Unwana N. Udoumoh¹

¹Department of Nursing Science, University of Calabar, Cross River State, Nigeria. E-mail: brigentle2016@gmail.com; 2238982@alumni.brunel.ac.uk

Background: Emerging infectious diseases have persistently plagued Nigerians over the past decade. The recent escalation of Monkeypox cases since its resurgence in 2017 evoked psychological and social distresses akin to that experienced during the HIV/AIDS and COVID-19 outbreaks. This scoping review aims at providing an overview of recent evidence on Mental Health Implications associated with Monkeypox Outbreak in Nigeria.

Materials and Methods: The PubMed electronic database was searched to identify relevant peer-reviewed literature published between January 2018 and April 2023. Gray data search was conducted from other search engines such as the World Health Organization and the National Centre for Disease Control. The Population, Intervention Comparator, and Outcome method was used to develop keywords and to identify relevant studies across diverse socio-economic backgrounds of Nigeria. Findings were charted and analyzed using Thematic Content Analysis, based on the Mental Health Domains Model.

Results: A total of 19 publications were reviewed, charted, and thematically analyzed. The predominant mental health impacts were self-perceptions and values based as 52.6% of articles revealed low self-esteem, stigmatization, discrimination, fear and anxiety of infection, indifference toward Monkeypox control interventions, due to misconceptions about the disease, and gross impact on quality of life among Nigerians.

Conclusion: Knowledge deficit regarding mental health and paucity of research examining the psychological implications of the Monkeypox outbreak in Nigeria was evidenced. Therefore, a systematic review in the field would produce low outcomes; hence, further studies should be conducted in this area.

Implication for Mental Health Practice: Prioritizing mental health promotions during public health emergencies will improve Nigerians’ overall quality of life.

Keywords: Monkeypox, Mental health, Emerging infectious diseases

Iwegim Samuel Franklin¹, Francis Vincent Udoh¹

¹Department of Pharmacology, Faculty of Basic Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: samuelfranklin1707@gmail.com

Background: Salacia lehmbachii is commonly found in the tropical forest of Cameroon and Southeastern Nigeria. It has been reported to possess analgesic and anti-inflammatory potentials and anti-abortificient activities in the rat model. We compared the anti-inflammatory effects of Ethanol root extract of S. lehmbachii (ERESL), prednisolone, and acetylsalicyclic acid on carrageenan-induced air pouch inflammation in Wistar rats; the study focused on oxidative stress and inflammatory biomarkers in rat model since there is great similarity and homology between the genomes of humans and rodents.

Methods: The anti-inflammatory activity of ERESL in Wistar rats at graded doses (200 mg/kg and 400 mg/kg) was compared with two standard drugs (aspirin 100 mg/kg and prednisolone 5 mg/kg) using Carrageenan-induced air pouch inflammation. The effects of ERESL and standard drugs on inflammatory biomarkers and oxidative stress markers were compared; the results were analyzed using a one-way analysis of variance followed by a Bonferroni post hoc test.

Results: Pretreatment with ERESL (200 and 400 mg/kg, p.o.) and prednisolone (PRE) (5 mg/kg, p.o.) significantly (P < 0.05) prevented carrageenan-induced glutathione (GSH) alteration when compared with carrageenan (control group). However, pretreatment with aspirin (ASP) (100 mg/kg, p.o.) failed to prevent carrageenan-induced alteration on GSH concentration in rats. Post hoc analysis by Bonferroni test revealed that carrageenan injection into the 6^th day old pouches significantly (P < 0.05) increase the malondialdehyde (MDA) concentration when compared with vehicle group. On the other hand, pre-treatment with ERSL (200 and 400 mg/kg, p.o.), PRE (5 mg/kg, p.o.), and ASP (100 mg/kg, p.o.) significantly (P < 0.05) inhibited carrageenan-induced increased MDA concentration when compared with carrageenan (control group). Histopathological studies revealed that administration of carrageenan to air pouches produced tissue damage characterized by prominent congested blood flow, inflammatory cellular infiltrates occupying the lower two-third of the deeper dermis tissue and cellular enlargement of pouch wall, suggesting tissue damage. However, pretreatment with ASP (100 mg/kg, p.o.), PRE (5 mg/ kg, p.o.), and ERESL (200 and 400 mg/kg, p.o.) showed tissues with intact epidermis consisting of stratified squamous epithelium displaying reduced edema and inflammatory tissue infiltration.

Conclusion: Results from this study provide evidence which suggests that ethanol root extract of S. lemhbachii attenuated air pouch inflammatory reactions induced by carrageenan through mechanisms related to antioxidant, inhibition of cellular migration and tissue protection.

Keywords: Salacia lehmbachii, Carrageenan-induced inflammation, Anti-inflammatory effects, Oxidative stress markers

F. Nneoyi-Egbe Ada¹ https://orcid.org/0000-0001-5065-8562 , O. Onyenweaku Eridiong¹ https://orcid.org/0000-0001-6691-8269

¹Department of Human Nutrition and Dietetics, Faculty of Basic Medical Sciences, University of Calabar, Cross River State, Nigeria.

E-mail: contactdy@yahoo.com

Background: The study investigated the nutritional composition of different species of land snails, focusing on white-skinned (AMW) and black-skinned (AMB) Archachatina marginata, and Limicolaria (L) snails. Understanding their proximate, mineral, and vitamin compositions is crucial for evaluating their nutritional value and dietary benefits.

Methods: Snail samples were collected from a local market in Calabar. Proximate composition (moisture, crude fiber, fat, ash, protein, and carbohydrates), mineral content (iron, zinc, calcium, magnesium, and potassium), and vitamin levels (A, E, K, and D) were analyzed using standard procedures. Statistical significance was determined (P ≤ 0.05).

Results: Moisture content was highest in L (89.50 ± 0.10%) and lowest in AMB (86.10 ± 0.01%). L had undetectable crude fiber. AMW and AMB had higher crude fat (2.82 ± 0.25%, 2.60 ± 0.02%) than L (1.23 ± 0.25%). AMB exhibited the highest protein content (8.37 ± 0.02%). AMW had the highest iron (2.44 ± 0.01 mg/100 g), zinc (5.66 ± 0.02 mg/100 g), and calcium (6.77 ± 0.02 mg/100 g), while AMB had the highest magnesium (26.44 ± 0.04 mg/100 g) and Vitamin A (8.37 ± 0.01 mg/100 g). AMW showed the highest Vitamin E (0.66 ± 0.01 mg/100 g). Significant differences were observed among species for most nutrients.

Conclusion: The snail species varied significantly in proximate, mineral, and vitamin compositions, highlighting their nutritional diversity and potential dietary importance. This study contributes valuable insights into nutritional research and suggests dietary diversification strategies for improved health.

Keywords: Archachatina marginata, Limicolaria, Micronutrients, Proximate composition, Snails

Ashiru Aliyu Zainulabidin¹

¹School of Sciences and Humanities, SR University, Warangal, Telangana, India.

E-mail: aaliyuzainulabidin@gmail.com

Background: Enzymes play a crucial role in various cellular processes, and their dysregulation can lead to numerous diseases. Enzymes can act as biomarkers for many diseases. Targeting specific enzyme bio-classes can lead to effective treatments for various diseases. The design of drugs that interact with enzymes is crucial for inhibiting disease-related enzyme activity. Computational methods for predicting enzyme inhibition are highly valuable to pharmaceutical companies and other industries. Despite existing inhibitor prediction models, there is a gap for transaminase, topoisomerase, and kinesin-linked enzymes bio-classes.

Objective: The aim of this study was to revolutionize enzyme inhibition prediction by developing a comprehensive machine learning models for critical enzyme bio-classes, potentially leading to a prediction server.

Methods: We utilized the best-performing molecular fingerprints, Morgan 2 and 3, to predict ligand activity on enzyme bio-classes due to their high accuracy, ability to capture complex molecular relationships, and robustness in identifying potential inhibitors. Before selecting the fingerprint, we evaluated multiple machine learning models with four fingerprints (molecular access system [MACCS], Morgan 2, Morgan 3, and substructure fingerprint) to determine the optimal combination. We then performed feature selection using the best model and fingerprints, followed by optimization of the previous models using selected features. Optuna was employed to optimize hyperparameters, and final models were generated based on the best parameters. Performance metrics, such as receiver operating characteristic and Matthews correlation coefficient values, were analyzed.

Results: The results demonstrate the potential of machine learning models for predicting ligand activity, providing insights into feature importance, and enhancing our understanding of ligand-peptidase interactions.

Conclusion: Our model enables researchers to input ligand simplified molecular input line entry system (SMILES) and predict activity on the enzyme bio-classes, facilitating rapid identification of potential inhibitors.

Keywords: Bioinformatics, Computational chemistry, Drug discovery, Enzyme inhibition prediction, Kinesin-linked enzymes, Ligand activity prediction, Machine learning, Molecular fingerprints, Topoisomerase, Transaminase

Obaje Godwin Sunday¹ https://orcid.org/0000-0002-7121-3180 , Eko Williams¹

¹Department of Human Anatomy, Faculty of Basic Medical Sciences, College of Medical Sciences Alex Ekwueme Federal University, Abakaliki, Nigeria.

E-mail: godwin.sunday@funai.edu.ng

Background: Adolescents and adults engage in social media use, and psychological theories are trending to suggest how it is used, preferred, how much time is spent using it, and significant implications for psychological well-being and mental health, respectively. Most recent studies find that age and gender are factors, while limiting time spent but not eliminating social media has beneficial effects on humans. Correlational and predictive findings suggest that other factors not included in the analysis might be more influential in determining social media behavior. Hence, the study identified other more influential factors in determining social media behavior.

Methods: A cross-sectional survey design was employed, collecting data from participants on demographics, social media usage patterns, and hours spent. Descriptive statistics, Chi-square tests, correlation analysis, multiple linear regression, and hierarchical clustering were used to analyze the data.

Results: Significant differences were found between males and females in social media usage (P = 0.89). WhatsApp was the most preferred platform (35.7%). The average hours spent on social media were 7.94, mostly at night (56.7%). Gender was a significant predictor (P = 0.003). This study revealed distinct social media usage patterns and preferences among demographics. Gender significantly influenced social media behavior, while age did not.

Conclusion: Findings highlight the importance of understanding demographic-specific patterns in social media usage for targeted interventions and platform development.

Keywords: Age, Gender, Social media, WhatsApp

Mary A. Mgbekem¹, Felicia Lukpata¹, Nduka Ndukakwe¹, Faith Nlumaze², Sylvia Ibor¹, Funmi Siyanbade¹

¹Department of Nursing Science, University of Calabar, ²Department of Nursing Services, University of Calabar Teaching Hospital, Calabar, Nigeria. E-mail: achimgbekem@yahoo.com

Background: This study examined current healthcare practices among healthcare professionals in Cross River State with attention on partnership as a key component for effective collaboration. Considering our cultural background, resource limitations, and small-scale settings, a cohesive and strategic governance approach is needed to increase the health workforce and improve manpower development to strengthen health systems in low-resource settings.

Objectives: The aim of this study was to examine the existence and operation of partnership coordination mechanisms in enhancing health workforce development, identify effective collaborative model and strategies for health workforce development, and analyze the impact of partnership on health workforce resilience and sustainability.

Methods: A mixed-methods approach using a survey of health-workers, key informant interviews of 12 key stakeholders in the Hospital, and an adapted Human Resource for Health framework for guidance and analysis was employed for the study.

Results: Health workforce development is a political process that necessitates the will and the capacity to coordinate efforts on the part of different sectors and constituencies in each facility. Stakeholder coordination mechanisms co-exist, but a unified approach for support and timely development through clinical governance was noted to be absent. Challenges identified among stakeholders are willingness, commitment, operational accountability, and superiority complex.

Conclusion: The use of clinical governance (both formal and informal), roles, and responsibilities for collective action and decision-making in a system with diverse stakeholders is required for improved health workforce literacy and development to strengthen contributions to healthcare performance and goals.

Keywords: Health manpower development, Healthcare practices, Health professionals, Clinical governance

Samuel Archibong Efanga¹, Gbenga Abimbola Kajogbola¹, Oluwagbemiga Oluwole Ayoola¹, Itoro Efanga¹

¹Department of Radiology, University of Calabar, Calabar, Cross River State, Nigeria. E-mail: samuelefanga@rocketmail.com

Introduction: Leriche syndrome is a form of peripheral vascular disease involving the infra-renal aorta, aortic bifurcation, and iliac vessels. Its clinical symptoms vary according to the level of occlusion and the degree of developed collaterals.

Methods: A non-diabetic 35-year-old male presented with swelling of the left foot of 2 months duration. On physical examination, he was pale and dehydrated. The left foot was warm, tender, and swollen. No pulsation of the dorsalis pedis was noted, and the femoral pulses were diminished. Laboratory results were within normal limits. Computed tomography (CT) angiography demonstrated an abrupt termination of the contrast outline of the aorta, just distal to the origin of the right renal artery. Arterial collaterals reconstituting the femoral arterial vasculature were seen. A diagnosis of Leriche syndrome was made.

Results: Leriche syndrome is mainly due to atherosclerosis, but a few cases result from Takayasu arteritis, aortic coarctation, aortic dissection, and embolus. Clinical features include absent/diminished arterial pulses, pallor, gangrene of the legs, impotence, and intermittent claudication. The patient was pale and had diminished femoral pulses. Medical management involves the control of hypertension, blood sugar, blood cholesterol, and antiplatelet therapy, while surgical management is achieved through one of three options: (i) Aorto-iliac or aorto-femoral bypass or axillofemoral bypass. (ii) Endovascular procedure. (iii) Laparoscopic procedure. The patient was booked for aorto-femoral bypass.

Conclusion: A 35-year-old male with Leriche syndrome, diagnosed due to leg swelling, presented. CT angiography demonstrated the occlusion of the infra-renal aorta. Patients are yet to undergo surgery due to lack of funds.

Keywords: Atherosclerosis, Computed tomography angiography, Leriche syndrome

Samson O. Paulinus¹, Effiom A. Effiom¹, Valentine C. Ikamaise¹, Nneoyi O. Egbe¹

¹Department of Radiography and Radiological Science, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: samsonpaulinus@unical.edu.ng

Background: Radiography plays a key role in modern healthcare service delivery, offering essential diagnostic services that aid in treatment planning and disease management but with a significant gap in knowledge that exists among the public, especially in low-resource settings (rural areas), potentially limiting the effective utilization of these services.

Objective: The study assessed public awareness, knowledge, perception, and challenges related to radiography service delivery in the Odukpani Local Government Area.

Methods: A descriptive survey using a self-administered structured questionnaire was used to collect data from 320 respondents selected through simple random sampling techniques in the study region. The questionnaire was subjected to validity and reliability test-retest following ethical approval, with the respondents assured of confidentiality and anonymity of responses. Data obtained were analyzed using the Statistical Package for the Social Sciences version 26.0 with confidence level set at P = 0.05.

Results: Majority (72%) of the respondents demonstrated fair level of awareness (43%), knowledge (46%), and perception (42%) of radiography services, with X-rays being the most known procedure (67%). The challenges identified were distance to the nearest facility (38%), cost of services (35%), and the lack of qualified/professional staff (23%). In addition, the respondents suggested increasing the number of facilities, lowering costs, the presence of qualified personnel, and enhancing awareness programs as strategies for improving radiography service delivery.

Conclusion: Radiography services in rural settings should be declared a state of emergency, as there is a critical need for interventions to improve public access to radiography services in healthcare delivery. This is essential in ensuring that the rural population is able to make informed healthcare decisions.

Keywords: Awareness, Healthcare, Knowledge, Perception, Radiography

Samson O. Paulinus¹, Bassey E. Archibong¹, Grace O. James¹, Nneoyi O. Egbe¹

¹Department of Radiography and Radiological Science, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: samsonpaulinus@unical.edu.ng

Background: The practice of radiation protection in radiography plays a crucial role in modern medical diagnostics by ensuring that good-quality radiographs are produced to an optimal standard. Despite its importance, associated radiation exposure poses significant health risks. Furthermore, while traditional protective measures such as lead aprons have been effective, they present limitations including discomfort and ergonomic issues.

Objective: The study evaluates the feasibility and adoption of next-generation protective technology.

Methods: A prospective survey design using a convenient random sampling technique to distribute a well-structured questionnaire to practicing radiographers/imaging scientists in the radiography departments of various hospitals in the South-South of Nigeria was adopted. The questionnaire was distributed using an online format (Google Forms) and a physical form. Data obtained from 120 respondents were analyzed using the Statistical Package for the Social Sciences version 26.

