Health

By Uzair Adam Imam

A recent study conducted by scientists at the University of California has uncovered intriguing insights into the mechanics of sleep, particularly focusing on the brain’s activity during this crucial rest period.

Published in Nature, the study sheds light on how sleep acts as a “reset” for the brain, primarily during the initial half of the night.

According to the research, during sleep, the brain undergoes a process of weakening newly formed connections between neurons, known as synaptic pruning. This phenomenon predominantly occurs during the first half of sleep, suggesting that this period is crucial for streamlining neural connections.

However, the purpose of the second half of sleep remains enigmatic. While researchers speculate that it may involve processes such as waste removal or cellular repair, further investigation is needed to elucidate its exact function.

Lead author Professor Jason Rihel from UCL Cell & Developmental Biology explains, “When we are awake, the connections between brain cells get stronger and more complex.

“If this activity were to continue unabated, it would be energetically unsustainable. Too many active connections between brain cells could prevent new connections from being made the following day.”

The study supports the Synaptic Homeostasis Hypothesis, suggesting that sleep serves as a necessary reset for the brain, facilitating optimal cognitive function.

Using optically translucent zebrafish, researchers monitored synaptic activity over multiple sleep-wake cycles.

They observed that brain cells gain connections during wakefulness and lose them during sleep, with the extent of synaptic rearrangement influenced by sleep pressure.

Furthermore, the study revealed that synaptic remodeling predominantly occurs in the first half of the nightly sleep cycle, correlating with patterns of slow-wave activity.

While the findings provide valuable insights into the role of sleep in synaptic regulation, questions persist regarding the functions of the second half of sleep.

The study hints at potential avenues for future research into the broader functions of sleep beyond synaptic pruning.

By Muhammad Muzdaleefa

The groundbreaking ceremony for the AMA Medical Manufacturing OSD Plant marks a turning point for the Nigerian medical industry.

The new plant, which will produce oral solid dosage (OSD) medications, will not only boost the local economy but also improve access to high-quality healthcare for the Nigerian people.

It is a testament to the company’s commitment to investing in the future of healthcare in Nigeria.

The ceremony was conducted by the Director General of the World Trade Organization, Dr. Ngozi Okonjo Iweala, and attended by a number of dignitaries, including the Governor of Kaduna State, Senator Uba Sani, Deputy Governor of Kaduna State, Dr. Hadiza Sabuwa Balarabe, Minister of Health, Prof. Ali Pate, the Permanent Secretary of the Ministry of Trade and Industry, the Vice President’s representative, Emir of Zazzau, Amb. Ahmad Nuhu Bamalli among others.

A number of medical experts from UK, US, Germany and representatives from numerous health organizations were also in attendance, including the ambassador of Indonesia in Nigeria, partners from Korea, and representatives from the National Agency for Food and Drug Administration and Control (NAFDAC).

Also, a number of memorandums of understanding (MoUs) were signed during the ceremony, reflecting the commitment of various stakeholders to supporting the new plant and its mission to improve healthcare in Nigeria.

The event was a clear sign of the importance of the new plant to the future of healthcare in the country. It is imperative to note that prior to the establishment of the AMA Medical Manufacturing plant, there is virtually no medical companies operating in northern Nigeria.

This meant that many people in the region had limited access to high-quality, affordable medical products and services.

The AMA Medical Manufacturing plant aims to address this issue by providing a reliable source of quality medical products for the people of northern Nigeria.

In addition, the plant’s location in Kaduna State, which is central to the region, makes it accessible to a large population and well-positioned to serve as a hub for medical products distribution.

The founder of AMA Medical Manufacturing, Alhaji Musa Bello Abdullahi, chose Kaduna as the location for the new plant because of its strategic location and rich history.

Kaduna is a major transportation hub, with good road, rail, and air links, making it easy to get medical products from the plant to people across the region.

In addition, Kaduna has a long history as a center of industry and commerce, and the founder hopes that the plant will help to revitalize the local economy.

During her address, the DG of the WTO stated that she is pleased to see the establishment of the AMA Medical Manufacturing plant in Kaduna, and believes that it has the potential to become a global leader in medical equipment production.

She has expressed her commitment to providing the company with the necessary support and assistance to help it achieve this goal.

This includes helping the company to access international markets and comply with international standards.

The Minister of Health has also voiced the federal government’s support for the AMA Medical Manufacturing plant, stating that the government is committed to assisting the company in any way possible.

This includes providing regulatory and policy support, as well as assistance with accessing capital and markets. The Minister has expressed confidence that the plant will help to address some of the healthcare challenges facing Nigeria, and will contribute to the overall development of the country.

