenting at Ahmadu Bello University Teaching Hospital (ABUTH) in North-Western Nigeria between June 2019 and December 2020. This was a cross-sectional study. Sociodemographic characteristics, total sialic acid (TSA), free sialic acid (FSA), bound sialic acid (BSA) and haematological parameters were determined. The mean age of the respondents was 47.46 ± 10.71 years, and the modal age range was 41-50 years. About 40% of the patients had triple-negative breast cancer subtype, and 83.1% had invasive carcinoma. There was an association between breast cancer grade and body mass index (χ2= 26.306, P= 0.001). The TSA, FSA and BSA concentrations were significantly (P&lt;0.05) higher in luminal A and triple-negative breast cancer patients when compared to apparently healthy controls and were highest in stage IV patients. The TSA correlated with the third and sixth chemotherapy courses. Significant (P&lt;0.05) decrease was observed in PCV and Hb among the breast cancer patients irrespective of subtype compared to healthy control. The results suggest that TSA, FSA and BSA were higher in breast cancer patients, necessitating further research on their possible prognostic implications.

ACCESSING OF SOME RISK FACTORS OF RHEUMATOID ARTHRITIS USING LOGISTIC REGRESSION

Rheumatoid arthritis occurs when the immune system attacks the synovium (the lining of the membrane that surrounds the joints). The resulting inflammation thickens the synovium, which can eventually destroy the cartilage and bone within the joint. This research aims to find out the significant risk factors of 240 patients with Rheumatoid Arthritis in Ahmadu Bello University teaching hospital Zaria. The variables considered for this research are Obesity, gender, Smoking, Age, Alcoholism, and family history which were the selected risk factors and is been analyzed using logistic regression analysis and descriptive statistics. Statistical analysis showed that alcoholism and age have a significant association with Rheumatoid Arthritis and have a positive effect on developing the disease. The result also shows that the risk factors highly contribute to rheumatoid arthritis. However, there is no significant association of Rheumatoid Arthritis with gender, obesity, smoking, and family history. Based on the findings from the research study, it is imperative to critically evaluate the lifestyle of patients developing Rheumatoid Arthritis for future clinical research.

Adenoid and Tonsil Hypertrophy in Zaria, North Western Nigeria: Review of Clinical Presentation and Surgical Outcome.

Background:Adenotonsillar hypertrophy is one of the most common childhood disorder that necessitates presentation to the ear nose and throat specialist. The disorder may be managed conservatively or by surgery.Aim:To highlight the clinical presentation and surgical treatment outcome of patients managed for adenoid and tonsillar hypertrophy at Ahmadu Bello University Teaching Hospital Zaria, Nigeria.Materials and Methods:The case records of patients managed for adenoid and tonsil hypertrophy were reviewed from January 2013 to December 2017 at the Division of Otorhinolaryngology, Department of Surgery Ahmadu Bello University Teaching hospital Zaria, - Northwestern Nigeria. Case notes with incomplete information and /or missing pages were excluded. The data were analyzed using IBM SPSS (for windows, version 23)Results:There were 56 (55.4%) males and 45 (44.6%) females with male to female ratio of 1.2:1. Their ages ranged from 2–16 years with a mean and standard deviation of 4.0 and 3.2 respectively. The most common symptom at presentation was snoring 85 (84.2%) followed by rhinorrhea 81(80.2%). Findings from the radiologic investigations revealed that majority of the patients had severely narrowed nasopharyngeal air column 83(82,2%) Adenotonsillectomy was the most common surgery performed on most of the patients 63(62.4%) who presented with adenotonsillar hypertrophy. Majority of the patients 95(94.1%) had resolution of symptoms within the period of follow up. Four (4.0%) of them had recurrent adenoidal growth.Conclusion:Snoring, rhinorrhea and mouth breathing were the most common symptoms of adenotonsillar hypertrophy. The outcome of adenotonsillar surgeries in our patients is good, with the majority having resolution of symptoms.

Prevalence and characteristics of rotavirus acute gastroenteritis among under-five children in ahmadu bello university teaching hospital, Zaria, Nigeria.

