Bowen University Teaching Hospital

Congenital heart disease (CHD) poses a significant yet under recognized public health challenge in Africa. Despite advancements in diagnosis and treatment globally, many African countries still have significantly high mortality due to limited facilities of health care, inadequate infrastructure and delays in the diagnosis and management. This scoping review explores the socioeconomic impact of CHD on families across Africa and evaluates current policies, healthcare interventions, and systemic challenges. A comprehensive scoping review was conducted using multiple academic databases, focusing on studies published in international and national articles in English that examined the socioeconomic, psychosocial, and healthcare dimensions of CHD in African settings. Thematic synthesis was applied to interpret findings and compare them with trends in other low-, middle-, and high-income countries. Families affected by CHD in Africa face significant financial burdens due to out-of-pocket healthcare expenses, long travel distances for treatment, and insufficient health insurance coverage. These challenges often lead to catastrophic health expenditures, debt, and delayed treatment. Caregivers face of patients faces significant psychosocial distress, with elevated rates of anxiety, depression, and social isolation. Geographic and systemic disparities result in long wait times for surgery and limited access to cardiac care. Although successful models such as cardiac surgery missions, NGO-public partnerships, and regional training centers exist, their reach and sustainability remain limited. Current health policies by government lack integration of routine screening methods such as pulse oximetry, and most African nations lack national CHD registries and dedicated pediatric cardiac programs. CHD presents a major challenge in Africa, with profound financial, emotional, and systemic impacts on children and families. This review highlights the urgent need for improved infrastructure, early screening, and specialized care. Policy reforms, local cardiac centers, and involvement of stakeholders—including cultural leaders and international partners—are essential. Strengthening research on CHD outcomes and its socioeconomic effects will guide effective, equitable healthcare strategies across the continent.

The global population, including that of sub-Saharan Africa, is rapidly ageing, resulting in a higher incidence of fragility fractures. This study investigates the epidemiology of fragility hip fractures (FHFs) at a Nigerian teaching hospital, focusing on the predictors of two key outcomes: (1) mobility and mortality 3 months post-discharge, and (2) mortality 12 months post-discharge. A retrospective study was conducted involving 102 older adults aged ≥ 60 who received treatment for femoral neck, intertrochanteric, and subtrochanteric fractures at a mission teaching hospital in Nigeria over 6 years. Data collected included demographics, causes of fractures, comorbidities, treatment methods, time-to-surgery, length of stay, mobility, and mortality rates. Univariate analyses were performed to identify mobility and mortality outcomes predictors at 3 and 12 months post-discharge. The mean age was 78.0 years, with 49.0% of patients in the oldest-old category. 70.6% regained mobility 3 months post-discharge. The mortality rate was 3.9% at 3 months and 22.5% at 12 months. Predictors of better mobility and mortality outcomes included younger age, no/mild comorbidities, fractures due to community falls, femoral neck fractures, surgical treatment, and shorter time to surgery. Patients who regained mobility by 3 months had a lower 12-month mortality rate (p < 0.001). This study emphasizes the importance of effective surgical management for FHFs in Nigeria's ageing population. The findings suggest that a multidisciplinary care approach, encompassing comprehensive management of comorbidities, age-friendly housing design, ongoing research, and investment in healthcare infrastructure, is essential to address the growing burden of FHFs.

Abstract Rationale Oxygen therapy, one of the most common medical interventions in the acute care setting is indicated in a variety of medical conditions that can result in hypoxaemia. Globally, about 20% of hospitalized children with hypoxaemia will require oxygen and 1.4 million deaths have been reported due to a lack of / suboptimal oxygen therapy. Previous studies focused on oxygen therapy practice among health workers caring for adults, leaving out the paediatric cohort in whom respiratory illnesses constitute a huge burden. The study sought to determine the overall knowledge (knowledge and oxygen delivery practice) of paediatric health workers in Nigeria. Methods This was a cross-sectional study of doctors and nurses in 22 tertiary centres across Nigeria (a minimum of three centres each from the six political zones). Subjects were recruited via multi-staged sampling. A validated acute oxygen therapy AOT questionnaire was used to collect data from subjects via self-administration. The overall AOT scores were classified as good (score ≥80%), fair (60-&amp;lt;80%) and poor (&amp;lt; 60%). Results Of the 1127 respondents, 717 (63.6%) were females and 410 (36.4%) were males, with an overall mean ± SD age of 35.89 (± 8.81) years. About half (602, 53.4%) of the subjects were aware of guidelines for AOT and 499 (43.7%) had applied it in clinical practice. The overall mean (SD) AOT score was 71.17 (11.1). The proportion of respondents with overall good, fair and poor AOT knowledge were 284 (25.2%), 668 (59.3%) and 171 (15.1%), respectively. Junior cadre workers constituted the majority (132, 75.4%) with poor knowledge. Lower proportion of doctors (93/799) had poor AOT knowledge compared to nurses (82/328). Odds ratio (OR) 0.40; 95% CI: 0.28-0.55. There was no significant difference in the proportion of health workers with good AOT knowledge who had no formal training on AOT [135/585} compared to those with formal training (149/542) OR 0.79 95% C.I. 0.06-1.04. The mean oxygen delivery practice score of the participants was 6.74 ± 2.03 (total score obtainable was 11). Doctors had significantly higher mean oxygen delivery practice scores than nurses. Health workers who had worked for more than 10 years had higher mean oxygen delivery practice scores compared to those who had worked for ≤ 10 years. Conclusion Knowledge of paediatric AOT is suboptimal and can lead to increased morbidity and mortality in children. Interventions like periodic Training of paediatric health workers in Nigeria can result in improved health indices.

