Annals of Health Research <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> en-US <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> (Prof. Tinuade Ogunlesi) (Temitope Soretire) Sat, 25 Dec 2021 14:47:45 +0000 OJS 60 Prevalence and Antifungal Susceptibility Pattern of Candida species Isolated from Patients with Urinary Tract Infections <p><strong>Background:</strong> The presence of <em>Candida</em> species in the urine is termed candiduria, and it is a common form of urinary tract infection (UTI). Many other species of <em>Candida</em> organism apart from <em>Candida albicans</em> are known with increasing the occurrence of resistance to available antifungal agents.</p> <p><strong>Objectives:</strong> To determine the prevalence and sensitivity pattern of <em>Candida</em> isolates obtained from urine samples of diagnosed urinary tract infections.</p> <p><strong>Methods:</strong> Midstream urine of patients attending the Lagos University Teaching Hospital, Ikeja Lagos, were collected and inoculated on Sabouraud Dextrose Agar (SDA). Microbiological processing was done with Gram reaction, germ tube test, CHROME agar TM and sugar fermentation test using API 32C system. Antifungal susceptibility tests were done using the agar disc diffusion method.</p> <p><strong>Results:</strong> <em>Candida species </em>were obtained from 36 (12.9%) of 280 patients with UTI. <em>Candida albicans</em> (CA) had the highest frequency (12; 33.3%) compared to 24 (66.7%) for Non-albicans Candida (NAC). The speciation of <em>Candida</em> using Chrome Agar showed some misidentification from the API32C identification, but there was a significant correlation between API32C and Chrome Agar methods (r = 0. 9793). Half of the <em>C. albicans</em> species were sensitive to fluconazole while <em>C. hellenica</em> was only sensitive to Nystatin. The <em>C. parapsilopsis</em> had the highest susceptibility pattern, with 86% and 71% for fluconazole and ketoconazole, respectively. Generally, ketoconazole had the highest effectiveness on <em>Candida </em>species.</p> <p><strong>Conclusion:</strong> This study demonstrated the role of <em>Candida</em> species in UTIs and their high susceptibility to ketoconazole.</p> IA Lawal, OA Osinupebi, OV Adeosun Copyright (c) 2021 Annals of Health Research Fri, 24 Dec 2021 23:06:08 +0000 Hypoglycaemia among adults with Type 2 Diabetes mellitus in a Family Medicine Clinic <p><strong>Background: </strong>The prevalence of Diabetes mellitus (DM) is increasing worldwide. The complications of DM arising from hyperglycaemia are well documented and. However, there is a lack of data, poor awareness and information on hypoglycaemia in DM.</p> <p><strong>Objective</strong>: To describe the prevalence and factors associated with hypoglycaemia among patients with Type 2 Diabetes mellitus (DM).</p> <p><strong>Methods</strong>: This was a retrospective study of the clinical records of patients with Type 2 DM at the Family Medicine Clinic of a Nigerian teaching hospital from January 2019 to January 2020. The sociodemographic and clinical characteristics, including hypoglycaemia, Glycosylated Haemoglobin (HbA1c), Fasting and Random blood glucose, were retrieved.</p> <p><strong>Results:</strong> A total number of 570 patients were assessed, with a prevalence of 43 (7.5%) of hypoglycaemia. The mean age of the patients in the study was 58.2±10.9 years (range: 36-83 years). Metformin (557; 97.7%), Sulphonylureas (377; 66.1%), Dipeptidylpeptidase -4 inhibitors (137; 24.0%) and insulin (72; 12.6%) were the most prescribed anti-diabetic medications. hypoglycaemiaA majority (29; 67.4%) of the hypoglycaemia episodes occurred in the morning, while most (24; 55.8%) of the episodes of hypoglycaemia were mild. Mean age (t= 2.35; p = 0.019), presence of hypertension (X<sup>2 </sup>= 6.92, p = 0.008) and dyslipidaemia (X<sup>2 </sup>= 7.86, p = 0.005) were associated with hypoglycaemia.