Abdulrazaq Habib - Academia.edu (original) (raw)

Papers by Abdulrazaq Habib

Transactions of The Royal Society of Tropical Medicine and Hygiene, 2015

British Journal of Applied Science & Technology, 2016

Background: There is inequality in vaccination coverage, and adult farmers in tropical rural comm... more Background: There is inequality in vaccination coverage, and adult farmers in tropical rural communities could have missed tetanus toxoid as campaigns target children. Snakebite is not uncommon and partly because of lack of effective antivenom, management in inaccessible areas could be complicated with tetanus in unimmunized victims. Patients and results: Four snakebite victims who developed tetanus were seen in northern

Tropical Medicine & International Health, 2015

To compare the cost of facility-based MDR TB care (F) to home-based care (H) from the perspective... more To compare the cost of facility-based MDR TB care (F) to home-based care (H) from the perspective of the Nigerian national health system. We assessed the expected costs of the two MDR TB treatment approaches using a decision-analytic model with a follow-up of 6 months. MDR TB treatment outcomes were obtained from a systematic review of randomized clinical trials. The outcomes of interest included treatment success, treatment failure, treatment default, and mortality, and did not vary significantly between the two alternatives. Treatment costs included the cost of: drug therapy (F, H), hospital stay (F), nurse care (F, H), physician care (F), nursing facility (F), and transport to the health care provider (H). Finally, we estimated the potential cost savings associated with home-based treatment for all patients starting MDR TB treatment in Nigeria. The average expected total treatment cost for a Nigerian patient treated for MDR TB was estimated at US$ 2095 for facility-based care and $ 1535 for home-based care, a potential saving of 25%. One of the major drivers of this difference is the significantly more intensive, and therefore more costly, nursing care in hospitals. In 2013, a total of 426 patients were initiated on facility-based MDR TB treatment in Nigeria. Thus the potential savings through home-based care are US$ 223,204 per year. In Nigeria, treatment of MDR TB using home-based care is expected to result in similar patient outcomes at markedly reduced public health costs as facility-based care. This article is protected by copyright. All rights reserved.

PLOS Neglected Tropical Diseases, 2015

Snakebite envenoming (SBE) is a major problem in rural areas of West Africa (WA). Compared to oth... more Snakebite envenoming (SBE) is a major problem in rural areas of West Africa (WA). Compared to other Neglected Tropical Diseases (NTD), the public health burden of SBE has not been well characterized. We estimated the impact of snakebite mortality and morbidity using the Disability Adjusted Life Years (DALYs) metrics for 16 countries in WA. We used the reported annual number of SB deaths and mean age at time of SB and converted these into years of life lost (YLL). Similarly, the years of life lived with disability (YLD) were estimated by multiplying the number of amputations by the respective disability weight of 0.13. In WA, the annual cases of SB mortality and amputations ranged from 24 (95% Confidence Interval: 19-29) and 28 (17-48) respectively in Guinea-Bissau with the highest estimates of 1927 (1529-2333) and 2368 (1506-4043) respectively in Nigeria. We calculated that the annual DALYs associated with a SB death ranged from 1550 DALYs (95%CI: 1227-1873 DALYs) in Guinea Bissau to 124,484 DALYs (95%CI: 98,773-150,712 DALYs) in Nigeria. The annual DALYs associated with amputation for the two countries were 149 DALYs (95%CI: 91-256 DALYs) and 12,621 DALYs (95%CI: 8027-21,549 DALYs) respectively. The total burden of SBE was estimated at 319,874 DALYs (95% CI: 248,357-402,654 DALYs) in the 16 countries in WA. These estimates are similar, and in some instances even higher, than for other NTDs encountered in WA (e.g., Buruli ulcer, Echinococcosis, Intestinal Nematode Infections, Leishmaniasis, Onchocerchiasis, Trachoma and Trypanosomiasis) as reported in the Global Burden of Diseases 2010 (GBD). The public health burden of SBE in WA is very substantial and similar to other more widely recognized NTDs. Efforts and funding commensurate with its burden should be made available for the control of snakebite in the sub-region.

