Background Noma, a neglected disease mostly affecting children, with a 90% mortality rate if untreated, is an orofacial gangrene that disintegrates the tissues of the face in <1 wk. Noma can become inactive with early stage antibiotic treatment. Traditional healers, known as mai maganin gargajiya in Hausa, play an important role in the health system and provide care to noma patients. Methods We conducted 12 in-depth interviews with caretakers who were looking after noma patients admitted at the Noma Children's Hospital and 15 traditional healers in their home villages in Sokoto state, northwest Nigeria. We explored perceptions of noma, relationship dynamics, healthcare practices and intervention opportunities. Interviews were audiorecorded, transcribed and translated. Manual coding and thematic analysis were utilised. Results Traditional healers offered specialised forms of care for specific conditions and referral guidance. They viewed the stages of noma as different conditions with individualised remedies and were willing to refer noma patients. Caretakers trusted traditional healers. Conclusions Traditional healers could play a crucial role in the early detection of noma and the health-seeking decision-making process of patients. Intervention programmes should include traditional healers through training and referral partnerships. This collaboration could save lives and reduce the severity of noma complications.

The Nigerian Ministry of Health has been offering care for noma patients for many years at the Noma Children's Hospital (NCH) in Sokoto, northwest Nigeria, and M edecins Sans Fronti eres has supported these initiatives since 2014. The comprehensive model of care consists of four main components: acute care, care for noma sequelae, integrated hospital-based services and communitybased services. The model of care is based on the limited evidence available for prevention and treatment of noma and follows WHO's protocols for acute patients and best practice guidelines for the surgical treatment of noma survivors. The model is updated continually as new evidence becomes available, including evidence generated through the operational research studies performed at NCH. By describing the model of care, we wish to share the lessons learned with other actors working in the noma and neglected tropical disease sphere in the hope of guiding programme development.keywords cancrum oris, model of care,

The use of plant products in the management of diabetes has gained ground in pharmacotherapy. It becomes imperative to evaluate the antidiabetic effects of fruit extracts of Ziziphus mauritiana (HMZM), Ziziphus spina christi (HMZS) and Glibenclamide on blood glucose, total protein, albumin and lipid profile in alloxan induced diabetic rats. 68 albino rats weighing 70-130g were used in this study. 26 rats were used for acute toxicities of Ziziphus mauritiana and Ziziphus spina christi. 42 rats of 7 groups of 6 rats each were used to test antidiabetic effects of Ziziphus mauritiana and Ziziphus spina christi plant extracts. Group 1 served as the negative control, groups 2-7 were intraperitoneally administered 360mg/kg of alloxan in normal saline respectively. Group 2 served as positive control, groups 3 and 4; 5 and 6 were respectively administered daily dose of 200 and 400mg/kg of HMZM and HMZS, group 7 was administered 0.21mg/kg of glibenclamide. Results showed Ziziphus mauritiana and Ziziphus spina christi non toxic at dose of 5000mg/kg. 48 hours after alloxan administration, blood glucose levels were found to be significantly higher (P<0.05) in groups 2-7 compared to group 1, thus confirming induction of diabetes. In groups 3-7, on 7 th and 14 th days of administration of extracts and Glibenclamide, there was a significantly lower (p<0.05) serum glucose, triacylglycerol, High density Lipoprotein, Low density lipoprotein and significantly higher (P > 0.05) serum level of total protein and albumin compared to group 2. The results obtained showed a significantly lower (P < 0.05) serum level of glucose. The effects of HMZM and HMZS fruit extracts on blood glucose, total protein, albumin and lipid profile was dose dependent. Conclusively, this study has demonstrated the antidiabetic effects of HMZM and HMZS with HMZS having a more pronounced effect on Blood glucose and lipid profile.

This quality improvement study uses a novel data collection and visualization tool to audit hand hygiene adherence before and after training among health care workers in low-resource settings at 2 hospitals in Nigeria.

The adoption of Internet resources for learning continues to grow in the world today. Despite the abundant benefit of utilizing social media due to the growth of web 2.0, an internet resource for communication and interaction, its use has not been fully embraced as a teaching tool in Nigeria. Social media is becoming a prominent communication tool and found to be facilitating teaching and learning activities among students. However, the user readiness of social media in learning by the students has been challenging. Despite the wide acceptance of social media (such as Facebook, Twitter, and WhatsApp, e.t.c.) amongst Nigerian polytechnic students, they do not utilize it for academic pursuit. This study examined the Use of Social Media among students in Nigerian Polytechnics. The main objective of this study is to find out the user readiness' factors that influence the use of social media by the students in Nigerian Polytechnic. The evaluation results show that social media is an indispensable Internet platform among Nigerian Polytechnic students.