Olayinka A. Olasode

The Prevalence and Pattern of Superficial Fungal Infections among School Children in Ile-Ife, South-Western Nigeria

Fungal infections of the skin and nails are common global problems with attendant morbidity among affected individuals. Children are mostly affected due to predisposing factors such as overcrowding and low socioeconomic factors. The aim of this study was to determine the prevalence and the clinical patterns of superficial fungal infections among primary school children in Ile-Ife. A multistage sampling was conducted to select eight hundred pupils from ten primary schools in Ile-Ife. Data on epidemiological characteristics and clinical history was collected using a semistructured questionnaire and skin scrapings were done. The prevalence of superficial fungal infections among the 800 respondents was 35.0%. Male pupils constituted 51.0% of respondents while the females were 49.0%. The mean age for all the respondents was 9.42 ± 2.00. Tinea capitis was the commonest infection with a prevalence of 26.9% and tinea unguium, tinea corporis, and tinea faciei had a prevalence of 0.8%, 0.6%, and 0.5%, respectively. Tinea manuum had the least prevalence of 0.1%. Pityriasis versicolor had a prevalence of 4.4%. Microsporum audouinii was the leading organism isolated. The study shows that the prevalence of superficial fungal infection (SFI) among primary school children in Ile-Ife is high with tinea capitis as the commonest SFI.

Determinants of adherence to antiretroviral drugs among people living with HIV/AIDS in the Ife-Ijesa zone of Osun state Nigeria.

ABSTRACT Background The advent of antiretroviral (ARV) drugs has transformed HIV/AIDS into a chronic manageable disease and strict adherence is required for the medication to be effective. However, factors influencing adherence to ARV therapy (ART) vary from country to country. Method 120 subjects who received ARV drugs at a federal government-designated ART site located within the Obafemi Awolowo University Teaching Hospital complex, (OAUTHC), Ile-Ife, and a community-based non-governmental organisation, Living Hope Care (LIHOC), Ilesa, from February to May 2006 were serially recruited and studied. Relevant data were collected using an interviewer-administered, patient medication adherence questionnaire. Focus group discussions were also held among the subjects to further elicit qualitative information on factors influencing adherence to ART. Results The age of participants ranged from 21 to 65 years with a mean age of 40.2 + 10.3 years. Participants had been on ARV drugs for a period ranging between three and 60 months. The overall adherence rate in the study population was 44%. 66% of participants who accessed ARV drugs from LIHOC, Ilesa, had good adherence while only 14% of participants who accessed ARV drugs from OAUTHC, Ile-Ife, had good adherence. Participants with good adherence did not pay funds for the preliminary ARV eligibility investigations and they were also offered regular adherence counselling. These facilities were barely available in the group with poor adherence. Demographic factors such as age, gender and marital status did not seem to have any significant association with adherence level (p > 0.05). Conclusion The level of adherence was high in a cohort of PLWHA accessing ARV drugs in Ilesa while it was low among PLWHA receiving ART in Ife. The most important reasons for this difference were lack of funds for investigations and poor psycho-social counselling.

Traumatic spinal cord injuries in Ile-Ife, Nigeria, and its environs.

In Ile-Ife, Nigeria, traumatic brain injuries are largely due to traffic accidents caused mainly by the bad maintenance of the roads and unsafe driving. Young men in the productive stage of their lives are those most affected. The resultant disabilities include quadriplegia (in more than half the patients) and paraplegia. The cost of treating and providing adequate facilities for these patients imposes a heavy economic burden upon developing countries.

Keloids: An old problem still searching for a solution

An increasing number of patients with keloids present to the plastic surgeon and dermatologist practising in a predominantly black population such as ours. The black and Asian races are more affected than Caucasians. Apart from the aesthetic, psychological and social consequences, keloids may be symptomatic, causing severe itching, pain and tenderness, restriction of chest movement (presternal keloid), sleep disturbances, infection and suppuration. The multiplicity of treatment modalities suggests that there is no satisfactory therapy, with frustration to both the patients and physician. This paper reviews the current state of knowledge of the pathophysiology and the various approaches to treatment. Research efforts are still ongoing to discover more effective therapeutic intervention.

Pattern of paediatric dermatoses at dermatology clinics in Ile-Ife and Ilesha, Nigeria

Background: In developing countries, skin diseases are one of the most common causes of morbidity. Aim: A prospective descriptive study was conducted to determine the pattern of skin diseases in childhood and adolescents presenting to the outpatient dermatology clinics of Obafemi Awolowo University Teaching Hospitals Complex at Ile-Ife and Ilesha, Osun State. Methods: Patients aged 2 weeks to 19 years attending the clinics between October 2009 and September 2012 were included. Results: A total of 491 dermatoses were recorded in 441 patients. There were 244 (49.6%) males. Dermatophyte infections (17.1%), papular urticaria (6.7%), atopic dermatitis (6.3%), vitiligo (5.3%), acne (4.7%) and viral warts (3.7%) were the most frequent dermatoses. Skin infections and infestations, mostly dermatophyte infections and viral warts, accounted for 57.6% of the skin conditions. Of the non-infectious diseases, papular urticaria and atopic dermatitis were the most common. Dermatophyte infections were the most prevalent in children (25.8%), and acne vulgaris in adolescents (11.8%). Conclusion: Skin infections and infestations, mostly dermatophyte infections, were the most prevalent in children, and acne vulgaris in adolescents.

