Annals of Health Research 2019-12-09T18:45:51+00:00 Dr. Tinuade Ogunlesi Open Journal Systems <p>Peer-reviewed open access journal of medical and health-related sciences to&nbsp;disseminate research works and ideas in the fields of clinical sciences, basic medical sciences and public health with the ultimate goals of enhancing knowledge, improving practice and encouraging practice-centred research. It is indexed by African Index Medicus and Index Copernicus. It is also registered with the Committee for Publication Ethics (COPE) and the Directory of Open Access Journals (DOAJ).</p> <p><em><strong>This journal is published under the Creative Commons License Attribution Non-Commercial CC-BY NC. This license lets others remix, tweak and build upon our works non-commercially and although, their new works must also acknowledge us and be non-commercial, they do not have to license their derivative works on the same terms.</strong></em></p> Screening of newly-diagnosed adults with Tuberculosis for Diabetes mellitus and Impaired Glucose Tolerance in a Local Government Area in Ogun State, Nigeria 2019-12-09T18:45:28+00:00 AA Salako OA Adenowo O Amoran O Odusan JG Mautin F Sanya-Isijola <p><strong>Background:</strong> Emerging patterns in epidemiological transitions have led to increased risk for Non-Communicable Diseases and infectious conditions globally. Diabetes mellitus (DM) in a population is one such risk factor that could lead to the development of Tuberculosis (TB) due to weakened immune functions in affected persons, with implications for mortality. If not diagnosed early, DM also leads to poor treatment outcomes in TB.</p> <p><strong>Objective:</strong> To assess the prevalence of DM and impaired glucose tolerance (pre-diabetes) among newly diagnosed tuberculosis cases in Ijebu-Ode Local Government Area of Ogun State, Nigeria.</p> <p><strong>Methods:</strong> This cross-sectional study was conducted among 100 newly diagnosed Pulmonary TB patients in ljebu-Ode LGA. The patients were selected from four health facilities and were screened for elevated Fasting Blood Glucose levels using a laboratory spectrophotometer (glucose oxidase method).</p> <p><strong>Results:</strong> The mean age of the 100 study participants was 33 years (± 9.82), with ages within 19 -62 years. Eleven (11.0%) had elevated blood glucose levels suggestive of DM, while 20 (20.0%) had impaired fasting blood glucose levels. Among these 31 patients, 18 (58.0%) were males while 13 (42.0%) were females. The modal ages were within 20-39 years.</p> <p><strong>Conclusion: </strong>Screening for DM by healthcare providers should be routinely conducted before commencing TB patients on treatment. This will aid early detection, improve treatment outcomes of TB and prevent mortality among patients with these co-morbidities.</p> 2019-12-09T17:24:28+00:00 Copyright (c) 2019 Annals of Health Research An echocardiographic study of Rheumatic Heart Disease amongst children in a Tertiary Centre 2019-12-09T18:45:29+00:00 WE Sadoh CA Oguejiofor JA Amake <p><strong>Background:</strong> Rheumatic Heart Disease (RHD) is a major form of acquired heart disease amongst children in developing countries, where it continues to be a cause of childhood morbidity and mortality.</p> <p><strong>Objective: </strong>To describe the prevalence and spectrum of valvular affectation in children with RHD from the echocardiography laboratory.</p> <p><strong>Methods:</strong> The records of echocardiographic scans conducted over a 10-year period in a tertiary health facility were reviewed. Children with RHD, diagnosed using standard criteria were identified. The pattern and severity of valvular involvement and other associated cardiac abnormalities were recorded.</p> <p><strong>Results:</strong> Forty-one of the 2742 (1.5%) children who had echocardiography had RHD. Their mean age was 10.9±3.1 years; 28 (68.3%) were aged ≥10 years while 21 (51.2%) were males. Mitral valve was the predominantly affected valve in 40 (97.6%) children and mitral regurgitation was the commonest valvular abnormality in 19 (46.3%) cases. Nineteen (46.3%) had severe valvular damage, 5 (12.2%) had pericardial effusion while 7 (17.1%) died. Only 2 (4.9%) children had valvular repair surgery.