Open Access Original Research Article

Outcome of Childhood Tuberculosis at a Specialist Hospital in Gusau, Nigeria

Garba Bilkisu Ilah, Muhammad Aminu Sakajiki, Yusuf Ibrahim, Ibrahim Tukur Mafara, Ahmad Murtala Muhammad, Yusuf Tahir, Onazi Sunday Ochapa

Asian Journal of Medicine and Health, Page 1-5
DOI: 10.9734/AJMAH/2018/40490

Introduction: Tuberculosis (TB) is a chronic infectious disease that is preventable and curable, yet a major cause of childhood morbidity and mortality. Tuberculosis prevalence and mortality are under-estimated in many high burden countries. Directly Observed Treatment Short course (DOTS) enhances treatment outcome with an overall reduction in morbidity and development of multidrug resistant TB.

Objective: To determine the pattern and outcome of childhood tuberculosis managed at the DOTS clinic in Gusau, Nigeria.

Methodology: A retrospective study of children managed for TB at the DOTS clinic over a 30 months period. The clinic serves both children and adults. All children (≤ 18years) treated for tuberculosis over the study period were included. Relevant information from the register was retrieved and analysed accordingly. Treatment outcomes were assessed according to World Health Organisation (WHO) and National Tuberculosis and Leprosy Control Programme (NTLCP) guidelines. “Cured’’ and “treatment completed’’ outcomes were classified as treatment successful.

Results: Of the 415 patients managed, 76(18.3%) were children; males were 30(39.5.2%), with a M: F ratio of 1:1.5. Mean±SD age was 8.89±5.38 years, with 29(38.2%) being in the 0-5 years age group. Pulmonary TB (PTB) was seen in 58(76.3%), more females had pulmonary TB than males, which was not significant (χ2=1.350, p=0.245). Seventy-five (98.7) were new cases, with 1(1.3%) treatment after failure.

Acid-fast bacilli (AFB) were positive in 12(15.8%) while GeneXpert MTB/RIF sensitivity was detected in 7(9.2%). Majority 51(67.1%) completed treatment, 12(15.8%) were cured, 9(11.8%) were transferred out, 3(3.9%) died, while 1(1.3%) was lost to follow up; with the successful outcome of 82.9%.

Conclusion: Treatment outcome using DOTS strategy was excellent, with a success rate close to 85.0% of WHO benchmark. The proportion of childhood TB indicates that childhood TB as compared to the adult cases is still under diagnosed and undertreated.

Open Access Original Research Article

Dietary Pattern and Prevalence of High Blood Pressure among Adult Traders in Port Harcourt, Nigeria

G. O. Wordu, O. M. Akusu

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/AJMAH/2018/37430

High blood pressure is a diet related disease with high incidence of morbidity and mortality. Identification of its diet risk factors will inform intervention for its control. The thrust of this study was to determine the prevalence of hypertension among adult traders in Port Harcourt Local Government Area, Rivers state, Nigeria.  A descriptive cross-sectional study was carried out using a structured questionnaire among randomly selected 215 men and women who were adult traders in the creek road market. Informations obtained included the socio-economic characteristics, life style characteristics and food consumption pattern of the traders in creek road market, Port Harcourt. Anthropometric indices (height and weight) were measured to determine the body mass index (BMI).  Blood pressure values were also determined and classified according to World Health organization and international society of Hypertension classification. The statistical package for social sciences was used for data analysis. More than half (53.5%) of the respondents were men and 46.5% were female. The prevalence of hypertension was 50.3% for pre-hypertensive and prevalence of stage I and stage II hypertension were 18.5% and 11.1% respectively.  Hypertension was significantly higher (P < 0.05) in the male than in female respondents.  The mean body mass index (BMI) of the respondent was 26.6% and the prevalence of overweight and obesity was 23.6% and 21.4% respectively.

Conclusion: The study showed that hypertension and its associated factors, obesity and diet are still problem among the study population.  Adequate nutrition intake, physical activity should be encouraged through public education. 

Open Access Original Research Article

Seminal Analysis as a Tool to Determine the Infertility Prevalence among Men Reported to Infertility Clinic in Port Harcourt

K. I. Green, E. O. Nwachukwu

Asian Journal of Medicine and Health, Page 1-6
DOI: 10.9734/AJMAH/2018/38237

Objectives: The aim of this study was to determine the prevalence of male infertility among men that attended the infertility clinic of Green Care Medical Consultants, in Port Harcourt such that those with severe seminal parameters were referred for assisted conception.

Methods: A retrospective review of couples managed for infertility in this clinic was conducted. The case notes of couples managed for infertility over five years’ period between 1st January 2012 and 31st December 2016 were retrieved. Semen collection, processing and analysis were carried out as per WHO standards.

