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New Study Advocates Revision of Global Guidelines on Preventing Surgical Infections

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Wound  infections are the most common post-operative problem, particularly in developing countries, but promised innovations to tackle the issue do not work thereby requiring  revision of global guidelines, a new study has said.

Both the World Health Organisation (WHO) and the UK’s National Institute of Health Research (NIHR) guidelines recommend that surgeons use alcoholic chlorhexidine skin preparation and triclosan coated sutures to prevent Surgical Site Infections (SSI).

However, the Falcon study, funded by the NHIR as the world’s largest wound infection trial, carried out in Benin, Ghana, India, Mexico, Nigeria, Rwanda and South Africa, could not demonstrate superiority of these interventions over lower cost alternatives.

Publishing their findings on Tuesday, in the British medical journal, The Lancet, researchers participating in this study called for the revision of the guidelines recommending these measures, either specifically to low and middle-income countries (LMIC) or at the global level.

Co-author Mr. Aneel Bhangu, from the University of Birmingham, said: “Surgical site infection is the world’s most common postoperative complication – a major burden for both patients and health systems. We have delivered the biggest trial of its kind, where we could not demonstrate the superiority of these interventions over cheaper alternatives.

“Our findings are hugely important for a wide range of care providers in LMICs, as following existing WHO and NICE guidelines, would mean significant cost implications for organisations, which have limited resources.”

Patients who develop SSI, experience pain, disability, poor healing with the risk of wound breakdown, prolonged recovery times and psychological challenges.

Those patients in LMICs are disproportionately affected by higher rates of SSI compared to those in high-income countries – increasing the risk of catastrophic expenditure, impoverishment, and wider negative community impact.

The NIHR Global Health Research unit’s Global Surgery trial covered 5,788 patients from 54 hospitals in seven countries – a broad and representative range, including adults and children undergoing contaminated/dirty surgery, emergency surgery and caesarian section.

Co-author Prof. Adesoji Ademuyiwa, of the University of Lagos’ Teaching Hospital, who coordinated the study in 12 hospitals across different geopolitical zones in Nigeria, said: “The overall SSI rate was very high at 22% – a preventable complication that is causing unnecessary suffering and burden to patients and systems.

“It is clear that small randomised trials should now be avoided and should be replaced with larger trials that can provide more robust evidence on the incidence of SSI, ultimately leading to more effective measures to help tackle this global healthcare challenge.

”This high quality evidence will impact heavily on practice in LMICs, including Nigeria, as cheaper and available options can be confidently used for patients with calm assurance that the outcome will not be adversely affected.”

Co-investigator Prof. Lukman Abdur-Rahman, of the University of Ilorin, Nigeria, commented: “We have often thought that the use of skin preparation agents and anti-microbial impregnated sutures recommended by WHO and NICE gave the high-income countries advantage in the reduction of Surgical site infections as compared with the LMICs, where these expensive agents and sutures are not readily available.

”This multi-centred pragmatic randomized study in LMICs showed no significant reduction in SSI rates, despite the choice and use of the materials or agents. There is a need for global review of the guidelines of measures to reduce SSI.”

Dr Samson Olori, a co-investigator from the University of Abuja Teaching Hospital, states that: “The Falcon study was a huge attempt at finding solutions to the persistent menace of the SSI in LMICS.

”We latched onto it hoping that the perennial question on how best to address SSI in our environment could be answered, alas, that was not to be. But the study was a huge success in itself, because it has further proved that large scale randomised studies will provide trusted data to address a research question.

”For now, the quest continues, perhaps a follow up study designed along the peculiarities of the LMICS may help find answers to SSI.”

“This high quality, multinational large scale trial in Iow and middle income countries (LMICs) has finally rested the argument on the superiority of either alcohol chlorhexidine or povidone iodine and triclosan coated antibiotic sutures in surgical site infection control” says Dr Hyginus Ekwunife, the Principal Investigator at Nnamdi Azikwe University Teaching Hospital (NAUTH).

He added: “For long, decisions concerning the high SSI in LMICs has been based on data extrapolated from high income nations with risks of poor validity and efficiency.

”The multinational surgical site infection trial is good news for the LMICs where increasing cost of surgery tends to cause catastrophic expenditures and further impoverishment.

”Hopefully, this beautiful research experience will open further research doors to contain the still high SSI rate on LMICs. Considerations need to be given to processes more than products.” (NAN) 

Health

Stakeholders Call for Better Menstrual Hygiene To Boost Health

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 Stakeholders have stressed the need for increased awareness and improved practices around menstrual hygiene, particularly to support better health outcomes and dignity for girls in underserved communities.

They made the call on Wednesday in Abuja ahead of the 2025 Menstrual Hygiene Day, commemorated globally every May 28 to address inequalities in menstrual health and hygiene.

The event was organised by Tabitha Cumi Foundation (TCF) under its Always Keeping Girls in School (AKGIS) project, with support from Charities Aid Foundation (CAF America).

Mrs Tayo Erinle, Executive Director of TCF, said menstrual hygiene remained a critical yet often overlooked aspect of reproductive health, especially among adolescent girls.

“Many girls live in households where no one provides sanitary pads or pays attention to that part of their lives.

“It happens monthly, and every girl deserves dignity and support,” she said.

Erinle added that more than 1,600 marginalised girls across 32 junior secondary schools in the FCT, Lagos, and Benue states were empowered through puberty education and menstrual hygiene management under the AKGIS project.

She said beneficiaries also received a one-year supply of Always sanitary pads and emergency kits.

“The project has boosted the girls’ confidence.

“Menstruation was once shrouded in secrecy, stigma, and confusion for many. Now, with access to correct information and education, they feel empowered,” she added.

