The Delta Oghara Medical Journal (DOMJ) is a biannual, peer-reviewed, open-access journal published by the MDCAN DELSUTH chapter. It provides a platform for researchers, clinicians, and academics in Nigeria and beyond to disseminate scientific information to the medical community and society at large. DOMJ publishes original research, case reports, review articles, etc, focusing on advancements in medical sciences.... Continue Reading. Submit an Article |Instruction for Authors | Current Issue | Past Issue | Contact/Support
The Medical and Dental Consultants' Association of Nigeria (MDCAN), DELSUTH Chapter
This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0). You are free to share and adapt the material for non-commercial purposes, provided appropriate credit is given to the author(s) and Delta Oghara Medical Journal, a link to the licence is provided, and any adapted material is distributed under the same licence. Licence link: https://creativecommons.org/licenses/by-nc-sa/4.0/
Utility of NT-proBNP in the Diagnosis of Heart Failure Phenotypes in a Sub-Saharan African Population
Background: N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) is a cornerstone in the diagnostic algorithm for heart failure (HF). However, its behaviour across different HF phenotypes, particularly in sub-Saharan African (SSA) populations where patient characteristics and HF aetiologies differ, is not well described. This study evaluated the utility of NT-proBNP in diagnosing HF phenotypes in a Nigerian cohort using the 2016 European Society of Cardiology (ESC) criteria. Methods: In a prospective observational study, 130 adults with HF were classified into HF with reduced ejection fraction (HFrEF, LVEF<40%), mid-range EF (HFmrEF, LVEF 40-49%), and preserved EF (HFpEF, LVEF≥50%) based on comprehensive assessment including echocardiography and clinical evaluation. Plasma NT-proBNP was measured using a high-sensitivity ELISA. The Kruskal-Wallis test was used to compare NT-proBNP levels across phenotypes. Diagnostic performance was assessed by the proportion of patients meeting the ESC NT-proBNP threshold (>125 pg/mL for ambulatory and >300 pg/mL for hospitalized patients). Results: The median NT-proBNP level for the entire cohort was 3800.0 pg/mL (IQR: 2900.0-4500.0). All 130 patients (100%) had NT-proBNP levels above the ESC diagnostic thresholds. There was no significant difference in median NT-proBNP levels between the three phenotypes (HFrEF: 3900.0 pg/mL [IQR: 3075-4600], HFmrEF: 3700.0 pg/mL [IQR: 2275-3700], HFpEF: 3850.0 pg/mL [IQR: 2700-4325]; p=0.461). The biomarker was equally elevated in both inpatient and outpatient settings. Conclusion: NT-proBNP is a highly sensitive biomarker for confirming the diagnosis of HF in this SSA population, with 100% of patients exceeding the recommended ESC cut-offs. Contrary to findings from other regions, NT-proBNP levels were uniformly and markedly elevated across all HF phenotypes, showing no discriminatory value between HFrEF, HFmrEF, and HFpEF. This suggests that while NT-proBNP is indispensable for ruling out HF in this setting, its level cannot be used to infer the underlying phenotype.
N-terminal pro-B-type Natriuretic Peptide
Copyright (c) 2026 Delta Oghara Medical Journal https://creativecommons.org/licenses/by-nc-sa/4.0
KNOWLEDGE, AWARENESS, AND RISK ASSESSMENT OF LASSA FEVER AMONG RESIDENTS OF ESAN WEST LOCAL GOVERNMENT AREA, EDO STATE, NIGERIA
Background: Lassa fever is endemic in Esan West Local Government Area (LGA), Edo State, Nigeria, yet community-level data on awareness, knowledge, and behavioural risk remain scarce. This study assessed the awareness, knowledge, and risk level of Lassa fever among residents of Esan West LGA and identified their sociodemographic determinants. Materials and Methods: A descriptive cross-sectional study was conducted among 300 residents selected across all 10 wards of Esan West LGA between July and December 2013. Multi-stage sampling was employed. Knowledge was assessed using a 28-item scale and graded as good (≥75%), fair (50–74%), or poor (<50%). Risk level was assessed using a 20-item scale and graded as high (>75%), moderate (50–74%), or low (<50%). Chi-square test was used to evaluate associations between outcomes and sociodemographic characteristics at a significance level of 0.05. SPSS version 25 was used to analyse all data. Results: The mean age of respondents was 43.6 ± 21.6 years. Awareness of Lassa fever was recorded in 44.0% of respondents, with the ISTH Outreach Team and electronic media as the leading information sources. Only 7.0% had good knowledge, while 33.7% had poor knowledge. Educational level was the sole significant predictor of both awareness (χ² = 11.14, p = 0.011) and knowledge (χ² = 19.8, p = 0.011). High behavioural risk was identified in 37.0% of respondents. Female gender, employment in skilled and unskilled occupations, community of residence, and longer duration of stay were significant determinants of high risk (p < 0.05 to p < 0.001). Conclusion: Awareness and good knowledge of Lassa fever were low among residents of Esan West LGA. We recommend a shift from passive information delivery to peer-driven, structural, and incentivised interventions that embed health education into daily survival and cultural routines.
