Background: Asthma is a chronic inflammatory disease of the airways. There is increasing international interests in the role of nutrition in asthma control. Objectives: This study was carried out to determine the nutritional status of children with asthma using the World Health Organization (WHO) growth reference charts for height, weight, and body mass index (BMI) for age and to determine the relationship if any between nutritional status and frequency of acute asthmatic exacerbations. Materials and Methods: It was a descriptive cross-sectional study of children aged 6–17 years with asthma attending the pediatric respiratory clinic of a tertiary hospital from October 2017 to March 2019. All the values obtained were interpreted using the WHO reference growth charts z-scores. Results: A total of 71 children participated in the study. The study showed that 94% of the children with asthma were of normal height with 2.6% stunted and 2.6% severely stunted. There was no significant association between the height and the frequency of acute exacerbation. About 65% of the children had normal BMI. Those that were wasted/severely wasted were 19.7%, whereas 15.5% were overweight/at risk of overweight. There was no significant association between the BMI and the frequency of acute exacerbations (P > 0.05). The odds of having more frequent exacerbations in children with either above normal or below normal BMI were 1.05 (0.11–10.44) and 0.81 (0.08–7.88), respectively. Conclusion: Majority of the children with asthma were of normal height. Despite the fact that there were more children who were wasted/severely wasted than overweight/risk of overweight, these findings were not significantly associated with more frequent acute exacerbations.

Background: Globally, dysmenorrhea is a common menstrual condition among adolescent girls. It interferes with the emotions and physical activities and adversely affects school attendance and performance. However, the prevalence and pattern of presentation are underexplored in Nigeria. Objective: The objective of this study is to determine the prevalence and patterns of dysmenorrhea and its effect on school attendance in adolescent girls in Enugu, South-East, Nigeria. Materials and Methods: This study is a population-based cross-sectional survey of the prevalence and pattern of dysmenorrhea among 326 secondary school girls in Enugu Metropolis between October and December 2019. A structured questionnaire was used to collect relevant information. Data were analyzed using Statistical Package for Social Sciences (SPSS) IBM version 23.0. Chi square was used to test for association between categorical variables, and a P-value of less than 0.05 was considered statistically significant. Results: Prevalence of dysmenorrhea was 75%. Majority of the students (60.7%) had 1–2 days of menstrual pain, with 39.3% presenting with severe pain. The length of menstrual cycle (P < 0.011) and duration of flow (P < 0.009) were significantly higher among subjects with dysmenorrhea than those without dysmenorrhea. Forty-six students (14.1%) were absent from school due to dysmenorrhea; however, there was no significant association between dysmenorrhea and school absenteeism (P > 0.05). Also, there was no significant association between degree of pain and school absenteeism (P > 0.05). Conclusion: The prevalence of dysmenorrhea was high among secondary school girls in Enugu, Nigeria. It was associated with the length of menstrual cycle and duration of flow. There was no association between degree of dymenorrhean and school absenteeism.

Background: In a resource-limited setting where nutrient availability is a challenge, it may be necessary to determine factors that affect dietary diversity in people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) as addressing them could lead to better access to diversified diets in this group. Objective: The objective of this study was to determine the factors that influence dietary diversity among HIV clients attending the HIV clinic in a low-resource tertiary health facility. Materials and Methods: An institutional-based cross-sectional study was conducted among HIV clients receiving anti-retroviral therapy in Enugu state, Nigeria. A systematic random sampling technique was employed in selecting the study participants. Bivariate analysis was done using the chi-square test which was further subjected to multivariate logistic regression analyses to determine predictors of dietary diversity. Results: In this study, respondents who earned a family monthly income of 72.5 US dollars and below were 2.6 times less likely to have high dietary diversity (AOR = 0.378, CI = 0.180–0.792) compared to those who earned above 145 dollars. Also, HIV clients on cotrimoxazole prophylaxis were 2.3 times more likely to have high dietary diversity (AOR = 2.304, CI = 1.155–4.598) compared to those who were not on the prophylaxis. Conclusions: High family monthly income and being on cotrimoxazole prophylaxis were predictors of high dietary diversity in People living with HIV/AIDS. Therefore, there is a need to improve the income of PLWHA as well as ensure the ready availability of cotrimoxazole to reduce the rate of opportunistic infections thus leading to better consumption of diversified diets.

