UNASSIGNED: The devastating scourge of cervical cancer in Africa is largely due to the absence of preventive interventions, driven by low awareness and poor perception of the disease in the continent. This work is a preliminary effort toward understanding key social drivers promoting this disease in our immediate environment with a view to mitigating it.
UNASSIGNED: Female students of two tertiary health institutions in Azare, northeastern Nigeria, were approached to participate in this cross-sectional descriptive study. A structured self-administered questionnaire was administered to consenting participants and covered questions on their socio-demographics, awareness, perception, and attitude about/toward cervical cancer and its prevention. The responses were scrutinized for coherency and categorized into themes using summary statistics, while a chi-square test was used to determine the association between awareness of cervical cancer and participant age, marital status, religion, screening uptake, and willingness to undergo screen.
UNASSIGNED: Awareness of cervical cancer was recorded among 174/230 (75.7%) respondents who enrolled in this study; 117 (67.2%) knew that it was preventable, but only three (1.3%) respondents had undergone screening. Among the aware participants, 91 (52.3%) and 131 (75.3%) knew that sexual intercourse and multiple sexual partners are risk factors for the disease, respectively. In contrast, knowledge of the etiology was poor; 82 (47.1%) respondents who knew it was preventable had heard about human papillomavirus (HPV), while 72 (41.4%) knew that HPV causes cervical cancer. Most (78%) of the participants expressed willingness to take a human papillomavirus vaccine or undergo screening (84.6%) if made available to them. Awareness was significantly associated with participants\' age (p = 0.022) and willingness to undergo screening (p = 0.016).
UNASSIGNED: This study revealed discordance between awareness and knowledge about cervical cancer. Educational initiatives reflective of population perception/knowledge of cervical cancer are needed to mitigate the rising incidence of this disease, especially among female healthcare providers.

Ectoparasites of dogs represent an important group of parasites. They often suck blood, cause pruritis, and could serve as vectors of many pathogens of veterinary and public health importance. In northeastern Nigeria, there is a lack of data regarding ectoparasites of dogs. Therefore, this study was undertaken to explore the external parasites of dogs and the associated epidemiological risk factors. A total of 1041 dogs (mean age = 8.5 ± 2.1 months) from residential house visit (54.9%) and those attending veterinary clinic (45.1%) were sampled in northeastern Nigeria. Multivariate logistic regression analysis assessed epidemiological risk factors associated with canine ectoparasitic infections. Of the 1041 dogs screened, 92.5% (963/1047) harbored one or more ectoparasites. Rhipicephalus sanguineus (52.4%), Linognathus setosus (7.8%), Ctenocephalides canis (2.3%), and Otodectes cynotis canis (1.4%) were the significantly encountered tick, lice, fleas, and mite species, respectively. Being female dog (OR = 1.8; p = 0.01), cross (OR = 2.2; p = 0.029), and exotic breeds (OR = 2.4; p = 0.02), < 7 months (OR = 3.1; p = 0.04) and 7-12 months (OR = 2.1; p = 0.01) aged dogs as well as rainy season (OR = 1.9; p = 0.02) were strong predictors for tick infestation. Similarly, cross (OR = 7.2; p = 0.001) and local breeds (OR = 2.8; p = 0.0001), dogs aged > 12 months (OR = 2.5; p = 0.03), and dogs used for hunting (OR = 3.2; p = 0.01) and as security guards (OR = 3.8; p = 0.01) were strongly associated with lice infestation. Results from this study revealed a high prevalence of external parasites parasitizing majority of the sampled dogs. Some of these parasites may serve as vectors of zoonotic pathogens posing public health risks.