Economic Burden AND Patterns of Noncommunicable Diseases in Rural Nigeria
Background: Noncommunicable diseases (NCDs) are a growing global health crisis, accounting for nearly three-quarters of all deaths worldwide. In Nigeria, the burden of hypertension, diabetes, and other chronic conditions is rising rapidly, exacerbated by limited health insurance coverage, fragmented healthcare infrastructure, and high out-of-pocket costs. This study assessed the economic burden and healthcare utilisation patterns related to NCDs in a rural Nigerian setting. Methods A descriptive cross-sectional study was conducted among 206 adults in Esan Central LGA, Edo State. Multistage sampling was used to select participants. Data on sociodemographics, NCD diagnoses, and direct healthcare costs were collected via structured questionnaires. Out-of-pocket expenses for consultations, medications, investigations, transportation, and hospital admissions were documented. Associations between age and NCD prevalence were tested using chi-square analysis. Results Nearly one-third of respondents reported an NCD diagnosis, with hypertension and diabetes being the most prevalent. Age was significantly associated with a higher incidence of NCDs. Affected individuals faced multiple financial burdens across care categories, with medications and hospital admissions being the most expensive. Over 75% relied on personal funds for treatment, with minimal support from insurance or family. Conclusion The study highlights the cumulative economic strain of NCD management in resource-limited settings, emphasising the urgent need for financial protection mechanisms. Policies expanding insurance coverage, subsidising essential care, and decentralising NCD services to primary care levels are crucial to reduce this burden and improve health equity in Nigeria.
Copyright (c) 2026 Delta Oghara Medical Journal https://creativecommons.org/licenses/by-nc-sa/4.0/
Malnutrition: Prevalence and Associated Factors among School Age Children in Delta State, Nigeria
Background: Malnutrition continues to be a fundamental health problem across school-age children in poor resource countries, including Nigeria. Both undernutrition and overnutrition adversely affect physical and brain development, educational performance, and prospective health outputs. Objective: The objective of this research was to evaluate the frequency of malnutrition and identify factors influencing nutritional status of primary and secondary school children across Delta State. Methodology: Across Delta State, Nigeria, 201 primary and secondary school students between the ages of 6 and 17 participated in a cross-sectional survey. A multistage sampling process was employed to select study participants. Systematic questionnaire was employed to obtain information on dietary pattern and sociodemographic traits. Body Mass Index (BMI) percentile was computed using anthropometric data, such as height and weight. WHO growth references were used to categorize malnutrition based on age-for-height and sex. SPSS version 23 was utilized for data analysis. Chi-square test, multinomial logistic regression, and descriptive statistics were employed at 95% confidence threshold. Results: The study sample comprised 58.7% females and 41.3% males. Prevalence of thinness, overweight, stunting, and underweight was 14.9%, 5.0%, 7.0%, and 3.5%, respectively. Most respondents (80.1%) had normal nutritional status. Association between gender and nutritional status was statistically significant (χ² = 7.308, p = .026), prevalence of thinness was more common among males compared to females. Vegetable consumption was significantly associated with nutritional state (χ² =11.572, p = .003). Multinomial logistic regression showed that female gender was independently associated with reduce odds of thinness (AOR = .15, 95% CI: .024–0.951, p = .044). Conclusion: Despite the normal nutritional status of most school children, thinness and stunting remain important public health concerns. School-based nutritional interventions and health promotion of dietary consumption is recommended.