The establishment of the AMA Medical Manufacturing plant in Kaduna is a significant development for both the state and Nigeria as a whole.

The company has the support of both the federal government and the WTO, and has the potential to become a global leader in the medical equipment industry.

With the right support and commitment, the plant can play a major role in improving healthcare in Nigeria and making the country a more competitive player in the global economy.

The future of medical equipment manufacturing in Nigeria looks bright, thanks to the efforts of AMA Medical Manufacturing.

Muhammad Muzdaleefa writes from Kaduna and can be reached via mohammedadamu736@gmail.

By Aishat M. Abisola

Nigeria, a nation marked by diverse landscapes and cultural richness, grapples with significant healthcare disparities between urban and rural areas. While urban centers face issues such as minimal medical resources, a lack of healthcare workers and a lack of necessary equipment, they still provide decent healthcare services unlike rural communities who face numerous challenges that hinder their access to essential healthcare services.

Rural communities in Nigeria encounter formidable barriers on regular basis when it comes to accessing healthcare services. One of the primary challenges is the shortage of healthcare facilities and trained medical professionals in remote areas.

According to a report by the World Health Organization (WHO), there is a significant urban-rural divide in the distribution of healthcare resources in Nigeria, with the majority concentrated in urban centers.

Challenges in Rural Healthcare Access

Geographic Barriers: One of the primary obstacles to healthcare access in rural areas is the geographic isolation of these communities. Many rural regions in Nigeria are situated far from urban centers, making it difficult for residents to reach healthcare facilities promptly. Long distances, poor road conditions, and a lack of reliable transportation options have contributed to delays or altogether neglected healthcare seeking behaviors.

Shortage of Healthcare Facilities and Personnel: Rural areas frequently deal with a shortage of healthcare facilities and trained medical professionals. Nigeria has a disproportionately low number of healthcare facilities in rural areas compared to urban centers. This shortage not only limits the availability of essential services but also results in prolonged waiting times for medical attention.

Financial Constraints:
Economic factors also play a significant role in healthcare access, especially in rural communities where poverty rates tend to be higher. The majority of rural residents often struggle to afford healthcare services, medications, and transportation costs to reach medical facilities. Out-of-pocket expenses associated with healthcare often deter individuals from seeking timely medical attention, exacerbating health problems and perpetuating a cycle of poverty.

Healthcare Infrastructure Disparities: The disparity in healthcare infrastructure between urban and rural areas is stark. Urban centers have significantly better hospitals and clinics, while many rural healthcare facilities are plagued by dilapidation and a lack of essential medical equipment. The Nigerian government’s National Health Facilities Registry highlights the uneven distribution of healthcare infrastructure, with urban areas having a higher concentration of better equipped facilities.

Lack of Skilled Personnel: In addition to inadequate facilities, rural areas face a shortage of skilled healthcare professionals. The WHO reports that the distribution of healthcare workers in Nigeria is highly skewed as urban areas have a more significant concentration of doctors, nurses, and other healthcare providers. This scarcity of skilled personnel in rural regions further diminishes the quality of healthcare services available to residents.

Power Challenges: Another critical aspect of healthcare infrastructure often overlooked is the lack of reliable electricity in rural regions. Many healthcare facilities in remote areas struggle with power shortages which hinders the functionality of medical equipment and limits the provision of essential healthcare services. Electrification rates in rural areas are considerably lower than in urban centers, exacerbating the healthcare infrastructure divide.

Proposed Solutions

Investment in Rural Healthcare Infrastructure: Increasing investments in rural healthcare facilities is imperative in order to address the healthcare infrastructure disparities. Building new, well-equipped healthcare centers and upgrading existing ones will improve the availability and quality of healthcare services in remote regions. The Nigerian government, in collaboration with international partners, can allocate funds specifically for rural healthcare infrastructure development.

Training and Deployment of Healthcare Professionals: Addressing the shortage of healthcare professionals in rural areas requires a comprehensive strategy. Government initiatives and incentives should be implemented to encourage medical professionals to work in undeserved communities. Investing in the education and training of local community health workers can also enhance primary healthcare services in rural areas and provide a sustainable solution to the shortage of skilled personnel.

Improving Transportation Infrastructure: Efforts to improve healthcare access should also focus on transportation infrastructure. Constructing and maintaining reliable roads in rural areas, as well as implementing affordable and accessible public transportation options, can significantly reduce travel barriers for rural residents seeking medical attention.