</p> <p><strong>Conclusion:</strong> Although the prevalence of RHD in this study is low, it is noteworthy that RHD still affects Nigerian children. The poor access to surgery emphasizes the need to strengthen both primary and secondary prevention of RHD while enhancing facilities for surgical intervention.</p> 2019-12-09T17:23:22+00:00 Copyright (c) 2019 Annals of Health Research Knowledge of Research and Publication Ethics in a Nigerian Medical College 2019-12-09T18:45:29+00:00 SO Ogundele YA Kuyinu MA Salisu O Odusanya <p><strong>Background:</strong> In academia, the aphorism 'publish or perish' is commonly used. The pressure to publish academic papers can sometimes lead researchers to engage in unethical practices in the conduct, reporting or publishing of their research works.</p> <p><strong>Objective:</strong> To assess the awareness and practices of ethical issues in the conduct, reporting, and publishing of research among academics.</p> <p><strong>Methods:</strong> The study was a descriptive, cross-sectional survey of the academic staff of a Nigerian medical college. A structured questionnaire was used to collect relevant information about publishing experience and observation of practices considered to be acts of research misconduct.&nbsp;&nbsp;</p> <p><strong>Results:</strong> A total of 94 out of 108 academics responded to the questionnaires giving a response rate of 87%. The commonest act of research misconduct reported by the respondents was plagiarism with an incidence rate of 25%. The incidence rates for awareness of data fabrication and falsification were 22% and 21% respectively. The proportions of respondents who were aware of gift and ghost authorship were 63% and 20% respectively. Only 41% of the respondents could recall all the criteria for authorship of an academic paper while 20% could not recollect any of the criteria.</p> <p><strong>Conclusion:</strong> Research misconduct and unethical publication practices are common observations among the respondents in this survey. It is recommended that researchers should familiarize themselves with the various ethical guidelines and requirements for authorship and agree on the sequence of the names of authors in the by-line of the proposed publication at the start of project work.</p> 2019-12-09T17:22:38+00:00 Copyright (c) 2019 Annals of Health Research Pattern and outcome of Diabetic Ketoacidosis among children with Type 1 Diabetes mellitus at Ile-Ife, Nigeria 2019-12-09T18:45:31+00:00 JB Elusiyan AJ Kareem OE Olorunmoteni OC Odunlade <p><strong>Background:</strong> Diabetic ketoacidosis (DKA) is a life-threatening complication of Diabetes mellitus. There are few reports on the pattern and outcome of DKA in childhood diabetes in Nigeria but none on the diabetic population from Osun State, Nigeria.</p> <p><strong>Objective:</strong> To determine the pattern and factors influencing the outcome of children managed for DKA at the Paediatric Endocrinology Unit of the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria, over a ten-year period.</p> <p><strong>Methods:</strong>&nbsp; A retrospective review of the clinical records of all the children managed for Type-1 Diabetes mellitus (TIDM) over ten years (2007-2016) was done. Relevant information was obtained from the clinical records and the data were analyzed.</p> <p><strong>Results:</strong> A total of 15 children with DKA comprising 8 (53.3%) males and 7 (46.7%) females were studied. The male to female ratio was 1.1:1. Twenty-eight episodes of DKA were recorded during the period, thus putting the average frequency per patient at 1.9. DKA was the first manifestation of DM in the majority (86.7%) of the subjects. The mean age at diagnosis of DM was 11.9<u>+</u>3.6 years with about half (53.3%) occurring during pre-adolescence. The socio-economic status of the affected families had an inverse relationship with the frequency of DKA.