PREVALENCE OF PREAURICULAR SINUS AMONGST ANNANGS AND IBIBIOS
A preauricular sinus is a congenital anomaly that occurs at the anterior margin of the ascending limb of the helix of the external ear. Its prevalence varies significantly across different ethnic and geographical populations worldwide. This study aimed to determine its prevalence among Annang and Ibibio patients attending an ENT outpatient clinic in Southern Nigeria. It is a cross-sectional observational study, involving a systematic observation and assessment of patients attending the ENT outpatient clinic of the University of Uyo Teaching Hospital, Akwa Ibom State. Three hundred and two subjects with a mean age of 25.2 years were recruited in this study, out of which 35.4% [107/302] were of the Annang tribe and 64.6% [195/302] were of the Ibibio tribe. The M:F ratio of respondents was 1:1.5. A prevalence of 17.6% [53/302] was noted. The Annang subjects had the highest prevalence rate of 19.6% [21/107], while the Ibibios had 16.4% [32/195]. Only 24% [72/302] of the participants had heard of PAS prior to the survey, while 25% [18/72] of those affected sought medical attention. Health education to improve public awareness of the condition is advocated.
Prioritizing Routine Dental Visits in Developing Nations: Addressing the Silent Epidemic
In developing countries, the burden of oral disease remains a silent epidemic, yet not considered very important in comparison to other systemic health-associated challenges. While significant strides are being achieved in curbing major communicable diseases, some non-communicable diseases are not gaining the same ground, particularly oral diseases such as Dental caries and Periodontal diseases. The review, therefore, aims to highlight the significant role of” Routine Dental Visits” in mitigating against a rise in the global burden and the key factors responsible for its non-utilization generally. It identifies factors such as; poor perception and ignorance of the importance of oral health in relation to overall health, of both the individuals and the government, cultural barriers, affordability of oral health services, a generalized poor health seeking behavior, non\insufficient- health insurance coverage for oral diseases and the curative health model approach of the government system of care, as responsible. The consequence of this neglect was further analysed to be a worsening of clinical presentations, requiring a much higher level of funding than would have been needed for preventive oral healthcare. This subsequently translates to a higher financial burden on oral healthcare for both the individual and the government at large. Changing the status quo would require a change in the curative model approach to oral health to a preventive model of oral healthcare. This would include prioritizing routine oral\dental visits, as a core component of primary healthcare, leveraging on community-based strategies and the integration of oral healthcare into existing health platforms.
Copyright (c) 2026 Delta Oghara Medical Journal https://creativecommons.org/licenses/by-nc/4.0
Maintaining Infection Control Standards: Challenges in a Resource-Constrained Environment
Standard Infection Control Protocols (SICPs) are the foundations of safe healthcare delivery for both the patient and the healthcare worker. It houses the key to the prevention of cross-infection in such environments. These protocols are generally designated “Universal Standard Precautions,” known to be strictly adhered to in high-income countries (HICs). However, their implementation in resource-constrained environments (RCEs) reveals a profound chasm between policy and practice. This narrative review synthesizes evidence to explore the multifaceted challenges that undermine SICP adherence in low- and middle-income countries (LMICs) and under-resourced settings within high-income nations. A close review and analysis of the challenges confronting the practice of SICPs in RCE settings reveals the root cause to be; a failure of the system. This is expressed as chronic infrastructural instability, fractured supply chains, an unsupported health workforce, and pervasive socio-cultural and economic barriers. This review, therefore, unveils the challenges bedeviling compliance and the possible route of repair that can create a positive paradigm shift in favour of compliance with SICPs.
A Ten-Year Survey of Uterine Fibroids in a Tertiary Hospital in Niger-Delta Region of Nigeria
Background: Uterine fibroid is a common gynaecological problem among women of reproductive age, and it commonly affects the quality of life of the affected women. Objective: To determine the prevalence, clinical presentation and management outcome of uterine fibroid at the Delta State University Teaching Hospital, Oghara, Nigeria. Methodology: This was a ten-year retrospective descriptive study of patients with uterine fibroids managed at Delta State University Teaching Hospital, Oghara from January 1, 2014 to December 31, 2023. Folders of patients who were managed for uterine fibroid were retrieved from the medical records of the hospital, and relevant information on socio-demographic parameters (such as age, parity, level of education), clinical presentations and mode of treatment was extracted and analyzed using SPSS version 26. Results: The prevalence of uterine fibroid was 27.7%. The mean age was 36.3.2 ± 8.05years. The modal age group was 31 – 39 years. The commonest clinical presentation was infertility (78.4%). Majority of patients (97.4%) had open myomectomy. Conclusion: Uterine fibroid is a common benign gynaecological tumour. The majority of patients presented with infertility. Myomectomy was the commonest mode of treatment because most of the patients were in reproductive age group and desirous of fertility. Future application of newer techniques may reduce the prevalence of open myomectomy.