Vitiligo on tribal mark: A demostration of Wolf’s isotopic response

Koebner phenomenon is the development of new lesions in a normal skin following injury and it is a welldocumented feature of vitiligo [1]. The appearance of a new skin disease on a healed scar of an old lesion known as Wolf’s Isotopic response are not frequently reported. We present a 74 year old woman who presented with features of Wolf’s Isotopic response by the development of vitiligo on tribal mark.

Fixed drug eruption induced by moringa oleifera leaf extracts – A case report

The natural origin and supposed safety of alternative medicine in form of herbal medication have made them to gain wide acceptability throughout the world. Moringa oleifera has been of particular interest as evidence by its increasing cultivation and use especially in Nigeria in the past one decade. Despite increased use, not much has been said about the adverse reactions especially cutaneous side effects following consumption of its different partsleaves, pods, beans, back and roots. We are reporting a rare case of fixed drug eruption (FDE) following consumption of aqueous leaf extract of Moringa oleifera. We suggest that attending dermatologist be aware and have high index of suspicion of Moringa oleifera as a cause of FDE while making a diagnosis most especially in those that developed FDE while taken herbal preparations.

Seborrheic Dermatitis Induced Koebnerization: A Probable Outcome Determinant in Vitiligo

Backgrounds: Vitiligo is a pigmentary disorder characterized by depigmentation and absence of melanocyte. It occurs in 0.5-1% of the population and commonly associated with Koebner phenomenon. Koebner phenomenon which is the occurrence of new lesions at site of injury has been described in several dermatoses including vitiligo. It could serve as a useful diagnostic aid and sometimes influence approach to the management of vitiligo when considering surgical intervention. Case report: We report a 64 year old Nigerian who had progressive depigmentation on the scalp, face and palms of 1 year duration. He had prior scaly rashes for eight years which are distributed over the seborrheic areas. The depigmenting lesions were noted to be perpetuated by seborrheic dermatitis induced koebnerization. Conclusion: Koebners phenomenon induced by seborrheic dermatitis may be a perpetrating factor in vitiligo with attendant challenge in the treatment of the patients. This may further worsen the hitherto poor outlook of vitiligo thereby compounding the associated morbidity.

The Prevalence and Pattern of Skin Disorders at a University Teaching Hospital in Ile-Ife and Ilesha, Nigeria

ABSTR ACT BACKGROUND: The WHO recommends increased priority given to dermatoses in developing countries as they cause high morbidity and impacts quality of life. This study is to determine the prevalence and pattern of skin disorders in adults presenting to dermatologists at OAU Teaching Hospitals’ Complex (OAUTHC). MATERIALS AND METHODS: This is a prospective study based on age, sex, and dermatological condition of new patients at OAUTHC Dermatology Clinics in Ile-Ife and Ilesha, Osun State, from October 2009 to September 2012. The results were compared with other geographical zones in Nigeria and Africa. RESULTS: A total of 1013 patients were studied, with ages 18–90 years, 55% were women. Prevailing dermatoses were dermatophytes (9.8%), acne (9.5%), pityriasis versicolor (4.6%), warts (3.8%), lichen planus (3.7%), and seborrheic eczema (3.6%). CONCLUSION: Dermatoses mostly presenting to dermatologists in Nigeria and Africa were skin infections and eczemas. Concerted effort need to be made to control these conditions.

Genital TB: an unusual threat to reproductive health in the tropics.

Reproductive health is a state of physical mental and social well-being and not merely the absence of disease or infirmity in matters related to the reproductive system and its functions. We report a case of tuberculous salpingitis in a 35-year-old woman who reported to a sexually transmitted disease clinic with history suggestive of a pelvic inflammatory disease. Providing effective reproductive health-care delivery in resource limited settings requires clinical expertise and a high index of suspicion in the absence of sophisticated investigative facilities. A 35-year-old woman from a polygamous home setting the first of two wives of her husband presented to our sexually transmitted disease clinic with a history of irregularity of her menstrual cycle dull lower abdominal pain and inability to get pregnant. She had been pregnant three times but had only one surviving child who was 14 years of age. Her last confinement was 8 years prior to presentation. Her other two children died in infancy ofunrelated causes. She had her previous deliveries one at a village post by a community health extension worker and the other two at a church mission maternity centre. She had had two previous blood transfusions one for anaemia in pregnancy and the other for postpartum haemorrhage. She complained of weight loss and poor appetite. There was no history of sexually transmitted diseases in the past. (excerpt)