West African Journal Of Medicine[JOURNAL]
Sun
200 papers
Multicentric Castleman Disease Initially Diagnosed as Disseminated Tuberculosis in an Adolescent Boy in Sokoto, Nigeria.
Isezuo KO, Mohammed Y, Waziri UM … +10 more , Sani UM, Raji TA, Abubakar FI, Salihu A, Na'uzo AM, Udah IC, Emetumah F, Ado S, Adamu A, Omar M
West Afr J Med · 2026 Apr · PMID 42177836
BACKGROUND: Castleman disease (CD) is a rare lymphoproliferative clinicopathological entity characterized by non-neoplastic lymph node hypertrophy with distinct histopathology. It has a wide spectrum of presentation rang...
BACKGROUND: Castleman disease (CD) is a rare lymphoproliferative clinicopathological entity characterized by non-neoplastic lymph node hypertrophy with distinct histopathology. It has a wide spectrum of presentation ranging from benign localized unicentric CD to idiopathic multicentric CD and human herpes virus (HHV) associated disease which are potentially life-threatening. Treatment includes steroids, chemotherapy and immunotherapy. It has not been reported in Nigerian children. CASE SUMMARY: A 13-year-old boy presented with fever and body swelling of four weeks, cough of one week and difficulty in breathing of three days duration. On examination he was acute on chronically ill-looking, in respiratory distress, with significant generalized lymphadenopathy, bilateral pedal oedema and hepatosplenomegaly. Disseminated tuberculosis (TB) and lymphoproliferative disease were considered. He had leucocytosis with predominant neutrophils, elevated erythrocyte sedimentation rate and inflammatory cells on bone marrow cytology. GeneXpert and retroviral screen were negative. Chest X-ray showed mediastinal shadows. Abdominal ultrasound scan showed hypoechoic lobulated masses with branching margins. Lymph node biopsy showed encapsulated lymphoid tissue composed of proliferating large-sized atretic lymphoid follicles with expanded mantle zones and lymphocytes arranged in strata giving an onion-skin appearance characteristic of CD. HHV was not excluded. Caregivers were counselled on chemotherapy but defaulted. CONCLUSION: CD is rare but presents similarly to disseminated TB or lymphoma clinically. Efforts and provisions should be made for early histological diagnosis in suspected cases.
Long-term Outcomes of Low-Energy Open Tibial Shaft Fractures: A 10-Year Follow-up Study of Infection Rates.
Adedire A, Oluwadiya KS, Ajibade A … +9 more , Faniyi AJ, Folami EO, Asafa OQ, Oyeniyi GA, Ajayeoba OT, Akinyoade ON, Ogungbemi AO, Olayemi O, Ejim T
West Afr J Med · 2026 Apr · PMID 42177835
BACKGROUND: Low-energy open tibial shaft fractures present a clinical challenge, particularly in resource-limited settings. While high-energy injuries have been widely studied, the long-term outcomes of low-energy mechan...
BACKGROUND: Low-energy open tibial shaft fractures present a clinical challenge, particularly in resource-limited settings. While high-energy injuries have been widely studied, the long-term outcomes of low-energy mechanisms remain underreported. This study assessed the clinical outcomes and long-term complications of cast immobilization following surgical debridement in patients with low-energy open tibial shaft fractures. METHODS: A prospective study was conducted over ten years at UNIOSUN Teaching Hospital, Osogbo, Nigeria. Sixty-six patients with Gustilo-Anderson type I or II open tibial shaft fractures caused by low-energy mechanisms were enrolled. Data were collected on demographics, injury characteristics, treatment timelines, and outcomes. Follow-up assessments were performed at 1, 5, and 10 years post-treatment to evaluate bone union, joint stiffness, and chronic osteomyelitis. RESULTS: The majority of patients were male (77.3%) and young adults (57.6%). Most injuries were due to road traffic accidents (78.8%). All patients were managed by surgical debridement followed by plaster cast immobilization. Primary wound closure was delayed in 59.1% of cases. Bone union complications were observed in 16.7% of patients at 1 year, decreasing to 10.6% at 5 years, and 6.1% at 10 years. Joint stiffness was reported in 3.0% at 1 year but resolved by year 5. Chronic osteomyelitis occurred in 7.6% at 1 year and declined to 4.5% at 10 years. Overall, the majority of patients achieved satisfactory wound healing and functional outcomes. CONCLUSION: Cast immobilization following timely debridement remains a viable treatment for low-energy open tibial shaft fractures in low-resource settings, with a low rate of long-term complications. Early intervention and adequate follow-up are critical to optimizing outcomes.
The Ibadan Chronic Heart Failure Project: Baseline Clinical Profile, Management, and Six-Month Outcomes of the First 1,290 Participants.
Ogah OS, Orimolade OA, Oguntade AS … +8 more , Anyikwa CL, Ogah CM, Adepoju F, Aje A, Adebayo OM, Adebiyi AA, Adeoye AM, Oladapo OO
West Afr J Med · 2026 Apr · PMID 42177830
BACKGROUND: Chronic heart failure is an increasing cause of morbidity and mortality across sub-Saharan Africa, yet contemporary data from large African cohorts remain limited. OBJECTIVES: To characterise the clinical pro...