</p> <p><strong>Conclusions:</strong> The prevalence of hypoglycaemia in the Outpatient clinic was low, while the presence of comorbidities&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(hypertension and dyslipidaemia) and age were associated with hypoglycaemia. There is a need for patient education and Self-Monitoring of Blood Glucose (SMBG) to prevent complications of hypoglycaemia. hypoglycaemia</p> OO Sodipo, AB Ademolu, S Odunaye-Badmus, EO Oluwatuyi, R Odiana Copyright (c) 2021 Annals of Health Research Fri, 24 Dec 2021 22:59:58 +0000 Knowledge, Attitude and At-Risk Behaviour for Heart Diseases among Secondary School Teachers in Ibadan Metropolis <p><strong>Background</strong>: Cardiovascular diseases remain the leading cause of death in developed countries, becoming prevalent in the developing world. Risk behaviour may result in unfavourable outcomes in cardiovascular diseases. Secondary school teachers constitute a large cohort of educated middle-level income earners who can influence young and upcoming individuals due to their profession.</p> <p><strong>Objective</strong>: To assess the knowledge, attitude and at-risk behaviour for heart diseases among secondary school teachers in Ibadan Metropolis.</p> <p><strong>Methods</strong>: A cross-sectional research design was used. Self- developed, field pre-tested questionnaire was employed to collect the relevant data from 200 randomly teachers. Cronbach alpha method was used to test the internal consistency of the test instruments and a measure of its scale in reliability.&nbsp;&nbsp;</p> <p><strong>Results</strong>: The study population comprised 39.0% males and 61.0% females. Most of the respondents (58.5%) were over 40 years, with an overall mean age of 40.2±3.1 years. The knowledge of secondary school teachers about heart diseases was poor (47.8%), while attitude and at-risk behaviours were unsatisfactory (weighted means 2.34 and 2.23 respectively against a criterion of 2.5).</p> <p><strong>Conclusion</strong>: The secondary school teachers in Ibadan Metropolis had poor knowledge of heart diseases and demonstrated poor attitude and unsatisfactory at-risk behaviour about the diseases.</p> IF Familoni, OA Moronkola, OB Familoni Copyright (c) 2021 Annals of Health Research Fri, 24 Dec 2021 22:53:59 +0000 Urine Bacteriology in Post-Kidney Transplant Patients with Double-J Stents <p><strong>Background: </strong>Kidney transplantation is the gold standard treatment modality for patients with end-stage renal disease. Ureteric stenting is commonly used during kidney transplantation to reduce the incidence of ureteric complications post-transplantation. The presence of ureteric stents could be complicated by bacterial colonisation and urinary tract infections.</p> <p><strong>Objective:</strong> To identify the urinary flora in patients with double-J stents following kidney transplantation and establish bacteria colonisation and their antimicrobial susceptibility.</p> <p><strong>Methods:</strong> Over one-year, single urine samples of consecutive 100 post-renal transplant patients were subjected to bacteriologic analysis. Early morning midstream urine was obtained into a sterile bottle from all the participants for laboratory analysis.</p> <p><strong>Results:</strong> The mean age of post kidney transplantation patients was 47.6 ±12.3 years. Hypertension and diabetes were the commonest co-morbidities associated with End-Stage-Renal-Disease (ESRD), accounting for 61% and 28%, respectively. <em>E. coli</em> was the commonest isolate (70.4%). Microbiological evidence of Urinary Tract Infection (UTI) revealed by pyuria (pus cells &gt;4/HPF) was found in 40.9%. Tigecycline, nitrofurantoin and tetracycline showed the highest sensitivity pattern in 9%, 8% and 8%, respectively, with significant resistance against cephalosporins and fluoroquinolones.</p> <p><strong>Conclusion:</strong> The fourth week of double-J ureteric stent insertion in kidney transplant recipients showed a high incidence of urinary bacterial colonisation.</p> S Abu, MC Igbokwe, OO Olatise, M Okafor, SO Asaolu, AR Adetunbi Copyright (c) 2021 Annals of Health Research Fri, 24 Dec 2021 22:47:56 +0000 Evaluation of the Functions and Radiographic Severity of Osteonecrosis of the Head of Femur in South-west Nigeria <p><strong>Background: </strong>Osteonecrosis of the femoral head is likely to be a complex of diseases rather than a single entity. In sub-Saharan Africa, epidemiological studies on the subject are uncommon.