BACKGROUND:This study aims to establish the level of knowledge, attitudes, and practices (KAP) of healthcare professionals towards Marjolin's ulcers prevention. METHODS:A descriptive cross-sectional study was conducted among healthcare professionals of a Nigerian Teaching Hospital. A validated self-administered questionnaire was used to collect data with specific sections on knowledge, attitude, and practices of healthcare workers on Marjolin's ulcer prevention. Data analysis was done using descriptive statistics. Association between KAP and demographic characteristics was tested using the Chi-square test. Binary logistic regression was performed to identify factors associated with KAP, and statistical significance was considered at P < 0.05. RESULTS:Data from 254 participants were analyzed. Mean age of the respondents was 34.6 ± 10.1 years. Majority of the respondents were female 157 (61.8%), with 97 (38.2%) males, and a male to female ratio of 1:1.6. Most respondents were Nurses, 85 (33.5%). Mean score of the knowledge scale was 3.52, with mean scores of the latency period, childhood Marjolin's ulcer, traumatic ulcer as precursor lesions 2.63, 2.02, and 2.49 respectively. 21.9% (49) will decline skin grafting. Bivariate analysis showed that gender and knowledge were significantly associated with practice (χ² = 4.900, p = 0.027; χ² = 11.148, p = 0.001). Logistic regression analysis indicated that males had higher odds of good practice compared to females (AOR = 2.034; 95% CI: 1.065-3.887; p = 0.032). CONCLUSIONS:Improved practices towards Marjolin's ulcer prevention require focused educational programmes, enhanced donor-site aesthetic appearance, and adoption of skin substitutes to assist healing of chronic wounds.
Context: Challenges with reproductive health (RH) and poor perception of its services significantly define the outcome of an individual’s reproductive health status. Previous studies on the subject in south-western Nigeria have largely assessed the perception of young adults towards RH without paying attention to the determinants of their perception toward its services. Objective: This study aimed at investigating young adults' knowledge of RH and the determinants of their perceptions towards reproductive health services (RHS) at the Federal Teaching Hospital Ido-Ekiti, Ekiti State, Nigeria. Methods: A cross-sectional survey was conducted among 326 respondents aged 18-26 years. Selection was done using the multi-stage sampling technique. A semi-structured, interviewer-administered questionnaire that assessed RH knowledge, RHS perception and utilization was used for data collection. Frequencies and percentages were used to describe variables while the chi-square test and binary logistic regression were employed for inferential data analysis. Statistical significance was set at p-value less than 0.05. Results: Majority 205(62.9%) of the respondents had a good knowledge (≥50% score) of RH while a minority 148(45.4%) had a good perception of RHS. Significant determinants of RHS perceptions included age (p = 0.04, AOR = 2.51, 95% CI = 1.098-4.904), gender (p<0.001, AOR = 3.93, 95% CI = 1.569-7.191), marital status (p = 0.011, AOR = 3.49, 95% CI = 1.426-6.478), education level (p = 0.026, AOR = 2.97, 95% CI = 1.214-7.578), relationship duration (p = 0.03, AOR = 3.74, 95% CI = 1.333-6.375), degree of comfort in discussing sexual issues with partner (p <0.001, AOR = 4.34, 95% CI = 2.044-10.258), frequency of discussing RH issues with partner (p = 0.034, AOR = 3.67, 95% CI = 1.379-8.001), shared understanding of RH between partners (p = 0.027, AOR = 4.99, 95% CI = 1.236-12.363) and knowledge of RH (p = 0.002, AOR = 4.21, 95% CI = 1.931-9.889). Conclusion: This study concluded that while over three-fifth of the respondents had an overall good knowledge of RH, only a little above two-fifth had a good perception of its services. The study highlights the need for improvement in targeted educational initiatives to address misconceptions especially among the early young adults, males, unmarried, the less educated, those in relationships of less than 6 months, those having partners and those with poor knowledge of RH.