Results: The Majority (82.50%) of the respondents indicated that their facility’s traditional protective equipment is moderately effective (75.70%). Similarly, the majority (88.20%) of the respondents believed that next-generation protective equipment is feasible with cost and funding identified as the most common barrier in integrating next-generation protective equipment (technology) which account for 45.50%. In addition, 28.57% of the respondents inferred technical training to be the most effective in facilitating the adoption of these advancements while 2.86% suggested for its incorporation into the radiography undergraduate curriculum.

Conclusion: While there are significant hurdles to overcome in the adoption of next-generation radiation protection technology for advancing radiography practices in South-South Nigeria, there is a need to enhance and improve patient comfort while ensuring the production of good-quality radiographs with an optimal standard.

Keywords: Practice, Protection, Radiographer, Radiography

L. C. Aburime¹, S. O. Ogri¹, J. D. Udoiwod¹

¹Department of Human Nutrition and Dietetics, Allied Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: aburimelilian@gmail.com

Background: Changes in dietary patterns of students in the university could be due to several factors, ranging from the availability of good food to a lack of time to prepare it, and the pressure of study. This may be a cause for concern as it affects the students’ health.

Objective: This study evaluates and compares the dietary patterns and nutritional status of undergraduate students at the University of Calabar, Calabar, Cross River State, Nigeria.

Methods: A descriptive cross-sectional study and multistage sampling technique were adopted. To elicit information from respondents, structured questionnaires were distributed to four hundred respondents (124 males and 276 females). Using a simple random sampling technique, four faculties were selected from the seven faculties in the school, departments were selected from each faculty, and 50 respondents were selected from each selected department. The data generated were analyzed using the Statistical Package for the Social Sciences version 20.

Results: The results showed that 80% of the respondents indicated that their eating habits had changed negatively while in school compared with their homes. Most of the students skipped meals (59%). The mean body mass index (BMI) (kg/m²) was 25.6 (male) and 24.01 (female) undergraduate students. Some 61% of all the respondents had a normal BMI. More females (8.7%) were in the obese category than their male counterparts (6.0%) whereas more of the male respondents were overweight. The obesity and overweight indices in this anthropometry can be explained based on the poor nutrient diet coupled with poor eating habits observed earlier in this study.

Conclusion: There is the need for an effective nutrition education program at the University.

Keywords: Body mass index, Dietary pattern, Nutritional status, Overweight and obesity

O. Bassey Stella¹, E. Egbung Josephine¹, Ude Connie¹, Eteng Ofem¹

¹Department of Human Nutrition and Dietetics, Faculty of Basic Medical Science University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: basseystella0@gmail.com;ofemeffiom@gmail.com

Background: Nearly all the food we consume originates from plants or animals. The processed foods we eat daily, such as chips, cakes, pizzas, and sandwiches, are made from various ingredients derived from these sources.

Objective: The aim of this study was to analyze the proximate composition and functional properties of cookies made from rice-based composite flour.

Methods: The parameters measured included moisture, ash, protein, fat, carbohydrate, energy, bulk density, water absorption capacity, oil absorption capacity, and swelling index. The rice-based composite flour was created from blends of rice (RF), soybean (SF), coconut (CF), water-yam (WYF), and sweet-potato (SPF) flours in different ratios: Sample B (40:15:5:40% RF, SF, CF, and WYF), Sample C (40:15:5:40% RF, SF, CF, and SPF), Sample D (40:15:5:20:20% RF, SF, CF, WYF, and SPF), Sample E (40:15:5:10:30% RF, SF, CF, WYF, and SPF), and Sample F (40:15:5:30:10% RF, SF, CF, WYF, and SPF), with Sample A (100% WF) as the control. Standard methods were used to analyze the rice-based composite flour samples.

Results: Samples D and E had the highest protein content, while Samples E and B had the lowest moisture content. Samples C and A exhibited the highest ash and fiber content. Sample A had the lowest fat content, whereas Samples B and A had the highest carbohydrate content. Samples F and B had the highest energy content.

Conclusion: This study provides new insights into how nutritional advice can enhance the understanding of new food sources, aiding in the development of dietary guidelines that promote good health and development.

Keywords: Rice, Soya-beans, Sweet potato, and coconut flour, Water yam

Eyam Sunday Eyam¹, Eyam Lilian Eberechukwu¹, Y. Ene Asuquo Basse¹

¹Department of Chemical Pathology, Faculty of Basic Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: dr.eyam@yahoo.com

Introduction: Vitamin D deficiency is a worldwide problem that goes undiagnosed, especially in patients being managed for prostate diseases, which are prevalent in Nigeria.

Methods: A cross-sectional descriptive study that assessed the Vitamin D status of 101 patients being managed for prostate diseases in Cross River State, Nigeria. A semi-structured interviewer administered questionnaire was employed for data collection. Blood samples were obtained and analyzed for Vitamin D, calcium, magnesium, and prostate-specific antigen (PSA).

Results: It showed that 44 (43.6%) of participants were within 61–70 years. Fifty-two of the patients were managed for prostate cancer (PCa), 39 for benign prostatic hyperplasia, and 10 for prostatitis. The majority of 76 (75.2%) had sufficient Vitamin D levels, 4 (4.0%) had insufficient levels, and 21 (20.8%) had toxic levels. A high proportion (93.1%) had hypocalcemia, 51.5% were hypomagnesemic, and 55.4% had high PSA concentrations. Hypermagnesemic patients accounted for 81.4% of those with Vitamin D sufficiency and the association was statistically significant (P = 0.001). Sufficient Vitamin D was seen in hypocalcemic patients, 72 (76.6%), and patients with high PSA, 42 (75.0%) but were both statistically insignificant at P = 0.317 and P = 0.428, respectively. The association of Vitamin D with the highest level of education and occupation were both statistically significant at P = 0.040. Similarly, 87.5% of patients on antibiotics/non-steroidal anti-inflammatory drugs had sufficient Vitamin D levels, slightly lower compared with patients on other treatments, although the difference was not statistically significant (P = 0.297).

Conclusion: A high proportion of patients being managed for prostate diseases in Cross River State, Nigeria, had sufficient Vitamin D levels and low calcium and magnesium concentrations.

Keywords: Vitamin D, Prostate disease, Cross river

Eyam Lilian¹, Eyam S. Eyam¹, Margaret Akpan¹, Utibe Archibong¹

¹Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: lilyeyam@yahoo.com

Background: Despite its widespread use and practical advantages, single use plastic has faced criticism in recent years due to its environmental impact. The material is non-biodegradable and can persist in the environment for hundreds of years, contributing to pollution and posing hazards to wildlife. This study assessed the knowledge on the health effects of single use plastics, utilization, and disposal practices among street food vendors in Calabar municipality, Cross River State, Nigeria.

Methodology: A cross-sectional descriptive design. A sample size of 241 street food vendors was selected through a multi-stage sampling technique, and data were collected using an interviewer-administered questionnaire facilitated by the Open Data Kit. The data were analyzed with the Statistical Package for the Social Sciences Version 23 and Microsoft Excel.

Results: It showed that about 170 (70.4%) of the street food vendors had good knowledge of the health effects of single-use plastics while 71 (29.5%) had poor knowledge. The level of utilization was high as about 187 (77.8%) used it. Perceived barriers included for convenience, cost-effectiveness, availability, customers demand, hygienic concerns, and lack of alternatives. Good practice was (34) 14% and (207) 84% had poor disposal practices. There was no statistically significant association between level of knowledge and utilization among participants X² = 7, P = 0.31.

Conclusion: Although the knowledge was high and utilization was very high, the practice of disposal was poor. More disposal facilities and alternatives for food packaging should be created to avoid the use of single used plastic for food packaging and its health implications.

Keywords: Health effect, Knowledge, Single use plastics, Street food vendors

Margaret Akpan¹, Ebenezer Balogun¹, Aniekanababasi Okon¹, Idang Ojong¹, Inemesit Akpan¹, Abasiofon Akpan¹,

Antor O. Ndep¹, Bernadne Ekpenyong¹

¹Department of Public Health, University of Calabar, Calabar, Cross River State, Nigeria. E-mail: magginem2000@yahoo.com

Background: As populations age, the demand for primary health care services becomes increasingly crucial, especially for the elderly who often need frequent and specialized care.

Objective: This study aimed to assess the awareness and utilization of primary health care services among the elderly in Akamkpa Local Government Area, Cross River State, Nigeria.

Methods: A cross-sectional descriptive design was used to engage elderly participants aged 50–65 years. The sample size of 327 was determined using Cochran’s formula, with multi-stage random sampling for participant selection. Quantitative data were analyzed using Statistical Product for Service Solution Version 25.0.

Results: Results were presented in frequency tables, percentages, and charts, with Chi-square tests used to test the association between socio-demographic characteristics and awareness levels. The mean and standard deviation of awareness were 8.46 ± 5.24, while utilization had a mean of 14.5 ± 2.3. The findings revealed that 63.6% of respondents had high awareness levels, but 75.5% had low utilization levels. The highest frequency of utilization was 11.3% monthly. Key factors affecting utilization included access (45.0%), cost (52.7%), distance (52.7%), ignorance (50.2%), waiting time (47.8%), and stigmatization and discrimination (44.9%), among others. The Chi-square analysis showed that awareness levels were significantly associated with age (χ² = 11.11, df = 2, P = 0.003) and religion (χ² = 2.40, df = 2, P = 0.014).

Conclusion: The study found high awareness of primary health care services among the elderly, but low utilization.

Keywords: Awareness, Elderly, Primary health-care service, Utilization

Kokei U. Uyire¹, Antor O. Ndep¹, Peter B. Enyievi¹, Edward O. Okoi¹, Margaret I. Akpan¹, Lilian E. Eyam¹, Favour A. Inyang-Ogim¹, Sylvia A. Agba¹,

Marvin M. Bisong-Edam¹, Unwana A. Essien¹, Aniekanabasi J. Okon¹, Bernadine N. Ekpenyong¹

¹Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, ²Department of General Studies, College of Health Technology, Calabar, Cross River State, Nigeria.

E-mail: itamkokei@gmail.com

Introduction: Access to contraceptive services has a major effect on youth vis-à-vis their health, education, employment opportunities, and general transformation into adulthood.

Aim: The aim of the study was to determine the knowledge and uptake of contraceptive services among young adults in the Southern Senatorial District of Cross River State.

Methodology: A cross-sectional descriptive design was used, and 436 young adults aged 15–24 were randomly selected from three Local Government Areas. The Health Belief Model guided the study objectives, questions, and data analysis. Hypotheses were tested using the Chi-square at the 0.05 level of significance. The research protocol was approved by the Cross River State Research Ethics Committee (CRS/MH/HREC/021/Vol.V1/211).

Results: Of the 436 copies of the questionnaire distributed, 422 were completed. Of the 422 respondents, 281 (66.6%) were female, 33 (7.8%) lived with their sexual partners, 245 (58.1%) had high knowledge levels on contraception, and 289 (68.5%) used contraceptives. Of the 289 respondents who used contraceptives, 227 (78.5%) used condoms, and 130 (30.8%) reported a high perceived susceptibility to getting pregnant as the motivator. Perceived barriers to contraceptive use were parents, 382 (90.5%), unfriendly service providers, 178 (42.1%), and unavailability, 85 (20.1%). There was a significant relationship between knowledge levels and contraceptive uptake (X² = 49.743, P = 0.0001); knowledge levels and barriers to contraceptive uptake (X² = 360.731, P = 0.0001); and between perceived parents’ attitude toward contraceptives and young adults’ contraceptive uptake (X² = 14.395, P = 0.0001).

Conclusion: The uptake of contraceptives is influenced by respondents’ perceived susceptibility to getting pregnant and perceived barriers. Health education campaigns targeting the reduction of stigma and promoting the uptake of reproductive health services are recommended.

Keywords: Contraceptive services, Knowledge, Uptake, Young adults

Boniface U. Ago¹, Sunday E. Oyama¹, Edima M. Olory¹, Elizabeth Bala¹, Ayemo Ubi¹, Eric I. Archibong¹

¹Department of Obstetrics and Gynaecology, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: bonifaceago@yahoo.com

Background: Ovarian ectopic pregnancy is rare, occurring in 0.5–3.5% of ectopic pregnancies. It is a cause of severe intra-abdominal hemorrhage if it ruptures. Most ruptures occur in the first trimester of pregnancy.

Introduction: Ovarian pregnancy is rare, constituting about 0.5% - 3.5% of ectopic pregnancy. In this condition, fertilization and implantation occur within the ovary. Most often, it is detected and terminated in the first trimester of pregnancy because of the associated risk of intraabdominal haemorrhage and mortality when it ruptures. In rare instances the diagnoses may be missed and pregnancy advances into later gestations including term, and post term.

Result: We present a 22-year-old G2P1 woman who booked for antenatal care at 16 weeks of gestation. Pregnancy was uneventfully carried to term when she noticed reduced fetal movement, for which emergency cesarean section was attempted. Surgery was abandoned, and the patient was referred to our facility due to suspected placenta percreta. At laparotomy, we noticed that she had an ovarian pregnancy fulfilling the Spiegelberg criteria.

Discussion: It may be reasoned that the ovary can carry pregnancy to term, but can we knowingly extend antenatal care services in such confirmed ovarian pregnancies till full term.

Conclusion: The ovary can carry pregnancy to term, but we are intrigued whether we can allow ovarian pregnancy detected in the first trimester of pregnancy to proceed to term.

Keywords: Unruptured ovarian pregnancy, Intra-abdominal haemorrhage, Pregnancy

Christabel O. Francis¹, Christie E. Fischer¹

¹Department of Anatomical Sciences, College of Medical Sciences, Faculty of Basic Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: christiefischer2407@gmail.com

Introduction: This study highlighted the teratogenic potential of the ethanolic leaf extract of Lawsonia inermis (Henna) on the fetal cerebral cortex of albino Wistar rats. L. inermis is predominantly used in the Northern part of Nigeria by males to boost fertility while their female counterparts ingest it for abortifacient purposes. The aim of this study was to determine the possibility of the occurrence of abnormalities, especially when ingested during the critical period of brain development, at doses inadequate to cause abortion.

Method: Twenty adult female Wistar rats (150–200 g) and eight adult male rats (190–220 g) were purchased for the study. The female rats were divided into four groups labeled A-D. The control, Group A was given rat chow and water. The experimental groups, B-D had maternal administration of the extract at 200, 400, and 600 mg/kg b.w, respectively, at the 6^th–11^th day of gestation. On day 20, the experiment was terminated; the rats anaesthetized with ketamine and the litters were removed through abdominal incisions and uterectomy.

Result: The number of fetuses decreased as the dosage of the extract increased, with the presence of resorption sites in the medium and high-dose groups. There was a significant decrease (P < 0.05) in the cell count of the high-dose group (600 mg/kg b.w) compared to the control, indicating hypoplasia of brain cells. There was a significant increase (P < 0.05) in cell size in the high-dose group (600 mg/kg b.w) compared to the control, causing hyperplasia of brain cells.

Conclusion: The ethanolic leaf extract of L. inermis has the potential to cause brain birth defects.

Keywords: Abortion, Brain, Fetus, Henna, Teratogen

Mfoniso Udonkang¹, Flora Odili¹, Light Obi¹

¹Department of Histopathology and Cytology, Faculty of Medical Laboratory Science, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: mfonisoudonkang@gmail.com

Introduction: Excess iron accumulation in the body has led to several morbidities and mortalities. The demonstration of iron pigment in histopathology involves the use of expensive and toxic chemicals, which calls for safer and cost-effective substitutes. The aim of this study was to investigate the staining potential of aqueous and ethanol extracts of Beta vulgaris (beetroot) on iron deposits of spleen tissue.

Method: The pH and spectrophotometry of aqueous and ethanol extracts of beetroot were determined. Formalin-fixed paraffin wax-embedded iron pigment-laden spleen tissue was cut into six groups and stained as follows: Group A with hematoxylin and eosin, Group B with Perl’s only, Group C and D with aqueous and ethanol extracts of beetroot, respectively, Group E with combined Perl’s/aqueous beetroot extract, and Group F with combined Perl’s/ethanol beetroot extract.

Result: The pH of beetroot was 4.76 and 5.68 for aqueous and ethanol extracts, respectively. Spectrophotometric measurement had a peak absorbance of 0.70 at a wavelength of 380 nm, demonstrating betalain pigment. Iron pigment in the spleen tissues-stained dark brown with hematoxylin and eosin, blue with Perl’s, and dark brown with aqueous and ethanol beetroot and for combined Perl’s/aqueous and Perl’s/ethanol extracts of beetroot. The staining characteristics were graded and analyzed. There was no statistically significant difference in the iron staining potentials among beetroot stains with Perl’s and hematoxylin and eosin stains (χ² = 0.397, P = 1.000). Conclusion: B. vulgaris is acidic, contains betalain, and can stain iron pigment effectively. Beetroot is a safer and cost-effective alternative for histological staining of iron pigments.

