Annals of African Medicine
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  Citation statistics : Table of Contents
   2007| September  | Volume 6 | Issue 3  
    Online since October 9, 2009

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Awareness and uptake of cervical cancer screening in Owerri, South-Eastern Nigeria
BU Ezem
September 2007, 6(3):94-98
DOI:10.4103/1596-3519.55727  PMID:18240495
Background : Cancer of the cervix is the most common cancer of the female genital tract and accounts for about two hundred and fifty thousand deaths yearly most of which occur in the developing countries. It has assumed greater prominence with the decrease in deaths due to infective causes and the increase in the incidence of HIV/AIDS which is a predisposing factor. A significant drop in its incidence has been recorded in the developed countries as a result of intensive program of cervical screening. This study determines the level of awareness and uptake of cervical screening in Owerri, South Eastern part of Nigeria. Method : This is a cross sectional study in which self administered questionnaires returned by eight hundred and forty six respondents were analysed using simple percentages. Results : The level of awareness of cervical screening was 52.8 %( 447), while 7.1 %( 60) had ever done the test. The major sources of information about cervical smear were hospital /health facilities (31.3%) and friends (30.9%).The most common reasons given for not doing the test were lack of awareness 390(46.1%),no need for it 106( 12.5%) and fear of a bad result 98(11.6%). Conclusion : The level of awareness of cervical screening is low and worse still, is the level of uptake at the present level of uptake no significant impact will be made on the incidence of cervical cancer which needs to be reduced. A national cervical smear screening policy is advocated but in the interim, greater public education and the greater use of opportunistic screening by physicians should be vigorously pursued.
  36 19,301 119
Parasitic contamination of vegetables in Jos, Nigeria
JG Damen, EB Banwat, DZ Egah, JA Allanana
September 2007, 6(3):115-118
DOI:10.4103/1596-3519.55723  PMID:18240499
Background : Intestinal parasites are very common in developing countries including Nigeria. There are diverse ways of their transmission; the study attempts to determine the level of intestinal parasitic contamination on vegetables sold in Jos. Methods : Sample of 200 each of Tomatoes (Lycopersium sativus), Letus (Loctus satival) Carrot (Davcus carota L) Cabbage (Brassica Denceal) and Green leafy vegetables were analyzed using standardized Centrifugal-floatation technique methods. Results : Of the 1250 samples of vegetables examined, 450 (36.0%) were positive for intestinal parasites, cabbage recorded the highest prevalence of 64% while tomatoes had the least prevalence of 20%. Conclusion : Vegetables in Jos are heavily contaminated with intestinal parasites and there is need for public enlightenment campaign on the danger of consuming inadequately washed and prepared vegetables.
  31 23,822 111
Knowledge, attitude and practice of school health programme among head teachers of primary schools in Egor local government area of Edo state, Nigeria
GE Ofovwe, AN Ofili
September 2007, 6(3):99-103
DOI:10.4103/1596-3519.55726  PMID:18240496
Background : School health program (SHP) is an important component of the overall health care delivery system of any country. In developing countries such as Nigeria where infant and early childhood mortality is high its importance cannot be overemphasized. For this reason and the recent action plan of the Federal Government of Nigeria concerning SHP, the knowledge, attitude and practice of SHP among head teachers of primary schools in a Local Government Area in Nigeria was evaluated. Methods : A pre-tested questionnaire designed to evaluate the knowledge attitude and practice of SHP by the researchers was administered by assistants to 133 head teachers of 104 private and 29 public primary schools in Egor Local Government Area of Edo State, Nigeria. The School premises were also inspected to check provision of pipe borne water, sick bay, toilet facilities and the adequacy of the school environments among other things. Results :None of the head teachers had adequate knowledge of SHP. 93.1% from private compared to 48.3% from public schools had poor knowledge of SHP (χ2 = 56.86, p < 0.05). A favorable attitude was demonstrated by all the teachers. Up to 40.4% of private compared to 31.0% of public schools have SHP. Overall 27.7% of the schools had no toilet facility, 33.3% had pit latrine while 40.0% had water closet. Only 25.6% had hand washing facilities. Regarding health services, 51.0% of private schools compared to 27.6% of public schools perform medical inspection of the pupils. Similarly 39.4% private compared to 3.4% public schools have sick bay (χ2 = 11.11; p < 0.05). A total of 16.5% of the schools undertake medical screening of food handlers/vendors, while 20.2% private compared to 3.4% public schools screen food handlers/vendors (χ2 = 4.47; p < 0.05). Conclusion : The poor status of SHP in Nigeria may be attributed to failure of policy enunciation, poor primary health care base and lack of supervision.
