Background:Sickle cell anaemia (SCA) significantly contributes to skeletal morbidity in Nigeria, with bone complications like pain crises and avascular necrosis prevalent. Osteocalcin (OC) and bone-specific alkaline phosphatase (BALP) are potential markers of bone formation, yet their diagnostic utility in SCA is underexplored in African populations. Objective:To assess serum OC and BALP levels in Nigerian SCA patients during bone pain crises (BPC), steady state, and in healthy controls, evaluating their diagnostic relevance for bone turnover. Methods:This cross-sectional study at Ahmadu Bello University Teaching Hospital, Zaria, enrolled 180 adults (60 SCA in BPC, 60 steady state, 60 HbAA controls). Serum OC and BALP were measured via ELISA. Data were analyzed using Kruskal-Wallis tests, Spearman's correlation, and ROC curves (p≤0.05). Results:Median OC and BALP levels were significantly higher in SCA BPC (26.53 ng/mL, 23.51 µg/L) and steady state (24.40 ng/mL, 14.42 µg/L) compared to controls (16.07 ng/mL, 9.95 µg/L; p=0.022, p<0.001). BALP showed superior diagnostic accuracy (AUC=0.789, sensitivity=98.3%) compared to OC (AUC=0.592). OC correlated with BMI (p=0.020), but not age or gender. Conclusion:BALP is a more reliable marker than OC for detecting bone turnover alterations in SCA, particularly during BPC, supporting its use in resource-limited settings.
Background:Dietary diversity is an essential concept in the prevention of malnutrition. Nutrient adequacy in the diet is especially crucial in women of childbearing age as it helps to prevent diseases and reduce poor pregnancy outcomes. This study assessed dietary diversity and its associations among women in Jaja, a rural community in Kaduna state, Nigeria. Methodology:This was a cross-sectional descriptive study of women aged 15-49 years selected from each house in the community using a multistage sampling technique. Following informed consent, data were collected using a pre-tested semi-structured interviewer-administered questionnaire. Information on socio-demographic characteristics and dietary patterns of the women was gathered and analysed using IBM SPSS version 26 software. Associations between the Women's Dietary Diversity Score (WDDS) and variables such as level of education, parity, nutrition sensitisation, and ownership of farmlands were tested, and statistical significance was set at p-value <0.05. Results:A total of 371 women were enrolled, predominantly married, Hausa Muslims. Their diet was made up of starchy staple 366(98.7%), Organ Meat 32(8.6%), Fish/Seafood 36(9.7%), Vitamin A rich foods 282(76.0%) and Iron rich foods 69(18.6%). The WDDS was low and had a statistically significant relationship with factors such as the woman's formal education (p-value 0.04), parity (p-value 0.009), geophagia, and having had nutrition sensitization (p-value 0.018) and farmland ownership (p-value 0.022). Conclusion:Dietary diversity was low, with several socio-economic factors identified as its significant predictors among study participants. Multi-layered policies and targeted interventions to improve and sustain dietary practices are recommended.
Background Nigeria has the highest global prevalence of sickle cell disease (SCD), necessitating effective preventive measures to control the disease. Prenatal diagnosis (PND) is a key early intervention for SCD, yet there is a shortage of studies in Northern Nigeria focusing on mothers of children with SCD. These mothers not only carry the burden of the disease but also face the risk of having more affected children, making them vital stakeholders in managing and controlling SCD. This study assessed the awareness and acceptability of prenatal diagnosis PND for SCD among mothers of children with the disease. Methods A cross-sectional study was conducted involving 297 mothers of children with SCD attending the Paediatric Haematology clinic at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Data were collected via an interviewer-administered questionnaire addressing the characteristics of the children and mothers, as well as their awareness, attitudes, and acceptability of PND. SPSS version 23 was used for data analysis, with a p-value < 0.05 considered statistically significant. Results Most participants (90.9%) were of Hausa ethnicity and 97.0% were of Islamic faith. A majority (77.8%) had less than tertiary education, and 57.9% lacked personal income. Nearly 41% had more than one child affected by SCD, and about one-fifth had lost a child to SCD complications. Only 22.2% of mothers had heard of PND, mostly from healthcare workers, and just 0.3% had undergone the procedure. After receiving information about PND, 93.3% were willing to accept it, though 45% of those who declined cited religious beliefs. Factors associated with PND acceptance included the mother's education and the child’s SCD severity. Conclusion Awareness of PND among at-risk mothers is low, yet most expressed willingness to accept it. Educational level and disease severity were associated with PND acceptability.