Introduction Continued medical education is vital for cancer control in low-resource settings. A recent survey of healthcare providers (HCPs) in Nigeria identified lack of training programs as a major barrier to implementing breast cancer genetic testing. In response, we developed and evaluated an online program aimed at improving breast cancer genetics education for Nigerian HCPs. Methods A multidisciplinary team of subject matter experts including genetic counsellors, surgical oncologists, a gynaecologist/obstetrician, and education experts from West Africa and North America, collaboratively designed a four-module education program. Pre- and post-module knowledge assessments were conducted using the Wilcoxon signed-rank test. Participants who completed the online course were invited to complete a structured survey assessing content quality, platform usability, and self-reported knowledge improvement. Results Thirty-one HCPs participated. Across all modules, both physician and nurse cadres showed significant improvements in knowledge. Physician scores increased by 1.00-2.22, highest in Module 3 (p<0.001). Nurses improved by 1.40-2.00, with the greatest increase in Module 4 (p=0.009). Twenty-six participants completed the evaluation survey: 96.2% indicated the program met its intended objectives; over 88% reported improved understanding of BRCA1/2 pathogenic variants; and 92.3% reported improved knowledge of genetic testing and counselling. Content was well presented, with 96.1% commending the clarity and effectiveness of the course. Over 96% found online learning effective. Module duration and contextual relevance were noted for improvement. Conclusion The program significantly enhanced participants’ understanding of hereditary breast cancer and was highly rated for quality and usability. Online training is an effective and scalable approach to strengthen cancer genetic services in low-resource settings.
Despite being the most common cardiovascular risk factor, the actual burden of hypertension is poorly characterized in Africa. We meta-analysed the most extensive pooled data to determine the overall prevalence of hypertension in Africa. Following Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, we systematically searched Google Scholar, PubMed, ScienceDirect, and Web of Science databases to retrieve prevalence studies only on hypertension among Africans published between 2002 and 2023. Furthermore, we meta-analysed the crude and age-adjusted prevalences of hypertension using a random effect model due to the expected high heterogeneity, with logit transformation of the original proportions. Seventy-eight (out of an initial 779 screened) articles with complete data were included, with a total number of hypertension cases of 71 004 and a denominator population of 286 575, mostly from community-based studies in 23 countries. The pooled crude prevalence of hypertension was 28.5/100 persons [95% confidence interval (CI): 25.3-31.8%] and a 95% prediction interval of 7.6-65.6%; the pooled prevalence increased with age and was highest among the aged ≥75 years: 51.4% (95% CI: 42.0-60.6%) and remained highest in the Southern Africa region overall (34.8%) and in the last decade (2013-23; 44.5%). The point estimate of the pooled crude prevalence was higher among urban dwellers, 32.9% (95% CI: 26.8-39.5%), than rural residents, 26.3% (95% CI: 20.4-33.3%). In a subset of 21 articles reporting age stratification consistent with the World Health Organization standard population, the pooled age-standardized prevalence was 27.2/100 persons (95% CI: 20.9-33.6%). The burden of hypertension remains high, especially in urban areas and with increasing age. Frequent screening and treatment are recommended, especially in urban areas.
Antimicrobial resistance (AMR) poses a global health threat, particularly in low- and middle-income countries (LMICs). Clustered regularly interspaced short palindromic repeats (CRISPR)–Cas system technology offers a promising tool to combat AMR by targeting and disabling resistance genes in WHO bacterial priority pathogens. Thus, we systematically reviewed the potential of CRISPR–Cas technology to address AMR. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted using the Scopus and PubMed databases, focusing on publications from 2014 to June 2024. Keywords included “CRISPR/Cas,” “antimicrobial resistance,” and “pathogen.” The eligibility criteria required original studies involving CRISPR/Cas systems that targeted AMR. Data were extracted from eligible studies, qualitatively synthesized, and assessed for bias using the Joanna Briggs Institute (JBI)-standardized tool. Data from 48 eligible studies revealed diverse CRISPR–Cas systems, including CRISPR–Cas9, CRISPR–Cas12a, and CRISPR–Cas3, targeting various AMR genes, such as blaOXA-232, blaNDM, blaCTX-M, ermB, vanA, mecA, fosA3, blaKPC, and mcr-1, which are responsible for carbapenem, cephalosporin, methicillin, macrolide, vancomycin, colistin, and fosfomycin resistance. Some studies have explored the role of CRISPR in virulence gene suppression, including enterotoxin genes, tsst1, and iutA in Staphylococcus aureus and Klebsiella pneumoniae. Delivery mechanisms include bacteriophages, nanoparticles, electro-transformation, and conjugative plasmids, which demonstrate high efficiency in vitro and in vivo. CRISPR-based diagnostic applications have demonstrated high sensitivity and specificity, with detection limits as low as 2.7 × 102 CFU/mL, significantly outperforming conventional methods. Experimental studies have reported significant reductions in resistant bacterial populations and complete suppression of the targeted strains. Engineered phagemid particles and plasmid-curing systems have been shown to eliminate IncF plasmids, cured plasmids carrying vanA, mcr-1, and blaNDM with 94
