Hospital Abuja Research Articles

Molecular Detection of Plasmid-Mediated Quinolone Resistance in Ciprofloxacin-Resistant Escherichia coli from Urine of Patients attending Garki Hospital, Abuja, Nigeria

Urinary tract infections (UTIs) caused by Escherichia coli (E. coli) is common worldwide; and its successful treatment using antibiotics is limited by acquisition of resistance by the bacteria. This study investigated the occurrence of plasmid-mediated quinolone resistance (PMQR) genes in ciprofloxacin-resistant E. coli from urine of patients with suspected cases of UTIs attending Garki Hospital Abuja (GHA), Nigeria. A total of 8 confirmed ciprofloxacin-resistant E. coli was screened for carriage of PMQR genes using polymerase chain reaction (PCR) method. The occurrences of the PMQR genes detected were in the order: aac-(6′)-Ib-cr (87.5%) > qnrB (50.0%) > qnrS (37.5%) > oqxAB (12.5%) > qnrA(0.0%). qnrB and qnrS did not exist alone, but in combination with other genes; aac-(6′)-Ib-crexisted both alone and in combination with others; the most prevalent patterns of existence were aac-(6′)-Ib-cr alone and aac-(6′)-Ib-cr + qnrB + qnrS at 25.0% each. This study has shown that the ciprofloxacin-resistant E. coli harbored aac-(6′)-Ib-cr, qnrB, qnrS and oqxAB PMQR genes, with aac-(6′)-Ib-cr being the most prevalent. The genes were present either alone or in combination with one another. This has implication for the clinical application of fluoroquinolones to treat UTI in the study location and environs.

Plasmid-mediated Quinolone Resistance Genes in Salmonella typhi from Patients Attending Selected General Hospitals in Abuja Municipal, Nigeria

This study investigated the antimicrobial resistance profile and presence of plasmid-mediated quinolone resistance (PMQR) genes in Salmonella typhi from patients attending selected general hospitals in Abuja municipal, Nigeria. Four hundred stool samples from patients with suspected typhoid fever were collected from Asokoro General Hospital Abuja (AGH), Garki Hospital Abuja (GHA), Maitama General Hospital Abuja (MGHA) and Wuse General Hospital Abuja (WGHA) and S. typhi was isolated and identified using standard microbiological methods. Antimicrobial susceptibility testing of the isolates was carried out using Clinical and Laboratory Standards Institute (CLSI) method. Molecular detection of PMQR genes in the ciprofloxacin-resistant isolates was carried out using Polymerase Chain Reaction (PCR) method. The overall occurrence of the isolates was 13.3% (53/400), with the highest hospital-related occurrence at WGHA (18.0%). The occurrence was highest at age 21-30yrs in AGHA (20.0%), GHA (33.3%) and WGHA (45.0%). The occurrence was higher in females at AGHA (12.7%) and GHA (16.0%); but higher in males at MGHA (11.4%) and WGHA (18.2%). Resistance to ciprofloxacin was the least at 30.2%, distributed as follows: AGHA (20.0%), GHA (35.7%), MGHA (36.4%) and WGHA (27.8%). The most common resistance phenotype was: NA-S-XT-AMC-TE-CRO-C-CN with overall occurrence of 9.4% (5/53) observed in AGH (10.0%), GHA (16.7%) and MGHA (18.2%) but not in WGHA. All (100%) isolates were multiple antibiotic resistance (MAR) isolates, with MAR indices above 0.2; and the commonest MAR index of 0.6 (30.0%) in AGHA, 0.8 (35.7%) in GHA; 0.8 (45.6%) in MGHA, and was 0.7 (38.9%) in WGHA. Multidrug resistance (MDR) was the commonest at 96.2% (51/53), with occurrences in the selected hospitals as follows: AGHA (90.0%), GHA (100.0%) and MGHA (100.0%) and WGHA (94.4%).The PMQR genes detected had overall frequency in the order: aac(6′)-Ib-cr (50.0%) >qnrB (37.5%) >qnrS (18.8%); qnrS was absent in AGHA and WGHA. The genes co-existed with one another with the qnrB+ aac(6′)-Ib-cr combination, present in isolates from all the hospitals, being the most common at (31.3%). Ciprofloxacin was the most effective antibiotic against the isolates; most isolates were MAR with prior exposure to antibiotics; most isolates were MDR and the ciprofloxacin-resistant isolatesharbored qnrS, qnrB and aac(6′)-Ib-cr PMQR genes, with aac(6′)-Ib-cr being the most prevalent.

