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   2018| April-June  | Volume 21 | Issue 2  
    Online since July 6, 2018

 
 
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ORIGINAL ARTICLES
Cold chain management: An assessment of knowledge and attitude of health workers in primary health-care facilities in Edo State Nigeria
Esohe Olivia Ogboghodo, Vivian Ossaidiom Omuemu, Oisedebame Odijie, Ofure Jennifer Odaman
April-June 2018, 21(2):75-82
DOI:10.4103/smj.smj_45_17  
Background: The use of vaccination to prevent diseases is the greatest public health success of the last century. Due to the sensitive and labile nature of vaccines, appropriate measures need to be put in place to ensure that vaccines remain potent from point of manufacture to administration. Adequate knowledge of cold chain management by health workers is necessary to manage vaccines appropriately and efficiently to ensure the vaccines remain potent. Objective: The objective of this study is to assess the knowledge and attitude toward cold chain management among health workers in primary health-care (PHC) facilities in Benin City, Edo State. Materials and Methods: This was a descriptive, cross-sectional study among health workers working in PHC facilities offering immunization services in Benin City. The participants were selected using multistage sampling technique. Data were collected using pretested structured self-administered questionnaires and data analysis was by IBM SPSS (IBM Corp, Armonk, New York, United States) version 21.0. The level of significance was set at P < 0.05. Results: Of the 425 respondents who participated in the study, 272 (64.0%) had poor knowledge while 396 (93.2%) had positive attitude toward cold chain management. Determinants of knowledge were cold chain management training (P = 0.018), presence of functional refrigerators (P = 0.011), and National Programme on Immunization supervision (P < 0.001). Determinants of attitude were level of education (P = 0.005) and knowledge of cold chain management (P < 0.001). Conclusion: The study showed a gap in knowledge and good attitude toward cold chain management among the respondents. All stakeholders should ensure collective effort in improving the knowledge and attitude of health workers toward cold chain management.
  7,644 638 5
Prevalence and knowledge of Salmonella infections among food handlers: Implications for school health in Southwestern Nigeria
Adebimpe Wasiu Olalekan, Faremi Ayodeji Oluwaseun, Hassan Abd Wasiu Oladele
April-June 2018, 21(2):99-103
DOI:10.4103/smj.smj_27_16  
Background: Food handlers play important roles in transmission of Salmonella infections in unregulated school food programs, most especially in settings where surveillance of foodborne disease is not routine. This study assessed the determinants and prevalence of Salmonella infections among food handlers and its implications for public school health in Southwestern Nigeria. Materials and Methods: A cross-sectional descriptive study among 526 food handlers was carried out using semi-structured interviewer-administered questionnaires. Stool collection and laboratory procedures were carried out under standard techniques. The SPSS software version 17.0 was used in data analysis. Frequency tables and charts were generated while binary logistic regression was used to demonstrate predictors of Salmonella infections, and P ≤ 0.05 was considered statistically significant. Results: The mean age of the respondents was 33.0 ± 7.6 years, 504 (95.8%) were females, and 378 (71.9%) were in the lowest socioeconomic class. Two hundred and seventy-seven (52.7%) had poor, 101 (19.2%) had moderate, while 148 (28.1%) had good knowledge scores as regards transmission, prevention, and control of Salmonella infections. Twenty-two (4.2%) had positive, 18 (3.4%) had indeterminate, while 486 (92.4%) had negative test results to Salmonella infections. Predictors of positive test results were being in the lower socioeconomic class, being a female and using pit toilets. Conclusion: Food handlers studied had significant prevalence rate and poor knowledge of Salmonella infections. Improving their knowledge could bring about a positive behavioral change toward a successful school feeding program.