BACKGROUND: Chronic heart failure is an increasing cause of morbidity and mortality across sub-Saharan Africa, yet contemporary data from large African cohorts remain limited. OBJECTIVES: To characterise the clinical profile, management, and short-term outcomes of patients with chronic HF enrolled in the Ibadan Heart Failure Project. METHODS: The Ibadan Heart Failure Project is a real-life, pragmatic, prospective, hospital-based cohort of adults with chronic heart failure being conducted at University College Hospital, Ibadan, Nigeria. The present report is based on participants recruited between September 1, 2016, and December 31, 2022. Baseline sociodemographic, clinical, and echocardiographic data were obtained, and participants were followed for six months. The primary outcomes were all-cause mortality and hospital readmission. RESULTS: Among 1,290 patients (mean age 56.7 ± 15.4 years; 55.8% men), hypertensive heart disease was the leading cause, followed by dilated cardiomyopathy and rheumatic heart disease. Women were younger and more likely to have preserved or mildly reduced ejection fraction. The use of sodium-glucose cotransporter-2 inhibitors (3.3%) was low. The cumulative incidence of readmission, death, and a composite of these events at six months was 4.9%, 12.9%, and 17.8%, respectively. The use of beta blockers was associated with 43% reduction in the risk of readmission (HR-0.57, 95%CI-0.33-0.97), while the use of renin -angiotensin-aldosterone axis inhibitors was associated with 62% and 46% reduction in the risk of death and composite of readmission and death, respectively. A unit increase in serum creatinine is associated with 11% and 32% increase in readmission and death, respectively (HR-1.11, 95%CI-1.00-1.23 and HR-1.32, 95% CI-1.21-1.45, respectively) In addition, a unit increase in tricuspid annular plane systolic excursion is associated 64% and 53% lower risk of death and composite of readmission and death, respectively. (HR-0.36, 95%CI-0.22-0.60, HR-0.47, 95%CI-0.30-0.73 respectively). No significant sex or age-related differences were observed in adjusted risks of hospitalization or death. CONCLUSIONS: Hypertensive heart disease remains the predominant cause of chronic heart failure in Nigeria. Despite similar short-term outcomes across sexes, suboptimal use of newer evidence-based therapies underscores the need for system-level interventions to improve HF care in sub-Saharan Africa.
Whispers from a Hollow Place: Caregiver Experiences Following Childhood Cancer Survival in Lagos State: A Qualitative Study.
Akinsete AM, Fakile UO, Adisa O … +6 more , James BO, Joseph AO, Damola-Okesiji A, Quadri B, Akindele K, Temiye EO
West Afr J Med · 2026 Apr · PMID 42177822
BACKGROUND: As childhood cancer survival improves globally, increasing attention is directed toward the emotional and social challenges faced by families, especially caregivers. However, in low- and middle-income countri...
BACKGROUND: As childhood cancer survival improves globally, increasing attention is directed toward the emotional and social challenges faced by families, especially caregivers. However, in low- and middle-income countries such as Nigeria, caregivers' coping experiences remain underexplored despite extensive documentation in high-income settings. OBJECTIVES: To explore the psychosocial and health-related experiences of caregivers of childhood cancer survivors after treatment completion in Lagos, Nigeria, focusing on their coping strategies, emotional responses, and perceived family impact. METHODS: A qualitative descriptive design was employed, with 15 caregivers of childhood cancer survivors recruited through purposive sampling. Data collection combined semi-structured focus group discussions with standardized assessments, including the Hospital Anxiety and Depression Scale (HADS), the PTSD Checklist for DSM-5 (PCL-5), and the Connor-Davidson Resilience Scale (CD-RISC). Discussions were audio-recorded, transcribed verbatim, and thematically analyzed using Braun and Clarke's six-phase framework. RESULTS: The analysis revealed three key themes: (1) Physical Consequences, including loss of employment, reduced work efficiency, and financial hardship; (2) Emotional Strain, marked by symptoms of PTSD, feelings of helplessness, and anxiety about potential relapses; and (3) Social Adjustments, such as improved health-seeking behaviours and stronger family relationships. Among participants, 60% demonstrated high levels of resilience, while 73% showed signs of anxiety, and the same proportion exhibited PTSD-related symptoms. All three male caregivers reported experiencing PTSD symptoms. DISCUSSION: Caregivers of childhood cancer survivors in Lagos experience notable physical and emotional strain, including symptoms of anxiety and PTSD. Despite minimal formal support, many adapt through strengthened family ties, improved health practices, and spiritual traditions. These results suggest a need for culturally sensitive, caregiver-focused support within survivorship care. Further research should guide the development of targeted interventions in low-resource settings. CONCLUSION: Caregivers of childhood cancer survivors in Lagos continue to experience significant psychosocial burdens beyond active treatment. There is an urgent need for structured psychosocial support integrated into survivorship care plans, especially in LMIC contexts.
Effect of a Mobile Health Intervention on Sexual and Reproductive Health Literacy and Service Utilisation among University Students in Southwest Nigeria.
Olajubu AO, Komolafe AO, Olajubu TO … +1 more , Olowokere AE
West Afr J Med · 2026 Apr · PMID 42177811
BACKGROUND: Sexual and Reproductive Health (SRH) literacy influences young people's health behaviours and outcomes. Mobile health (mHealth) technologies are potential tools for the delivery of health education and servic...
