healthcare

Sexually Transmitted Infections – Dangers of stigmatization

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Sexually Transmitted Infections (STIs) or STDs, also known as venereal diseases, are infections or diseases that are passed from one person to another through sexual contact – usually spread by having vaginal, oral, or anal sex. Bacteria, viruses, or parasites that are on the skin or mucus membranes of the genital area or are present in semen, vaginal secretions, saliva or blood, can be transmitted from one person to another.

What are the symptoms of STIs?

Many STIs have only mild symptoms or none at all. Symptoms in women could easily be mistaken for a urinary tract infection or common yeast infection. Usual symptoms of STIs include burning sensation during urination, itching, swelling or sore in the genital area, pelvic pain/painful intercourse and vaginal/penile discharge. Sometimes women may have a change in color, odor and/or thickness of their usual vaginal secretions.

 

 

The stigma of STIs

Research conducted in Kenya and Nigeria showed interesting findings. Men were more likely than women to seek treatment for STIs. Women tend to bear the bulk of the stigma attached to STIs, with infections often being seen as a sign of promiscuity. As a result, women may choose not to confide in anyone, even if they have an unusual discharge or a sore.

 

The majority of young women who reported at least one STI symptom were married and may have been infected by their husband. Married women, out of fear of possible repercussions, may choose to treat their STIs themselves rather than risk going to a public health facility that might share their information with their husband. In fact, many women who experience such STI symptoms as vaginal discharge and genital itching do not regard them as serious or as the result of sexual intercourse and, therefore, do not believe that they need to be treated.

 

Stigma-related violence or the fear of violence and other stigma prevents many people from seeking testing (especially HIV testing), returning for their results, or getting treatment, possibly turning what could be a manageable illness into a death sentence and continuing the spread of STIs.

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Testing

If you suspect you have an STI, it’s important to get tested. The sooner you know, the sooner you get treated and the less likely you are to spread the infection. Testing can be done at health centers, general hospitals, family planning clinics, state teaching hospitals, private health facilities and designated HIV test centers.

 

Anyone who tests positive for any STI should get tested for HIV and other STIs and follow up with testing for partners. Doctors often recommend treatment for you and your partner but keep in mind that the STI may have been contracted from a former sexual partner.

Anyone who tests positive for HIV should:

  • Get screening and treatment for other diseases like Tuberculosis, Malaria and other STIs
  • Follow up with testing for partners and children

It is troubling that recent estimates report that only 51% of people with HIV know their HIV status. HIV testing can be done confidentially or anonymously.

 

Treating STIs

Bacterial and parasitic infections, such as Chlamydia, Gonorrhea, and Syphilis can be treated and cured with antibiotics.

Viral STIs such as Genital Herpes (HSV-2), HIV/AIDS and Hepatitis B & C cannot be cured. They can be managed with medications to help reduce the signs and symptoms of the illness related to the infection as well as its complications.

  • For all of these sexually transmitted diseases, it is important to note that EARLY DETECTION is the key to a good outcome.

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How can you prevent STIs?

 

The only fail-safe way to prevent an STI is SEXUAL ABSTINENCE!

 

If you do have sex, lower your risk of getting an STI with the following steps:

  • Limit your number of sex partners – Your risk of getting STIs increases with the number of partners you have
  •  Be monogamous – Having sex with just one partner can reduce your risk for STIs
  • Get vaccinated – There are vaccines to protect against HPV and Hepatitis B.
  • Use a Barrier Contraceptive – Condoms are the best way to prevent STIs when you have sex.
    • Oral contraceptives and implanted devices, do NOT protect from STIs
  • Get tested – Be sure you and your partner are tested for STIs. Talk to each other about the test results before having sex
  • Avoid douching – It removes some of the normal bacteria in the vagina that protects you from infection. This may increase your risk of getting STIs.
  • Do not abuse alcohol or drugs – Drinking too much alcohol or using drugs increases risky behavior and may put you at risk of sexual assault and possible exposure to STIs

 

These steps work best when used together. No single step can protect you from every single type of STI.