</p> <p><strong>Objectives: </strong>To determine hip function, radiographic severity and other characteristics of patients with osteonecrosis of the femoral head (ONFH) at presentation in a sub-Saharan Africa population</p> <p><strong>Methods: </strong>A combined prospective clinical survey and retrospective chart review of patients was done.</p> <p><strong>Results: </strong>Fifty hips in 44 patients were studied (29 retrospectively and 15 prospectively). The prevalence of ONFH was 1.6%. The mean age was 24.8±13.2 years. The lesion was unilateral in 86.4% and bilateral in 13.6% of the hips. Sickle Cell Disease (SCD) occurred in 43.2%, sickle cell trait in 13.6%, and 20.5% of cases were idiopathic. Overall, 12% of affected hips were presented early, and all the hips were painful at presentation. Of the 18 hips studied prospectively, 72.2% had necrosis &gt;30% and &gt;30% subchondral collapse in 61.1%. The mean combined necrotic angle was moderate size, 197<sup>o</sup>±29.7<sup>o</sup> and 177.2<sup>o</sup>±69.4<sup>o</sup> for the right and left hips, respectively (p = 0.8). The mean WOMAC scores were 37.2 ±17.4 for function, 10.2±4.3 for pain and 4.2±2.7 for stiffness.</p> <p><strong>Conclusion: </strong>Patients with osteonecrosis of the femoral head tended to be young adults and those with SCD. The majority present with large-sized osteonecrosis and subchondral collapse but moderate hip pain and stiffness.</p> LO Thanni, SA Gbadegesin Copyright (c) 2021 Annals of Health Research Fri, 24 Dec 2021 22:41:51 +0000 Predictors of Healthcare-Seeking Behaviour, Health Services Access and Utilization in Ajebo Community, South-West, Nigeria <p><strong>Background:</strong> Health is a fundamental requirement for living a socially and economically productive life. Poor health inflicts great hardships on households, including debilitation, substantial monetary expenditures, loss of productivity and sometimes, death.</p> <p><strong>Objectives:</strong> To describe healthcare-seeking behaviour, access to health services and utilisation, and their predictors in a southwestern Nigerian community.</p> <p><strong>Methods:</strong> A descriptive, cross-sectional study was conducted in Ajebo community, Obafemi/Owode Local Government Area in Ogun State. A total of 420 respondents were studied using an interviewer-administered questionnaire to collect quantitative data.&nbsp;</p> <p><strong>Results:</strong> More than half (54.0%) of the respondents had access to public health facilities, 41.7% had access to private health facilities, while patent medicine stores were accessed by 4.3% of the respondents. Out of the 249 (59.3%) who were ill in the preceding three months, 92.4% of them sought healthcare. More males utilized government-owned health services s than females (χ² = 3.878, p = 0.049). More than half (56.4%) travelled &gt;10 minutes to access healthcare services. Lack of formal education was not a hindrance to seeking healthcare (OR = 31.392, p = 0.003, CI = 3.323-2.347). Income earning &lt;30,000 Naira was the strongest predictor of healthcare utilization (OR = 3.304, p =0.001, 95% CI = 2.007-5.441). Education with OR = 31.392 (p = 0.003, 95% CI = 3.323-96.570) was the strongest predictor of healthcare-seeking behaviour.</p> <p><strong>Conclusion:</strong> Healthcare-seeking behaviour was not limited by lack of formal education. The utilisation of public health facilities was high among the respondents. State of employment and income were strong predictors of healthcare utilisation in Ajebo community.&nbsp;</p> AK Ahmed, GB Imhonopi, MM Fasiku, A Ahmed, MO Osinubi, T Soyannwo Copyright (c) 2021 Annals of Health Research Fri, 24 Dec 2021 22:33:58 +0000 Knowledge, Attitude and Uptake of Pap Smear among Female Healthcare Professionals in a Nigerian Teaching Hospital <p><strong>Background:</strong> Despite the high prevalence of cervical cancer (CC) in Nigeria, the uptake of screening services, including Pap smear, remains poor, even amongst healthcare providers.