Tertiary Hospital In Nigeria Research Articles

Blood donation practices, processing and utilisation of blood components in government tertiary hospitals in Nigeria: a multicentre cooperative study.

Timely access to safe blood and blood components is still a challenge in Nigeria. This study aimed to determine blood donation practices, processing and utilization of blood components across government tertiary hospitals (THs) in Nigeria. This was a descriptive cross-sectional study done in Nigeria in June-July 2020. Data were analysed with SPSS version 21.0. Data were collected from 50 THs. The majority (68%) of the THs lack facilities for blood component preparation and only 18% and 32% provide cryoprecipitate and platelet concentrate, respectively. Whole blood was most commonly requested (57.04%). All facilities tested blood for HIV, HBV and HCV, but the majority (23 [46%]) employed rapid screening tests alone and nucleic acid testing was not available in any hospitals. The manual method was the most common method of compatibility testing in 90% (45/50) and none of the THs routinely perform extended red cell typing. The average time to process routine, emergency and uncross-matched requests were a mean of 109.58±79.76min (range 45.00-360.00), 41.62±25.23 (10.00-240.00) and 11.09±4.92 (2.00-20.00), respectively. Facilities for blood component preparation were not widely available. Concerned government authorities should provide facilities for blood component preparation.

Prevalence, pattern and trend of rheumatic heart disease in a tertiary hospital in Nigeria: A 12-year retrospective echocardiographic study

Abstract Introduction Though the health-related burden of rheumatic heart disease has been reported to decline worldwide, rheumatic Heart Disease (RHD) still remains one of the major causes of death and disability in developing countries.(1) In 2019, RHD affected about 40.5 million people globally and caused over 300,000 deaths, mostly in low and middle-income countries (LMICs), with the potential to undermine national productivity since it affects the most productive part of the population.(2) This preventable, treatable but not curable form of cardiovascular disease is needlessly killing many, mainly due to the misunderstanding of its burden in these countries. Purpose To determine the prevalence, pattern and trend of RHD over the 12-year period in our facility using echocardiography. Methods This hospital services population of 6.3 million people in the region.(3) In this retrospective cross-sectional study, transthoracic echocardiography (TTE) data collected from cardiology unit in our facility over a twelve-years period (2009 to 2020) were reviewed. RHD diagnosis was based on the World Heart Federation Criteria for the diagnosis of RHD.(4) Patients with a diagnosis of RHD were identified and presented as a proportion of the total number of cardiac diseases presenting at the facility. Demographic data, pattern of valvular involvement and echocardiographic indications were recorded. The Cochran-Armitage trend test was used to identify the presence of a trend in the RHD proportion across the 12 years. Results Over a 12-year period from 2009 to 2020, 3311 TTE was done and 3259 (98.43%) results were correctly captured. Seven hundred and ninety-one had RHD at prevalence of 24.27% over the period. More females had RHD compared to males (56.05%versus 43.95%), p=0.06. Those with RHD were significantly younger than those without RHD (48.34 versus 52.14 years, p<0.001). Pure mitral regurgitation (MR) was the commonest valve lesion seen in 258 patients (32.62%), and was frequently associated with aortic regurgitation (AR) in 263 patients (33.29%), followed by pure AR in 200 patients (25.28%). Nineteen patients (2.40%) had pure aortic stenosis (AS), 10 patients (1.26%) had mixed AR + AS. Six patients (0.76%) had MR + AS, as well as pure MS respectively and only 4 patients (0.51%) had MR + MS. The highest prevalence was recorded in 2011 at 46.6% and 46.2% in 2012. The lowest prevalence were seen in 2019 (12.4%) and 2016 (13.2%). Prevalences were higher in the first 5 years (2009 to 2013) and began to reduce from 2014 to 2022. The commonest indications for TTE were hypertensive heart disease (40.06 %), congestive heart failure (24.66%) and valvular heart disease (9.55%). Conclusion RHD is still an important cause of cardiac morbidity despite the decreasing trend in recent years and the commonest valve lesion was mitral regurgitation. It will be valuable to investigate latent RHD and patients’ outcomes for better estimate of the burden of the disease.Comparing patterns of valve abnormalityTrend of Rheumatic heart disease

Management Outcomes of Hand Dermatitis in a Tertiary Hospital in Southwest Nigeria.

