Annals of Health Research https://www.annalsofhealthresearch.com/index.php/ahr <p>Peer-reviewed open access journal of medical and health-related sciences to&nbsp;disseminate research works and ideas in the fields of clinical sciences, basic medical sciences and public health with the ultimate goals of enhancing knowledge, improving practice and encouraging practice-centred research. It is indexed by African Index Medicus and Index Copernicus. It is also registered with the Crossref, Committee for Publication Ethics (COPE) and the Directory of Open Access Journals (DOAJ).</p> <p><em><strong>This journal is published under the Creative Commons License Attribution Non-Commercial CC-BY NC. This license lets others remix, tweak and build upon our works non-commercially and although, their new works must also acknowledge us and be non-commercial, they do not have to license their derivative works on the same terms.</strong></em></p> Medical and Dental Consultants Association of Nigeria, OOU Teaching Hospital, Nigeria en-US Annals of Health Research 2476-8642 <p>The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.</p> Research and Publication Ethics https://www.annalsofhealthresearch.com/index.php/ahr/article/view/150 <p>Research is an effort to seek the truth and communicate it. In the process, participants or subjects of research must be recognised and respected, and the principles of research ethics must protect the vulnerable from exploitation. The researcher must do the reporting of research findings with honesty and professionalism. Non-adherence to the above principles in the early research period resulted in gross abuse of personality and autonomy. Research is now subjected to rigorous scrutiny to stem the tide of abuse and ascertain and guarantee the sanctity of the research participants, process and product. These are the fundamentals of the practice of ethics in both research and publication. In effect, this paper aims to address ethics and its application to research and publications.</p> PO Olatunji Copyright (c) 2021 Annals of Health Research http://creativecommons.org/licenses/by-nc/4.0 2021-09-27 2021-09-27 7 3 198 207 10.30442/ahr.0703-01-130 Anti-diabetic Agents and the Potentials for Reducing Cardiovascular Risks in Type-2 Diabetes Mellitus https://www.annalsofhealthresearch.com/index.php/ahr/article/view/356 <p>Recent reports from Cardiovascular Outcome Trials (CVOTs) revealed that some newer anti-diabetic drugs impact Major Adverse Cardiovascular Events (MACE). These medications include the Sodium-Glucose Co-Transporter (SGLT2) inhibitors and the Glucagon-like Peptide-1 (GLP-1) receptor agonists. There is a need for a review of the mechanisms of action of these drugs, in addition to their glucose-lowering effects and CV benefits. This review paper aims to explore the cardio-protective effects and CV risks of anti-diabetic medications, their mechanisms of action and the CV benefits evidenced by CVOTs. Using internet search, with search items such as Type 2 Diabetes mellitus, cardiovascular risk factors, cardiovascular outcome trials, major adverse cardiovascular events, sodium-glucose transporter-2 inhibitors, glucagon-like peptide-1 receptor agonist, the Google Scholar, EMBASE, PubMed, Medline, Web MD, and Scopus were checked for various relevant published articles. Analyses of the results of multiple CVOTs from various parts of the world were considered. These CVOTs were reviewed to assess the role of anti-diabetic agents in reducing cardiovascular risk in patients with T2DM. The SGLT2 inhibitors and GLP1 agonists were found to be beneficial in lowering MACE when compared with placebo. This is in addition to their anti-hyperglycaemic benefits.</p> <p><strong>In conclusion, </strong>SGLT2 inhibitors and GLP-1 agonists confer dramatic beneficial CV risk reduction on patients with T2DM, as shown by the various CVOTs. This is in addition to their anti-hyperglycaemic effects. This remarkable benefit justifies the need by various guidelines to adopt them as second line agents to metformin in managing patients with T2DM.</p> IU Ezeani A Eregie AE Ohwovoriole Copyright (c) 2021 Annals of Health Research http://creativecommons.org/licenses/by-nc/4.0 2021-09-27 2021-09-27 7 3 208 226 10.30442/ahr.0703-02-131 Knowledge of Non-nutritive Digit Sucking Among Mothers of Under-Five Children in Ilorin, Nigeria https://www.annalsofhealthresearch.com/index.php/ahr/article/view/339 <p><strong>Background:</strong> The sucking habits of infants can be nutritive and non-nutritive sucking. Digit-sucking is normal in babies and young children, but sometimes it may persist into early childhood. &nbsp;</p> <p><strong>Objective: </strong>To determine the burden, knowledge and belief of mothers/caregivers concerning digit sucking among under-five children.