BACKGROUND: Sexual and Reproductive Health (SRH) literacy influences young people's health behaviours and outcomes. Mobile health (mHealth) technologies are potential tools for the delivery of health education and services, but evidence on their effectiveness in strengthening SRH literacy is limited in the study setting. This study assessed the effect of an mHealth intervention on SRH literacy and service utilisation among in-school young people in Osun State, Nigeria. METHODS: A quasi-experimental design was employed among undergraduate students aged 18 - 24 years in two tertiary institutions in Osun State. Participants were allocated by institution into intervention (n = 60) and control (n = 60) groups. The intervention group received a six-week mHealth SRH literacy programme delivered through a mobile application. Data was collected at baseline and post-intervention. Paired t-tests, analysis of covariance and regression analyses were done. RESULTS: Post-intervention, the intervention group demonstrated a significant increase in mean SRH literacy scores compared with baseline (p = 0.018). The post-test SRH literacy scores were significantly higher in the intervention group than in the control group (p = 0.002), with a large effect size (partial η² = 0.84). The mHealth intervention independently increased the odds of good SRH literacy (AOR = 3.69; 95% CI: 1.54 - 8.86), SRH service utilisation (AOR = 6.25; 95% CI: 1.29-30.16), and the intention to use SRH services in the future (AOR = 2.86; 95% CI: 1.03 - 7.95). CONCLUSION: The mHealth-based intervention significantly improved SRH literacy and service utilisation among young people. The deployment of mHealth interventions to strengthen health literacy competencies in the study setting should be considered.
Optimising Asthma Control in a Sub-Saharan African Population: Assessing Agreement among Five Standardized Questionnaires.
Kehinde FM, Awopeju O, Adewole OO … +4 more , Afolabi M, Adejuyigbe T, Adeniyi B, Erhabor GE
West Afr J Med · 2026 Apr · PMID 42177808
BACKGROUND: Asthma management prioritises symptom control, typically assessed using standardized questionnaires. However, comparative data on their performance and agreement remain scarce in Sub-Saharan Africa. METHODS:...
BACKGROUND: Asthma management prioritises symptom control, typically assessed using standardized questionnaires. However, comparative data on their performance and agreement remain scarce in Sub-Saharan Africa. METHODS: In a cross-sectional study of 100 adults [79% females, mean age 38.1±14.6 years] with physician-diagnosed asthma at a Nigerian tertiary hospital, asthma control was evaluated using Global Initiative for Asthma (GINA), Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ-7), Royal Society of Physicians 3 Questions (RCP-3Qs) and Asthma Therapy Assessment Questionnaire (ATAQ). Agreement was measured with Cohen's kappa statistics. Diagnostic accuracy for GINA-defined well-controlled asthma was analysed using ROC-derived thresholds, with GINA serving as the reference standard to assess the performance of ACT, ACQ, RCP-3Qs, and ATAQ. RESULTS: The level of controlled asthma ranged from 73% to 83% across tools. Agreement among control tools was low; GINA showed slight agreement with others (κ = 0.018-0.107), while ACT and ACQ had moderate agreement (κ = 0.546). ACT, ACQ, and RCP-3Qs demonstrated strong diagnostic accuracy for identifying GINA-defined well-controlled asthma (AUC 0.90; 95% CI: ACT 0.76-0.95; ACQ 0.75-0.94; RCP-3Qs 0.78-0.92), whereas ATAQ performed poorly (AUC 0.5; 95% CI: 0.29-0.59). At pre-specified thresholds of >20, ≤1.57, ≤1 and 0.5, the specificity of ACT, ACQ, RCP-3Qs, and ATAQ was 92.6%, 70.4%, 70.4%, and 85.2%, respectively; while sensitivity was 73.7%, 94.7%, 100%, and 26.3%. CONCLUSION: ACT, ACQ, and RCP-3Q effectively identified GINA-defined well-controlled asthma, while ATAQ showed poor diagnostic value. Low agreement among the tools suggests they are not interchangeable for assessing asthma control.
Patients' Satisfaction with Healthcare Services in a Tertiary Healthcare Facility, North-Central, Nigeria.
Bello CSS, Eseigbe P, Elisha A … +1 more , Chima AAG
West Afr J Med · 2026 Apr · PMID 42177807
BACKGROUND: Patient satisfaction is the extent to which a healthcare facility fulfils patients' expectations. It is a critical and integral part of patient-oriented healthcare, serving as a key indicator for measuring th...
BACKGROUND: Patient satisfaction is the extent to which a healthcare facility fulfils patients' expectations. It is a critical and integral part of patient-oriented healthcare, serving as a key indicator for measuring the quality of care provided to patients. Assessing patients' satisfaction with care is a way of obtaining feedback from patients, which can be a measure of the effectiveness of healthcare services. This study aimed to assess the level of patient satisfaction with services received at the Bingham University Teaching Hospital in Jos, Plateau State, to improve healthcare services. METHODS: The study was a descriptive, cross-sectional study conducted in the Bingham University Teaching Hospital (BHUTH). The BHUTH is a private tertiary hospital located in Plateau State's capital city of Jos, the North-central region of Nigeria. Participants were selected conveniently from the outpatient clinics and wards. The data was collected using the Long-form Patient Satisfaction Questionnaire (PSQ-III) and included the participants' sociodemographic characteristics. There are seven domains in the PSQ-III, namely General satisfaction, Technical quality, Interpersonal care, Communication, Financial aspects, Time spent with the doctor, and Access/availability/convenience. Data collected was analyzed using IBM SPSS Statistics for Windows, version 27. RESULTS: There were 236 respondents. A little more than half (51.7%) of the patients were in the 18 - 39 years age group, and more (59.7%) were females. A majority (62.7%) of the responders had attained a tertiary level of education. The overall patient satisfaction rate was 67.6%. Only 52.5% of patients reported having a high general satisfaction, 56.4% were highly satisfied with the financial aspects of healthcare services, and 86.0% had high satisfaction with the communication. CONCLUSION: This study has revealed an overall average patient satisfaction. Among the domains of satisfaction assessed, communication had the highest rate of satisfaction, and the financial aspect of healthcare services was among the lowest rates of patient satisfaction. These findings can help prioritize strategies for improving healthcare services.