A netnographic assessment of a laboratory scientists' WhatsApp group

Adopting a qualitative methodology (netnography), this study explores the WhatsApp group experience of scientists in the Laboratory Service Department of Natic Hospital in Abuja, Nigeria. Based on interviews with ten scientists and the analysis of the archived comments of the WhatsApp group for four months (October 2019 – January 2020), the study found that the scientists of the department experience WhatsApp from diverse perspectives, including "cyberspace classroom," "formal learning," "affordability," and "convenience." The study found that a significant disadvantage arising from the use of WhatsApp is posting unwanted content. Nevertheless, this does not restrain its use as a considerable number of scientists admit to its potency in their work. Besides, this study revealed that there are two levels of determinants to using and joining the WhatsApp group: individualistic and organizational determinants. This study concludes that WhatsApp is effective in engendering health communication among scientists of the Laboratory Services Department of Natic Hospital.

Abstract D066: A prospective study on chemotherapy-induced anemia using serial hemoglobin measurement in cancer patients undergoing treatment at National Hospital Abuja, Nigeria

Abstract Introduction: Anaemia is a common complication of myelo-suppressive chemotherapy. Severe anaemia is usually treated with red blood cell transfusion, however, mild-to-moderate anaemia are most often managed conservatively. There is no universally established benchmark for haemoglobin of patients selected for cancer chemotherapy to guide a global best practice and enhance patients treatment outcome and their quality of life. Objective: The objective of this study is to examine the change in Hb levels of cancer patients undergoing chemotherapy measuring Hb after treatment. Materials & Methods: A total of 100 voluntary patients with solid malignancies were recruited within a period of eight (8) months. Baseline demographic characteristics and type of tumours were documented. Pre-treatment Hb level was measured on the first day of consultation and repeated every 2 weeks during and after the therapy until after three consecutive Hb readings (6 weeks). Results & Analysis: All data were analysed using IBM statistical package for Social Science (SPSS) version 20. 88 of the 100 cancer patients were female. Breast 68% (68) was the commonest site of tumour. Prevalence of anaemia in the study was 72% and majority of the patients had their Hb within the range of 9.60 g/dl to 10.62 g/dl at the end of their treatment. At P-value >0.05 and standard deviation there was no statistical significance on distribution of mean haemoglobin values, were independent of sex and type of treatment. Conclusion and Recommendation: Our results show that chemotherapy has no significant effect on Hb level between 11 g/dl to 12 g/dl. Prevalence of anaemia in the cohort of patients was 72%. We recommend a benchmark minimum of Hb of 11 g/dl for all patients being selected for chemotherapy in Nigeria. Citation Format: Simeon Chinedu Aruah, Rasaq Oyesegun, Oche Ogbe, Sampson Ezikeanyi, Elias Aniwada, Manjit Dosanjh, Laurence Wroe, Norman Coleman. A prospective study on chemotherapy-induced anemia using serial hemoglobin measurement in cancer patients undergoing treatment at National Hospital Abuja, Nigeria [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D066.

Vimentin and Cytokeratin Immunostaining: The Role in Basic Diagnosis and Prognosis of Sarcomas

Introduction: Specific diagnosis which provides diagnostic, prognostic, and therapeutic information to guide patient care defines the primary goal of sarcoma management and care. The role of immunohistochemistry, using vimentin (mesenchymal linage marker) and cytokeratin (epithelial linage marker) as basic markers for diagnosis and classification of sarcomas for specific management strategies and prognosis was elucidated in the present study.
 Materials and Methods: Twenty four (24) archived paraffin wax processed tissue block sarcoma samples were randomly selected from the histopathology Laboratories and museums of the Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi and National hospital Abuja and necessary data obtained from records. Blocks were re-embedded with fresh paraffin wax and 3µ thick sections cut with the aid of a rotary microtome. Haematoxylin and Eosin staining method was employed to confirm diagnosis before proceeding to immunohistochemistry. Antibodies for vimentin and pancytokeratin were employed for immunohistochemistry while exposed mouse and rabbit specific horseradish peroxides/diaminobenzidine detection IHC kit was employed for immunostaining.
 Results: The mean age of patients was 26 years while the ages range from 11 to 48 years with 14 (58.3%) females and 10 (41.7%) males. Vimentin had strong positive immunoreactivity for all sarcoma samples whereas cytokeratin had positive immunoreactions for synovial sarcoma only, which also showed co-expression of both genes.
 Conclusion: Vimentin and cytokeratin may play vital role as basic biomarkers not only for diagnosis and characterization of sarcomas but for specific management regime and prognostication. However, IHC must be performed at high standard using appropriate antibodies, samples and reagents.
 Keywords: Sarcoma, immunohistochemistry, vimentin, cytokeratin, biomarker.

