Nigeria

摘要： Objective: Out of pocket expenditure is the primary means of financing healthcare in middle and low-income countries. The 2021 government health expenditure in Nigeria at 4.52% falls short of the 15% recommendation of the 2001 Abuja Declaration. This paper examines healthcare purchasing in Nigeria, in order to explore how resources were allocated and create better insight into healthcare purchasing for universal health coverage. Data Source/Study Setting: The study was conducted in the Federal Capital Territory and three states—Lagos, Enugu and Sokoto. Study Design: A cross sectional method was used to examine health purchasing functions in Nigeria. Key informant interviews and review of grey and published literature on health financing in the selected study areas. Data Collection Methods: Primary data were collected from relevant stakeholders across the selected study areas, using a structured interview guide. A search of grey and published literature gave a total of 57 references. Principal Findings: The NHIS has a clearly articulated benefit package, for its formal sector and pro-poor BHCPF program. NHIS covers only about 5% of the Nigerian population. BHCPF (SOML) program targets the bottom 40% of Nigerians on paper, but there is no specific design for reaching them. The NHIS uses both public and private sector providers. It is not clear which providers are used for the BHCPF (SOML) program. The NHIS uses actuarially calculated capitations for primary care services and market-based fee-for-service rates for reimbursing secondary and tertiary care. BHCPF (SOML) uses a macroscale pay-for-performance mechanism to reward states achieving specific health outcomes. Conclusion: Health purchasing functions have serious implication for UHC. However, health care provision in Nigeria is not pro-poor and government efforts do not promote efficiency. Available option is prioritization of health initiatives that ensure value for money through performance-based financing and partnering with the private sector.

摘要： Introduction: Acute poisoning in children is cause of hospitalization and death worldwide. It is a Paediatrics emergency with significant economic cost. There are epidemiological differences in acute poisonings in children evaluated in Emergency departments across different countries and regions of the world. The aim of this study was to determine the causes of poisoning in children in our health facility during the period 2000-2019. Methodology: Case notes of children 6 months to 18 years managed for acute poisoning from January 2000 to December 2019 at Paediatrics unit, Federal Teaching Hospital Gombe (FTHG), were analysed. The International classification of Disease ICD 10 was used. Ethical Clearance was obtained. Results: 26,716 children were admitted with 76 cases of Acute poisoning giving a prevalence rate of 2.8/1000 children. 56.6% (43) were males. 63.2% (48) of children were years of age. 69.7% (53) were urban dwellers and 59.2% (45) from low socioeconomic class. 52.6% (40) of poisoning occurred in rainy season. 97.3% (74) of children had unintentional poisoning. Organophosphates 22.3% (17) and kerosine 22.3% (17) were the most common substances ingested. Snake-bite and corrosive ingestion occurred in 13.1% and 11.8% of children respectively. Ingestion was the route in 84.2% of cases. 75.0% (57) of poisoning occurred at home. ACP occurred in children aged 1 - 5 years (p-value = 0.025); More in Children from low socioeconomic status (p-value = 0.001) and urban settings (p-value = 0.001). There was no statistically significant relation between type of poisoning and gender p = 0.839, season p = 0.608, religion p = 0.504 and ethnic background p = 0.342. 4.2% (3) children died each from organophosphate, snake bite and tramadol poisoning. Conclusion: Kerosine and organophosphate were the leading cause of accidental childhood poisoning.

摘要： Background: Adiponectin possesses essential physiological functions that protect against the onset of cardiovascular and metabolic diseases. Although several studies have discussed the association between adiponectin and Blood Pressure (BP) in adults and older adolescents. To the best of our knowledge, this is the first study to explore the relationship between adiponectin and BP among children in Africa. Significance: This novel discovery is expected to serve as a benchmark for future local studies in examining the role of adiponectin in cardiovascular disorders among Africans. Method: A cross-sectional study was conducted among 86 healthy children aged 4 to 11 years with normal BMI. BP values were measured and percentiles derived from the 2017 revised clinical practice guidelines of the American Academy of Paediatrics. Fasting blood adiponectin values were determined with ELISA, and the level of statistical significance was set at p Result: 86 children were comprised of 42 (48.8%) males and 44 (51.2%) females. The mean age of all subjects was 7.5 ± 2.3 years, while that of fasting adiponectin was 4.8 ± 2.1 ng/dl. There were no significant differences in the age, Body Mass Index, BP and adiponectin concentrations across gender. 69 (80.2%) participants had normal BP while 5 (5.8%) and 12 (14.0%) had elevated BP and stage 1 hypertension. Mean adiponectin values for normal BP, elevated BP and stage 1 hypertension were 5.1 ± 2.1 ng/ml, 3.3 ± 1.2 ng/ml and 4.1 ± 1.9 ng/ml respectively (p-value = 0.039). A significant negative correlation was observed between adiponectin and systolic BP independent of age, sex, and BMI. Although a negative correlation was noted between adiponectin and diastolic blood pressure, this was not statistically significant. Conclusion: Adiponectin correlates negatively with systolic BP in young Nigerian children independent of age, Body Mass Index and gender. More studies are indicated to investigate this relationship in association with vital metabolic factors across different age groups in Africa.