</p> <p><strong>Conclusion:</strong> DKA is the most common initial presentation of Type-1 DM among Nigerian children, with a high rate of recurrence and an inverse relationship with socioeconomic status.</p> 2019-12-09T17:22:04+00:00 Copyright (c) 2019 Annals of Health Research Factors associated with the knowledge and attitude towards Female Genital Mutilation among antenatal clinic attendees in Southern Nigeria 2019-12-09T18:45:33+00:00 AI Obi OE Obarisiagbon OL Igbinadolor KM Fatai OO Adesoye <p><strong>Background:</strong> Female Genital Mutilation (FGM) remains a common cultural practice in Benin City, Edo State and by extension, Nigeria. The knowledge and attitude towards FGM may play significant roles in influencing this harmful socio-cultural practice.</p> <p><strong>Objective: </strong>To identify factors associated with knowledge and attitude towards female genital mutilation (FGM) among Antenatal Clinic (ANC) attendees in selected health facilities in Benin City, Edo State.</p> <p><strong>Methods:</strong> A facility-based, descriptive, cross-sectional study was conducted involving 400 pregnant women recruited by systematic sampling technique from selected health facilities in Benin City, Edo State. A pre-tested, interviewer-administered questionnaire was utilized for data collection from consenting pregnant women attending antenatal care clinics in selected public tertiary and secondary health facilities in the study area. Information related to socio-demographic characteristics, knowledge, and attitude towards FGM were collected.</p> <p><strong>Results:</strong> The mean age of the respondents was 30.3±4.8 years. All the respondents were aware of the term Female Genital Mutilation. Two hundred and forty-eight (62%) and 302 (75.5%) had good knowledge and negative attitude towards FGM respectively. Age group (p = 0.005), religion (p = 0.007) and educational status (p &lt;0.001) were identified as significant factors influencing knowledge of FGM while in relation to attitude towards FGM, knowledge of FGM (p&lt;0.001) had significant influence.</p> <p><strong>Conclusion:</strong> This study identified a gap between knowledge and attitude towards FGM among the respondents. Good knowledge of FGM significantly influenced attitude towards FGM. There is a need to scale up health sensitization during ANC sessions to bridge the gap identified.</p> 2019-12-09T17:19:20+00:00 Copyright (c) 2019 Annals of Health Research Oxidative stress markers and disease severity among children with Sickle Cell Anaemia 2019-12-09T18:45:34+00:00 OS Smith SA Adegoke MA Akinlosotu AO Ajose <p><strong>Background:</strong> Sickle cell anaemia has been associated with oxidative stress. Total Antioxidant Capacity (TAC), Total Oxidant Status (TOS) and Oxidative Stress Index (OSI) are cumulative markers of oxidative stress.</p> <p><strong>Objective<em>:</em></strong> To evaluate the serum levels of oxidative stress markers in children with sickle cell anaemia (SCA) and determine the relationship between these markers and disease severity.</p> <p><strong>Method:</strong> One hundred and fifty-six children, comprising 78 with SCA, aged 1 - 15 years and 78 age- and sex-matched Haemoglobin AA controls were studied. Serum TOS, OSI, and TAC were determined using ELISA kits. The severity of the SCA was determined using clinical and laboratory parameters.</p> <p><strong>Result:</strong> Children with SCA had lower mean serum TAC (0.83±0.31UAE) than controls (1.19±0.24UAE) with p&lt;0.001. However, the mean serum TOS and OSI of children with SCA was higher than among the controls (13.33±4.64U/ml vs. 9.70±2.72U/ml and 20.95±16.75 vs. 8.68±3.76 respectively) with p&lt;0.001. SCA subjects with mild disease had higher mean serum TAC (0.91 ± 0.27UAE) than those with moderate disease (0.54±0.27UAE) (p&lt;0.001). On the other hand, the mean TOS and OSI were lower in children with mild disease compared to those with moderate disease (12.64±4.32U/ml vs. 15.63±5.07U/ml, p = 0.016 and 16.26±10.25 vs. 36.61±23.89 p&lt;0.001 respectively). Sickle cell disease severity score had negative correlation with TAC (r = -0.60, p &lt; 0.001) but positive correlation with TOS (r = 0.3, p = 0.008) and OSI (r = 0.6, p &lt; 0.001).