Understanding Etiologies of Road Traffic Crashes, Injuries, and Death for Patients at National Hospital Abuja: A Qualitative Content Analysis Using Haddon’s Matrix

Road traffic crashes and sequelae are reaching pandemic proportions globally and have currently achieved disproportionately high levels in Nigeria. Quantitative studies are accumulating in the peer-reviewed literature, but there is a paucity of qualitative research in Nigeria. Data for this study of structural and behavioral factors of road traffic crashes and injuries in Federal Capital Territory were collected in semi-structured interviews with crash survivors at National Hospital Abuja. Interviews were analyzed via qualitative content analysis, revealing crash location and participant beliefs about crash etiologies. Units of analysis were developed from participant statements and were structured within four a priori etiologic categories using Haddon’s (1980) matrix: human-, vehicle-, physical environment-, and socioeconomic environment-related. Subcategories were generated. Human-related subcategories included reckless behavior and drivers, limited technical knowledge and skill. Vehicle-related subcategories included vehicular disrepair and lack of safety equipment. Physical environment-related subcategories included road disrepair, infrastructural inadequacy, and weather. Socioeconomic environment-related subcategories included government, prehospital care, money, and prayer. Subcategories were organized temporally by pre-event, event, and post-event phases, with most units of analysis allocated in the pre-event phase. These qualitative results can be utilized to guide future research along community-aligned priorities, and to structure community-engaged preventative and interventional efforts.

Persistence of Non-Vertigo Symptoms in Meniere Disease During Remission - A Preliminary Report.

Though the absence of vertigo in Meniere disease is often interpreted as remission, patient-centered subjective assessment of quality of life remains the best indicator of such remission. To assess the presence and severity of aural pressure/tinnitus, hearing loss, unsteadiness, nausea and vomiting in MD patients during remission. Urban tertiary care referral hospital in a developing country. Consecutive patients with diagnosis of Definite Meniere were selected from the Balance and Dizziness Clinic of National Hospital Abuja for the study. Quality of life assessment was carried out using 3 validated tools - Modified MD-POSI, Vertigo Symptom Scale and Tinnitus Handicap Inventory (THI). Patients were included only when they have been vertigo free for at least 4 weeks. Pure tone audiometry was carried out in those with subjective hearing loss at recruitment and 4 weeks later. A total of 26 patients completed the study. All had cinnarizine for acute vertigo control and Betahistine for maintenance of vertigo control. There was female preponderance (17:9). The age range was 32-56 years. The duration of MD ranges from 4 months to 12 years. The total and subscale MD-POSI scores for "between attacks" significantly correlated with hearing, unsteadiness and tinnitus/pressure when compared to during attack. 69.2 per cent of participants experienced symptoms of unsteadiness during remission. 13/26 of participants reported persistent, though less annoying tinnitus that poorly correlated with THI score during remission. Our study showed that significant non-vertigo symptoms affect the quality of life during remission. Perhaps there is need to properly define, in future studies, what constitutes remission in patients with MD.

The efficacy of intermittent preventive therapy in the eradication of peripheral and placental parasitemia in a malaria-endemic environment, as seen in a tertiary hospital in Abuja, Nigeria.