  11 20,668 116
Ophthalmic manifestations of lymphoma
AE Omoti, CE Omoti
September 2007, 6(3):89-93
DOI:10.4103/1596-3519.55728  PMID:18240494
Background : Ophthalmic involvement in lymphoma is a relatively rare condition that can result from a primary intraocular lymphoma or an intraocular manifestation of systemic lymphoma. This report reviews the ophthalmic manifestations of lymphoma. Methods : Review of relevant information from journal articles and Internet search. Results : Almost all the structures in the orbit, adnexiae and eye can be involved in lymphoma. Lymphoma of the eye and adnexiae are most frequently of B lineage. Most of the ocular manifestations frequently masquerade as other more benign intraocular conditions including allergic or infectious conjunctivitis, uveitis, multiple evanescent white dot syndrome, acute retinal necrosis or herpetic retinitis. Correct diagnosis thus depends on a high index of suspicion and frequently requires radiologic imaging, histologic analysis, particularly vitreous biopsy or flow cytometry, subretinal aspiration and retinal biopsy. Diagnosis is often delayed and may lead to a fatal outcome. Recognition of its modes of presentation facilitates early diagnosis and treatment that may improve prognosis. Conclusions : It is important to review the ocular manifestations of lymphoma to assist the ophthalmologist to play a pivotal role in the prompt diagnosis and treatment of ocular lymphoma, and the haematologist/oncologist to recognize the need for a complete ophthalmic evaluation in the diagnosis, follow-up and management of lymphoma patients.
  9 6,992 187
Community perspective of maternal mortality: Experience from Konduga local government area, Borno state, Nigeria
MB Kawuwa, AG Mairiga, HA Usman
September 2007, 6(3):109-114
DOI:10.4103/1596-3519.55724  PMID:18240498
Background / objective : High maternal mortality in Nigeria in particular and Sub-Saharan Africa in general has remained one of the key indicators of our poor health care services, infrastructural facilities and negative socio-cultural attitudes to healthy living. The objective is to identify barriers to prompt and effective treatment of obstetric complications leading to maternal mortality in order to develop appropriate strategies to address them at the community level. Method : The study took place between 10th October and 10th December 2003. An in-depth interview guide developed by the network for the prevention of maternal mortality (NPMM), which contains mainly open ended questions, modified to suit our socio-cultural setting was used. Results : There was a good understanding among the people of the area that women are dying during pregnancy, labour and puerperium. 28(93.3%) of the respondents recognized some obstetric complications. The main obstacles to accessing the hospital for emergency obstetric care were lack of money and transportation difficulties. Equipping the health facilities, employment of qualified staff, community supported emergency funds for obstetric emergency and the provision of reliable, effective and affordable transport are identified as necessary measures to prevent maternal mortality. The Local Government Areas and community leaders are to champion the cause for the provision of these facilities in their localities. Conclusion : There is a good understanding of obstetric complications in the community leading to maternal death. The main reasons for delay in seeking care are ignorance, poverty, lack of transportation and distance. Community enlightenment, health education, training of TBAs, poverty reduction and effective, affordable and reliable transportation are means of obviating delays in the decision and transportation leading to maternal mortality. Upgrading and re-equipping of health facilities to provide emergency obstetric care services are mandatory. Community participation in the safe motherhood drive can be ensured using the traditional rulers, religious leaders and the Local Government Authority.
  8 4,776 84
Evaluation of serum lipid profile of under-five Nigerian children
SA Akuyam, HS Isah, WN Ogala
September 2007, 6(3):119-123
DOI:10.4103/1596-3519.55722  PMID:18240500
Background : Serum lipid profile assay forms one of the special investigations in most chemical pathology laboratories worldwide. Several studies in children from different countries have shown that serum lipids exhibit age and geographical pattern of variation prior to puberty. This study was conducted to evaluate serum lipid profile in Nigerian children aged 6 to 36 months. Methods : A total of 115 randomly selected apparently healthy children were studied. These consisted of 38, 40 and 37 children in groups I (6 to 12 months), II (13 to 24 months) and III (25 to 36 months) respectively. There were 60 male and 55 female children. Serum concentrations of total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG) were measured by enzymatic colorimetric method using reagent kits supplied by Human, Gesel Für Biochemica Und Diagnostica mbH (Wiesbaden, Germany). Serum low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) were subsequently estimated using Friedewald formula. Results : The reference ranges and (Mean ± SEM) of serum TC, LDL-C, HDL-C, TG, VLDL-C and TC/HDL-C for the total group of children were 1.55-5.42(2.89±0.12),0.50-3.29(1.28 ± 0.15), 0.45-2.77(1.12 ± 0.14), 0.93-3.43(0.79 ± 0.14), 0.17-0.72(0.35 ± 0.14) mmol/L and 1.01-4.74(2.19 ± 0.13) respectively. There were no sex differences in all these parameters. Serum levels of TC, LDL-C, HDL-C and TC/HDL-C in the 3 age groups were also statistically similar (p>0.05). Concentrations of TG and VLDL-C were lower (p<0.001) in group II than in I. These values were also significantly lower (p<0.02) in group III than in I. Serum TG and VLDL-C in groups II and III were statistically comparable (p>0.05). Conclusion :Serum concentrations of TC, TG and VLDL-C decrease with advancing age, with more marked decrease between first and second years of life. We hereby recommend that the reference values established in this study be utilized for the interpretation of serum lipid results in pre-school children in Nigerian hospitals and possibly elsewhere in Africa.