Hand dermatitis (HD) is inflammation of the skin of the hands. It ranges in severity and has a significant impact on quality of life (QoL). The physical and psychosocial burden of the disease is comparable with psoriasis in impairment of the QoL of the patient and depression. Quality of life correlates with disease severity. To evaluate the management outcome of HD with a disease severity tool by the physician and quality of life index. This was a cross-sectional study of a cohort of patients with HD over 24 weeks in the dermatology clinic of a tertiary hospital in Nigeria. Disease severity and quality of life were measured using the physician global assessment (PGA) and dermatology life quality index (DLQI), respectively. These were re-administered 6 weeks after treatment. Results were collated and analyzed. One hundred and seventy-seven (13.3%) of 1,329 patients had HD with F/M ratio of 1.2: 1; a mean age of 34.6 ± 7.4 years. Comparing PGA scores at baseline and 6 weeks, a statistically significant improvement was noted P < 0.001. The mean DLQI score at baseline was 10.38 and reduced to 3.02 post-treatment. The difference between the two means of the DLQI was ≥5 from baseline signifying improved quality of life. The domain of symptoms and feelings was the most affected at baseline and most improved afterward. HD has a significant impact on its sufferers and this correlates with disease severity. Appropriate management improves disease outcome and patients' quality of life.

Erectile Dysfunction among Male Infertile Men Attending the Surgical Outpatient Clinic in a Tertiary Hospital in Nigeria over a 7-Year Period—A Single Surgeon’s Experience

Background: There is misconception about male Infertility and erectile dysfunction (ED) with poor health seeking behaviour in our clime. This study aims at finding the association between erectile dysfunction and male infertility in Ibadan. Methods: This was a retrospective comparative study that analysed records of all men with male infertility between May 2016 and April 2023 at the surgical outpatient in a tertiary hospital in Ibadan. Data included demography, social habit, the severity and prevalence of ED, and type of infertility. The data were analysed with a Statistical Package for the Social Sciences (SPSS) version 25. Logistic regression analysed the association between male infertility and erectile dysfunction. A p-value of &lt; 0.05 was regarded as statistically significant. Results: A total of 109 cases of male infertility of which 65 (59.6%) had ED. The overall mean age for primary and secondary infertility were 37.62 ± 6.95years and 40.62 ± 8.322 years respectively (t=2.892; p&lt; 0.004). The mean age for absence and presence of ED were 39.08 ± 6.61years and 39.56 ± 7.94years respectively (t=0.340; p= 0.734). There is association between alcohol consumption and ED (χ2=6.969; p&lt; 0.008). Similarly, statistically significant association between the ED and the type of infertility as mild, mild-moderate, and moderate ED were commoner among men with primary infertility and all men with severe ED had secondary infertility (χ2=12.283; p&lt;0.015). Conclusions: The prevalence of erectile dysfunction among male infertility was 59.6% with statistically significant association between the severity of ED and male infertility. Public awareness is advocated.

A Prospective, Observational Cost Comparison of Laparoscopic and Open Appendicectomy in Three Tertiary Hospitals in Nigeria

BackgroundThe clinical benefits of laparoscopic appendicectomy are well recognized over open appendicectomy. However, laparoscopic procedures are not frequently conducted in many low-and middle-income countries (LMICs) for several reasons, including perceived higher costs. The aim of this study was to assess the feasibility and cost of laparoscopic appendicectomy compared to open appendicectomy in Nigeria.MethodsA multicenter, prospective, cohort study among patients undergoing appendicectomy was conducted at three tertiary hospitals in Nigeria. Data were collected from October 2020 to February 2022 and analyses compared the average healthcare costs at 30 days after surgery. Quantile regression was conducted to identify variables that had an impact on the costs, reported in Nigerian Naira (Naira) and US dollars ($), with standard deviations (SD).FindingsThis study included 105 patients, of which 39 had laparoscopic appendicectomy and 66 had open appendicectomy. The average healthcare cost of laparoscopic appendicectomy (147,562 Naira (SD: 97,130) or $355 (SD: 234)) was higher than open appendicectomy (113,556 Naira (SD: 88,559) or $273 (SD: 213)). The average time for return to work was shorter with laparoscopic than open appendicectomy (mean: 8 days vs. 14 days). At the average daily income of $5.06, laparoscopic appendicectomy was associated with 9778 Naira or $24 cost savings in return to work. Further, 5.1% of laparoscopic appendicectomy patients had surgical site infections compared to 22.7% for open appendicectomy. Regression analysis results showed that laparoscopic appendicectomy was associated with $14 higher costs than open appendicectomy, albeit non-significant (p = 0.53).InterpretationDespite selection bias in this real-world study, laparoscopic appendicectomy was associated with a slightly higher overall cost, a lower societal cost, a lower infection rate, and a faster return to work, compared to open appendicectomy. It is technically and financially feasible, and its provision in Nigeria should be expanded.