 

 

Is there Stroke in your family? By Dr Biodun Ogungbo

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Stroke is sudden weakness of an arm, or leg, sudden blindness, sudden confusion, sudden problems with speaking, difficulty walking, sudden severe headaches, sudden collapse and death. Stroke is due to blockage of a blood vessel carrying blood to the brain, leading to injury or death of that part of the brain. Stroke also occurs when a blood vessel bursts open inside the brain. This is why it occurs ‘suddenly’ as the tap carrying food to the brain gets turned off! In both situations, the brain does not get the food and oxygen it requires.

Stroke: Time is brain

Stroke, is an emergency and requires immediate action to prevent brain damage and death. Stroke causes injury because vital nutrients are not delivered to the brain; and so brain tissue dies. This happens in real  strokes, but there are also minor strokes, partial strokes in which the brain does not die or become permanently injured. These people recover almost perfect function. But, see below.

Stroke: Big or small

 

Minor strokes, mini-strokes, small strokes and transient ischemic attacks (TIAs) are one and the same. TIAs are common events characterized by stroke symptoms that completely resolve. They were previously thought to be benign but research over the past decade has revealed the high risk of further strokes in these patients. Having a TIA is a risk factor for having a major stroke.

 

TIAs and strokes cause the same symptoms, such as paralysis (opposite side of body from the affected part of the brain) or sudden weakness or numbness. A TIA may also cause sudden dimming or loss of vision slurred speech and mental confusion. But unlike a stroke, the symptoms of a TIA can resolve within a few minutes or 24 hours. Brain injury may still occur in a TIA lasting only a few minutes, therefore it should not be ignored by patients, relatives or doctors. Small stroke is a warning from God!

 

Stroke is common in Nigeria

 

Every Nigerian knows someone within their family, on their street, at their place of work, village or town who has suffered a stroke. Stroke is next door and coming to a street near you! It is the most popular horror movie in life. That someone hale and hearty could suddenly go blind, deaf, become mute, have weakness on one side and die without prior warning is your worst nightmare. Stroke is a devastating illness, which maims and kills Nigerians daily.

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Is there stroke in your family?

Has a member of your family suffered a stroke? Mine have, in large numbers. Many people in my family have suffered devastating strokes and I am trying everyday to prevent stroke in myself. I run, jog, do sports, exercise and watch what I eat on a daily basis. Any indulgence, eating the biggest meat in the pot, the most amount of food, fat or oily food etc is frowned at in my family.

 

The risk of further strokes in higher in families with a history of stroke. If your father, brother or sister has had a stroke, be very careful. Similarly, history of hypertension, diabetes and heart attacks are important as risk factors for stroke in the family.

 

Can you afford a stroke?

 

We are not managing stroke well at all. We do not have the emergency numbers and ambulance services to deliver patients to hospitals within an hour of a stroke, so doctors can at least try to reopen the blocked vessels in the brain. We do not have the clot bursting drugs for removing the obstruction. Brain scans and other required tests cost an arm and a leg (pun intended). We do not have the means to investigate and treat acute stroke without asking for money.

 

So, if you come to one of Nigeria’s premier hospitals without as much as N100, 000 (One hundred thousand Naira), you may not get the immediate life saving care you need. Many come with just prayers and a breath expecting miracles.

 

Open a stroke account

 

It is vital to prevent stroke. If you don’t, you might as well open an account where you can save money should you suffer a stroke! The minimum deposit is N100, 000 but please save as much as N3, 000, 000. (three million Naira only). Regardless, just because you can afford it, is no excuse to have a stroke! What if you cannot write a cheque or even remember the account password? So, please look after your blood pressure, control diabetes, stop smoking, lose weight, exercise and keep fit.