To determine whether intermittent preventive therapy in pregnancy (IPTp) eradicates peripheral and placental malaria and improves birth weight. A cross-sectional study was conducted of 426 pregnant mothers on IPTp with sulphadoxine-pyrimethamine against malaria who presented in labor, at National Hospital Abuja, Nigeria between January and June 2017. The hospital is within the malaria-endemic zone of West Africa. Consenting pregnant women with uncomplicated singleton term pregnancy who had antenatal care in the hospital and lived in the study area for at least 6months were consecutively recruited. Peripheral and placental blood were collected and examined for malaria parasite by microscopy. Babies were weighed at birth. The prevalence of peripheral malaria parasitemia and placental parasitization were 12.9% (95% confidence interval [CI] 10.0-16.6) and 9.4% (95% CI 7.0-12.7), respectively. Parasite density in both peripheral parasitemia and placental parasitization was low among the women that took IPTp, decreasing with increasing doses, with no parasitemia or parasitization in women that took up to three doses. Birth weight was lower in babies of mothers with plasmodium infestation than in those without infestation (P<0.001, P=0.024). IPTp reduces both peripheral parasitemia and placental parasitization, with the capacity to eliminate or prevent them. IPTp also reduces low birth weight.

Prevalence and Risk Factors of Human Immunodeficiency Virus and Hepatitis C Virus Infection among Pregnant Women Attending Antenatal Care at a Tertiary Hospital in Abuja, Nigeria.

Context:Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) co-infection in pregnant women has increased potential for Mother-to-Child Transmission risks of both viruses. The reports on the prevalence and risk factors for HIV and HCV co-infection in pregnancy are limited in Nigeria.Aim:The aim of the study is to determine the prevalence and potential risk factors for HIV and HCV infection among pregnant women in Abuja.Study Design:A cross-sectional seroprevalence study carried out on pregnant women attending antenatal clinic of a tertiary hospital in Abuja from July 1st to October 31st 2016. Patients were recruited consecutively and counselled for HIV and HCV. Structured questionnaire was used to collect socio-demographic data, and information on potential risk factors for HIV and HCV infections. Blood samples were collected for HIV and HCV screening using rapid test kits following the national testing algorithm. Data generated were analyzed with statistical package for social sciences (SPSS) version 20.0. P-value less than 0.05 was considered statistically significant.Result:252 pregnant women participated in this study. The mean age of the study population was 31.7 ± 4.9 years. The prevalence of HIV and HCV was 12.3% and 1.2% respectively. The prevalence of HIV/HCV co-infection was 0.8%. The prevalence of HCV among HIV positive cohorts was 6.5%. HIV infection was significantly associated with history of blood transfusion (P = 0.047), presence of tattoo/scarification marks (P = 0.009) and multiple sexual partners (P < 0.0001). HCV infections was not significantly associated with any of the risk factors studied.Conclusion:HIV prevalence is high among the pregnant women. HCV co-infection is common in women who are HIV infected. HIV infection unlike HCV was significantly associated with history of blood transfusion, presence of tattoo/scarification marks and multiple sexual partners.

Should children know their HIV status? Prevalence, caregiver's perspectives and barriers to disclosure at the National Hospital Abuja, Nigeria.

Nigeria ranks second globally with a HIV/AIDS prevalence of 3.2%. HIV infected children are surviving to adolescence because of anti-retroviral therapy, but many do not know why they need to take these medicines. Disclosure is critical to long-term disease management, yet, if, how and when caregivers and or health professionals disclose to children is not well known in resource-limited settings. The barriers to disclosure remain largely undocumented. To determine the prevalence and age of HIV disclosure to children in Abuja, Nigeria and identify caregivers perspectives as well as barriers to disclosure. A cross-sectional study was done June-July 2016 using a structured questionnaire, convenience sampling and quantitative methods at the infectious disease clinics of National Hospital Abuja. A sample of 164 caregivers of HIV-positive children aged 5-16 years receiving antiretroviral therapy for at least 1 year were enrolled. Prevalence of full disclosure was 24.5%, partial disclosure 22.7%, with overall prevalence of 47.2%. Mean age at full disclosure was 11.87 years. Bivariate analysis showed significant difference between disclosure and child's level of education (χ2 for trend 26.710, P < 0.001), support for disclosure (χ2 4.399, P = 0.036) and if caregiver held the opinion that children should have disclosure done (Pearson's χ2 30.174, P < 0.001). However, on logistic regression, only the age of the child (P < 0.001, 95% CI 1.176-1.499) and the caregiver's opinion (P = < 0.001, 95% CI 4.914-2.542) remained significant. Various barriers to disclosure were identified. The prevalence of full disclosure is low and several barriers prevent early disclosure. Caregiver's and HCWs need empowerment with culturally appropriate skills and platforms to increase disclosure rates, which may help improve adherence.