Examining the adequacy of preoperative informed consent in a developing country: Challenges in the era of surgical specialisation.

Preoperative informed consent is a legal and ethical requirement that ensures patients understand a procedure, its associated risks and benefits, alternative treatment options, and potential complications to make an informed decision about their care. This cross-sectional study evaluated the informed consent process for major orthopaedic surgeries at a tertiary hospital in Nigeria. A self-administered questionnaire was used to collect data from 120 adult participants. Results showed that many patients do not read the consent form before signing it, and surgeons do not adequately explain the alternatives to surgery, potential risks, and available anaesthetic options. Higher-educated patients are more likely to read the consent form. Surgeons performed well in explaining the nature of the condition and prognosis, the procedure's potential benefits, and answering patients' questions. The study emphasises the need to improve the informed consent process to ensure patients understand and can make rational decisions about their healthcare.

Immunohistochemical and Clinicopathological Characteristics of Invasive Breast Carcinoma in Nigeria.

We aimed to study the immunohistochemical and clinicopathological characteristics of invasive breast carcinoma among Nigerian women. We conducted a retrospective assessment of female patients diagnosed with breast carcinoma at a tertiary hospital in Nigeria between 2012 and 2019. Archived pathology request forms and processed specimens (tissue blocks and slides) were used as source data in addition to the patients' demographic and other relevant data. Reports pertaining to 113 patients were assessed. Their age range was 30 to 80 years (mean = 52.1±12.1 years). Breast carcinoma was most common in patients aged 40 to 49 years (32.7%), closely followed by those aged 50 to 59 years (30.1%). Invasive ductal carcinoma was the most common histopathological subtype (94.7%). Nottingham grade III and grade II breast carcinoma accounted for 41.6% and 40.7% of the cases, respectively. Mastectomy specimens formed 68.1% of the samples. The most common tumor size (75.9%) was > 5cm (mean = 6.8±3.2cm), consistent with the most common staging of T3 (46.0%). The most common lymph node involvement was N1 (56.6%). Immunohistochemical assessment of these tumors with estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2 (HER-2) biomarkers expressed positivity of 36.3%, 28.3%, and 41.6%, respectively. These tumors were immunohistochemically classified into luminal A (16.8%), luminal B (20.4%), HER-2 enriched (20.4%), and triple-negative (42.5%) subtypes. The most common immunohistochemical subtype of invasive breast carcinoma among this sample of Nigerian women was the triple-negative subtype, similar to the finding among African Americans.

Prevalence of Type III Secretion System (T3SS) and Biofilm Development in Genetically Heterogeneous Clinical Isolates of Pseudomonas aeruginosa from Nigeria.

Pseudomonas aeruginosa infection in seriously ill patients is a major concern due to its ability to form biofilm and secrete effector toxins. There is little information on the prevalence of T3SS effector toxins and biofilm production in clinical isolates of P. aeruginosa from Nigeria. The goal of this study is to evaluate the prevalence of T3SS toxins and biofilm production among isolates from selected tertiary hospitals in Nigeria. This study examined 430 clinical isolates from our previous work, comprising 181 MDR (multidrug-resistant) and 249 non-MDR isolates. Biofilm production and type III secretion toxins were determined using colorimetric microtiter plate assay and polymerase chain reaction, respectively. Carbapenem-resistant isolates were typed using REP-PCR and BOX-PCR. Biofilm production was detected in 386/430 (89.8%) of the isolates. Out of 386 biofilm producers, 167 (43.3%) were multidrug-resistant isolates. PCR identified four T3SS virulence types among 430 isolates, including 78 (18.1%) exoU+/exoS- isolates, 343 (79.8%) exoU-/exoS + isolates, 5 (1.2%) exoU+/exoS + isolates, and 4 (0.9%) exoU-/exoS- isolates. Both REP- and BOX-PCR consist of eight clusters. On the REP-PCR dendrogram, ExoU+/ExoS- isolates majorly occupied cluster IV. Clusters IV, VII, and VIII consist of isolates from wounds on BOX-PCR dendrogram. There was a positive association between strong biofilm production and multidrug resistance in our P. aeruginosa isolates. This study identified multidrug-resistant, biofilm-producing P. aeruginosa strains that secrete cytotoxic effectors which are significant virulence factors in P. aeruginosa. This poses a severe risk to our healthcare system and highlights the importance of continuous surveillance to prevent infectious disease outbreaks.