Rotavirus infection is a significant cause of gastroenteritis in developing countries and, in severe cases even leads to death. The impact of rotavirus vaccine introduction in reducing the rotavirus disease burden in children was well known. The study was aimed to determine the prevalence and clinical characteristics of rotavirus gastroenteritis before the introduction of rotavirus vaccine into Nigeria's routine immunization program. We conducted a cross-sectional hospital-based study involving 735 children aged 0-59 months with acute gastroenteritis hospitalized at the Ahmadu Bello University Teaching Hospital Zaria from September 2017 to August 2020. Relevant sociodemographic and clinical data were obtained and entered into the World Health Organization standardized case investigation forms. Stool specimens were tested for rotavirus Group A antigen using the ProSpecT™ Rotavirus Microplate Assay by Thermoscientific Oxoid Microbiology UK. One hundred and fifty-three stool samples tested positive for rotavirus giving a prevalence of 20.8%. One hundred and two (66.7%) children with rotavirus gastroenteritis were infants. There were 87 males and 66 females with M: F ratio of 1.3:1. Only 30 (19.6%) children with rotavirus-associated diarrhea presented with severe dehydration. The presence of vomiting was significantly associated with rotavirus diarrhea (P = 0.001). More cases of rotavirus diarrhea occurred in September through February. None of the studied children were vaccinated against rotavirus. The prevalence of rotavirus diarrhea remains high in this study. Infants were recognized as a high-risk group, and none of them were vaccinated against rotavirus and this underscores the urgent need for implementing the rotavirus vaccine in the national vaccination program to reduce the disease burden in the country.

Application of Queuing Theory and Management of Waiting Time Using Multiple Server Model: Empirical Evidence From Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria

In many hospitals, time spent by the patients to get service in the healthcare facility is always the main problem faced by the health care providers. This trend is on the increase and it is a potential threat to healthcare services. In Nigeria, general hospitals with large number of patients have cases where patients may not be attended to on time. The consequences of keeping patients in a queue for too long in order to get medical care can cause a slew of problems or even lead to death. In this study, the multiple servers queuing models were used to analyze service efficiency of the Ahamadu Bello University Teaching Hospital Zaria, Kaduna State. Primary data was collected through observation and questionnaire methods at the hospital over a two-week period to determine the queuing model that minimizes patients waiting time. The results showed that a significant percentage of the patients were not satisfied with how queues management strategies put in place by the hospital. Regression analysis shows that all the dimensions of service quality have significant positive relationship with the patient’s satisfaction.

P–683 Correlation of vitamin D deficiency with anti-Mullerian hormone (AMH) among infertile women in comparison to fertile women in a tertiary health facility in North-Western Nigeria