 

Dr Biodun Ogungbo, Consultant Neurosurgeon in Abuja is a UK General Medical Council Registered Specialist in Neurosurgery and Nigerian Medical and Dental Council registered Surgeon. He has extensive surgical repertoire in elective and emergency surgery. He supports medical education and is active in health advocacy. He is interested in stroke and spine problems and has written extensively about these conditions.

How a little infection can kill you (2) By Dr. Biodun Ogungbo

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The most minor infections can lead to sepsis. Sepsis is an extremely serious condition, due to an overwhelming reaction of the body to infection. The infection causes the body to release chemicals as a defence mechanism. However, the chemicals themselves can cause widespread inflammation, which can then damage the body organs and cause death. Sepsis is a medical emergency.

 

Anyone can get sepsis, but the elderly, young children and those who have diminished immunity as a result of some other medical condition, are particularly at risk.

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How is it treated?

  1. Broad-spectrum antibiotics – these are medicines that kill many types of bacteria.
  2. Oxygen and intravenous fluids

The truth is that a little infection can lead to much misery and death if ignored. A little thing like the flu, common cold, catarrh, mosquito bite, bug bite and even that nail puncture can be the harbinger of misfortune. A man who stepped on a fish bone nearly died 2 weeks later from sepsis through the tiny wound on the sole of his feet! Carelessness can be perilous.

Sometimes, it is self medication, a visit to the local chemist or an unsuspecting medical doctor that makes a little issue assume mammoth proportions. Sometimes, it is ignorance and nonchalance that compounds the problem. Sometimes, it is articles like this that save lives.

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What should you do if you think you have an infection or sepsis?

  • Go to the emergency room immediately if you have any signs or symptoms of an infection or sepsis. THIS IS A MEDICAL EMERGENCY.
  • It’s important that you say, “I AM CONCERNED ABOUT SEPSIS.”
  • If you are continuing to feel worse or not getting better in the days after any kind of surgery, ask your doctor about sepsis. Sepsis is a common complication of people hospitalized for other reasons.

 

What you can do to prevent sepsis

  • Get yourself and your children vaccinated against pneumonia, and any other infections that could lead to sepsis. Talk to your doctor for more information.
  • Prevent infections that can lead to sepsis by:
    • Cleaning scrapes, cuts and wounds properly
    • Practicing good hygiene (e.g., hand washing, bathing regularly)
  • If you have an infection, look for signs like: fever, chills, rapid breathing and heart rate, rash, confusion, and disorientation.

Guidelines for what to do in case of infection and to prevent sepsis are from The Centers for Disease Control and Prevention (CDC).

 

Dr Biodun Ogungbo, Consultant Neurosurgeon in Abuja is a UK General Medical Council Registered Specialist in Neurosurgery and Nigerian Medical and Dental Council registered Surgeon. He has extensive surgical repertoire in elective and emergency surgery. He supports medical education and is active in health advocacy. He is interested in stroke and spine problems and has written extensively about these conditions.

 

Preventive Healthcare – An Investment For Life

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Suppose someone gave you a hundred million naira, as a gift? Now, imagine that you are offered the chance to make a sound, sure proof investment with that money that will yield another hundred million naira.

 

Sounds like everyone’s dream right? Would you take the offer? Surely that’s a no-brainer – of course we’d all jump at the offer!

 

You already have that gift – it’s called life. It is priceless, worth way more than a hundred million naira! You can take ownership of this gift by not being careless with your health and investing wisely through preventive health care. The goal of preventive health care is to help you live a healthier and happier life by improving your health and preventing disease.

 

Times are tough for just about everybody right now. There are so many financial responsibilities and obligations that your already tight budget cannot manage. There’s a reason though that the expression “health is wealth” exists. Making the time and setting aside the funds for well doctor visits for you and your children are worthy investments that will pay off in the long run. The alternative is what most of us practice now – expensive curative care – where we see the doctor only when we’re really sick. The problem with this kind of health care is that it doesn’t give you the tools to prevent future illness.  It also places you in a situation where you have to pay the doctor and hospital when you can ill afford it but have no choice.