Microbiological Assessment of Indoor Air Quality in Selected Patient Wards at a Tertiary Hospital in Nigeria

Aims: Patients are at higher risk of nosocomial infections from pathogenic microbes contaminating the indoor air of hospitals. This study evaluated selected patient wards at University of Calabar Teaching Hospital (UCTH), for bacterial and fungal contaminants. The study also determined the microbial contamination level when compared to recommended sanitary standards.&#x0D; Methodology: To determine microbial load, petri-plate gravitational settling method was used. The set-ups were exposed for one hour (at morning and noon) for passive sampling onto growth media plates, in accordance with the 1/1/1 scheme as stipulated by the index of microbial air contamination standard. Petri-plates were subsequently covered with lids and placed in a cold box. Samples were then transported to the laboratory for further evaluation. Sampling was performed in duplicates within three months, and further analysis were conducted based on standard protocols. Mean counts of bacteria and fungi was recorded and expressed as colony forming units (CFU/m3).&#x0D; Results: Microbial counts in all wards surveyed ranged from ‘intermediate’ to ‘high’ when compared to the sanitary standards of the European Commission for non-industrial premises. However, the counts were within the WHO acceptable sanitary standard (&lt;1000 CFU/m3). Eleven bacterial genera and seven fungal genera were identified. Isolated bacteria were Staphylococcus aureus (18.3%), CoNS (6.7%), Bacillus sp (13.3%), Streptococcus spp (6.7%), Corynebacterium sp (1.7%), and Micrococcus sp (1.7%), Pseudomonas aeruginosa (15%), Escherichia coli (10%), Klebsiella pneumoniae (10%), Acinetobacter baumannii (8.3%), Salmonella sp (5%) and Enterobacter sp (3.3%). Conversely, isolated fungal contaminants were A. niger (25.9%), A. flavus (20.4%), Penicillium sp (16.7%), Candida sp (9.3%), Rhizopus sp (3.7%), Mucor sp (7.4%), Cladosporium sp (14.8%), and Fusarium sp (1.9%).&#x0D; Conclusion: Regular monitoring of indoor air quality in health-care settings is encouraged to effectively guide infection prevention and control strategies and to limit nosocomial infections occurrence.

Obstetric Outcome of Induction of Labour in a Tertiary Hospital in Nigeria: A Five-Year Retrospective Cross-Sectional Study.

Induction of labour has remained one of the most valuable interventions in obstetric practice. Over the years, the proportion of women undergoing induction of labour (IOL) has been on a steady increase. The significance to obstetrics practice as well as its maternal and perinatal outcomes are sacrosanct, hence the need for its periodic review. To determine the obstetric outcomes of induction of labour. A five-year retrospective study of all cases of induction of labour at the maternity unit of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria between January 1st 2017 and 31st December 2021. The labour ward's records were assessed to determine the total number of women who had induction of labour during the study period. Women whose case files could be not retrieved were excluded. The folder numbers of the patients were extracted and their case files retrieved from the medical records department of the hospital. The primary outcomes measures were the indications and the methods of induction of labour, while the secondary outcome measures were the mode of delivery, cause of failed induction, and the perinatal outcome. Data were obtained using proformas and analysed using statistical packages for social sciences (SPSS) version 26.0 IBM corporation. A total of 3,638 deliveries were taken during the period under review and 168 patients had induction of labour giving an overall prevalence of 4.6% (46/1000 deliveries). Induction of labour was successful in 71.2% of cases. Misoprostol was used in 90.4% of cases as an induction agent. The commonest indication for induction of labour was postdate pregnancy (53.8%). Failed induction was due to fetal distress, poor progress of labour from cephalopelvic disproportion/malposition and failed cervical ripening. In about 72% of deliveries, there was good perinatal outcome, 10.3% of babies had moderate to severe asphyxia while 1.3% had neonatal death. Induction of labour is a safe and beneficial procedure in obstetrics. However, it can be associated with adverse obstetric outcomes.

Association between keratoconus and allergic conjunctivitis in children attending a Tertiary Hospital in Nigeria.

