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Background Infants born to diabetic women have certain distinctive characteristics, including large size and high morbidity risks. The neonatal mortality rate is over five times that of infants of non diabetic mothers and is higher at all gestational ages and birth weight for gestational age (GA) categories. The study aimed to determine morbidity and mortality pattern amongst infants of diabetic mothers (IDMS) admitted into the Special Care Baby Unit of University of Port Harcourt Teaching Hospital. Methods This was a study of prevalence of morbidity and mortality among IDMs carried out prospectively over a two year period. All IDMs (pregestational and gestational) admitted into the Unit within the period were recruited into the study. Data on delivery mode, GA, birth weight, other associated morbidities, investigation results, treatment, duration of hospital stay and outcome were collated and compared with those of infants of non diabetic mothers matched for GA and birth weight admitted within the same period. Maternal data were reviewed retrospectively. Data were analyzed using SPSS 16.0. Results Sixty percent of the IDMs were born to mothers with gestational diabetes, while 40% were born to mothers with pregestational DM. 38 (74.3%) were born by Caesarian section (CS), of which 20 (52.6%) were by emergency CS. There was no significant difference in emergency CS rates, when compared with controls, but non-IDMs were more likely to be delivered vaginally. The mean GA of IDMs was 37.84 weeks ± 1.88. 29 (61.7%) of them were macrosomic. The commonest morbidities were Hypoglycemia (significantly higher in IDMs than non-IDMs) and hyperbilirubinaemia in 30 (63.8%) and 26 (57.4%) respectively. There was no difference in morbidity pattern between infants of pre- gestational and gestational diabetic mothers. Mortality rate was not significantly higher in IDMs Conclusions The incidence of macrosomia in IDMs was high but high rates of emergency CS was not peculiar to them. Hypoglycaemia and hyperbilirubinaemia were the commonest morbidities in IDMs. Referring women with unstable metabolic control to specialized centers improves pre- and post- natal outcomes. Maternal-Infant centers for management of diabetes in pregnancy are advocated on a national scale to reduce associated morbidity and mortality

To ascertain the prevalence and pattern of congenital abnormalities that are peculiar to the Niger Delta area of Nigeria. This is a descriptive retrospective cross-sectional study. It involved data from the labor ward and neonatal birth registers of the University of Port Harcourt Teaching Hospital on the total number of births and the babies that were delivered with major birth defects between August 2011 and December 2014. We also conducted a statistical comparison of the prevalence of congenital abnormalities in the Niger Delta with that in other regions of Nigeria and the developed world of Europe. Out of the 7,670 deliveries that occurred, 159 maternities had babies with major birth defects giving a prevalence of 20.73 cases per 1,000 live births. This figure is far more than that which was obtained in other regions of Nigeria -4.15:cases per 1,000 live births in the South East ( <0.001), 15.84:1,000 in the South West ( <0.01), and 5.51:1,000 in the North East ( <0.001). Eighty-five (53.46%) of the defects occurred in 1,681 unbooked patients, while 74 (46.54%) happened in 5,989 booked maternities ( <0.001). The predominant abnormalities were those of the central nervous system at 27.0%, gastrointestinal system 11.95%, cardiovascular system 10.69%, anterior abdominal wall 8.18%, skeleton 6.29%, and chromosomal abnormalities at 5.66%. The prevalence of major birth defects at the University of Port Harcourt Teaching Hospital was 20.73 cases per 1,000 live births and it was more in the unbooked than the booked maternities. All body systems were affected with those of the central nervous system predominating at 27.0% of the total diagnosed defects.

ObjectivesRetinopathy of prematurity (ROP) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for ROP between 2017 and 2020 as well as the outcome of these activities in Nigeria.DesignDescriptive case study.SettingNeonatal intensive care units in Nigeria.ParticipantsStaff providing services for ROP, and 723 preterm infants screened for ROP who fulfilled screening criteria (gestational age <34 weeks or birth weight ≤2000 g, or sickness criteria).Methods and analysisA WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity-building, national and international collaborative activities between 2017 and 2018. A national protocol for ROP was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017–2018 and to assess challenges in service provision.ResultsIn 2017 only six of the 84 public neonatal units in Nigeria provided ROP services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any ROP; and 29 (22.8%) developed type 1 ROP. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challenges included lack of equipment to regulate oxygen and to document and treat ROP, and lack of data systems.ConclusionROP screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and ROP treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.