Clinicopathological analysis of prostatic lesions in a tertiary hospital in Nigeria

Background: Prostatic neoplasms are important source of morbidity and mortality among men globally. A rising trend is noted worldwide especially involving sub-saharan African males where paradoxically data is grossly inadequate. We hereby present prostatic lesions from a tertiary center in sub-saharan Africa.Materials and Method: A retrospective analytic study of all prostatic samples received in the histopathology of National Hospital Abuja (NHA), a tertiary hospital in Nigeria, from 1st January 2005 to 31st December 2015 was carried out.Result: The major affected age group is the 61 – 70 year cohort. Majority of neoplastic lesions encountered are malignant adenocarcinomas of moderate differentiation. The predominant presenting symptoms are dysuria, frequency, and acute urinary retention in that order, while raised prostatic specific antigen (PSA) is a frequent sign. Conclusion: Prostatic adenocarcinoma is significant malignancy in NHA while benign prostatic hyperplasia is the commonest benign lesion. Gleason scores 5 and 7 are the predominant malignant differentiation obtained.

Colonoscopy: Early Experience in National Hospital Abuja Nigeria

Colonoscopy has become one of the most important modalities in the assessment of the lower gastrointestinal lesions. This study focused on our early experience with colonoscopy documenting the indications and outcome in the first five years of Colonoscopy in National Hospital, Abuja, Nigeria. This was a retrospective analysis of demographic data, indications for colonoscopy, agents used for bowel preparation, type of anaesthesia used, endoscopic findings, and extent of colon intubation from the endoscopy unit register of National Hospital, Abuja between July 2007 and June 2012. Patients whose data were incomplete or procedure abounded were excluded. Two hundred and eleven patients had colonoscopy during the 5 year period. Only 153 patients fulfilled the inclusion criteria and their data analysed. Males were 107 (69.9%) and 46 (30.1%) were females given a male/female ratio of 2.3:1 Age range was 2years to 90years with a Mean of 48.02. The commonest indications were bleeding per rectum (33.3%), haemorrhoids (24.8%) and suspicion of malignancy of the lower gastrointestinal tracts (24.3%). The most common findings on colonoscopy in our study were haemorrhoids (47.7%) and malignancies (24.2%) of various parts of the large bowel. 12.4% of the patients had normal study. Our Ceacal intubation rate was 75.8%. Majority of the lesions were found in the Anorectal region (69.9%) with only 17.7% in the rest of the Colon 24.2% of our findings were malignancies of lower intestinal tract. 97.3% of the malignancies were Adenocarcinoma. 83.8% of the malignancies were located in the left colon. Assessment of lower gastrointestinal symptom is incomplete without colonoscopy. Colonoscopy gives a good yield in well selected patients, it is safe and has low complication rate.

Comparison of clinical efficacy of long- versus short-acting gonadotrophin-releasing hormone agonists for pituitary down regulation in In vitro fertilisation cycles.

Gonadotrophin-Releasing Hormone agonist (GnRHa) - long and short acting - is used for pituitary down regulation prior to ovarian stimulation in in vitro fertilisation (IVF) treatment. However, there are controversies in the literature as to their effectiveness, dose of gonadotrophin needed subsequently for ovarian stimulation and the clinical outcome. The objective of the study was to compare the efficacy of single-dose long-acting GnRHa - goserelin - and daily dose short-acting GnRHa - buserelin - for pituitary down regulation and their clinical outcome in IVF treatment. : This prospective comparative study was undertaken at the IVF centre in National Hospital Abuja, a public tertiary hospital in Nigeria. A total of 114 IVF patients were consecutively allocated into either long-acting GnRHa - goserelin - 3.6 mg single dose (Group A) or short-acting GnRHa - buserelin - 0.5 mg daily (Group B) both starting on day 21 of the cycle preceding the IVF treatment. The effects on pituitary down regulation and treatment outcomes were compared. Time taken (days) to achieve down regulation (22.6 ± 4.3 vs. 26.1 ± 8.0; P = 0.084) and the mean number of human menopausal gonadotrophin (HMG) doses used (57.7 ± 13.7 vs. 54.2 ± 16.7; P = 0.222) were similar in the two groups. Although the number of oocytes retrieved (9.9 ± 6.7 vs. 7.2 ± 5.0; P = 0.02) and fertilised (6.2 ± 4.4 vs. 4.6 ± 3.5; P = 0.04) were significantly higher in Group A, there was no statistically significant difference in the number of embryos (4.4 ± 2.6 vs. 4.0 ± 3.0; P = 0.850) and clinical pregnancy rate at 6 weeks (49.2% vs. 43.6%; odds ratio 1.249; confidence interval = 0.579-2.612; P = 0.578) in both the groups. While group B had a significantly higher number of hospital visits (P = 0.0001) as well as a higher number of injections (P = 0.0001), the mean cost of GnRHa and gonadotrophin used was significantly higher in Group A (P = 0.043). Single-dose long-acting GnRHa is as effective as daily dose short-acting GnRHa for pituitary desensitisation prior to controlled ovarian stimulation in IVF cycles.