Objective: To ascertain an association between keratoconus and allergic conjunctivitis and to know if it is necessary to investigate all patients with allergic conjunctivitis for keratoconus. Methods: A hospital-based prospective study in which the eyes of children presenting with ocular allergic diseases were examined. Social demographics and clinical data were captured in a questionnaire. All the patients underwent keratometry using the autorefractor-keratometer and the pachymeter was used to measure the central corneal thickness. Data analysis was done with IBM SPSS version 28 for Windows. Frequency and chi-square were used as descriptive statistics to determine the association between dependent and independent variables. Inferential statistics using one-way ANOVA and t-test. P - Value at <0.05 was considered statistically significant. Results: 121 children with allergic conjunctivitis were reviewed. Males were 72 and females 49. The visual acuity was 6/ 6-6/ 18 in 116, and mild visual impairment - 6/ 18-6/ 60 in 5. The most common complaint was frequent itching in 109 (90.1%). Keratometry was normal in 120 (99.5%), while probable keratoconus was found by keratometry in only one patient (0.5%). Central corneal thickness was within the normal range in 33 (27.3%) children, 43 (35.5%) had thin corneas, while 45 (37.2%) had cornea thickness of more than 560 microns. Discussion: Pediatric keratoconus tends to be more aggressive than adult keratoconus with an increased risk of corneal opacities and subsequent keratoplasty. As a result of these negative impacts, early detection and prompt treatment are mandatory. Conclusion: The prevalence of keratoconus was not found to be high in this study population, but with facts emerging between the association of allergic conjunctivitis, and increased prevalence of keratoconus, it is pertinent to integrate keratoconus screening as part of the management of allergic conjunctivitis using an appropriate tool such as video keratography and slit lamp biomicroscope. Abbreviations: KC = Keratoconus, CLEK = Collaborative Longitudinal Evaluation of Keratoconus, SAC = Seasonal Allergic Conjunctivitis, PAC = Perennial Allergic Conjunctivitis, VKC = Vernal Keratoconjunctivitis, IOP = Intraocular Pressure, CCT = Central Corneal Thickness, TNF-α = Tumor Necrosis Factor-Alpha, IL = Interleukin.

Pattern of metastasis of head and neck cancer in Nigeria: A 10 year review.

Head and neck cancer is a common and aggressive malignancy with a high morbidity and mortality profile that occur in several anatomical sites in the head and neck region. They constitute the tenth most common cancer in the world. Metastatic head and neck cancers are associated with severe morbidities and its treatment is mainly palliative. This study examined the patterns of metastases of head and neck cancer in patients in a tertiary hospital in Nigeria. The data extraction form was used to obtain information from the Radiotherapy treatments records and the case notes of patients with histological diagnosis of Head and Neck Cancers between 2002 and 2011 at the Radiotherapy department, University College Hospital, Ibadan. Analyses was done using statistical Package for Social Sciences (SPSS) Version 20.0. A total of 481 patients were seen in this study. The age of the patients ranged from 11 years to 80 years with mean age of 42 years. The male to female ratio was 2:1. The peak age of incidence was between 40-49 years. Most patients presented with stage III and IV. Nasopharyngeal carcinoma had the highest proportion of occurrence 205 (42.6%) followed by paranasal sinuses. Lung had the commonest site of metastasis followed by bones. More than half of the patients presented late with the commonest cancer being nasopharyngeal carcinoma. Lung was the commonest site of distant metastasis with nasopharyngeal carcinoma having the highest proportion of metastasis to the lungs at two years follow up.

COVID Stress Scales: A Cross-sectional Study of its Psychometric Properties among Africans with Chronic, Stable Medical Conditions

Background: The coronavirus 2019 pandemic (COVID-19) elicited in various populations, diverse psycho-behavioral responses. The COVID Stress Scales (CSS) was developed and validated in the general population, among US and Canadian adults, in response to the COVID-19 pandemic. Expectedly, population-specific variations in response are likely, hence, the need to validate psychometrically sound instruments across cultures and diverse populations.&#x0D; Aim: To determine the factor structure and reliability estimates of the CSS among participants with chronic, stable medical conditions in a Nigerian Tertiary Hospital.&#x0D; Methods: The cross-sectional study, involved 1047 consenting adults with chronic, stable medical conditions attending the out-patient specialist clinics of a foremost tertiary hospital in Nigeria. The participants were enrolled consecutively over a four-month period straddling the first and second waves of the COVID-19 pandemic. The CSS was administered to participants who fulfilled the study criteria. Exploratory Factor Analyses (EFA) using Principal Component Analysis and Oblimin rotation with Kaiser Normalization, was used to extract the factors. &#x0D; Results: A six-factor structure emerged: COVID-19-related socio-economic consequences; contamination; xenophobia; traumatic stress; compulsive checking and reassurance seeking; and danger. The internal consistency within items of each domain was acceptable (Cronbach alpha 0.85 and above) and correlation between the domains was moderate to strong.&#x0D; Conclusion: The CSS maintained a six-factor structure, corresponding to the six scales, among Nigerian participants with chronic, stable medical conditions. It has acceptable reliability estimates and can be used to assess COVID-19-related anxiety in this population. The inter-correlation of the various domains is a strong evidence for the existence of COVID stress syndrome.