BACKGROUND: Rheumatoid arthritis (RA) is considered rare and mild in Africa, its exact burden is unknown.
OBJECTIVE: To determine the pattern of RA and medications used in its management at University of Maiduguri Teaching Hospital (UMTH), Nigeria.
METHODS: A retrospective cross-sectional study of RA patients, aged >18 years, satisfying the American college of rheumatology (ACR)/European alliance of associations for rheumatology (EULAR) 2010 and/or ACR 1987 classification criteria seen over six years (January 2015 to December 2020) at UMTH. Ethical approval was granted by the hospital\'s Ethics committee. Excluded, were other Rheumatic and musculoskeletal diseases (RMDs) and those with incomplete data. Sociodemographic, clinical features, laboratory results, medications used, and clinical disease activity index (CDAI) were recorded. Data were analyzed using SPSS version 23.0. A p-value of < 0.05 was considered significant.
RESULTS: Of the 1,315 RMDs seen, 162 (12.3%) had RA of which 32 were excluded due to incomplete data. Their median [IQR] age was 40.9 [29.6-54.0] years and 78.5% were females. The median [IQR] disease duration before presentation was 3 [2-5] years. The wrist joint was the most affected (88.5%), while the hip was the least (15.4%). Sicca symptoms was reported by 42.3% while, 41.1% had subcutaneous nodules. The median [IQR] erythrocyte sedimentation rate (ESR) was 66.2 [45-72.3] mm in the 1st hour, 65.7% had positive Rheumatoid factor (RF). The mean(±SD) CDAI score was 33.0(±9.5) and 86.2% of patients had high disease activity. All patients were treated with steroids, 70.0% had methotrexate (MTX) while none received biologics.
CONCLUSIONS: In Maiduguri, RA patients present late with high disease activity and poor access to biologics. There is a need to improve early diagnosis and prompt referral to a rheumatologist.
BACKGROUND: La polyarthrite rhumatoïde (PR) est considérée comme rare et bénigne en Afrique, son poids exact est inconnu.
OBJECTIVE: Déterminer le profil de la PR et les médicaments utilisés pour sa prise en charge à l’hôpital universitaire de Maiduguri (UMTH), au Nigeria.
UNASSIGNED: Étude rétrospective transversale des patients atteints de PR, âgés de plus de 18 ans, répondant aux critères de classification 2010 de l’American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) et/ou ACR 1987, examinés sur une période de six ans (de janvier 2015 à décembre 2020) à l’UMTH. L’approbation éthique a été accordée par le comité d’éthique de l’hôpital. Ont été exclues, les autres maladies rhumatismales et musculosquelettiques (RMD) et celles dont les données étaient incomplètes. Les caractéristiques sociodémographiques et cliniques, les résultats de laboratoire, les médicaments utilisés et l’indice d’activité clinique de la maladie (CDAI) ont été enregistrés. Les données ont été analysées à l’aide de SPSS version 23.0. Une valeur p de < 0,05 a été considérée comme significative.
UNASSIGNED: Sur les 1 315 DMR examinés, 162 (12,3 %) étaient atteints de PR, dont 32 ont été exclus en raison de données incomplètes. Leur âge médian [IQR] était de 40,9 [29,6-54,0] ans et 78,5% étaient des femmes. La durée médiane [IQR] de la maladie avant la présentation était de 3 [2-5] ans. L’articulation du poignet était la plus touchée (88,5 %), tandis que la hanche était la moins touchée (15,4 %). Des symptômes de siccité ont été signalés par 42,3 % des patients, tandis que 41,1 % présentaient des nodules sous-cutanés. Le taux de sédimentation érythrocytaire médian [IQR] était de 66,5 %. La vitesse de sédimentation des érythrocytes (VS) médiane [IQR] était de 66,2 [45-72,3] mm au cours de la première heure, 65,7 % avaient un facteur rhumatoïde (FR) positif. Le score CDAI moyen (±SD) était de 33,0 (±9,5) et 86,2% des patients présentaient une forte activité de la maladie. Tous les patients ont été traités par stéroïdes, 70,0 % par méthotrexate (MTX) et aucun n’a reçu de produits biologiques.
CONCLUSIONS: A Maiduguri, les patients atteints de PR se présentent tardivement avec une forte activité de la maladie et un faible accès aux produits biologiques. Il est nécessaire d’améliorer le diagnostic précoce et l’orientation rapide vers un rhumatologue.
UNASSIGNED: Polyarthrite rhumatoïde, Nord-Est du Nigeria, Investigations, Disease Activity Management.