</p> <p><strong>Methods:</strong> <strong>A cross-sectional study involving</strong> children under the age of 5 years attending the University of Ilorin Teaching Hospital, Ilorin, Nigeria, was conducted. The mothers of selected children were surveyed using an interviewer-administered questionnaire.</p> <p><strong>Results:</strong> The prevalence of non-nutritive digit sucking was 45.8%. While 68 (43.9%) of these children sucked their digits, 3 (1.9%) sucked pacifiers. The thumb and two digits were the preferred digits (52.9%). Sucking was done while awake in 36 (52.9%) children while 32 (47.1%) sucked whether awake or sleeping. Most (60.3%) mothers have the wrong perception of digit sucking and had attempted to discourage it.</p> <p><strong>Conclusions:</strong> The prevalence of non-nutritive and digit sucking was high in the population studied. Sucking occurs while awake and asleep, both day and night. Most mothers have the wrong perception of digit sucking and had attempted its stoppage.</p> SO Bello RM Ibraheem A Saka Copyright (c) 2021 Annals of Health Research http://creativecommons.org/licenses/by-nc/4.0 2021-09-27 2021-09-27 7 3 227 234 10.30442/ahr.0703-03-132 Booster Dose of Bacille Calmette-Guérin Vaccine for Tuberculosis in Low and Middle-Income Countries: A Systematic Review https://www.annalsofhealthresearch.com/index.php/ahr/article/view/364 <p><strong>Background:</strong> The Bacille Calmette-Guérin (BCG) vaccine, given as a single dose, offers variable protection against Tuberculosis (TB). It is plausible that repeat doses could improve the effectiveness of the BCG vaccine in settings where the population remain at risk of the disease.</p> <p><strong>Objective:</strong> To assess the effectiveness of BCG revaccination as a booster dose in preventing TB in Low- and Middle- Income Countries (LMICs).</p> <p><strong>Methods:</strong> We searched the electronic databases without language or publication restrictions and followed the procedures for preparing systematic reviews, including assessing the risk of bias as outlined in the Cochrane handbook. We included randomised controlled trials (RCTs) conducted in LMICs involving children and adults receiving one or more BCG vaccine doses after the primary BCG vaccination. The incidence of severe forms of TB, active TB and adverse events were the primary outcomes.</p> <p><strong>Results:</strong> Five RCTs were included in this systematic review. Revaccination with BCG probably makes little or no difference to the risk of active TB measured after five years (Relative risk (RR) 1.16, 95% CI 0.88 to 1.51; 348,083 participants; one study, moderate certainty evidence) or nine years post-revaccination (RR 0.96, 95% CI 0.82 to 1.12; 348,083 participants; one study, moderate certainty evidence). In populations with HIV co-infection, revaccination probably increases the risk of pulmonary tuberculosis compared to placebo (RR 1.74, 95% CI 1.00 to 3.01; 46,764 participants; one study, moderate certainty evidence).</p> <p><strong>Conclusion:</strong> The available evidence suggests that BCG revaccination probably makes little or no difference in preventing tuberculosis disease in LMICs.</p> OA Oduwole JP Mwankon J Okebe EB Esu M Chibuzor A Sallahdeen DI Arikpo C Meremikwu EE Effa MM Meremikwu Copyright (c) 2021 Annals of Health Research http://creativecommons.org/licenses/by-nc/4.0 2021-09-27 2021-09-27 7 3 235 252 10.30442/ahr.0703-04-133 Awareness and Preparedness for the Ongoing Community Spread of Coronavirus Infections Among Healthcare Workers in a Nigerian Private Tertiary Facility https://www.annalsofhealthresearch.com/index.php/ahr/article/view/366 <p><strong>Background:</strong> Healthcare workers (HCWs) are at high risk of contracting and spreading the novel Coronavirus Disease 2019 (COVID-19) disease putting themselves, the patients and the community at large at risk. Therefore, there is a need for adequate preparedness in the face of this pandemic.</p> <p><strong>Objectives:</strong> To assess the knowledge of HCW (clinical and non-clinical) on COVID-19, determine the level of HCWs preparedness against COVID-19 and evaluate the level of preparedness of the hospital facility against COVID-19.