IntroductionNigeria has one of the highest maternal mortality ratios in the world as well as high perinatal mortality. Unfortunately, the country does not have the resources to assess this critical indicator with the conventional health information system and measuring its progress toward the goal of ending preventable maternal deaths is almost impossible. Médecins Sans Frontières (MSF) conducted a cross-sectional study to assess maternal and perinatal mortality in Makoko Riverine and Badia East, two of the most vulnerable slums of Lagos.Materials and methodsThe study was a cross-sectional, community-based household survey. Nearly 4,000 households were surveyed. The sisterhood method was utilized to estimate maternal mortality and the preceding births technique was used to estimate newborn and child mortality. Questions regarding health seeking behavior were posed to female interviewees and self-reported data were collected.ResultsData was collected from 3963 respondents for a total of 7018 sisters ever married. The maternal mortality ratio was calculated at 1,050/100,000 live births (95% CI: 894–1215), and the lifetime risk of maternal death at 1:18. The neonatal mortality rate was extracted from 1967 pregnancies reported and was estimated at 28.4/1,000; infant mortality at 43.8/1,000 and under-five mortality at 103/1,000. Living in Badia, giving birth at home and belonging to the Egun ethnic group were associated with higher perinatal mortality. Half of the last pregnancies were reportedly delivered in private health facilities. Proximity to home was the main influencing factor (32.4%) associated with delivery at the health facility.DiscussionThe maternal mortality ratio found in these urban slum populations within Lagos is extremely high, compared to the figure estimated for Lagos State of 545 per 100,000 live births. Urgent attention is required to address these neglected and vulnerable neighborhoods. Efforts should be invested in obtaining data from poor, marginalized, and hard-to-reach populations in order to identify pockets of marginalization needing additional resources and tailored approaches to guarantee equitable treatment and timely access to quality health services for vulnerable groups. This study demonstrates the importance of sub-regional, disaggregated data to identify and redress inequities that exist among poor, remote, vulnerable populations—as in the urban slums of Lagos.
School surveys and hospital-based studies on the distribution of eye conditions and diseases have indicated that conjunctivitis, refractive errors, corneal scarring and injuries are some of the major eye conditions affecting Nigerian children. 5,6,7,8,9,10 The prevalence of blindness across all age groups in Cross River State (CRS) in Nigeria, according to the report of the state population-based survey on blindness and visual impairment in 2006, was 0.8%, and 'the major causes of blindness, defined as presenting visual acuity of less than 3/60, were refractive error, Aim: This study assessed the types and prevalence of eye problems among school-age children in Cross River State (CRS), Nigeria. Method:The study design was a cross-sectional analytic survey of 2418 school children aged 6-17 years from seven public and three private schools in CRS, selected using the multistage random sampling technique. Ethical approval was obtained from the Ethical Committee, CRS Ministry of Health, Nigeria. The following tests were carried out on all children enrolled in the study: researcher-administered semi-structured questionnaires, LogMAR visual acuity measurements, external and internal eye examinations, non-cycloplegic auto-refractions, retinoscopy and subjective refractions. Quality assurance was carried out to validate the data collected, and data were analysed using SPSS and EPI info.Results: A total of 2418 school children were enumerated, and 2110 (87.3%) were examined; 1117 (52.9%) were girls, and 1250 (59.2%) were 6-11 years old, while 860 (40.8%) were 12-17 years old, and 77% attended public schools. The majority, 1895 (89.9%) of the children examined, had never had an eye examination. The prevalence of eye diseases among the school children was 32.1%, and the major causes were conjunctivitis 397 (18.8%; confidence interval [CI] 19.2-13.0), refractive error 243 (11.5%; CI 10.2-13.0), glaucoma suspects 52 (2.5%; CI 1.9-3.2), amblyopia 7 (0.3%; CI 0.0-0.7) and corneal opacity 4 (0.2%; CI 0.1-0.5). Analysis using chi-square tests and logistic regression shows a positive higher association of refractive error in private (16.7%) than public schools (9.9%) (crude odds ratio [COR] 1.8150; adjusted odds ratio [AOR] 1.9129, p < 0.001), higher socio-economic status of parents (COR 2.3402, AOR 1.9819, p < 0.001), older age group (COR 1.7258, AOR 1.8202, p < 0.001) and girls (13.1%) versus boys (9.8%) (COR 0.7200, AOR 0.7144, p < 0.001). Conclusion:Physical and eye health examination of children before school entry is strongly recommended. The application of 2 D lens for children who fail a standard visual acuity test should be routine during vision screening to ensure that significant refractive errors are not missed. Visual status and prevalence of eye disorders among school-age children in southern NigeriaRead online:Scan this QR code with your smart phone or mobile device to read online.