Financial Support and Health Insurance: The government can establish and promote health insurance programs targeted at low-income individuals in rural areas. These programs can provide financial relief and encourage healthcare utilization by covering medical expenses. Additionally, subsidies for essential medications and preventive healthcare measures can contribute to a healthier rural population.

Alternative Energy Solutions: Implementing alternative energy solutions such as solar power is crucial to provide a solution to address power challenges in rural healthcare facilities. The integration of sustainable energy sources can ensure a reliable electricity supply, enabling the consistent operation of medical equipment and improving the overall quality of healthcare services in rural areas.

Last line

Nigeria’s urban-rural disparities in healthcare accessibility and infrastructure can only be resolved when there is a concerted effort from the government, healthcare organizations, and the international community. By acknowledging the challenges faced by rural communities and implementing comprehensive, sustainable solutions, Nigeria can pave the way for a more equitable healthcare system.

Bridging these gaps is not just a matter of social justice but a strategic investment in the nation’s health and development. When stakeholders work collaboratively, the possibility of attaining accessible, quality healthcare for all Nigerians, regardless of their geographic location, can become a reality.

Aishat M. Abisola is a NYSC corps member with PRNigeria in Abuja

By Aisha Musa Auyo

I have been writing about how women should be patient, understanding, tolerant, verbally appreciative of their men, admire them, massage their egos, and constantly upgrade themselves to please their men, etc. The men are loving it. It’s about time women get their concerns heard.

We all love good things. And I know it’s a man’s nature not to care what his woman thinks about his looks after he marries her. The truth is, smart men know that appeasing their women pleases themselves. Most of the time, women reciprocate what they feel. If they’re happy, they radiate that energy to the people around them, and trust me, a positive vibe is contagious.

You’ve seen her, and you wanted nothing but to marry her at that moment. You will do anything to please, impress, convince, attract, and marry her. That’s not the end, though. You need to work on staying happily married to her. You need to stay attractive to her. Women are strange beings—simple yet complicated. Basic things like hygiene (oral, toilet, clothes, head, nails, and general body cleanliness), choice of perfume, or outfits can make her love or hate you. Yes, we don’t dislike—we hate. Lol.

Frankly, I don’t want to write about this. I don’t want to start telling adult males how to groom themselves, but the direct messages and tags I receive are too numerous to ignore. So, let’s do this!

It was reported to me that most men don’t flush after peeing. Yes, you read that correctly. I feel compelled to bring this out for the sake of my girls. Furthermore, when they flush after a number two, they don’t bother to wait and see if everything is cleared, let alone use the toilet brush or air freshener.

The ideal way to clean up after using the toilet is to wash yourself with soap and water. Water alone will suffice for purification, but soap is necessary for hygiene and a pleasant smell.

When it comes to underwear, kindly change them daily. Buy as many as you can afford. There are affordable ones for everyone’s pocket. Nigerian weather is not very friendly. Those sweatpants and tight trousers are bad for hygiene. Please let your body breathe!

Mouthwash, clove, and chewing gum are not for women alone. They’re oral hygiene products for both genders. Teeth scaling, polishing, and dental check-ups are not just for celebrities. They’re for everyone. Manicures, pedicures, and shaving (for men) every Friday are sunnah. Shampoo, conditioner, and anti-dandruff products are for both genders, especially men who want to grow their hair. However, they should be aware that this decision comes with financial responsibility.

Wash or sanitize your hands immediately when you get home. Bathe and brush your teeth after work, and use deodorant, body spray, antiperspirants, and perfumes (I know most of you do these things before going out). The problem is when you are home. Your wife deserves the best version of you. Please ask her what she thinks of your perfume. If her choice is different from yours, use your own choice when you are going out and her choice when you are home.

When your wife nonchalantly suggests that you freshen up, get the clue, dude… she may not spell out that you stink. And if anyone you trust offers you a clove, chewing gum, or minted sweets, gladly accept it; chances are, you need to freshen your breath. Accept corrections and observations about your hygiene with an open mind.

If you notice that your wife is avoiding physical contact or conversations with you, check your hygiene. A wife prepares herself and waits the whole day just to be with her husband. So if she’s keeping her distance, something must be amiss. Freshen up and both of you will be fine.

Women love money, they say, but decent women love hygienic and good-smelling men more. If you have money, use it to look and smell good. If you don’t, make sure you are not dirty. There are cheaper options for looking and smelling good. A woman can never hate a neat and good-smelling guy. Women pay more attention to how you smell than how you look.