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Adults

Regular well-care doctor visits make it easier to detect diseases like hypertension, diabetes, heart disease, and even certain types of cancer early when they are easy to treat and before they lead to serious complications. It’s a good idea to see your doctor when you’re well at least once a year for a thorough examination, any necessary preventive health screenings, and tests. A good time to schedule one is around the time of your birthday. During your well-care visit, you and your doctor will discuss various ways to improve your overall health and prevent disease.

 

Children

For your children, regularly scheduled checkups, often called well-child visits, should begin shortly after birth and continue through the teen years. These visits allow the doctor to keep a close eye on your child’s general health, growth and development. Finding possible problems early gives your child the best chance for proper and successful treatment. Also, any concerns you have about your child can be discussed during these visits. Well-child visits are also an opportunity to ensure that vaccinations are up to date and are given to the child if necessary.

 

Make the sacrifice now and include well care visits for the whole family in your budget. It’s way more important than some of the other things we spend money and time on such as clothes, jewelry, cars and parties.

Eat to live, don’t live to eat.

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You’ve probably heard and read so much about healthy eating that you’re sick and tired of it all.

It just seems like too much work and no fun! The fact none of us can get away from however is that healthy eating, like fitness, is one of the pillars of a healthy lifestyle.

 

Understanding some basic principles of nutrition will help it all make sense and perhaps even spur you on to take that leap into a healthier future. It is never too late to make good lifestyle changes that improve your chances of living long and living healthy.

 

Metabolism and why it’s important

Metabolism refers to the biochemical processes that your body uses to carry out basic functions, such as breathing, keeping your heart pumping, digestion, controlling body temperature, brain function, and cell growth. Basal Metabolic Rate or BMR is the amount of energy, measured in calories, that is needed to allow your body to carry out these basic life functions at rest or when sleeping. Basal metabolic rate (BMR) affects the rate that you burn calories and is an important factor in whether you maintain, gain, or lose weight.

 

Several factors affect your BMR including age, genetics, weight, body fat percentage, your general state of health and gender. The lower your BMR, the more likely you are to be overweight. Your BMR slows down at roughly 5% every 10 years after the age of 20. This is why you gain weight, as you get older, if you maintain the same eating habits. Women have a lower BMR than men, because men usually have a lower percentage of body fat and a higher percentage of muscle. The higher your body fat percentage the lower your BMR.

 

Your total daily calorie requirement is the amount of calories needed for basic body functions, and any activity you do. It is equal to your BMR plus the calories needed for activity. The more active you are, the more calories you will expend or burn.

 

Total Daily Calorie Requirement:

  • Sedentary(little or no exercise): BMR x 1.2
  • Lightly active(easy exercise/sports 1-3 days/week): BMR x 1.375
  • Moderately active(moderate exercise/sports 3-5 days/week): BMR x 1.55
  • Very active(hard exercise/sports 6-7 days a week): BMR x 1.725
  • Extremely active(very hard exercise/sports and physical job): BMR x 1.9

An active person burns up to one and a half times more calories than a sedentary person.

 

What goes in must come out

If you eat more than your body needs daily (BMR + your activity level), you will become overweight – that’s the bald truth. Here’s the good news – if you can increase your activity level a little and eat more nutritious foods, you can begin to correct the results of years of unhealthy eating habits.

 

Eating more calories than you expend = weight gain, as extra calories are stored as fat.

Eating the same calories as you expend = maintain your weight as there are no extra calories.

Eating fewer calories than you expend = weight loss, as your body uses up stored fat for additional energy.

 

Join us as we discuss good and bad foods in our next post.

Is it possible to reverse diabetes?

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You’ve probably read claims from people saying they reversed their diabetes within 4 weeks and perhaps even seen advertisements for “natural” products that “cure” diabetes. Is it really possible to cure diabetes or reverse it?