摘要： Background: Nigeria is currently a malaria endemic country with an estimated 76% of her population at risk of contracting malaria [1]. According to a study in Nigeria, the first line of action mothers took when their children under 5 years have malaria showed that over 50% of them used non-prescription drugs they have at home or bought from pharmacy stores. And 60% of the most commonly used drugs for malaria treatment were chloroquine [2]. Many recent studies have demonstrated re-emergence of chloroquine-sensitive P. falciparum, suggesting a possible role in future malaria control [3]. Objective: The aim of this study was to investigate the effect of home-based oral chloroquine treatment among children under 5 years with Plasmodium falciparum malaria attending Jos University Teaching Hospital and OLA Hospital in Jos Metropolis. Method: This is a cross-sectional study of 93 malaria and non-malaria children. Malaria diagnosis was carried out using microscopical examination of Leishman’s stained thick and thin blood films, P. falciparum parasitemia was assessed by standard microscopy techniques and complete blood count was done using Beckman Coulter Analyzer. Results: The body temperature on admission was significantly lower (p ˚C ± 0.07˚C) than in the three malaria groups. The mean body temperature of chloroquine treated children with malaria was significantly lower (p < 0.05) than that of children presenting with severe malaria. Parasitaemia was significantly lower (p < 0.05) in the pre admission chloroquine treated group (18.13% ± 0.49%) than in the non-treated simple malaria group (34.35% ± 2.75%) and severe malaria group (43.57% ± 5.49%), respectively. The average number of days before the cases were reported in the hospital was 4.80 days. The haemoglobin concentration of 7.23 ± 1.01 g/dl obtained for non-treated malaria patients indicates a mild anaemia, whereas the haemoglobin concentration values of 9.60 ± 0.51 g/dl and 10.52 ± 0.16 g/dl obtained for chloroquine treated children and control children respectively show that the two groups of children were not anaemic and the values obtained were within the normal range. Conclusion: The results obtained in this study demonstrate that there was significant positive impact of chloroquine treatment on Plasmodium falciparum parasitemia and degree of anemia in children under 5 years with Plasmodium falciparum in Jos Metropolis.

摘要： Background: Post stroke depression (PSD) is the most common psychiatric complication following stroke. There has not been any study to demonstrate its burden in Abakaliki, Nigeria. It is against this backdrop that we embarked on this study of the frequency and pattern of PSD in Abakaliki Nigeria. Method: This is a cross-sectional observational hospital based study undertaken at the Adult Neurology Outpatient Clinics of Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria from February 2021 to July 2021 (6 months period). Results: Amongst the 110 stroke survivors enrolled in the study, 36 (32.7%) had Post Stroke Depression (PSD) with preponderance of mild type. Female gender and young age were associated with the presence of PSD. Conclusion: Post stroke depression is prevalent amongst stroke survivors in Abakaliki, Nigeria and more preponderant in women and young individuals.

摘要： The conversion of bone waste obtained from meat processing in slaughterhouses is of great significance across the world, with rising concerns about its utilization in developing countries. In Nigeria, for instance, there are fewer successful strategies to transform bone waste into high-value products. While most research papers have concentrated on revealing the environmental, aesthetic, and catastrophic health problems associated with the current slaughterhouse waste disposal in developing countries, this paper presents an engineering approach to managing slaughterhouse solid wastes that majorly consist of bones and horns. A medium-size bone milling machine was designed and fabricated with well-detailed design principles to make it reproducible in any industrial capacity. 3D modeling and simulation were employed to evaluate the machine design and performance. Static simulations performed show that the machine can withstand values of 219.313 kPa, 12.7 exp 7 MPa and 2182.5 Nm for the shaft bending moment, hammer pressure, and output torque, respectively. The machine is 98% efficient on performance evaluation, milling 250 kg of treated sun-dried cow bones in an average time of 10 min 2 sec. This paper also recommends workable means for the installation and utilization of the bone milling machine in slaughterhouses across Nigeria.

摘要： Objective:To assess and compare the relationship between spousal communication,fertility preference,and other factors with contraceptive use among married couples in Ekiti State,Nigeria.Methods:This cross-sectional study was carried out in AdoEkiti Local Government Area of Ekiti State,Nigeria between the 12th of August 2017 and the 15th of February 2018.A pre-tested,semi-structured interviewer-administered questionnaire was used to collect data from 976 respondents by a multi-stage sampling technique.Data were analyzed(univariate,bivariate,and binary logistic regression analysis)using SPSS version 24.0.Factors that showed statistical significance(P<0.05)were included in a binary logistic regression to determine significant predictors of contraceptive use.Results:The proportion of respondents currently using contraceptives was 56.9%.The education status of the respondents revealed that those with primary education were more likely to use contraceptives than those without formal education[adjusted odds ratio(aOR)8.4,95%confidence interval(CI)1.97-36.2,P<0.001].Respondents with fair spousal communication were more likely to use contraceptive than those with poor communication(aOR 4.9,95%CI 2.80-8.71,P<0.001).In addition,fertility preference of 4 or less children was found to be significantly associated with contraceptive use(aOR 3.0,95%CI 1.67-5.50,P<0.001)compared to a preference of more than 4 children.Finally,the urban respondents were more likely to use contraceptives than those in the rural setting(aOR 1.7,95%CI 1.16-2.41,P=0.047).Conclusions:Educational status,residential site,spousal communication,and fertility preference significantly influence the level of contraceptive use among married couples.Couples should endeavor to discuss more on issues bordering on their fertility preference and contraceptive issue.Government should formulate policies to improve the rural uptake of contraceptives using identified target interventions.