Sustainable management of groundwater resources in geological transition zones (GTZ) is essential due to their complex geology, increasing population, industrialization, and climate change. Groundwater quality monitoring and assessment represent a viable panacea to this problem. Therefore, there is a great need to investigate groundwater resources in terms of their chemistry and pollution to ascertain their quality and implement robust pollution abatement strategies. This study focused on the characterization of groundwater in a typical geological transition zone in northeastern Nigeria. Eighty-seven (87) groundwater samples were collected from dug wells and boreholes during the 2017 dry season. pH, conductivity, and total dissolved solids (TDS) were measured in situ using a multiparameter probe, while major cations and anions were measured using atomic absorption spectrometry and ion chromatography, respectively. Data were analyzed using descriptive statistics, principal component analysis (PCA), water quality index, and standard hydrochemical plots. TDS ranged between 95 and 1154 mg L-1 in basement terrains and between 49 and 1105 in sedimentary areas. pH ranged between 6.8 and 7.7 mg L-1 in basement terrains and between 5.0 and 6.5 in sedimentary areas, suggesting a moderately acidic to alkaline low mineralized groundwater. Calcium (2.6-128.0 mg L-1) was the dominant cation in the basement areas, suggesting silicate weathering/dissolution, while sodium (1.9-106.0 mg L-1) dominated the sedimentary zones due to base exchange reactions. The PCA analysis suggests that mineral dissolution (mostly silicate weathering) controls the hydrochemistry of the basement aquifers, while ion exchange and albite weathering, with some influence of anthropogenic factor, control the sedimentary aquifers. The water quality index revealed that the basement setting was predominated by poor to unsuitable groundwater, while the sedimentary terrain was characterized by potable groundwater. The dominant hydrochemical facie in the basement areas was Ca2+-(Mg2+)-HCO3- characteristic of recharge meteoric water. The Na+- (K+)-HCO3- facie characterized the sedimentary zones, indicative of cation exchange reactions, while the mixed water facie typifies the geological contact zones. The shallow nature of the basement groundwaters makes them more susceptible to geogenic and anthropogenic pollution compared to the sandstone aquifers. However, the basement aquifers have better irrigation indices (Kelly ratio and soluble sodium percent) as compared to the sandstone aquifers, which exhibit poor Kelly ratios (< 1) and soluble sodium percent (> 50) ratings. Results from the study clearly highlight the poor-unsuitable groundwater quality in parts of the studied GTZ and can be very instrumental to the policymakers in implementing sustainable water treatment strategies and cleaner production technologies in GTZ to forestall the incidence of water-related diseases.

Understanding the epidemiology of canine parasitic infections, gastrointestinal helminthic infections in particular, is crucial for designing an efficient control programs targeted at minimizing the risks of zoonotic transmission. A total of 470 dogs attending veterinary clinics in Northeastern Nigeria were screened for gastrointestinal helminths using standard parasitological techniques. Epidemiological risk factors associated with the canine parasitic infections were assessed using multivariable logistic regression analysis. In total, 77.9% (366/470) of dogs had harboured one or more species of the gastrointestinal helminths: Ancylostoma caninum (40.2%), Toxocara canis (35.1%) Trichuris vulpis (26.6%), Spirocerca lupi (5.7%), Taenia/Echinococcus (12.3%), Dipylidium caninum (10.9%) and Diphyllobothriid ova (2.8%). Female dogs (OR=2.1; p=0.02), local breeds (OR=2.3; p<0.01), younger dogs (OR=3.2; p<0.001), dogs adopted as security guards (OR=1.8; p<0.01) and poor body condition score (OR=3.1; p<0.001) were strongly associated with A. caninum infection. For T. canis and T. vulpis, younger dogs (OR=2.5; p=0.02 and OR=2.3; p<0.01) and poor body condition score (OR=4.2; p<0.001 and OR=2.2; p<0.01) were the strong predictors for infection, whereas female dogs (OR=2.8; p=0.02), younger dogs (OR=4.1; p<0.001) and poor body condition score (OR=4.0; p<0.001) were strongly associated with D. caninum infection in dogs. The results revealed high prevalence of gastrointestinal helminths-some of which have zoonotic potential-among dogs underlying huge public health risk.