Abstract 61: Management of Clinically Localized Prostate Cancer: Guideline Concordance and Clinical Outcomes From Tertiary Institutions in Nigeria

Abstract Purpose: Patients with clinically localized prostate cancer have a potentially curable disease. However, there are gaps in the quality of care these patients receive in Nigeria. Granular clinical data are needed to design interventions for quality improvement. This study aims to describe guideline concordance of cancer management and its association with patient outcomes. Methods: A 3-year retrospective study of all patients with T1-T3a, N0, M0 prostate cancer at three tertiary hospitals in Nigeria was conducted. Data on clinicopathologic characteristics, D’Ámico risk group, TNM staging, treatment practices, post-treatment PSA and survival were collected. Concordance with the 2022 European Association of Urology guidelines was assessed. Primary endpoints were guideline concordance of staging and treatment, and associations between concordance and outcomes. Results: This study included 110 patients; mean age 68 years. Sixty-six patients (60%) were high-risk, 34 (31%) were intermediate-risk, and 9 (8%) were low-risk. Most patients were staged with abdominopelvic ultrasound (65%, n = 71). Guideline-concordant magnetic resonance imaging for T-staging was significantly higher in low-risk (44%, n = 4) than high-risk (12%, n = 8) patients (p = 0.041). Guideline-concordant axial imaging for N and M staging was used in 11% (n = 7) of high-risk patients. In the overall cohort, 16 patients (15%) received guideline-concordant definitive treatment with either radical prostatectomy (n = 10; 9%) or radiotherapy (n = 6; 5%), whereas 62 patients (56%) received non-concordant androgen deprivation therapy (ADT) alone and 21 (19%) received no treatment. Median time to biochemical recurrence was not significantly different between those who received surgery (18 months), radiation therapy (median not obtained), or ADT alone (11 months) (log-rank p = 0.103). After a median follow-up of 36 months, median overall survival was similar for guideline-concordant and non-concordant treatment groups (37 and 34 months, respectively; log-rank p=0.540). Conclusion: Prostate cancer staging was suboptimal across all risk groups. Only a minority of patients received radical treatment for this potentially curable disease. Our results will inform the development of tailored multifaceted interventions to improve the quality of care. Citation Format: Musliu Adetola Tolani, Muhammed Ahmed, Rufus Wale Ojewola, Christian Agbo Agbo, Shehu Salihu Umar, Ernie Kaninjing, Alan Paciorek, Rebecca DeBoer. Management of Clinically Localized Prostate Cancer: Guideline Concordance and Clinical Outcomes From Tertiary Institutions in Nigeria [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 61.

Comparative Assessment of Serum Selenium Status in HIV-Infected and Non-infected Children: A Pilot Study in a Tertiary Hospital in Nigeria.