Background Explicit and implicit cultural patterns are critical cultural norms, beliefs, and practices that determine women’s health-seeking behaviour. These cultural patterns could limit women’s use of maternal health services, resulting in maternal health complications. The study aims to provide an in-depth understanding of explicit and implicit cultural patterns, their meanings and how they influence women’s use of maternal health services among Igala women in Nigeria. Methods Roper and Shapira’s (2000) focused ethnography was employed with 43 women aged 18–43 years recruited using the purposive and snowballing technique. The study was conducted with 21 women for one-on-one interviews and two focus group discussions with six women in the rural area and seven women in the urban area. In addition, participant observation of nine women from the third trimester to birth was conducted, yielding 189 h of observation in two primary healthcare facilities in rural and urban areas. Data analysis was conducted using Roper and Shapira’s (2000) method. Result Three themes were generated using the PEN3 cultural model: perceptions, enabler, and nurturers. Subthemes generated under the theme of perception were, Belief in witchcraft, Pregnancy announces itself, I cannot tell people I am in labour, and Unspoken acquiescence to the culture. Under the theme of nurturer, Home birth was found to limit access to maternal health services. The theme of enabler yielded subthemes such as You are not woman enough; I want my placenta and Rising matriarchs. Conclusion Implicit and explicit cultural patterns significantly influence women’s use of maternal health services. Given the complexity of culture and its influence on women’s use of maternal health services, multifaceted strategies tailored to the cultural needs of communities are needed to enhance the realization of Sustainable Development Goal #3:1 in Nigeria.

Background Cultural and religious structures encompass a set pattern of values, beliefs, systems and practices that define a community's behaviour and identity. These structures influence women's health-seeking behaviour and access to maternal health services, predisposing women to preventable maternal health complications. However, most maternal health policies have focused on biomedical strategies, with limited attention to women’s cultural challenges around childbirth. The overall aim of this paper is to provide a thick description and understanding of cultural and religious structures in Nigeria, their meaning and how they influence women’s use of maternal health services. Methods Roper and Shapira’s (2000) focused ethnography comprising 189 h of observation of nine women from the third trimester to deliveries. Using purposive and snowballing techniques, 21 in-depth interviews and two focus group discussions comprising 13 women, were conducted in two Nigerian primary healthcare facilities in rural and urban area of Kogi State. Data was analyzed using the steps described by Roper and Shapira. Results Using the PEN-3 cultural model, nine themes were generated. Positive factor, such as the language of communication, existential factor, such as religion, and negative factors, such as the use of prayer houses and lack of women’s autonomy, were either positive or negative enablers influencing women’s use of maternal health services. Additionally, women's perceptions, such as their dependency on God and reliance on cultural norms were significant factors that influence the use of maternal health services. We also found that the use of herbal medicine was a negative enabler of women’s access to facility care. At the same time, family support was also a positive and a negative nurturer that could influence how women use facility care. Finally, factors such as religion, Ibegwu, and male child syndrome were negative nurturers influencing women’s contraceptive use. Conclusion Cultural and religious structures are significant factors that could promote or limit women’s use of maternal health services. Further studies are needed to understand culturally focused approaches to enhance women’s use of maternal health services in Nigeria.

Background Facilitating factors are potential factors that encourage the uptake of maternal health services, while limiting factors are those potential factors that limit women’s access to maternal health services. Though cultural norms or values are significant factors that influence health-seeking behaviour, there is a limited exploration of the facilitating and limiting factors of these cultural norms and values on the use of maternal health services in primary health care facilities. Aim To understand the facilitating and limiting factors of cultural values and norms that influence the use of maternal health services in primary healthcare facilities. Methods The study was conducted in two primary healthcare facilities (rural and urban) using a focused ethnographic methodology described by Roper and Shapira. The study comprised 189 hours of observation of nine women from the third trimester to deliveries. Using purposive and snowballing techniques, data was collected through 21 in-depth interviews, two focus group discussions comprising 13 women, and field notes. All data was analyzed using the steps described by Roper and Shapira (Ethnography in nursing research, 2000). Results Using the enabler and nurturer constructs of the relationships and the expectations domain of the PEN-3 cultural model, four themes were generated: 1, The attitude of healthcare workers and 2, Factors within primary healthcare facilities, which revealed both facilitating and limiting factors. The remaining themes, 3, The High cost of services, and 4, Contextual issues within communities revealed factors that limit access to facility care. Conclusion Several facilitating and limiting factors of cultural norms and values significantly influence women’s health-seeking behaviours and use of primary health facilities. Further studies are needed on approaches to harness these factors in providing holistic care tailored to communities' cultural needs. Additionally, reinvigoration and strengthening of primary health facilities in Nigeria is critical to promoting comprehensive care that could reduce maternal mortality and enhance maternal health outcomes.

Background Little information exists in the literature regarding the burden and impact of mpox infection in the newborn population since the detection of the first case of human mpox over five decades ago. Case presentation We report a case of laboratory-confirmed mpox in a full-term male neonate with HIV-exposure who presented with a febrile vesiculo-pustular rash syndrome and a centrifugal pattern of distribution (marked on the scalp, face, neck and limbs and sparse on the thorax and abdomen) on day 16 of life at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. He had his first skin eruption on the fourth day of life. There was a history of similar lesions in both parents, who are living with human immunodeficiency virus. Vesicular fluid polymerase chain reaction testing confirmed the presence of monkeypox virus (MPXV) DNA and was negative for varicella-zoster virus. Despite the diagnosis of mpox in the early neonatal period with the high likelihood of a transplacental route of transmission, the possibility of a postnatal transmission could not be entirely ruled out. He was optimized on supportive care including nutrition, skin care, fluid management, blood transfusion, and the use of targeted antibiotics. While on admission, he developed bacterial skin co-infection with methicillin-resistant Staphylococcus aureus, prolonged illness, and eventually recovered following a delayed time to resolution of skin lesion of 48 days. Conclusions Neonatal mpox infection is rare and could lead to prolonged morbidity and mortality. Clinicians should always maintain a high index of suspicion and consider mpox in the differential diagnosis of a neonatal vesiculo-pustular rash, particularly if there is a history of similar rash in the family, as early disease recognition and early treatment are associated with improved outcomes. Further studies are needed to better understand the transmission routes of MPXV in newborns.