</p> <p><strong>Conclusion:</strong> Children with SCA had lower TAC but higher TOS and OSI than matched controls. Oxidative stress markers had a significant relationship with SCD severity.</p> 2019-12-09T17:21:11+00:00 Copyright (c) 2019 Annals of Health Research Pattern of haemostatic parameters and their relationship with microalbuminuria among hypertensives in Northern NigeriaPattern of haemostatic parameters and their relationship with microalbuminuria among hypertensives in Northern Nigeria 2019-12-09T18:45:36+00:00 IP Ijei H Bello-Manga R Yusuf BG Sani AI Mamman <p><strong>Background:</strong> Hypertension is a common, non-communicable disorder of public health significance. Abnormalities in haemostasis and blood rheology have been linked to target organ damage (TOD) in hypertension. Microalbuminuria (MA) is an independent predictor of TOD.</p> <p><strong>Methods:</strong> A cross-sectional study was carried out among 107 consecutively recruited hypertensives attending the Cardiology Clinic at ABUTH, Zaria, Nigeria. Complete blood counts, haemostatic screening tests and microalbuminuria assay were performed on blood and urine specimens.</p> <p><strong>Results:</strong> The mean age of participants was 50.2±11.3 years and 59.3±18.2 years for females and males respectively with a female predominance (91/107; 85%). The frequencies of abnormal platelet counts, prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, D-dimer and MA were 15%, 57%, 54.2%, 64.5%, 100%, 25.2%, and 41% respectively. Participants with poor BP control had an increased risk of derangements in aPTT and platelet counts (OR = 1.4, 1.4) but there was no significant difference in means with BP for aPTT, fibrinogen, and platelets (p = 0.517, 0.257 and 0.525 respectively). The impact of the duration of hypertension was shown in D-dimer levels up to 10 years. Participants on ARB/ACEI- containing regimens showed a higher risk of derangement in TT, aPTT, PT and D-dimer in contrast to platelet counts (OR = 0.96, p = 0.836). Haemostatic parameters showed weakly positive, statistically significant correlation on regression analysis.</p> <p><strong>Conclusion:</strong> There is a high prevalence of, and positive correlation between haemostatic abnormalities and MA among hypertensives in Northern Nigeria. Abnormal haemostatic screening tests may indicate MA and increased risk of TOD.</p> 2019-12-09T17:20:06+00:00 Copyright (c) 2019 Annals of Health Research Does the laterality of breast cancer affect disease outcomes on bone scan? 2019-12-09T18:45:38+00:00 YA Onimode AA Adenipekun <p>Background: The incidence of breast cancer (BC) continues to rise, with the latest record being 2.08 million globally. It also remains the most common female malignancy worldwide. Increasing awareness and screening have been suggested as contributory factors.<br>Objective: To determine the relationship between disease laterality in breast cancer and disease outcome in terms of bone metastasis.<br>Methods: The study is a hospital-based six-year retrospective review of all breast cancer patients who had bone scans done between 2011 and 2016.<br>Results: A total of 992 bone scans (BS) were analysed for 500 (50.4%) patients with left-sided breast cancer and 492 (49.6%) with right-sided breast cancer. While 638 bone scans were abnormal, 354 were benign and 242 (24.39%) were equivocal. There was no association between primary tumour laterality and BS outcome (p = 0.544). Furthermore, Chi-Square for trend assessed the association between patients’ age and BC laterality but yielded no significance (p = 0.67).<br>Conclusion: The laterality of breast cancer did not affect the stage of breast cancer as shown by bone scan outcomes in this study.