University of Abuja Teaching Hospital

The introduction of significantly shorter, all-oral regimens has significantly shifted the management of drug-resistant tuberculosis (DR-TB) towards a more tolerable and patient-centred therapeutic approach that aims to enhance treatment adherence, clinical outcomes, and quality of life among patients. Nigeria has gradually adopted this all-oral, shorter regimen, but the impact of this regimen in programmatic settings has not yet been studied. In 2022, a longitudinal, two-armed cohort study was conducted to explore the effectiveness, safety, and feasibility of the all-oral shorter regimen in the programmatic management of RR/MDR-TB in Nigeria. Consenting and eligible RR/MDR-TB patients receiving the all-oral regimen (intervention group) in four states were consecutively enrolled and compared to those receiving the standard of care (SOC). Treatment effectiveness, proportion, and 95% confidence intervals of favourable and unfavourable outcomes were measured at the end of treatment and during follow-up (six and 12 months post-treatment). In total 383 Participants were followed monthly throughout the 9-12-month treatment phase and then reassessed at 6 and 12 months after treatment completion, giving a total possible observation period of up to 24 months (185 received the intervention and 198 the standard of care). At the end of follow-up, there was a higher but non-significant proportion of favourable outcomes among the intervention vs. SOC group (80% vs. 69.7%); a higher proportion of favourable outcomes was also noted at the end of treatment among intervention participants (81.1 vs. 76.8%). Around one third of patients reported at least one serious adverse event (SAE), with no significant differences between arms, and none were deemed related to the use of medication. Intervention participants reported greater improvements in health-related quality of life between baseline and four months compared to those receiving the SOC. These findings support the programmatic use of all-oral shorter treatment for RR/MDR-TB as a regimen that is effective, tolerable, safe, and associated with enhanced health-related quality of life for patients in Nigeria.

In recent times, sourcing alternatives to river sand (RS) as a fine aggregate (FA) has been on the rise for sustainable construction, due to an increase in construction activity that has led to the depletion and scarcity of RS. This review synthesizes the characteristics and performance of various sources of FA, such as rock-, agro waste-, and waste polymer-based for construction applications, focusing on formation, physical and chemical characterization, and their influence on concrete (workability and mechanical behaviours). The review revealed that not more than 35% rock-based FA is suitable for RS replacement as FA in concrete. Moreover, the replacement of RS with waste polymer-based materials, such as polyethene terephthalate Polypropylene expanded polystyrene and melted plastic crushed fine aggregate should not exceed 5, 10, 10, and 6%, respectively, to produce lightweight concrete for environmental sustainability. In addition, the replacement of RS with agro-waste, such as rice husk, in concrete indicated that not more than 30% should be used, respectively, to enhance concrete strength and durability. Therefore, this review suggests that sourcing river sand (RS) alternatives to address environmental problems emanating from waste that threatens the ecosystem becomes necessary to reduce pressure on the use of RS for sustainable construction. However, the use of multiple RS alternatives should be considered in future studies, while academic, industry, and government collaboration is crucial for the establishment of policies and frameworks to promote the adoption of RS alternatives for environmental sustainability.

<title>Abstract</title> Background Anxiety disorders commonly coexist with chronic illnesses and significantly worsen clinical outcomes, treatment adherence, and quality of life. Despite this, anxiety is often underdiagnosed in medical settings. This study assessed the prevalence, determinants, and impact of anxiety disorders among patients with chronic illnesses attending the University of Abuja Teaching Hospital (UATH), Gwagwalada, Abuja. Methods A descriptive cross-sectional study was conducted among 206 outpatients with chronic illnesses. Data were collected using a structured questionnaire incorporating the Hospital Anxiety and Depression Scale – Anxiety Subscale (HADS-A). Descriptive statistics, Chi-square tests, and logistic regression were used for analysis at a significance level of p &lt; 0.05. Results The prevalence of abnormal anxiety was 24.3%, with an additional 25.2% presenting borderline symptoms. Significant determinants of anxiety included young age (p = 0.003), female gender (p = 0.034), stigma (p &lt; 0.001), comorbidities (p = 0.002), prior mental illness (p &lt; 0.001), and sleep disturbance. Anxiety impaired concentration (46.1%), reduced productivity (50.0%), worsened physical symptoms (50.5%), and disrupted sleep (56.3%). More than half (54.4%) reported reduced quality of life. Conclusion Anxiety disorders are common among chronic illness patients at UATH and are influenced by demographic, psychosocial, and clinical factors. Anxiety significantly impairs functioning and disease outcomes.

