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   2018| January-June  | Volume 16 | Issue 1  
    Online since January 22, 2018

 
 
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ORIGINAL ARTICLES
Blood pressure pattern among adults in Lagos: Analysis of data from public health screenings
Babawale Taslim Bello, Yemi Raheem Raji, Christiana Oluwatoyin Amira, Rotimi William Braimoh, Olamide Olutosin Olowoyo, Babatunde Abdulmajeed Akodu
January-June 2018, 16(1):10-14
DOI:10.4103/NJGP.NJGP_20_17  
Background: Knowledge of the pattern of blood pressure (BP) in a population is useful in documenting within-population differences in hypertension prevalence as well as identifying groups at increased risk of complications. Materials and Methods: BP data obtained from 1061 participants in population screenings carried out in five local government areas within Lagos were analyzed. BPs were measured in both arms with individuals seated and the limb supported on a table by medical interns using a mercury sphygmomanometer. The higher of the two recordings was taken as the patient's BP. Results: The study population was made up of 54.5% females with an overall mean age of 39.2 ± 15.0 years and a range of 18–84 years. Mean systolic and diastolic BPs increased significantly and progressively with age in both male and female participants. BP was elevated in 35.6% of the study population with 48.3% of those having moderate-to-severely elevated BP. The prevalence of elevated BP increased with age; however, there was no significant difference in the prevalence of elevated BP between male and female participants. Between 11% and 20% of individuals aged 18–29 years had elevated BP, with the proportion being much higher among males than females. Conclusion: The study provides further evidence supporting the fact that hypertension is highly prevalent, is severe, and may have an onset earlier in life among African populations. There is need to institute polices focused on prevention, early detection, and prompt treatment of hypertension.
  6,085 478 1
Review of twin deliveries and fetomaternal outcomes in a Tertiary Hospital in Lagos, Southwest Nigeria
Kehinde Sharafadeen Okunade, Ebunoluwa Daramola, Muis Adenekan, Adebayo Sekumade, Adegbenga Ajepe, Gbemisola Eniola Osanyin
January-June 2018, 16(1):6-9
DOI:10.4103/NJGP.NJGP_19_17  
Background: Twin pregnancies make up the greater majority of multiple pregnancies and are associated with significantly high maternal and perinatal morbidity and mortality. Objectives: The objective of the study was to determine the rate and fetomaternal outcome of twin deliveries at the Lagos University Teaching Hospital (LUTH). Methodology: This was a 5-year review of twin deliveries conducted at LUTH between January 1, 2010, and December 31, 2014. The case notes of all women who had twin deliveries during the study period were retrieved from the Medical Records Department and the relevant information extracted. The data were analyzed and then presented in simple descriptive statistics using tables and charts. Results: The rate of twin pregnancies was 1 in 28.4 deliveries. The mean age of the studied women was 35.4 ± 9.7 years, with majority (80.9%) being either primi- or multipara and 50% belonging to the Yoruba ethnic group. The most common mode of delivery was cesarean section with a mean gestational age at delivery of 34.7 ± 0.6 weeks and mean birth weight of 2.05 ± 0.4 kg. The stillbirth rate was 24 per 1000 total births, while the maternal mortality ratio was 1114 per 100,000 live births. Conclusion: The rate of twin pregnancies and its attendant adverse fetomaternal outcomes still remain high in our environment. Multiparity and belonging to the Yoruba ethnic group are the two most important risk factors.