 

Diabetes is a disease in which the body is unable to properly use and store glucose (a form of sugar). Glucose backs up in the bloodstream — causing one’s blood glucose (sometimes referred to as blood sugar) to rise too high. Blood sugar (glucose) is the body’s main source of fuel for energy. Insulin is the hormone that the body makes to help us use and store glucose properly.

 

Experts believe that by the time someone is diagnosed with Type 2 diabetes, the condition has been going on for five to ten years and the person has lost more than half of their body’s ability to make insulin. There is no magic bullet, no natural product or special formulation that can reverse damage to the body that has occurred over a period of several years.

 

More than ten years of research by the National Institute of Health (NIH) Diabetes Prevention Program on people with normal blood sugar levels, patients with prediabetes and those with Type 2 diabetes, show that losing weight and keeping it off, eating healthy and exercising 150  – 175 minutes per week delays the onset of prediabetes, delays progression of prediabetes to type 2 diabetes, or slows the progression of type 2 diabetes.

 

In another study, by following the same regimen and limiting daily intake of calories, 10% of patients with diabetes were able to get off medications within a year. The best results were in those who lost the most weight, had less severe diabetes from the start or were newly diagnosed with diabetes.

 

The term ‘reversal’ is used when people are able to stop using medication but must still maintain a healthy lifestyle program in order to stay off the meds. Lifestyle changes are crucial to managing diabetes. Reversal depends on how long you’ve had the condition and how severe it is. Your genes play a role too and so you can be thin and still develop diabetes.

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The conclusion:

There is no “cure” for diabetes but with lifestyle changes it is possible for some people to reverse diabetes. For others a combination of a healthy lifestyle and medications will keep blood sugar levels at their best.

 

Move more – Physical activity is an essential part of the treatment plan for diabetes, because it lowers blood sugar levels and decreases body fat. Your goal is to exercise at least 30 minutes a day, five days a week.

 

Lose weight – Studies show that as little as 5% – 10% weight loss (4.5kg to 9kg weight loss for a 90kg person) makes a difference, slowing the progression of diabetes, reducing cholesterol and triglycerides and reducing blood pressure.

See your doctor every 2 – 3 months – to make sure you’re on track and for encouragement

Eat better – low fat, low salt, low carbohydrate, lean protein, high fiber, vegetables, fruit

Get enough sleep – 7 – 8 hours daily

Get support – surround yourself with positive influences, enlist people to hold you accountable

Choose life – commit to a healthy lifestyle program

Zika virus continues to dominate health news

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Zika virus continues to dominate health news and is causing a major health scare throughout the Americas. An outbreak of the virus, which started in Brazil in May 2015 is spreading explosively and now involves several countries in the South/Central American and Caribbean region. Cases have also been reported in Australia, Ireland, and in the U.S., all of which are related to recent travel to affected countries. One case in Texas may have been contracted through sex with a partner who had recently returned from Venezuela.

 

This outbreak is significant because it has brought to light the possibility that Zika virus may be dangerous to pregnant women and their babies. Health officials, including the WHO and Centers for Disease Control and Prevention (CDC), now “strongly suspect” a link between this recent outbreak of Zika and an increase in neurological problems and a condition called microcephaly in which babies are born with unusually small heads.

 

The World Health Organization on Monday Feb 1, 2016 declared the spread of the Zika virus a global public health emergency, signaling the seriousness of the outbreak. It is estimated, that up to 4 million people could be infected by the end of the year.

 

What is Zika virus?

Zika virus was first discovered in a monkey in Uganda in 1947, and is named after the Zika forest where it was discovered. Similar to the viruses that cause yellow fever and Dengue fever, it is native mainly to tropical Africa, with outbreaks in Southeast Asia and the Pacific Islands. The Brazil outbreak is the first time the virus has been documented in the Americas.

 

Studies conducted in Nigeria as far back as 1968 and during 1971–1975 showed that up to 40% of the persons tested had evidence of previous Zika virus infection. In the studies, children as young as 10 months old and up to 10 years of age who had fever, tested positive for Zika virus.