Education is the most powerful instrument man has devised towards shaping his own fortune. Vocational Technical Education (VTE) was viewed as the cornerstone for sustainable technological development of a society. Its relevant components hold the key to transforming Nigeria technologically. This paper focuses on VTE as a key to Nigeria’s sustainable employment ( SE). It explored SE, employability and education as better measures to rescue poor employment. This paper also considered the concept, philosophical, goals and objectives, barriers, benefits and features that set VTE in Nigeria sustainable development (SD). Employability and Vocational Education (VE), a better option for SE and developments, were also enumerated. Thus, this paper is expected to empower the stakeholders, especially the policy- makers, so VTE will be readily accepted and adopted as an important component of achieving SD goals through the total learning system that provides relevant knowledge, skills and competencies for employability, quality living and learning outcomes. Consequently, VTE can be seen as the master key with the ability to open all the doors of life-long learning, improve vocational expertise and provide the quality of living that is a component of SD. Hence, VTE should be integrated properly into the general education system. The government should provide adequate funds to support VE, ensure that facilities are provided and maintained and develop a culture of entrepreneurial thinking by integrating entrepreneurship into the nation’s education system. It then recommends VE and its adoption as a better option for SE in Nigeria.

The fish composition of the three landing sites of Ikere-gorge were studied over a period of six months (September 2023- February 2024). The catches were sorted into taxonomic groups (families and species) using standard fish identification keys. A total of twenty-three (23) fish species belonging from thirteen (13) families were obtained. The family Claroteidae was the dominant family with Chrysichthys nigrodigitatus being the most abundant fish species while family Malapteruridae was the least with only 0.01% of the total abundance. The family Cichlidae was the most represented and well distributed family with four different species; Coptodon zilli, Sarotherodon galilaeus, Oreochromis niloticus and Hemichromis fasciatus. Five fish species were abundant, eight were common and fairly common fish species respectively while only two species (Parachanna obscura nad Malapterurus electricus) were uncommon fish species based on relative abundance. Biodiversity indices of this study sites; species richness ranges from 1.65 to 2.65, species diversity ranges from 1.84 to 2.09 and species evenness falls between 0.59 and 0.68. The result from this study shows that there is pressure on aquatic organisms in this community as fewer fish species were in abundant. Measures to regulate the fishing activities of this reservoir especially closed season that will allow younger fish to grow into adult and give room for mature breeders to reproduce should be put in place in order to maintain Maximum Sustainable Yield of this water body.

Abstract Background: The need to integrate mental health services into primary healthcare service provision in Nigeria is now more urgent than previously considering the huge and increasing gap in access to mental care at the community level. This study therefore, assessed the critical roles and responsibilities of family physicians in facilitating the successful integration of Mental Health Services (MHS) into primary healthcare settings in Nigeria, with the goal of improving health outcomes, improving patient-centered care, and promoting a more efficient and effective healthcare system. Methods: A mixed method research design was used to collect both quantitative and qualitative data from Nigerian primary care physicians (PCPs) across the six (6) geo-political zones of the country. A semi-structured questionnaire was used to elicit their socio-demographic information, their view of the current state of MHS, factors affecting MHS integration into PHC, while key-informant interview guide was used to explore their opinions on how MHS can be enhanced in the country and how MH care can be integrated into primary health care in Nigeria. Results: The most common role identified by respondents is serving as a link between primary care and mental health specialists (29.7%), followed by being managers of healthcare resources (20.3%) and researchers (19.4%). The study revealed that family physicians have diverse roles in providing comprehensive and coordinated mental health care. Family physicians can use their unique position to facilitate early diagnosis, prompt intervention, provide ongoing support, and foster a collaborative care approach that addresses the complex needs of patients with mental health conditions, ultimately improving overall health outcomes and overall well-being. Conclusion:Family Physicians have important roles to play in bridging the gap between primary healthcare and mental healthcare, particularly in low and middle-income countries like Nigeria. it is recommended that family physicians receive targeted training in mental health care, have access to updated clinical guidelines, and be supported by robust referral systems to ensure seamless collaboration with mental health specialists.