  4,989 410 -
Communication preferences for human papillomavirus and other health information in Gwagwalada, Federal Capital Territory, Nigeria
Mustapha Abubakar Jamda, Obiageli E Nnodu, Lovett Lawson, Rabi Susan Adelaiye, Andrew E Zamani
January-June 2018, 16(1):1-5
DOI:10.4103/NJGP.NJGP_16_17  
Introduction: Primary prevention of infection-associated cancers such as cervical cancer includes deployment and acceptance of vaccines, which is centered on educating people, intervention program designs, and community inputs. Such health promotion programs in Africa have suffered setbacks through inadequate attention to the peculiarities of context. It is, therefore, important to ascertain available health communication resources and preferences. Objective: The objective of this study is to ascertain the knowledge of human papillomavirus (HPV) and cervical cancer, sources and communication preferences of health communication among the respondents. Methods: Four hundred 15–45-year-old patients, were selected by random sampling technique. A questionnaire was used to document their biodata, knowledge of HPV and cervical cancer, and health communication resources and preferences. Focus group discussions (FGD) was used to supplement the quantitative data. Results: The knowledge of HPV and cervical cancer was poor compared to 60% for HIV/AIDs. HPV was not considered sexually transmitted by the majority of respondents. The FGD revealed misconceptions that included HPV infection as “punishment from God,” “spiritual attacks from enemies,” “possibility of transmission through inheritance, poor hygiene, or mosquito bite.” The preferred channel of health communication about HPV and cervical cancer was through religious associations, 30%; electronic media, 28.5%; traditional rulers, 12.2% and social clubs/ethnic associations, 11.5%. The respondents recommended the use of communal methods such as town crier, ethnic associations, and traditional leaders for health communication. Conclusion: Respondents had poor knowledge of HPV and cervical cancer. Context tailored intervention programs, using their preferred means of health communication could improve knowledge and practice toward these conditions.
  4,094 350 1
The uptake of cervical cancer control services at a cancer information service center in Lagos, Nigeria
Kehinde Sharafadeen Okunade, Omolola Salako, Muis Adenekan, Oyebola Sunmonu, Kahmil Salawu, Adebayo Sekumade, Ebunoluwa Daramola, Gbemisola Eniola Osanyin
January-June 2018, 16(1):20-24
DOI:10.4103/NJGP.NJGP_21_17  
Background: There is currently an increase in the incidence of cervical cancer in Nigeria and cancer information service (CIS) is now assuming an emerging role in cervical cancer control. Objectives: The objective of this study is to assess the uptake of the CIS program and also determine the rate of positive screening using visual inspection with acetic acid (VIA) as a screening modality among the female CIS users in Lagos. Materials and Methods: This was a cross-sectional study carried out over a period of 1 year (January to December 2015), using a health communications program (mHealth). An initial period of public awareness was carried out over a 3-month period after which members of the public were encouraged to call the cervical cancer helplines. Cervical cancer information was provided by the callers and data were recorded by information specialists during the study. Data analyses were carried out using Epi info version 7.2 and descriptive statistics were computed for all data. Association between outcome of VIA screening and previous cervical screening were tested using the Fisher's exact test. Statistically significant result was reported at P < 0.05. Results: An average of 33 calls per month, equivalent to 4.4 per 100,000 population in Lagos state, was received during the study. Of the callers referred for screening, only 16 out of the 301 (5.3%) that presented had positive VIA test. There was about 1.9 fold risk of testing positive to VIA screening among the previously unscreened women compared to those with previous cervical screenings (crude odd ratio – 1.87, 95% confidence interval – 0.99–3.05, P= 0.116). Conclusion: There is a significantly low uptake of the CIS in Lagos, and there is an even lower practice of cervical cancer screenings among the CIS callers. However, the rapid growth of mobile phone use in Nigeria still presents a unique opportunity that can be explored to improve cancer care.
  3,988 293 1
Determinants of dental caries among pensioners in Port Harcourt, Rivers State, Nigeria
Omoigberai Bashiru Braimoh, Alezi Braimoh Ifindon Eroje
January-June 2018, 16(1):15-19
DOI:10.4103/NJGP.NJGP_18_17  
Background and Aim: Data on oral health of the elderly are uncommon in the South-South region of Nigeria. The purpose of this research was to find the relationship between dental caries and oral health knowledge, attitude, behavior, and oral hygiene status of the pensioners in Port Harcourt, Rivers State. Materials and Methods: The research was a correlational study. A total of 543 pensioners were selected by systematic random sampling. Data were collected with a self-developed Oral Health Assessment Questionnaire designed in five sections (A-E) and analyzed using SPSS version 20 (IBM SPSS Armonk, New York, USA). Relationship between variables was established using simple and multiple regressions. Significance was determined at 0.05 alpha level. Results: The mean knowledge, attitude, and behavior scores were 12.23, 27.61, and 8.76, respectively. Whereas oral health knowledge accounted for 11.56% (R2 = 0.1156) of the variance in the pensioners' dental caries status, oral health attitude and behavior, respectively, accounted for 39.69% (R2 = 0.3969) and 27.04% (R2 = 0.2704) of the variance in the pensioners' dental caries status. Oral hygiene accounted for 33.64% (R2 = 0.3364) of the variances in the dental caries status of the pensioners. Conclusion: This study found a low and negative nonsignificant correlation between dental caries and oral health knowledge, a moderate and negative nonsignificant correlation between dental caries and oral health attitude, and a moderate and negative significant correlation between oral health behavior and dental caries. Similarly, oral hygiene level of the pensioners was moderately and significantly correlated to dental caries.