Background Selenium is an essential micronutrient that plays a crucial role in a wide range of physiological processes, including immune responses. Selenium deficiency has been recognized as an associated factor in the progression of HIV to advanced HIV disease and/or mortality. Although selenium supplementation has been shown to reduce hospitalizations andimprovecellular immunity, the evidence remains mixed. This study aimed to determine the prevalence of selenium deficiency and its relationshipwithHIV disease markers in HIV-infectedchildren at the Lagos University Teaching Hospital. Methodology This is a cross-sectional, comparative, pilot study of plasma concentrations of selenium in HIV-infected (n = 30) and non-infected (n = 20) children enrolled in the pediatric HIV clinic of the Lagos University Teaching Hospital, Lagos, Nigeria, from May 2019 to May 2021. HIV-infected children were on stable antiretroviral therapy (ART) with an undetectable viral load. The serum concentrationof selenium was measured using the automated atomic absorption spectrophotometer (hydride generation method).Logistic regression was used to study the effect of selenium status on the levels of HIV disease markers (CD4 count, viral load, weight, opportunistic infections) in the study participants. Results The median age of all participants was nine (4-12) years, with 74% being boys. The mean selenium concentrations were lower in HIV-infected children (91.1 ± 12.0 µg/L) compared to the comparison group without HIV(147.8 ± 4.9 µg/L) (p = 0.001). After controlling for age, ART duration, markers of HIV infection, and other potentially confounding variables, participants with selenium deficiency had approximately 11-fold odds of increased hospital admissions (adjusted odds ratio = 10.57, 95% confidence interval = 1.58 to 70.99; p = 0.015). Conclusions In this study, selenium concentrations were significantly lower in HIV-infected children than in the HIV-negative comparison group. Lower serum selenium concentrations were associated with increased hospitalizations. Although our findings suggest the potential need for selenium supplementation for children living with HIV in Nigeria, further studies are warranted to determine the safety and efficacy of selenium supplementation in this key population.

Assessing the Correlation Between Patient-Specific Characteristics and Braden Pressure Injury Risk Score at a Suburban Tertiary Hospital in Nigeria.

Background and objective Pressure injury (PI) is a frequent complication of hospital admissions, and it increases healthcare costs, morbidity, and mortality. This study aimed to use the Braden scale to assess the PI risk among hospitalized patients without PI and determine its association with patient-specific factors. Methods A cross-sectional study was conducted at a suburban tertiary hospital involving a total of 211 hospitalized patients recruited during the study period (October 2022). Patients were assessed using the Braden scale and their sociodemographic data were also recorded. Data analysis was performed using IBM SPSS Statistics version 26.0 (IBM Corp., Armonk, NY). Results The mean ageof the patients was 41.8 ±23.0 years and 54.0% of the patients were females. The average Braden score of the patients was 19.01 ±3.42, and more than half (58.3%) of the patients showed no risk while only 0.9% of the patients had a severe risk of PI. There was a statistically significant association between PI risk and patients' age (r=-0.353, R=12.5%, p<0.001), pre-admission occupation (F=10.290, p<0.001) as well as the ward of admission (F=11.915, p<0.001). However, gender and social support were not significantly associated. Conclusion The age, pre-admission occupation, and ward of admission of patients werefound to be significantly associated with the risk of developing PI.It is recommended that more resourcesbe channeled toward preventing PI among high-risk patients in resource-limited settings.

Serum Levels of Vitamin D in Male Partners of Women with Infertility in a Tertiary Hospital in Nigeria

Globally infertility affects 8-12% of couples, with male and female causes contributing equally. Micronutrient's deficiency such as vitamin D has been implicated as a cause of infertility in animal studies, there is therefore the need to evaluate its role in humans. This study determined serum levels of vitamin D in males who were partners of patients presenting with infertility.&#x0D; This was a prospective cross- sectional study involving 170 consenting male partners of women presenting with infertility at the University College Hospital (UCH), Ibadan. A structured questionnaire was administered while blood sample and semen were collected for serum vitamin D assay and seminal fluid analysis (SFA) analysis. The data was entered into the Statistical Package for Social Sciences version 21 and statistical significance was set at less than 5%.&#x0D; Eighty-four (49.4%) participants had at least one abnormal parameter on SFA. The mean vitamin D level was higher in participants with normal SFA (34.4+12.6ng/ml) compared with abnormal SFA (32.8 + 15ng/ml). None of the participants had vitamin D deficiency, however the prevalence of vitamin D insufficiency among participants with abnormal and normal SFA was 62.5 % and 37.5% and this was statistically significant. (p = 0.01). Sperm progressive motility was the only SFA parameter associated with serum Vitamin D levels. (p-value = 0.03).&#x0D; This study showed that vitamin D insufficiency is associated with male infertility, therefore it may be added as an investigation for men with infertility and Vitamin D supplement be given where insufficiency or deficiency are noted.