Results: The results of the semen analysis of 382 male partners of the infertile couples were retrieved and analyzed. The patterns of semen density noted in infertile males were normospermia, oligospermia and azoospermia, found in 52%, 46% and 3%, respectively. Morphological abnormalities (teratozoospermia) were observed in18.3% and motility abnormalities (asthenozoospermia) were found in 20.9%of the subjects. Other multiple abnormalities such as oligoteratozoospermia, asthenoteratozoospermia and oligoasthenozoospermia were seen in 2.9%, 3.9% and 3.9% of subjects respectively. Rig workers and older patients 50-59 years had the highest percentage of azoospermia found in 6.45%, and 4,55% of cases respectively. There was a high level of bacterial infections in oligospermic semen.

Conclusion: There is a high rate of abnormal semen quality of male partners of infertile couple in our environment and is an indication for the need to focus on the management of this condition and the institution of preventive program for male infertility.

Open Access Original Research Article

Evaluation of Hematological Parameter, Glycemic Status and Risk Factors Responsible for Neonatal Septicemia and Bacterial agents Causing Neonatal Sepsis in Chittagong, Bangladesh

Farhana Nasrin, Rashedul Hasan Chowdhury, Shahriar Ahmed, Major Kaiser Jahan, Mohammed Maruf-ul-Quader, Chowdhury Mohammad Monirul Hasan

Asian Journal of Medicine and Health, Page 1-13
DOI: 10.9734/AJMAH/2018/39613

This study was undertaken to assess haematological parameter, glucose status, the possible maternal and neonatal risk factors responsible for neonatal septicemia and the pattern of bacterial agents causing neonatal sepsis. Blood cultures were performed for 147 newborn babies (0-28 days) admitted into the hospital with a clinical diagnosis of neonatal sepsis where 66% were males, and 34% were females resulting in an overall male to female ratio of approximately 2:1. Among them, 57.1% neonates were presented with EONS, 42.9% with LONS and 21.8% were preterm. Approximately, 37.4% neonates with sepsis had low birth weight (< 2500 g), 6.8% had very low birth weight (< 1500 g). The most prevalent clinical features were reluctance to feed 56.5%, respiratory distress 36.7%, jaundice 19.7% and convulsion 15.0%. Among the 147 neonates, 8.2%  had high WBC count (>18,000/cm) and 2.0% had low WBC count (<5000/cm). Immature/total neutrophils ratio ≥0.16 and <0.16 was observed in 8.8% and 91.2% peripheral blood smear examined respectively. While 36.7% had neutropenia (<54%), 48.3% had higher (>62%) neutrophils. 23.8% neonates had low, and 76.2% had higher haemoglobin where 35.4% had higher C-reactive protein level. Out of 147 neonates 27.9% were hypoglycaemic (< 45 gm/dl) and 19.0% were hyperglycaemic (>140 gm/dl). Among the neonates with EONS, 40.5% were hypoglycaemic, and 17.9% were hyperglycaemic while with LONS, 11.1% were hypoglycaemic and 20.6% were hyperglycemic. As for the neonatal risk factors, A significant difference was found for C-reactive protein Levels (p<0.05) and neutrophils (p<0.05) between the culture positive and negative culture sepsis. However, 29.3% had positive blood culture for bacteria. Klebsiella spp. accounted for 13 (30.2%) of the total isolates followed by S. aureus 8 (18.6%). The Gram-positive and Gram negative bacteria accounted for 34.9% and 65.1% respectively.

Open Access Original Research Article

Implanon Implant Contraception at the University of Port Harcourt Teaching Hospital: A Periodic Review

E. O. Oranu, J. D. Ojule

Asian Journal of Medicine and Health, Page 1-6
DOI: 10.9734/AJMAH/2018/40017

Background: Implanon subdermal implant has been in use for contraception in our centre for over a decade; hence we decided to evaluate its usage so as to improve services.  

Objectives: To determine the acceptance, efficacy and side effects among users of Implanon in the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria

Methods: It is a 10 year longitudinal retrospective study of clients who accepted and used Implanon for contraception in the University of Port Harcourt Teaching Hospital, Southern Nigeria. The case files in the family planning clinic were retrieved and information on their biodata, source of information, complications and reason for removal were extracted. Data obtained was filled into a spread sheet, analyzed using statistical package for social sciences (SPSS) version 21.0 and presented in tables of frequencies and percentages.

Results: Of the 3,829 who accepted modern contraception in the period under review, 361 women chose Impanon giving an up take rate of 9.4%.  Their mean age was 32.1±7.1; most of them were multipara 340(94.2%) with a mean parity of 4.±5.3 while 346(95.7%) had secondary education and above. Irregular vaginal bleeding was the major complaint 73(86.9%) while the main reason for removal of the implant was desire for conception 87(48.6%). Pearl index was 0.003.

Conclusion: Implanon is a very effective and safe method of contraception with increasing acceptance in Port Harcourt, southern Nigeria.