Keywords: Beetroot, Iron pigment, Perl’s, Spectrophotometry, Spleen, Substitute

Mfoniso Udonkang¹, Stanley Anyanwu¹, Victory Nzeaka¹, Laura Orubu¹, Ruth Odu¹, Vincent Adamede¹

¹Department of Histopathology and Cytology, Faculty of Medical Laboratory Science, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: mfonisoudonkang@gmail.com

Introduction: Formalin is a routine fixative for tissue preservation but causes several health toxicities, including carcinogenicity, thus the need for substitutes. Palm bunch ash solution has been observed to have some preservation capacities due to its long bench life. The aim of this research was to investigate the use of palm bunch ash solution (PBAS) as fixative in histology.

Method: The pH and chemical properties of PBAS were determined. The gross study involved fixing three tissues from a goat in 10% formal saline and PBAS of 10%, 50%, 70%, and 90% concentrations for durations of 24, 48, and 72 h, 1 and 2 months, respectively. Histological study involved dividing tissues from albino rat into three groups and fixed as follows: Group A in 10% formal saline, B1-4 in 10%, 50%, 70%, and 90% PBAS, and C1-4 in 10%, 50%, 70%, and 90% PBAS with normal saline for 24 h, respectively. The paraffin wax-embedded tissues were stained with hematoxylin and eosin.

Result: The results showed pH of PBAS (10.96), total alkalinity (25.98), total salinity (12.45), total carbon (19.39%), chloride (22.50), calcium (5.20), and nitrite (2.20). The PBAS fixed the tissues for 24 h, like formalin (P = 0.777). There was no fixation after 48 h and beyond (χ² = 28.800, P = 0.001). The 10% PBAS solution gave better nuclear/cytoplasmic staining, histological details, and clarity like formalin (χ² = 0.501, P = 0.998). The PBAS has alkaline pH and high salt contents.

Conclusion: The 10% PBAS can serve as a short-term, cheap, locally available, and non-toxic alternative to formalin.

Keywords: Alkaline, Fixative, Formalin, Hematoxylin and eosin, Palm bunch ash, Palm oil

Toochukwu James Paulmiki Ide¹, Ngozi Uchechi Ukam¹, Catherine Kenyoh Eteng¹

¹Department of Human Nutrition and Dietetics, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: toochukwujames@gmail.com

Background: Behavioral science is a fast-evolving field of the human health sciences, including nutritional behavior. This research work was undertaken to determine the behavioral lifestyle of adults in Calabar Metropolis.

Method: The cross-sectional descriptive study involving 500 adults adapted the World Health Organization stepwise questionnaire to generate the data. The data generated were analyzed using the Statistical Package for the Social Sciences version 22.0.

Result: Fifty-four percentages (54%) of females as against 46% males participated in the study, whereas the majority (99.4%) were of the Christian faith. The alcohol consumption rate was 63%, while 98% of the respondents consumed sweetened soft drinks at varying frequencies. Palm wine (46%), beer (43%), and brandy/hot drinks (43%) were the most consumed alcohol beverages. The unavailability of food (64%) and lack of time (54.3%) were the major reasons why meals were skipped by the respondents. Brisk walking was the exercise performed most (47.2%) by the respondents out of the total proportion of 67% that were involved in physical exercise. The distribution of the respondents based on their occupations showed that 33.8% were students/apprentices, 31.6% businessmen and women, while 29.6% were either teachers/lecturers or civil/public servants. The physical activity pattern of the respondents revealed that 91.2% were sedentary. Both primary and secondary smoking added up to 27.2% of the respondents.

Conclusion: The findings of the study could be attributed to high social life, urbanized, motorized transport system of the city, and poor awareness of the inherent dangers of the unhealthy lifestyle exhibited; hence, the urgent need for the intervention of public health and nutrition experts in the study area.

Keywords: Adults, Behavioral lifestyle, Calabar metropolis, Males and females, Nigeria

Sylvia A. Agba¹, Margaret I. Akpan¹, Elvis Anyaehiechukwu Okolie^1,2,3, Unwana Paul Obadare¹, Abasiofon I. Akpan^4,1, Felicity Nneoma Ike¹, Antor O. Ndep¹

¹Department of Public Health, University of Calabar, ²Department of Public Health, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria, ³School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom, ⁴Department of Sociology, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: elvisa.okolie@gmail.com

Introduction: Despite advancements in HIV prevention, young people remain disproportionately affected. Pre-exposure prophylaxis (PrEP) is promising, but there is limited research on the knowledge and uptake among youths. This study assessed PrEP knowledge, attitudes, and uptake among students in tertiary institutions in Calabar Metropolis, Nigeria.

Methods: This study used a cross-sectional descriptive design to assess the knowledge, attitude, and uptake of PrEP among 420 students who were recruited using a multi-stage sampling technique. A semi-structured questionnaire was utilized to obtain relevant data from participants on PrEP. Data were exported to and analyzed using Statistical Product and Service Solution version 26 to produce descriptive and inferential statistics.

Results: Among respondents who had heard of PrEP (51.7%), 58.1% had high knowledge of it, and 84.3% were willing to use it in the future. However, only 6% of sexually active participants had ever used PrEP. Barriers to uptake included lack of information on where and how to access PrEP (48.3%), low knowledge (46.5%), friend disapproval (44.6%), unavailability (45%), fear of side effects (38.2%), and perceived cost. Chi-square analysis showed that age (P = 0.033) and tribe (P < 0.001) were significantly associated with PrEP uptake.

Conclusion: This study emphasizes the need to improve PrEP awareness and knowledge, translating participants’ willingness into actual uptake. It also calls for multifaceted strategies to address barriers to PrEP use in this high-risk group.

Keywords: Africa, HIV prevention, HIV, Nigeria, Pre-exposure prophylaxis, Young people

Eteng, Katherine Kenyoh¹, Nneoyi-Egbe, Ada Francesca¹, Ide Toochukwu James Paulmiki¹, Obeten Stella Collins¹, Uboh Friday Effiong¹

¹Department of Biochemistry, Faculty of Basic Medical Sciences, College of Medical Sciences, University of Calabar, Cross River State, Nigeria.

E-mail: kathyabam@gmail.com

Background: Benign prostatic hyperplasia (BPH) is the most common urological condition among elderly men, beginning around the age of 40 and reaching a prevalence of up to 90% of men in their 80s. It is a non-cancerous enlargement of the prostate which may develop gradually over several years.

Method: The study involved a total of 32 Wistar rats, weighing 120–150 g. Group 1 (Positive control), was served rat chow + water, Group 2 (Negative control), 3, and 4 were given rat chow + water + 5 mg/kg body weight testosterone propionate, intraperitoneally for BPH induction for 4 weeks, rat chow + water + Testosterone for BPH induction + Finasteride, rat chow + water + Testosterone for BPH induction + 0.45 mL/kg leaf juice, respectively. All the hematological indices were determined using the Sysmex automated hematological analyzer (BC-2600 RX ZIN).

Result: Costus afer leaf juice produced a significant (P < 0.05) reversal in the levels of most of the BPH-induced derangements in the hematological indices. The positive effect expressed by the C. afer leaf juice may be used in the treatment of these complications in BPH.

Conclusion: The findings of the study showed that C. afer leaf juice possess ameliorative potential against the negative of testosterone induced BPH rats in the hematological indices.

Keywords: BPH, Costus afer, Finasteride, Hematology, and Wistar rats

Eyo Aniekan-Augusta O.¹, Eyo Gokola O.¹, Asuquo Anne E¹

¹Department of Medical Bacteriology, Virology and Mycology, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: aniekanaugusta48@gmail.com

Introduction: Antimicrobial resistance is currently one of the most serious global public health challenges, resulting in longer hospital stays and treatment failure. Antimicrobial resistance profiles and phylogenetic analysis of clinical and environmental Gram-negative bacteria in Calabar were studied.

Method: A total of 210 bacterial isolates were obtained from clinical samples, 105 from the University of Calabar Teaching Hospital (UCTH) and 105 from the General Hospital Calabar (GHC). From UCTH, 48 (45.7%) were Gram-negative, while 32 (30.5%) from GHC were Gram-negative, making a total of 80 (38.1%) clinical Gram-negative isolates. Two hundred and ten environmental specimens were collected from within the hospital environment and outside the hospital environment, and 28 (13.3%) Gram-negative isolates were obtained. Forty of these Gram-negative isolates were systematically selected and identified using the Vitek^® 2 Compact system, 30 (75%) clinical and 10 (25%) environmental isolates.

Method: Antibiotics susceptibility testing by the modified Kirby-Bauer disk diffusion method revealed high levels of resistance to meropenem 4 (13.3%); 0 (0.0%), cefixime 20 (66.7%); 5 (50.0%), Augmentin 24 (80.0%); 5 (50.0%), ceftazidime 21 (70.0%); 4 (40.0%), piperacillin/tazobactam 12 (40.0%); 4 (40.0%), ceftriaxone 15 (50.0%); 1 (10.0%), cefuroxime 27 (90.0%); 7 (70.0%), levofloxacin 12 (40.0%); 3 (30.0%), ciprofloxacin 11 (36.7%); 1 (10.0%), and amikacin 10 (33.3%); 3 (30.0%) for clinical isolates (χ² = 2613.485, P < 0.001); and environmental isolates (χ² = 3009, P < 0.001), respectively. Majority of the organisms in this study showed multidrug resistance ranging from R3 to R8 for both clinical and environmental isolates. The multiple antibiotic resistance index ranged from 0.2 to 1.0 for both groups of isolates.

Conclusion: The organisms tested showed the presence of resistance genes, including NDM-1, bla KPC, bla SHV, and bla CTXM, and the phylogenetic analysis showed strong relatedness of the Gram-negative bacteria from clinical and environmental sources. Strict antibiotic stewardship is encouraged.

Keywords: Anti-microbial resistance, Phylogenetics, Gram-negative bacteria

Pauline Egba¹, Margaret Akpan¹, Chioma Ubah¹, Abasiofon Akpan¹, Mmefone Ojong¹, Favour Inyang-Ogim¹

¹Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: magginem2000@yahoo.com

Background: Gender-based violence (GBV) is often perceived as an issue primarily affecting women, yet men can also be victims, with far-reaching consequences for well-being. This study aimed to investigate the determinants of GBV against men and its implications for well-being in Calabar Municipality, Cross River State, Nigeria.

Methods: The research used a cross-sectional design, collecting data from 376 men through structured questionnaires.

Results: The study revealed that emotional/psychological abuse was most prevalent (64.1%), followed by physical violence (45.3%) and economic abuse (44.34%). Sexual violence (9.16%) and financial exploitation (0.24%) were less common. The study also showed that key factors such as age, marital status, and employment status significantly influenced GBV occurrence, with married men reporting the highest rates (73.9%). There was a significant decline in men’s post-abuse, with positive well-being decreasing from 36.14% to 32.29%, and significant issues affecting well-being increasing from 5.06% to 16.87%. Binary logistic regression showed men aged 25–34 (adjusted odds ratio [AOR] = 3.567, P = 0.000), those with primary education (AOR = 2.134, P = 0.037), and unemployed men (AOR = 2.232, P = 0.002) faced higher risks of GBV. The relationship between types of violence and post-abuse well-being was strongly significant (χ² = 571.840, P = 0.000, Cramer’s V = 0.390).

Conclusion: This study highlights the overlooked issue of GBV against men and its harmful impact on family health in Calabar Municipal, emphasizing the need for targeted interventions to raise awareness, reduce stigma, and support male victims, promoting healthier family dynamics and societal well-being.

Keywords: Calabar munucipality, Gender-based violence, Male

Egeonu Yochi Immaculata¹, Phillip Bassey Etabee¹, Henshaw Uchechi Okoroiwu², Efut Joseph Ajah¹, Anthony Agbajor Anyam¹

¹Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Cross River State, ²Department of Medical Laboratory Science, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria.

E-mail: igbokagud@gmail.com

Background: Healthy blood donors may harbor plasmodium parasite without signs, and blood from such donors poses a very serious risk to transfusion recipients. Malaria is a parasitic infection caused by the Plasmodium species. Nigeria had the highest prevalence (31.7%), followed by Ghana (19.4%) and Sudan (17%). The aim of this study was to determine the Malaria parasite density among blood donors in the southern senatorial district of Cross River State.

Methodology: A cross-sectional descriptive study design was used with a quantitative method. A multi-stage sampling technique was used to select 342 subjects aged 18 and 65, males and females, from health facilities. A questionnaire was used to obtain data. Thick and thin blood smears were prepared and viewed microscopically to identify malaria parasites. Data were analyzed using Microsoft Excel 2007 and Statistical Package for the Social Sciences software version 23.0.

Result: Most subjects were adults aged 28–37 years 160 (46.8%). Mean age of subjects was recorded as 33.30 ± 9.58 years. The ratio of male 314 (91.8%) to female 28 (8.2%) was about 11:1. Most subjects were students 87 (25.4%). Malaria parasite prevalence among subjects was 82 (24.0%). Subject aged 18–27 years (342.24) had the highest mean parasite density. Educational level (P ≤ 0.031) and occupation (P ≤ 0.035) were significantly associated with mean parasite density of donors with malaria parasites. Perceived malaria preventive measures identified by blood donors were, sleeping under insecticide treated net, anti-malaria drug, and health education.

Conclusion: There should be health education on malaria, its risk, health implications, and prevention. Pre- and post-transfusion surveillance should be considered.

Keywords: Blood donors, Parasite density, Plasmodium malaria, Prevalence

Torty Chimaeze¹, Nwankwo Grace¹, Bassey Glory¹, Otu Vivien¹, Otu Ekaobong¹, Asindi A. Asindi¹

¹Department of Paediatrics, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: drchimatorty@gmail.com/chimaezetorty@unical.edu.ng

Background: Opsoclonus-myoclonus-ataxia syndrome (OMAS) is a rare inflammatory neurological disorder characterized by acute onset ocular, motor, behavioral, sleep, and speech disturbances. The etiology of OMAS remains unclear, but infectious triggers have been implicated. Salmonella is a common cause of gastrointestinal infections; however, its neurological complications and association with OMAS is rare and poorly understood.

Case Report: This was a 15-year-old male who presented to our facility with opsoclonus, multifocal myoclonus, truncal titubation, generalized tremor, and unsteady gait preceded by a 5-day history of malaise, vomiting, headaches, and fever. Brain computed tomography and abdominal magnetic resonance imaging scans showed no significant abnormalities. Blood culture isolated Salmonella spp., and the full blood count result showed leukocytosis with differential neutrophilia. HIV antibody test was negative, and the other results were normal. He was treated with tabs prednisolone, tabs clonazepam, and ciprofloxacin. Patients made significant improvements and were eventually discharged after 9 days of admission. The Salmonella Typhi titer levels checked after 2 weeks follow-up were high, but symptoms of unsteady gait and residual tremors progressively resolved over 6 weeks and patient had remained stable.

Conclusion: This report highlights the association between Salmonella infection and OMAS, a rare and debilitating neurological disorder. This suggests that Salmonella should be considered a potential trigger for OMAS, particularly in the pediatric age group. A high index of suspicion, prompt diagnosis, and appropriate treatment may improve outcomes and reduce the risk of long-term neurological sequelae.

Keywords: Neurological disorder, Opsoclonus-myoclonus-ataxia syndrome, Salmonella

Aruwajoye Evelyn Omotolani¹

¹Department of Public Health, University of Derby, Derby, England. E-mail: udemeefanga@gmail.com

Introduction: Numerous situations necessitate social adjustments within families, and the birth of a child represents a fundamental instance. However, no matter how prepared a family is, none is prepared enough for the birth of a child with autism spectrum disorder (ASD) and the challenges that comes with it. The complexities associated with the birth and upbringing of an autistic child intertwine intricate array of challenges both within the family unit and within the broader societal context. Asides, confronting societal isolation, parents grapple not only with comprehending the intricacies of autism but also with primary questions regarding causality, management strategies, avenues for support, and the uncertainties of their children’s future. This constant struggle manifests in persistent stress, anxiety, and depression, as substantiated by existing research, which underscores a higher prevalence of these mental health challenges amongst parents raising children with ASD in comparison to their counterparts raising typically developing children.