Risk Factors for Paediatric Intensive Care Unit Admission and In-hospital Mortality among Paediatric Emergencies in Nigeria: A Single Centre Study.
Akindolire A, Adebayo B, Fagbohun A … +5 more , Folayan O, Ashubu O, Robert O, Tongo O, Lee JH
West Afr J Med · 2026 Apr · PMID 42177770
BACKGROUND: In Nigeria, the burden of critical illness and risk factors for mortality remains poorly described. This study describes the epidemiology of patients admitted at the children's emergency ward (EW) and risk fa...
BACKGROUND: In Nigeria, the burden of critical illness and risk factors for mortality remains poorly described. This study describes the epidemiology of patients admitted at the children's emergency ward (EW) and risk factors for Paediatric intensive care unit (PICU) admission and in-hospital mortality (IHM). METHODS: This was a retrospective study of patients admitted to the Children's EW of the University College Hospital, Ibadan, Nigeria, from 1st December 2022 to 30th November 2023. Patient's demographics, presenting clinical features and diagnosis at admission were extracted. The primary outcome was PICU admission. Secondary outcomes were duration of hospital stay and IHM. RESULTS: There were 649 patients; 421(64.9%) were <5 years old. Median age was 2.3 (interquartile range 0.8-7.0) years. Most common presenting features were dyspnoea [269 (41.4%)], vomiting [182 (28%)] and hypoxaemia [188 (29%)]. At presentation, 51 (7.9%) and 63 (10.3%) had altered mental status and seizures, respectively, while the most common diagnoses were sepsis [250 (39%)], malaria [192 (30%)], and pneumonia [165(26%)]. At presentation, 217 (33.5%), 110 (16.9%), 48 (7.4%), and 32 (4.9%) required oxygen, blood transfusion, fluid bolus, and inotropes, respectively. Twenty (3.1%) patients required cardiopulmonary resuscitation (CPR), and 101 (15.6%) required PICU admission. Median duration of hospital stay was 5 (interquartile range 3-9) days, while IHM was 74 (6.6%) patients. On bivariate analysis, gender, dehydration, breathlessness, dyspnoea, cyanosis, cold extremities, thready pulses and altered mental state were associated with mortality, while breathlessness, hypoxaemia, dyspnoea, dehydration, cyanosis, thready pulses, cold extremities, convulsion and altered mental status were associated with PICU admission. CONCLUSION: Shock state and hypoxaemia were associated with poor outcomes in paediatric emergencies. The introduction of basic critical care services will reduce the burden of adverse outcomes.
Socio-Demographic, Economic Factors, and Antibiotic Self-Medication among Residents of Rivers State in South-South, Nigeria.
Nnadi NO, Ikurayeke J, Amaechi IG … +2 more , Dienye NP, Olaniyan FA
West Afr J Med · 2026 Apr · PMID 42177752
BACKGROUND: Self-medication with antibiotics is a threat to global health and is becoming increasingly observed in both developed and developing countries with prevalence of 32.5 - 81.5% worldwide. This study assessed th...
BACKGROUND: Self-medication with antibiotics is a threat to global health and is becoming increasingly observed in both developed and developing countries with prevalence of 32.5 - 81.5% worldwide. This study assessed the socio-demographic, economic factors and use of antibiotic self-medication among dwellers in River State, South-south, Nigeria. METHOD: This was a cross-sectional study among 250 patients who attended the Family Medicine Clinic at the Rivers State University Teaching Hospital, Port Harcourt. Interviewer-administered questionnaires were used for data collection. The data was analyzed using SPSS version 23. Chi-Square test was used to assess the association between socio-demographic and economic characteristics with antibiotic self-medication. A p-value of <0.05 was considered statistically significant. RESULTS: Majority of the respondents were females (65.2%), were within the age group of 20-39 years (59.2%) and had tertiary level of education (64.0%), while about 2.8% had no formal education. The overall prevalence of antibiotic self-medication was 75.2%, males (81.6%) self-medicated more than the females (71.8%) and all the respondents with no formal education (100%) practiced self-medication. The association between self-medication and educational status was statistically significant with a p-value of 0.004. The antibiotic most frequently used for self-medication in this study was Ampiclox (Ampicillin plus Cloxacillin) -an antibiotic class of the Penicillin. CONCLUSION: Self-medication with antibiotics is still prevalent and was associated with a person's educational level. There is need for tailored educational programs to advocate for appropriate antibiotic utilization to mitigate this prevalent misuse.
Posterior Urethral Valves at the University College Hospital Ibadan: A Seven-Year Review.