  6,501 395 7
Quality of life in patients with advanced cervical cancer in Nigeria
Marliyya Sanusi Zayyan, Matthew Akpa, David A Dawotola, Adekunle O Oguntayo, Abimbola O Kolawole
April-June 2018, 21(2):61-69
DOI:10.4103/smj.smj_61_16  
Background: Cancer of the cervix is the most common female genital tract malignancy in Nigeria. Patients present in advanced stages of the disease due to ignorance, poverty, lack of national screening program, and poor utilization of the few available services. At a tertiary referral center, a dearth of resources, coupled with high cancer burden, results in many not only succumbing to their disease but also dying in pain and indignity. Objective: The aim of this study was to determine the quality of life (QoL) in patients with advanced cancer of the cervix. Materials and Methods: This is a cross-sectional descriptive study. Women with advanced cancer of the cervix at Ahmadu Bello University, Zaria, Nigeria, between April 1 and December 31, 2014 were enrolled in this study. Consecutive patients with histologically confirmed cervical cancer; patients with FIGO stages IIB IIIA, IIIB, IVA, and IVB were recruited. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire–core 30 (QLQ-C30) questionnaire was used to assess their QoL. Two trained nursing staff administered the pretested questionnaires. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software. Results: All domains of QoL were affected in the 378 patients with advanced cervical cancer. Physical functions were affected in 264 (69.9%) role functions in 218 (57.7%), cognitive in 138 (36.5%), emotional in 230 (60.8%), and financial in 288 (76.2%). Sexual domain was affected in more than 323 (85%) of the patients. Reduction in various economic facets was reported by 268 (70.9%) patients. In social domain, only 150 (39.7%) family members and 134 (35.4%) friends were reported to have offered financial support. There was no support from governmental or nongovernmental organizations. Conclusion: Severe disruptions in QoL domains occur in patients with advanced cervical cancer.
  6,317 546 -
Indications and outcome of tracheostomy at a Federal Teaching Hospital in North Eastern, Nigeria
Toye Gabriel Olajide, Ahmad Ali, Babatunde Oludare Fakuade, Longret Kabilis, Yahaya Abdul Majid, Yahaya Abdulkadir Kabiru
April-June 2018, 21(2):70-74
DOI:10.4103/smj.smj_8_17  
Background: Tracheostomy is an important life-saving surgical procedure used in managing airway emergencies. Objective: This study was conducted to evaluate indications, complications, and outcome of tracheostomy at a Federal Teaching Hospital, Gombe in North Eastern Nigeria. Methodology: A 5-year retrospective review of 45 patients who presented to ear, nose, and throat facility of Federal Teaching Hospital, Gombe and had tracheostomy done between November 2011 and October 2016 was carried out. Patients' information was retrieved from the hospital medical record department. Results: A total of 45 cases were analyzed, age ranged between 5 months and 84 years, mean of 26.37 years ± 20.89 standard deviation male to female ratio was 1.8:1. The peak age group was 0–15 years (37.8%). Forty (91.1%) of the tracheostomies were performed as an emergency while 8.9% as elective procedures. The major indication for tracheostomy was upper airway obstruction (80.0%). Trauma (33.3%) was the most common cause of upper airway obstruction. Thirteen patients (28.9%) had complications, and the most common complication was tube blockage in 6 (13.3%). Thirty-three patients (73.3%) were successfully decannulated. The mortality rate of 8.9% was recorded. They were related to patients underlying diseases. Conclusion: Tracheostomy is still a useful live-saving procedure. Upper airway obstruction due to trauma from crime-/violence-related activities was the most common indication for tracheostomy in this study.
  5,739 302 2
Perception of midline diastema in dental- and nondental-oriented individuals
Bolanle Oyeyemi Akinboboye, Donna Chioma Umesi, Temitope Ayodele Esan
April-June 2018, 21(2):104-108
DOI:10.4103/smj.smj_3_17  
Background: The perception of maxillary midline diastema differs in different individuals and continent. Culture and other factors are believed to influence the perception of maxillary midline diastema. The aim is to determine the influence of dental knowledge on the perception of maxillary midline diastema. Materials and Methods: Study was done in Nigeria, which consists of diverse ethnic and social African groups. A two-stage sampling method was done to select participants between the ages 20 and 49 years. Participants were randomly selected from the University of Lagos and Teaching Hospital, Lagos, Nigeria. A structured questionnaire including a set of color smile photographs with varying sizes of maxillary midline diastema (narrowest = 2 mm; widest = 6 mm) was administered, and grading of attractiveness of smile was done. This information was evaluated using a Likert scale. Results: Study participants were 89 and age range was between 20 and 49 years with the mean age being 27.9 ± 7.9 years. Female participants were 49.4%, while male was 50.6%. The proportion of those who were medically inclined was 47.2% and those that were nonmedically inclined were 52.8%. Prevalence of midline diastema was 16.9%. About 52% of the medically inclined and 48.9% of nonmedically inclined participants rated maxillary midline diastema of 4 mm as acceptable (P = 0.02). At 6 mm width, there was a general rating of unattractiveness with 83.3% medically inclined and 66% nonmedically inclined participants rating it unattractive (P = 0.03). A higher percent (73.8%) of the medically inclined participants did not like midline diastema (P = 0.00). Conclusion: This study was able to demonstrate the perception of maxillary midline diastema in dental and nondental professionals.