This study assessed the impact of the Nigerian nursing curriculum on clinical practice, focusing on its relevance, the integration of theory and practice, and areas requiring reform. Despite recent reforms by the Nursing and Midwifery Council of Nigeria (NMCN) to align nursing education with global standards, concerns persist regarding graduates' preparedness for modern healthcare demands. This survey aimed to evaluate the integration of theoretical knowledge with practical skills, assess the curriculum's effectiveness in clinical practice, and identify existing gaps. A cross-sectional descriptive survey was conducted among 231 registered nurses at the University of Abuja Teaching Hospital, Gwagwalada, using a structured questionnaire. Data were analyzed with descriptive and inferential statistics, alongside a thematic analysis of open-ended responses. Findings revealed that the curriculum received an overall "Very Good" rating (73%). It performed strongly in design and regulatory alignment (80%) but received lower ratings for institutional support and clinical exposure. While evidence-based practice and core nursing skills were adequately emphasized, the integration of modern healthcare technologies (34%) and community/public health nursing (52%) was limited, highlighting a persistent theory-practice gap. Major deficiencies included digital/technological competence (30%), community/public health preparation (25%), and leadership and advocacy training (20%). The study concludes that although the Nigerian nursing curriculum provides a solid theoretical foundation, it inadequately prepares graduates for real-world challenges, thereby slowing their progression along Benner’s novice-to-expert continuum. Recommendations include regular curriculum reviews, strengthened clinical training, the incorporation of digital health technology, expanded community-based experiences, and embedded leadership development. Addressing these gaps is essential for producing competent, confident, and practice-ready nurses capable of meeting Nigeria’s evolving healthcare needs.

A 60 days’ experiment was carried out to examine the effects of adding Cosmos sulphureus flower powder to the diet of Mewari laying hens on their growth, egg quality, and blood components. One hundred dual purpose Mewari laying hens at the age of 45 weeks with an average initial weight of 1488 ± 2.00 g were used for the experiment. Birds in treatment 1 (control) received basal diet without Cosmos sulphureus flower powder while those in treatment 2, 3, 4 and 5 were fed basal diet supplemented with Cosmos sulphureus flower powder at 5 g, 10 g, 15 g and 20 g/kg diet respectively. Result on the carotenoid content of Cosmos sulphureus flower powder showed that it contained -carotene (45.12 µg/g) and -cryptoxanthin (20.88 µg/g). Quantification of phyto-compounds in Cosmos sulphureus powder showed that flavonoids had the highest concentration of 16.88 % while glycosides was lowest (0.11 %). Other compounds found in the sample were, phenols (12.06 %), tannins (9.51 %), alkaloids (3.95 %), steroids (2.70 %) and saponins (0.68 %). Dietary supplementation of Cosmos sulphureus flower powder enhanced (p&lt;0.05) the average final weight, Average weight gain, feed conversion ratio, hen day egg production, hen housed egg production except average feed consumption and creatinine level (p˃0.05). Cosmos sulphureus flower powder dietary supplementation increased (p&lt;0.05) egg weight, egg shape, egg length, albumen height, yolk colour and haugh unit. The levels of haematocrit, haemoglobin, red blood cell, total protein, serum levels of alanine transaminase and aspartate aminotransferase and decreased (p&lt;0.05) cholesterol level. In conclusion, dietary supplementation of Cosmos sulphureus flower powder up to 20 g/kg diet of hens had no detrimental effect on their growth performance and health status

Placenta adhesion disorders (PAD) are increasingly encountered in obstetric practice due to the increase in caesarean section deliveries and placenta previa rate. If a case is confronted unexpectedly, the result is massive blood loss, which cannot be managed optimally unless identified in the antenatal period. This study was conducted to assess the value of placental dark bands in T2 W images in predicting the severity of hemorrhage at delivery. Retrospective analysis of clinical data and magnetic resonance imaging (MRI) for 55 women who underwent pelvic MRI scans between February 2010 and October 2013 due to risk factors for placental adhesion. The frequency of delivery complications was higher in cases with T2 dark bands in comparison with that with no bands {blood loss (ml) median (25,75) 1500(500-3500) vs 550(400-1000), P=0.006; blood transfusion(ml) median (25,75) 1500(0-4200 vs 0(0,0), P=0.003; length of stay in hospital (days) median (25,75) 3(2-6) vs 2.5(2-3), P=0.02}. The median blood loss was higher in women with T2 multiple dark bands (3000 ml) compared to those with single dark bands (550 ml). Placenta previa (PP) was a cofactor for bleeding (PP present associated with blood loss mean ± SEM 2877.3± 525.6 vs 1441.9± 353.7 when PP absent, the difference in means [95%CI] 1435.4[-2692.5- -178.3] P=0.026). However, multiple bands are an independent factor for maternal bleeding as the amount of blood loss increases with the number of bands, irrespective of the presence or absence of PP. PAD is associated with severe blood loss and blood transfusion. T2 Dark bands have the potential ability to predict the severity of hemorrhage at delivery.