Ademola AD, Asinobi AO, Olulana DI … +13 more , Takure AO, Adebayo SA, Alao MA, Tongo OO, Ayede AI, Akinmoladun JA, Adenigba PT, Olatunji RB, Lawal TA, Lawal TA, Ogundoyin OO, Olapade-Olaopa EO, Shittu OB
West Afr J Med · 2026 Apr · PMID 42177751
BACKGROUND: Posterior urethral valve (PUV) is the most common severe obstructive uropathy in boys. We reviewed patients with PUV in our hospital to provide an update on the presentation, management and outcome of PUV in...
BACKGROUND: Posterior urethral valve (PUV) is the most common severe obstructive uropathy in boys. We reviewed patients with PUV in our hospital to provide an update on the presentation, management and outcome of PUV in our setting. METHODOLOGY: A retrospective study of patients with PUV admitted in our hospital between January 1, 2016 - December 31, 2022. RESULTS: Fifty-one patients were included, seven (median age 6.4 IQR 2.3, 10.8 years) had undergone valve ablation before presentation, while 44 (median age 1.3 IQR 0.1, 2.9 years) had not. Among the 44, four (9.1%) had abnormal features on antenatal ultrasound. 15.9% and 56.9% presented in the neonatal period and after one year of age respectively. The main complaints were voiding symptoms (45.5%), abdominal swelling (40.9%) and history of fever (38.6%). Wasting occurred in 43.9%. Serum creatinine ranged from 0.2-25.5 (median 1.4, IQR 0.8-3.0) mg/dl. Thiry seven children underwent valve ablation. Additionally, four of the 51 patients underwent repeat valve ablation. End-stage kidney disease (ESKD) occurred in five (9.8%). Dialysis was carried out in six patients (11.7%) including two patients with acute kidney injury. None underwent kidney transplantation. Mortality occurred in 10 (19.6%) and was due to sepsis (n=5) and ESKD (n= 4). CONCLUSION: Posterior urethral valve is an important cause of morbidity and mortality in low resource settings and has 19.6% mortality in our centre over a 7-year period. Enhanced access to antenatal detection, early diagnosis and treatment, and kidney transplantation have the potential to improve outcomes.
Leveraging mHealth and Digital Innovations for Healthcare Service Delivery.
Erhabor GE
West Afr J Med · 2026 Apr · PMID 42177670
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Acute Necrotizing Cholecystitis: A Case Report and Review of Literature.
Momah T
West Afr J Med · 2025 Dec · PMID 42035354
Acute Necrotizing Cholecystitis (ANC) is a rarely diagnosed condition, with a 2 to 20% prevalence amongst cases of acute cholecystitis. The decreased prevalence is, however, associated with a high mortality rate (15-40%)...
Acute Necrotizing Cholecystitis (ANC) is a rarely diagnosed condition, with a 2 to 20% prevalence amongst cases of acute cholecystitis. The decreased prevalence is, however, associated with a high mortality rate (15-40%) when left untreated or intervention delayed due to non-specific signs and symptoms. A high index of suspicion is therefore requisite if a diagnosis of ANC is not to be missed. We present the case of a Seventy-One year old African American Male who was diagnosed post-operatively with ANC.
Clinical Presentation and Outcome of Tropical Diabetic Hand Syndrome in Diabetic Patients: A Case Series from Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Adeleye AO, Okpe IO, Bello F … +2 more , Abubakar S, Mathew MB
West Afr J Med · 2025 Dec · PMID 42035353
BACKGROUND: One of the complications of Diabetes Mellitus (DM) - both type 1(T1DM) and type 2 (T2DM) is Tropical diabetic hand syndrome (TDHS). The initiating event ranges from trivial trauma to overt injury to the hand...
BACKGROUND: One of the complications of Diabetes Mellitus (DM) - both type 1(T1DM) and type 2 (T2DM) is Tropical diabetic hand syndrome (TDHS). The initiating event ranges from trivial trauma to overt injury to the hand in the presence of hyperglycaemia, usually aggravated by poorly treated wounds, superimposed infection and peripheral neuropathy. This case series aims to highlight the different forms of presentation of TDHS and their outcomes. MATERIALS AND METHODS: This is a case series that reviewed four cases of TDHS managed at the Endocrine Unit of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, over an 11 months period from August 2023 to June 2024. Out of seven identified cases, four with complete treatment records were included. RESULTS: Case 1: A 24-year-old female single lady with a 2-week history of a stick injury to the left hand presented with a random blood sugar (RBS) of 22.2 mmol/L, swelling, ulcers, and pus discharge. Staphylococcus spp. was cultured from the wound. She was treated with antibiotics and underwent debridement. Case 2: A 20-year-old female trader presented with a 2-weeks history of spontaneous blisters on the right hand with an RBS of 22.5mmol/L, she exhibited similar symptoms as case 1. Staphylococcus spp. was also cultured. She had antibiotics and debridement. Case 3: A 44-year-old male butcher presented with a 3-weeks history of a knife injury to the left hand, along with swelling, ulcers, pus, and gangrene with an RBS of 18.5mmol/L. He required debridement and subsequent amputation. Case 4: A 49 year-old widow, a known T2DM, and Hypertensive heart failure patient who presented with left hand swelling and ulceration from the cannula site. She eventually died from multiple organ failure. CONCLUSION: TDHS remains a serious and preventable complication among diabetic patients in tropical regions. This case series underscores the importance of educating patients on hand care in addition to other forms of diabetic education to prevent severe outcomes such as gangrene and amputation.