Abstract Study question is there correlation between Vitamin D Deficiency and AMH levels in infertile and fertile women? Summary answer there is no significant correlation between Vitamin D deficiency and AMH levels in both infertile and fertile women What is known already Vitamin D deficiency and insufficiency is a global health problem affecting over a billion people with higher prevalence among reproductive-age women, and blacks. Vitamin D is well known to play significant role in calcium-phosphate homeostasis and bone metabolism, however, recent studies have demonstrated diverse expression of vitamin D receptors in reproductive organs. This suggest the probable role of vitamin D in reproductive physiology and fertility. The pathogenesis of vitamin D in infertility is poorly understood, but thought to involve hypothalamo-pituitary axis, ovarian folliculogenesis and uterine implantation. Most studies are done in Assisted Reproduction Technology and in developed countries Study design, size, duration A case-control study that involved 128 consecutively consenting women within the reproductive age group; 64 infertile women as the cases and 64 age and body mass index (BMI) matched fertile women as the controls. The study was conducted over a period of six (6) months Participants/materials, setting, methods The study was conducted in Obstetrics and Gynaecology and Chemical pathology departments of Ahmadu Bello University Teaching Hospital Zaria, a tertiary hospital in North-Western Nigeria. It involved all cases of female-factor infertility as cases, while the controls were fertile women from 6 weeks postpartum to 1 year. Venous blood samples were assayed for serum 25(-hydroxy) vitamin D and AMH levels using Enzyme-Linked Immunosorbent Assay (ELISA) and data analysed with level of significance set as &amp;lt; 0.05 Main results and the role of chance The mean ± standard deviation (SD) of serum Vitamin D levels in the infertile women and fertile women were 17.01 ± 7.61ng/ml and 11.34 ± 6.12ng/ml respectively, significantly higher in the infertile women (p-value &amp;lt;0.000). The prevalence of Vitamin D deficiency (&amp;lt;20ng/ml) was found to be significantly higher in the fertile women compared to infertile women (89.1% versus 68.8%; p-value 0.007). Vitamin D levels were found to be positively correlated with age (r 0.374; p-value 0.002) and parity (r 0.338; p-value 0.006). There was no association between vitamin D with type of, and causes of infertility. Vitamin D deficient women were found to be 6.5 times less likely to be infertile than non-deficient women (aOR 95% confidence interval 1.96–21.55; p-value 0.002). There was no significant correlation between vitamin D and AMH levels in vitamin D deficient women of both study groups (rs 0.180; p-value 0.242 and rs 0.088; p-value 0.521). Interestingly, there was significant relationship between AMH levels and causes of infertility (p-value 0.001), with higher levels of AMH found in infertile women with polycystic ovarian syndrome Limitations, reasons for caution There is no consensus on the cut-off values for vitamin D levels as it relates to fertility, and no reference values for vitamin D deficiency and AMH levels in study area. The sample size was limited by cost, and the study was conducted in a single study area Wider implications of the findings: The vitamin D levels in women with infertility was low but yet not significantly correlated with AMH. Overall, prevalence of vitamin D deficiency among reproductive-age women was found high. There is need for life-style and dietary modifications. Further researches are needed to ascertain the effect of vitamin D on fertility. Trial registration number Not applicable

Dietary pattern of undernourished children and their Vitamin A status in institute of child health Ahmadu Bello University Teaching Hospital Zaria

Context: Vitamin A deficiency (VAD) affects an estimated six million pre school children in Nigeria and 20 million in Africa. When associated with severe undernutrition, it increases both morbidity and mortality of under five children. Aims: The study was aimed to determine the dietary pattern and its relationship with Vitamin A levels in undernourished children and controls in Institute of Child Health (ICH), Ahmadu Bello University Teaching Hospital Zaria. Settings and Design: This was a case–control, hospital based descriptive study carried out at the ICH Banzazzau, Zaria. Materials and Methods: Systematic sampling method was adopted to select undernourished children aged 6–59 months for the study. A semi-quantitative food frequency questionnaire was developed following the International Vitamin A Consultative Group guidelines for dietary assessment of Vitamin A intake. The questionnaire consisted of a list of 22 food items obtained during survey from local markets. Serum Vitamin A level was analysed by high performance liquid chromatography. The frequency of values below a cut off, usually taken as 0.70 μmol/L (20 μg/dl) for low and 0.35 μmol/L (10 μg/dl) for deficiency. Statistical analysis: The data were analysed using the Statistical Package for the Social Sciences version 20.0. Results: The prevalence of low serum Vitamin A level (10–