And that annoying jallabiyya you men wear from Friday evening until Monday morning, please try to change the habit. It really annoys us. If we ladies can change at least two outfits a day just to please you, you may as well reciprocate the gesture. There are comfortable casual clothes that are very available and affordable.

The dreaded morning breath… we know it’s unavoidable, but hey, brush your teeth before sleeping, use mouthwash, chew mint leaves or cloves before bed. That morning intimacy couples rave about isn’t so great with morning breath. Please brush before going to Subhi prayer (that one is a complaint from your fellow men). Just brush before talking to anyone. Drink water and eat a date or apple to neutralize the acidity in your empty stomach.

In general, a pleasant smell has a calming effect on the person who wears it and the person who breathes it in. A bad smell is not only offensive to the nose but also damages the recipient’s mood, angering them instantly. The unfortunate thing is that most people who exude a bad smell are unaware of it. Therefore, as an individual, do everything humanly possible to avoid having an unpleasant odor. Never be too busy or in a hurry to the detriment of your personal hygiene and grooming.

Aisha Musa Auyo is a Doctoral researcher in Educational Psychology, a mother of three, a homemaker, caterer, and parenting/relationship coach. She can be contacted via aishamuauyo@gmail.com.

By Muhammad Yakubu Abare

In the quiet corners of our shared memories, a vibrant, so enduring soul exists that even the passage of time cannot diminish its brilliance. MB Mohammed is a name that resonates with the echoes of laughter, shared dreams, and the unspoken bond of a friendship that weathered the storms of life. It is with a heavy heart that we bid farewell to a companion, a confidant, and a cherished friend who, after a valiant three-decade struggle, succumbed to the relentless grip of sickle cell anaemia on the 1st of November, 2023.

Our journey together began in the embrace of a shared childhood, where our families were not just neighbours but kindred spirits united by the thread of fate. From when our parents toiled side by side in the pursuit of livelihoods to their eventual retirements and relocations, MB and I traversed the meandering paths of life hand in hand. An enthusiastic learner, he possessed an insatiable thirst for knowledge, which propelled him to pursue Economics at the University of Maiduguri, from which he emerged with commendable distinction. 

In the journey of life together, MB faced challenges that would have deterred a less resilient spirit. Living with sickle cell anaemia, he confronted each hurdle with courage that spoke volumes of his determination. His path, marked by periodic bouts of illness, bore witness to a remarkable strength that defied the limitations of his physical condition. Beyond the confines of health struggles, MB was not only a scholar but also a tech virtuoso. His proficiency in programming and computer skills illuminated a path of endless possibilities. 

Before venturing into the humanitarian sector, MB donned the hat of a dedicated teacher at a private school. Here, he harnessed his programming prowess for the greater good, developing software solutions for school management, including salary vouchers, results computation, and attendance tracking – all offered selflessly, free of charge. His passion for education extended beyond the classroom as he initiated science-based student clubs, fostering a love for learning.

During his one-year service in the NYSC, MB’s altruism shone brightly. Despite battling his health challenges, he engaged in community services, particularly in education. His efforts included distributing free books to school libraries, which garnered him well-deserved awards. This selfless dedication defined his remarkable life, turning adversity into opportunities for others. Though he grappled with sickle cell, his existence was a testament to the extraordinary resilience that marked his every endeavour.

Our closeness transcended mere friendship; it was a kinship forged in the crucible of shared aspirations and mutual support. Our mothers often remarked on the uncanny synchronicity of our thoughts as though our minds danced to the same rhythm. As we embarked on our respective careers, we found solace in exchanging our companionship. CV reviews, career advice, and shared triumphs became the threads weaving the tapestry of our intertwined professional lives.

In a moment of need, MB opened his doors and heart, welcoming me into his rented apartment for an entire year when I embarked on the employment journey. His generosity and unwavering support were a testament to the depth of our connection. He stood as a pillar of strength, a beacon of guidance whenever the tides of life grew tumultuous. It is with a profound sense of disbelief and grief that I learned of his passing, a mere four days after our last communication on the 27th of November via WhatsApp.

The news of his departure on the 1st of November shook the foundations of my world, leaving a void that words struggle to fill. Yet, in this time of sorrow, I find peace in the memories we created, the shared laughter, and the indomitable spirit that defined MB Mohammed. As we mourn his physical absence, let our hearts be united in prayers for the eternal peace and tranquillity of his soul. In these days of grief, we turn our hearts heavenward, seeking solace in the divine and entrusting the departed soul to the mercy of Allah.

“Inna lillahi wa inna ilayhi raji’un” – Surely, we belong to Allah, and to Him shall we return. May MB’s soul find tranquillity in the divine embrace, and may his memory continue to illuminate our paths as we navigate the journey of life.