Association Between Obstructive Sleep Apnoea, Excessive Daytime Sleepiness, and Road Traffic Accidents Among Nigerian Truck Drivers.
Adeoti AO, Desalu OO, Fadare JO … +2 more , Elebiyo T, Faramade AA
West Afr J Med · 2025 Dec · PMID 42035348
BACKGROUND: Obstructive sleep apnoea (OSA) and excessive daytime sleepiness (EDS) are recognized contributors to road traffic accidents (RTAs). However, the association between OSA, EDS, and RTAs remains underexplored am...
BACKGROUND: Obstructive sleep apnoea (OSA) and excessive daytime sleepiness (EDS) are recognized contributors to road traffic accidents (RTAs). However, the association between OSA, EDS, and RTAs remains underexplored among Nigerian truck drivers. METHODS: A cross-sectional study was conducted among 306 adult male long-distance truck drivers in Ado-Ekiti, Nigeria. The Berlin Questionnaire was used to assess the risk of OSA while the Epworth Sleepiness Scale evaluated excessive daytime sleepiness (EDS), and self-reported previous RTAs were adapted in the questionnaire. RESULTS: The mean age (SD) of the truck drivers was 42.3±9.1 years. The prevalence of snoring, excessive daytime sleepiness and dozing off while driving among the participants was 57%, 46.7% and 21% respectively. Overall, 43.5% of truck drivers were identified as having high risk for OSA. The risk factors associated with OSA were advanced age (50 years and above), self-reported systemic hypertension, obesity and increased neck circumference. In the three years preceding the study, approximately one-third of truck drivers reported being involved in RTAs which was associated with the use of stimulants aOR 11.63(95%CI 3.73 to 36.24, p=0.001), sleeping pills aOR 5.26(95%CI 1.50 to 18.40, p=0.001), high OSA risk aOR 2.21 (95%CI 1.60 to 4.80, p=0.03), EDS aOR 2.75(1.60 to 4.80, p=0.001) and extended working hours aOR 1.02(95%CI 1.00 to 1.04, p=0.03). More than 90% of the drivers were unaware that EDS constitutes a medical concern. CONCLUSION: The high prevalence of excessive daytime sleepiness, and obstructive sleep apnoea among truck drivers highlights the underrecognized contributors to road traffic accidents. This underscores the need for targeted sleep disordered screening and regulatory interventions by policymakers to improve road safety in Nigeria.
Effect of Non-surgical Periodontal Therapy on the Control of Chronic Obstructive Pulmonary Disease Among Patients Attending a Tertiary Health Institution in Nigeria.
Adewole OM, Onabanjo OA, Ogunwemimo MT … +5 more , Ogundiran T, Ogunleye BA, Oguntoye OA, Nwhator SO, Adewole OO
West Afr J Med · 2025 Dec · PMID 42035331
BACKGROUND AND OBJECTIVES: The links between periodontal disease and a number of systemic diseases including respiratory diseases have been widely reported in the literature. The burden and prevalence of periodontal dise...
BACKGROUND AND OBJECTIVES: The links between periodontal disease and a number of systemic diseases including respiratory diseases have been widely reported in the literature. The burden and prevalence of periodontal disease and chronic obstructive pulmonary disease (COPD) is increasing globally. Periodontitis is now recognised as an independent risk factor for COPD. In addition, these two chronic diseases have similar pathogenic mechanisms. Despite these facts, the role of prevention of periodontitis in the management of COPD had not been fully explored. The aim of the study was to look at the effect of non-surgical periodontal therapy on the control of symptoms of Chronic Obstructive Pulmonary Disease (COPD) in our resource-limited settings. METHODS: Sixty-nine COPD patients with concurrent periodontitis, who were at least 40 years old, were recruited from the Chest clinic of a tertiary institution in Ile Ife, Osun State, Nigeria between July 2021 and January 2023. Using GraphPad software, the participants were randomly categorised into two groups (control and intervention). The intervention group received non-surgical periodontal therapy (NSPT) and oral hygiene instructions (OHI) while the control group received oral hygiene instruction (OHI) only after the initial determination of the aMMP-8 assay and oral examinations. However, they had their non-surgical periodontal therapy after the three months follow-up. Clinical parameters such as COPD Assessment Test (CAT) scores, probing pocket depths (PPD), clinical attachment level (CAL) and a biomarker active matrix metalloproteinase-8 (aMMP-8) were recorded at baseline and after 3 months. Independent t-test was used for normally distributed variables for the two groups while Mann-Whitney U test was used for non-normally distributed variables. Paired t-test was used for the intra-group comparisons of the mean values and p value set at <0.05. RESULTS: A total of 69 participants comprising 35 participants in the intervention group and 34 participants in the control group were enrolled in this study. The intervention group demonstrated statistically significant improvements in the CAT scores from 18.66 to 15.06 (p<0.04), aMMP-8 from 26.28ng/ml to 18.66ng/ml (p<0.001), mean PPD from 2.78mm to 2.64mm (p<0.05) and mean CAL from 4.64mm to 4.50mm (p<0.001) in comparison to the control group ( CAT scores from 18.91 to 17.59 p=0.07, aMMP-8 from 30.80ng/ml to 27.11ng/ml p=0.11, mean PPD from 2.82mm to 2.84mm p=0.37, and mean CAL from 4.88mm to 4.89mm p=0.69). CONCLUSION: The results of this study emphasize the possible advantages of incorporating periodontal care into strategies for managing COPD.