 

How Does Zika Spread?

It is spread by mosquitos, which carry the Zika virus from person to person in a manner similar to malaria transmission. The Aedes mosquito (tiger mosquito), which carries the virus, bites during the daytime and is different from the mosquito, which carries malaria.

 

If a pregnant woman is infected, the Zika virus can be transmitted to her baby while she is pregnant or around the time of birth. Transmission from person to person, through infected blood or sexual contact though rare, also occurs.

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What are the symptoms?

The illness is usually mild with symptoms lasting from two days to a week, followed by full recovery.  Only 1 in 5 persons infected develops symptoms and severe disease requiring hospitalization is not common. Symptoms include fever, rash, joint pain, and conjunctivitis (red eyes). Some people also may experience headache, muscle pain or vomiting.

 

The possible link to birth defects, including microcephaly has health experts concerned. In microcephaly, a baby is born with a small head because of under-development of the brain. It is unclear however if the increase in microcephaly cases is directly caused by Zika or if other factors are involved. Case control studies are to begin in two weeks to determine if Zika virus is implicated.

 

The other concern is the development of Gullain-Barre syndrome in some patients, a neurological complication in which the body’s immune system attacks its own nervous system causing weakness and sometimes paralysis.

 

Travel Warning for Pregnant Women

The CDC recommends that pregnant women avoid traveling to areas where Zika virus has been reported. Health officials have even gone as far as recommending that women in the affected countries in South/Central American and Caribbean avoid pregnancy during this outbreak.

 

What should you do if you have Zika?

There is no specific treatment for Zika and the development of a vaccine is at least 10 years away. Simply treat the symptoms:

  • Get plenty of rest
  • Drink fluids to prevent dehydration
  • Take medicines such as acetaminophen or paracetamol to reduce fever and pain

 

Do not take aspirin or ibuprofen or other non-steroidal anti-inflammatory drugs. The symptoms of Zika are similar to Dengue fever and aspirin or ibuprofen can cause severe, often fatal bleeding in patients with Dengue fever.

 

Preventing Zika virus infection

Avoid mosquito bites by covering up, use insect repellent and keep windows closed or screened.

 

Clean up standing water where mosquitos can breed and fumigate your surroundings.

Wrong Diagnosis – Whose fault? By Dr. Chika Nya-Etok

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I write a column in a newspaper titled “Your Health, Your Choice” and the following story illustrates exactly what I mean.

 

Twenty-five year old John was not feeling well at all. He had had quite a bit to drink at his elder brother’s traditional marriage ceremony two days before and developed the symptoms the next day. He knew it was just a hangover plus. But he became a little worried when he developed a fever that persisted. He decided to visit the clinic and have the doctor check if he was suffering from malaria. He had heard the jingles on the radio advising that malaria should be treated promptly within 24 hours of onset of symptoms to avoid complications that could become life-threatening. But since they also insisted that malaria should be treated using the most effective drugs, Artemisinine Combination Therapy (ACT) ONLY, AFTER CONFIRMATION by testing, he asked the doctor for the malaria test.

 

Having had consultations in the past where the doctor warned him about his frequent bouts of high alcoholic intake at parties, he was not going to tell her about the nagging abdominal pains that he had been experiencing even before the fever started. The malaria test gave a positive result and he went home with the prescribed antimalarial drugs.

 

Later that evening, the abdominal pains became excruciating and he started vomiting. He managed to endure it till morning when he was rushed into the emergency room of the hospital.

 

The doctor was genuinely perplexed. How did things get so bad, she asked John. Now he knew he had to tell the whole story because he thought he might be dying! “Doctor, I’m sorry I didn’t tell you everything when I came to the clinic yesterday. I’ve been experiencing these abdominal pains for three days now but I thought it was because of my excessive alcohol consumption at my brother’s engagement. I knew you wouldn’t approve so I left it out of my complaints. Please help me!”

