Pro Health International

BackgroundCardiovascular disease (CVD) remains a major cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM), particularly when complicated by hypertension. This study explored markers of glycaemic control, systemic inflammation, and lipid-related atherogenicity, and their relationship with CVD risk among a population of Nigerian patients with T2DM and co-morbid hypertension.MethodThis hospital-based cross-sectional analytical study was conducted over a period of 13 months among patients with T2DM, including those with co-morbid hypertension. The 10-year estimated CVD risk was determined using the WHO CVD risk assessment chart validated for Western sub-Saharan Africa, while glycated haemoglobin (HbA1c), atherogenic index of plasma (AIP), and high-sensitivity C-reactive protein (hsCRP) were assessed as markers of glycaemic control, atherogenicity, and inflammation, respectively. Statistical analyses, including binary logistic regression, were conducted using SPSS version 25, with significance set at p < 0.05.ResultsHypertensive patients with T2DM had significantly higher hsCRP (2.57 mg/L, IQR: 2.63 vs. 0.86 mg/L, IQR: 1.72; p < 0.001) and AIP (0.071, IQR: 0.39 vs. 0.002, IQR: 0.34; p = 0.015). They also had significantly higher mean WHO CVD risk scores (11.3 ± 4.7 vs. 7.2 ± 4.1; p < 0.001), with 60.0% (n = 75) classified as moderate-to-high risk. However, after adjusting for potential confounders in the multivariable analysis, HbA1c (OR = 0.82, p = 0.062), hsCRP (OR = 1.01, p = 0.905), and AIP (OR = 2.22, p = 0.293) did not emerge as significant predictors.ConclusionAlthough hsCRP and AIP levels were elevated in higher CVD risk categories, they did not independently predict risk among patients with T2DM and hypertension. This highlights the limited utility of traditional biochemical markers in this group and the need for early risk assessment and aggressive blood pressure control. Further multicentre studies are needed to validate these results and inform targeted interventions in resource-limited settings.

Antimicrobial resistance (AMR) is a critical challenge to public health within the healthcare system globally and in Nigeria. It is one of the leading causes of morbidity, mortality, and emergency room visits in the 21st century. This review summarizes the current body of evidence regarding the prevalence, determinants, and interventions for AMR in Nigeria. We conducted a narrative review of the literature to generate information for patient care and policy. We utilized PubMed and Google Scholar, in addition to official reports from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), the Ministry of Health of Nigeria, and published articles from recorganized health research institutes which gave rise to a total of eight sources. This was carried out by two reviewers independently. Data were summarized using tables and descriptive statistics. The review found high AMR rates in Nigeria, with 67.8% MRSA resistance in tertiary hospitals and 28.6% Carbapenem resistance in Enterobacterales. Major drivers include widespread antibiotic misuse (72.4% of pharmacies sell without prescriptions), poor health infrastructure (only 23.4% of secondary facilities have microbiology labs), low public awareness (23.8%), and heavy antibiotic use in agriculture (87.4% of poultry farms). AMR costs 2.4% of Nigeria’s GDP, with resistant infections costing 287% more to treat. Despite launching a National Action Plan in 2017, only 45% of the activities were implemented by 2021 due to funding constraints and competing health priorities. AMR is widespread in Nigeria due to poor public awareness, irrational antibiotic use, and improper disposal in both human and agricultural sectors. This has led to high treatment costs and health risks. Addressing AMR requires strengthened regulations, better healthcare infrastructure, improved surveillance, public education, and reforms in agricultural practices.

IntroductionThe enduring legacy of colonisation on global health education, research and practice is receiving increased attention and has led to calls for the ‘decolonisation of global health’. There is little evidence on effective educational approaches to teach students to critically examine and dismantle structures that perpetuate colonial legacies and neocolonialist control that influence in global health.MethodsWe conducted a scoping review of the published literature to provide a synthesis of guidelines for, and evaluations of educational approaches focused on anticolonial education in global health. We searched five databases using terms generated to capture three concepts, ‘global health’, ‘education’ and ‘colonialism’. Pairs of study team members conducted each step of the review, following Preferred Reporting Items for Systematic reviews and Meta-Analyse guidelines; any conflicts were resolved by a third reviewer.ResultsThis search retrieved 1153 unique references; 28 articles were included in the final analysis. The articles centred North American students; their training, their evaluations of educational experiences, their individual awareness and their experiential learning. Few references discussed pedagogical approaches or education theory in guidelines and descriptions of educational approaches. There was limited emphasis on alternative ways of knowing, prioritisation of partners’ experiences, and affecting systemic change.ConclusionExplicit incorporation of anticolonial curricula in global health education, informed by antioppressive pedagogy and meaningful collaboration with Indigenous and low-income and middle-income country partners, is needed in both classroom and global health learning experiences.