Background:Pre-eclampsia is a major cause of maternal and perinatal morbidity, characterized by endothelial dysfunction and renal impairment that may alter electrolyte balance. However, findings on electrolyte disturbances remain inconsistent, and the absence of population-specific reference intervals limits clinical interpretation in low-resource settings. Objective:To evaluate plasma electrolyte patterns among pre-eclamptic and normotensive pregnant women and establish locally relevant reference intervals for electrolyte parameters in Zaria, Nigeria. Methods:A comparative cross-sectional study was conducted at Ahmadu Bello University Teaching Hospital, Zaria, from January to August 2024. A total of 222 pregnant women were enrolled, comprising 100 women with pre-eclampsia and 122 normotensive controls. Plasma sodium, potassium, chloride, and bicarbonate concentrations were measured using an ion-selective electrode analyzer. Independent t-tests and chi-square tests were used for group comparisons, while multivariable linear and logistic regression analyses adjusted for gestational age. Reference intervals were derived from the normotensive cohort. Results:Mean concentrations of sodium, potassium, chloride, and bicarbonate did not differ significantly between groups (all p > 0.05). However, hyponatraemia was significantly more prevalent among women with pre-eclampsia than controls (44.0% vs. 27.9%) and remained independently associated with pre-eclampsia after adjustment for gestational age (adjusted OR 3.54, 95% CI 1.75-7.17; p < 0.001). No significant differences were observed in potassium, chloride, or bicarbonate abnormalities. Reduced bicarbonate levels in both groups were consistent with physiological renal compensation for pregnancy-related respiratory alkalosis. Locally derived reference intervals showed modest differences from conventional ranges. Conclusion:Electrolyte disturbances in pre-eclampsia are better reflected by distributional abnormalities than by differences in mean concentrations. The strong association between hyponatraemia and pre-eclampsia highlights its potential clinical relevance and underscores the need for context-specific reference intervals and prospective studies to determine its temporal and prognostic significance.
This narrative review elaborates on the development of neurovascular surgery in Nigeria, highlighting the growth over the years. It also elucidates the severe shortage of specialists, the financial burden to patients who may require neurovascular services, and the limited diagnostic and therapeutic equipment. It highlights the critical need for specialized training programs, workforce expansion, infrastructural improvements, sustainable financing, and financial reforms. The authors reviewed the literature narratively and examined, in broad strokes, the historical background of neurovascular surgery in Nigeria, the current practices, outcomes, and training and gave recommendations. Search keywords used include neurovascular surgery in Nigeria, history of neurosurgery in Nigeria, endovascular facilities in Nigeria, and advances in neuroimaging in Nigeria in various combinations using Boolean operators. Searches were conducted in a nonsystematic manner through Public/Publisher MEDLINE, SCOPUS, and African Journal Online. The field of neurovascular surgery experienced significant growth, driven by the contributions of Dr E. L. Odeku in the 1960s and 1970s. However, this progress was hindered by economic and political instability between the 1980s and 2001s. Since the resurgence era began in 2002, substantial advancements have been made. However, the challenges being faced are numerous, and development is quite slow. A multidisciplinary approach is crucial to improving neurovascular care in Nigeria and other low- and middle-income countries, and addressing these deficiencies is essential for optimizing patient outcomes and advancing neurovascular care. This study highlights the state of neurovascular surgery in Nigeria, elucidates the challenges of this practice, and offers recommendations for improvement.