</p> <p><strong>Methods:</strong> Purposive sampling technique was used in this cross-sectional study. A self-administered questionnaire adapted from a validated questionnaire was used to collect appropriate data on socio-demographics, knowledge about COVID 19 and preparedness.</p> <p><strong>Results: </strong>A total of 170 HCWs with a mean age of 34.7±6.9 years participated in this study. More than half (56.5%; 96/170) were females. The average knowledge score among clinical staff was 9.04±13.77, with 80 clinical staff having good knowledge of COVID-19. The majority of non-clinical staff had a fair knowledge of COVID-19 with an average knowledge score of 5.11±47.07. About 63.4% were not confident enough in caring for a suspected coronavirus case even though more than half (57.6%) have had formal training in Infection Prevention and Control and above 77% (131/170) confirmed the availability of PPE in their facility. However, about three-quarters (74.7%; 127/170) believed the hospital is well prepared to manage COVID-19 cases.</p> <p><strong>Conclusion: </strong>This study revealed that this cohort of HCWs have good knowledge of COVID-19 and are convinced that they and their facility are well prepared for outbreaks of COVID-19.</p> AE Ladele JO Ogunkoya CJ Elikwu TA Oyedele KE Tuta O Abiodun A Idowu S Eigbe Copyright (c) 2021 Annals of Health Research http://creativecommons.org/licenses/by-nc/4.0 2021-09-27 2021-09-27 7 3 253 267 10.30442/ahr.0703-05-136 Rural-Urban Disparities and Factors Associated with Clients’ Satisfaction with Healthcare in a Nigerian population https://www.annalsofhealthresearch.com/index.php/ahr/article/view/363 <p><strong>Background:</strong> Clients’ satisfaction surveys are required to identify gaps and challenges in providing healthcare services; to ensure the quality of care and patient satisfaction.</p> <p><strong>Objectives:</strong> To compare and assess factors responsible for healthcare satisfaction among rural and urban communities in Ilorin East Local Government Area (LGA) of Kwara State to improve service provision among the communities.</p> <p><strong>Methods:</strong> This was a comparative, cross-sectional study involving rural (250) and urban (250) respondents selected through a multi-stage sampling technique and surveyed using an interviewer-administered questionnaire. Focus Group Discussion was also used to collect qualitative data. Participants were selected through the purposive sampling technique.</p> <p><strong>Results:</strong> The proportion of clients who expressed satisfaction was 172 (68.8%) among urban and 175 (70.0%) among rural respondents, (z = 0.57; p = 0.45). The attitude of healthcare personnel influenced satisfaction among both the rural (56.0%) and urban (63.3%) respondents, respectively; short waiting time (12.8%) and privacy of the consulting rooms (13.7%) were reasons influencing satisfaction with service.</p> <p><strong>Conclusion: </strong>Short waiting time and privacy of consulting room were reasons for service satisfaction among clients. Waiting time was a strong predictor of satisfaction. There is a need to improve health personnel’s attitude to work to ensure clients’ satisfaction with healthcare services.</p> AK Ahmed OY Ojo MJ Saka GA Salaudeen Copyright (c) 2021 Annals of Health Research http://creativecommons.org/licenses/by-nc/4.0 2021-09-27 2021-09-27 7 3 268 281 10.30442/ahr.0703-06-137 Assessment of the Antimicrobial Activity of Lactic Acid Bacteria from Sorghum Slurry on Clinical Strains of Diarrhoeagenic Escherichia coli https://www.annalsofhealthresearch.com/index.php/ahr/article/view/341 <p><strong>Background: </strong>Sorghum is a nutrient-rich grain ground into flour to make different types of delicacies, and it has been reported to possess probiotic potentials.</p> <p><strong>Objective:</strong> To assess the antimicrobial activity of <em>L</em><em>actobacillus plantarum</em> obtained from sorghum slurry on strains of enteropathogenic <em>Escherichia coli </em>from cases of diarrhoea.</p> <p><strong>Methods:</strong> A total of 36 samples of wet-milled sorghum slurry and liquor pH were obtained and cultured on MRSA and were, after that, biochemically characterized for <em>Lactobacillus plantarum, </em>which was tested by agar well diffusion against 15 strains of <em>Escherichia coli</em> isolated from cases of diarrhoea.