Method: This study meticulously employed a systematic search approach across two prominent databases, Cinahl Ultimate and PsyINFO. After the application of rigorous exclusion and inclusion criteria, the review and assessment of articles from these databases encompassed the selection of ten articles, elucidating pertinent insights.

Result: The findings revealed a recurring pattern of increased levels of stress, depressive symptoms, and anxiety, adverse mental health outcomes among parents raising children with ASD due to an interplay of innumerable numbers of factors. This complex interplay of factors included the critical influence of social support both formal and informal, societal lack of understanding culminating in isolation and stigmatization, behavioral challenges exhibited by ASD children which make them constantly fall below societal expectation, coping mechanisms adopted by parents, socioeconomic factors which serve as a predictive elements for ASD severity, and fear of the future which plays a pivotal roles in influencing parental mental health outcome.

Conclusion: Enhancing the mental health outcomes of parents navigating the challenges of raising children with ASD necessitates a comprehensive and collaborative approach involving all societal stakeholders. The implementation of robust policies and structures stands imperative to provide sustained and consistent support for this specific cohort of parents.

Keywords: Anxiety, Autism spectrum disorder, Childbirth, Social adjustment, Societal isolation, Stress

Iwara, Promise Eyo¹, O. Iloma David¹,

Ekpenyong Bernadine Nsa¹; Uwazie Charles Chukwudi¹, Akpan Margaret Inemesit¹, Efut Joseph Ajah¹

¹Department of Public Health, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: promiseiwara@gmail.com

Background: Malaria is a tropical disease caused by Plasmodium parasites, and symptoms can be life-threatening. Infants, under-five children and pregnant women are at higher risk. Malaria can be prevented by avoiding mosquito bites. It accounts for approximately 30% of under-five mortality. We investigated perception of caregivers and the effectiveness of long-lasting insecticide treated nets (LLITNs) use in under-five children.

Methods: We conducted a survey of 888 parents/caregivers’ perception of the use of LLITNs using a 3-point Likert Scale, and the data were analyzed in proportions. We investigated the effectiveness of LLITNs among 42 treatments and 42 control groups with a pre- and post-test intervention program; controls did not use LLITNs. Groups were tested for malaria parasites after 1 month. We tested significant difference in perception of LLITNs use within the treatment group with Paired sample t-test while that between the two groups was tested using independent sample t-test.

Results: Of the 888 respondents, 365 (41.1%) used LLITNs due to the shape, while 366 (41.2%) do not use LLITNs for fear of chemicals. After the intervention, 39 (92.7%) of the 42 treatment group tested negative for malaria, while 36 (85.7%) of the controls tested positive. Significant difference in perception within treatment group (t [41] = −18.7, P < 0.05) and difference between the two groups (t [82] = −18.1, P < 0.05).

Conclusion: Perception of caregivers and effectiveness of the use of LLITNs improved between the groups after the intervention, as malaria episodes among under-five children who used LLITNs reduced. We recommended that health promotion be intensified to use LLITNs in under-five children.

Keywords: Effectiveness, Long-lasting insecticide treated nets, Malaria, Perception, Under-five children

V. O. Ezenwali¹, M. O. Ezenwali¹, A. K. Nwobodo¹

¹Department of Biochemistry, Faculty of Biological Sciences, University of Nigeria, Enugu, Nigeria.

E-mail: obinna.ezenwali@esut.edu.ng

Introduction: Proper execution of fundamental cellular and organelle functions demands (oxidative) redox-homeostasis or excess endogenous antioxidant, since oxidative stress is central to various diseases and budding evidence suggests that it is a major contributor in the development or pathology of a diseased state, besides other cellular factors. This study aims to determine the in vitro antioxidant activities and qualitative phytochemical analysis of both the ethanol extract and different solvent fractions of C. truncata leaf.

Method: Standard assay methods were used for the determination of in vitro antioxidant activities – phosphomolybdate assay, reducing power assay, 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging, ferric reducing antioxidant power, and nitric oxide scavenging activity. The solvent fractions were obtained by successive fractionation of the extract using different solvents (n-hexane, dichloromethane, ethyl acetate, and ethanol) in a silica gel column chromatography to partition the phytoconstituents of the extract into different fractions based on their polarities.

Result: Qualitative phytochemical tests on the extract gave positive reactions to tannin, flavonoid, phenol, saponin, terpenoid, and alkaloids, while (ethanol fraction [EF]1-7), (EF1-2), and (n-hexane fraction [n-HF]1-2 and ethyl acetate fraction [EAF]-1) gave positive reactions to (flavonoid and alkaloid), (phenol), and (phytosteriods), respectively. Saponin, tannin, terpenoid, and quinone were found to be presence in EF1-7, and EAF1-2, EF1-4, and EAF-1, EF1 and n-HF1, 4, 6–9, 12–15, and EF1-5, 7; EAF1-4; and n-HF1-7, 9–14, respectively. EF1-7 exhibited significant reductant potential of both Fe³⁺ - Fe²⁺ and Mo⁶⁺ - Mo⁵⁺ and significant free radical scavenging activities of DPPH in comparison with ascorbic acid.

Conclusion: n-HF6-9 exhibited non-significant free radical scavenging activities of DPPH in comparison with ascorbic acid.

Keywords: Ethanol fraction, Ethyl acetate fraction, and n-hexane fraction, Free radical scavenging activities, Phytochemicals, Redox-homeostasis, Reductant potential

Inyang Udeme Asibong¹, Nelson Osuchukwu¹, Benardine Nsa Ekpenyong¹, Joseph Ajah Efut¹

¹Department of Public Health, University of Calabar, Calabar, Cross River State, Nigeria. E-mail: inyangasibong@gmail.com/josephefut21@gmail.com

Background: This study explores the health status of internally displaced persons (IDPs) and indigenous adults of Bakassi, Cross River State, Nigeria, amidst ongoing displacement due to conflicts and natural disasters. Globally, over 55 million people are internally displaced, with 11.1 million in sub-Saharan Africa. IDPs face various risk factors such as overcrowding, poor sanitation, inadequate shelter, food shortages, and limited access to healthcare, leading to heightened vulnerability to communicable diseases.

Methodology: The study employed a comparative cross-sectional design, involving 860 participants, evenly split between IDPs and indigenous adults. Results show significant disparities in living conditions and health outcomes between the groups. Only 20.5% of IDPs had proper accommodation, compared to 95.3% of indigenous adults, and fewer IDPs used insecticide-treated nets. Both groups reported challenges accessing healthcare due to high costs, with 39.1% of IDPs and 37.2% of indigenous adults citing it as expensive.

Results: Statistical analysis revealed that IDPs had poorer physical health, with a mean score of 44.6 compared to 55.7 for indigenous adults. Mental health outcomes were also worse among IDPs, with 60% experiencing psychiatric disorders compared to 36.7% of indigenous adults. Factors such as age, marital status, occupation, and access to healthcare significantly influence health outcomes.

Conclusion: The study highlights the urgent need for healthcare infrastructure and services for IDPs, including antenatal care and immunization. Government intervention is crucial to improve health outcomes for IDPs, addressing both physical and mental health needs in Bakassi and similar locations.

Keywords: Comparative assessment, Indigenous adults, Internally displaced persons, Mental health, Physical health

Joseph Efut¹, Philip Bassey¹, Maurice-Joel Ugbe¹,

Monica Elaunire¹, Immaculata Egeonu¹, Dominic Offiong¹

¹Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: ushumolog@gmail.com

Background: Obesity and overweight result from an imbalance between energy intake and expenditure, leading to excess energy stored in fat cells. Globally, obesity has reached alarming levels, contributing to about 2.8 million deaths annually. In Nigeria, the prevalence of obesity ranges between 8.1% and 22.2%. This study examined the prevalence and risk factors associated with overweight and obesity among civil servants in the Southern Senatorial District of Cross River State, Nigeria.

Methodology: A cross-sectional study was conducted among 420 civil servants aged 18–60 years. Anthropometric measurements, including weight, height, and waist circumference, were collected. A multi-stage sampling technique was used, and participants completed a semi-structured questionnaire. Data were analyzed using Microsoft Excel and Statistical Package for the Social Sciences version 20.

Results: The mean age of participants was 37.98 years. More than half had a tertiary education, and 39.1% were married. The mean weight, height, and body mass index were 75.30 kg, 1.69 m, and 26.12, respectively. Overweight and obesity prevalence were 34.0% and 22.6%, respectively. Females were more overweight, while males had higher obesity rates. Sedentary lifestyles, high-fat diets, and fast-food consumption were major perceived risk factors. Suggested preventive measures included reducing fat and sugar intake, increasing consumption of healthy foods, and avoiding weight-gain drugs and contraceptives. Obesity was significantly associated with age, marital status, and income. Drug use, smoking, and family history were identified as key risk factors.

Conclusion: High levels of overweight and obesity were observed. Regular physical activity, health education, and government policies promoting healthy diets and physical activity are recommended to reduce related health risks.

Keywords: Civil servants, Obesity, Overweight, Prevalence, Risk factors

Bassey Iya Eze¹, O. T. Ugwu¹, B. E. Icha¹, K. U. Okoi¹, I. P. Isong¹, U. O. Akpan¹, G. D. Ugochukwu¹, C. J. Agbo¹, B. O. Agu¹, S. A. Akuraga¹, G. E. Asu¹, C. O. Dan¹, E. A. Eyibio¹, G. E. Kinane¹

¹Department of Clinical Chemistry and Immunology, Faculty of Medical Laboratory Science, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: iyaezebassey@gmail.com

Introduction: Vitamin D deficiency has been reported to be common in Nigerians and associated with advanced stage, higher tumor grade, and mortality in prostate cancer. This study assessed the Vitamin D status, oxidative stress markers, sub-nutritional indices, and renal function in prostate cancer patients in Enugu, Nigeria.

Method: Thirty prostate cancer patients with and 30 without Vitamin D deficiency attending the Urological clinic of the University of Nigeria Teaching Hospital, and 30 controls were randomly recruited. Prostate specific antigen (PSA) and Vitamin D were determined using enzyme-linked immunosorbent assay methods; total antioxidant capacity (TAC) by ferric iron reducing antioxidant power method, total plasma peroxide (TPP) by FOX-2 method, malondialdehyde (MDA) by Burge and Aust method, and oxidative stress index (OSI) calculated. Serum creatinine, urea, PO43-, Mg, Zn, and Ca were determined using colorimetric methods and eGFR by CKD-EPI formula. Data were analyzed using Student’s t-test, analysis of variance at P ≤ 0.05.

Result: Prostate cancer patients exhibited significantly higher (P < 0.05) PSA, phosphate, urea, creatinine, TPP, OSI, and peroxidase but had significantly lower (P < 0.05) calcium, zinc, eGFR, TAC, and Vitamin D levels compared to controls. Prostate cancer patients with Vitamin D deficiency showed significantly elevated PSA, phosphate, urea, OSI, and peroxidase and significantly lower (P < 0.05) calcium, zinc, and TAC compared to those with sufficient Vitamin D. However, there were no significant differences (P > 0.05) in creatinine, eGFR, thiamine pyrophosphate (TPP) and malondialdehyde (MDA) between the two groups.

Conclusion: These findings suggest that Vitamin D deficiency is associated with altered sub-nutritional balance, oxidative stress and renal dysfunction may play a role in the pathophysiology of prostate cancer among Nigerian men.

Keywords: Enugu State, Oxidative stress, Prostate cancer, Renal function, Vitamin D

E. E. Edu¹, A. O. Oku¹, F. K. Udechukwu¹, F. I. Adung¹, D. E. Efiong¹, F. S. Ebughe¹, M. O. Maduka¹

¹Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: afyokuene@gmail.com

Background: Globally, mistreatment/abuse has been recognized as a regular phenomenon faced by undergraduate medical trainees that could undermine the quality of medical education and the well-being of future health professionals. This study was therefore conducted to assess the prevalence, patterns, and factors associated with mistreatment experienced by clinical students at the University of Calabar.

Method: A descriptive cross-sectional study was conducted among 390 clinical students at the University of Calabar. Systematic sampling was used to recruit participants into the study. A self-administered, semi-structured, and pre-tested questionnaire was employed to obtain information on mistreatment experienced by medical undergraduates. Data were analyzed using the Statistical Package for the Social Scientists version 25 and level of significance set at <0.05.

Results: The overall mean age of clinical students was 24.4 ± 3.42 years. A little over three- fifths (61.9%) of the clinical students interviewed had experienced one or more forms of mistreatment during their training, with 61.2% experiencing it monthly and occurring mainly in the hospital wards (57.9%). The most common form of mistreatment experienced was verbal abuse (66.2%), and the main perpetrators of these incidents were medical consultants/lecturers (58.5%) resident doctors (58.2%) and administrative staff (27.5%). Being single (62.8%) in the Clinical II level of study (97%), residing on campus (69.3%) and aged 24 years and above (70.0%) were significantly associated with experiencing mistreatment in this study (P < 0.05). However, only 6.3% reported these incidents.

Conclusion: With more than half of undergraduate medical trainees experiencing mistreatment, the development of appropriate strategies for the prevention and reduction of these incidents is strongly recommended.

Keywords: Abuse, Calabar, Medical students, Mistreatment, Nigeria

I. E. Bassey¹, A. O. Oku¹, E. I. Abiaka¹, F. S. Ebughe¹, C. Nweke¹, F. K. Udechukwu¹, A. E. Okafor¹

¹Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: afyokuene@gmail.com

Background: Human papillomavirus (HPV) is a widespread sexually transmitted infection associated with various cancers, including cervical cancer. Despite the introduction of the effective HPV vaccines, uptake remains low, especially in developing countries like Nigeria. Teachers significantly influence students’ health behaviors and community health perceptions. Their knowledge and attitudes toward HPV vaccination are critical for improving acceptance and implementation. This study therefore aims to evaluate secondary school teachers’ knowledge, perception, and acceptability of HPV vaccination in Calabar Municipality, Cross River State.

Method: A descriptive cross-sectional study was conducted among 100 secondary school teachers in Calabar Municipality, using multistage sampling. A self-administered, semi-structured, and pre-tested questionnaire was used to gather data on knowledge, perception, and acceptability of HPV vaccination. Data analysis was performed using the Statistical Package for the Social Sciences version 25, with significance set at P < 0.05.

Results: The mean age of participants was 41.66 ± 9.09 years. Most teachers (89%) were aware of the HPV vaccine, with the most common information source being health workers (58%). Nearly, half of the teachers interviewed (43%) had poor knowledge of HPV vaccine, while 58% had positive perceptions and 75% were willing to vaccinate their wards. Key facilitators of HPV vaccine acceptance were recommendation by health professional (74%) and free vaccination services (45%) while perceived barriers included concerns about the vaccine (58%) and lack of information (47%). Factors significantly associated with HPV knowledge were sex of children, teaching experience, and subjects taught (P < 0.05).

Conclusion: Our study emphasizes the importance of targeted educational efforts to address safety concerns and enhance awareness, ultimately aiming to improve HPV vaccination uptake among adolescents.

Keywords: Acceptance, Calabar, Human papilloma virus vaccine, Knowledge, Teachers

B. B. Gbarayege¹, N. O. Ekpenyong¹, B. J. Asuquo¹, O. Nwankwo¹, E. S. Izontimi¹, B. I. Akwandaye¹, C. A. Ekeh¹

¹Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: nnekon2015@gmail.com

Background: Malaria in pregnancy, though a preventable disease, still poses a threat to both maternal and fetal well-being. Other preventive measures have not been successful in combating malaria; hence, the development of the malaria vaccine is a key public health strategy for the prevention of malaria. This study assessed the factors associated with the willingness to accept the malaria vaccine among antenatal care attendees in Health Facilities in Calabar, Nigeria.

Method: This was a descriptive cross-sectional study among 426 antenatal care attendees selected through a multi-stage sampling procedure in public health facilities in Calabar, Nigeria. A semi-structured, interviewer-administered, and pre-tested questionnaire was used.

Results: The study found that among the respondents, willingness to accept the malaria vaccine was high (85%), mainly driven by benefits for mother and child (34.8%), recommending the vaccine 87%, and willingness to pay for the vaccine (52.1%) with slightly more than two-thirds of respondents willing to pay between 500 and 1000 naira for the vaccine. Unwillingness to accept the vaccine was significantly related to good knowledge of the vaccine (P < 0.05) with key reasons being fear of side effects (23%), cost (16.4%), and insufficient information (16%).

Conclusion: This study found that knowledge of the malaria vaccine did not translate to willingness to accept the vaccine, with major reasons being fear of side effects, cost, and insufficient information on the vaccine. Targeted education on the malaria vaccine benefits and safety can help increase uptake among antenatal care attendees.