Pattern of haemoglobin phenotypes in newborn infants at the national hospital abuja using high performance liquid chromatography

Haemoglobin (Hb) disorders are among the most common blood genetic disorders worldwide, and they constitute an important cause of morbidity and mortality, especially in Nigeria. Despite the clinical significance of early diagnosis, newborn screening for these conditions is not routinely done in Nigeria. This study was undertaken to document the pattern of Hb phenotypes of newborn babies at the National Hospital Abuja and highlight the relevance of neonatal screening for early diagnosis of abnormal Hb phenotypes in Nigeria. A prospective study of eligible newborn babies delivered in the hospital at the study site was undertaken following parental informed consent. Venous blood was collected from the babies into an ethylenediaminetetraacetic acid sample bottles. The samples were analysed using high-performance liquid chromatography (HPLC) techniques, and the Hb phenotypes obtained were documented. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 20 (IBM-SPSS, Armonk, NY, USA). Three hundred and eleven newborns (male = 173, female = 138) aged 0-28 days were recruited. Two hundred and thirty-six (75.9%) babies had Hb AA (FA) phenotype, 63 (20.3%) Hb AS (FAS), 6 (1.9%) Hb SS (FS), 4 (1.3%) Hb AC (FAC) and 2 (0.6%) had abnormal HbA variants. The overall prevalence of abnormal Hb phenotype was 24.1%. The results showed a significant association of sex (P = 0.003) and ethnicity (P = 0.047) with Hb phenotype. There is a wide spectrum of abnormal Hb phenotypes in Nigeria, and these phenotypes can easily be detected at birth using HPLC. We, therefore, recommend routine neonatal screening for sickle cell disease by HPLC in Nigeria.

Determination of Appropriate Deferral Time for Repeat Apharesis Platelets Concentrate Donation in Abuja, Nigeria

Background: Plateletpheresis is the process by which a therapeutic adult dose of platelet concentrate is produced from a single donor using automated cell separator equipment. Recently, the demand for Apheresis Platelets concentrate transfusions has been increasing in our hospitals. This has been attributed to increased cases of malignancy associated bone marrow suppression and various other causes of thrombocytopaenia and thrombopathies. The Increasing use of myeloablative chemotherapy in treatment of haematological and other malignancies also results in transient severe fall in platelet count. The demand generally outstrips the supply necessitating the need to search for additional donor sources to increase the supply of platelets for transfusion. Is it therefore possible to reduce the time interval between plateletpheresis while maintaining donor safety? Aims and Objectives: The aim of the study was to determine the platelets recovery time after platelets concentrate donation with a view to determining the appropriate deferral time for repeat plateletpheresis Methods: The study was conducted at the National Hospital Abuja. Fifty seven healthy plateletpheresis donors were recruited over a period of seven months and their haematological parameters were analyzed on days 0, 2 and 7 post donation. We excluded donors whose pre-donation platelet count were less than 200 x 109/L Results and Analysis: Analysis was done in only forty eight (48) donors as nine (9) participants withdrew before the end of the study. The results show There was a significant decrease in the platelets counts (p &lt;0.001), with subsequent good platelets recovery post donation (Pre: 259.83±44.61 x 109/L; Post - Day 0: 205.29±36.77 x 109/L, day 2: 216.88±32.71 x 109/L and day 7: 240.3±41.83 x 109/L). The apheresis donors recovered 64.29% of the lost platelets by day 2 of donation and subsequently attain 92.49% of pre-donation count within 7 days of donation. There was a statistically significant transient increase in the immediate post donation haemoglobin concentration (14.72±1.32)g/dL but this gradually reduced on day 2 (13.75±1.04)g/dL and 13.83±1.04g/dL on day 7 showing no significant different from the pre-donation Hb of 13.96±1.02g/dL Conclusion: This study has shown statistically significant platelets recovery 7 days after plateletpheresis making a 7 day deferral for repeat plateletpheresis feasible in our environment. The study also shows feasibility of a 2 days deferral as recommended by AABB. Strict monitoring and pre-donation evaluation of donors should be done to prevent any adverse events such as anaemia and thrombocytopenia. Disclosures No relevant conflicts of interest to declare.