HIV-related implementation research holds great promise in achieving the potential of efficacious prevention and treatment tools in reducing the incidence of HIV and improving HIV treatment outcomes among people living with HIV. From the perspectives of HIV-related implementation research training and academia and through consultations with funders and investigators new to implementation research, we identified 5 myths that act as barriers to engagement in implementation research among new investigators. Prevailing myths broadly include (1) one must rigidly apply all aspects of an implementation framework for it to be valid, (2) implementation research limits the type of designs available to researchers, (3) implementation strategies cannot be patient-level or client-level approaches, (4) only studies prioritizing implementation outcomes are "true" implementation research, and (5) if not explicitly labeled implementation research, it may have limited impact on implementation. We offer pragmatic approaches to negotiate these myths with the goal of encouraging dialog, ensuring high-quality research, and fostering a more inclusive and dynamic field of implementation research. Ultimately, the goal of dispelling these myths was to lower the perceived bar to engagement in HIV-related implementation research while still ensuring quality in the methods and measures used.

ClinMed International Library is an Open Access Publisher of more than 50 Journals covering the major disciplines of Clinical Medicine. The main aim of ClinMed Journals is to serve as an Open repository for all the latest research updates in the multidisciplinary fields of Medical and Clinical Sciences. All the ClinMed Journals are bound to the policies of Open Access and Peer Review System.

Motivation/Background: Little is known of adverse pregnancy outcomes resulting from Excess Gestational Weight Gain (EGWG) in Benue state, Nigeria. In this study, we aimed to assess the effects and association of EGWG on pregnancy outcome in tertiary hospitals in Benue State. Method: We used retrospective cohort study to examine the data obtained from the general Antenatal Care (ANC) Register of 350 pregnant women who attended ANC clinic between January 1, 2016 and December 31, 2016. Pre-pregnancy Body Mass Index (BMI) was calculated by dividing weight in kilograms within first 14 weeks of gestation by square of height in meters while total gestational weight was calculated as difference between weight before, or at 14 weeks and weight at 37 weeks of gestation prior to delivery. Results: Data analysis was done using SPSS version 21. Out of the sampled folders, 103 (29.4%) women gained excess weight during pregnancy, 130 (37.1%) women gained the recommended weight while 117 (33.4%) women gained weight less than the recommended value. Analysis showed strong association between EGWG and pregnancy induced hypertension/pre-eclampsia, caesarean section and macrosomia. Conclusions: The study concluded that EGWG should be avoided by educating women on the need to gain appropriate weight during pregnancy to prevent adverse pregnancy outcomes which affect both mothers and their offspring.

In immunodeficiency diseases such as Human Immunodeficiency Virus (HIV) infection, various body functions may be affected; visual function could be one of them. In a child, there are predictable adverse outcomes of the disease that bother physical and mental development. This study sought to investigate any potential compromise of visual function amongst HIV-infected children on anti-retroviral drugs known as Highly Active Antiretroviral Therapy (HAART) use by comparing the visual acuity, colour sense and field of vision in infected and non-infected children. One hundred (100) children aged between 5 to 15 years consisting of fifty (50) HIV infected and fifty (50) non-HIV infected were selected through random sampling. Visual acuity test (Snellen’s method), colour sense test (Ishihara chart method) and field of vision test (confrontational method) were carried out. Latest Cluster of Differentiation 4 (CD4+) count of the HIV infected subjects also was collected. Statistical analysis was carried out using the Student T Test and ANOVA. The mean visual acuity of Human Immunodeficiency Virus (HIV) infected children was slightly low compared to the negative group (94.2±4.61and 96.4±12.58 respectively) but was not statistically significant (p>0.05). The mean of Ishihara colour sense test and that of the field of vision test also showed no statistically significant change between infected and non-infected children. Mean CD4+ count of the HIV infected children increased with age and use of anti-retroviral drugs. From 11 to 15 years, percentage defect in visual acuity increased amongst the HIV infected children, compared to the other ages but not statistically significant (p>0.05). It was concluded that visual acuity decreases slightly with improving CD4+ count and increasing age, for HIV positive children on anti-retroviral drugs. These parameters could be observed in subsequent years and subjects monitored for further investigation.

The global picture of the HIV epidemic has continued to show evidence of impact of the social, biomedical and behavioral HIV prevention strategies [1], with new HIV infections dropping to 2.1 million in 2015 [2] from 5 million in 2001 [3].

Lassa fever cases have increased in Nigeria since 2016 with the highest number, 633 cases, reported in 2018. From 1 January to 28 April 2019, 554 laboratory-confirmed cases including 124 deaths were reported in 21 states in Nigeria. A public health emergency was declared on 22 January by the Nigeria Centre for Disease Control. We describe the various outbreak responses that have been implemented, including establishment of emergency thresholds and guidelines for case management.