 

After a thorough physical examination and laboratory investigations, a diagnosis of acute appendicitis was made and John had immediate surgery for removal of the inflamed appendix. He made a full recovery and the next week he was back on his feet and going about his business as usual.

 

So, in your opinion, whose fault was it that John was misdiagnosed with Malaria instead of Acute Appendicitis?

 

Your Health, Your Choice!

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There is a serious and urgent need to recognize that, in order to significantly improve your state of health and well-being, you must be an active participant in decision-making concerning your healthcare.

 

The doctor/nurse or other practitioner make diagnoses based on the history the patient gives them and their own clinical findings plus or minus results of laboratory and other tests. They do not function like native doctors who divine and hear from supernatural sources what the problems are by just looking at their client. Keen observation of bodily functions, clear explanation and full disclosure by a patient to the doctor are very critical to ensuring that diagnostic errors are minimized. The choices you make are just as important in seeking and applying preventive health information as they are in taking decisions about when and where to go for treatment when there are symptoms and signs of ill-health.

 

Your Health, Your Choice!

 

Dr Chika Nya-Etok is a former Country Medical Adviser of Unilever Nigeria, and is the Principal of HealthWise Concepts in Nigeria. She has been a guest expert on episodes of The HealthZone. Her passion is the dissemination of health information with a view to empowering the individual towards positive behavioral change for health promotion and disease prevention.

Complications of Pregnancy and Childbirth Pt 2

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Did you know that every year more than a million children lose their mother as a result of her death in pregnancy or childbirth?

Why is all of this important?

These children are up to 10 times more likely to die prematurely than those living in families with a mother. They are also less likely to receive proper nutrition, health care and education.

The implications of a mother’s death are particularly great for her daughters, often leading to a continued cycle of poverty and poor health.

There is also significant economic impact, as it is estimated that over $15 billion in productivity is lost due to maternal and new-born death – a huge burden for Africa’s developing nations.

There are three main areas of focus for preventing complications during pregnancy and childbirth:

  1. Health Education
  2. Access to antenatal care
  3. Skilled health care during childbirth

Health Education:

Educating women and communities about birth planning and emergency preparedness during pregnancy, as well as the danger signs of both maternal and new-born complications is crucial to saving lives.

Signs that require immediate medical attention during or after childbirth include:

Mother:

  • If her waters break but she is not in labor after six hours
  • Labour pains that continue for more than 12 hours
  • Heavy bleeding (soaks more than two to three pads in 15 minutes)
  • Placenta not expelled one hour after the birth of the baby

Baby:

  • Difficulty breathing (no cry at birth)
  • Not able to feed
  • Fever (>38°C) or feels cold (<35.5°C)
  • Very small (less than 1,500 grams or born earlier than 32 weeks/8 months)

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Access to Antenatal care

A quarter of all maternal deaths occur during pregnancy. Every woman who is pregnant should receive antenatal care – it may involve traveling long distances to the nearest health centre but it is worth the effort and cost to ensure the wellbeing of the expectant mother and unborn child.

The WHO recommends a minimum of 4 antenatal visits.

  • First visit should be early at 2 to 3 months of pregnancy (1st stage of pregnancy)
  • Second visit at 6 months of pregnancy (2nd stage of pregnancy)
  • Third visit at 7 to 8 months of pregnancy (3rd stage of pregnancy)
  • Fourth visit at 8 to 9 months of pregnancy (3rd stage of pregnancy)

Skilled health care during childbirth

It is particularly important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death. Clinical officers, midwives, and nurses in health canters must be trained to become competent in identifying and managing maternal and new-born complications

 

 

Lassa fever – Why You Should Be Worried

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It has been confirmed that there is a new outbreak of another haemorrhagic fever (Lassa fever) across 10 states in Nigeria. Over 86 people have been infected, with 40 deaths – that is a 46% mortality rate. Nearly half of infected persons have died so far, should you be worried?

 

What is Lassa fever?

