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Background: Despite the high burden of Sickle Cell Disease (SCD) in Nigeria, the underlying haemoglobinopathy profile remains uncertain. Although a number of urbanised areas have pilot hospital-based newborn screening programmes, the impact of the disease in rural areas is unknown.Methods: From January 2010 to December 2011 this community-based study screened children aged 0-60 months in 29 randomly selected local communities of three adjoining northern Nigerian states -Abuja, Kaduna and Katsina. For infants 0-6 months, blood spots were used and for infants 7-60 months EDTA blood samples were analysed using high performance liquid chromatography (HPLC). 31 selected sample with high Hb A2 (3.5-7.4%) were further analysed using molecular diagnosis to ascertain the presence of the Beta Thalassemia gene.Findings of 10,001 infants and children screened, 269 (2.69%) had a SCD diagnosis; 90% of which were HbSS (n=243), 5% HbSC (n=13), 3% with high A2 > 6% (possible S with existence β thalassaemia (n=9) and 1% HbSD (n=2). 74% of infants screened were HbAA (n=7,391). 2,341 (23%) were carriers; 96% HbAS (n=2,236), 2% HbAC (n=51), 1% HbAD (n=25) and 1% HbABeta-thal (n=22). HbSβo was confirmed by molecular analysis from the 31 selected samples. Conclusion:Early infant diagnosis of SCD in Northern reports an incidence of 1.72%, Homozygous SS accounts for over 90% of cases; double heterozygous SC is very low (4%). The presence of beta (β) thalassemia coinheritance is now confirmed using molecular analysis. Community and family counselling and educational material in Northern Nigeria must include the risk of beta thalasemia inheritance.

Background: Sickle-cell disease (SCD) is the most common inherited genetic disorder in sub-Saharan Africa, and it is associated with early mortality and lifelong morbidity. Early diagnosis is essential for instituting appropriate care and preventive therapy. Objective: To compare parental knowledge or perception of their offspring's hemoglobin phenotype prior to testing and actual validated laboratory test results. Methods: In a prospective community-based survey, we assessed parental knowledge of their children's hemoglobin phenotype and corroborated this with the results from a laboratory confirmatory test determined by high-performance liquid chromatography. Results: We screened 10,126 children aged less than 5 years. A total of 163 (1.6%) parents indicated that their offspring had been previously tested and had knowledge of the child's hemoglobin genotype. However, 51 (31.2%) of 163 parents of children who had been previously tested did not know the result of their offspring's test, and 18 (35.3%) of these 51 children were found to have SCD. Of those who claimed previous knowledge, 25 (15.3%) of 163 reported incorrect results. Overall, we identified 272 (2.76%) new cases from 9,963 children who had not been previously tested. Conclusion: There is the need to promote public awareness about SCD and the benefit of early diagnosis, quality assurance in laboratory diagnosis and institution of sustainable patient care pathways.

SUMMARY Between 1977 and 1981, 3089 patients attended the sexually transmitted diseases (STD) clinic in Zaria, northern Nigeria. The male-to-female ratio of attenders was 6:1. Postpubertal gonorrhoea accounted for 28-1lo of cases, non-specific genital infections for 22 4%, and syphilis for 1 20o. Illiteracy, polygamy, the purdah system, widespread prostitution, and inadequate facilities are factors aiding the spread of these diseases in northern Nigeria.

Background This NHS/HTA‐funded study aimed to rank five commonly used antimicrobial therapies for acne in order of their clinical effectiveness and cost‐effectiveness. We also wanted to identify which agents are less likely to promote resistance and those which are effective in patients who harbour high numbers of resistant Propionibacterium acnes strains. Methods From surgeries and colleges in the Nottingham and Leeds areas, 649 patients with mild to moderate facial acne were recruited. The two primary outcome measures were patient self‐assessment of improvement in overall acne severity and reduction in inflamed lesion count, measured at 18 weeks. Secondary outcome measures included two acne severity scores, assessors' global estimation of improvement, quality of life and utility scores, enumeration of antibiotic resistant propionibacteria, and the incidence of adverse events. Results and Conclusions The most effective treatments (percentage with at least moderate improvement according to patients, mean change in lesion count) were the topical Benzamycin® b.d. (66%, − 27) and its components given separately (topical erythromycin o.d. + 5% benzoyl peroxide o.d.) (63%, − 26), followed by 5% benzoyl peroxide b.d. (60%, − 23). The least effective were oral oxytetracycline (55%, − 18) and minocycline (54%, − 22). The most cost‐effective treatment was benzoyl peroxide and least cost‐effective was minocycline. In terms of quality of life, benzoyl peroxide moved down the rankings and minocycline moved up. The two topical erythromycin‐containing regimens produced the largest reductions and the oral treatments the smallest in the prevalence and population density of cutaneous propionibacteria. Prior bacterial colonisation did not affect outcome in the topical groups. Efficacy of both oral preparations was influenced by tetracycline resistant P. acnes strains. Disclaimer The views and opinions expressed are those of the authors and do not necessarily reflect those of the Department of Health.