  5 4,128 86
Recommendations for early diagnosis of chronic kidney disease
IB Bosan
September 2007, 6(3):130-136
DOI:10.4103/1596-3519.55719  PMID:18240503
Background : Chronic kidney disease is an important component of chronic non&#8211; communicable diseases that are now of pandemic proportions and are the major cause of morbidity and mortality worldwide. Patients with reduced renal function represent a population not only at risk for progression of kidney disease and development of end stage renal disease (ESRD), but also at a greater risk of cardiovascular disease and mortality. Unfortunately, chronic kidney disease is under diagnosed and undetected resulting in lost opportunities for improving the clinical outcome. Early diagnosis with appropriate interventions will improve the quality of care of patients and prevent or delay progression to end stage renal disease. Our objective is to review existing recommendations and examine their adaptation to improving the quality of care for patients with chronic kidney disease in our environment. Method : Hand searches of published articles and electronic data were the primary sources. Only articles published in the English language were consulted excluding case reports, letters and conference abstracts. Articles of original data were searched from 1980 while review articles and expert committee reports were from 2000. Results : Early diagnosis of chronic kidney disease is crucial to improving the clinical outcome and reducing the incidence of end stage renal disease. Certain individuals with specific socio demographic and clinical factors are at increased risk of chronic renal disease. All individuals should be assessed as part of routine health encounter, to determine whether they are at increased risk of developing chronic kidney disease based on clinical and socio demographic factors. Individuals at increased risk of developing chronic kidney disease should undergo testing for markers of kidney damage, and to estimate the level of GFR.Individuals found to have chronic kidney disease should be evaluated and treated appropriately. A clinical action plan should be developed for each patient based on the type and stage of renal disease, co-morbid conditions, complications of the disease and risk factors for progression of renal disease or development of cardiovascular disease. Conclusion : Individuals at increased risk, but found not to have chronic kidney disease, should be advised to follow of risk factor reduction, if appropriate, and undergo repeat periodic evaluation.
  5 4,184 141
Foetal chondrodysplasia: Intrauterine diagnosis
AG Adesiyun, A Eka, MOA Samaila
September 2007, 6(3):128-129
DOI:10.4103/1596-3519.55720  PMID:18240502
Chondrodysplasias are rare occurrence. We present a case of short-limbed chondrodyplasia diagnosed in a 22 week fetus of a 28 year old. She was para 4+0 with two children alive. She had similar occurrences in her last two pregnancies. The index pregnancy and the last two eventful pregnancies were preceded with ingestion of trado-herbal drug to treat subfertility.
  3 2,629 42
Pathology of peripheral lymph node biopsies in Kano, Northern Nigeria
O Ochicha, ST Edino, AZ Mohammed, AB Umar, AT Atanda
September 2007, 6(3):104-108
DOI:10.4103/1596-3519.55725  PMID:18240497
Background : Lymphadenopathy is a common clinical problem here in Kano, Northern Nigeria but there has been no formal study. We therefore undertook this review to evaluate the pattern in our locality. Method : This is a seven-year (1998-2004) retrospective review of all histologically diagnosed lymph node biopsies received at Aminu Kano Teaching Hospital, Kano. Results : Cervical, axillary and inguinal nodes were the most frequently biopsied accounting for 46%, 23% and 13%, while tuberculosis, lymphomas and metastases were the most commonly diagnosed lesions comprising 30%, 24% and 19% respectively. In general, benign lesions were more common constituting 57% of nodal biopsies. Lymphadenopathy was observed to be most prevalent in the first three decades. Conclusion : Our findings were broadly similar to most other Nigerian studies and slightly at variance with other African countries but significantly different from the Western World. The limitations of lymph node histopathology in the absence of modern molecular diagnostic techniques are highlighted.
  3 4,675 60
Sexual and family planning practices and needs of people living with HIV/AIDS in Nigeria: A rapid ethnographic assessment
SB Garko
September 2007, 6(3):124-127
DOI:10.4103/1596-3519.55721  PMID:18240501
Background : This study was conducted among people living with HIV/AIDS (PLWHAs) and it tries to understand their sexual and reproductive lives, with the aim of understanding what they know about reproductive health, social challenges of life they face daily and what are their needs. Method : The study was conducted in the Northern state of Kaduna, Nigeria; a qualitative approach was employed using group interviews, in-depth interviews and focus group discussions. Individual PLWHAs, their associations and officials of the associations were interviewed. Results : People living with HIV/AIDS ( PLWHAs) are a group of people whose life has not been studied very well, they have a lot of pressing social issues such as their circumstances of diagnosis, bad experiences following the diagnosis, and lack of adequate provisions for their healthcare. They wish to see their welfare addressed with provision of drugs and social support. Conclusion : PLWHAs and their associations expressed concerns about how they are treated by both medical workers and the society. There is need to address these issues in the way of research aimed at changing the views of policy makers favourably.
  1 3,556 80