BackgroundDiarrhoea accounts for 1.8 million deaths in children in low- and middle-income countries (LMICs). One of the identified strategies to prevent diarrhoea is hand washing.ObjectivesTo assess the effects of hand washing promotion interventions on diarrhoeal episodes in children and adults.Search methodsWe searched the Cochrane Infectious Diseases Group Specialized Register (27 May 2015); CENTRAL (published in the Cochrane Library 2015, Issue 5); MEDLINE (1966 to 27 May 2015); EMBASE (1974 to 27 May 2015); LILACS (1982 to 27 May 2015); PsycINFO (1967 to 27 May 2015); Science Citation Index and Social Science Citation Index (1981 to 27 May 2015); ERIC (1966 to 27 May 2015); SPECTR (2000 to 27 May 2015); Bibliomap (1990 to 27 May 2015); RoRe, The Grey Literature (2002 to 27 May 2015); World Health Organization (WHO) International Clinical Trial Registry Platform (ICTRP), metaRegister of Controlled Trials (mRCT), and reference lists of articles up to 27 May 2015. We also contacted researchers and organizations in the field.Selection criteriaIndividually randomized controlled trials (RCTs) and cluster-RCTs that compared the effects of hand washing interventions on diarrhoea episodes in children and adults with no intervention.Data collection and analysisThree review authors independently assessed trial eligibility, extracted data, and assessed risk of bias. We stratified the analyses for child day-care centres or schools, community, and hospital-based settings. Where appropriate, incidence rate ratios (IRR) were pooled using the generic inverse variance method and random-effects model with 95% confidence intervals (CIs). We used the GRADE approach to assess the quality of evidence.Main resultsWe included 22 RCTs: 12 trials from child day-care centres or schools in mainly high-income countries (54,006 participants), nine community-based trials in LMICs (15,303 participants), and one hospital-based trial among people with acquired immune deficiency syndrome (AIDS) (148 participants).Hand washing promotion (education activities, sometimes with provision of soap) at child day-care facilities or schools prevents around one-third of diarrhoea episodes in high income countries (rate ratio 0.70; 95% CI 0.58 to 0.85; nine trials, 4664 participants, high quality evidence), and may prevent a similar proportion in LMICs but only two trials from urban Egypt and Kenya have evaluated this (rate ratio 0.66, 95% CI 0.43 to 0.99; two trials, 45,380 participants, low quality evidence). Only three trials reported measures of behaviour change and the methods of data collection were susceptible to bias. In one trial from the USA hand washing behaviour was reported to improve; and in the trial from Kenya that provided free soap, hand washing did not increase, but soap use did (data not pooled; three trials, 1845 participants, low quality evidence).Hand washing promotion among communities in LMICs probably prevents around one-quarter of diarrhoea episodes (rate ratio 0.72, 95% CI 0.62 to 0.83; eight trials, 14,726 participants, modera...