Morbidly Adherent Placenta in an Unscarred Nigerian Uterus: A Case Report and Review of Literature.
Morbidly adherent placenta (MAP) is a rare but potentially life-threatening complication of pregnancy that can results in massive obstetrics hemorrhage and often leads to hysterectomy. It is associated with maternal and fetal morbidity and mortality. One-third to one-half of all emergency postpartum hysterectomies are performed as a result of adhesive placental disorders. The prognosis of MAP can be improved with prenatal diagnosis, which has been shown to reduce morbidity by 50% however, only half of MAP cases are diagnosed prenatally. Management could be conservative or surgical. We report a case of morbidly adherent placenta in a 24 years old G1P0+0 Nigerian nulliparous lady that was diagnosed intra-operatively.
maternal , mortality, morbidity, DELSUTH
Clinicopathologic Discordance in Atypical Unilateral Dorsolateral Lichen Simplex Chronicus Mimicking Kaposi Sarcoma
Background: Lichen simplex chronicus (LSC) is a chronic inflammatory dermatosis arising from repetitive mechanical trauma that sustains an itch-scratch cycle and leads to epidermal hyperplasia and dermal fibrosis. Although frequently encountered in dermatologic practice, dorsolateral involvement is rare and may assume exaggerated morphologic features that simulate infectious or malignant processes. Objective: To report an unusual case of unilateral dorsolateral LSC clinically mimicking Kaposi sarcoma and to emphasize the indispensable role of clinicopathologic correlation in atypical acral dermatoses. Methods: Comprehensive clinical evaluation with histopathologic examination and repeat biopsy confirmation. Results: Histopathology demonstrated irregular acanthosis, compact orthokeratotic hyperkeratosis, hypergranulosis, pseudoepitheliomatous hyperplasia, papillary dermal fibrosis with vertically oriented collagen bundles, and dense lymphocytic infiltrates. These findings confirmed LSC. Due to persistent clinical concern for neoplasia, repeat biopsy was performed and reconfirmed the diagnosis. Combination corticosteroid-based therapy led to marked clinical improvement. Conclusion: This case underscores how atypical anatomic presentations of otherwise common inflammatory dermatoses can create substantial diagnostic ambiguity and clinical uncertainty. When lesions arise in unusual locations or exhibit overlapping morphologic features, reliance on clinical impression alone may be misleading. In such scenarios, histopathologic evaluation serves as the definitive diagnostic anchor. Moreover, when clinicopathologic discordance persists, repeat biopsy and careful correlation between clinical findings and microscopic features are essential to establishing an accurate diagnosis.
Attitudes of dental students to communication skills learning in Obafemi Awolowo University, Ile-Ife, Osun state.
Background: Effective communication is a key component of dentist-patient interaction and it is a fundamental skill that can improve the effectiveness of patient management. Communication skills training aims to develop communication not only with the patient but also with the family of the patients, colleagues and other health care professional. There is virtually no research identifying dental students’ attitude towards communication skills learning in Nigeria. Aim: The study aimed to investigate the attitude of dental student towards communication skill learning in Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria. Methodology: A cross-sectional study conducted among 129 undergraduate students (Part 1 – 6) of the Faculty of Dentistry, Obafemi Awolowo University, Ile – Ife. A self-administered questionnaire of the communication skills attitude scale (CSAS) which comprise of both the positive attitude scale (PAS) and negative attitude scale (NAS) was used for the data collection from participants. The data collected was sorted and cleaned to remove any missing values. Inferential statistics analysis was done using IBM SPSS version 26.0. Results: A total of 129 dental undergraduate students completed a structured questionnaire on communication skills learning; The communication skills attitude scale (CSAS). The mean score for the positive attitude scale (PAS) was 50.98±5.61 and for the negative attitude scale (NAS) was 37.64±6.56. There were no statistically significant differences based on age and study year in attitudes toward learning communication skills. However, the negative attitude scale showed a statistically significant difference between males and females (p-value=0.001). Conclusion: The study concluded that dental students generally have a positive attitude towards communication skills learning.