Computerized tomographic patterns of intracranial tumors in Northwest Nigeria

Background: Brain tumors are among the most challenging disorders encountered worldwide. Early and accurate diagnosis is essential for the management of these tumors. Different patterns of distribution of intracranial tumors have been described in various regions of the world, with previous reports in Africa suggesting that brain tumors were uncommon. This relative rarity has been attributed to low detection due to lack of neurosurgical and advanced neuroimaging facilities previously, a limitation that has now been gradually surmounted with the establishment of neurosurgical and more advanced radiological facilities on the continent. Objectives: The objective of this study is to describe the current pattern of intracranial tumors on computed tomography (CT) scan seen in Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Northwest Nigeria. Methods: This is a retrospective study of CT images of 60 patients of all age groups diagnosed with brain tumors between January 2015 and December 2019. The CT scans of the brain were performed using General Electric Hi-Speed NX/i dual-slice CT scanner (Germany). The age, sex, diagnosis using the WHO histological, and the pattern on CT were recorded, and data were analyzed using Statistical Package for the Social Sciences version 22.0, ARMONK, NY, USA 2013. Only cases with conclusive histology diagnosis were analyzed. This study was approved by the Health Research Ethics Committee of the ABUTH, Zaria (approval Number ABUTH/HREC/M36/2015), on January 23, 2015, before commencement. Results: In the 60 cases of brain tumors studied, patients' age range was 6 months–65 years, with a peak in the fourth and fifth decades of life (accounting for 38.3%). The mean age was 33.04 years ± 17.73 standard deviation. There was equal occurrence among males and females. About 96.7% of the tumors were primary and 3.7% secondary tumors; meningioma (MEN) (45%) was the most common tumor seen. About 45% of the cases were extra-axial, while 55% were intra-axial. Most (81.67%) of the tumors were located in the supratentorial region, while 18.33% were infratentorial. Headache (75%) and visual impairment (53.3%) were the most frequent clinical presentations. Conclusion: MEN was the most common tumor type seen in this study. This corroborates most studies in Nigeria and other African countries but contradicts some studies among Caucasians that showed glioma to be more common. This affirms that racial factors and environmental influence could have significant effects on the pattern of diseases. The results of this study will provide useful data on the pattern of brain tumors in this environment.

Abstract PO-156: Emerging demographic changes of first eighteen (18) most common cancers among West Africans in Zaria Nigeria (1972 – 2019)

Abstract The African continent is facing enormous challenges from cancer crisis, and the lack of reliable population database on cancer incidence and mortality hinders high quality decision on prevention and management modalities. The objective of this study is to analyze the trend of malignant tumors in a population of rural Africans attending Ahmadu Bello University Teaching (ABUTH) Hospital Zaria, Nigeria with particular emphasis on the first eighteen (18) frequently diagnosed cancers over a period of 46 consecutive years (1972 - 2019) excluding the year 1988. Histologically diagnosed cancers from the population-based cancer registry of the ABUTH Zaria were included in this study. There were 19, 884 histologically diagnosed cancers over 46 years in ABUTH Zaria with the following in descending order: Cervical cancer 2,335 (12%, [squamous cell carcinoma = 1, 809; others = 529]), Breast cancer 1,982 (10% [invasive ductal carcinoma = 1,589; others = 393]), Lymphoma 1,927 (10% [non–Hodgkin’s lymphoma = 1,335; Hodgkin’s lymphoma = 492]), Sarcomas 1,177 (6% [Kaposi sarcoma = 296; Rhabdomyosarcoma = 172; Osteosarcoma = 166; Dermatofibrosarcoma = 102; Fibrosarcoma = 83; others = 358]), Prostate cancer 1,073 (5%), Colorectal cancer 816 (4% [other adenocarcinomas = 666, mucinous adenocarcinoma = 93; signet ring cell adenocarcinoma =14, others = 43]), Non- melanoma skin cancer 717 (4%), Eye/ Orbit cancer 537 (3% [retinoblastoma = 302; squamous cell eye cancer = 153; others = 82]), Bladder cancer 515 (3%), Liver cancer 481 (2% [primary liver cell carcinoma = 399; others = 79]), Salivary gland cancer 398 (2%), Melanoma 394 (2%), Ovarian cancer 278 (1%), Nasopharyngeal cancer 235 (1%), Kidney cancer 201 (1% [nephroblastoma = 113; renal cell carcinoma = 77; others = 11]), Esophageal cancer 145 (1%), Thyroid cancer 122 (1%), Pancreatic cancer 60 (0.29%) and Others 7,053 (33%). This total, exclude referred cancer cases to oncology department of ABUTH from other hospitals across the country which makes up 60% of cancer cases treated in institution and a handful of clinically diagnosed cases. The results show unusual change in trend with: 2 fold increase for cervical cancer, 6 fold increase for Breast cancer, 8 fold increase for Prostate cancer, 3 fold increase for colorectal cancer; 6 fold increase for Pancreatic cancer, 13 fold increase for Nasopharyngeal cancer and 16 fold increase for Oesophageal cancer when comparing incidence of cancer from 2011-2019 with 1972-1980. However, the results show 12 fold decrease for Liver cancer and 3 fold decrease each for Lymphoma and Non-melanoma skin cancer when comparing cancer cases from 2011-2019 with 1972 - 1980. Understanding the phenomenon behind the rapid change in trend of different cancer types in sub Saharan Africa may contribute to addressing cancer challenges and better policy decision on cancer in the continent. Citation Format: Faruk Mohammed, Abdulmumini Hassan Rafindadi, Sani Ibrahim, Yawale Iliyasu, Sirajo Mohammed Aminu, Ahmed Adamu, Adamu Abdullahi, Aishatu Maude Suleiman, Abdullahi Mohammed, John Idoko, Abdulkadir Lawal Rafindadi, Danladi Amodu Ameh, Bello Kumo, Ahmad Bello, Abdullahi Jubril Randawa, Usman Mohammed Aminu, Muhammad Manko, Tajudeen Olasinde, Mohammed Dauda Maigatari, Ahmed Mai, LMD Yusuf, Abdullahi Alfa Mohammed, Yahaya Ukwenya, Oguntayo Olanrewaju Adekunle, Maitama Yusuf Hussaini. Emerging demographic changes of first eighteen (18) most common cancers among West Africans in Zaria Nigeria (1972 – 2019) [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-156.