</p> 2019-12-09T17:18:29+00:00 Copyright (c) 2019 Annals of Health Research Effect of exercise on basal insulin levels in normoglycaemic offspring of patients with Type 2 Diabetes mellitus 2019-12-09T18:45:39+00:00 EO Taiwo OA Sofola AA Fasanmade G Onyemelukwe <p>Background: Low basal insulin level is a risk factor for Type 2 Diabetes mellitus (T2DM) as a result of altered insulin sensitivity pattern. However, it is uncertain if exercise may influence the occurrence of T2DM in the offspring of diabetic parents. <br>Objective: To assess the effect of exercise on basal insulin levels in the offspring of T2DM parents compared with the offspring of non-diabetic parents.<br>Design: The participants were assigned into four groups using a convenience sampling method; 27 Normal-weight Offspring of Non-Diabetic Parents (NONDP), 21 Normal-weight Offspring of Diabetic Parents (NODP), 26 Overweight Offspring of Non-Diabetic Parents (OONDP) and 21 Overweight Offspring of Diabetic Parents (OODP). Each participant followed a protocol of graded exercise using ''tummy trimmer'' everyday spending 30-45 minutes daily for 24 weeks. Blood samples were obtained after overnight fasting for determination of insulin level using standard methods (immunoassay technique) at baseline, six weeks, 12 weeks, 18 weeks and 24 weeks respectively.<br>Results: There were 23/42 males (54.8%) in the study groups and 34/51 females (64.2%) in the control groups. Thirty-one (58.7%) in the control group and 24 (57.1%) in the study group were aged 21-30 years. An increase in insulin levels was recorded at 12 weeks in all groups except in NONDP where the insulin levels decreased. The insulin level change was highest in the NODP (2.25ng/ml) group.<br>Conclusions: Graded exercise improved insulin levels in all test groups. The clinical importance of graded exercise in the prevention of diabetes mellitus among the offspring of diabetic parents may be promising.</p> <p>&nbsp;</p> 2019-12-09T17:29:07+00:00 Copyright (c) 2019 Annals of Health Research Identifying childhood diarrhoea training needs of Nigerian frontline health care workers 2019-12-09T18:45:41+00:00 AE Sadoh C Okoro I Mbarie <p>Background: Health education and case management are important in the reduction of morbidity and mortality resulting from childhood diarrhoea.<br>Objective: To identify the training needs of health care workers as a measure of their empowerment to fulfil their roles in the control of childhood diarrhoea.<br>Methods: This cross-sectional, descriptive study utilized a self-administered pre-tested questionnaire to obtain demographic information, knowledge about diarrhoea, features of dehydration, management, and prevention of diarrhoea from 165 health care workers drawn from the 18 local government areas of Edo state.<br>Results: Only 24 (14.5%) of health care workers could correctly define diarrhoea. Majority of respondents could identify features of dehydration: thirst 161 (97%), loss of skin turgor 149 (90.3%) and irritability 142 (86.1%) but 93 (56.4%) and 52 (31.5%) did not know that unconsciousness and passage of small volume/no urine respectively were features of dehydration. Only 15 (9.1%) could correctly constitute Salt Sugar Solution (SSS). Up to 42.2% of health workers use antibiotics regularly to manage childhood diarrhoea while another 48.8% considered the use of antibiotics during the diarrhoeal episode a preventive strategy.<br>Conclusion: Frontline health care workers need periodic training and retraining with consistent supportive supervision to ensure that children with diarrhoea are appropriately evaluated and managed.</p> 2019-12-09T00:00:00+00:00 Copyright (c) 2019 Annals of Health Research Correlation between Prostate Specific Antigen and Prostate Biopsy Gleason Score 2019-12-09T18:45:42+00:00 PE Ngwu GO Achor VU Eziefule JI Orji FT Alozie <p>Background: Prostate Specific Antigen (PSA) is a commonly used marker in prostate cancer management. Gleason grading is one of the most powerful predictors of prostatic biological behaviour. PSA, when combined with the Gleason score and clinical stage, improves the prediction of the pathological stage for prostate cancer.<br>Objectives: To assess the degree of correlation between PSA level and Gleason score as well as determine the likelihood of aggressiveness of prostate cancer using Gleason score as a parameter.