Odontogenic tumours in children and adolescents: a study of 78 Nigerian cases.

BACKGROUND: There is paucity of literature on odontogenic tumours in children and adolescents. Available records are difficult to compare due to differences in study criteria. To contribute to the records, a 20-year study of odontogenic tumours on the basis of the WHO classification (Kramer et al., 1992) in Nigerian African children and adolescents < or =18 years of age was undertaken. MATERIAL: A retrospective survey of oral/jaw tumours and allied lesions in children and adolescents < or =18 years of age seen at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria between 1979 and 1998. Data collected were histopathologic type, age, clinical features, radiologic appearance, treatment and record of recurrence. METHOD: Odontogenic tumours selected using the WHO classification were used for further study. Data were collected from case notes, radiographs, histopathologic reports and follow-up records. Information retrieved was used to complete a questionnaire and subjected to analysis. RESULTS: Two hundred and fifty-two (252) subjects < or =18 years were recorded, from which 78 (31%) had odontogenic tumours. Among seven types of odontogenic tumours seen, ameloblastoma (54%), odontogenic myxoma (19%) and adenomatoid odontogenic tumour (9%) were predominant. All patients seen were from 6 to 18 years with more than half (53%) between 15 and 18 years of age. A patient with multiple, bilateral odontomas of the maxilla and mandible resembling Herrmann's syndrome was recorded. Seventy-three patients were treated using enucleation (37%), dentoalveolar resection with preservation of lower border (15%) and segmental resection (48%). Five patients absconded after tumour diagnosis. No tumour recurrence was recorded in 65 treated cases followed-up for between 2 months and 10 years. CONCLUSION: This report shows that while ameloblastoma was the predominant odontogenic tumour, its frequency in Nigerian African children was lower than in the adult population. A case resembling Herrmann's syndrome is also presented.     

Making health markets work better for poor people: the case of informal providers

There has been a dramatic spread of market relationships in many low- and middle-income countries. This spread has been much faster than the development of the institutional arrangements to influence the performance of health service providers. In many countries poor people obtain a large proportion of their outpatient medical care and drugs from informal providers working outside a regulatory framework, with deleterious consequences in terms of the safety and efficacy of treatment and its cost. Interventions that focus only on improving the knowledge of these providers have had limited impact. There is a considerable amount of experience in other sectors with interventions for improving the performance of markets that poor people use. This paper applies lessons from this experience to the issue of informal providers, drawing on the findings of studies in Bangladesh and Nigeria. These studies analyse the markets for informal health care services in terms of the sources of health-related knowledge for the providers, the livelihood strategies of these providers and the institutional arrangements within which they build and maintain their reputation. The paper concludes that there is a need to build a systematic understanding of these markets to support collaboration between key actors in building institutional arrangements that provide incentives for better performance.     

Effect of training programme on secondary schools teachers' knowledge and attitude towards reproductive health education in rural schools Ile-Ife, Nigeria

This study assessed the effect of training programme on teachers' knowledge of and attitude towards reproductive health education /sexuality education [RHE/SE] in five randomly selected rural schools in Ife-North local government area [IFLGA], Southwest, Nigeria.All the 84 teachers in the selected schools in the LGA were recruited for the study. They [84 teachers] were all given training in RHE/SE for one month. Their knowledge and attitude towards RHE/SE were assessed pre-and post-training programme. The results show a significant increase in percentage of those who had good knowledge in general areas of RHE/SE at post-training assessment compared with pre-training assessment[from 14.3% to 53.6%, p=0.0001].Also, pre-post attitudinal disposition assessments show that there was an increase in percentage of those who were favourably disposed to the teaching of RHE/SE in Nigeria Schools at post-training assessment [from 17.9% to 45.2%, p=0.0011].The study suggests that RHE/SE should be included and made compulsory in all training programme for all teachers in Nigeria.     