Lassa fever is a severe and often fatal viral hemorrhagic illness caused by Lassa virus. It is is highly contagious, and can spread rapidly. Viral haemorrhagic fevers (VHFs) are a group of illnesses caused by viruses, which include the Ebola and Marburg, Lassa fever, and Yellow fever and Dengue fever viruses. VHFs have several similar features:

 

  • They affect many organs
  • They damage the blood vessels causing hemorrhage (bleeding)
  • They impair the body’s ability to regulate itself

 

Discovered in 1969 in the village of Lassa in Borno State, Nigeria, Lassa fever has caused countless outbreaks of various magnitude and severity across West Africa, where it is now endemic. In some areas of Nigeria, Sierra Leone and Liberia, it is known that 1 out of every 6 people admitted to hospitals every year have Lassa fever, which indicates the serious impact of the disease in this region.

 

How do you get Lassa fever?

Humans contract the virus primarily through contact with the Multimammate rat (Mastomys rodent), which is the natural reservoir for the virus. The infected rats shed the virus in their urine and feces and direct contact with these materials, through touching soiled objects, eating contaminated food, or exposure to open cuts or sores, can lead to infection.

 

  • These rats often live in and around homes and scavenge on leftover human food items or poorly stored food. They deposit their urine and feces on floors, tables, beds and food and so direct contact transmission is common.
  • In some regions, the rats are also sometimes consumed as a food source and infection may occur when rodents are caught and prepared.
  • Airborne contact with the virus may also occur when a person inhales tiny particles in the air contaminated with infected rodent excretions during cleaning activities, such as sweeping and dusting.
  • Similar to Ebola virus, transmission of the Lassa virus between humans occurs through direct contact with infected blood or bodily secretions.

 

Casual contact without exchange of body fluids does not spread Lassa virus. Person-to-person transmission is common in health care settings (hospitals, clinics) where proper personal protective equipment (PPE) is not available or not used. Lassa virus may also be spread in contaminated medical equipment, such as reused needles.

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How do you know if you have Lassa fever?

In the early stages, Lassa fever is often misdiagnosed as the flu, typhoid or malaria, and as a result many patients do not receive appropriate medical treatment. A blood test will confirm Lassa fever. Onset of the illness is typically slow, about 1 to 3 weeks after contact with the virus, with no specific symptoms that distinguish it from other illnesses with fever. Early signs include high fever, headache and general malaise, followed by a sore throat, nausea, vomiting, abdominal pain and diarrhea in some cases. After 4 to 7 days, most patients will start to feel better, but some will go on to display symptoms such as swelling, hypertension, bleeding and shock, leading eventually to death. Death from Lassa fever usually occurs 10 to 14 days after the start of symptoms.

 

Is there a treatment for Lassa fever?

No vaccine for Lassa fever is currently available for use in humans. The only available drug, ribavirin, is only effective if administered early in the infection, within the first 6 days of the disease.

 

What can you do to prevent Lassa fever?

 

Avoid contact with rats and their excreta.

  • Observe good personal hygiene including hand washing with soap and running water regularly
  • Dispose of waste properly and clean your environment so that rats are not attracted
  • Store foods in rat-proof containers and cook all foods thoroughly before eating.
  • Discourage rodents from entering the house by blocking all possible entry points
  • For food manufacturers and handlers, do not store or serve food where rats can have access to it.
  • All fluids from an infected person are extremely dangerous.

 

Use rat poison with caution, as it can be poisonous to children and adults as well!!

 

Report any cases of above symptoms or persistent high fever not responding to standard treatment for malaria and typhoid fever to the nearest health center.

 

Health workers are also advised to be on alert, wear personal protective equipment, observe universal basic precautions, care for suspected cases in isolation and report to the Local Government Area (LGA) or Ministry of Health immediately.

 

Emergency Contact information

  • Directorate of Disease Control, Lagos State Ministry of Health – 08037170614, 08023169485.

 

  • Federal Ministry of Health – 08093810105,08163215251, 08031571667 and 08135050005.