<br>Methods: A cross-sectional prospective study was conducted among 234 consecutive consenting patients presenting to the Urology Out-Patient Clinic between April 2015 and March 2018. Serum PSA was done and patients with values above 4ng/ml and/or abnormal Digital Rectal Examination (DRE) were selected to have a prostate biopsy. The sample was histologically analysed with Gleason score recorded for those with prostate cancer. Gleason score was then correlated with PSA levels.<br>Results: The mean age for prostate cancer patients was 71.3±8.7 years. The mean PSA for patients with prostate cancer was 52.3±37.5ng/ml (Confidence Interval = 46.1-58.6) with p&lt;0.001. About 18.2% of histologically confirmed prostate cancer cases had Gleason score 8-10 implying a high level of tumour aggressiveness. There is a positive correlation between PSA and Gleason score with R-value 0.590 indicating a good degree of correlation.<br>Conclusion: There is a good degree of a positive correlation between PSA level and Gleason score, as well as a high level of aggressiveness of prostate cancer in Umuahia.</p> 2019-12-09T17:12:54+00:00 Copyright (c) 2019 Annals of Health Research Antidiarrhoeal activity of ethanolic stem bark extract of Newbouldia laevis in castor oil-induced diarrhoea in rats 2019-12-09T18:45:44+00:00 AA Aderinola J Ejiofor OE Oyinloye TA Fasanya E Eremu <p>Background: Diarrhoeal disease is the second leading cause of morbidity and mortality in developing countries requiring urgent attention. Many of the conventional anti-diarrhoeal drugs cause serious adverse effects, hence the need to screen various plants for their medicinal values becomes imperative.<br>Objective: To investigate the anti-diarrhoeal activity of ethanolic stem bark extract of Newbouldia laevis in castor-oil induced diarrhoea in rats.<br>Methods: The stem bark of Newbouldia laevis collected from Abeokuta, Ogun State, was air-dried, ground, macerated in 90% ethanol and concentrated to dryness in a water bath and then reconstituted using distilled water. Fifty (50) albino rats of both sexes used for the study were divided into two groups: A and B with twenty-five (25) rats per group. <br>Group A was used for the gastro-intestinal motility test using charcoal meal while<br>Group B was used for castor-oil induced diarrhoea test and the number of stool pellets was counted over an hour period.<br>Results: The extract (250-1000mg/kg) showed significant (p = 0.0399) anti-diarrhoeal activity by decreasing the distance of the gastrointestinal movement of charcoal meal in the treated rats and also inhibited the severity of diarrhoea induced by castor-oil in a dose-dependent manner when compared with the control (distilled water). This activity could be attributed to phytochemicals like flavonoids and tannins present in Newbouldia laevis.<br>Conclusion: The results showed that stem bark extract of Newbouldia laevis possesses a significant anti-diarrhoeal property and this supports the traditional use of the plant in the treatment of diarrhoea.</p> 2019-12-09T17:12:02+00:00 Copyright (c) 2019 Annals of Health Research A 17-year study of paediatric cytopathology in a tertiary hospital in Sokoto, Nigeria 2019-12-09T18:45:46+00:00 K Abdullahi B Jibrin <p>Background: Cytopathology offers a rapid diagnosis of suspicious lesions, aiding prompt clinical judgment. The extent of the cytopathologic practice is variable, thus justifying the need to assess the frequency of its use in health care centres in resource-challenged settings.<br>Objectives: To assess the frequency of use of cytopathology services, the demographic features of the patients and the various diagnostic outcomes.