Occupational Health Hazards Among Medical Waste Handlers in Ahmadu Bello University Teaching Hospital Zaria Northwest Nigeria

Background: Occupational injuries are important public health issues, especially among healthcare workers. The medical waste handler is at risk of hazards posed by medical waste as well as from the environment. The aim of the study was to determine occupational hazards that hospital waste handlers in Ahmadu Bello University Teaching Hospital, Zaria, were exposed to and to assess their knowledge and practice of safety measures. Methods: A cross-sectional descriptive study was conducted among 79 medical waste handlers in Ahmadu Bello University Zaria using a multistage sampling technique. Data were collected using structured self-administered and interviewer administered questionnaire and analyzed using SPSS version 20 software with significance set at P &lt; .05. Results: More than half of the respondents (56.4%) were men, and most (70.3%) had &lt;5 years work experience. Most of the respondents (60.8%) had had an injury in the previous 6 months. The most common injuries were falling on a slippery floor (48.1%), contact/irritant dermatitis (40.5%), and 34.2% from stress. Only 45.6% received treatment following injury at the work place. Most respondents (75.9%) were aware of safety devices, and more than half (51.9%) received their information from special safety training. More than half of the respondents (51.1%) had poor knowledge of use of safety devices, and 60% had special training in occupational safety. Most respondents (89.9%) used heavy-duty rubber hand gloves, but only 5.1% used aprons. Also, 82.3% of respondents used these devices regularly at work, and more than half of respondents (62%) had been immunized against hepatitis. Also, 65.8% practiced universal precautions. Occupational injury was higher among those aged 15–19 years (occupational injury rate, 75%) compared to those aged 34–39 years (occupational injury rate, 16%). A positive association was detected between gender and injury in the last 6 months; injury was more common among men (43%) than among women (15%). Conclusions: Among respondents, there was a high level of injury and poor knowledge of the use of protective devices. Regular use of protective measures was not commensurate with the reported level of awareness. Concerted efforts are needed to ensure the safety of the medical waste handlers in his work place.Funding: NoneDisclosures: None

Estimation of Relative Hazard between Groups of Cancer patients in North West Nigeria

A problem in population-based cancer survival analysis is the estimation of relative hazard between patients with different characteristics handled in the same registry center. In this work, we use the Cox proportional hazard model to find an estimated hazard ratio between two patients having different characteristics. The procedure was then fitted has been applied on the data collected from Ahmadu Bello University Teaching Hospital (ABUTH) Zaria Cancer Registry Center. The result indicated that female and frail patients are more prone to failure than male and non frail patients respectively.