Outcome of the Management of Patients with Tropical Diabetic Hand Syndrome.
Akintayo AJ, Yiltok SJ, Choji JD … +8 more , Egga A, Kaffi SS, Akubuko SO, Idrisu A, Wodung F, Edah JO, Odoh G, Puepet FH
West Afr J Med · 2025 Dec · PMID 42035327
BACKGROUND: Tropical Diabetic Hand Syndrome (TDHS) is an acute, rapidly progressive hand infection affecting patients with diabetes mellitus (DM), often following trivial trauma. Unlike those with diabetic foot disease,...
BACKGROUND: Tropical Diabetic Hand Syndrome (TDHS) is an acute, rapidly progressive hand infection affecting patients with diabetes mellitus (DM), often following trivial trauma. Unlike those with diabetic foot disease, neuropathy and vasculopathy play a minor role, while poor glycaemic control, delayed presentation, and minor injuries are key risk factors. TDHS is often not recognised in Nigeria despite its potential for disability and mortality. This study reviews the management outcomes of patients presenting with TDHS at a tertiary hospital in Nigeria. METHODOLOGY: A retrospective review was conducted of all patients with DM managed for TDHS at the Jos University Teaching Hospital from 2015 to 2024. Data were extracted on socio-demographics, type and duration of diabetes, clinical presentation, treatment, and outcomes. Descriptive statistics were applied using SPSS version 25. RESULTS: Thirteen patients were included: mean age 45.4 ± 11.2 years, with a female predominance (61.5%). Most (92.3%) had type 2 diabetes of a median duration of 6 years, and poor glycaemic control was observed in 86.6%. Abscesses (53.8%) and ulcers (30.8%) were the commonest presentations, predominantly affecting the digits (61.5%). Incision and drainage with dressings (that included the use of povidone iodine) was the main surgical treatment, while flap cover was rarely required. The mean hospital stay was 26.5 ± 23.9 days. Outcomes were favourable in 86.6% (discharged), with one death (7.7%) and one patient leaving against medical advice. CONCLUSIONS: TDHS remains a preventable but serious complication of diabetes in Nigeria, predominantly affecting middle-aged women with poorly controlled type 2 diabetes. Prompt surgical and medical management yielded favourable outcomes, but prolonged hospitalisation and mortality highlight its burden. Strengthening diabetes care, patient education, and clinician awareness are vital to reducing incidence and improving outcomes.
Zinc Deficiency Among Children Living with HIV on Antiretroviral therapy in Lagos, Nigeria.
Fakile UO, Akinsete AM, Akintan PE … +3 more , Oyenusi EE, Abdulraheem KS, Temiye EO
West Afr J Med · 2025 Dec · PMID 42035317
BACKGROUND: Zinc is an essential micronutrient vital for immune function and growth. HIV infection commonly leads to zinc deficiency due to increased demand, malabsorption, and reduced intake, potentially worsening disea...
BACKGROUND: Zinc is an essential micronutrient vital for immune function and growth. HIV infection commonly leads to zinc deficiency due to increased demand, malabsorption, and reduced intake, potentially worsening disease progression. While antiretroviral therapy (ART) improves overall health, its specific impact on zinc levels in HIV-positive children, particularly in Nigeria where ART is now widespread, remains under-researched. This study aims to determine the prevalence of zinc deficiency in HIV-positive children on HAART in Lagos, Nigeria. METHODOLOGY: This study was a subgroup analysis of the HIV arm of a comparative study conducted over 11 months. A total of 170 HIV-positive children were assessed. Although the eligibility criteria spanned 6 months to 18 years, the actual age range of the recruited cohort was 9 months to 18 years, as no eligible children aged 6-8 months were enrolled during the study period. Serum zinc levels were measured using a conventional atomic absorption spectrophotometer, with normal values defined as 70 to 125 µg/dL. RESULTS: Participants aged 9 months to 18 years (mean 10.9±3.4 years) had been on ART for an average of 7.8 years, with 60.0% on first-line medication. Zinc deficiency prevalence was 69.4% (118/170). While no associations were found with sociodemographic, anthropometric, or clinical variables (all p>0.05), longer ART duration was significantly associated with normal zinc levels (9.1±3.4 vs 7.3±3.6 years, p=0.002; OR=0.860, 95% CI: 0.770-0.960, p=0.007). CONCLUSION: The study found high zinc deficiency prevalence among HIV-positive children in Lagos, Nigeria, despite ART participation. Longer HAART duration may protect against zinc deficiency. Routine zinc assessment is needed, and randomized controlled trials should explore zinc supplementation benefits for improving HIV outcomes in this vulnerable population.
Prevalence of Cryptosporidium Species in Well Water in Ife East Local Government Area, Ile-Ife, Nigeria.
Olopade BO, Apata CO, Odetoyin BW … +1 more , Onipede AO
West Afr J Med · 2025 Dec · PMID 42035313
BACKGROUND: Cryptosporidium is a water-borne protozoal parasite that infects humans and causes water-borne diarrhoea outbreaks. OBJECTIVES: This cross-sectional study determined the prevalence of Cryptosporidium in wells...
