Diabetes mellitus and its associated factors among patients with tuberculosis attending directly observed treatment centres in Oyo State, Nigeria: a cross-sectional evaluation.

OBJECTIVE: Diabetes mellitus (DM) and tuberculosis (TB) comorbidity is evolving into an emerging epidemic globally. In Nigeria, a high burden of both diseases, respectively, exists with limited information on tuberculosis-diabetes mellitus (TB-DM) comorbidity. We determined the fasting blood glucose (FBG) level among patients with TB and factors associated with TB-DM comorbidity in Oyo State, South-west Nigeria. METHODS: A cross-sectional study was conducted among patients with TB aged 15 years and above, who were selected using multistage sampling. Data were collected on patients' biodata, anthropometric measurements and FBG levels using a pretested semistructured questionnaire. The FBG test was conducted on patients with confirmed pulmonary TB (old and newly diagnosed patients with TB) at any stage of anti-TB treatment. Background characteristics and FBG level were summarised using descriptive statistics and factors associated with TB-DM comorbidity were examined at bivariate and multivariable analyses. RESULTS: Of the 404 patients with TB, 30 (7.4%) had impaired fasting glucose and 32 (7.9%) were diagnosed with diabetes. The mean age of the male and female respondents was 41 (±14.2) and 36.8 (±15.0), respectively. Females were more likely than males to have diabetes (10.6% vs 6.3%). Median FBG level for the patients was 88 (IQR: Q1: 99, Q3: 79) mg/dL. Age, marital status and educational level were not associated with TB-DM comorbidity. In the multivariable model, only normal body mass index was independently and significantly associated with diabetes. CONCLUSION: TB-DM was prevalent among the studied population in South-west Nigeria. We recommend the integration of DM screening within the continuum of care for TB management.

Technical quality of delivery care in private- and public-sector health facilities in Enugu and Lagos States, Nigeria.

Private-sector providers are increasingly being recognized as important contributors to the delivery of healthcare. Countries with high disease burdens and limited public-sector resources are considering using the private sector to achieve universal health coverage. However, evidence for the technical quality of private-sector care is lacking. This study assesses the technical quality of maternal healthcare during delivery in public- and private-sector facilities in resource-limited settings, from a systems and programmatic perspective. A summary index (the skilled attendance index, SAI), was used. Two-staged cluster sampling with stratification was used to select representative samples of case records in public- and private-sector facilities in Enugu and Lagos States, Nigeria. Information to assess criteria was extracted, and the SAI calculated. Linear regression models examined the relationship between SAI and the private and public sectors, controlling for confounders. The median SAI was 54.8% in Enugu and 85.7% in Lagos. The private for-profit sector's SAI was lower than and the private not-for-profit sector's SAI was higher than the public sector in Enugu [coefficient = -3.6 (P = 0.018) and 12.6 (P < 0.001), respectively]. In Lagos, the private for-profit sector's SAI was higher and the private not-for-profit sector's SAI was lower than the public sector [3.71 (P = 0.005) and -3.92 (P < 0.001)]. Results indicate that the technical quality of private for-profit providers' care was poorer than public providers where the public provision of care was weak, while private for-profit facilities provided better technical quality care than public facilities where the public sector was strong and there was a relatively strong regulatory body. Our findings raise important considerations relating to the quality of maternity care, the public-private mix and needs for regulation in global efforts to achieve universal healthcare.

Experiences of girls with hearing impairment in accessing reproductive health care services in Ibadan, Nigeria.

Delivery of health services to people with hearing impairment is poorly understood in Nigeria and limited research has been done to throw more light on the process involved. This study described experiences of 167 girls with hearing impairment in accessing reproductive health services in Ibadan using a validated questionnaire. Descriptive statistics and binary logistic regression were used to analyze the data. Almost 95.0% of respondents had ever visited health facility for reproductive health issues. Of these 6.2% and 4.6% went for treatment of STIs and pregnancy termination respectively; 36.7% were embarrassed to ask questions in the presence of an interpreter, communication (40.5%) and cost (10.8%) were key barriers to access and 85.6% would use facility if hearing impairment-friendly services are provided. Respondents who were currently working were 20 times more likely to receive services they wanted (OR = 20.29, CI = 1.05-392.16). Availability of certified interpreters and ensuring confidentiality are key to effective service delivery for the hearing impaired.