Keywords: Antenatal care, Calabar, Malaria vaccine, Pregnancy, Willingness

Okorie Isaiah¹, Chukwukere Evan¹, Obeten Heart¹,

Asor Divine¹, Ita-Lincoln Freedman¹, Ogban Omoranyia¹

¹Department of Community Medicine, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: italincoln77@gmail.com

Background: Despite widespread knowledge of the impact of sleep on health and well-being, many undergraduates still report poor sleep quality, largely due to increasing screen time use amidst other multifaceted factors. This study aims to assess the relationship between screen time and sleep quality among undergraduates at the University of Calabar, Nigeria.

Methods: A cross-sectional study design using a multi-stage sampling technique was used to obtain quantitative data from 384 undergraduates of the University of Calabar, Nigeria, through a structured validated interviewer-administered questionnaire. Sleep quality was measured using Pittsburgh sleep quality index (PSQI) and screen time usage was assessed using participant’s parental control and digital well-being mobile applications. Statistical analysis was done using IBM Statistical Package for the Social Sciences version 26. Descriptive statistics such as frequency, percentages, mean, and standard deviation were used to describe the variables and Chi-square used to test the significance of association between categorical variables.

Results: A total of 384 respondents with a mean age of 22.38 ± 3.42 years, with a male: female ratio of 1:1.3 completed the study. Mean screen time use was 7.11 ± 2.84 h, and a total of 266 undergraduate students (69.3%) had poor sleep quality with a global PSQI score >5. The prevalence of poor-quality sleep was higher amongst undergraduates who had screen time use more than 5 h daily (74.4%) compared to those whose screen time use was 5 h or less (57.0%) (P = 0.001). Non-screen time related factors associated with poor sleep quality were female sex (P = 0.032), engaging in night reading more than twice a week (P = 0.008), not having a regular bedtime (P = 0.012), history of depression (P = 0.014), uncomfortable sleeping room (P = 0.017), and alcohol and caffeine consumption (P = 0.002) etc.

Conclusions: This study provides objective evidence of sleep quality among undergraduates and highlights the relationship between screen time and non-screen time-related factors with poor sleep outcomes. Thus, it underscores the need for concerted and targeted efforts involving enlightenment and lifestyle modifications to improve positive screen time use and sleep quality.

Keywords: Digital well-being, Screen time, Sleep quality, University of Calabar

P. E. Effiom¹, N. O. Ekpenyong¹, O. Nwankwo¹, I. Agbor¹, G. D. Aniara¹, C. E. Ekefre¹, E. Eboh¹

¹Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: nnekon2015@gmail.com

Introduction: Sleep is central to numerous human physiological functions, particularly learning capacity, memory consolidation, neurocognitive functions, and mental health. However, the demands and expectations of a high-pressure occupation and course of learning, such as medicine and medical studies, may place increased strain on time, resulting in varied coping mechanisms, including cutting back on sleep. This can affect the learning and academic performance of students. This study aims to assess the effect of sleep quality on the perceived academic performance of clinical students in a tertiary institution in Nigeria.

Method: This cross-sectional descriptive study was conducted among 392 randomly selected clinical students at the University of Calabar, Cross River State, Nigeria. Data were collected by a self-administered and semi-structured questionnaire adapted from the standardized Pittsburg sleep quality index (PSQI). Chi-square was used to test for associations between sleep quality and academic performance (P < 0.05).

Results: Respondents had a mean sleep duration of 5.1 ± 1.2 h, with a range of 2–8 h, with 67.5% reporting poor sleep quality as measured by PSQI. There was a significant association between poor sleep quality and poor academic performance (P < 0.005) as 17.5% of respondents with poor sleep quality reported poor academic performance compared with 2% of those with good sleep quality who reported poor academic performance.

Conclusion: Most respondents in this study had poor sleep quality, which was significantly associated with poor academic performance. Findings from this study hold implications for decision-makers to seek ways to encourage better sleep quality among clinical students.

Keyword: Clinical students, Nigeria, Pittsburg sleep quality index, Sleep quality

W. C. Amaechi¹, O. E. Akpet¹, P. K. Izama¹, J. A. Adie¹, B. M. Ebu¹, T. E. Ekpenyong¹

¹Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: winniedomini@gmail.com

Background: Hepatitis B viral (HBV) infection is a vaccine-preventable disease that puts an increased economic burden on the population. An effective HBV infection prevention is a product of good knowledge, attitude, and uptake of hepatitis B vaccination. This study aimed to determine the knowledge, attitude, and uptake of hepatitis B vaccination among nursing students at University of Calabar.

Method: A descriptive cross-sectional study was carried out among 280 nursing students, using systematic sampling. A self-administered, semi-structured, and pretested questionnaire was used to collect relevant information. Data were analyzed using IBM Statistical Package for the Social Sciences version 26.0, and the P-value was set at <0.05.

Results: The mean age of the respondents was 21.6 ± 3.2 years. The mean knowledge score was 22.5 ± 3.5. Two-thirds (66.8%) of the respondents had good knowledge. The mean attitude score was 50.4 ± 9.9, and 158 (56.4%) of the respondents had a good attitude toward hepatitis B vaccination. More than half (67.5%) of the respondents had never received a dose of vaccine. Some factors responsible for this include cost of vaccines (40.7%), lack of money (40%), and fear of side effects (35.7%). There was significant relationship between level of uptake of hepatitis B vaccination and level of knowledge (P = 0.012) with good knowledge having more uptake of the complete doses of the hepatitis B vaccines.

Conclusion: The high number of unvaccinated respondents in this study is a serious public health concern, since these nursing students also work in high-risk health facilities. The Management of the Nursing College, Unical, should take serious action to reverse this dangerous trend.

Keywords: Calabar, Hepatitis B vaccine, Nigeria, Nursing students, Uptake

K. P. Nwike¹, N. O. Ekpenyong¹, B. J. Asuquo¹, M. E. Okeme¹, C. J. Nweke¹, J. O. Betialikong¹

¹Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: nnekon2015@gmail.com

Introduction: Intimate partner violence (IPV) is a pervasive public health issue that affects about one in three women globally. Our study aimed to evaluate the factors that are associated with IPV among women of reproductive age in Calabar Municipality, Nigeria.

Method: This was a community-based descriptive cross-sectional study involving 410 women of reproductive age (18–49 years) recruited through a multi-stage sampling procedure. A selfadministered, semi-structured, and pre-tested questionnaire was employed to obtain information on IPV among respondents. Data were analyzed using IBM Statistical Product and Services Solutions version 26.0, and the level of significance was set at <0.05

Result: The general prevalence of IPV among respondents was 18.2%, with stalking (12.7%) and sexual violence (10.7%) being more prevalent. IPV knowledge among respondents was poor (42.5%), although 97.1% had a positive perception about IPV. Factors associated with IPV in this study were level of education, employment status, and marital status (P < 0.05). The prevalence of IPV was higher in women with a low level of education (100%) and women whose partners were 40 years or older. Physical violence was more in women with low levels of education and those who were self-employed. Psychological violence was more in women who were cohabiting/ married, low level of education, were self-employed, and whose partners were in the older age groups.

Conclusion: In Calabar Municipality, about 2 in 10 women still experience IPV. The factors linked to IPV can serve as important indicators for identifying the most vulnerable groups, and targeting interventions such as female education can help reduce the prevalence of IPV.

Keywords: Intimate partner violence, Nigeria, Reproductive age, Women

P. U. Ugwu¹, A. O. Oku¹, F. E. Etene¹, F. S. Ebughe¹, K. F. Udechukwu¹, P. T. Njoku¹

¹Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: afyokuene@gmail.com

Background: Human papillomavirus (HPV) vaccination is crucial for the prevention of cervical cancer and other HPV-related diseases, yet its uptake has remained persistently low in Nigeria since its introduction in 2009. Caregivers play a critical role as key decision makers in the vaccination status of their wards. This study, therefore, assessed knowledge, perception, and acceptance of HPV vaccination among caregivers in Calabar, Cross River State, Nigeria.

Methods: A descriptive cross-sectional study design was employed. Three hundred and forty-four caregivers were recruited into the study from two selected wards using multistage sampling methods. Data were collected using a pre-tested interviewer-administered questionnaire and analyzed using IBM Statistical Package for the Social Sciences version 26.0. Univariate and bivariate analysis were conducted with the level of significance set at P < 0.05.

Results: The mean age of respondents was 40.08 ± 10.04 years. A little above half (52.9%) of caregivers had good knowledge, while 265 (77%) had positive perceptions toward HPV vaccination. Majority of respondents 243 (71%) were willing to accept HPV vaccination for their wards. Perceived barriers of acceptance as reported by caregivers were lack of information about the vaccine (68.6%) and fear of side effects (58.9%). Tertiary level of education was significantly associated with good knowledge of HPV vaccine while a significantly higher proportion of caregivers with good knowledge of HPV vaccine were more likely to accept HPV vaccination (P < 0.05).

Conclusion: Despite caregivers’ fair knowledge of the HPV vaccine, their acceptance of the vaccine was quite high and encouraging. Efforts should therefore be targeted at improving caregivers’ knowledge, which is crucial for the HPV vaccination program.

Keywords: Acceptance, Caregivers, Human papilloma virus vaccination, Knowledge, Nigeria, Perception

M. C. Osuagwu¹, N. O. Ekpenyong¹, B. J. Asuquo¹, H. I. Eguma¹, D. G. Owo¹

¹Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: nnekon2015@gmail.com

Background: The school health program (SHP) is a vital intervention for promoting health and well-being among students. In Nigeria, SHP has been identified as a critical strategy for addressing numerous health challenges faced by school-aged children, but despite this recognized importance of SHPs, there are limited data on the level of knowledge and uptake of these programs among different stakeholders, especially school-aged children. This study aimed to assess the knowledge and uptake of the SHP among secondary school students in Calabar, Cross River State.

Method: This was a descriptive cross-sectional study involving 420 students selected through simple random sampling from four secondary schools in Calabar. Data collection was by a self-administered, semi-structured, and pre-tested questionnaire. Data were analyzed using IBM Statistical Package for the Social Sciences Version 26 and the test of significance was set at 0.05

Results: The predominant age group in this study was 10–13 years (53.6%). Other findings revealed moderate knowledge (54.5%) and uptake (15.5%) of the SHP among respondents. Significant associations existed between knowledge, perception, uptake, and sociodemographic factors (gender, class, and parent occupation). Female students, early adolescents, and students with government-employed parents/guardians demonstrated better knowledge and uptake of SHP (P < 0.05).

Conclusion: This study highlights the need for targeted interventions to enhance SHP knowledge and uptake among secondary school students. Tailoring programs to adolescent needs, more engagement with self-employed parents, and developing gender-sensitive strategies are recommended.

Keywords: Calabar, Cross River State, Knowledge, School health program, Secondary school students, Uptake

R. I. Asuquo¹, O. E. Akpet¹, T. P. Nwachukwu¹, O. B. Ojegbalemeh¹, F. O. Wada¹, T. E. Ekpenyong¹

¹Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: roxylittle@yahoo.com

Background: Breast self-examination (BSE) is an easy and efficient means for early detection of breast lumps and other changes that could lead to breast cancer. Breast self-examination involves both visual inspection and manual palpation of the breast, targeting the early detection of abnormalities and changes to enhance prompt medical intervention.

Aim: The aim of this study was to study the knowledge, attitude, and practice of breast self-examination among female undergraduate students at University of Calabar, Cross River State, Nigeria.

Methods: A descriptive cross-sectional study was conducted among 307 undergraduates using a multistage sampling method. Respondents were administered pretested and self-structured questionnaires. Data were entered into and analyzed using IBM Statistical Package for the Social Sciences version 26. Categorical data were summarized using frequencies and percentages, and the results were presented in tables and figures. Numerical variables were summarized using means and standard deviation. A test of statistical significance was done using Chi-square, with a P-value set at < 0.05.

Results: The study had a 100% response rate and respondent’s mean age was 21.0 ± 0.2 years and a greater proportion of the respondents had good knowledge of and good attitudes toward BSE (97% and 98%, respectively). However, 59% of the respondents had poor practice of BSE.

Conclusion: Breast self-examination is very critical in the early detection of sinister signs and symptoms; hence, its importance cannot be over emphasized in curbing the mortality and morbidity this menace brings. The relevant authorities should take more serious steps to improve the poor practice of BSE noticed among the respondents in this study.

Keywords: Breast self-examination, Calabar, Female undergraduate, Nigeria, University

D. M. Achua¹, K. J. Ishember¹, G. E. Alekwu¹, G. A. Dien¹, U. Effiwatt¹, A. Etokidem¹

¹Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: afyokuene@gmail.com

Background: Postpartum family planning (PPFP) is an integral component of maternal and child healthcare aimed at preventing unintended pregnancies and reducing maternal mortality by promoting birth spacing. Despite the known benefits of family planning, the uptake among postpartum women in Nigeria remains relatively poor. Understanding the factors that influence family planning decisions is critical to enhancing maternal health outcomes. This study aimed to examine the factors influencing family planning use among postpartum women attending public health facilities in Calabar Municipality.

Method: A cross-sectional study was conducted in six public health facilities in Calabar Municipality. A total of 410 postpartum women were selected using a multi-stage sampling technique. Data were collected using a semi-structured questionnaire and analyzed with the Statistical Package for the Social Sciences version 26. Descriptive statistics and Chi-square tests were used to summarize the data and explore associations between variables.

Results: The prevalence of family planning use was 52.1%, with male condoms (47.0%) being the most used method. Socio-demographic factors significantly associated with family planning use included age, marital status, and income. Fear of side effects (41.6%) and partner opposition (37.6%) were the main barriers to family planning use. Women with higher incomes and those cohabiting were more likely to use contraceptives (P < 0.05).

Conclusion: Although knowledge of family planning was high, its utilization among postpartum women in Calabar Municipality is still limited by fear of side effects and lack of partner support. Addressing these barriers through targeted interventions could significantly improve family planning uptake.

Keywords: Family planning, Maternal mortality, Nigeria, Postpartum

P. U. Utionkpan¹, H. H. Assam¹, J. U. Ogar¹, N. B. Nwabuokei¹, U. Efiwatt¹, A. Etokidem¹

¹Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria. E-mail: afyokuene@gmail.com

Background: Diarrhea is the second leading cause of mortality in children globally, accounting for over half a million deaths annually with sub-Saharan African countries including Nigeria bearing the highest burden. These deaths which result from dehydration can be prevented by the application of simple cost-effective strategies using oral rehydration therapy/Salt Sugar Solution, zinc tablets and continuous feeding. Caregivers play a pivotal role in the prevention and management of diarrhea. This study, therefore, seeks to assess the knowledge, attitude, and practice of home management of diarrhea among caregivers of children under 5 years in Akim Ward, Calabar Municipality, Cross River State, Nigeria.

Methods: A community-based descriptive cross-sectional study was conducted among 416 caregivers of children under 5 years using a cluster sampling method. Caregivers were interviewed face to face using a pretested and semi-structured questionnaire adopted from a standardized tool and adapted to our setting. Data were analyzed using IBM (Statistical Package for the Social Sciences statistics software version 26. The test of statistics was Chi-square, and P < 0.05 was considered statistically significant.

Results: Slightly more than half of the caregivers had good knowledge of diarrhea and home management (56.7% and 57.5%, respectively). More than two-thirds of caregivers had a positive attitude toward home management of diarrhea. Regarding their practice, 57.9% had good practice of home management of diarrhea.

Conclusion: Although most caregivers demonstrated good knowledge, positive attitude, and slightly above average practice, gaps identified in our study underscore the need for reinforcement of targeted community-based interventions to consolidate knowledge and attitude while improving caregivers’ practice.

Keywords: Diarrhea, Home management, Nigeria, Under-five children

A.P. Oti¹, O. E. Akpet¹, V. E. Ekanem¹, E. E. Ubeng¹, T. E. Ekpenyong¹

¹Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: paulynoti@gmail.com

Background: Anemia in pregnancy remains a serious public health issue worldwide, posing risks to both maternal and fetal health, with the burden highest in low- and middle-income countries. Prevention of anemia through adequate nutrition, iron and folic acid supplementation, and regular medical check-ups is essential but often hindered by limited awareness, perceptions, and adherence among pregnant women. This study assesses the knowledge, perception, and practices of anemia prevention among pregnant women attending antenatal clinic at the University of Calabar Teaching Hospital (UCTH).

