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Research Article
Efficacy and Safety of eLAXTM Probiotic-Botanical Supplement in Improving Constipation: A Single-Center, Single-Arm Study
Issue:
Volume 11, Issue 4, December 2026
Pages:
392-403
Received:
16 July 2026
Accepted:
30 September 2026
Published:
9 October 2026
Abstract: Background: Functional constipation impairs gut health and quality of life. Okra (Abelmoschus esculentus), traditionally used for treating gastrointestinal complaints, is rich in soluble dietary fiber and mucilaginous polysaccharides thought to increase stool water retention, soften feces, and promote luminal bulk, thereby facilitating colonic transit. Preclinical studies link okra mucilage to gut barrier support and favorable shifts in gut microbiota composition. The eLAXTM Probiotic-Botanical Supplement (eLAX) combines okra extract with Lactobacillus casei probiotics. We evaluated its efficacy and safety in a single-center, open-label, self-controlled study and report the complete 12-week dataset. Methods: Fifty-one adults meeting Rome IV criteria for functional constipation were enrolled at Xiangya Hospital; 49 completed the study and were analyzed. Participants received descending doses of eLAX over 10 weeks with intervening washouts (Weeks 1-2: 4 tablets/day; Week 3 washout; Weeks 4-6: 3/day; Week 7 washout; Weeks 8-10: 2/day), then 2 weeks of observation without product. The primary endpoint was the responder rate (increase in spontaneous bowel movements [SBMs] per 24 h versus baseline) at Weeks 2, 6, 10, and 12. Exploratory endpoints included gut microbiota, PAC-SYM, PAC-QOL-12, bowel diaries (frequency, straining, Bristol Stool Scale [BSS], abdominal pain), and assisted-defecation use. Safety included laboratory tests and colonoscopy in a subset. Results: Responder rates (N=49) were 87.8%, 61.2%, 55.1%, and 42.9% at Weeks 2, 6, 10, and 12. Mean SBM frequency rose from 0.51/day at baseline to 1.88, 1.35, and 1.12/day at Weeks 2, 6, and 10 (all p<0.0001), remaining above baseline at Week 12 (0.82/day, p=0.0086). Mean time to first bowel movement was 5.88±4.12 h (61.2% within half a day). BSS shifted from types 1-2 toward types 3-7 after 10 weeks (mean +2 grades); 69.3% retained ideal types 3-4 at Week 12. Straining resolved by Week 10; incomplete evacuation and abdominal pain declined. PAC-SYM (0-30) fell from 15.96±3.33 to 1.00±1.98 at Week 10 (−93.73%, p<0.0001) and remained improved at Week 12 (−78.64%). PAC-QOL-12 improved by 88.76% at Week 10 (p<0.0001). Microbiota diversity rose 9.65% (p=0.0091) and the Bacteroidetes/Firmicutes ratio rose 162.57% (p<0.0001) at Week 10. No product-related adverse events occurred; colonoscopy (n=10) showed no melanosis coli. Conclusion: Over 12 weeks, eLAX was associated with significant improvements in bowel frequency, stool consistency, symptoms, quality of life, and gut microbiota, with a favorable safety profile. Benefits were most durable in participants without baseline spontaneous defecation; milder cases may need longer low-dose maintenance after tapering.
Abstract: Background: Functional constipation impairs gut health and quality of life. Okra (Abelmoschus esculentus), traditionally used for treating gastrointestinal complaints, is rich in soluble dietary fiber and mucilaginous polysaccharides thought to increase stool water retention, soften feces, and promote luminal bulk, thereby facilitating colonic tran...
