Annals of African Medical Research <p>The <strong>Annals of African Medical Research (AAMR)</strong> is a multidisciplinary medical journal published by the College of Medical Sciences, <em>Abubakar Tafawa Balewa University Bauchi</em> Nigeria. AAMR is an open source, peer reviewed and international journal providing rich sources of high impact African medical research outputs and beyond.</p> <h4>Focus, Scope and Objectives</h4> <p>The journal welcomes high quality research works in Biomedicine, Medical and Allied Health Sciences, including Original Articles, Review Articles, Letters to the Editor, Case Notes, Field Notes, Pictures and Reports. The vision of AAMR is to redefine the global perception of Africa’s Medical Research through consistent and persistent publication of high quality research works and to create international medium for scholarly sharing of knowledge between Africa and the rest of the world. The mission of AAMR is to be the front runner, closing the gap in African medical research publication and the global scientific community. Equipped with team of experienced editors and international advisory board made of scholars from Africa, Asia, Middle East, USA, Europe and the United Kingdom. All manuscripts submitted to AAMR shall be subjected to timely peer review and accepted by the editorial board upon satisfactorily meeting all publications requirements specified by both the editorial board and the publisher. Other guidelines and processing fees are specified with the publisher’s guidelines for prospective authors.</p> en-US <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="" target="_blank" rel="noopener"><strong>Creative Commons Attribution NonCommercial 4.0 International License</strong></a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.<br><br> An Open Access Publication is one that meets the following two conditions:</p> <ol> <li>the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.</li> <li>a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.</li> </ol> <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> <li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</li> </ol> (Emanuela Fusinato) (Tiziano Taccini) Wed, 19 Dec 2018 09:15:47 +0100 OJS 60 Low grade transitional cell carcinoma of the urethra successfully treated with only intraurethral instillation of Mitomycin-C <p>Urethral cancer is very rare disease, accounting for less than 0.5% of incidences of malignancies. Data on its management are scarce due to the rare nature of the cases. We present a 34-year-old man, who presented to our hospital with a month history of hematuria. He had no lower urinary tract symptoms and no significant risk factors for urothelial cancer. He was evaluated and found to have lesions in the posterior urethra on urethrocytoscopy, biopsy of which revealed a low-grade urothelial cancer. He was counselled and had 6 courses of intraurethral instillation of 40mg of Mitomycin-C diluited in 50mL of saline held in the urethra with penile clamp for 30 minutes. The hematuria stopped after the second course, a repeat urethrocystoscopy 6 months after the completion of the chemotherapy, showed resolution of the lesion and repeat biopsy showed no evidence of malignancy. However, the patient developed short segment partial penile urethral stricture that was treated with dilatation. In conclusion, low-grade urothelial cancer of the urethra can be successfully cured with Intraurethral instillation of Mitomycin-C, without prior transurethral resection.</p> Sharfuddeen A. Mashi, Sani A. Aji, Muzzammil Abdullahi, Bashir Yunusa, Sani U. Alhassan ##submission.copyrightStatement## Wed, 19 Dec 2018 09:15:02 +0100 Learning from experience: whys and wherefores of the polio non-compliance during immunization-plus-days in some high-risk wards in Bauchi Local Government Area, Nigeria <p>Poliomyelitis is a highly infectious viral disease that causes lower limb paralysis in young children. The incidence rate of the diseases has persisted in some part of northern Nigeria despite the national and global effort to eradicate it. The study aims to describe the factors associated with polio vaccination non-compliance by some parents/guardians of targeted children in five high-risk wards of the study area. The study adopts a cross sectional qualitative study, conducted from 2014-2015, to gain insights into the factors associated with non-compliance to polio vaccination in high-risk wards in Bauchi LGA, Nigeria. 