Onchocerciasis is a parasitic disease transmitted by black flies. Human onchocerciasis is a public health and socioeconomic problem in Nigeria. Its prevalence and morbidity have reduced over the years because of control efforts especially, Mass Drug Administration with ivermectin. The current goal is to eliminate the disease transmission by 2030. Understanding the changes in transmission patterns in Cross River State is critical to elimination of onchocerciasis in Nigeria. This study was designed to determine the transmission dynamics of onchocerciasis in Cross River State after over two decades of mass ivermectin distribution in endemic communities. Agbokim, Aningeje, Ekong Anaku and Orimekpang are four endemic communities from three Local Government Areas of the State selected for this study. Transmission indices such as infectivity rates, biting rates and transmission potentials, parity rates and diurnal biting activities were determined. A total of 15,520 adult female flies were caught on human baits, Agbokim (2831), Aningeje (6209), Ekong Anaku (4364) and Orimekpang (2116). A total of 9488 and 5695 flies were collected during the rainy and dry seasons respectively in the four communities studied. The differences in relative abundance among the communities were statistically significant ( P  < 0.001). Monthly and seasonal fly numbers varied significantly ( P  < 0.008). There were differences in diurnal biting activities of flies in this study at different hours of the day and different months. The peak monthly biting rates were 5993 (Agbokim, October), 13,134 (Aningeje, October), 8680 (Ekong Anaku, October) and 6120 (Orimekpang, September) bites/person/month while the lowest monthly biting rates were 400 (Agbokim, November), 2862 (Aningeje, August), 1405 (Ekong Anaku, January) and 0.0 (Orimekpang, November and December) bites/person/month. Differences in biting rates among the study communities were significant ( P  < 0.001). The peak monthly transmission potential in Aningeje was 160 infective bites/person/month in the month of February while the lowest (except for months with no transmission) was 42 infective bites/person/month in the month of April. All other study sites had no ongoing transmission in this study. Transmission studies showed that there is progress toward transmission interruption especially in 3 out of the four studied areas. Molecular O-150 poolscreen studies is required to confirm the true transmission situation in the areas.

This paper examined the online social networking tools used as techniques for effective marketing of services in selected academic libraries in Imo State. The study was guided by three research questions and objectives. A survey research design was adopted for the study. The population of the study was fifty nine (59); comprising Heads of departments/units and librarians working in the libraries studied. The population also served as the sample due to its manageable nature, hence the adoption of census enumeration technique. The data obtained were analyzed using descriptive statistics involving mean scores. The findings revealed that: the mostly used social networking tools to market library products and services in the academic libraries studied are Facebook, WhatsApp, and Twitter; that some of the benefits of social networking tools in academic libraries are: promotion of library resources; knowledge creation and sharing among libraries/librarians; helping to publicize special events and programmes of the library; enhancing research and scholarly publications among librarians and others; and that the academic libraries are being affected by a lot of challenges in their quest to use social networking tools to market their products and services to the public which include, inadequate funding, lack of qualified ICT librarians, network problems, erratic power supply, among others. It was therefore recommended that academic libraries should endeavour to embrace other forms of social networking tools in addition to Facebook, WhatsApp, and Twitter to market their products and services to users and install solar energy in order to tackle the issue of erratic power supply.

School bullying is a global problem involving a high proportion of students worldwide. However, its prevalence and types in secondary schools in Port Harcourt is not yet known. This study aimed to determine the prevalence and types of bullying in secondary schools in Port Harcourt. A total of 1160 students from six secondary schools in Port Harcourt comprised the sample. This was a cross-sectional school-based study conducted in Port Harcourt in March 2014. Two mixed schools, two all-boys schools, and two all-girls schools were selected using purposive sampling technique. Stratified random sampling technique, by class strata (senior secondary 1, 2 and 3) was used to select 1160 students from the six schools. A 22-item self-administered questionnaire adapted from a previous study was modified and used in this study. The questions covered the prevalence, type of bullying, and socio-demographic data. Data were analyzed using SPSS version 20 (IBM SPSS Incorporated, Chicago, IL, USA). About 82.2% reported being victims of bullying, whereas 64.9% reported being bullies. About 9.7% and 11.8% were neither bullies nor bullied, respectively. Bullying was significantly higher in the all-boys (90.8%) and all-girls (82.9%) schools than in the mixed schools (73.5%), p=0.000. More males were victims (53.4%) and bullies (53.3%) but more females (55.4%) were bully-victims. The most common (57.5%) type of bullying was physical bullying. The rate of bullying was found to be very high in secondary schools in Port Harcourt.