Method: A descriptive cross-sectional study was conducted among 200 pregnant women in UCTH. Systematic sampling was used to recruit participants into this study. A pre-tested, self-administered, and semi-structured questionnaire was used to get relevant information from the respondents. Data analyzed using IBM Statistical Package for the Social Sciences version 25, with P-value set at < 0.05.

Results: The mean age of the respondents was 31.3 ± 2.0 years. The majority (91.5%) of the participants had good knowledge of anemia in pregnancy. More than half (68.5%) of the respondents demonstrated positive perception toward anemia prevention in pregnancy. A little <2 thirds (63%) of the respondents slept under insecticide-treated nets. Some barriers to preventing anemia in pregnancy include cost of iron supplements (89.7%), forgetfulness (87.0%), lack of awareness (83.5%), poor knowledge of balanced diet (78.0%), and cultural preference (55.5%).

Conclusion: Enhancing anemia prevention in pregnancy requires combined efforts of community education, targeted public health initiatives, and dietary guidelines. Healthcare workers should intensify their health education during ante natal care visits by pregnant women.

Keywords: Anemia, Antenatal care, Calabar, Knowledge, Nigeria, Practice, Pregnancy, Prevention

F. E. Ajake¹, C. Njoku¹, F. E. Atu¹, V. O. Ironbar¹, I. E. Iro¹, N. Ekpeyong¹, O. Nwankwo¹

¹Department of Community Medicine, University of Calabar, Calabar, Cross River State, Nigeria. E-mail: drogonnanwankwo@gmail.com

Introduction: Human papillomavirus (HPV) vaccines prevent cancer-causing HPV infections in both men and women. Students, by their age and predisposition to risky health behaviors, can benefit immensely from receipt of HPV vaccines. This study aims to assess the knowledge and uptake of human papillomavirus vaccine among undergraduate students in University of Calabar, Calabar, Cross River State.

Method: This was a cross-sectional descriptive study carried out among 408 students of the University of Calabar recruited using a multi-stage sampling method. A self-administered, semi-structured, and pre-tested questionnaire was used for data collection. Data analysis was carried out using the Statistical Package for the Social Sciences version 25, with significant level set at P < 0.05.

Results: The mean age of the respondents was 21.93 ± 2.4 years with more than half of the respondents being females 239 (58.6%). Slightly above half of the participants had good knowledge of HPV 210 (51.5%) with only about four percent having received the HPV vaccine 19 (4.6%). For the doses received, 47.4% received one dose and 52.6% received two doses. The perceived reasons for non-uptake of the HPV vaccines include cost concerns (34.6%), lack of awareness and education (26.5%), limited accessibility and availability (20.6%), concerns about effectiveness and safety (8.4%), and social and cultural factors (6.4%), among others. Sex, relationship status, and level of knowledge were significantly associated with uptake of the human papillomavirus vaccine (P < 0.05).

Conclusion: There is a need for interventions to improve the knowledge of HPV among university students while removing access barriers to the vaccines, such as cost.

Keywords: Human papilloma virus, Vaccines, University of Calabar

Q. Egba¹, C. Njoku¹, C. Osanekwu¹, V. B. Effiom¹, O. J. Ohochukwu¹, N. Ekpeyong¹, O. Nwankwo¹

¹Department of Community Medicine, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: drogonnanwankwo@gmail.com

Introduction: Globally, there is increasing evidence of the threat of climate change to the health of the population. There is a need for vulnerable populations to take action to adapt and mitigate against the effects of climate change. Physicians are regarded as a trusted and reliable source of health information as well as strong advocates for health. Thus, physicians can play a role in engaging the population and policymakers to take action on climate change. This study aims to assess the knowledge, perceptions, and practices of physicians regarding climate change in Calabar, Cross River State, Nigeria.

Method: This was a cross-sectional descriptive study carried out among 346 physicians working in Calabar using a multi-stage sampling method. A self-administered, semi-structured, and pre-tested questionnaire was used for data collection. Data analysis was carried out using the Statistical Package for the Social Sciences version 25, with significant level set at P < 0.05.

Result: The mean age of the respondents was 38.86 ± 9.8 years, with a higher proportion of the participants being males, 203 (58.7%). Slightly above half had good knowledge about climate change, 185 (54.6%). The majority of the participants feel physicians have a responsibility to bring the health effects of climate change to the attention of their patients, 312 (90.1%), and the public, 297 (85.8%). About half of the participants have discussed the health impacts of climate change with their patients 202 (58.4%). Less than half of the participants, 171 (49.4%), have overall good practice toward climate change. Age, sex, and self-rated socioeconomic status of the participants were significantly associated with the level of knowledge (P < 0.05).

Conclusion: There is a need to develop appropriate strategies and interventions to improve the knowledge and practice of physicians regarding climate change.

Keywords: Climate change, Physician, Health impact

F. Ita-Lincoln¹, O. Nwankwo^1,2, G. Joseph², T. Gbelebo², H. Egba², Q. Ugo-Inyama¹, C. Njoku¹

¹Department of Public Health and Community Medicine, University of Calabar Teaching Hospital, ²Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: italincoln77@gmail.com

Background: Immunization remains one of the most cost-effective interventions against preventable childhood diseases. Despite this evidence, there is poor uptake as a result of poor knowledge and attitudes of mothers toward childhood immunization. With recent calls for interventions to improve knowledge and attitude, this study aims to assess the effect of an innovative audiovisual animation on the knowledge attitude and intention of mothers to complete their children’ vaccination.

Method: This is a non-equivalent quasi-experimental study that involved 302 mothers visiting two health facilities in Calabar, Nigeria, for vaccination of their children (Intervention-group: 77 vs. 72, Control-group: 97 vs. 56). Mothers in the intervention arm watched the video-animation on television at each visit while their counterparts received the traditional face-to-face health education as routinely practiced in the facility. Quantitative outcome on knowledge, attitude, and intention to complete vaccination was assessed at 0 and 14 weeks. Data analysis using the Statistical Package for the Social Sciences version 28 was conducted and Chi-square test carried out at P < 0.05 and 95% confidence interval.

Result: This study was conducted from January 2024 to October 2024. Baseline mean age (standard deviation) was 28.05 (5.26) versus 29.14 (5.14) for the audiovisual and face-to-face group, respectively. At baseline, 15.6% and 41.2% of mothers in the audiovisual and face-to-face arm, respectively, had good knowledge, which significantly increased to 88.9% in the audiovisual arm after the intervention (P < 0.001). There was no statistically significant difference in attitude toward vaccination among mothers in both arms, but intention to complete child’s vaccination increased significantly from 84.4% at baseline to 91.7% in the audiovisual arm after intervention (P = 0.016).

Conclusion: A locally developed and tailored audiovisual animation on childhood immunization can significantly increase the knowledge of immunization among mothers and the intention to complete their child’s vaccination.

Keywords: Complete child’s vaccination, Immunization, Audiovisual animation

S. S. Onuada¹, N. E. Mkpanam¹, U. O. Eyong¹, J. O. Edor¹, E. E. Asuquo¹, S. N. Ogar¹, R. E. Bassey¹

¹Department of Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: drogonnanwankwo@gmail.com

Background: Over 3.1 billion people in the world could not afford a healthy diet, and many children under 5 suffer from malnutrition. Nearly 25 million Nigerians are at risk of facing hunger. This study was, therefore, conducted to assess the factors associated with food insecurity among households in Calabar Municipality.

Method: A descriptive cross-sectional study was conducted among 240 households in Calabar Municipality. Simple random sampling was used to recruit participants into the study. A self-administered, semi-structured, and pre-tested questionnaire was employed to obtain information on factors associated with food insecurity among households in selected communities in Calabar Municipality. Data were analyzed using the Statistical Package for Social Scientist version 25 and level of significance set at <0.05.

Result: The overall mean age of households was 41.18 ± 8.14 years. About 99% of households were food insecure. The following factors were associated with food insecurity; gender (male) 63%, lack of job 93%, and chronic illness 73.6%.

Conclusion: With more than half of households in Calabar Municipality experiencing food insecurity, addressing it requires a multi-faceted approach, including improving economic opportunities, enhancing agricultural productivity, and implementing targeted social programs to support vulnerable households.

Keywords: Coping mechanism, Food insecurity, Household

Mboso Ofonime Eve¹, Iwara Iwara Arikpo¹, Odey Oko Michael¹, Isangedihi Grace¹

¹Department of Biochemistry, Faculty of Basic Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: evemboso2@gmail.com

Background: Indomethacin is a common antipyretic and anti-inflammatory agent that has harmful interference with ovarian health and function. Indomethacin enters the bloodstream following oral, subcutaneous, or rectal administration. This study aimed to determine the effect of ethyl acetate and aqueous leaf extracts of Eremomastax speciosa leaves on vaginal Pap smear and sex hormones of indomethacin (INDO) treated female Wistar rat.

Method: Thirty-five female Wistar rats were divided equally into five groups including the control (CTRL) group. In group two, toxicity was induced by oral administration of INDO at 5 mg/kg/body weight for 14 days and treatment groups with INDO + clomiphene citrate at a dose of 12.5 mg/ kg/body weight, INDO + ESETAC fraction at 64 mg/kg/body weight, and INDO + ESAQ fraction at 64 mg/kg/body weight, for 14 days.

Result: Treated rats with eremomastax speciosa ethanol extract (ESETAC) and eremomastax speciosa aqueous extract (ESAQ) recorded estrus cyclicity at proestrus and estrus stages, significantly increased (P < 0.05) follicle-stimulating hormone, luteinizing hormone, and testosterone levels.

Conclusion: These findings showed that treatment with ESAQ and ESETAC fractions was effective as reproductive therapeutics against toxicity from indomethacin in females through specific regulatory mechanisms.

Keywords: Inflammation, Ovulation, Reproduction, Sex hormones

Margaret Uyilewhoma Inde¹, Nelson Osuchukwu¹, Benardine Nsa Ekpenyong¹, Joseph Ajah Efut¹

¹Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: indemargaret14@gmail.com/josephefut21@gmail.com

Background: This study focuses on intimate partner violence (IPV), a global public health issue and human rights concern, defined as any behavior within an intimate relationship that inflicts physical, psychological, or sexual harm. Globally, over one in four women aged 15 and older have experienced IPV. The study aimed to assess the prevalence and determinants of IPV among Sero-Positive Adults in the Southern Senatorial District of Cross River State, Nigeria.

Method: A cross-sectional descriptive design with mixed methods was conducted in the Government Hospitals in the region. The study involved 294 participants for the quantitative part and 60 for the qualitative part, using multi-stage sampling. Semi-structured questionnaires were administered during clinic days, and data were analyzed with IBM Statistical Package for the Social Sciences version 20.0. Descriptive and inferential statistics were used to analyze quantitative data, while qualitative data were thematically analyzed from focus group discussions.

Results: The mean age of respondents was 39 years, and the response rate was 95.6%. IPV prevalence was recorded at 46.3%, with 84.1% of participants having a high knowledge of IPV. Key determinants of IPV included age, cultural norms, low income, disrespect for partner, seropositive status, extramarital affairs, gender, and poor health facility utilization. Health education significantly impacted participants’ knowledge and preventive measures (P = 0.001). There were also significant associations between knowledge level and IPV occurrence (P = 0.001).

Conclusion: The study concludes that IPV remains prevalent and recommends intensified health education to enhance awareness and preventive practices among seropositive adults in the region.

Keywords: Determinants, Intimate partner violence, Prevalence, Sero-positive adults

Abdulhakeem Rotimi Agboola¹, Gregory Elayeche Oko¹, Onyeweaku Eridiong¹, Ekaette Sunday Udoh¹, Chinedum Martins Ekeleme¹, Ako Hogan Itam¹,

Eyuwa Ignatius Agwupuye¹

¹Department of Biochemistry, College of Medicine, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: agboolara@unical.edu.ng

Background: Diabetes mellitus is a complex metabolic disorder with intricate and multifaceted etiologies, often necessitating multimodal management approaches. This study evaluated the anti-inflammatory and antidiabetic potential of the ethanolic extract from the leaves and stems of an edible fern (Diplazium esculentum).

Method: In vitro anti-inflammatory activity was assessed using the Human Red Blood Cell (HRBC) membrane stabilization method, proteinase inhibition assay, and inhibition of protein denaturation assay. Antidiabetic activity was evaluated through α-amylase and α-glucosidase inhibition assays, as well as the yeast glucose uptake method. Diclofenac, acarbose, and metformin were employed as standard controls for the anti-inflammatory and antidiabetic assays, respectively.

Result: Results indicated that the ethanolic extract of the edible fern demonstrated significant anti-inflammatory and antidiabetic activities in a dose-dependent manner. Anti-inflammatory activity results for the extract included 83.98 ± 0.86% HRBC membrane stabilization, 59.94 ± 0.23% proteinase inhibition, and 62.89 ± 0.83% inhibition of protein denaturation, compared to diclofenac values of 86.79 ± 1.07, 87.77 ± 0.86, and 89.73 ± 0.47%, respectively. The extract also showed substantial antidiabetic activity, with α-amylase inhibition of 74.81 ± 0.87% and α-glucosidase inhibition of 71.97 ± 0.68%, in comparison to acarbose values of 88.96 ± 0.95% and 94.36 ± 0.41%, respectively. In the yeast glucose uptake assay, the extract achieved a value of 47.99 ± 0.74% relative to 62.05 ± 0.85% for metformin.

Conclusion: These findings suggest that the ethanolic extract of edible fern may hold therapeutic potential for managing inflammation and diabetes mellitus.

Keywords: Diplazium esculentum, Anti-inflammatory, Antidiabetics

Greg Elayeche Oko¹, Abdulhakeem Rotimi Agboola¹, Onyenweaku Eridiong¹, Chinedum Martins Ekeleme¹, Ako Hogan Itam¹, Eyuwa Ignatius Agwupuye¹

¹Department of Biochemistry, College of Medicine, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: agboolara@unical.edu.ng

Background: Free radical accumulation is associated with various diseases in humans, and antioxidants play a crucial role in neutralizing these radicals, thereby mitigating their harmful effects. This study aimed to investigate the antioxidant and free radical-scavenging properties of the ethanolic extract of edible fern (Diplazium esculentum).

Method: Antioxidant activities, including ferric iron reducing antioxidant power (FRAP), 2,2-diphenyl-1-picrylhydrazyl (DPPH), in vitro lipid peroxidation (ILP), glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT) were evaluated using several standard spectrophotometric assays. Qualitative and quantitative phytochemical screenings were performed following established procedures.

Result: The fern extract demonstrated dose-dependent scavenging activities in the FRAP, DPPH, and ILP assays, with the highest activities observed at 500 µg/mL: 81.34 ± 0.77 (FRAP), 68.03 ± 0.79 (DPPH), and 62.93 ± 0.56 (ILP). These values were comparable to those of the standard (ascorbic acid) at 500 µg/mL, with activities of 95.01 ± 0.57 (FRAP), 91.86 ± 0.38 (DPPH), and 90.63 ± 0.82 (ILP). There was also a dose-dependent increase in the activities of GSH, SOD, and CAT, with the highest activities recorded at the highest extract concentration, 100 µM, namely, 17.40 ± 1.03, 59.07 ± 0.82, and 63.43 ± 1.12, respectively. Phytochemical analysis of the extract identified various bioactive compounds, including alkaloids, flavonoids, phenols, oxalates, and anthraquinones, with saponins being the most abundant.

Conclusion: The findings indicate that the ethanolic extract of edible fern is a promising natural antioxidant source and an effective free radical scavenger, with potential applications as a plant-based pharmaceutical for managing diseases linked to free radicals.

Keywords: Diplazium esculentum, In vitro antioxidants, In vivo antioxidant

Obinna C. Godfrey¹, Eze A. Adindu¹, Uwem O. Edet¹, Elizabeth N. Mbim¹, Fredrick C. Asogwa¹

¹Department of Biochemistry, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: godfreyobinna@yahoo.com

Background: Obesity represents a significant global health issue that continues to escalate in prevalence. Obese patients usually experience leptin resistance in the face of paucity of strategies geared toward reversing this resistance and restoring “satiety.” This study is the first to investigate the effect of plant derived fatty acids from Cola lepidota seed for the purpose of reversing leptin resistance in obesity condition.

Method: Experimental GC-MS extraction technique, theoretical Fourier transform infrared, and ultraviolet-vis analysis under the framework of density functional theory (DFT) at the B3LYP/6-311++G(d,p) level of theory were use. Molecular docking and pharmacokinetics studies were employed to reveal the drug-likeness of the studied compounds, in silico.