Background: The impact of uncontrolled hypertension results in undesirable cardiovascular events. Hence, there is a need to emphasize on adequate control of blood pressure. Objectives: The objectives of this study were to determine the prevalence and determinants of controlled blood pressure and the complications of hypertension in a tertiary hospital in Nigeria. Materials and Methods: This was a retrospective study of 257 patients of Cardiology Unit of University of Nigeria Teaching Hospital diagnosed with hypertension from 2014 to 2018. A proforma-designed questionnaire was used to retrieve responses from the patients’ medical records. Data were entered and analyzed using Statistical Package for Social Sciences version 20. The level of significance was set at 0.05. Results: The prevalence of controlled blood pressure was 35.8% with mean blood pressure of 112.39/72.72 mmHg. Adherence to drug therapy was found to be associated with controlled blood pressure (χ² = 8.370, P = 0.005). Two-thirds of patients diagnosed with hypertension developed complications of which hypertensive heart disease, stroke, and chronic kidney diseases were the commonest. Age (χ² = 9.629, P = 0.008) and the initial presenting diagnosis (χ² = 7.662, P = 0.004) were factors associated with the development of complications. Conclusion: Adequate blood pressure control is still a challenge among hypertensive patients in the study population. A comprehensive program is advocated for the control of blood pressure that will accommodate drug adherence in addition to education, and socio-behavioral change modifications.

Background: Prostate-specific antigen (PSA) testing has been recommended for prostate cancer screening by the World Health Organization. The combined use of total and free PSA and digital rectal examination is said to improve the sensitivity and specificity of total PSA and also to reduce the need for 20% of unnecessary biopsies. Tertiary hospital laboratories ought to be appropriately equipped to offer these tests for improved patient outcomes. Objective: The objective was to determine the proportion of Nigerian tertiary care laboratories that offer quantitative total and free PSA testing. Materials and Methods: A cross-sectional survey was carried out in functional government-owned tertiary hospitals in all the geopolitical zones of Nigeria. Respondents were drawn from the Laboratory section of each hospital. Data were collected using semi-structured self-administered questionnaires and analyzed using SPSS version 22. Results: The study included a total of 34 tertiary care laboratories. The mean (SD) age of respondents was 43.71 (5.2) years. Of the surveyed hospitals, 27 (79.41%) had facilities for PSA testing, whereas 7 (20.59%) had no functional PSA testing facility. Of those with a functional testing facility, 27 (100%) had facilities for total PSA whereas 12 (44.44%) had facilities for free PSA. Three facilities [3 (42.85%)] out of the seven facilities with no functional testing facilities cited equipment breakdown as the reason. Conclusion: Availability of PSA testing facilities was not adequate in tertiary care laboratories in Nigeria, with free PSA facilities being less than total PSA facilities. More support is needed in making these important testing facilities more readily available in Nigerian tertiary healthcare laboratories.