Muhammad Yakubu Abare wrote via muhammadyakubuabare@gmail.com.

By Aliyu Nuhu

I saw a post by a friend advising people not to check their symptoms on internet and should go to hospitals for all their complaints. He was partially correct, but wrong in underestimating the power and importance of internet-based knowledge.

Medicine recognizes home treatment for non emergency medical conditions. But there is a caveat that you should consult a doctor if symptoms persist or get worse.

Always remember that doctors themselves know a lot about their speciality, but they also know little in a vast ocean of knowledge in other fields of medicine. You can know better than them if you choose to read.

My son was given about fifteen medications to take after heart surgery. But because I have knowledge of the disease and drug options,I was able to engage the doctor and at the end the drugs were reduced to four. Take note that I did not reduce the medication on my own. I only used my knowledge of pharmacy to engage the doctor and get him to reduce them himself. Some of the drugs were to be taken for few weeks and to be discontinued. Some were doing the same job and one of them has to go. Some were to alleviate symptoms, and if the child didn’t have the symptoms what was the need for them? Some were for pains from surgery and if the wound was healed there was no need for them. I once educated a doctor for asking a child to take calcium for bone strength, but he obviously didn’t know that the body would need vitamin D to successfully process calcium. Medicine is so vast that doctors must also read the internet to keep abreast.

There are treat-at-home symptoms you can learn from internet. I successfully treated myself for common illnesses through internet and over the counter medications. Why should I for instance go to hospital to treat nail fungus? You are your own best doctor. Arm yourself with knowledge before approaching your doctor.

There are symptoms that you know you need professional help. You know the red flags for potentially life threatening symptoms. When you can’t breathe you don’t need anyone to tell you to rush to get medical help at the hospital. When you have severe headache and other symptoms you never had before you should know that you need an immediate medical emergency.

I know when to see a doctor. The important thing for you is to also know when to see your own doctor. Even when meeting with my doctor, my vast knowledge of medicine prepares me for drug options and procedural choices. Internet makes you even choose the right doctor. If you have blood in your urine check for the possible causes. The regular GP may not detect if your condition is postate cancer. Oncologist knows what other tests to do and confirm if you have the condition. If you have shortness of breath, painful arm, etc, the cardiologist is the person that will know that you need angiogram to know if there is blockage in the circulatory system.

We have good doctors no doubt but always know that we have imposters, some that did not even read medicine in the university. Our hospitals are populated with half-baked professionals that only knowledge could save you from their deadly mistakes.

A whole teaching hospital treated a relative of mine for cerebral malaria when she actually had tuberculosis of the spine. My son was diagnosed with truncus ateriosis when in actual fact he had tetralogy of fallot. Without internet I would have been lost. However, a careful check gave me better understanding of the symptoms and led me to the right laboratory that identified the right disease. Internet led me to the right doctors abroad.

It will be suicidal just to rely on doctors without having elementary knowledge of your symptoms and treatment options. Drugs have side effects and also, interaction issues with other drugs or foods. If you don’t read you won’t know. Your doctor is human and has many patients and will not have time to educate you. Educate yourself. Knowledge is not only power, but in medicine it can be a life-saver.

Aliyu Nuhu writes from Abuja, Nigeria.

By Ibrahim Tukur

Skin bleaching in Africa has become pervasive and a concerning issue with far-reaching consequences. This phenomenon is driven by a complex interplay of cultural, social and economic factors, with detrimental effects on individuals and society as a whole.

Skin bleaching, also known as skin lightening or whitening, involves the use of various products to reduce melanin levels in the skin, resulting in a lighter complexion. While this practice is not exclusive to Africa, it has gained significant prominence in many African countries. The desire for fairer skin is often rooted in deeply ingrained societal beauty standards, where lighter skin is sometimes perceived as more attractive and a symbol of success.

The use of skin bleaching products in Africa has dire consequences for individuals and public health:

Many skin bleaching products contain harsh chemicals such as hydroquinone, tretinoin, and mercury. Prolonged use of these substances can lead to skin irritation, burning sensations, excessive redness, permanent discoloration, and the formation of stubborn pimples that can result in scarring.

Skin bleaching can lead to health issues beyond skin damage. The use of mercury in some products can lead to mercury poisoning, causing a range of serious health problems, including kidney damage and neurological issues.

The societal pressure to bleach one’s skin can take a toll on individuals’ mental and emotional well-being. It reinforces harmful stereotypes and can lead to a sense of inferiority among those who do not conform to the “lighter is better” ideal.

