A Multicentre Study of Awareness and Practice of Vaccination Against Infectious Diseases Among Haemo-Dialysis Subjects in Nigeria

BACKGROUND

Numerous studies indicate that immunization against vaccine-preventable infectious diseases lowers mortality among Chronic Kidney Disease/dialysis patients and improve their quality of life. However, their knowledge and practice of this appears to be poor in Nigeria and parts of Africa.

OBJECTIVES

We set out to determine subjects' awareness of vaccination against preventable infectious diseases and its impact on their participation in vaccination programs.

METHODS

A prospective, cross-sectional study. Data was collated using questionnaires, laboratory results and dialysis entries and analyzed using IBM SPSS Statistics19.

RESULTS

One hundred and twenty-four participants (mean age, 48.26±14.45 years) undergoing maintenance haemodialysis were studied. Sixty-two subjects (50.4%), 15.3% and 16.9% had heard of Hepatitis B Virus, S. pneumoniae and H. influenza virus respectively. Thirty-four (54.6%) of the participants first heard of these infections from sources other than healthcare personnel. Of the three common infections, study participants only received formal counselling on Hepatitis B Virus (HBV) infection. Majority had never heard of S. pneumoniae or H. influenzae. Seven (5.7%) had completed their HBV immunisation schedule only. Better educated participants were more aware of necessary vaccination against Hepatitis B Virus (p=0.000) S. pneumoniae (p=0.005) and H. influenza virus (p = 0.003). A significantly higher proportion of participants who received health-personnel driven formal education commenced vaccination against Hepatitis B virus (p=0.000).

CONCLUSION

Awareness and practice of vaccination against infectious diseases by haemodialysis patients was found to be poor. Defective system and practice of information dissemination by healthcare workers was remarkably contributory.

Study of association between sickle cell trait and renal dysfunction among young adults in South-west Nigeria

Background

Although sickle cell disease has become a recognized etiology of chronic kidney disease (CKD), the sickle cell trait (SCT) variant was until recently believed to be a benign carrier state with little or no effect on the health of affected individuals. However, recent studies now appear to suggest an association between SCT and CKD.

Objective

The objective of the study is to determine the association between SCT (hemoglobin AS) and renal dysfunction among young Nigerian adults.

Methodology

This was a cross-sectional, descriptive study among apparently healthy undergraduates of Adeyemi College of Education, Ondo, southwest Nigeria. Their hemoglobin genotypes were determined using standard alkaline electrophoresis; their blood pressure, anthropometry, serum total cholesterol (TC), creatinine, and estimated glomerular filtration rate (eGFR) were determined. Data analyzed using Statistical Package for Social Sciences (SPSS) 20 were significant at P < 0.05.

Results

Six hundred and two subjects with HbAS (SCT, n = 465) and HbAA (non-SCT, n = 137) were studied. Their age range was 18-30 years with male-to-female ratio 1:3.8. There was no difference in the prevalence of renal dysfunction between SCT and non-SCT subjects (5.1% vs. 5.2%, P = 0.591). There was no increased risk of CKD among subjects with SCT (PR, 0.99 at 95% CI [0.417-2.348]).

Conclusion

SCT was not associated with increased risk of renal dysfunction among young adults in Nigeria. Further studies are needed to clarify the controversy, especially in Nigeria, with a relatively higher prevalence of SCT.

Concomitant gentamicin-induced nephrotoxicity and bilateral ototoxicity

Co-occurrence of aminoglycoside-induced ototoxicity and nephrotoxicity is rare, possibly as a result of divergent mechanisms of tissue damage despite similarities in the anatomy of the inner ear and the proximal renal tubular epithelium. We present the case of a 63-year-old hypertensive woman who developed nonoliguric acute exacerbation of chronic renal failure and sudden onset of sensorineural deafness after receiving daily injections of gentamicin. Coexisting ototoxicity and nephrotoxicity from aminoglycosides can occur, though rare. Adverse effects of aminoglycosides are better prevented by a careful exercise of discretion by prescribers.

Performance of laying pullets fed on cereal-free diets based on maize offal, cassava peel and reject cashew nut meal

1. A 70-d experiment was conducted to determine the response of 26-week-old laying pullets to cereal-free diets based on maize offal, cassava peel and full-fat cashew nut meal (CNM) in comparison with a standard 550 g maize/kg reference diet. The 4 test diets all contained 315 g CNM/kg 232.5, 155.0, 77.5 and 0.0 g/kg of maize offal in combination with 77.5, 155.0, 232.5 and 315.0 g/kg of cassava peel, respectively. 2. Pullets fed on the 4 CNM-based diets consumed (P<0.05) less food than those fed on the reference diet; they also had lower (P<0.05) rates of lay, produced less (P<0.05) egg mass, had lower (P<0.05) food conversion efficiencies and their eggs had a lighter (P<0.05) yolk colour. Pullets fed some of the CNM-based diets also gained more (P<0.05) weight, the heaviest (P<0.05) being birds reared on the diet containing 315 g/kg cassava peel. Egg weight, shell thickness and albumen height from all eggs were similar. Pullets fed on the CNM-based diets had inferior (P<0.05) retention of dry matter and protein. 4. It was concluded that feeding full-fat CNM allowed for high dietary inclusion rates of cassava peel and maize offal and the resultant diets, which contained no maize, supported satisfactory performance of laying hens.