</p> <p><strong>Objective:</strong> To assess Pap smear knowledge, attitude, and uptake among female healthcare professionals (FHPs).</p> <p><strong>Methods:</strong> A cross-sectional descriptive study was conducted at the University of Ilorin Teaching Hospital (UITH), Kwara State, Nigeria, using a self-administered questionnaire.</p> <p><strong>Results:</strong> A majority (343, 98.6%) of the FHPs knew Pap smear. Five (26.3%) medical laboratory scientists did not know what a Pap smear was. All the nurses, doctors, pharmacists, physiotherapists and medical social workers knew Pap smear. Only a fifth (71; 20.4%) of the FHPs had ever done a Pap smear. The most common reason cited for not having done a Pap smear was lack of time (109; 31.3%). There was a relationship between age and uptake of Pap smear (<em>p = </em>0.024). Only 188 (54%) of the FHPs had ever recommended Pap smear to other women.</p> <p><strong>Conclusion:</strong> Despite the high level of knowledge of Pap smear amongst FHPs in Nigeria, attitude and uptake remain poor. There is a need for further training and education of FHPs on the benefits of CC screening to increase their uptake and improve their effectiveness in promoting positive attitudes towards CC screening and prevention in the general population.</p> AO Olarinoye, MM Shiru, AE Ubom, AO Olabinjo, IF Abdul, OA Ijarotimi, S Nyeche, PC Oriji, L Amadi, JI Ikimalo Copyright (c) 2021 Annals of Health Research Fri, 24 Dec 2021 22:15:06 +0000 Mauriac Syndrome in a Nigerian child with Type 1 Diabetes Mellitus: A Case Report <p>A 14-year-old boy with Type 1 Diabetes mellitus (diagnosed at eight years of age) presented with complaints of fever, weight loss, growth failure, pubertal delay, abdominal swelling and discomfort. He was on Premixed insulin (70/30) with inadequate follow-up and poor diabetic control. Examination revealed cachexia, generalised lymphadenopathy, a protuberant abdomen and hepatosplenomegaly. Anthropometry showed a bodyweight of 19.6kg, a height of 116cm and a BMI of 14.1kg/m<sup>2</sup>, all markedly below the 3<sup>rd</sup> centile. He had no secondary sexual characteristics: axillary hair stage 1, pubic hair stage 1, penile length of 4.9cm and prepubertal testicular volumes of 3mls bilaterally. At presentation, his random blood glucose was 400mg/dl, and glycosylated haemoglobin was 11.6%. Screening for tuberculosis, human immunodeficiency virus, hepatitis and lymphoproliferative disorders were negative. Other blood investigation findings included leucocytosis, erythrocyte sedimentation rate of 30mm/hr, normal liver function tests, normal serum electrolytes, urea and creatinine. His haemoglobin genotype was AS. Chest radiograph showed features of bronchopneumonia. A presumptive diagnosis of Mauriac Syndrome was made. With the optimisation of glycaemic control, he improved clinically with a weight gain of 5.7kg over four months and resolution of hepatosplenomegaly.</p> EE Oyenusi, IU Ezeani Copyright (c) 2021 Annals of Health Research Fri, 24 Dec 2021 22:24:50 +0000 Cerebrovascular Accident Complicating Diabetic Ketoacidosis in a Nigerian Adolescent: A Case Report and Review of the Literature <p>Cerebrovascular accident (CVA) is a rare neurological complication of diabetic ketoacidosis (DKA) in the paediatric population. The risk of developing CVA in DKA patients is often increased due to abnormalities in coagulation factors, platelet activation, blood volume and flow, and vascular reactivity. Cerebral oedema, the most common neurological complication of DKA, may also predispose to CVA. We report the case of a -12-year-old adolescent with DKA complicated by CVA. She developed features of right hemispheric CVA while on admission and had radiological confirmation of an ischaemic CVA. This report highlights that cerebrovascular accidents in DKA can easily be missed or confused with cerebral oedema.</p> IJ Akinola, G Akinyosoye, SA Adedokun Copyright (c) 2021 Annals of Health Research Fri, 24 Dec 2021 00:00:00 +0000 List of Reviewers Tinuade A Ogunlesi Copyright (c) 2021 Annals of Health Research Fri, 24 Dec 2021 23:13:20 +0000