Lightening the skin reduces its natural protection against the harmful effects of UV radiation. This puts individuals at a higher risk of skin cancer, a particularly concerning consequence of skin bleaching.

The widespread use of skin bleaching perpetuates harmful stereotypes and the belief that one’s worth is determined by their skin color. This affects societal cohesion and can exacerbate discrimination and inequality.

Addressing the skin bleaching epidemic in Africa requires a multi-faceted approach:

Governments should impose stricter regulations on the import, sale, and use of skin bleaching products, particularly those containing harmful substances. Banning these products can go a long way in protecting public health.

Comprehensive and targeted public awareness campaigns are crucial to dispel the myths surrounding skin bleaching and educate the population about its risks. These campaigns should promote self-acceptance and the appreciation of diverse beauty standards.

 Providing access to mental health services and counseling is essential for individuals who may suffer from the psychological effects of skin bleaching.

In conclusion, the skin bleaching epidemic in Africa is a pressing issue with far-reaching consequences. 

In conclusion, the skin bleaching epidemic in Africa is a pressing issue with far-reaching consequences. To combat this problem effectively, we must collectively strive to promote healthier beauty standards, protect public health, and support individuals affected by this harmful trend. It is our collective responsibility to create a society where every individual can embrace their natural beauty without feeling pressured to alter their skin colors.

Ibrahim Tukur

Dr. Ismail Muhammad Bello

Beyond hospital settings, harmful practices persist, particularly in developing countries where obtaining drugs over the counter is prevalent, and drug vendors may lack comprehensive knowledge of medications and diseases. From Penicillin to Ceftriaxone, these precious drugs, which require protection, can be obtained without prescriptions, posing a significant threat.

The ease of access to drugs has paved the way for self-treatment or “chemist” consultations, fostering malpractices. Again, a frequent occurrence is the prescription of antibiotics for the common cold. Research indicates that the common cold is predominantly caused by viruses, which are not responsive to antibiotics. It is a self-limiting condition that can be managed with measures such as steam inhalation, antihistamines like loratadine, and decongestants.

Similar to the common cold, most cases of sudden onset of watery stool, not stained with blood or mucus, with or without vomiting, are often of viral origin. This is typically a self-limiting condition that usually does not require antibiotics. In the management of diarrhoea, especially in children, the primary focus is on fluid therapy using Oral Rehydration Solution (ORS). Drug treatment is seldom beneficial, and antidiarrheal (antimotility) drugs can be harmful. Unfortunately, many individuals quickly resort to taking Flagyl, Loperamide, or Lomotil at the onset of diarrhoea.

However, bloody or mucoid stool, high fever, severe abdominal pain and prolonged diarrhoea are pointers to more serious conditions that may warrant antimicrobial use and should be quickly evaluated by a qualified doctor. In such instances, the use of antimotility agents is highly discouraged as it could lead to catastrophic outcomes like bowel perforation.

Another problem that continues to fuel this issue is the widespread and perplexing “Malaria-Typhoid diagnosis.” The lack of clinical skills needed to appropriately discern acute febrile illnesses coupled with excessive reliance on the outdated Widal test is driving an alarming prevalence of this peculiar diagnosis. 

Most cases exhibit a sudden onset of high-grade intermittent fever with chills and rigours, particularly worsening in the evening. This is usually associated with generalized body weakness and pain, with no symptoms attributable to the gastrointestinal system (abdomen). In a region and time where malaria is quite prevalent, this most likely suggests a simple case of Uncomplicated Malaria that should be managed as such. Strangely in our setting such cases are quickly subjected to not only Malaria but also Widal (Typhoid) tests at the request of a healthcare worker or even on self-referral.

Numerous studies have consistently demonstrated that the Widal test lacks high specificity, particularly in endemic zones such as ours, where repeated exposure to the bacteria is prevalent. Cross-reactivity with various diseases, including Malaria—a frequent cause of fever in Nigeria—and challenges in interpretation further restrict its reliability as a diagnostic indicator. 

It is therefore evident that the indiscriminate demand for the Widal test is causing the over-diagnosis of Typhoid fever, leading to the inappropriate use of antibiotics. 

This practice has also led to the wrong notion of “chronic symptomatic typhoid” among gullible persons. Typhoid fever is not in the league of HIV & Hepatitis B. Infection in typhoid does not endure indefinitely but could recur, especially when the underlying risk factors like unsafe water and poor hygiene persist. 