Binary logistic regression methods for modeling broncho-pneumonia status in infants from tertiary health institutions in north central Nigeria

Acute respiratory tract infections, predominantly bronchopneumonia, are one of the leading causes of infant deaths in developing countries and around the world. This work models the effects of the significant risk factors on infants’ bronchopneumonia status and also fits some reduced models and determines the best model with minimum number of parameters. The data for this study consist of a random sample of 433 births to women seen in the obstetrics clinic of two sampled tertiary health institutions in north-central Nigeria. These include University Teaching Hospital (UTH) Abuja, and Federal Medical Center (FMC) Keffi, Nasarawa State. Binary logistic regression was used to identify and model the effects of the various risk factors while stepwise regression technique was used to fit some reduced logistic regression models. Then the best fitting model with minimum number of parameters was identified using likelihood ratio statistic. It was observed that baby’s weight at birth, baby’s weight four weeks since birth, and mother’s occupation have significant effects on infant’s bronchopneumonia status. Additionally, among the four fitted reduced models, model4 is the best predictor of infants’ bronchopneumonia status, followed by model3 and then model2. Therefore, community service like home visiting for health education, supplementation of vitamin A, etc., would be an advantage if provided for teenaged pregnant women as it would, in turn, reduce incidence of low birth weight and thereby reduce bronchopneumonia infection among these children. Keywords: Bronchopneumonia, Multiple Logistic Regression Model, Fitness, likelihood ratio test

Antimicrobial resistance profile and molecular detection of MecA gene in methicillin resistant Staphylococcus aureus from patients in selected general hospitals in Abuja municipal, Nigeria

Staphylococcus aureus (S. aureus) is globally recognized as an important pathogen associated with both hospital and community acquired infections. Studies on antibiotic resistance profile of S. aureus and carriage of mecA gene in methicillin resistant isolates from patients attending selected general hospitals in Abuja Municipal, Nigeria was carried out. Three hundred and sixty (360) clinical samples (200 urine, 50 high vaginal swabs, 60 ear swab and 40 wound swabs) were collected from Asokoro General Hospital (AGH), Garki Hospital Abuja (GHA) and Wuse General Hospital (WGH); and S. aureus was isolated and identified using standard microbiological methods. Antibiotic susceptibility testing of the isolates was carried out using disc diffusion method. Molecular detection of mecA gene in methicillin resistant isolates was carried out using the polymerase chain reaction method. The total occurrence of S. aureuswas 15.3% (55/360); and the occurrence in relation to the selected hospitals was high in GHA (22.7%) and low in AGH (10.3%). The occurrence of S. aureus was highest in wound swabs in all the hospitals in the order: GHA (47.1%) > AGH (40%) > WGH (35.7%). The isolates from all the hospitals were highly (≥ 50.0%) resistant to all the antibiotics tested; but moderately (≤ 40.0%) to gentamicin and levofloxacin. The occurrence of multi-drug resistant (MDR) isolates in the selected hospitals was high in GHA (27%) but low in AGH (12%). Of the 32 oxacillin resistant isolates, mecA gene was detected in 30 (93.8%). The S. aureus isolates were less resistant to gentamicin and levofloxacin and most of the oxacillin resistant isolates harbored mecA gene.

Access to care and financial burden for patients with breast cancer in Ghana, Kenya, and Nigeria.