The flaviviruses are mosquito borne pathogens that continue to pose a considerable public health risk to animals and humans. The members of this group includes, Dengue virus (DENV), Yellow fever virus (YVF), Japanese encephalitis virus (JEV), West Nile virus (WEV) and Zika virus (ZKV). The DENV mosquito vector is endemic to tropical and subtropical climates, placing ∼40% of the world\'s population at direct risk of dengue infection. Currently, in Nigeria the status of DENV serotypes circulating among mosquito vectors is unknown. Our study was designed to identify and characterize the DENV serotypes circulating in Aedes mosquito populations collected in selected sites in Nigeria. The mosquitoes were collected and identified morphologically to species level using colored identification keys of Rueda. Generally, each species identified was tested in pools of 20 individuals of each Aedes species. RT-PCR and semi nested PCR were used to detect DENV serotypes in mosquitoes and characterized using Sanger sequencing methods. The results showed that DENV serotypes were detected in 58.54% (24/41) of the pools of Aedes mosquitoes from Mubi, Numan and Yola screened. All DENV1-4 serotypes were detected in Ae. aegypti. While DENV 1, 2 and 4 were detected in Ae. albopictus. And only DENV 2 was detected in Ae. galloisi with DENV4 serotype being reported for the first time in Nigeria. DENV2 (37.8%) was the most detected serotypes, while double and triple co-infections of serotypes were detected in 24.4% of the pools. Phylogenetic analysis revealed a strong evolutionary relatedness of DENV serotypes in our study with that of South and Southeast Asia, North America, and other African countries. This is the first reports on the natural DENV serotypes co-infection among Aedes species pools in Nigeria, which can create possible interaction with other flaviviruses causing animal and human diseases. In addition, our study postulates the possible linkage between DENV serotypes infection and human febrile flu-like disease burden being experienced by host communities in northeastern Nigeria.

Northeastern Nigeria has over the decade suffered from the Boko Haram insurgency and is still in the process of recovery from the complex humanitarian crisis that has displaced and subjected millions of vulnerable children, women and elderly population to poverty, disease outbreaks, hunger and malnutrition. Yet, the conflict-affected states in Northeastern Nigeria is not far away from being the worse-hit by the COVID-19 pandemic if urgent public health preventive measures are not taken to contain the spread of the deadly and highly infectious virus. The question arises, \"what is Nigeria doing to tackle the burden of a COVID-19 spread and an ongoing humanitarian crisis?

Cholera is endemic in sub-Saharan Africa, especially in areas affected by natural disaster and human conflict. Northeastern Nigeria is experiencing a health crisis due to the destruction of essential amenities such as health infrastructure, sanitation facilities, water supplies, and human resources by Boko Haram insurgents. In 2017, a cholera outbreak occurred in five local government areas (LGAs) hosting internally displaced persons. The Nigeria Center for Disease Control, World Health Organization, Mĕdecins Sans Frontiĕres International, and several other organizations supported disease containment. An emergency operating center (EOC) established by the State Ministry of Health (SMoH) then coordinated the outbreak response.
We conducted a retrospective analysis of data extracted from the line list utilized by the SMoH to investigate outbreaks. We evaluated the outbreak by time, place, and person. Attack rate by LGA and age-specific case fatality rate (CFR) was calculated based on cases with complete records for age, sex, place of residence, date of symptom onset, and disease outcome.
A total of 5889 cholera cases were reported from five LGAs with an overall attack rate of 395.3/100,000 population. Among 4956 cases with documented outcome, the overall CFR was 0.87%, with CFR ranging from 0% to 6.98% by LGA. The age-specific CFR was highest among those aged ≥60 years (1.92%) and least among those aged 20-29 years at 0.3%. The epidemiological curve revealed two peaks that coincided with periods of heavy rain and flooding.
This study reports on the largest ever documented cholera outbreak in five LGAs in Borno State. The outbreak was focused in LGA hit hardest by the destructive activities of insurgents and then spread to neighboring LGAs. The low CFR recorded in this cholera outbreak was achieved through timely detection, reporting, and response by the coordinated efforts of the EOC established by the SMoH that harmonized the outbreak response.
Résumé Contexte: Le choléra est endémique en Afrique subsaharienne, en particulier dans les zones touchées par des catastrophes naturelles et des conflits humains. Le nord-est du Nigéria traverse une crise sanitaire en raison de la destruction d\'équipements essentiels tels que des infrastructures de santé, des installations sanitaires, des réserves d\'eau et des ressources humaines par les insurgés de Boko Haram. En 2017, une épidémie de choléra est survenue dans cinq zones de gouvernement local (LGA) accueillant des personnes déplacées. Le Centre nigérian pour le contrôle des maladies, l\'Organisation mondiale de la santé, Médecins sans frontières internationaux et plusieurs autres organisations ont plaidé en faveur du contrôle de la maladie. Un centre d\'opération d\'urgence (EOC) établi par le ministère de la Santé de l\'État (SMoH ) a ensuite coordonné la réponse à l\'épidémie. Méthodes: Nous avons effectué une analyse rétrospective des données extraites de la liste de lignes utilisée par le SMoH pour enquêter sur les épidémies. Nous avons évalué l\'épidémie par heure, lieu et personne. Le taux d\'attaque par LGA et de l\' âge - le taux de létalité spécifique (CFR) a été calculé sur la base des cas avec des dossiers complets pour l\' âge, le sexe, le lieu de résidence, la date d\'apparition des symptômes, et le résultat de la maladie. Résultats: Un total de 5889 cas de choléra ont été signalés par cinq LGA avec un taux d\'attaque global de 395.3/100,000 personnes. Parmi les 4956 cas dont les résultats ont été documentés, le taux de létalité global était de 0,87%, avec une valeur variant entre 0% et 6,98% par la LGA. L\'âge - CFR spécifique était le plus élevé parmi les personnes âgées de ≥60 ans (1,92%) et moins parmi les 20-29 ans à 0,3% âgés. La courbe épidémiologique a révélé deux pics qui coïncidaient avec des périodes de fortes pluies et d\'inondations. Conclusion: cette étude fait état de la plus grande épidémie jamais enregistrée dans l\' époque du choléra dans cinq LGA de l\' État de Borno. L\'épidémie était concentrée dans les collectivités locales touchées le plus durement par les activités destructrices des insurgés et s\'était ensuite étendue aux collectivités locales voisines. Le faible taux de CFR enregistré dans cette épidémie de choléra a été atteint grâce à une détection, une notification et une réponse rapides, grâce aux efforts coordonnés du COU, mis en place par le SMOH, qui a harmonisé la réponse à la flambée. Mots-clés: Taux de mortalité, choléra, insurrection, nord-est du Nigéria, épidémie.