450 non-compliant houses were randomly selected for the study. The in-depth interviews consisted of 36 fathers and 18 mothers, while the key note interviews involved 18 Muslim clerics and 18 prominent traditional rulers, using semi-structured questionnaire. The results of the study revealed frequency or too many rounds of vaccine administrations; misconception/myth about the vaccine, migration, and child absence during immunization as reasons for non-compliance. Other factors include negative perception regarding the health and immunity status of the children, religious beliefs, while some of the respondent refused for no clear reason. It is therefore, essential to adopt programs that would enhance vaccine compliance; by for example, developing effective polio vaccines that can be administered at fewer visits to communities. Also, efficient health education needs to be conducted to enlighten the at-risk population, including special strategies targeting internally displaced and migrant populations.</p> Saba’atu Elizabeth Danladi Nahuta, Ahmed Yakubu, Samuel Bitrus Bawa, Habu Dahiru, Hassan Gunda, Bako Garba Gamawa ##submission.copyrightStatement## Wed, 19 Dec 2018 09:17:51 +0100 Laparoscopy for evaluation of infertility patients in a tertiary center in north-eastern Nigeria <p>Laparoscopy uses fiber optic endoscope passed through the abdominal wall to visualize the peritoneal cavity for both diagnosis and therapy; it is also referred to as Minimal Access Surgery. It is an important tool in the evaluation of infertility. The objective of this study is to determine the value of laparoscopy for evaluation and treatment of infertility patients in Bauchi. North east, Nigeria. This is a retrospective cross-sectional study of women who had evaluation using laparoscopy. The case files and theatre records of all the women who had laparoscopy over a 5-year period between the 21st February, 2012 and 20th January, 2017 were retrieved and analyzed. Data on age, parity, type of infertility, intra operative findings and type of procedures done were extracted using a proforma. Analysis was done using statistical package for social sciences (SPSS version 21, IBM). One hundred and thirty-seven women had laparoscopy and or hysteroscopy during the review period, retrieval rate was 98%. Mean age was 29 years ±SD. Median number of pregnancies was 2. Most of the women had laparoscopy for secondary infertility indicated by tubal or an ovarian factor. Thirty-two (32) women (23.4%) had normal study. Sixteen (16) interventional procedures (12%) were done during the&nbsp;study period ranging from ovarian cystectomy, adhesiolysis, salpingectomy and sterilization. There were nine (9) congenital abnormalities detected during the period. Fifteen (15) women had both hysteroscopy and laparoscopy. Three women (2.8%) had uterine perforation with only one converted to laparotomy giving an overall success of 97%. Laparoscopy has changed the perception of many gynecologists in the diagnosis and treatment of infertility from mere imaginative to definitive thoughts.</p> Muhammad B. Aminu, Lamaran M. Datttijo, Saidu A. Kadas, Abubakar M. Shehu, Calvin M. Chama ##submission.copyrightStatement## Wed, 19 Dec 2018 09:20:52 +0100 A comparative study on selected iron status assessment assays among secondary school students in Bauchi State, Nigeria <p>Iron deficiency anemia (IDA) is the most common form of anemia worldwide, with highest burden in developing countries. The assays used in detecting iron deficiency comprise of red blood cell indices such as Mean Corpuscular Hemoglobin and Mean Corpuscular Volume, serum ferritin, soluble transferrin receptor (STfR) and STfRL-index. Each of these assessment tools has its drawback(s). This study was conducted to assess IDA diagnostic inter-rater agreements between red cell indices, serum ferritin, STfR and STfLF-Index. A cross sectional descriptive study using systematic random sampling of eligible secondary school students in Misau LGA, Bauchi State, Nigeria. Complete Blood Count with cellular indices, serum ferritin and STfR assays were conducted. Data was analyzed using SPSS version 23.0. Proportions were compared using Z-tests of proportions. Cohen’s Un-weighted kappa analyses were used to assess pairwise agreements in the ability of STfLF-Index, serum ferritin, STfR and red cell indices to classify participants into IDA and non-IDA. Level of significance was set at P≤0.05. A total of 210 participants were enrolled in the study with females constituting 153 (72.9%). STfLF-Index, STfR, serum ferritin levels and red cell indices revealed that 130/210 (61.9%), 160/210(76.2%), 7/210 (3.3%) and 112/210 (53.3%) respectively had iron deficiency. STfR revealed a significantly higher percentage of students with iron deficiency compared to serum ferritin, STfLF-Index and red cell indices. Assessment of iron deficiency showed concurrence between STfR and STfLF-Index. STfR and STfLF-Index have similar ability in classifying iron status.