Introduction: Tropical calcific pancreatitis is known to be associated with malnutrition and insulin-requiring diabetes mellitus. Recent studies suggest that genetic and environmental factors play a role in its etiopathogenesis. Objective: The objectives of this was were to study the prevalence, profile, and outcome of children managed for type 1 diabetes mellitus with pancreatic calcification. Materials and Methods: This was a cross-sectional study of children managed for type 1 diabetes mellitus in the pediatric endocrine unit of Federal Teaching Hospital Abakaliki, Nigeria. All patients who consented underwent ultrasonography of the pancreas. We undertook a case note review to identify factors that may be associated with pancreatic calcification. Results: Thirty-seven children were diagnosed with diabetes mellitus. The mean age was 12.3 years (5–17 years), 21 males and 16 females. Twenty of 37 (54.1%) patients were screened for pancreatic calcifications using abdominal ultrasound. Seventeen of 37 were not studied as nine of them (24.3%) died, six lost to follow-up, and two declined to participate. The mean duration of diabetes mellitus was 2.7 years (3 months–8 years). All patients were managed with a premixed twice-daily insulin regimen. Pancreatic calcification was seen in seven out of the 20 (35%) and was commoner among males and older children. The average glycosylated hemoglobin (Hba1c) was 13 and 11, and average height/weight standard deviation score was –1.9/–1.9 and –1.03/–1.02 in those with calcification and those without, respectively. Conclusion: Tropical calcific pancreatitis is common among children diagnosed with diabetes mellitus in Abakaliki, Nigeria and is associated with morbidity. Routine pancreatic ultrasound of patients with type 1 diabetes mellitus may be necessary.

Background: The Integrated Management of Childhood Illness (IMCI) guidelines are a standardized diagnostic and treatment approach developed by the World Health Organization for the management of common childhood diseases. Objective: This study assessed the adherence and implementation-related challenges of the IMCI guidelines among nurses at health centers in Port Harcourt, Nigeria. Materials and Methods: A cross-sectional descriptive-analytical design was employed to examine nurses in all the 12 Model Comprehensive Primary Healthcare Centers (MCPHCs) in Port Harcourt, Nigeria. The census sampling technique was used to enroll 52 consenting participants. Data were collected by (1) observation and recording on a checklist and then (2) semi-structured questionnaire. Collected data were analyzed using frequency, percentages, Chi-square, and prevalence ratio at a 5% level of significance with the aid of IBM-SPSS version 25. Results: About half (53.8%) of the participants demonstrated adequate overall adherence to all the steps of the IMCI guidelines. Adequate adherence to all the steps of the IMCI guidelines was 83% higher among participants trained on the IMCI guidelines (P = 0.038). The participants’ educational qualifications (P = 0.722) and years of professional nursing practice (P = 0.477) were not associated with adherence to the IMCI guidelines. The categories of the IMCI guidelines implementation-related challenges reported by the participants were a lack of training update on the IMCI guidelines (94.2%), a lack of the IMCI booklets (69.2%), and work-time pressure (53.8%) among others. Conclusion: Adherence to the IMCI guidelines was short of desired levels. In recommendation, frequent training and regular provision of the IMCI booklets in the MCPHCs are required.

Background: Breast cancer is one of the leading causes of cancer-related deaths among women worldwide. Mammography was recently introduced at the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria for breast cancer screening and diagnosis at the institution. Objective: The objective of this study is to determine the diagnostic accuracy of mammography in the assessment of palpable malignant breast lump among adult females referred from the NAUTH outpatient clinics using histopathology as gold standard. Materials and Methods: This prospective cross sectional study involved recruitment of consenting adult females with palpable breast lump referred for mammography between October 2017 and November 2019 at NAUTH, Nnewi, Nigeria. Two standard views—cranio-caudal (CC) and medio-lateral oblique (MLO)—were done for each patient. Spot magnification or other supplementary views were only done when indicated. Data analysis was done using Statistical Package for the Social Sciences (SPSS) version 21.0 for Windows software. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of malignant breast lesions were 41.4%, 98%, 96.7%, 54.4%, and 65%, respectively. The most common features of malignancy were mammographic opacity with an irregular outline (86.7%) and architectural distortion (80%), whereas asymmetric density (10%) was the least common feature. Conclusion: Mammography has a fairly high overall diagnostic accuracy in breast cancer diagnosis. However, an alternative imaging modality is required for dense breasts. This study’s reported specificity (98%) suggests that the test has a very high ability to correctly identify non-cancerous breast lumps. This is particularly relevant in breast cancer screening with an objective to rule out the presence of the disease among adult females in the population.