Result: The Result shows that ODA has the highest energy gap of 7.4244 eV, followed by HXD at 7.4230, then BISP at 5.5849 eV, and finally LA at 2.8216 eV. Therefore, the order of stability is as follows: ODA > HXD > BISP > LA. Molecular docking analysis of the compounds reveals promising interactions with the receptor protein, while the pharmacokinetics reveals favorable drug-like properties with no toxicity effects with respect to hepatotoxicity, immunotoxicity, cytotoxicity, mutagenicity, and carcinogenicity, and did not also penetrate the blood-brain barrier or exhibit clearance delays.

Conclusion: These compounds have positioned themselves as promising agents in obesity management, warranting significant interest as potential drug candidates.

Keywords: Cola lepidota, Fatty acids, Pharmacokinetics, Molecular docking

M. A. Mgbekem¹, Nduka Nwakwue¹, J. Eneji, F. Anjor¹, S. Ogbeche¹, V. Edem¹

¹Department of Nursing Science, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: achimgbekem@yahoo.com

Background: Climate change, a significant global challenge with its consequences on health, has now become a common topic for everyday discussion in all spheres of life. Nursing, a caring profession with the largest workforce in the healthcare industry, has a pivotal role in being proactive and responsive to the environmental changes and climate-related events that now plague our health. This descriptive study was designed to determine nurses’ knowledge and role in sustainable care delivery in climate change health communication.

Method: A structured questionnaire was used in the study. Two research questions were formulated to guide this study. A simple random sampling technique was used to select a sample size of 120 nurses from five nursing training institutions in Cross River State using the Kish and Leslie formula. Data were analyzed using the Statistical Package for the Social Sciences-25 for descriptive statistics and Chi-square for inferential statistics at 0.05 significance level. Descriptive data was presented in tables and percentages while chi-square was used for hypothesis testing.

Result: The findings revealed good knowledge, 95 (72.5%), but poor understanding of the sustainable role, 45 (37.5%), of the participants in climate change. Chi-square analysis showed a statistically significant relationship between knowledge of climate change and educational level of the participants (X² cal = 89.62a, X² tab = 3.84; df = 1, P < 0.05).

Conclusion: The study concluded that nurse educators and curriculum developers should stress the need to develop a teaching guide for nurses to provide a clear description of roles in the practice of climate change care delivery in Nigeria.

Keywords: Climate change, Nursing, Structured questionnaire

Nkwocha John Nnaemeka¹, B. A. Amadi¹, K. T. Nwauche¹, O. E. Ezim¹

¹Department of Biochemistry, Faculty of Science, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria.

E-mail: johnnkwocha400@gmail.com

Background: This study evaluated the enzyme inhibitory properties and molecular docking of n- hexane extract of Ficus carica leaves.

Method: Three enzymes were used for this study, namely xanthine oxidase, carbonic anhydrase, and cholinesterases. The leaves of the plant were obtained from a farm in Owerri, Imo State, Nigeria. The leaves were identified at the Department of Plant Science and Biotechnology, University of Port Harcourt, Rivers State, Nigeria. The leaves were washed, air-dried, and blended to powered form using blender. The phytochemical composition, as well as mineral constituents of the leaf using standard methods.

Result: Fifteen phytochemical compounds were detected, the majority of which belonged to the phenol, flavonoid, sterol, and triterpenoids classes of secondary metabolites. The presence of benzoic acid, epicatechin, and naringin was determined using high-performance liquid chromatography with photodiode array detection analysis. The extract showed higher inhibition on xanthine oxidase than the standard drug (allopurinol). The extract had no inhibitory effect on the cholinesterases while the standard drug (donepezil) showed moderate inhibitory effect on the cholinesterases. The result revealed a higher inhibitory effect of the extract on carbonic anhydrase than the standard drug (acetazolamide).

Conclusion: The result obtained from molecular docking using three molecules: Allopurinol, donepezi, and acetazolamide showed the interaction of these ligands to xanthine oxidase, cholinesterases, and carbonic anhydrase, respectively. The leaf extract of F. carica can be used in the treatment of diseases.

Keywords: Acetazolamide, Allopurinol, Benzoic acid, Carbonic anhydrase, Cholinesterases, Donepezil, Ficus carica, Molecular docking

N. U. Ukam¹, E. E. Ekpenyong¹, V. A. Agada¹

¹Department of Human Nutrition and Dietetics, Faculty of Basic Medical Sciences University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: ukamngozi@yahoo.com

Background: Soup is a tasty, nutritious food made from the combination of condiments from stocks, vegetables, fish, and meat (poultry, venison, goat meat, etc.). The aim of this research was to evaluate the nutrient, vitamins, and anti-nutrients composition of Cissus populnea soup.

Method: A Focus group discussion was used to find out the ingredients and the methods of preparation of the soup. Ten (10) women were randomly selected from the ten (10) villages of Idoma land. The Okoho stem was scraped, beaten with a pestle, removed in strands, submerged in very hot water, and pressed vigorously with the palm to extract the slime. Some of the other ingredients used in the soup meal preparation were Okpehe (fermented locust beans), Ikpepi oono (bitter eggplant), mushroom, mangala (dried catfish), Bouillon cubes (Knorr/crayfish maggi), crayfish, scotch bonnet, goat meat, etc. The proximate analysis (moisture, protein, fat, crude fiber, ash, available carbohydrates, vitamins, and anti-nutrients, were determined using standard procedures.

Result: Result of the proximate analysis showed 4.97, 9.36, 9.88, 1.46, 47.01 (%) for moisture, protein, ash, fiber, fat, and carbohydrate, respectively. Vitamin A, C, and E results indicated as follows, 74.04, 0.18, and 0.91 (mg/g), respectively. The B-complex vitamins results were as follows, 1.31, 3.21, 1.75, 9.12, and 21.21 (mg/g) each. The anti-nutrient results showed the following: HCN (0.004 mg), oxalate (0.90 mg), and phytate (1.41 mg) were found to be lower than the safe level of 50 mg/day.

Conclusion: It was concluded that C. populnea contains appreciable nutrients, vitamins, and anti-nutrients that are below safe levels.

Keywords: Cissus pulpunea, Eggplants, Fermented locust bean, Molded melon, Okoho

N. U. Ukam¹, T. J. Ide¹, C. C. Nze¹

¹Department of Human Nutrition and Dietetics, Faculty of Basic Medical Sciences University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: ukamngozi@yahoo.com

Background: Justicia carnea is a local herb used medicinally but has not been used for cocktail drinks; hence, this work was done to fill the gap. The leaves were plucked from University of Calabar staff quarters in June 2023.

Method: Standard methods were used in the determination of proximate composition and microbial load.

Result: The result shows that with regard to proximate composition, amino acid sample B (50% J. carnea leaf extract + 50% beetroot extract) had the best carbohydrate, protein, and fat composition. Sample B also had the highest amino acid profile while sample C (40% J. carnea leaf extract + 30% beetroot extract + 30% date) had the best fatty acid composition. Furthermore, the study showed that sample A (100% J. carnea drink extract) had no microbial load, which is an indication that J. carnea has a lot of antimicrobial properties.

Conclusion: This leaf has been used for a long time medicinally, but this work has proven that it can be used in the production of cocktail drinks, which contain appreciable amounts of micronutrients that could combat micronutrient deficiency diseases.

Keywords: Fruit drink, Herbs, Justicia carnea, Leaves extract, Micro-nutrients

Udoh Ekaette Sunday¹, Odoala Finan Kelechi¹,

Icha Bassey Edward¹, Abdulhakeem Rotimi Agboola¹, Ojibima Christabel Francis¹, Ajaba Mathias Okang¹, Agwupuye Eyuwa Ignatius¹, Alpha Gulack Obadiah¹, Ohadoma Sylvester Chika¹, Essiet Grace Akanimo¹

¹Department of Pharmacology, University of Calabar, Calabar, Cross River State, Nigeria. E-mail: ekaetteudoh@unical.edu.ng

Background: Despite significant progress in the treatment of malaria over the past decades, it has remained a formidable health challenge due to its parasite’s remarkable genetic polymorphism that confers its resistance. This has led to a growing interest in contemporary alternatives. Moringa oleifera with Gossypium herbaceum leaf (MOGH) has a range of complementary pharmacological activities, including antiplasmodial, antipyretic, and antianemic amidst others. Therefore, this study was aimed at determining the possibility of its co-therapy efficacy.

Method: Malaria infection in mice was induced by intraperitoneal administration of P. berghei NK-65 red blood cells inoculum (1:1; infected donor mice blood: Normal saline) and confirmed through daily microscopy of blood smears. Four days post-infection, the animals were treated based on their groupings with 2% dimethyl sulfoxide (DMSO) (Vehicle), 25 mg/kg/d chloroquine, 100, 200, and 300 mg/kg/d of MOGH extract while the un-infected group (Sham) was given 2% DMSO for 7 days. Analyses were conducted for parasitemia, pyrexia, hematology, oxidative stress, cytokines, and biochemical assays using standard procedures. Histopathological studies of tissues of brain, liver, spleen, and kidney were also evaluated.

Result: MOGH suppression of P. berghei was significant and had marked efficacy in ameliorating anemic conditions in the infected animals. It also elevated the levels of interleukin (IL)-6, IL-10, tumor necrosis factor-α, malondialdehyde, and suppressed the expression of superoxide dismutase, catalase, and glutathione peroxidase, alongside exhibiting hematopoietic effects. However, biochemical aberrations and organ toxicities were noted.

Conclusion: MOGH exhibited remarkable synergistic antiplasmodial activity, thereby, demonstrating potential for use as alternative or adjunct in treatment of malaria.

Keywords: Moringa oleifera, Gossypium herbaceum, Malaria, Plasmodium berghei.

Dominic A. Offiong¹, Antor O. Ndep³, Glory M. Nja², Aniekanabasi J. Okon², Margaret I. Akpan², Joseph A. Efut², Joseph A. Omang³, Monica A. Abua³

¹Department of Science Laboratory Technology, Federal Polytechnic Ugep, ²Department of Public Health, University of Calabar, ³Cross River State College of Nursing Sciences, Calabar, Cross River State, Nigeria.

E-mail: asuquooffiong@yahoo.com

Introduction: The International Labor Organization estimates that about

2.3 million people around the world succumb to occupational accidents or diseases every year. This study aimed to determine the effect of health education on knowledge of occupational health hazards among auto-technicians in Cross River State, Nigeria.

Method: Guided by two research questions and one hypothesis, the study employed a quasi-experimental design consisting of three phases: pre-intervention survey, health education intervention, and post-intervention survey. A sample size of 222 auto-technicians (111 for control and intervention groups, respectively) was selected using a multi-stage sampling technique. The data collection instruments included a semi-structured questionnaire. Data were analyzed using Chi-square statistics and paired sample t-tests, with a significance level set at <0.05.

Result: Majority of the auto-technicians were male, 108 (97.3%), and with an age bracket of 21–30 years 104 (93.6%). Baseline findings revealed a low knowledge level of occupational health hazards between the control 27 (11%) and intervention group 30 (12.2%), which were not statistically significant (P = 4.356; χ² = 0.113). The end-line finding showed a high knowledge level of occupational health hazards between the control 28 (11.4%) and intervention group 108 (43.9%), which were statistically significant (P = 0.001; χ² = 121.0).

Conclusion: The targeted health education intervention significantly improved auto-technicians’ knowledge of occupational health hazards. The translation of improved knowledge into preventive practices may require further study. A holistic occupational health and safety education during the monthly meeting of the auto-technicians’ association is recommended.

Keywords: Auto-technicians, Health education intervention, Knowledge, Occupational health

E. Ekpe Moses¹, O. Ndep Antor¹, Ayodeji Owolabi¹, Nuria Nwachukwu¹, Owai Onun¹

¹Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: ekpemoses1@gmail.com

Introduction: Malaria remains a critical Public Health issue in Nigeria. The Nigeria Malaria Information Survey, 2021 report shows that the prevalence of malaria in the Cross River State was 24%, out of which 40.7% of pregnant women were found to be Malaria positive. The main objective of this study is to assess the management practices (diagnosis, treatment, and prevention) of malaria in pregnancy (MiP) among primary healthcare workers (PHCWs) in hard-to-reach (HTR) facilities of Cross River State and factors (human resources, Tools, commodities, etc.) influencing adherence to national guidelines in MiP management.

Method: Mixed-method study design is employed in this study. A cross-sectional descriptive study design is used to obtain data for quantitative research. Furthermore, a case study design will be used to obtain information for the qualitative aspect. Eighty (80) interviewer-administered questionnaires will be administered to PHCWs in HTR facilities. Interviews will be conducted with eight relevant stakeholders at Local Government Area (LGA) level. Health Records and District Health Information System 2 (DHIS2) data review on MiP records will be conducted to obtain information. Data analysis will be conducted employing the Statistical Package for the Social Sciences version 25.0. Chi-square test of the hypothesis and regression will be conducted.

Result: Factors such as poor management practices, inadequate training/ mentoring, resource constraints/limitations, and poor data management will significantly impact adherence to relevant MiP protocols/guidelines.

Conclusion: The findings of this research are expected to inform targeted interventions/programs that enhance adherence to protocols/guidelines, ultimately improving health outcomes for pregnant women in underserved areas in Cross River State.

Keywords: Facilities, Factors, Hard-to-reach, Healthcare worker, Malaria, Management, Practices, Pregnancy

Monica Agianipe Elaunire¹, Antor Odu Ndep¹, Margaret Inemesit Akpan¹, Aniekan-abasi Okon¹, Joseph Efut Ajah¹, Dominic Asuquo Offiong¹

¹Department of Public Health, University of Calabar, Calabar, Cross River State, Nigeria. E-mail: abuamonique@gmail.com

Background: Socio-cultural norms significantly influence health behaviors, including umbilical cord care. This study explores the socio-cultural factors affecting umbilical cord care practices among caregivers of neonates in Cross River State.

Methods: A qualitative approach was utilized, involving 11 focus group discussions with 9–11 participants each. Thematic analysis was performed to identify recurring themes and subthemes related to socio-cultural beliefs and practices.

Results: The analysis revealed themes including traditional beliefs about cord burial and the roles of family members in cord care. A significant majority (77.5%) believed that mothers-in-law should handle cord care, reflecting deep-rooted cultural norms. Furthermore, socio-cultural beliefs had a significant influence on umbilical cord care practices among the respondents. While some cultural practices align with medical recommendations, such as the frequency of cleaning, other harmful practices, such as using non-medical substances for cleaning, were prevalent potentially posing risks to newborn health.

Conclusion: Socio-cultural factors heavily influence umbilical cord care practices among caregivers in Cross River State. Interventions must consider these cultural contexts to promote safe and effective care practices.

Keywords: Socio-cultural influences on umbilical cord care practices among caregivers of neonates

Ofem Athanasius Christopher¹, Ihesiulo Alozie Chinwendu¹, Udie John Agiabe¹, Isika Anastasia Ikilishi Isika¹

¹Department of Public Health and Community Medicine, Faculty of Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: anastasiaisika@yahoo.com

Background: Cervical cancer is the second most frequent cause of cancer deaths among women of reproductive age. Even though it is a preventable disease with the possibility of complete curative treatment if detected early, the burden, morbidity, and mortality remain high in low- and middle-income countries like Nigeria. This study investigates the knowledge, attitude, and practice of cervical cancer screening among market women in Calabar.

Method: A cross-sectional study was conducted among 213 women in two markets in Calabar from Watt and Marian between April and July 2024. The sample size was determined using Cochran formula. Respondents were recruited using multistage technique. Data were collected using a pre-tested interviewer-administered questionnaire and analyzed using IBM Statistical Package for the Social Sciences version 21.

Results: The mean age of the respondents was 35.55 (±10.93) years. About 49.3% of the respondents had poor knowledge of cervical cancer screening, and 61% did not know about screening procedures. The majority (82.2%) had a positive attitude toward cervical cancer screening but over 84.5 had poor practice/uptake of cervical cancer screening. Reasons for not screening were lack of information, indecision, cost, perception of good health, and pain associated with the screening procedure. On bivariate analysis, the age, level of education, and income were factors associated with uptake of cervical cancer screening.

Conclusion: There was poor knowledge of cervical cancer screening among women in both markets, which translated into poor uptake. Therefore, there is a need for targeted intervention in both markets to improve the knowledge and uptake of cervical cancer screening.

Keywords: Calabar, Cervical cancer, Market women

Ojeamiren Maria Tosan¹, Igiri Bassey Hilary¹, Anyia Esteemvera Aluo¹, Ntaji Winifred Awa¹, Isika Anastasia Ikilishi Isika¹

¹Department of Public Health and Community Medicine, Faculty of Clinical Sciences, University of Calabar, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.