Chronic carriers do exist but are typically asymptomatic, holding more significance for public health due to their ongoing shedding of bacteria in their stool, a phenomenon reminiscent of the famous story of Typhoid Mary. Hence, statements like “Typhoid dina ne ya tashi” (I have a flare of a longstanding typhoid infection) and “Typhoid dina ne ya zama chronic” (I have a chronic typhoid infection) are grossly inaccurate.

While not antibiotics, antimalarials, unfortunately, face their fair share of misuse. A prevalent mispractice involves the irrational use of injectable antimalarial drugs such as IM Arthemeter and even the almighty Artesunate. Nowadays, individuals often opt for injections, citing reasons like “I prefer not to swallow pills” or the perception of faster and more effective results. The most concerning scenario occurs when the condition is misdiagnosed as Malaria, especially in many “chemist” settings. This not only entails misuse but also results in economic waste, unnecessary stress, and the potential risks associated with injections.

Regrettably, injectable antimalarials are meant for treating severe forms of malaria, which someone walking into a chemist likely does not have. This is akin to deploying elite special forces for a minor crime. These forces should be mobilized only for significantly heightened threats or when the situation surpasses the capacity of initial responders.

Recommendations: The government plays a crucial role in this battle. Policies and regulations must be established to ensure the optimal utilization of these drugs. To address our persistent issue, these policies should not remain mere documents in offices but must be strictly enforced, with penalties imposed on those who violate them. These regulations should encompass various aspects, including the use of antibiotics in veterinary practice and food production, as well as proper oversight of the opening and operation of patent medicine stores.

Prevention is certainly better than cure. Tackling infectious diseases at the primary level is more impactful and cost-effective. The COVID-19 pandemic has underscored the significance of Water, Sanitation and Hygiene (WASH) in disease transmission & control. Hand hygiene, a practice widely adopted in 2020, stands out as the most crucial measure to prevent the spread of infections. Therefore it is crucial to provide communities with access to potable water and sufficient sanitary infrastructure to forestall the spread of these diseases in our society.

In managing most infections, a standardized treatment guideline outlines the specific drugs, their timing, and proper usage. You might be intrigued to discover that many practitioners may not even be aware of a specific Nigeria Standard Treatment Guideline document or other guidelines for various medical conditions.

In the absence of a local protocol, variations in management may arise among colleagues due to diverse backgrounds and training. Nowadays, particularly in secondary healthcare, many learn primarily through apprenticeship without referring to standards or understanding the rationale behind certain “innovative” practices. Unfortunately, what one is accustomed to may be incorrect and potentially harmful, or at best suitable only within the constraints commonly found at lower levels of healthcare.

Therefore, despite the challenges in our setting, doctors must prioritize continuous medical education to stay updated on global trends and standards while navigating the complexities of our setting. These innovations should not only be embraced as centre-specific practices or based on individual preferences like “this is how we do it in our centre” or “this is how Prof XYZ does it,” but they should also serve as opportunities for research and scientific validation.

Also, hospitals should formulate treatment protocols tailored to their unique circumstances, disseminate them widely, offer them as job aids at points of care, and ensure strict adherence by practitioners.

Furthermore, healthcare practitioners should dedicate time to counsel patients about the significance and potential risks associated with adhering to the prescribed dosage and duration of treatment. In well-established hospitals, it is imperative to institutionalize antimicrobial stewardship to ensure effective utilisation and surveillance of resistance patterns. 

Ultimately, this is a battle declared by the microbial world on humanity, and everyone has a crucial role to play. Individuals should actively seek sound medical advice regarding diseases and treatments, avoiding the inclination to resort to self-help or patronize quacks. So when you take antibiotics for a simple common cold, know that you may be endangering humanity. When you fail to complete your antibiotics for the duration prescribed, you are surely endangering humanity. When you continue to treat typhoid when it is not the culprit, you are harming the patient and the world at large. Even you the medical practitioner, if you prescribe inappropriately, you are hurting the system.

Lastly, I encourage everyone to be advocates for responsible antibiotic use. Let’s utilize these valuable and endangered assets judiciously to avert a future where no drugs can cure pneumonia, syphilis, or meningitis – a potential regression to the 19th century. Remember, this is natural selection in action – it is not a lost battle but a fight for survival, one that we must undoubtedly triumph in. Dr. Ismail Muhammad Bello is a proud graduate of ABU Zaria. He is a Malnutrition Inpatient Care trainer and currently serves as a Medical Officer at both Khalifa Sheikh Isyaka Rabiu Paediatric Hospital in Kano and Yobe State Specialists Hospital in Damaturu. He can be reached at ismobello@gmail.com

By Bello Hussein Adoto

One, two, three. Every three seconds, someone somewhere is receiving blood, and they don’t know where it comes from. The person could be an accident victim with a broken leg, a woman bleeding after birth, a sickle cell patient hanging on to life, a man with haemophilia whose blood just won’t clot, or a snakebite victim whose cells are lysing away.