<br>Methods: The study was a retrospective analysis of 17 years’ records; including parameters like the basic demographics and cytomorphologic diagnoses in paediatric practice. Data was sought from histopathology department registers and cytopathologic request forms for patients in the age range of 0-15 years. <br>Results: The total number of the paediatric cytologic specimen was 930 constituting 12.3% of all cytologic specimens received in the study period. The mean age was 8.0 years with a range of 1 day to 15 years. There were 537/930 (57.7%) males and 378/930 (40.6%) females with a male-to-female ratio of 1.4:1. The specimens were obtained by fine-needle aspiration cytology in 596/930 (64.1%) cases or smears of exfoliative specimens in 334/930 (35.9%) cases. Most of the samples were obtained from children in 6 - 10 years age group. The commonest clinical indication for the cytology was “suspected malignancy” comprising 370/930 (39.8%) cases. The most frequent cytopathological diagnosis was “positive for malignancy”, accounting for 232/930 (24.9%) cases.<br>Conclusion: Cytopathology practice in a resource-poor setting remains a useful tool in the preliminary evaluation of lesions.</p> 2019-12-09T17:10:54+00:00 Copyright (c) 2019 Annals of Health Research Determinants of HIV serostatus disclosure and assessment of the competence of health care personnel in HIV serostatus disclosure 2019-12-09T18:45:48+00:00 MO Adekunle OA Olutekunbi BA Animasahun MA Afadapa P Ubuane <p>Background: Disclosure of HIV serostatus is essential for the care and eradication of HIV infection. The World Health Organization recommends disclosure to school-age children and younger children but this practice is commonly hindered by stigmatization and other presumed psychosocial effects of the disease.<br>Objective: To identify limitations to the disclosure of serostatus in HIV-infected children, outcomes of disclosure as well as compare the outcomes of disclosure by either parents/caregiver only with the involvement of health care personnel.<br>Methods: A questionnaire-based study of primary caregivers of children aged 6 years to 18 years with HIV infection who were enrolled at two government-owned tertiary institutions in Lagos State, Nigeria. The healthcare personnel directly involved in the care of these children also participated in the study.<br>Results: A total of 190 primary caregivers participated in the study. In all, 29 health care personnel completely filled the questionnaires. Disclosure (partial and full) was recorded among 31.0%. Older children and children with single parents were more likely to know their HIV status. Similar positive and negative impacts of disclosure were observed irrespective of the individuals involved in the processes. In all, 62.1% of healthcare personnel have had training on disclosure.<br>Conclusion: Disclosure rate in HIV-infected children was low. There is a need for more training of health personnel and education of caregivers on the benefits of disclosure as well as the introduction of effective measures to tackle the barriers to disclosure.</p> 2019-12-09T17:09:35+00:00 Copyright (c) 2019 Annals of Health Research Socio-medical burden of managing a Nigerian child with 46XY male disorder of sex differentiation: A Case Report 2019-12-09T18:45:49+00:00 OO Oba-Daini MB Fetuga IO Ogundele CC Nwokoro AA Olatunji OB Ogunfowora <p>Phenotypic expression of the male internal and external genitalia is due largely to the interplay between the proper differentiation of the bipotential gonad, the production of testosterone from the Leydig cells and the response of the undifferentiated external genitalia to Dihydrotestosterone. When any of the pathways involved in the mechanisms described above are distorted, it results in the 46 XY Disorder of Sex Differentiation (DSD).<br>The incidence of 46 XY DSD ranges from 20 to 41% among the cases of Disorder of Sex Differentiation (DSD) in Nigeria, though there is a paucity of data on this condition. This report describes an under-virilized genetically male child who presented with ambiguous genitalia in the neonatal period and was subsequently diagnosed as SRY positive 46 XY DSD with reduced testosterone synthesis. This report is necessitated by the need to create awareness and highlight the relevant medico-social challenges in the management of DSD in a resource-poor setting.</p> 2019-12-09T17:08:29+00:00 Copyright (c) 2019 Annals of Health Research