BackgroundGlobalization, over the past century, has extended the geographic range of infectious pathogens. Where physical distance previously protected populations from pathogens circulating in distant places, factors such as population growth, urbanization, modern transportation networks, and climate change have increased local expansion and amplification and cross-boundary spread of pathogens into naïve locations. Despite this possibility, a lack of historical endemicity of a pathogen in a region can delay its detection due to unfamiliarity with the symptomatology or limited diagnostics.MethodsWe developed the One Health transmission potential framework for assessing a pathogen, using a history-agnostic approach, that incorporates—but does not rely solely on—prior detection of it, to determine its transmission potential within a region. This framework was applied to 71 pathogens for Nigeria, and the results were used to inform the selection of pathogens for the Surveillance of Acute Febrile Illness Aetiologies in Nigeria (SAFIAN) study.ResultsThe assessment identified transmission potential for 16 pathogens for which no previous detection in humans in Nigeria was found. The SAFIAN study screened 1200 patients for 25 pathogens with transmission potential in Nigeria. Outcomes included the detection of 11 pathogens, with no previous molecular detection in humans in Nigeria, and 9 pathogens ranked as high risk for causing Public Health Emergencies of International concern.ConclusionsThese results indicate the utility of the One Health transmission potential framework and its role in global health security. To prepare for surreptitious circulation of a pathogen, a history-agnostic approach is needed, whereby evidence, beyond previous detection in a region, is used to determine pathogens' potentials.

BackgroundUndifferentiated acute febrile illness (AFI) is a diagnosis that elicits public health concern, as it may be the result of an undiagnosed case of a pathogen of epidemic potential. This study compares the hospital-based incidence and distribution of AFI-causing pathogens in Nigeria, utilizing polymerase chain reaction (PCR)-based surveillance.MethodsPatients presenting with AFI at tertiary hospitals in Federal Capital Territory (north-central) and Edo (south) were enrolled from August 2023 to September 2024. Patients were screened for 25 pathogens using the TaqMan Array Card multi-pathogen PCR. The analysis compared the occurrence and distribution of pathogens, alongside environmental and demographic factors.ResultsOne thousand two hundred febrile patients were enrolled, 600 (50%) from each site with 37.5% children. Twenty pathogens were detected in 694 (57.8%) enrollees. The three most commonly detected pathogens in this AFI population were Rickettsia spp. (n = 312, 26.0%), Plasmodium spp. (n = 293, 24.4%), and Lassa fever virus (n = 184. 15.3%). Other pathogens include Brucella spp. (n = 14), Neisseria meningitidis (n = 12), dengue virus (n = 10), o’nyong’nyong virus (n = 7), chikungunya virus (n = 6), Crimean-Congo hemorrhagic fever virus (n = 4), and 11 additional pathogens. No statistically significant differences were shown between the regions.ConclusionsThis epidemiologic study screening for the presence of 25 pathogens was instrumental in identifying pathogens of public health significance, including the first detection of four pathogens in humans in Nigeria. These findings suggest that there are likely other undetected cases of these pathogens, highlighting the need for continued surveillance to monitor and respond to emerging health threats.

The rapid expansion of drones otherwise known as Unmanned Aerial Vehicles (UAVs), in critical sectors has increased their exposure to cyber threats such as GPS spoofing, command hijacking, and firmware tampering. Existing forensic tools often fail to address UAV-specific challenges like volatile memory and limited storage, hindering effective investigations. Hence, to address this gap, this study proposes the Enhanced UAV Forensic Framework (EUAVFF) a modular, forensic-by-design model integrating blockchain audit trails, secure logging, telemetry offloading, and UAV-friendly encryption. Validated through a literature review and a stakeholder survey (n = 100), results showed that over 70% of respondents lacked awareness of UAV cyber risks, and current drones were rated poorly in key forensic areas, including tamper-proof logging and legal evidence handling. Only 28% were familiar with drone-specific threats, reflecting critical gaps in preparedness.These findings emphasize the urgent need for proactive forensic integration. EUAVFF offers a structured path to secure, accountable, and resilient UAV operations in increasingly hostile cyber environments.