E-mail: anastasiaisika@yahoo.com

Background: Improved access to antiretroviral therapy (ART) has significantly increased the survival and quality of life of HIV-infected people. Strict adherence to ART is crucial if viral suppression must remain optimal. Studies have shown that adherence to therapy could be affected by the level of satisfaction. We assessed predictors of satisfaction with ART among adult attendees in the University of Calabar Teaching Hospital (UCTH), Calabar.

Method: A cross-sectional survey was conducted among 264 adult patients on ART accessing care at the UCTH, Calabar, from April to July 2024. Respondents were recruited using systematic random sampling techniques. Data were collected using a pre-tested interviewer-administered questionnaire and analyzed using the Statistical Package for the Social Sciences version 25. Multivariate analysis was performed to determine predictors of satisfaction at 5% level of significance.

Result: Majority 139 (52.7%) of the respondents were female, with a mean age 42.32 ± 15.087 years. The overall level of satisfaction is 43.6%. Highest reason for dissatisfaction reported in waiting time and the lowest reported in content of the health talk and the doctors assigned. On bivariate analysis, sex, marital status, and level of education were seen to be factors associated with satisfaction. On binary logistic regression, age (Odds ratio 0.383, 95% confidence interval [CI] = 0.199–0.736, P = 0.004) and marital status (Odds ratio 2.110, 95% CI = 1.073–4.153, P = 0.031) were found as predictors of satisfaction

Conclusion: Satisfaction among patients in this study was poor. The predictors of satisfaction were age and marital status; the majority of the reasons for non-satisfaction were patient-related. There is a need for targeted intervention to improve satisfaction.

Keywords: Antiretroviral therapy, Calabar, Satisfaction, University of Calabar Teaching Hospital

Ahaotu Chidalu Ezinwanne¹, O. Eyo Aniekan-Augusta¹, E. Asuquo Anne

¹Medical Microbiology and Parasitology Unit, Department of Laboratory, Federal Neuropsychiatric Hospital Calabar, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: daluahaotu@gmail.com

Background: Fluoroquinolones, although no longer recommended as first-line treatment options for urogenital infections due to resistance, are still commonly used in Calabar and its environs. This study investigated the efficacy of fluoroquinolones against urogenital bacterial isolates obtained from women in health facilities in Calabar.

Method: Using the Kirby-Bauer disk diffusion and broth microdilution methods, the zones of inhibition of the antibiotics and minimum inhibitory concentrations (MICs) were, respectively, determined. The minimum bactericidal concentrations (MBCs) were determined by subculturing the content of the tubes without visible growth onto Mueller–Hinton agar and observing for bacterial growth. A total of 56 bacterial species were harvested including Escherichia coli (48.2%), Klebsiella pneumoniae (19.6%), Enterobacter cloacae (3.6%), Sphingomonas paucimobilis (3.6%), Acinetobacter baumannii (3.6%), Burkholderia cepacia (3.6%), Staphylococcus hemolyticus (3.6%), Pseudomonas aeruginosa (3.6%), Staphylococcus saprophyticus (1.8%), Enterococcus faecium (3.5%), Aerococcus viridans (3.5%), and Enterococcus faecalis (1.8%).

Result: The analysis of resistance profiles of the isolates showed that the least effective fluoroquinolone against K. pneumoniae was Ciprofloxacin (91%) and Pefloxacin (91%), while the most effective were Levofloxacin (55%) and Ofloxacin (55%). MIC values obtained for all the isolates were higher than the recommended breakpoint values. Their MBC values were up to 1,000-fold higher than the clinical MIC breakpoints.

Conclusion: The data obtained showed that the quinolone antibiotics performed poorly on urogenital isolates in the area and calls for adherence to current guidelines limiting their use in urogenital infections, including urinary tract infections.

Keywords: Urogenital infections, Fluoroquinolones, Antibiotics Urogenital infections, Fluoroquinolones, Antibiotics

Ogechi Efa Iwara¹, Glory Mbe Nja¹, Joseph Efut¹

¹Department of Public Health, University of Calabar, Calabar, Cross River State, Nigeria. E-mail: ogejayiwara@gmail.com

Background: The novel coronavirus disease (COVID-19) pandemic has been adjudged the most challenging global health calamity of the century, with more than 230 million cases and over 4 million deaths recorded globally; however, the advent of COVID-19 vaccination to combat the pandemic provided a ray of hope globally. This study therefore aimed to determine the knowledge level, perceptions, and acceptability of COVID-19 vaccination among health profession students in Calabar Metropolis, Nigeria.

Method: A descriptive cross-sectional design was adopted to randomly select 410 health profession students within Calabar Metropolis. Quantitative data were generated using semi-structured questionnaire and analyzed using SPSS version 20.0. The associations between knowledge, perceptions, and acceptability of COVID-19 vaccination were tested.

Results: Most of the respondents, 51.9% were female; most 42.1% were within the age bracket 20–24 years; all the respondents 100% have heard about COVID-19 vaccination, acceptability of COVID-19 vaccination was low, as the greater proportion 92.2% had not been vaccinated, with only 7.8% vaccinated. Only a third of the respondents 33.2% had good knowledge of COVID-19 vaccination, representing knowledge level of 84.3%. Knowledge and acceptability of COVID-19 vaccination were statistically significant. The majority 55.1% had good perceptions on COVID-19 vaccination; thus, associations between perceptions on COVID-19 vaccination and acceptability were statistically significant.

Conclusion: COVID-19 vaccination hesitancy is still significantly high among health profession students in Calabar, Nigeria. Hence, rigorous public health education intervention and awareness creation among health profession students are strongly advocated.

Keywords: Acceptability, Calabar metropolis, Coronavirus disease-19 vaccination, Health profession students, Knowledge, Nigeria, Perceptions

Omang Joseph Abang¹, Akpabio Idongesit Ibanga¹, Ndep Antor Odu¹, Esu Ekpereonne¹, Offiong Dominic Asuquo¹

¹Department of Nursing Sciences, University of Calabar, Calabar, Cross River State, Nigeria. E-mail: jomang2020@yahoo.com

Background: Globally, 50% of all Human Immunodeficiency Virus infections and Acquired Immune Deficiency Syndrome-related diseases occurred in people aged 15–25 and their prevalence among youth was 18.3%. The study determined knowledge, attitude, acceptance, and utilization of HIV and acquired immunodeficiency syndrome (AIDS) screening services among undergraduate students in Cross River State.

Methodology: A concurrent-parallel mixed methods multistage quasi-experimental, pre-and post-intervention, and qualitative study design was used. A sample of 405 comprising 397 for quantitative study and eight for qualitative study was selected using purposive and snowball sampling techniques. Semi-structured questionnaire and structured key informant interview guide were tools for data collection. Quantitative data analysis used frequencies, percentage, Chi-square, and one-way analysis of variance, powered by Statistical Package for the Social Sciences statistical software version 27 and results were presented in tables. Qualitative data analysis used thematic coding and illustrative quotes.

Results: Knowledge about HIV and AIDS was good (63.3%, effect size = 0.851), knowledge about HIV and AIDS preventive measures was good (75.4%, effect size = 0.848), knowledge about HIV screening services was very good (80.4%, effect size = 0.850), attitude toward acceptance of HIV screening was very positive (85.4%, effect size = 0.849), attitude toward utilization of HIV screening services was positive (55.6%, effect size = 0.849), acceptance of HIV screening was good (75.4%, effect size = 0.850), and utilization of HIV screening services was good (62.8%, effect size = 0.849).

Conclusion: Continuous HIV and AIDS interventions are essential at all levels of education in Nigeria.

Keywords: Acceptance, Acquired immunodeficiency syndrome, Attitude, HIV, Knowledge, Screening services, Utilization, Youth

A. J. Atangwho¹, U. E. Asibong¹, O. D. Oshiame¹, I. J. Atangwho¹, N. E. Udonwa¹

¹Department of Family Medicine, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.

E-mail: janietie@gmail.com

Background: Diabesity, a syndrome characterized by the co-occurrence of diabetes and obesity in a single patient, has emerged as a significant challenge in the medical field, reaching epidemic proportions in certain regions.

Aim/Objectives: This study aims to ascertain diabesity prevalence and influencing factors among adult patients visiting the General Outpatient Clinics of three government healthcare facilities in Calabar, Nigeria. The objective is to enhance healthcare delivery to at-risk patients.

Methods: A cross-sectional descriptive study design incorporating a mixed-methods approach, including quantitative and qualitative components such as focused group discussions (FGD) and key informant interviews (KII), was employed. The study population consisted of 190 participants aged 18–72 years with a body mass index (BMI) of ≥30 kg/m², selected using a systematic random sampling technique and analyzed using the Statistical Package for the Social Sciences and Atlas. ti.

Results: Sociodemographic variables indicated that the highest number of respondents fell within the 35–44 years (37.3%), with 83.7% being female and 76.8% married. Furthermore, 65.8% were classified as having class 1 obesity, while only 38% self-identified as obese. The occurrence of diabesity was found to be 12.6% (i.e., BMI ≥30 vs. FBS ≥7.0), with 38% of cases being previously undiagnosed. Qualitative assessment through KIIs and FGDs revealed that unhealthy diets, lack of exercise, and culture were major contributory factors to diabesity.

Conclusion: This study has disclosed a 12.6% occurrence of diabesity within the study population, with 38% of cases being previously undiagnosed. Unhealthy diets, snacking, and lack of exercise were identified as significant indicators of diabesity.

Keywords: Diabesity, Diabetes, Obesity, Prevalence, and Calabar

Idongesit KokoAbasi Isong¹, Uwem Okon Akpan¹, Victoria Effiong Bassey¹

¹Department of Clinical Chemistry and Immunology, Faculty of Medical Laboratory Science, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: akpauwem11@gmail.com

Background: Insulin autoantibodies have been linked to type 1 diabetes. This study assessed insulin autoantibody and fasting plasma glucose levels in 75 female subjects aged between 22 and 35, comprising 25 non-pregnant women as controls and 50 pregnant women (25 in both the first and second trimester).

Method: The insulin autoantibody levels were determined using the enzyme-linked immunosorbent assay method. Anthropometric data and blood pressure were determined using standard methods. Data were analyzed using Student’s t-test, analysis of variance, and Pearson’s correlation at P < 0.05.

Result: The fasting plasma glucose (FPG) was significantly higher (P = 0.036) in the pregnant women compared to the non-pregnant women. Other parameters were not significantly different between the pregnant and non-pregnant women. The pregnant women in their first trimester had significantly higher FPG levels (P = 0.020) and lower body mass index (BMI) (P = 0.039) compared to those in their second trimester. A significant positive correlation (P = 0.007, r = 0.378) between BMI and FPG in pregnant women was observed.

Conclusion: The findings of this study suggest that increased glucose levels may not be associated with insulin automatic body and pregnancy but may be associated with increased weight.

Keywords: Insulin autoantibody, Fasting plasma glucose, Type 1 diabetes

G. I. Ogban¹, U. E. Emanghe¹, A. A. Iwuafor¹, C. U. Idemo Udoh¹, U. E. Emanghe¹, S. N. Ushie¹

¹Department of Medical Microbiology and Parasitology, University of Calabar, Calabar, Cross River State, Nigeria.

E-mail: eviogban@yahoo.com

Introduction: Uropathogens produce antibiotic-inactivating enzymes as part of their virulence. Carbapenemases inactivate carbapenems, penicillins, cephalosporins, and monobactams, whereas extended-spectrum β-lactamases (ESBLs) inactivate third-generation cephalosporins and aztreonams but are inhibited by β-lactamases inhibitor antibiotics. Both are also associated with resistance to other classes of antibiotics. This study sought to determine the percentage of co-production of these enzymes and risk factors for acquisition among participants.

Method: This was a cross-sectional prospective study on ANC mothers in the University of Calabar Teaching Hospital, Calabar, Nigeria. Questionnaires were used to collect socio-demographic data. Samples were inoculated on s CLED agar and incubated for ≥16 h at 37°C in ambient air. Growths that conformed to significant bacteriuria were further processed to species levels using standard biochemical tests. Antibiotic sensitivity testing was done using Kirby-Bauer disk diffusion technique on the following Oxoid antibiotics: Ceftriaxone, piperacillin/tazobactam, ciprofloxacin, imipenem and meropenem, and amoxicillin/clavulanate, according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Isolates suspected to be ESBL- or carbapenemase-producing based on CLSI breakpoints were screened and confirmed as such using the combined disk diffusion method or the Modified Hodge Test, respectively.

Results: There were 21 (6.0%) cases of antibiotic abuse among the participants. Four isolates (1.1%) were quadriple multidrug resistant (4-MRGN). ESBL prevalence was 11 (3.2%), whereas the prevalence of carbapenemases was 18 (5.2%). No significant risk factor was established for the acquisition of quadruple multidrug resistance. This study revealed 10.0% UTI prevalence, like findings from some studies and at variance with others. Physiological changes and instrumentation during pregnancy are major factors predisposing to UTI in pregnancy. Quadruple multidrug resistance (4-MRGN) prevalence of 4 (1.1%) was recorded, depicting co-production of ESBLs and carbapenemases, with associated resistance to quinolones. This development, if unchecked, has the potential for a major therapeutic crisis.

Conclusion: Stringent IPC practices, involving isolation of indexed patients and laboratory-based antibiotic prescription practice potential mended.

Keywords: Carbapenemases, Control, Detection, Infection, Pregnancy, β-lactamases

Dearsly Emmanuel Markus¹, Eze Kingsley Chijioke¹, Chukwu Constance Adaeze¹, Ofem Lilian William¹

¹Department of Biochemistry, Salem University Lokoja, Kogi State, Adiabo, Nigeria.

E-mail: Kingseze192@gmail.com

Artificial intelligence (AI), poised to revolutionize drug discovery, offers solutions by addressing inherent inefficiencies, high costs, and extended timelines characteristic of traditional methods. This review explores the integration of AI technologies such as machine learning, deep learning, and natural language processing into the drug discovery process. AI-driven models enhance target identification, compound design, and optimization while predicting absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties ADMET which improve drug development speed, reduce costs, and increase success rates. Key applications of these innovations include drug repurposing, optimizing clinical trials, and personalized medicine as entailed in case studies of AI-driven success stories, such as in silico Medicine’s novel fibrosis drug and Benevolent AI’s repurposing of baricitinib for COVID-19, which highlights its potential in accelerating pharmaceutical advancements. Although challenges, including data quality, regulatory hurdles, and the interpretability of AI models, remain, collaborative efforts and advancements in AI, combined with emerging technologies like quantum computing, promise to shape the future of drug discovery, making it more efficient and effective.

Keywords: Artificial intelligence, Deep learning, Drug discovery, Machine learning, Natural language processing, Personalized medicine, Pharmaceutical innovation, Quantum computing

Emmanuel C. Ezugwu¹, Richmond E. Edugbo¹

¹Department of Applied Biology, School of Science, Communication and Information Technology, Federal University of Technology, Babura, Jigawa State, Nigeria.

E-mail: ecezugwu.btc@futb.edu.ng

Autoimmune connective tissue disorders (CTDs), including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and systemic sclerosis (SSc), are increasingly recognized in Sub-Saharan Africa, challenging previous assumptions of their rarity. Studies from the United States suggest higher prevalence rates of RA among individuals of African descent. In Nigeria, the research conducted in Port Harcourt identified SLE as the most prevalent CTD, constituting approximately 91% of cases, followed by RA at 6% and SSc at 3%, while a significant predominance of SLE was also reported at the Lagos University Teaching Hospital with a striking female-to-male ratio of 14.7:1. However, research in Western Cape, South Africa, highlighted a higher prevalence of RA (29%) among CTDs. The rising prevalence of CTDs in Sub-Saharan Africa may be attributed to improved diagnostic capabilities, enhanced specialization in rheumatology, and evolving environmental exposures. Interestingly, advancements in diagnostic protocols and the introduction of disease-modifying anti-rheumatic drugs, including biologics and targeted synthetic drugs, have demonstrated efficacy in managing conditions such as RA. However, some challenges persist, including delayed presentation due to the disease’s complex nature, multi-organ involvement, and limited access to biologics. Misdiagnosis remains prevalent, exacerbated by clinical overlaps with other diseases and cultural beliefs that delay medical intervention. Educating healthcare providers and the public on the diverse clinical manifestations of CTDs is crucial for early recognition and improved patient outcomes.

Keywords: Biologics, Misdiagnosis, Rheumatoid arthritis, Sub-Saharan Africa, Systemic lupus erythematosus, Systemic sclerosis