Robson classification of caesarean births: implications for reducing caesarean section rate in a private tertiary hospital in Nigeria

BackgroundCaesarean section (CS) is a potentially lifesaving obstetric procedure. However, there are concerns about the rising CS rate in many countries of the world including Nigeria. The Ten-Group Robson classification system is presently recommended as an effective monitoring tool for comparing CS rates and identifying target groups for intervention aimed at reducing the rates. The aim of this study was to evaluate the cesarean section rate and the groups with the highest risk of CS at the obstetric unit of Babcock University Teaching Hospital (BUTH), using the Robson classification system.MethodsA cross-sectional study involving 447 women who gave birth at the obstetric unit of BUTH between August 2020 and February 2022. Relevant information was retrieved from the delivery records of the study participants. Data were analyzed using the IBM-SPSS Statistics for Windows version 23.0 (IBM Corp., Armonk, NY, USA).ResultsThe overall CS rate was 51.2%. Multiparous women with previous CS, single, cephalic, term (group 5); nulliparous women, single cephalic, term, with induced labour or pre-labour CS (group 2); women with preterm single cephalic, term (group 10); and single cephalic term multiparous women in spontaneous labour (group 3) were the largest contributors to CS rate accounting for 34.5%, 14.0%, 12.6%, and 10.0% respectively. The commonest indication for CS was previous CS (87; 38.0%), followed by poor progress in labour (24; 10.5%).ConclusionsThe CS rate in BUTH is high and Robson groups 5, 2 10 and 3 were the major contributors to this high rate. Interventions directed at reducing the first CS by improving management of spontaneous and induced labours; and strengthening clinical practice around encouraging vaginal birth after CS will have the most significant effect on reducing CS rate.

Characteristics and outcomes of patients hospitalized with COVID-19 at a tertiary hospital in Nigeria.

Data regarding the features and outcomes of hospitalized COVID-19 patients in Africa are increasingly available. To describe socio-demographic, clinical and laboratory characteristics and outcomes of COVID-19 patients. A cross-sectional study of 86 adult patients hospitalized with COVID-19 between March and November 2020. Characteristics were described in survivors and non-survivors. Mean age was 60.9±16.1 years, 53(61.6%) were male. Co-morbidities were found in 77(89.5%) patients. On severity, 6(7%) were mild, 23(26.7%) moderate, 51(59.3%) severe and 6(7%) critical. Oxygen saturation and respiratory rate were 71±22% and 38±11/minute in non-survivors and 90±7% and 31±7/minute in survivors respectively (p<0.001, p<0.001)). Overall mortality was 47.7% with no death among patients with mild disease and deaths in all patients with critical disease. Duration of hospitalization was 2.0(1.0-4.5) days in those who died and 12(7.0-15.0) days in those who survived (p<0.001). Of the 42 patients that received dexamethasone, 11(26.2%) died, while 31(73.8%) survived (p=<0.001). Most of the patients had co-morbidities and there was high mortality in patients with severe and critical COVID-19. Mean oxygen saturation was low and respiratory rate high overall. Factors associated with mortality included: Significantly greater hypoxia and tachypnea, less dexamethasone use and shorter hospitalization.

Risk Assessment of Pre-dialysis Chronic Kidney Disease (CKD) Patients for Cardiovascular Disease (CVD) in a Tertiary Hospital in Nigeria: A Case-Controlled Cross-Sectional Study.

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the chronic kidney disease (CKD) population. CKD patients are more likely to die from CVD before ever reaching end-stage renal disease (ESRD). The study, therefore, seeks to identify the prevalence of risk factors of CVD in CKD patients such as systemic hypertension, anemia, dyslipidemia, hypoalbuminemia, albuminuria, and abnormal calcium/phosphate products. The study was a case-control cross-sectional study where one hundred fifty hypertensive CKD patients and age- and sex-matched hypertensive non-CKD subjects were consecutively enrolled at the renal unit of Delta State University Teaching Hospital (DELSUTH), Oghara. The findings of the study revealed the mean ages of cases and controls to be 48.91±11.93 years and 51.0±15.45 years respectively (p-value 0.182). There was an equal number of males and females among the study group and controls (92 males and 58 females) making a male-to-female ratio of 3:2. The prevalence of CVD risk factors such as diabetes mellitus, hypercholesterolemia, hypertriglyceridemia, elevated low-density lipoprotein, anemia, hypocalcemia, hyperphosphatemia, albuminuria, and hypoalbuminemia was significantly higher amongthe CKD group compared to controls. Similarly, the prevalence of reduced high-density lipoprotein (HDL) was higher amongcases than controls, the difference was however not statistically significant. The study has shown that systemic hypertension, diabetes, anemia, dyslipidemia, hypoalbuminemia, albuminuria, and abnormal calcium/phosphate products increases the risk for CVD in the general population but is more expressed and significant in CKD patients.