Abundance and diversity of Anopheles species (Diptera: Culicidae) associated with malaria transmission in human dwellings in rural and urban communities in Oyo State, Southwestern Nigeria

Mosquito samples were collected from rural and urban communities in three selected major towns in Southwestern Nigeria to determine the impact of urbanization on the diversity and abundance of Anopheles species associated with malaria transmission in human habitations. A total of ten Anopheles species were identified in the rural communities, while eight Anopheles species were identified in the urban communities. Out of the ten Anopheles species identified, only four species, Anopheles gambiae (Giles), Anopheles funestus (Giles), Anopheles moucheti (Evans), and Anopheles nili (Theobald), were established to be vectors of malaria occurring in greater than 50 % of the rural communities. Only A. gambiae occurred in all the urban communities, while the other three major vectors occurred in not more than 20 % of the urban communities. Margalef's and Shannon–Wiener indices showed that diversity and species richness were higher in the rural compared to the urban. Comprehensive information on malaria vector abundance and diversity in rapidly changing communities is an important tool in planning and implementing successful vector control programs.     

Breaking the poverty/malnutrition cycle in Africa and the Middle East

The cost to developing countries, for current and future generations, of not eradicating hunger and poverty – in terms of recurrent conflicts and emergencies, widening inequalities, depleted resources, ill health, and premature death – is enormous. Although strategies are underway to address certain problems in Africa and the Middle East, much remains to be done. Breaking the poverty cycle in these regions demands both local and international attention. Nutrition transition is a key factor, since many countries in the region also suffer the consequences of the excessive and unbalanced diets that are typical of developed countries. This paper reviews the experiences with facing malnutrition in Sub-Saharan and North Africa and the Middle East.     

Prevalence and impact of disability and sexual dysfunction on Health-Related Quality of Life of Nigerian stroke survivors

Purpose: To investigate the impact of disability and sexual dysfunction on Health-Related Quality of Life (HRQoL) among Nigerian stroke survivors (SSv) and to determine their association using sexual functioning (SF), Global Disability Measure and Function (GDMF), and demographic profiles.

Methods: This study involved 121 consecutive SSv attending healthcare services in two tertiary health facilities in Nigeria. Demographic details were obtained through interview while HRQoL, SF, and Global Disability (GD) were assessed using Stroke-Specific Quality of Life (SS-QoL-12), Changes in Sexual Functioning Questionnaire (CSFQ-14), and World Health Organization Disability Assessment Schedule (WHODAS-2.0), respectively. Determinants of HRQoL were explored using the Poisson regression analysis.

Results: Most of the SSv had moderate/severe GD (95%) and low SF (86.8%). Their HRQoL decreased with increase in their age (p?=?0.005) and with increase in GD (p?=?0.001). This association remained unchanged even when adjusted for SF (p?=?0.001). Those with low SF but with mild GD had relatively better HRQoL than those with moderate/severe GD even when they had higher SF. Their HRQoL was negatively impacted by their GD but not by their SF despite direct correlation between SF and HRQoL. With a unit increase in level of GD, there was 8% decrease in HRQoL scores in psychosocial and 17% decrease in physical domains.

Conclusion: Although sexual dysfunction and global disability are prevalent among Nigerian SSv, their low HRQoL is determined by their disability and not by SF. Hence, effort at reducing global disability should be the focus of rehabilitation after stroke.

• Implication for Rehabilitation

• Global functional and sexual deficiencies abound in stroke survivors and they impact negatively on their overall quality of life.

• Sexual dysfunction correlates negatively on physical and psychosocial wellbeing of stroke survivors.

• Rehabilitation goal(s) should focus disability reduction and improvement of sexual functioning to enhance quality of life.

• Rehabilitation professionals should equip themselves with tools to counsel stroke survivors on sex issue since sexual dysfunction is common post stroke.