Background: The advances in medical practice have increased the average life expectancy of people living with sickle cell disease (SCD) to 54 years. The high prevalence rates of SCD in Nigeria therefore highlights the need for research that will support overall disease management. Objective: To determine the health risk behavior (HRB) of adolescents with sickle cell disease in Nigeria. Materials and methods: In a cross-sectional descriptive survey using purposive sampling method, 122 adolescents with SCD attending sickle cell clubs in Ogun State, Nigeria were selected for the study. A 58-item questionnaire adapted from the Youth Risk Behavior Survey (YRBS) instrument developed by Centre for Disease Control and Prevention (CDC) was used to collect data from the adolescents. Results: The mean age of the respondents was 15.7 ± 2.3 years, there were more females (58.2%) than males (41.2%). Majority were from a monogamous family setting and average to large family size (≥3siblings) (63% and 76% respectively) and only 6% of the parents had no formal education. The mean ages at first sexual intercourse, cigarette smoking and alcohol use were 16 ± 5.7, 15.7 ± 0.7, and 14.9 ± 1.9 years respectively. One-fifth (21.3%) have had sex and half (50%) of them have had sex by the age of 17. Over one-tenth (13.9%) had smoked cigarette while 14.8% had taken alcohol. Adolescents from monogamous family background were more likely to be involved in substance abuse (χ²: 4.99; P=0.008) and exposed to sexual activities (χ²: 10.9; P=0.004) than those from polygamous or single parent family. Conclusion: It was concluded that adolescents with SCD are involved in HRB and may be dependent on family characteristics. It is recommended that regular health care of chronically ill adolescents should include screening and counselling for HRBs.

Background: One per cent of women diagnosed with cervical cancer are pregnant or postpartum at the time of diagnosis. Therefore, awareness during pregnancy is of utmost significance. Objective: To determine predictors of knowledge of cervical cancer screening among pregnant women who attended antenatal clinics in Enugu, Nigeria. Materials and Methods: It was a descriptive cross-sectional study of 419 pregnant women who attended antenatal care at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu (139) and the Mother of Christ Specialist Hospital, Enugu (280). A multistage random sampling method was used to select the study centres and the participants. The questionnaires were administered by the interviewers and the data collected included sociodemographic characteristics, knowledge, and practice of cervical cancer screening. Data were analyzed using SPSS version 23. Results: The mean age of the participants was 28.86 ± 5.69, Christians (92.7%), and married (82.5%). Most of the respondents (82.3%) heard about cervical cancer screening methods through their gynecologists and of the 198 respondents who have heard about cervical cancer screening, 151 (76.3%) knew about Pap smear. One hundred thirty-eight (69.7%) of the participants believe that screening for premalignant lesions of the cervix can be performed during pregnancy. Only 37.9% of the participants had ever done Pap’s smear in the past 3 years. Respondents with higher social status (Civil/Public servants) were 10 times more likely to know about cervical cancer screening than those with lower social status (Trader/farmer/artisan) (P = 0.027, OR = 9.957, 95% CI = 1.301 – 76.191). Conclusion: Higher social status is more predictive of knowledge of cervical cancer screening amongst pregnant women attending antenatal clinics. Gynaecologist disseminate the information on cervical cancer screening more and Pap’s smear remain the main screening modality known to pregnant women. Efforts should be made by other health workers and the media to disseminate appropriate information on screening modalities for the prevention of cervical cancer