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Research Article
Knowledge and Perception Towards Family Planning Utilization Among Males of Reproductive Age in Imo State
Issue:
Volume 11, Issue 4, December 2026
Pages:
404-426
Received:
5 September 2026
Accepted:
23 September 2026
Published:
20 October 2026
Abstract: Family planning utilization among males remains an important reproductive health issue in Nigeria, as poor knowledge, misconceptions, and limited male involvement may affect contraceptive use. This study assessed knowledge and perception towards family planning utilization among males of reproductive age in Imo State, Nigeria. A community-based cross-sectional study was conducted among 630 males selected using a multistage sampling technique. Data were collected using a structured interviewer-administered questionnaire and analysed using descriptive statistics, chi-square test, logistic regression, propensity score matching, and inequality analysis. The prevalence of family planning utilization was 67.14% (95% CI: 63.37-70.71). Respondents who utilized family planning had a higher proportion of positive perception than those who did not. Good knowledge was significantly associated with family planning utilization, with respondents having good knowledge more likely to utilize family planning services (AOR = 1.87; 95% CI: 1.19-2.92; p = 0.006). Respondents with tertiary education also had higher odds of family planning utilization compared with those with primary education or less (AOR = 2.48; 95% CI: 1.27-4.86; p = 0.008). The unmatched results revealed that males exposed to good knowledge had a higher mean knowledge score (7.42) compared to those not exposed to good knowledge (5.24), with a mean difference of 2.18 (SE = 0.17, t = 12.94). After matching, the average treatment effect on the treated (ATT) showed that males exposed to good knowledge had a higher mean knowledge score (7.43) compared to their matched unexposed counterparts (5.30), with a mean difference of 2.13 (SE = 0.17, t = 12.64). The study concludes that knowledge and educational attainment are important factors in family planning utilization among males in Imo State. Strengthening male-focused health education, improving access to accurate reproductive health information, and promoting male involvement in family planning are recommended to improve utilization.
Abstract: Family planning utilization among males remains an important reproductive health issue in Nigeria, as poor knowledge, misconceptions, and limited male involvement may affect contraceptive use. This study assessed knowledge and perception towards family planning utilization among males of reproductive age in Imo State, Nigeria. A community-based cro...
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Research Article
Extent of ICD-11 Implementation in Teaching Hospitals of North-East Nigeria: A Cross-Sectional Survey of Health
Information and ICT Professionals
Issue:
Volume 11, Issue 4, December 2026
Pages:
427-438
Received:
2 October 2026
Accepted:
13 October 2026
Published:
21 October 2026
Abstract: Background: The 11th revision of the International Classification of Diseases (ICD-11) took effect in January 2022, yet there is no published evidence on how far Nigerian hospitals have put it into use. We measured the extent of ICD-11 implementation reported by health information management (HIM) professionals and information and communication technology (ICT) personnel in three teaching hospitals in North-East Nigeria, and examined which respondent and hospital characteristics were associated with substantial implementation. Methods: This was the second objective of a cross-sectional survey of staff in teaching hospitals in Yola, Bauchi and Maiduguri, whose design is described in a companion paper. Twelve Yes/No indicators covering system availability, technical integration, functional readiness and interoperability were summed (range 0-12); a score of 6 or more was defined as substantial implementation. Associations were examined with chi-square tests and binary logistic regression. Results: Data from 475 respondents were analysed (373 HIM, 102 ICT; response 97.7%). A third (32.2%) reported none of the indicators, half (51.2%) reported one to five, and 16.6% (95% confidence interval [CI] 13.6-20.2) reported six or more. Substantial implementation was reported by 20.1% of HIM officers and 3.9% of ICT personnel (p < 0.001), and by 3.8% of respondents in Yola, 31.8% in Bauchi and 10.6% in Maiduguri (p < 0.001). After adjustment, ICT personnel (adjusted odds ratio [AOR] 0.14; 95% CI 0.05-0.42) and staff with 16 or more years of experience (AOR 0.17; 0.06-0.50) were less likely, and staff in Bauchi (AOR 13.57; 4.58-40.19) and Maiduguri (AOR 3.88; 1.25-12.03) more likely than staff in Yola, to report substantial implementation. Conclusion: ICD-11 implementation is at an early stage in these hospitals, with wide differences between professions and hospitals. Joint HIM-ICT planning, integration of the ICD-11 code set into existing systems, training and hospital-specific support are needed. The estimates rest on self-report and a pragmatic cut-off and should be confirmed by audits of actual coding.