Dr Adedolapo Fasawe, Mandate Secretary for the Health Services and Environment Secretariat, emphasised the importance of educating youths on reproductive health.

Represented by Dr Ruqayya Wamakko, Executive Secretary of the FCT Primary Health Care Board, she called for more sensitisation efforts to encourage young people to use health services in primary health centres.

“We give health talks, visit schools, form school clubs, and teach students how to care for themselves, maintain personal and menstrual hygiene, and stay safe,” she noted.

Mrs Nwakonye Onyirechi, Assistant Chief Investigative Officer in the Women and Children Department of the National Human Rights Commission (NHRC), reiterated the commission’s commitment to protecting the rights of the girl child.

“We go to schools to sensitise girls to their rights and encourage them to speak up when their rights are violated,” she said.

Dr Safiya Tamanuwa, Deputy Director of the Placement and Gender Unit at the Universal Basic Education Commission (UBEC), commended TCF for its support toward improving the health and well-being of schoolgirls.

Highlights of the event included the distribution of sanitary pads and kits, a literary presentation, and expert-led health talks.(NAN)

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Health

Group urges Nigerians to embrace healthy habits to prevent diseases 

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The Society of Lifestyle Medicine of Nigeria (SOLONg) has advised Nigerians to embrace healthy preventive lifestyle habits to prevent the root causes of chronic and lifestyle-related diseases.

The President of SOLONg, Dr Moyosore Makinde, gave the advice in an interview in commemoration of the “Global Lifestyle Medicine Week” on Tuesday in Lagos.

NAN reports that the Global Lifestyle Medicine Week, taking place from May 18 to May 24, 2025, has the theme “Celebrating Healthy Habits: Inspire Change with D.

R.E.A.M.S.”

Makinde, also an International Board-certified Lifestyle Medicine Physician, said the week was dedicated to raising awareness about the transformative power of lifestyle medicine in improving health outcomes and reducing the burden of chronic diseases worldwide.

According to her, lifestyle medicine empowers people to live healthier, happier and longer lives.

She explained that the D.R.E.A.M.S. acronym highlighted the six key pillars of lifestyle medicine that guide individuals toward healthier lives namely: Predominantly plant-based Diets, positive Relationships or social connections, Exercise, Avoidance of toxic substances, Mental wellness and stress management, and restorative Sleep.

She said that these pillars had been proven by scientific research to not only manage and prevent chronic diseases like coronary heart disease, diabetes, dementia and Alzheimer’s but also to promote a more sustainable and harmonious relationship with ourselves and with our planet.

Makinde added that it contributed to planetary health and the stability of our ecosystem.

“SOLONg is proud to announce its participation in Global Lifestyle Medicine Week, taking place from May 18 to May 24, 2025.

“Scientific studies, including numerous randomised clinical trials and longitudinal studies, have consistently shown the remarkable benefits of lifestyle interventions in reducing the incidence of chronic conditions.

“Additionally, these healthy habits play a pivotal role in strengthening resilience against infectious diseases.

“The ongoing impact of several pandemics has underscored the importance of adopting healthy behaviours, as poor lifestyle choices have been associated with worse disease severity and slower recovery times,” she said.

Contributing, the General Secretary of   SOLONg, Dr Chika Anozie, said that Global Lifestyle Medicine Week aimed to foster a community of like-minded individuals and healthcare professionals committed to lifestyle medicine.

Anozie, also a Family Physician, said that SOLONg would organise various activities to mark the week, including a  Webinars and educational workshops on lifestyle medicine topics.

She added that there would be courtesy visits and community outreach programmes promoting healthy habits, as well as social media campaigns sharing lifestyle medicine tips and resources.

“As we observe Global Lifestyle Medicine Week, it is clear that the need for Lifestyle Medicine is greater than ever.

“This is a clarion call for the government to create policies that promote healthy lifestyle practices while restricting behaviours that contribute to disease.

“We urge medical institutions to prioritise the accreditation of Lifestyle Medicine programs at both undergraduate and postgraduate levels.

“It is equally important that health professionals receive the proper training to effectively communicate these life-saving messages to the public.

“The Society encourages individuals to embrace the principles of healthy living, which are not only lifechanging but also long-lasting,” she said.(NAN)

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NAFDAC Clarifies Sachet Alcohol Ban Timeline

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The National Agency for Food and Drug Administration and Control (NAFDAC) has clarified its stance regarding the nationwide ban on sachet alcohol.

Mr Kenneth Azikiwe, Director of the FCT Directorate of the agency, in an interview on Monday in Abuja that the temporary lifting of the ban was only valid until Dec.

31, 2025.

He emphasised that the recent ministerial lifting of the ban was not permanent and urged the public to disregard misinformation suggesting that the government had permanently lifted the restriction.

“There is a ministerial lifting on the ban of sachet alcohol, but it is only temporary and will be reviewed by Dec. 31, 2025.

“After this date, the full enforcement of the ban will commence.

“The minister granted this temporary relief to allow manufacturers and regulators time to collaborate and ensure a more structured and effective implementation of the ban,” Azikiwe stated.”

He highlighted NAFDAC’s ongoing efforts to sensitise the public across the country, noting that awareness campaigns had reached every state.

“We have sensitised distributors, and we’ve emphasised that alcohol should not be sold to individuals under the age of 18, which is also clearly indicated on product labels,” he added.

Azikiwe also commended the Distillers and Beverages Association of Nigeria (DIBAN) for supporting the awareness drive.

He reassured the public that NAFDAC remained fully committed to regulating alcohol consumption and reiterated that sachet alcohol products containing less than 200 milliliters would be phased out after Dec. 2025.(NAN)

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