Background: Drug abuse is a global public health problem that is associated with increased psychiatric morbidity and mortality. Objectives: This study assessed the prevalence of drug abuse and its relationship with problematic Internet use (PIU), suicidality, anxiety, depression, and self-esteem among high school adolescents. Materials and Methods: This is a cross-sectional descriptive study involving 1304 Nigerian high school adolescents recruited through the multistage stratified sampling method. The participants completed a study-specific sociodemographic questionnaire, a 10-item Drug Abuse Screening Test (DAST), Problematic Internet Use Questionnaire-Short Form-6 (PIU-SF-6), the Mini International Neuropsychiatric Interview Suicidality module, the Hospital Anxiety and Depression Scale, and Rosenberg Self-Esteem Scale (RSES). Results: The prevalence rate of drug abuse was 49.8%. Adolescents who abused drugs had higher mean scores on PIU, suicidality, depression, and anxiety scales and lower scores on the self-esteem scale. All these variables cumulatively accounted for approximately 22% of the total variance in the DAST score. Conclusions: Drug abuse is still prevalent among Nigerian adolescents, with a significant association with PIU, suicidality, depression, anxiety, and low self-esteem. All these variables may provide the template for psychological and social interventions that are specifically targeted to the management of drug abuse among Nigerian adolescents.

Background: The median and the paramedian approaches are used to access the epidural space. Median approach is commonly used but can be technically difficult in certain patients. The paramedian approach is the alternative. Success rate during the blind procedure is determined by the skin to epidural distance (SED). SED in turn is affected by patients’ anthropometric characteristics. Prediction of the SED serves to determine the depth of needle advancement in order to improve the success rate. Objectives: The study compared the SED using median vs. paramedian approaches, the time required to access the epidural space, place the catheter, and investigate anthropometric factors which may have influenced this distance among the participants. Materials and Methods: The study was a blinded randomized controlled study. Following ethical approval and informed consent, 60 women scheduled for elective gynecological procedures were allocated to one of the two groups: Group M (median) (30) and Group PM (paramedian) (30). Results: The SED was longer using the PM approach. The mean time it took to gain access was shorter in the PM group. The mean SED increased as the body mass index increased in both groups (P < 0.0001). There was a significant association of anthropometric measurements with the SED using both approaches. Conclusion: The study showed that the SED was longer in the PM group. Also as the patient’s anthropometric measurements increased, so did the SED.

Background: Adolescent obesity is a serious public health issue. Inconsistent findings on its association with mental health problems are reported. Objective: This study aimed to determine the prevalence, pattern, and sociodemographic correlates of psychosocial disorders among obese adolescents in Enugu metropolis, Nigeria. Materials and Methods: A cross-sectional study was conducted over a 5-month period in 16 secondary schools in Enugu, Nigeria. A multi-staged systematic sampling technique was used to select participating schools. A total of 4364 adolescents aged 10–19 years from these schools were screened for obesity by measuring their height and weight, and calculating their body mass indices (BMIs), which were plotted on the Centers for Disease Control and Prevention BMI percentile chart. Seventy-four obese students were identified, and from their respective class registers, systematic sampling scheme was applied in selection of equal number of apparently healthy normal BMI (5th–84th percentile) controls matched for age and sex. The youth version of the Pediatric Symptom Checklist was used to screen for psychosocial disorder in the study participants. Results: The prevalence of psychosocial disorder was 17.6% and 12.2% among the obese and control adolescents, respectively (P = 0.02). Attention and externalizing problems were the highest among the obese adolescents, whereas psychosocial disorders were more in females than males (28.1% vs 9.5%; χ² = 4.34, P = 0.04). Conclusion: Obese adolescents have a higher prevalence of psychosocial disorder compared to controls, with attention and externalizing problems being most common, and this was influenced by gender. Periodic assessment of the mental health of obese adolescents is advocated.