  4,604 265 2
Spousal communication on family planning, pregnancy, and delivery care among men in rural Northern Nigeria
Muhammed Sani Ibrahim, Kabir Sabitu, Sulaiman Saidu Bashir, Abdulhakeem Abayomi Olorukooba
April-June 2018, 21(2):88-92
DOI:10.4103/smj.smj_66_16  
Introduction: Communication between a husband and wife is necessary for joint decision-making on reproductive health issues. This study assessed the practice of spousal communication and reasons for not engaging in spousal communication among married men in two rural communities in Northern Nigeria. Materials and Methods: It was a cross-sectional study conducted among 411 married men selected through multistage sampling. Data were collected using a structured interviewer-administered questionnaire containing open- and close-ended questions and analyzed using SPSS Statistics version 17.0. Results: All of the men were Muslim and Hausa-Fulani, with mean age 37.3 ± 10.9 years. Overall, spousal communication was adequate in 204 (49.6%) of them. It was highest on whether or not wife should attend antenatal care (ANC) (68.3%), importance of ANC (66.3%), and services available at the health facility during ANC and delivery (55.6%). It was lowest on whether or not the couple should use family planning (22.4%), when to get pregnant (21.0%), husband's or wife's feeling about family planning (21.0%), and number of children to have (14.6%). The most common reason given for not engaging in spousal communication was that religion forbids the act and such discussion is not important. Conclusion and Recommendation: More effort should be put into improving spousal communication, especially in relation to family planning and birth preparedness. Such effort must address harmful cultural and religious beliefs, possibly by collaborating with religious leaders.
  4,481 349 1
Kidney disease and children: Experience from the World Kidney Day 2016 campaign in Benin City, Nigeria
Moses Temidayo Abiodun, Nosakhare J Iduoriyekemwen
April-June 2018, 21(2):93-98
DOI:10.4103/smj.smj_62_16  
Background: There is a rising burden of chronic kidney disease (CKD) in all regions of the world. Hence, there is a need to enlighten the public on renal protective lifestyle. We evaluated the impact of the World Kidney Day (WKD) 2016 awareness campaign in four schools in Benin City. Materials and Methods: This was a prospective quasi-experimental study using a pre- and post-test design. The intervention comprised health education based on the WKD 2016 school toolkits. A structured questionnaire comprising four-point Likert scales and visual analog scale (VAS) was administered thrice to assess participants' perception of CKD risk factors. F-test was used to detect significant difference among weighted mean scores. Multiple logistic regression identified predictors of improved knowledge. Results: A total of 561 persons took part in the study. Nearly half (42.5%) of them had adequate baseline perception of kidney functions and dysfunction. Knowledge levels improved at posttests 1 and 2-55.5% and 52.5%, respectively. There was an upward trend in their mean scores over the period (F = 12.771, P = 0.000). Furthermore, their mean VAS scores increased significantly (50.4 ± 35.4 vs. 58.1 ± 32.2 vs. 61.2 ± 27.8; F = 4.064, P = 0.018). Their gender (odds ratio [OR] = 3.20, confidence interval [CI]: 1.43–7.18; P = 0.005), class (OR = 0.83, CI: 0.08–0.97; P = 0.04), and type of institution (OR = 5.56, CI: 1.05–29.41; P = 0.04) influenced their knowledge of kidney disease prevention on VAS postintervention. Conclusion: The WKD 2016 campaign led to a sustained increase in the awareness of kidney disease preventive measures among the participants. Relevant school health instructions would sustain the gain.