Parkinson Disease and Its Impact on Quality of Life
Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder which significantly impacts on the quality of life (QoL) of affected individuals. All the components of QoL (physical functioning, psychosocial, cognitive, and environmental) can be affected by the symptoms of Parkinson’s disease, side effects of treatment, and sociocultural factors. Methodology: This study is a literature review on the quality of life in patients with Parkinson's disease. Excerpta Medica (EMBASE), Medical Literature Analysis and Retrieval System Online (MEDLINE), Public Medline (PUBMED), Health Inter-Network Access to Research Initiative (HINARI) and Google Scholar databases were searched and scholarly articles on Parkinson’s disease and QoL were reviewed for the purpose of the study. Results: Parkinson's disease is primarily caused by the loss of dopaminergic neurons in the substantia nigrawhich result in motor and non-motor symptoms (such as cognitive function) with profound negative impact on the QoL. Also, with progression of the disease, and worsening of symptoms, an attendant decline has been observed in the QoL of patients with Parkinson's disease Family and social support is crucial in the management of the condition. Conclusion: PD significantly impacts on the QoL of patients and should be assessed for. Recognition of challenges in the lives of patients with PD is important in their management in addition to drug therapy. Family and social support including occupational and financial support are relevant in management.
Copyright (c) 2025 Delta Oghara Medical Journal https://creativecommons.org/licenses/by-nc/4.0
Pulmonary Arterial Hypertension in A 14 Year Old Girl:
Pulmonary hypertension carries a high morbidity and mortality especially when presentation occurs late. Due to its subtle manner of presentation and high cost of care, diagnosis is often delayed and treatment is beyond the reach of most affected Nigerians. A 15-year-old girl who presented with easy fatigability of 2 years duration and dypnoea on exertion of 3-weeks duration. She had features of systemic and pulmonary congestion on examination. An echocardiogram done revealed supra-systemic pulmonary pressure with a massively dilated and poorly functional right ventricle. A large secundum ASD with bidirectional flow of blood was also noted. She was commenced on anti-failure regimen and treatment for pulmonary hypertension. Due to high cost of care, combination therapy for pulmonary hypertension could not be sustained and patient eventually succumbed to the illness.
Strengthening Healthcare Access in Nigerian Tertiary Institutions:
Health is a critical factor that cannot be overemphasized in the human and social-economic development of any nation. Access to healthcare plays a vital role and is essential for maintaining and improving health. The Tertiary Institution Social Health Insurance Programme (TISHIP) was established by the National Health Insurance Authority (NHIA), and aims to provide affordable and quality health coverage for students in universities, polytechnics, colleges of education, and other post-secondary institutions. TISHIP is a laudable initiative, designed to reduce out-of-pocket healthcare expenses and protect students from catastrophic medical expenses through pooled contributions. The programme offers a wide range of preventive and curative services without making payments at the point of accessing care. However, various studies have reported mixed findings about the awareness, knowledge, utilization, attitudes and perception about the programme. Although the NHIA Act of 2022 makes health insurance coverage mandatory for all Nigerians as a means of achieving Universal Health Coverage (UHC), there has been a lack of enforcement, creating major setback to the its implementation. The implementation of TISHIP seems voluntary and at the discretion of each institution, with many having not yet subscribed to it, while some operate it inconsistently. Hence, the implementation challenges need to be tackled and addressed. Strengthening the programme will require a multi-sectoral approach involving all the stakeholders including NHIA, institutional authorities, HMOs, healthcare facilities and professionals, and student bodies. To improve the programme’s effectiveness, efforts should focus on increasing student awareness, strengthening human resources, improving service delivery, and enhancing monitoring and evaluation. It is also essential to ensure transparent fund management, set a premium that is sufficient and economically sustainable, make the programme mandatory, and establish consistent implementation frameworks across all tertiary institutions in the nation.
Gallbladder stones usually exhibit significant variation in size but rarely up to 5cm. Giant gallbladder stones, defined as stones greater than 5cm in diameter or more than 70 grams in weight, are a rare phenomenon and pose a management challenge. Laparoscopic cholecystectomy while being the gold standard of surgically removing gallbladders has a high rate of conversion to open even in expert hands due to the challenges of handling the giant gallstones. These challenges include difficulty grasping the gallbladder with the laparoscopic instruments, difficulty in exposing the anatomy of Calot’s triangle due to the size of the stone and extrinsic compression on the Calot’s triangle and difficulty in retrieving the specimen. We present the management of our first case of cholecystectomy for a giant gallbladder stone and discuss the choice of surgery.