BACKGROUND: Cryptosporidium is a water-borne protozoal parasite that infects humans and causes water-borne diarrhoea outbreaks. OBJECTIVES: This cross-sectional study determined the prevalence of Cryptosporidium in wells in Ile-Ife, and assessed the risk factors associated with its presence in well water in Ile-Ife. METHODS: Water samples were collected from 316 wells in the 10 wards that make up Ife East Local Government Area (LGA). A structured questionnaire was used to obtain relevant information on the wells from users. Modified acid-fast staining was used for the phenotypic identification of Cryptosporidium. Nested Polymerase Chain reaction (PCR) amplification of the 18S rRNA gene was carried out on the samples positive by staining. Cryptosporidium was confirmed by PCR and sequenced for species identification. Data was analysed using SPSS (version 21.0). Descriptive and inferential statistics were determined. A p-value of less than 0.05 was considered statistically significant. RESULTS: The results showed that 11 (3.5%) of the 316 sampled wells were positive for Cryptosporidium by acid-fast staining, however only one was positive for Cryptosporidium by Nested PCR and was confirmed as Cryptosporidium parvum by sequencing. However, none of the risk factors investigated were significantly associated with the presence of Cryptosporidium in the well (p>0.05). CONCLUSION: The study concluded that Cryptosporidium has low prevalence in wells in Ife East LGA. Cryptosporidium parvum was the species identified in the study area.
Prevalence and Correlates of Depression among Non-Parturient, Pregnant, and Postpartum Women in Ibadan, Nigeria.
Omokhodion F, Adebayo AM, Bello OO … +6 more , John-Akinola YO, Ilori T, Bella-Awusah TT, Cadmus EO, Ndikom CM, Ojengbede OA
West Afr J Med · 2025 Dec · PMID 42035309
BACKGROUND: Depression among women of reproductive age (WRA) is a major public health challenge because of its impact on mothers, children, and family members. OBJECTIVE: The study determined the prevalence of depression...
BACKGROUND: Depression among women of reproductive age (WRA) is a major public health challenge because of its impact on mothers, children, and family members. OBJECTIVE: The study determined the prevalence of depression and its associated factors among women of reproductive age at the three levels of healthcare in Ibadan, Nigeria. METHODS: This cross-sectional facility-based study was conducted to compare the prevalence and correlates of depression among 991 pregnant, 662 postpartum, and 674 non-pregnant women using the Hospital Anxiety and Depression Scale (HADS). Data were analysed using descriptive statistics, the chi-square test, and binary logistic regression to determine the factors associated with and predictors of depression at p<0.05%. RESULTS: The mean age of respondents was 29.9±6.3 years. Prevalence of depression was highest among pregnant women (38.5%), followed by non-pregnant (32.9%) and postpartum women (29.6%) (X2=14.93; p-value=0.001). Women whose husbands had primary education or below and those with financial problems were twice as likely to be depressed as those who did not. The presence of family problems and money-related issues were the predictors of depression across the groups. CONCLUSION: Depression was common in women across the reproductive age lifespan. There is a need for screening for depression during routine health care to identify the women most at risk and for prompt intervention.
Relationship between Refractive Error and Ocular Biometry in Secondary School Students.
Okorie IA, Badmus SA, Adegbehingbe BO … +3 more , Onakpoya OH, Adewara B, Awe O
West Afr J Med · 2025 Dec · PMID 42035305
BACKGROUND: Exploring the relationship between refractive error and ocular biometry in young African school children is essential for early detection, prevention, and management of visual impairments. OBJECTIVES: This st...
BACKGROUND: Exploring the relationship between refractive error and ocular biometry in young African school children is essential for early detection, prevention, and management of visual impairments. OBJECTIVES: This study aimed to profile the distribution of ocular biometry parameters and to identify correlates of spherical equivalent refraction (SE) among school children in Nigeria. METHODS: A cross-sectional study was conducted among 295 secondary school students aged 10-19 years in Ife Central Local Government Area. Ocular measurements, including axial length, corneal radius of curvature, keratometric readings, anterior chamber depth, and horizontal corneal diameter, were obtained using the IOL Master. Refractive error was assessed with an autorefractor, and subjective refraction was also performed on all participants. RESULTS: Out of the total participants, 109 students (37.0%) had refractive errors, comprising 43.1% males and 56.9% females. Astigmatism was the most common type of refractive error, found in 75 students (68.8%), followed by myopia in 22 (20.2%) and hypermetropia in 12 (11.0%). The median (IQR) axial length was 23.4 (0.8) mm. The average keratometric reading and average corneal radius of curvature were 43.5 ± 1.4 diopters and 7.8 ± 0.2 mm, respectively. The median (IQR) anterior chamber depth, horizontal corneal diameter and spherical equivalent refraction were 3.3 (0.3) mm, 12.2 (0.8) mm and -0.8 (1.3) diopters, respectively. Myopic students had longer axial lengths, deeper anterior chambers, and lower average keratometric readings. Spherical equivalent refraction was significantly negatively correlated with axial length (r = -0.147, p < 0.011), anterior chamber depth (r = -0.130, p < 0.026), and horizontal corneal diameter (r = -0.119, p < 0.042). A positive but non-significant correlation was observed with average keratometric reading (r = 0.009, p = 0.872). CONCLUSION: Axial length, anterior chamber depth, and horizontal corneal diameter showed significant inverse relationships with spherical equivalent refraction.
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