Background: The burden of venous thromboembolism (VTE) can be reduced through awareness programs, as VTE is largely preventable. Objective: We sought to determine the level of knowledge among medical students in Southeast Nigeria. Materials and Methods: We conducted a descriptive cross-sectional study in clinical students at four medical schools in the southeast of Nigeria. The pretested and prevalidated version 11 of the Ipsos-Reid questionnaire was used. Results: A total of 784 students with a mean age of 23.5 ± 3.0 years participated in the study. Our respondents showed a high level of awareness of VTE (99.1%). The majority 638 (87.6%) of the respondents correctly described vein thrombosis as a blood clot in a vein. A little more than half of them knew how clots feel in the legs (51.0%) and lungs (57.5%). Their level of awareness of possible risk factors for VTE was above 57%. The relationship between medical school and the level of perception was statistically significant ([P ≤ 0.0001. Conclusion: Awareness is high, but general knowledge was low among our medical students. This may be a call to curriculum adjustment in our medical schools.

Background: Effective viral haemorrhagic fevers (VHFs) control demand adequate emergency preparedness among healthcare workers (HCWs). Objective: This study assessed the emergency preparedness for VHF control among HCWs at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra state, Nigeria. Materials and Methods: It was a cross-sectional study conducted among 345 HCW at the NAUTH, Nnewi, Nigeria. Data was analysed using statistical package for social sciences (SPSS, IBM, Chicago IL, USA) software version 21. Chi square and student’s t-test were used to test associations between categorical and continuous variables, respectively. A p-value of <0.05 was considered statistically significant. Results: Their mean age and length of service were 33.9 ± 8.88 and 6.6 ± 7.08 years, respectively. Two-third were doctors, nurses and lab scientists. A major proportion of the HCWs were aware of VHF (88.4%), and knew it could be acquired at workplace (83.8%) and at least 2 correct features (74.2%) or one preventive measure (79.1%). Only 53.0% and 47.2% knew that the hospital had a VHF control policy and standard operating procedure (SOP), respectively. Different category of HCWs varied significantly in awareness of VHF; and knowledge about the risk of acquiring it at workplace, features or preventive measures, and VHF control policy or SOP. Doctors, nurses and lab scientists performed better than other HCWs in VHF knowledge. Previous training on VHF or encounter with suspected case was highest among the doctors (P < 0.001) while adequate supply (P < 0.001) or regular use (P = 0.008) of PPE was highest among lab scientists. Suspected VHF case was encountered by 21.2% of the HCWs out of which 26% (19/73) notified relevant unit. Only 29.3% of the HCWs agreed that VHF control was adequate in their unit. Commonest reasons cited for disagreeing were lack of training (79.2%), standard precaution materials (63.6%), SOPs (59.7%) and inadequate support by hospital management (58.4%). Conclusion: Emergency preparedness for VHF control was poor among studied HCWs. Innovative surveillance/notification system, and best practices for infection control should be enforced. HCWs should be adequately trained on VHF control.

Background: Since the turn of the millennium, efforts across the world have been aimed at promoting good living and reducing poverty. This has resulted in countries taking necessary steps to ensure increased access to affordable health care by promoting Universal Health Coverage. Nigeria is not an exemption especially as private health spending has its own substantial impoverishing effects on households. Objective: The objective of this study was to study willingness to pay (WTP) for Community-based Health Insurance Scheme in a Nigerian State. Materials and Methods: The study sample was purposively selected to cover the three senatorial zones of Enugu State, Nigeria. A questionnaire was used to collect data from the respondents that were randomly selected. Focus group discussions were held to collect qualitative data. Key variables which included WTP for in- and outpatient care for the different stated amount of of money in naira and dollar: ₦400 ($1.0), ₦500 ($1.25), ₦1000 ($2.5) or more) were compared across socio-economic status (SES) groups using “asset holding and level of WTP” with the groups classified into SES quartiles. Results: Most respondents were neither WTP a minimum of ₦400 ($1.0) nor a maximum of ₦1000 ($2.5) for inpatient or outpatient care. The overall maximum amount to pay by the groups was ₦500 ($1.25), whereas the minimum amount across the communities was ₦50 ($0.125). Conclusion: There was a ceiling of maximum/minimum willing amounts to pay across the different socio-economic strata and these ceilings were observed to be low.