Silica-coated super paramagnetic iron oxide nanoparticles (SPION) as biocompatible contrast agent in biomedical photoacoustics

In this study, we report for the first time the use of silica-coated superparamagnetic iron oxide nanoparticles (SPION) as contrast agents in biomedical photoacoustic imaging. Using frequency-domain photoacoustic correlation (the photoacoustic radar), we investigated the effects of nanoparticle size, concentration and biological media (e.g. serum, sheep blood) on the photoacoustic response in turbid media. Maximum detection depth and the minimum measurable SPION concentration were determined experimentally. The nanoparticle-induced optical contrast ex vivo in dense muscular tissues (avian pectus and murine quadricept) was evaluated and the strong potential of silica-coated SPION as a possible photoacoustic contrast agents was demonstrated.OCIS codes: (170.5120) Photoacoustic imaging, (170.3880) Medical and biological imaging, (160.4236) Nanomaterials     

Peptide based enzyme-linked immunoassays for detection of anti-HSV-2 IgG in human sera

Glycoprotein G of HSV-2 (gG2) and a peptide, corresponding to a previously recognised immunodominant epitope spanning residues 561-578 of the protein, were compared directly for type-specific serodiagnosis of HSV-2. The protein was affinity purified and obtained in a commercially available EIA kit while the peptide, previously designated as peptide 55, was made as a multiple antigenic peptide. A panel of 100 characterised serum samples (60 HSV-2 positive, 20 HSV-1 positive and 20 HSV negative) was screened using the two antigens. The intact protein and peptide 55 showed the same sensitivity for antibodies in the serum of HSV-2 infected individuals, reacting with 96.7% (58/60) of the samples. The peptide did not react with any of the HSV-1 positive or HSV negative sera. In contrast, gG2 gave a number of false positive results, reacting with 20% (4/20) of the HSV-1 positive sera and 10% (2/20) of the HSV negative sera. The superior performance of peptide 55, together with the very much lower costs of its production, compared with gG2 suggest that the peptide will become the antigen of choice in enzyme immunoassays for type-specific serodiagnosis of HSV-2.     

The influence of cultural perception of causation, complications, and severity of childhood malaria on determinants of treatment and preventive pathways

A cluster sample of 2,052 mothers and other caregivers of children from southwest Nigeria was studied. Qualitative and quantitative methods of data collection were employed, including semi-structured questionnaires, focus groups, in-depth interviews, and parasitological investigation forms/blood smears. "Too much work" (17.7%) and "too much sun" (12.6%) were the two most-often mentioned causes of malaria. Malaria was not perceived as a serious disease. Convulsions and anemia are not perceived as complications of malaria and are preferentially treated by traditional healers. Fifty-eight and one-half percent of children with malaria were treated at home. Choice of drugs used was based on previous experience and advice from various members of the community. Fathers (53.5%) and mother (32.5%) decided on where ill children received treatment. Mothers (51.5%) paid for the drugs more often than fathers (44.6%). Symptoms described as "iba lasan," which means "ordinary fever," conform to the clinical case definition of malaria. Cultural practices that are likely to influence appropriate treatment-seeking include cultural perception of malaria as ordinary fever, wrong perceptions of severe malaria, and father's role as decision maker.     

Using "mother trainers" for malaria control: the Nigerian experience

Studies of care seeking in Nigeria show that a tremendous amount of treatment for malaria takes place at home and, in most instances, such treatments are incorrect. This deficiency is attributed to caregivers' poor knowledge of treatment. This study was designed to empower households to treat malaria correctly in partnership with community members. Selected mothers from study communities were trained as "mother trainers" and were expected to train other members of their communities using a treatment protocol. "Mother trainers" were acceptable to most communities and judged to be effective. They were enthusiastic and their participation in the study boosted their ego and status in the community. Drop-out-rate of "mother trainers" was 24.2%. A few limitations to the use of mothers as trainers that were identified are discussed. It is concluded that mothers have good potential to effectively carry out health education activities in the community if appropriately selected, trained, and supervised.