Background: Causes of mortality among Human Immunodeficiency Virus (HIV) infected hospitalized pa... more Background: Causes of mortality among Human Immunodeficiency Virus (HIV) infected hospitalized patients on Anti-Retroviral Therapy (ART) have been studied in Sub-Saharan Africa. However, majority of deaths occur outside hospitals and exploring their causes might lead to targeted interventions. Methods: At Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria, currently with approximately 4000 HIV patients maintained on ART since 2005, we undertook clinical review of randomly selected patients who accessed ART there and died at home or in the hospital. We also conducted verbal autopsy and qualitative interview of the counsellors and Home Based Care Team who cared for the patients while alive. Results: 101 patient deaths while on ART were reviewed. Those who died at home (51) or hospital (50) had similar ages, gender, co-morbidities, proportions who disclosed to family members, proportions with stages III/IV disease and opportunistic diseases. The median pre-ART CD4 cell counts for those...

Neurology Research International, 2015

HIV-associated Neurocognitive Disorders (HAND) are common among HIV-positive individuals. This st... more HIV-associated Neurocognitive Disorders (HAND) are common among HIV-positive individuals. This study explored the prevalence and correlates of HAND in Nigeria. 80 HIV-positive and 40 HIV-negative adults selected from Aminu Kano Teaching Hospital (AKTH) received comprehensive evaluations. A multidomain neuropsychological test (MDNPT) battery assessing 7 domains was administered to the participants and their performance was combined with measures of functional status to classify impairments into various grades of HAND. Univariate and multivariate analyses were performed to identify correlates of symptomatic HAND. Among the HIV-positive individuals, 50% were highly active antiretroviral therapy-experienced (HAART+) and 50% were highly active antiretroviral therapy naive (HAART-). Symptomatic HAND was found among 40% of the HAART- individuals and 30% of the HAART+ individuals. Respective prevalence of HIV-associated dementia (HAD) was 23% and 5%, respectively (p = 0.0002). In a binary logistic regression model, only fewer years of education independently predicted symptomatic HAND [Odds Ratio (OR) = 1.2, 95% confidence interval (CI) = 1.04-1.44, p = 0.016]. The prevalence of HAND in Nigeria is high with HAD being commoner among HAART- patients. Provision of HAART and strict monitoring of patients at risk of HAND are needed to scale down the burden of the disease.

Case Reports in Infectious Diseases, 2015

Presentation of tuberculosis (TB) in pregnancy may be atypical with diagnostic challenges. Two pa... more Presentation of tuberculosis (TB) in pregnancy may be atypical with diagnostic challenges. Two patients with complicated pregnancy outcomes, foetal loss and live premature delivery at 5 and 7 months of gestation, respectively, and maternal loss, were diagnosed with pulmonary TB. Chest radiography and computed tomography showed widespread reticuloalveolar infiltrates and consolidation with cavitations, respectively. Both patients were Human Immunodeficiency Virus (HIV) seronegative and sputum smear negative for TB. Sputum GeneXpert MTB/Rif (Xpert MTB/RIF) was positive for Mycobacterium tuberculosis. To strengthen maternal and childhood TB control, screening with same-day point-of-care Xpert MTB/RIF is advocated among both HIV positive pregnant women and symptomatic HIV negative pregnant women during antenatal care in pregnancy and at puerperium.

International Cardiovascular Forum Journal, 2015

Sexually Transmitted Diseases, 2015

Untreated syphilis in pregnancy is associated with adverse clinical outcomes to the infant. The s... more Untreated syphilis in pregnancy is associated with adverse clinical outcomes to the infant. The study aimed to estimate the public health burden resulting from adverse pregnancy outcomes due to syphilis infection among pregnant women not screened for syphilis in 43 countries in sub-Saharan Africa. Estimated country-specific incidence of syphilis was generated from annual number of live births, the proportion of women with at least 1 antenatal care (ANC) visit, the syphilis prevalence rate, and the proportion of women screened for syphilis during ANC.Adverse pregnancy outcome data (stillbirth, neonatal death, low birth weight, and congenital syphilis) were obtained from published sources. Disability-adjusted life-year (DALY) estimates were calculated using undiscounted local life expectancy, the neonatal standard loss function, and relevant disability weights. The model assessed the potential impact of raising ANC coverage to at least 95% and syphilis screening to at least 95% (World Health Organization targets). For all 43 sub-Saharan Africa countries, the estimated incidence of adverse pregnancy outcomes was 205,901 (95% confidence interval [CI], 113,256-383,051) per year, including stillbirth (88,376 [95% CI, 60,854-121,713]), neonatal death (34,959 [95% CI, 23,330-50,076]), low birth weight (22,483 [95% CI, 0-98,847]), and congenital syphilis (60,084 [95% CI, 29,073-112,414]), resulting in approximately 12.5 million DALYs. Countries with the greatest burden are (in DALYs, millions) Democratic Republic of the Congo (1.809), Nigeria (1.598), Ethiopia (1.466), and Tanzania (0.961). Attaining World Health Organization targets could reduce the burden by 8.5 million DALYs. Substantial infant mortality and morbidity results from maternal syphilis infection concentrated in countries with low access to ANC or low rates of syphilis screening.