</p> Rufai A. Dachi, Sani Awwalu, Aliyu D. Waziri, Kasim M. Pindiga, Usman M. Abjah, Abdulaziz Hassan ##submission.copyrightStatement## Wed, 19 Dec 2018 09:24:58 +0100 Perception of medical students to learning methods in internal medicine: A pilot survey from Northern Nigerian University <p>Medical education aims to produce graduates who have knowledge and problem-solving skills with the professional attitude necessary to function as a doctor. We evaluated the perception of clinical medical students to their learning environment in internal medicine. A cross sectional study conducted during the intermediate clerkship posting on Medical students of Bayero University, Kano using a 20-item self-administered questionnaire adopted from the Dundee Ready Education Environment Measure (DREEM). The internal consistency of the questionnaire was calculated using the Cronbach’s Alpha coefficient. Principal components analysis was used for data reduction and grouping using the varimax rotation method. One hundred and twenty clinical medical students of Bayero University, Kano participated in the study with a mean age ± SD of the respondents was 23.6±2.3 years. A higher proportion of the students (60.8%) were males. The internal consis tency of the 20-items questionnaire was 0.82 measured using the Cronbach’s Alpha coefficient. The mean perception score of the respondents to undergraduate learning environment in internal medicine was 42.3 (out of maximum of 60) which showed satisfaction with their learning environment. Perception of Male students was more positive compared to their female colleagues (43 <em>vs.</em> 41, P=0.836). Medical students perceived their learning environment in internal medicine as satisfactory, which buttress the need to further strengthen the curriculum, in order to prepare them for the enormous challenges of clinical practice.</p> Aliyu Ibrahim, Musa Bello Kofar-Naisa ##submission.copyrightStatement## Wed, 19 Dec 2018 09:27:08 +0100 Effect of training and supportive supervision on knowledge and practice of integrated diseases surveillance and response among primary health care workers in Kano State, Nigeria <p>Communicable diseases continue to be major causes of, morbidity, mortality and rising health-care costs especially in developing countries. Integrated Diseases Surveillance and Response (IDSR) strategy was endorsed by Nigeria in 1998, as a means of strengthening communicable disease surveillance and response in order to make it more sensitive at all levels of government. A quasi-experimental study design was used to assess the effect of training and supportive supervision on knowledge and practice of IDSR among Primary Health Care (PHC) workers. Data was collected using an interviewer-administered questionnaire, and analyzed with the aid of Epi info version 3.5.3. Statistical significance was set at P&lt;0.05. The mean knowledge score of IDSR at baseline was 28.9±9.7 in the study and 27.4±10.5 in the control group. However, after the intervention, it improved to 51.3±11.8 in the study and slightly changed to 27.1±10.6 in the control group (P&lt;0.05). While, with regards to practice of IDSR, the mean practice scores improved in the study group from 6.43±1.25 to 16.37±3.86 after intervention (P&lt;0.05). In the control group, however, the mean practice score changed from 6.89±1.36 to 8.45±2.75 (P&lt;0.05) at the end of the study. The proportion of some IDSR core activity and supportive function changed from 0% and 16.6% to the standard benchmark of 80%. Training and retraining of health workers on IDSR were recommended as well as periodic supportive supervisory approach in order to enhance health workers capacity.</p> Usman Sunusi Usman, Abubakar Muhammad Kurfi, Yusuf Abdu Misau, Umar Lawal Bello, Aliyu Muhammad Maigoro, Adam Ibrahim Abdullahi ##submission.copyrightStatement## Wed, 19 Dec 2018 09:29:37 +0100 Evaluation of children with protein energy malnutrition and level of malaria parasitemia in Kwara State, Nigeria <p>Malaria and Protein-Energy-Malnutrition (PEM) are two major causes of childhood mortality in sub-Saharan Africa. Malaria can predispose a child to PEM and the reverse may also be true. Recent studies have presented inconsistent findings about nutritional status and the occurrence of malaria among the children. The goal of this study was to evaluate the association between PEM and malaria parasitemia if any. A case control study in which 90 children diagnosed for PEM (aged 6-59 months), and another well-nourished 90 children age and sex-matched controls were evaluated for malaria parasitemia. A semi-structured proforma was used to obtain relevant information on the children’s sociodemographic characteristics, nutritional indices amongst others. Venous blood sample was collected and thick and thin blood film were prepared and viewed under the microscope. Malaria parasitemia was