  4,088 239 -
CASE REPORTS
Placental chorioangioma
Umar Mohammed, A Mohammed, AO Jimoh, UA Eze, AA Panti
April-June 2018, 21(2):113-115
DOI:10.4103/smj.smj_54_16  
Chorioangioma is an expansile nodular lesion composed of capillary vascular channels, intervening stroma cells, and surrounding trophoblast. It is analogous to hemangioma at other body sites. Chorioangiomas are the most common placental tumors and are thought to be hamartomatous malformations. We present the case of a 22-year-old unbooked Para 3 + 0 at 32 weeks gestation who presented with history of premature rupture of membrane to the gynecology emergency clinic. Abdominopelvic ultrasound scan revealed polyhydramnios, no fetal cardiac activity, and suspected placenta cyst. She had stillbirth of male baby. The clinician made a provisional diagnosis of stillbirth with placental cyst with differential diagnosis of trophoblastic disease. The placental tissue revealed a fleshy nodular circumscribed lesion which is 10 cm × 6 cm × 4 cm in dimension, and microscopic examination led to the diagnosis of chorioangioma. Chorioangioma of the placenta, in a high-risk population, although small, is associated with significantly higher risk for preterm delivery; there is therefore need for regular color Doppler imaging for all obstetrics cases for prenatal differentiation between placental chorioangiomas and other nonvascular tumors and pathological examination of all placentas of patients with preterm delivery.
  3,831 230 2
ORIGINAL ARTICLES
Vascular tumors in Northern Nigeria: A 10-year retrospective review
Ibrahim Yusuf, Raphael Solomon, Akinfenwa Taoheed Atanda, Ali Bala Umar, Mohammed Ibrahim Imam, Alfa Alhaji Sule
April-June 2018, 21(2):83-87
DOI:10.4103/smj.smj_63_16  
Background: Vascular tumors range from benign hemangiomas to lesions that are locally aggressive but infrequently metastasize, to relatively rare, highly malignant angiosarcoma. Objectives: The objective of this study is to determine the relative frequency and histologic pattern of these tumors in this locality and discover if any, differences in frequency and histopathological pattern from other centers. Materials and Methods: This was a 10-year retrospective study of all cases of vascular tumors diagnosed in the Department of Pathology, in a Teaching Hospital. Results: A total of 305 cases of vascular tumors representing 16% of soft tissue tumors were analyzed. The benign cases constituted 68% and the remaining were malignant. Lobular capillary hemangioma (40%) was the predominant benign histologic subtype recorded while Kaposi sarcoma constitute the most frequent malignant entity (21.6%). Head and neck was the most common site of affectation. Conclusion: Hemangiomas and Kaposi sarcoma was the most common benign and malignant vascular tumors recorded in this locality, respectively.
  3,611 245 -
CASE REPORTS
Primary papillary carcinoma of a thyroglossal duct cyst: A rare case
Reddy Ravikanth
April-June 2018, 21(2):109-112
DOI:10.4103/smj.smj_5_17  
The incidence of papillary cell carcinoma arising in a thyroglossal duct cyst (TDC) is rare and occurs in 1% of TDCs. Due to embryological remnants of thyroid tissue located in the TDC, the same malignant tumors that develop in the thyroid tissue can also develop in the TDC. The occurrence of carcinoma of TDC, even though rare and unexpected, should always be considered an option and histologically ruled out mainly on account of the atypical localization. We report a case of papillary carcinoma arising in a TDC, presenting with an anterior neck mass in a 28-year-old woman, who underwent a Sistrunk procedure for removal of the mass with total thyroidectomy and neck dissection. Fine-needle aspiration cytology did not contribute to the diagnosis. Based on the histopathologic findings, the patient received postoperative iodine-131 ablation treatment (120 mCi). This type of carcinoma usually has a good prognosis with an overall survival rate of 95.5% at 10 years. Carcinomas of TDC demonstrate lower frequency of regional lymph node metastasis in comparison with that arising in the thyroid gland proper and can be successfully managed with surgery and careful follow-up.
  3,178 208 -
LETTER TO THE EDITOR
Prevalence of hepatitis B surface antigen in children with sickle cell anemia
Abubakar Umar Musa, Muhammad Alhaji Ndakotsu, Sani Bako Abubakar, Ibrahim AbdulQadir
April-June 2018, 21(2):116-116
DOI:10.4103/smj.smj_4_17  
  2,918 198 1
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