Abstract: Background: The 11th revision of the International Classification of Diseases (ICD-11) took effect in January 2022, yet there is no published evidence on how far Nigerian hospitals have put it into use. We measured the extent of ICD-11 implementation reported by health information management (HIM) professionals and information and communication tec...
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Research Article
Availability and Utilization of Tools for the Medical Certification of Causes of Death in Public Health Facilities in Senegal in 2025
Tidiane Gadiaga*
,
Adja Mah Djamaro Diane,
Ibrahima Ndiaye,
Ngone Seck,
Ousmane Dia,
Amina Abdoulaye,
Benjamin Clapham,
Mohamed M. Soumah,
Ousmane Thiam,
Babacar Gueye
Issue:
Volume 11, Issue 4, December 2026
Pages:
439-453
Received:
22 September 2026
Accepted:
4 October 2026
Published:
23 October 2026
DOI:
10.11648/j.wjph.20261104.14
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Views:
Abstract: Reliable data on causes of death are essential to guide health policy, yet fewer than one in ten deaths is medically certified in many sub-Saharan African countries. Since 2021, Senegal has progressively deployed a harmonized set of WHO-aligned death management tools, including a medical certificate of cause of death (MCCD); an initial 2023 assessment had revealed partial tool availability, frequent completion errors, and insufficient trained staff. A second national cross-sectional assessment was conducted in 2025, combining a facility-level structural audit with a systematic review of MCCDs completed in 2024, using a standardized digitized tool to record tool availability, utilization, and training coverage, and to score certificate content and form (score out of 30 points: poor ≤10, medium 11-20, good 21-30); data were analyzed descriptively. Of 183 targeted facilities, 147 (80.3%) were supervised (27/39 public hospitals [EPS], 69.2%; 120/144 health centers [CS], 83.3%). MCCD availability exceeded 90% in most EPS clinical departments but fell to 50-60% in surgery and intensive care and was nil in mortuaries; in CS, clinical documents were available in 99% of cases, versus 69-70% for mortuary-related registers, and utilization was consistently lower than availability. Training coverage reached 72.8% of supervised EPS departments and 73% of supervised CS. Among 1,469 MCCDs examined, representing 25% of the 5,852 medically certified deaths recorded nationally in 2024, only 292 (19.9%) were of good quality, 596 (40.6%) of medium quality, and 581 (39.6%) of poor quality, with poor quality predominating throughout the year (35.0-48.9% by month). The interval between disease onset and death was most frequently left blank (77%), and the causal sequence showed the highest error rate (27%), most often recording a sign or mechanism of death instead of a diagnosis. Only 46% of certificates were written in capital letters, 79% were legible, 66% were free of abbreviations, and 77% were free of crossing-out. Training deficit was the most frequently reported obstacle (65.6% of facilities), followed by non-availability of tools (13.1%). After two years of implementing harmonized death management tools, this assessment shows improved tool availability in Senegal's public health facilities but reveals persistent gaps in effective utilization and, above all, in the technical quality of medical certification, which remains well below what is required for reliable mortality statistics. Sustained initial and continuing training, systematic supervision, and uniform tool availability, particularly in surgery, intensive care, and mortuary services, are needed to ensure reliable cause-of-death data for national health policy.
Abstract: Reliable data on causes of death are essential to guide health policy, yet fewer than one in ten deaths is medically certified in many sub-Saharan African countries. Since 2021, Senegal has progressively deployed a harmonized set of WHO-aligned death management tools, including a medical certificate of cause of death (MCCD); an initial 2023 assessm...
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