</p> <p><strong>Results:</strong> Microbiological analysis of the 36 samples of sorghum explored produced 15 isolates of <em>Lactobacillus plantarum</em>. A progressive increase in acidity in relation to an increase in the period of fermentation was observed. Ninety-five per cent of the <em>Escherichia coli</em> strains showed resistance against some standard antibiotics. At the same time, the isolates of <em>Lactobacillus plantarum</em> obtained inhibited isolates of diarrhoeagenic <em>Escherichia coli</em> tested, showing potential usefulness of the sorghum slurry as a probiotic.</p> <p><strong>Conclusion:</strong> The inhibitory activity of <em>Lactobacillus plantarum</em> isolated from sorghum slurry showed antimicrobial potentials that could be used for therapeutic purposes in treating diarrhoea caused by&nbsp;&nbsp; <em>Escherichia coli, </em>pending further investigation<em>.</em></p> OL Okunye BM Okanlawon PA Idowu O Adeleye OC Fasuyi Copyright (c) 2021 Annals of Health Research http://creativecommons.org/licenses/by-nc/4.0 2021-09-27 2021-09-27 7 3 282 291 10.30442/ahr.0703-07-138 Saddle Block for Transrectal Prostate Biopsy: A Comparison of the Analgesic Efficacy of 0.25% Bupivacaine and 0.375% Ropivacaine https://www.annalsofhealthresearch.com/index.php/ahr/article/view/362 <p><strong>Background: </strong>Prostate biopsy is a painful procedure, and the degree of pain is related to the number of core biopsies taken.</p> <p><strong>Objective: </strong>To compare the analgesic properties of hyperbaric bupivacaine 0.25% with 0.375% ropivacaine for saddle block in transrectal prostate biopsy.</p> <p><strong>Methods</strong>: This was a randomised double-blinded study. Eighty patients with indications for prostate biopsy presenting at the Day-Case Theatre in a Nigerian tertiary facility were randomised into two equal groups: B (Bupivacaine) and R (Ropivacaine). Group B received 1ml of 0.25% bupivacaine, while Group R received 1ml of 0.375% ropivacaine for saddle block, respectively. Pain assessment, home readiness, patients' satisfaction, and time to first analgesic request were assessed and compared between the two groups.</p> <p><strong>Results:</strong> The Bupivacaine group had an earlier onset of sensory block (11.90±4.10 minutes <em>vs</em> 23.70±8.65 minutes, p = 0.000), slower sensory block regression (48.73±9.32 minutes <em>vs</em> 24.88±4.21 minutes, p = 0.000), but delayed home readiness (47.23±15.93 minutes <em>vs</em> 29.88±8.58 minutes, p = 0.000), than patients in the Ropivacaine group. The pain scores during, immediately after and 30 minutes post-biopsy were lower in the Bupivacaine group: p = 0.010, p = 0.028 and p = 0.023 respectively. The time to first analgesic request was also longer in the Bupivacaine group (48.73±9.33 minutes) than for those in the Ropivacaine group (24.88±4.21 minutes) with statistical significance (p = 0.000).</p> <p><strong>Conclusion:</strong> Intraoperative analgesic properties were better in the Bupivacaine group than in the Ropivacaine group. However, home readiness was earlier in the Ropivacaine group.</p> JO Bamigboye SO Olateju AF Faponle AA Salako Copyright (c) 2021 Annals of Health Research http://creativecommons.org/licenses/by-nc/4.0 2021-09-27 2021-09-27 7 3 292 301 10.30442/ahr.0703-08-139 Beta Inflated Regression Models on the Physical and Mental Health of Nigerian Stroke Survivors https://www.annalsofhealthresearch.com/index.php/ahr/article/view/358 <p><strong>Background:</strong> Stroke is one of the major public health problems worldwide. Physical and mental health data of stroke survivors are often expressed in proportions. Therefore, the Beta Regression models family for data between zero and one will be appropriate.</p> <p><strong>Objectives:</strong> To identify a suitable model and the likely risk factors of physical and mental health of stroke survivors.</p> <p><strong>Method</strong>: Secondary data of stroke survivors from two tertiary health Institutions in Ogun State, Nigeria, were analysed. Inflated Beta (BEINF) and Inflated-at-one-Beta (BEINF1) models were compared using Deviance (DEV), Akaike Information Criterion (AIC) and Bayesian Information Criteria (BIC) for model selection. The model with minimum DEV, AIC and BIC was considered to be better.