Objective(s): Different Cannabis sativa chemovars produce diverse pharmacological and behavioral effects. With the widespread use of cannabis in Nigeria, detailed toxicological effects of Nigerian chemovars are lacking. This study aimed to identify phytocannabinoids and investigate the toxic effects of an indigenous C. sativa.Materials and Methods: The plant samples were air-dried, powdered, extracted with ethanol, and characterized (phytochemical screening, Fourier Transformed Infrared Spectroscopy (FTIR), and Gas Chromatography-Mass Spectrometry (GC-MS)). Acute and subacute toxicity tests were done following Organisation for Economic Co-operation and Development (OECD) protocols.Results: Screening showed appreciable levels of alkaloids, tannins, saponins, cardiac glycosides, and phenol. FTIR analysis indicated functional groups and chemical linkages like alcohols, fatty acids, alkynes, ketones, and esters, and 11 phytocannabinoids with delta-9-tetrahydrocannabinol in abundance (35.78%) reported by GC-MS. Acute toxicity test indicated an oral lethal dose (LD50) value of ˃5000 mg/kg, a no-observed-adverse-effect-level (NOAEL) dose of ≤300 mg/kg, and a significant (P<0.05) decrease in the weight of animals in the 2000 mg/kg treatment group. The sub-acute toxicity test showed significantly (P<0.05) decreased ALP and ALT levels at 25 mg/kg body weight, and significantly lower triglyceride (P<0.01) and LDL (P<0.05) levels. Urea and some haematological parameters were significantly (P<0.05) higher in the 250 mg/kg group. Also, we observed mild to moderate necrosis in the excised pancreas and liver, and mild tubular changes in the kidney.Conclusion:This suggests that our indigenous variety of C. sativa may be considered safe following oral consumption.

BackgroundRheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by persistent synovitis, systemic inflammation, and progressive joint damage. Medication and physical exercise are the most common interventions documented for the treatment of RA. The current systematic review examined the efficacy of pharmacological and physical exercise interventions for RA.MethodsA systematic literature search utilized databases (PubMed, Web of Science, Google Scholar, Scopus, and CINAHL) to identify relevant randomized controlled trials (RCTs). The search strategy included keywords related to rheumatoid arthritis, pharmacological interventions, exercise therapy, and clinical outcomes. The review was registered with PROSPERO (CRD42024587378). Two independent reviewers screened the identified articles, and relevant data were extracted for analysis. The quality of evidence for the outcomes of interest in this systematic review and meta-analysis was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. Meta-analysis was carried out using a random-effects model. For the meta-analysis, we assessed the heterogeneity using the I2 statistic.ResultsEighteen RCTs with a total sample size of 7,062 were included. Of these, eleven studies (61.11%) investigated the efficacy of different pharmacological interventions, whereas seven (38.89%) assessed the effects of exercise interventions. Different exercise programs showed improved functionality, reduced pain, and improved patient quality of life (QoL), while short- and medium-term sensorimotor trainings were reported. Pharmacological interventions also reported varying levels of reduction in disease activity and improved functionality. Pooled effects of four studies included in the meta-analysis revealed the different categories of incremental clinical outcomes (1.89, 2.46, and 2.63) after 24 months based on the American College of Rheumatology (ACR) criteria—ACR 20, ACR 50, and ACR 70, respectively. Significant effect sizes (0.09 and −0.08) after 24 weeks were equally found in three studies, indicating the reduction in disease activity and an improvement in functionality, respectively. Despite robust efficacy data, a major limitation across the literature is the heterogeneity of reported ACR outcomes, attributable to pharmacological variation (immunogenicity and disease stage) rather than purely statistical bias.ConclusionPharmacological and physical exercise interventions benefit many patients with RA, particularly regarding clinical outcomes such as reduced disease activity and improved functional ability; and both interventions are potentially synergistic in RA. However, more RCTs are required, especially in Sub-Saharan Africa (SSA), to buttress the evidence base for these interventions. Crucially, the review notes the need for greater pharmacological discussion on safety and tolerability in future studies.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024587378.

The prevalence of diabetes mellitus (DM) has steadily increased as also the number of people bearing its complications. One of such complications is diabetic foot disease. Foot care is an integral part of diabetes self-care and preventive strategy for reduction of diabetic foot disease and ultimate amputation. To assess foot care practices among adults with diabetes mellitus accessing care at the Out-patient Clinic of the Bowen University Teaching Hospital, Ogbomoso, Nigeria. This was a cross-sectional study comprising of 384 adults aged 18 years and above with diabetes mellitus of at least 6 months duration. A systematic sampling technique was used to recruit the participants for this study. Nottingham Assessment of Functional Foot Care (NAFFC) was used to assess the foot care practices of the participants. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 23. Of the 384 participants recruited for the study, 321 (83.6%) had good foot care practice and 63 (16.4%) had poor foot care practice. Gender, level of education and medication use had significant association with foot care practice. Foot care practice was good in majority of the participants in this study. As such, clinicians need to be consistent in providing self-foot care practice education to prevent diabetic foot diseases.