6562 Background: Breast cancer is the most frequently diagnosed malignancy and the most common cause of cancer-related death in women in Ghana, Kenya, and Nigeria. We evaluated healthcare resource use and financial burden for patients treated at tertiary cancer centers in these countries. Methods: Records of breast cancer patients treated at the following government/private tertiary centers were included – Ghana: Korle-Bu Teaching Hospital and Sweden Ghana Medical Centre; Kenya: Kenyatta National Hospital and Aga Khan University Hospital; Nigeria: National Hospital Abuja and Lakeshore Cancer Center. Patients presenting within a prespecified 2-year period were followed until death or loss to follow-up. Results: The study included 299 patient records from Ghana, 314 from Kenya, and 249 from Nigeria. The use of common screening modalities (eg, mammogram, breast ultrasound) was &lt; 45% in all 3 countries. Use of core needle biopsy was 76% in Kenya and Nigeria, but only 50% in Ghana. Across the 3 countries, 91-98% of patients completed blood count/chemistry, whereas only 78-88% completed tests for hormone receptor and human epidermal growth factor receptor 2 (HER2). Most patients underwent surgery: mastectomy (64-67%) or breast-conserving Most patients in Ghana and Nigeria (87-93%) paid for their diagnostic tests entirely out of pocket (OOP) compared with 30-32% in Kenya. Similar to diagnostic testing, the proportion of patients paying OOP only for treatments was high: 72-89% in Nigeria, 45-79% in Ghana, and 8-20% in Kenya. Among those receiving HER2-targeted therapy, average number of cycles was 5 for patients paying OOP only vs 14 for patients with some level of insurance coverage. Conclusions: Patients treated in tertiary facilities in sub-Saharan African countries lack access to common imaging modalities and systemic therapies. Most patients in Ghana and Nigeria bore the full cost of their breast cancer care, suggestive of privileged financial status. Access to screening/diagnosis and appropriate care is likely to be substantively lower for the general population.

Abstract #323 Impact of Diabetes Education on Self Monitoring of Blood Glucose Among Patients with Diabetes Attending a Tertiary Hospital in Abuja, Nigeria

Abstract #323 Impact of Diabetes Education on Self Monitoring of Blood Glucose Among Patients with Diabetes Attending a Tertiary Hospital in Abuja, Nigeria

Knowledge Attitude and Practice of Geriatric Patients Towards Predictors of Healthy Living at a Tertiary Health Institution in Abuja Nigeria

The main objective of this study is to determine the knowledge, attitude and practices (KAP) of the geriatrics towards the predictor of healthy living in a tertiary hospital in Abuja, Nigeria. The study was carried out at the University of Abuja Teaching Hospital (UATH), Abuja – Nigeria. A descriptive cross sectional survey of the geriatric patients attending Clinic at the University of Abuja Teaching Hospital, Gwagwalada – Abuja – Nigeria, was carried out. Data was obtained through the use of structured, self-administered questionnaire. Summated scores were used to grade respondents’ knowledge attitudes and practices towards predictors of healthy living. Data analysis was done using the Statistical package for Social Science (SPSS) version 21. Data were presented using descriptive statistics of tables, frequencies, percentages, and pie charts. Inferential statistics of Chi-square was used to test for associations between socio-demographic variables and the knowledge, attitude and practice of geriatric patients towards predictors of healthy living. Out of 319 respondents, 50.5% have good knowledge while 49.5% have poor knowledge towards predictors of healthy living. It was also revealed in the study that a greater proportion of the respondents (52%) have poor attitude towards predictors of healthy living while less than half (48%) have good attitude. It was further discovered that 58.6% of the respondents have poor practice, while only 41.4% have good practice towards predictors of healthy living. Inferentially, Chi-square revealed that there was statistical significant association between marital status and knowledge of the respondents towards predictors of healthy living (P<0.05). Furthermore, the level of education and religion of the respondents was found to have statistical significant association with their attitude towards predictors of healthy living (P <0.05) and there was statistical significant association between the educational level and religion of the geriatric patients and their practice towards predictor of healthy living (P <0.05). There is a need for action from all concerned stakeholders to improve the KAP of the geriatric population towards predictors of healthy living. Suggested recommendations among others are; that government should enact enabling laws that will promote geriatrics’ healthy living, improve the community awareness on the predictors of healthy living among geriatrics through health promotions and provide qualitative education and training/retraining courses for health workers to improve their knowledge on geriatrics health and to effectively take up their roles in educating the target population.