</p> <p><strong>Results:</strong> The deviance (-86.0604,), AIC (-46.0604) and BIC (6.4391) values of the BEINF1 model for physical health and the deviance (-20.1217), AIC (19.8783) and BIC (72.3778) values of BEINF1 model for mental health were smaller than BEINF models. Therefore, BEINF1 was the better model to identify the health risk factors of stroke survivors. Age, marital status, diastolic blood pressure, disability duration and systolic blood pressure had a significant association with physical health, while BMI had a significant positive association with mental health.&nbsp;</p> <p><strong>Conclusion:</strong> The beta-inflated-at-one (BEINF1) model is suitable for identifying health risk factors of stroke survivors when the outcome variable is a proportion. Both demographic and clinical characteristics were significantly associated with the health of stroke survivors. This study would assist researchers in knowing the appropriate model for analysing proportion or percentage response variables.</p> KS Oritogun OO Oyewole Copyright (c) 2021 Annals of Health Research http://creativecommons.org/licenses/by-nc/4.0 2021-09-27 2021-09-27 7 3 302 312 10.30442/ahr.0703-09-140 Seroprevalence of Transfusion Transmissible Infections Among Voluntary Blood Donors at an Indian Hospital https://www.annalsofhealthresearch.com/index.php/ahr/article/view/330 <p><strong>Background: </strong>The knowledge of the incidence of blood Transfusion Transmissible Infections (TTIs) such as Hepatitis B, Hepatitis C, Human Immunodeficiency Virus infection, malaria and syphilis is essential for monitoring the safety of blood supply.</p> <p><strong>Objective: </strong>To describe the prevalence of TTIs for monitoring blood supply safety and evaluating the efficacy of screening procedures.</p> <p><strong>Methods: </strong>A five-year retrospective study spanning January 2016 to December 2020 was carried out on voluntary blood donors at blood donation camps organised by Adesh Medical College and Hospital, Kurukshetra, Haryana, India, and from donors at the hospital’s blood bank. The donated blood was tested for Hepatitis-B, Hepatitis-C, Human Immunodeficiency Virus (HIV), malaria and syphilis.</p> <p><strong>Results: </strong>There were a total of 10,468 voluntary blood donors during the period of study. Out of all the donors, 0.4% tested positive for at least one of the TTIs, including 0.06% testing positive for HIV, 0.21% for Hepatitis-B virus (HBV) infection (Hepatitis-B Surface Antigen) and 0.13% for Hepatitis-C virus (HCV) infection (Anti HCV Antibodies). None of the voluntary donors was positive for malaria or syphilis. There were no co-infections.</p> <p><strong>Conclusions: </strong>The prevalence of TTIs among voluntary blood donors was low hence the advocation for blood from this group of donors. Donated blood specimens should be more effectively screened, and blood should be rationally used.</p> M Kundra S Sood SP Gulia N Sharma Copyright (c) 2021 Annals of Health Research http://creativecommons.org/licenses/by-nc/4.0 2021-09-27 2021-09-27 7 3 313 321 10.30442/ahr.0703-10-141 Fertility-preserving Management of Cervical Ectopic Pregnancy in a Nigerian Teaching Hospital https://www.annalsofhealthresearch.com/index.php/ahr/article/view/335 <p>Cervical Ectopic Pregnancies (CEPs) are commonly associated with adverse outcomes due to diagnostic and treatment challenges. This report describes the successful management of an initially misdiagnosed CEP. A 30-year-old G<sub>4</sub>P<sub>2</sub><sup>+1</sup>(Alive 2) presented to the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria, with vaginal bleeding following 11 weeks amenorrhea. The patient was haemodynamically stable, with minimal bleeding <em>per vaginam</em>, and ultrasonography had previously diagnosed complete miscarriage. However, transvaginal ultrasonography demonstrated classical hour-glass uterus. The ballooned cervix contained a gestational sac and foetal node without cardiac activity. The patient was managed with a single dose of intramuscular methotrexate injection. Her serum B-HCG concentration declined from 460.8mIU/ml at presentation to &lt;5mIU/ml on the 10<sup>th</sup> day post-methotrexate injection, with a complete clinical and ultrasonographic resolution of the features. A high index of suspicion and appropriate ultrasonographic skills are necessary for prompt diagnosis of a CEP. Medical management could minimise the risk of intractable haemorrhage and hysterectomy.</p> IO Awowole OA Adeniyi OO Allen AB Adeyemi Copyright (c) 2021 Annals of Health Research http://creativecommons.org/licenses/by-nc/4.0 2021-09-27 2021-09-27 7 3 322 327 10.30442/ahr.0703-11-142