Sub-Saharan African Journal of Medicine, 2015

Journal of Global Infectious Diseases, 2015

Journal of Global Antimicrobial Resistance, 2015

Current HIV research, Jan 7, 2015

Virological suppression is the main goal of anti-retroviral therapy. To achieve this goal, effici... more Virological suppression is the main goal of anti-retroviral therapy. To achieve this goal, efficient interventions that promote treatment adherence are needed. This study was aimed at exploring the impact of peer-education on virological outcomes in Northern Nigeria. A randomized controlled trial (RCT) among patients receiving antiretroviral treatment was conducted in 2 phases between August 2006 and January 2008 in the "largely Muslim" northern Nigeria. Participants were randomized into one of three intervention arms: standard of care arm, a second arm which included daily reminders via alarm and follow-up calls from peer-educators, and adherence support by a home-based treatment partner; and a third arm which included second arm activities, plus home visits by peer-educators. We evaluated socio-demographic factors and adherence levels, measured using self-report and pharmacy (Rx) refill rates, as risk factors forviral load (VL) suppression. Of the 600 participants (43% m...

Annals of African medicine

Tuberculosis (TB) is an important cause of mortality and morbidity in human immunodeficiency viru... more Tuberculosis (TB) is an important cause of mortality and morbidity in human immunodeficiency virus (HIV) infection in Africa. The interaction between TB and HIV infections is reviewed. Literature on TB, HIV and their co-infection, especially in sub-Saharan Africa, including Nigeria, is reviewed. Burden of TB is fueled by the HIV epidemic, and clinical presentation of TB may be atypical with co-infection. Recommendations on drugs and timing of antiretroviral therapy (ART) initiation are discussed. Use of cotrimoxazole prophylaxis (CPT) in co-infected patients reduces morbidity and mortality, while the principles of TB prevention in HIV infection can be summarized with the three I's: intensive TB case finding and surveillance, isoniazid preventive therapy (IPT) and infection-control measures; to these can be added a fourth 'I,' viz., instituting ART. Clinical complications like drug resistance, toxicity and drug interactions; and immune reconstitution inflammatory syndrome...

Annals of the Academy of Medicine, Singapore, 2004

Enteric fever is imported to developed countries while non-typhoidal salmonella infections occur ... more Enteric fever is imported to developed countries while non-typhoidal salmonella infections occur globally. Clinicians and trainees need to recognise the varied presentations of serious salmonella infections. We reviewed the clinical presentations, hospital course, complications and outcomes of 50 patients who were blood culture positive for Salmonella spp seen in 2 years. Nineteen of 24 patients with enteric fever had recently travelled to Asian countries. All the enteric fever patients recovered fully. Out of 26 patients with non-typhoidal salmonellosis, 10 had malignancies, 7 had immune dysfunction states and 3 had aortic aneurysms. Five patients had recurrent episodes of salmonellosis. Eight of these patients who had cancer (4), diabetes mellitus with renal failure (2) and gastric diseases (2) died. Fatal cases were older with multiple admissions and co-morbidities (median, 3) and presentation followed immunosuppressive interventions, often with no fever (4). Onset was sudden wit...

The American journal of tropical medicine and hygiene, 1997

During the past decade, effective snake antivenoms have become scarce in northern Nigeria. As a r... more During the past decade, effective snake antivenoms have become scarce in northern Nigeria. As a result, many patients severely envenomed by the saw-scaled or carpet viper (Echis ocellatus), which is responsible for more than 95% of the snake bites in the region, did not receive effective treatment and mortality and morbidity increased. To combat this crisis, a new monospecific ovine Fab antivenom (EchiTab) is being developed. Its theoretical advantages over conventional equine F(ab')2 antivenom are a more rapid tissue penetration and larger apparent volume of distribution (the volume of [tissue] fluid in which the the antivenom would be uniformly distributed to achieve the observed plasma concentration). In a preliminary study, two vials (20 ml; 1.0 g of protein) of EchiTab rapidly and permanently restored blood coagulability and cleared venom antigenemia in seven envenomed patients. Four experienced early reactions that responded to epinephrine. In a randomized comparative tria...