  3,829 284 -
Prevalence of bacteremia among febrile children with severe malnutrition in North Western Nigeria
Umma Abdullahi Idris, Wammanda D Robinson, Jamilu A Faruk, Garba Dayyabu Gwarzo
January-June 2018, 16(1):25-29
DOI:10.4103/NJGP.NJGP_6_17  
Background: Malnutrition affects many children in Africa predisposing them to infection especially bacterial. Although malnutrition is highly prevalent among Nigerian children little is known about bacterial infection which is believed to adversely affect their outcome. Materials and Methods: This was a cross-sectional study. Ninety febrile children with severe Protein Energy Malnutrition aged 6–59-month based on modified wellcome classification were enrolled as individuals and; 90 febrile well-nourished children age- and sex-matched as controls. It was conducted at the emergency pediatrics unit of Aminu Kano Teaching Hospital from May to October 2013. Bacteremia was diagnosed using automated BACTEC method and Kirby-Bauer disk diffusion technique was used for antibiotic sensitivity. Results: Bacteremia occurred in 45.6% of the individuals which was significantly higher than 23.3% in the control group (odds ratio = 2.56, confidence interval = 1.45–5.22). Staphylococcus aureus(41.5%), Escherichia coli (17.1%), and Salmonella typhi (12.2%) were the most frequent isolates in the individuals. 87.8% of the isolates in the individuals were sensitive to ciprofloxacin, 85% to ceftriaxone, 51% to gentamicin, but very low sensitivity to amoxicillin (22%) and cotrimoxazole (12.1%). Conclusion: Bacteremia is highly prevalent among the malnourished children and the commonest isolate was S. aureus. The isolates were most sensitive to ciprofloxacin and ceftriaxone.
  3,693 336 3
CASE REPORTS
A case report of ipsilateral multiple long bone fractures with a floating knee complicated by compartment syndrome: A single-theater session, a panacea for early mobilization and rehabilitation
Thaddeus Chika Agu
January-June 2018, 16(1):32-35
DOI:10.4103/NJGP.NJGP_22_17  
An ipsilateral femoral and segmental tibial fracture with floating knee is a complex injury that could occur following a fall from height and a compartment syndrome further complicates it. This report highlights the need for the availability of ready implant pack for the emergency surgical management of a complex injury in a single-theater session. A 15-year-old male presented to our level II surgical facility after a fall from the balcony of the 5th floor of a storey building. Clinical evidence of fractures of the left femur and tibia associated with flail knee was noted in addition to early features of compartment syndrome of the leg. Fasciotomy as well as internal fixations of the fractures followed by a quick, uneventful recovery was performed. The severity and type of injuries sustained from accidental falls from heights depend on the height of fall, the pattern of landing, and the hardness of the impact surface. Fractures associated with floating knee and compartment syndrome should be treated as surgical emergency, and the availability of a ready implant pack is absolutely necessary for full intervention in one theater session. Emergency combination of fasciotomy and internal fixation of fractures in floating knee ensures early mobilization and reduces the length of hospital stay.
  3,161 248 -
An unusual foreign object in a tooth
Treville Pereira, Subraj Shetty
January-June 2018, 16(1):30-31
DOI:10.4103/NJGP.NJGP_17_17  
In dental practice, discovery of a foreign body entrapped within the root canal is not uncommon. The foreign object may have been accidently lodged due to traumatic injury, iatrogenically during treatment or it may be a self-inflicted injury. The patient usually reports only when he/she experiences pain and then the foreign object is discovered in radiographic examination. In this article, we present a case report of a 43-year-old woman with a staple pin lodged in a permanent maxillary first molar.
  3,107 236 1
LETTER TO EDITOR
Employing digital technology to strengthen public health services in African region
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
January-June 2018, 16(1):36-37
DOI:10.4103/NJGP.NJGP_23_17  
  2,557 220 1