present in 82 (91.1%) of malnourished group and 12 (13.3%) of the well-nourished group (P&lt;0.05 OR=66.62). Malaria parasitemia was highest in those with kwashiorkor and marasmic kwashiorkor compared with underweight. These differences were statistically significant (P&lt;0.05). The study demonstrates that malnourished children have higher degree of malaria parasitemia and are at risk of malaria. It also shows that severe forms of malnutrition are associated with heavier malaria parasitemia. It is therefore recommended that all malnourished children should have access to use of Insecticide Treated Nets (ITN), malaria chemoprophylaxis as well as empiric treatment of malaria in endemic areas where access to malaria parasite diagnosis is difficult.</p> Aishat Oluwatoyin Saka, Mohammed Jamiu Saka, Lateefat Olayinka Sa’adu ##submission.copyrightStatement## Wed, 19 Dec 2018 09:31:28 +0100 The prevalence of overweight and obesity and associated factors among Adults in Goni Gora Kaduna State, Northwestern Nigeria <p>Obesity is an epidemic disease in many developed countries and an emerging public health problem in developing countries, particularly in urban settings.The aim of this study was to determine the prevalence of overweight and obesity and the associated factors among adult residentsin Goni Gora community in Kaduna State. The study was conducted in Goni Gora a semi-urban setting in Chikun Local Government Area of Kaduna State, Northwestern Nigeria in January 2017. A multi-stage sampling technique was used to select 192 adult residents in the community. Data was collected using structured, pretested and interviewer-administered questionnaire using mobile data collection method (Epiinfo™ version 7.2). Data were analyzed using the Statistical Package for Social Sciences (SPSS) software version 21. The level of significance was set at a P value of ≤0.05. The majority of the respondents (32.3%) were within the age group of 20-29 years. The mean age of respondents was 34.6±13.1 years and males (52.1%) comprised the majority of the respondents. All the respondents were Christians with 55.2% of them being married. The prevalences of overweight and obesity were 6.7% and 1.1% respectively. Age (P=0.001), sex (P=0.001), marital status (P=0.002), average monthly income (P=0.004) and duration of physical activities per day (P=0.001) were found to be associated with overweight and obesity. There was, however, no association found between obesity and educational status (P=0.195). Overweight and obesity were found to be prevalent among the respondents in the study. Factors such as age, gender, marital status, average monthly income and duration of physical activities per day were found to be associated with overweight and obesity. There is a need to mount intervention programs that are targeted at prevention and control of overweight and obesity in the community.</p> Chinedu J.C. Igboanusi, Istifanus Anekoson Joshua, Julius Henry, Awawu Grace Nmadu, Mary Ojoneme Onoja-Alexander ##submission.copyrightStatement## Wed, 19 Dec 2018 10:05:35 +0100 Psychiatric disorders in diabetes mellitus patients attending a tertiary health institution in north-eastern Nigeria <p>Psychiatric disorders are common sequelae of diabetes mellitus and can further worsen the clinical state and quality of life of patients. The aims of this study were to determine the prevalence and pattern of psychological illnesses in patients with diabetes mellitus and to assess factors that predict these psychiatric disorders. The mental health of 114 eligible consenting adult patients with diabetes mellitus attending the diabetic clinic of Abubakar Tafawa Balewa University Teaching Hospital was assessed using Mini International Neuropsychiatric Interview (MINI). The prevalence of psychiatric disorders in the study respondents was 39.5% and the pattern of diagnoses found were Major Depressive Disorder (31.6%), Generalized Anxiety Disorder (6.1%) and Post-Traumatic Stress Disorder (1.8%). None of the sociodemographic variables was significantly associated with the presence of psychiatric disorders. The presence of diabetic complications (OR=2.519; 95% CI=1.056-6.001; P-value=0.037) was predictive of psychiatric disorders while good sugar control (OR=0.372; 95% CI=0.162-0.854; P-value=0.020) was a significant protective factor. A notable proportion of patients with diabetes mellitus develop mental health problems which can worsen the clinical outcome and further increase the burden of this illness. Efforts to promptly identify and manage these comorbid psychological problems can improve the prognosis of these patients.</p> Kazeem Ayinde Ayanda, Dauda Sulyman, Mahmud Yinka Mahmud, Joy Pius, Simeon Yinka Ategbese ##submission.copyrightStatement## Wed, 19 Dec 2018 10:19:30 +0100