BackgroundNigeria’s efforts to reduce under-five mortality has been biased in favour of childhood mortality to the neglect of neonates and as such the literature is short of adequate information on the determinants of neonatal mortality. Whereas studies have shown that about half of infant deaths occur in the neonatal period. Knowledge of the determinants of neonatal mortality are essential for the design of intervention programes that will enhance neonatal survival. Therefore, this study was conducted to investigate the trends and factors associated with neonatal mortality in Nigeria.MethodsThis was a retrospective analysis of the reproductive history data collected in the Nigeria Demographic and Health Surveys (NDHS) for 1990, 2003, 2008 and 2013. Neonatal mortality rates were estimated as the probability of dying before 28 completed days using synthetic cohort life table techniques. Univariate and multiple Cox proportional hazards regression models were used to explore the effects of selected maternal and bio-demographic variables on neonatal mortality. The Hazard Ratio (HR) and its 95% Confidence Interval (CI) were estimated to prioritize obtained significant factors.ResultsNigeria neonatal mortality rate stagnated at 41 per 1000 live births between 1990 and 2013. There were rural-urban and regional differences with more deaths occurring in rural areas and northern regions. In 1990, antenatal care (HR = 0.76; CI = 0.61-0.95), facility delivery (HR = 0.69; CI = 0.53-0.90) and births interval less than 24 months (HR = 1.67; CI = 1.41-1.98) were significantly associated with neonatal deaths. Factors identified from the 2013 data were antenatal care (HR = 0.76; CI = 0.61-0.95), birth interval less than 24 months (HR = 1.67; CI = 1.41-1.98), delivery at health facility (HR = 0.69; CI = 0.53-0.90), and small birth size (HR = 1.72; CI = 1.39-2.14).ConclusionThere was little improvement in neonatal survival in Nigeria between 1990 and 2013. Bio-demographic and health care related characteristics are significant determinants of neonatal survival. Family planning should be intensified while government should improve the quality of maternal and child health services to enhance the survival of neonates.

Under-five mortality in Nigeria has been reported to be on the decline, but the dynamics are yet to receive adequate attention. Thus the main objective of this study was to assess these factors and quantify their relative contributions to under-five mortality between 1990. The Nigeria Demographic and Health Survey data for 1990, 2003

The objective of the study was to identify the causes, outcome and prognosis of severe illness in patients with systemic lupus erythematosus (SLE) requiring intensive care unit (ICU) care in a University Hospital over a five-year period. The design was a cohort study. Forty-eight SLE patients requiring ICU management over a five-year period (January 1997-December 2001) were studied prospectively. Of 48 patients, 14 (29.2%) died, predominantly with multiorgan dysfunction syndrome (MODS). Patients whose APACHE II score was equal to or greater than 20 had higher mortality than those with APACHE score below 20 (60 versus 7.1%; and P < 0.01). All the 18 patients whose health status rated as 'good' survived, while 46.7% of 30 patients whose health rated as 'poor' died (P < 0.01). Patients who had thrombocytopenia associated with sepsis and/or disseminated intravascular coagulopathy (DIC) had the highest mortality (75%, five-year survival). In conclusion, SLE patients admitted to the ICU had a lower mortality rate than some of the previous reports. Patients with SLE with high APACHE score, > or =20, poor health status, thrombocytopenia and multiorgan dysfunction syndrome had poor prognosis in the ICU.

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BackgroundThe epidemiology of Alkhurma hemorrhagic fever disease is yet to be fully understood since the virus was isolated in 1994 in the Kingdom of Saudi Arabia.SettingPreventive Medicine department, Ministry of Health, Kingdom of Saudi Arabia.DesignRetrospective analysis of all laboratory confirmed cases of Alkhurma hemorrhagic fever disease collected through active and passive surveillance from 1st-January 2009 to December, 31, 2011.ResultsAlkhurma hemorrhagic fever (AHFV) disease increased from 59 cases in 2009 to 93 cases in 2011. Cases are being discovered outside of the region where it was initially diagnosed in Saudi Arabia. About a third of cases had no direct contact with animals or its products. Almost all cases had gastro-intestinal symptoms. Case fatality rate was less than 1%.ConclusionsFindings in this study showed the mode of transmission of AHFV virus may not be limited to direct contact with animals or its products. Gastro-intestinal symptoms were not previously documented. Observed low case fatality rate contradicted earlier reports. Close monitoring of the epidemiology of AHFV is recommended to aid appropriate diagnosis. Housewives are advised to wear gloves when handling animals and animal products as a preventive measure.

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BackgroundMalaria in pregnancy is still a major health issue in Nigeria, accounting for about 33% of cause of maternal death. Despite massive efforts to make insecticide-treated net (ITN) available to pregnant women in Nigeria, the use is still low. This study was conducted to identify facilitators and inhibitors for the use of ITN/long-lasting insecticidal net (LLIN) among pregnant women in Nigeria.MethodsData were obtained from the 2011 State-Specific HIV & AIDS, Reproductive and Child Health Survey conducted in 18 states of Nigeria. The survey was a population-based study among men and women of reproductive age living in households in rural and urban areas of Nigeria. Multistage cluster sampling technique was used to select eligible respondents. The sample size per state was 960 respondents. Data were collected between October and November 2011. The analysis was done using Statistical Package for Social Sciences (SPSS) version 20.ResultsA total of 11.5% of the respondents were pregnant at the time of the survey of which 73.2% lived in rural location and approximately 70% were either not educated or attained at most a primary school education. A total of 93.2% of respondents have heard of net, 82.6% were confident that they can hang or use a net, and 64.6% owned an ITN/LLIN in their household while the actual use was just 19.2%. We found education, location (urban–rural), confidence to use a net, and knowledge that the use of a net can protect a pregnant woman from malaria to be significant at 5% level. The number of nets owned per household, the length of time the net is owned, age, and marital status were not significant. Multiple logistics regression shows that pregnant women who are confident to hang or use a net were almost ten times more likely to use a net than those who do not know, while those who know that the use of an ITN/LLIN can protect a pregnant woman from malaria were almost two times more likely to use a net than those who do not know.ConclusionIn general, while owning a net facilitates its use, ownership does not necessarily translate to usage. Owning more than one ITN/LLIN per household was not significant in the use of an ITN/LLIN by pregnant women in this study, neither was the length of time the net was owned. This study shows that increasing the number of nets owned per household might not be a critical decider on whether the net will be used or not. We recommend massive education on the use of ITN. Skill building on use and increasing knowledge on the benefits of using nets may contribute to improving ITN use among pregnant women in Nigeria.

Background: Many Nigerian children with malaria are treated at home. Treatments are mostly incorrect, due to caregivers' poor knowledge of appropriate and correct dose of drugs. A comparative study was carried out in two rural health districts in southwest Nigeria to determine the effectiveness of a guideline targeted at caregivers, in the treatment of febrile children using chloroquine.