ImportanceThe global impact of COVID-19 has led to an increased need to continuously assess disease surveillance tools. The utility of SARS-CoV-2 serologic tools in determining immunity levels across different age groups and locations in helping to quickly assess the burden of COVID-19 with significant health policy implications is unknown.ObjectiveTo determine the prevalence of SARS-CoV-2 antibodies with respect to the age group and sex of participants.Design, Setting, and ParticipantsA cross-sectional survey of 4904 individuals across 12 states with high and low COVID-19 disease burden in Nigeria was carried out between June 29 and August 21, 2021.Main Outcomes and MeasuresEnzyme-linked immunosorbent assay was used for the detection of specific SARS-CoV-2 immunoglobulin G and immunoglobulin M antibodies, such as the nucleocapsid protein-NCP and spike protein S1. Interviewer-administered questionnaires provided information on participants’ history of disease and associated risk factors.ResultsA total of 4904 individuals participated in the study (3033 were female [61.8%]; mean [SD] age, 26.7 [6.51] years). A high seroprevalence of SARS-CoV-2 (78.9%) was obtained. Seropositivity was consistent across the states surveyed, ranging from 69.8% in Lagos to 87.7% in Borno. There was no association between sex and seropositivity (female, 2414 [79.6%]; male, 1456 [77.8%]; P = .61); however, an association was noted between age and seropositivity, with the peak prevalence observed in participants aged 15 to 19 years (616 [83.6%]; P = .001). Similarly, loss of appetite (751 [82.3%]; P = .04) and smell (309 [84.4%]; P = .01) were associated with seropositivity.Conclusions and RelevanceIn this cross-sectional study, a high SARS-CoV-2 seroprevalence was obtained among the study population during the low level of vaccination at the time of the survey. Thus, there is a need for both an efficacy and antibody neutralization test study to ascertain the efficacy of the antibody detected and the potential for herd immunity in Nigeria.
Background: Maternal mortality remains a major problem in many parts of the world including Nigeria. Understanding the causes of maternal mortality is crucial in confronting the challenge of unyielding high rates. The aim of this study was to determine the direct and indirect causes of maternal mortality in Lagos State, Nigeria. Materials and Methods:The study is a descriptive cross-sectional survey. The study population consisted of adults residing in Lagos State, Nigeria. The sample size used for this study was 29,988. The respondents were selected by multistage sampling from all the local government areas in the state. Data were collected using a structured interviewer-administered questionnaire. Data entry, cleaning, validation and analysis were done using Statistical Package for Social Sciences version 15.0. Results: Among the 29,988 respondents, 306 (1.0%) gave a history of married sisters who died during pregnancy, childbirth or during the postpartum period. Of the 306, 138 (45.1%) died during pregnancy; 107 (34.9%) died during childbirth, and 61 (19.9%) died during the postpartum period. Abortion, ectopic pregnancies and hypertension were the most commonly mentioned cause of death during pregnancy, while anemia, prolonged labor and obstructed labor were the common causes during childbirth. Human immunodeficiency virus/acquired immunodeficiency syndrome, infection and malaria were the common causes of maternal death during the 6 weeks after end of pregnancy/childbirth. Conclusions and Recommendation: Over half of the maternal deaths in Lagos State occurred during labor and immediately postpartum. Community education on the importance of having skilled attendants at delivery must be provided. Emergency obstetric care should be available, accessible and affordable at health facilities, and efforts must be made to prevent unwanted pregnancies and unsafe abortions by increasing contraceptive use. The malaria control efforts should be intensified.
Background: Visual impairment among school children is relatively common and research provides evidence for integration of comprehensive eye care into school health programmes.Aim: To determine the prevalence and determinants of visual impairment in school-aged children in Southern Nigeria.Setting: School aged children from 10 public and private-owned schools in Cross River State, Southern Nigeria. Methods:This cross-sectional analytic study used a multistage random sampling technique to select 2418 school children aged 6-17 years. Comprehensive eye examinations were performed on the study. The logistic regression analysis with 95% confidence interval (CI) was used to test hypotheses.Results: Of the 2418 school children selected, 2110 (87%) were assessed. The prevalence 'of uncorrected, presenting and best corrected visual acuity of 0.3 (20/40) or worse in the better eye' was 7.3%, 7.2% and 0.19%, respectively. Errors of refraction were the cause of the impairment in 198 (70.7%; 63.5-76.0) eyes with reduced vision, followed by glaucoma suspects 38 (19.2%; 13.8-24.8), amblyopia (3.0%; 1.1-6.4) and corneal opacity 3 (1.5%; 0.3-4.3). The major and independent predictors of visual impairment were age (adjusted odds ratio [AOR] 1.97, 95% 1.45-2.67), high socio-economic status (adjusted odds ratio [AOR] 1.68, 95% 1.36-2.09) and female gender (AOR 1.35, 95% 1.00-1.88). Conclusion:The common causes of visual impairment in school-aged children are avoidable, and are mostly because of uncorrected refractive error, which could reflect inadequate refractive error services in the area.
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