     

Predictability of physical activity and bodyweight on health-related quality of life amongst Nigerian type 2 diabetes mellitus

Physical inactivity and adiposity had been shown to increase the risk and progression of diabetes mellitus whilst combined effect on health-related quality of life (HRQoL) amongst type 2 diabetes mellitus (T2DM) patients has not been highlighted. This study examined the impact of physical activity (PA) and body weight on HRQoL amongst T2DM. Amongst a cross-section of 119 participants, PA was assessed using the long form of the International Physical Activity Questionnaire and categorized as physically active or inactive. Their body weight and height were assessed whilst their HRQoL was assessed with the Short Form-36 Questionnaire. The t test, Pearson’s correlation and regression analyses were performed. About 69 % of the participants were physically active whilst 61.8 % were overweight or obese. Role limitation due to physical health (RLDPHP) and role limitation due to emotional problems (RLDEP) were the worst affected domains of HRQoL. The HRQoL decreases in all domains with increasing bodyweight. The HRQoL of physically active participants were better than for physically inactive in all domains of the HRQoL scale. The effects of PA persisted on HRQoL when adjusted for bodyweight. Though HRQoL scores were better amongst physically active participants in all domains of normal weight and overweight/obese group, PA showed significant correlation with HRQoL in all domains except in emotional well-being, RLDEP and pain domains. Regression models showed that PA remains a significant predictor of HRQoL. This study affirms that physically active participants have better HRQoL than inactive patients, regardless of their bodyweight.     

Pill-induced esophageal injury

We report four cases of esophageal injury associated with the ingestion of commonly prescribed tablets or capsules. History and clinical characteristics of these cases suggest that the medications failed to transit the esophagus and acted locally to produce esophagitis. A search of English- and foreign-language medical journals documented 221 similar cases due to 26 different types of medication. While most of these esophageal injuries are self-limited and produce no morbidity beyond transient retrosternal pain, odynophagia, and dysphagia, major complications have occurred, such as mediastinal penetration, hemorrhage, and death. Patients should be counseled to take pills in an upright posture with liberal amounts of fluid well before retiring for the night.     

PSYCHOSOCIAL AND CULTURAL FACTORS ASSOCIATED WITH THE MANAGEMENT OF SPINA BIFIDA CYSTICA IN NIGERIA

A prospective study of the psychosocial and cultural factors influencing the management of spina bifida cystica was carried out on Nigerian children (48 males, 28 females) seen at the University College Hospital, Ibadan, between January 1982 and December 1983. The parents of 74 of the 76 children had never heard of the disease, many had no idea of its causation and one-third incriminated witchcraft. Of primary concern was the cyst on the back. The better-educated parents tended to demand surgical treatment more than the illiterate parents. 22 children were treated surgically. The default rate was high because parents failed to get the expected hospital treatment. Most mothers showed relief rather than remorse on the death of their child.     

Risk factors for malnutrition among rural Nigerian children

Protein Energy Malnutrition (PEM) remains a major public health problem in the developing world. The aim of this study was to determine the current nutritional status and the influence of feeding practices and family characteristics on the nutritional status of under-five rural Nigerian children. It was conducted using a cross sectional, community based survey design. From 344 households, 420 children were studied. Using the modified Wellcome Classification, the prevalence of PEM was 20.5 percent whereas the prevalence of underweight, wasting and stunting using the World Health Organization/ National Centre for Health Statistics (WHO/NCHS) standards were 23.1 percent, 9 percent and 26.7 percent respectively. Young age was significantly associated with a higher prevalence of underweight (P = 0.004). Overcrowding, low maternal income and the use of infant formula feeds in children who have attained the age of 6 months and above were associated with a higher prevalence of wasting (P = 0.029, P = 0.031 and P = 0.005 respectively). Improved living standard of families, empowerment of mothers with the aim of augmenting family income and parental education on appropriate feeding practices may help in reducing the incidence of under-five malnutrition in communities. The low prevalence rate of malnutrition was probably due to activities of the NGO in this community. This method of intervention is similarly achievable in any other community.