摘要： The Neoproterozoic quartz potassic syenite of the Iwo area,Southwestern Nigeria has been investigated for its magmatic history and zircon saturation temperature.The zircon morphology showed irregular shapes with sectoral and oscillatory micro zoning.The majority of the zircon grains have embayment,which corresponds to magmatic resorption.The syenite crystallized from probably multiple recharge of less evolved magma.Both the magma injection and subsequent crystallization of the rock occurred over a length of time giving the rock some degree of protracted thermal history and slight fluctuation in chemistry,which are manifested as zonation in the analyzed zircon grains.The initial stage of zircon crystallization was marked by a lower cerium anomaly than the final stage,which indicates changes from lower oxidizing to higher oxidizing conditions.The protracted history does not affect the europium anomalies at any stage of crystallization.An average zircon saturation temperature of 865°Cestimated from titanium in zircon(T_(Tiz)°C)thermometer using titanium activity of 0.7(^(a)TiO_(2)~0.7)is taken as reasonable crystallization temperature of the rock.This is fairly consistent with 877°Cdeduced from the zircon solubility model.The titanium in zircon temperature of 910°Cat aTiO_(2)~1 is rather too high to be a useful estimate.Both the temperatures 865 and 877°Care however consistent with those of intermediate rocks.The size of the syenite and protracted crystallization history would have made the temperature to have impacted the metamorphic envelope around the syenite.

摘要： This study assessed pollutants concentration at selected markets in Owerri. These markets were purposively selected after careful consideration of all major markets in the study area;the selected markets were considered to be more congested during the day as a result of open assess to road junctions coupled with a high density of vehicular movement, presence of offices, residential buildings, and human activities. Five air pollutants from vehicular emissions were monitored, namely: carbon monoxide (CO), carbon dioxide (CO2), nitrogen dioxide (NO2), particulate matter (PM 2.5) and particulate matter (PM 10). Assessments were carried out within 3 hours per dual diurnal section using approved standard methods which were converted to a 1-hour mean for the morning and afternoon period of sampling 7-10 am and 2-5 pm. These periods are known for the peak of human and vehicular movement within the study area. Results show that the highest level of CO concentration (0.293 - 0.387 ppm) was recorded at Alaba market and is less than the permissible limit of 35 ppm given by national ambient air quality standard (NAAQS). The highest range of CO2 (1153 - 1875 ppm) was recorded from Alaba market which is higher than the ambient standard of 314 ppm. The highest level of NO2 (0.116 - 0.297 ppm) was recorded from Relief market which is also higher than the permissible limit (0.100 ppm) of NAAQS. The highest range of particulate matter of PM 2.5 and PM 10 was recorded from Relief market (0.011 - 0.029 μg/m3) and (0.065 - 0.172 μg/m3) respectively and is far lower than the permissible limit (150 μg/m3) of NAAQS and WHO (base on target 1) standards. The study, therefore, concludes that there is a significant impact of emission from vehicles in the selected markets in Owerri metropolis as result indicates a high risk of health problems in the markets due to the high level of CO2 and NO2. It, therefore, recommends that an adequate mechanism should be put in place to decongest traffic density in the city especially near markets so as to have a substantial reduction in vehicular emissions and improve the livability of the citizens.

摘要： Objective:To identify factors that determine the uptake of in-vitro fertilization(IVF),and to determine the predicting effect of the identified factors on the uptake of IVF among couples attending fertility clinic at a tertiary health institution in Benin City,Nigeria.Methods:This study adopted a cross-sectional descriptive design.A self-structured questionnaire tested was validated and administered to 250 couples who attended fertility clinic.Data were collected from March 2021 to June 2021 and were analyzed using the Statistical Package for Social Science(SPSS)version 21.Data were presented and interpreted using descriptive statistics and inferential statistics such as Chi-square,univariate statistics and multivariate logistic regression analysis.Results:Among 250 couples,154(61.6%)were willing to adopt IVF.The multivariate logistic regression analysis showed that catholic religion[odds ratio(OR)0.21,95%confident interval(CI)0.54-0.73],family income(OR 1.50,95%CI 1.10-2.00)and age(OR 1.04,95%CI 1.01-1.10)were the major factors that determined the uptake of IVF,with P-value of<0.001,0.018 and 0.031,respectively.Conclusions:The uptake of IVF could be sustained or improved on,if the government should improve on the cost of living for families,and religious leaders need to be encouraged to pass on the information about IVF to their members to be well guided about the possibilities of IVF.