UNASSIGNED: The objective was to assess the prevalence of all forms of dental fluorosis (DF), the severity, and the request for treatment as a measure of the burden of the condition among adult patients seen at a tertiary health facility in an endemic region of Northeastern Nigeria.
UNASSIGNED: This was a cross-sectional study that collected required information using a questionnaire from adult dental patients followed by dental examination to assess for DF.
UNASSIGNED: Associations between sociodemographic distributions (age and gender) and prevalence were analyzed on the Statistical Package for the Social Sciences using the Chi-square test. Analysis was done at 95% confidence interval and the level of statistical significance was set at P < 0.05.
UNASSIGNED: Three hundred and twelve patients (41.7%) were diagnosed with DF among the patients who resided in the endemic region with a calculated Community Fluorosis Index of 0.62. The mean age of the affected patients was 33.8 ± 9.2 years, with a majority of the patients in the 16-25 (47.4%) years\' age group and a preponderance among females (P = 0.003). A greater proportion of the 312 diagnosed patients, 201 (64.3%), had fluorosis of esthetic concern, while only 9.3% sought treatment. Most of these patients that sought treatment had the severe form of the enamel defect.
UNASSIGNED: DF should be considered as a condition of public health importance in this region. It is necessary to conduct a community-based study and fluoride mapping of the northeastern region as well to determine other factors that may contribute to its occurrence in this population.

Clinical depression is a highly debilitating illness, which is often under-diagnosed and negatively impacts on the quality of life of its sufferers. When it co-exists with other medical conditions, its effect is even more incapacitating. Undiagnosed depression in the context of HIV infection leads to accelerated decline in CD4+ cell counts with concomitant increase in the viral load and poor adherence to the antiretroviral medications which lead to viral mutation and the evolution of resistant strains. This study examined the prevalence of depression, its correlates and the frequency of the diagnosis of the condition among HIV+ subjects on highly active antiretroviral therapy (HAART) by the internists and general physicians at the University of Maiduguri Teaching Hospital in Northeastern Nigeria. Three hundred and fifty representative samples of HIV+ adults on HAART were drawn from the Antiretroviral Therapy Clinic of the Institution. Diagnosis of depression was made using the International Classification of Diseases-10 criteria based on Composite International Diagnostic Interview generated data. Socio-demographic and clinical variables were also analyzed for their correlation with depression in the subjects. About 20% of the respondents were diagnosed with clinical depression and no diagnosis of the condition was hitherto entertained in all the respondents. The independent determinants of depression in the participants were: female gender [odds ratio (OR)=3.87 (95% confidence interval, CI: 2.089-7.183)], past history of psychiatric illness [OR=43.81 (95% CI: 9.731-197.30)] and family history of psychiatric illness in first-degree relatives of the subjects [OR=14.364 (95% CI=5.327-38.729)]. Depression is a relatively common psychiatric condition among adults on HAART, there is therefore the need for routine screening of this condition among HIV+ subjects in order to optimize patient care and improve clinical outcomes.