Three seconds. Someone is on the bed, being saved with another person’s blood. That blood could be yours—one pint drained from your body in ten minutes every three months (men can donate up to four times a year). Sometimes, it doesn’t take more than that to save a life.

Unfortunately, many people don’t donate blood because they frown at the idea that hospitals “sell” the blood they donate for free, so it is better that they don’t feed what they see as an unwholesome trade. Why should we donate blood for free if recipients have to pay for it? Let’s unpack the answer.

Blood is free. Hospitals—public ones, at least—don’t sell blood.

They collect service charges ranging from five to eight thousand naira in public hospitals to cover the cost of screening, collecting, bagging, storing, matching, and transfusing blood. The service charge is like revolving funds that keep the blood flowing from the donor to the patient.

Is it criminal? Not quite. Hospitals get blood from unpaid voluntary donors and relatives of transfusion recipients who donate to replace the blood their loved ones received. A third source is those who get paid for donating blood. However, getting blood from paid donors is discouraged for ethical and safety reasons. Whatever the source, blood recipients are required to pay processing fees to cover the cost of getting blood and transfusing it safely.

Let’s face it. Healthcare is subsidised, but it’s not free. The government can only pay for so much. Hospitals need facilities to receive donors and collect their blood. They need equipment, test kits, and reagents to screen the blood; bags and anticoagulants to keep the blood fluid and aseptic; storage units to keep the blood stable enough to be useful to the patient. These cost money and that’s the service charge that patients and their relatives pay.

The need for blood for voluntary blood donation is high in Nigeria. According to a recent National Blood Services Commission (NBSC) report, only 25% of blood transfusion demand is met in Nigeria. Unpaid voluntary donation closes the demand gap for blood donation. It makes blood available to patients, especially those with rare blood types and those needing many pints of blood.

While you are welcome to share your concerns about patients having to pay for blood, please don’t let that discourage you from donating. People need blood, and that need is critical. Malnourished children, pregnant women, people with severe malaria, and those with sickle cell disease are among the top groups in this category.

Your blood could be the difference between someone staying alive or dead. Imagine your younger sister or a parent desperately needs blood, but blood banks and reserves are depleted due to a lack of willing donors. What do we do then? Even if you worry that recipients will eventually have to pay for it, your blood gives them something to pay for.

Besides, your donation makes blood available so that desperate patients and their relatives don’t have to get it from the so-called black market, which is more expensive.

Beyond donating, you can raise awareness for other people to donate. As of 2022, only 8% of transfused blood in the country was voluntarily donated. We need more unpaid voluntary donations to make blood more accessible to those in need.

Transfusible blood is obtained only from humans. We can’t manufacture blood like normal saline or get it from animals like insulin. So, people need to donate blood.

We must also make the case for better investment in our health system. Many public hospitals across the country cannot collect or store blood. They often ask patients’ relatives to look for donors or collect and keep blood that may not be useful for transfusion. Better hospital facilities and more laboratory supplies will buffer these limitations and improve the quality of blood transfusion in Nigeria.

While I don’t deny that unscrupulous elements could profit from the blood trade, we need to see the bigger picture. Blood donors serve a great need. Your donation makes blood readily available and accessible to everyone. So, please, go out there and donate. You are saving a life.

Adoto, a researcher, writer, and journalist, writes via bellohussein210@gmail.com.

By Muhammad Suleiman Yobe.

Jigawa State Ministry of Health has confirmed 141 new cases of Cerebrospinal Meningitis that claimed eight lives in the state.

The ministry’s Permanent Secretary, Dr Salisu Mu’azu, confirmed the cases to Daily Reality in Dutse, the state capital.

The Permanent Secretary, who spoke through Dr Sabi’u Muhmmad of the disease control department in the ministry, outlined some areas in Kaugama, Birniwa, Gumel, and Maigatari Local Governments the cases were identified.

Dr Muhammad said 134 out of the 141 patients were infected by Neisseria Meningitis type C, and 6 contracted Strept pneumonia while one was identified with Neisseria Meningitis type X and among the cases identified, about eight death were recorded.

He said that all measures had been put in place to avert the pandemic. He further advised communities in the affected areas to be conscious and refer a suspected case to the nearest general hospital for all necessary action. The state government has procured free medication for patients with such cases.