Background Diarrhoea accounts for 1.8 million deaths in children in low‐ and middle‐income countries (LMICs). One of the identified strategies to prevent diarrhoea is hand washing. Objectives To assess the effects of hand‐washing promotion interventions on diarrhoeal episodes in children and adults. Search methods We searched CENTRAL, MEDLINE, Embase, nine other databases, the World Health Organization (WHO) International Clinical Trial Registry Platform (ICTRP), and metaRegister of Controlled Trials (mRCT) on 8 January 2020, together with reference checking, citation searching and contact with study authors to identify additional studies. Selection criteria Individually‐randomized controlled trials (RCTs) and cluster‐RCTs that compared the effects of hand‐washing interventions on diarrhoea episodes in children and adults with no intervention. Data collection and analysis Three review authors independently assessed trial eligibility, extracted data, and assessed risks of bias. We stratified the analyses for child day‐care centres or schools, community, and hospital‐based settings. Where appropriate, we pooled incidence rate ratios (IRRs) using the generic inverse variance method and a random‐effects model with a 95% confidence interval (CI). We used the GRADE approach to assess the certainty of the evidence. Main results We included 29 RCTs: 13 trials from child day‐care centres or schools in mainly high‐income countries (54,471 participants), 15 community‐based trials in LMICs (29,347 participants), and one hospital‐based trial among people with AIDS in a high‐income country (148 participants). All the trials and follow‐up assessments were of short‐term duration. Hand‐washing promotion (education activities, sometimes with provision of soap) at child day‐care facilities or schools prevent around one‐third of diarrhoea episodes in high‐income countries (incidence rate ratio (IRR) 0.70, 95% CI 0.58 to 0.85; 9 trials, 4664 participants, high‐certainty evidence) and may prevent a similar proportion in LMICs, but only two trials from urban Egypt and Kenya have evaluated this (IRR 0.66, 95% CI 0.43 to 0.99; 2 trials, 45,380 participants; low‐certainty evidence). Only four trials reported measures of behaviour change, and the methods of data collection were susceptible to bias. In one trial from the USA hand‐washing behaviour was reported to improve; and in the trial from Kenya that provided free soap, hand washing did not increase, but soap use did (data not pooled; 3 trials, 1845 participants; low‐certainty evidence). Hand‐washing promotion among communities in LMICs probably prevents around one‐quarter of diarrhoea episodes (IRR 0.71, 95% CI 0.62 to 0.81; 9 trials, 15,950 participants; moderate‐certainty evidence). However, six of these nine trials were from Asian settings, with only one trial from South America ...

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Background: Breast cancer is the commonest cancer among women globally. Early screening remains a critical approach to reducing morbidity and mortality. Mammography, one of such screening tools, is vital in improving outcomes and survival. However, poor knowledge and ignorance have been touted as major barriers to health services uptake in Low/Middle-income countries. This study therefore determined breast cancer knowledge and mammography uptake among women aged ≥40 years in Calabar Municipality. Methods: A cross-sectional study design was used to elicit information from 365 women that were randomly selected using a semi-structured questionnaire. Data analysis was carried out using SPSS version 20. The results were descriptively presented by frequencies and percentages. Pearson Chi-Square (ꭓ2) analysis was performed to detect the association between variables at 5% level of significance (p-value of ≤ 0.05). Results: Majority of the 365 study participants 121 (33.3%) were aged between 40 – 44 years and had attained tertiary level of education 231 (63.2%). Most of the respondents had low knowledge score 214 (58.6%) of breast cancer and mammography. Only 36 (9.9%) of the respondents have had mammography out of which most 22 (61.0%) used it only once. Knowledge level of breast cancer and mammography was statistically significantly associated with uptake (p = .00001). Conversely knowledge of breast cancer and mammography was not statistically significantly associated with educational attainment (p = .54). Conclusions: Knowledge level of breast cancer and uptake of mammography among women aged ≥40 in Calabar Municipality was very poor. The need to increase awareness about breast cancer and breast cancer screening are highly advocated.

Introduction After the World Health Organization declared COVID-19 a pandemic, a hand full of cases and deaths have been recorded globally, Nigeria inclusive. Methods A retrospective analysis of the COVID-19 weekly disease update report by the Nigeria Centre for Disease Control (NCDC) covering February 29, 2020 (Week 9) and March 28, 2021 (Week 12) was adopted for this study. Data were curated from the NCDC database. Results As of March 28, 2021, Nigeria is the 5 th most affected African country and the 77 th most affected country globally with 162,593 COVID-19 cases and 2,048 COVID-19 related deaths. COVID-19 has been reported in all 36 States and the Federal Capital Territory. However, Lagos has remained the epicenter of the pandemic accounting for 35.4% of the pandemic in Nigeria while Kogi State is the least affected State (0.003%). The trend showed male predilection while the age bracket 35-39 years was the most affected. The attack rate was found to be 78.8 per 100,000 of the population while the cumulative death per 100,000 of the population was found to be 1.0. The case fatality rate was found to be 1.30. Approximately 1,778,105 COVID-19 tests have been performed while 923,623 doses of vaccine have been administered. Conclusions COVID-19 has been reported in all states in Nigeria as well as the Federal Capital Territory with many of the cases involving males. The case trend showed a bimodal form indicating a second wave occurrence. Nigeria government has initiated some combative measures as well as vaccine initiation.