Patient reporting practices of suspected adverse drug reactions to antiretroviral drugs in a tertiary health facility in Nigeria.

AIMS AND OBJECTIVES: To assess the proportion of patients with suspected adverse drug reactions (ADRs) to highly active antiretroviral therapy (HAART) who reported the reactions to their healthcare providers and the factors associated with the reporting. PATIENTS AND METHODS: The study was conducted in the US President's Emergency Plan For AIDS Relief (PEPFAR) clinic at the University of Benin Teaching Hospital (UBTH), Benin City. The study population consisted of adult HIV infection patients receiving HAART at the clinic, who had suspected ADRs (SADRs). Using a systematic random sampling technique, patients were selected and interviewed with the aid of a structured questionnaire. The outcome measure was whether or not a SADR was reported to a healthcare provider. RESULTS: The study participants totalled 233, 171 (73.4%) of whom reported SADRs to their healthcare providers. Statistically significant difference was demonstrated with following higher-than-mean proportions of participants that reported SADRs: 100% (13/13) of respondents who experienced a SADR perceived to be life-threatening, (p=0.02; OR=0.00, 95%CI=0.00-0.87); 88.6% (31/35) of those who regarded their SADRs as severe (p=0.01; OR=4.02, 95%CI=1.28-16.63); and 95.2% (20/21) of those who had skin eruptions (p=0.02; OR=0.12, 95%CI=0.00-0.81). CONCLUSIONS: The finding that a high proportion of patients reported SADRs suggests that majority of patients contribute to pharmacovigilance and that they constitute opportunities for direct reporting of HAART-related ADRs to pharmacovilance centres. Facility-based pharmacovigilance desks should be set up and access should be created for patients to report SADRs directly. Healthcare providers should educate patients to report SADRs.

Asymptomatic malaria parasitaemia using rapid diagnostic test in unbooked pregnant women in rural Ondo-south district, Nigeria.

BACKGROUND: Malaria is a major contributor of maternal and peri-natal morbidity and mortality. The disease may be asymptomatic despite sequestration of parasitized red blood cells in the placental micro-circulation with antecedent complications. In such condition, it may also be difficult to identify the malaria parasite by the peripheral blood film microscopy, thus the need for use of simple but reliable tool for malaria parasite diagnosis. OBJECTIVE AND METHOD: To determine the prevalence of asymptomatic malaria parasitaemia using the Rapid Diagnostic Test in pregnant unbooked women seen in a primary health centre during a malaria control campaign programme in rural Ondo-south, District Nigeria. RESULTS: Prevalence of asymptomatic malaria parasitaemia was 25.9%. Only 3 (3.5%) of the 85 women had the long lasting insecticide-treated nets. There was no significant association between malaria parasitaemia, and the age group, parity and gestation age. CONCLUSION: Given the high prevalence of asymptomatic malaria in pregnancy, routine screening for malaria at booking and scaling-up of other malaria control strategies such as the use of long lasting insecticidal-treated nets and intermittent preventive therapy for pregnant women are recommended.

"He does his own and walks away" perceptions about male attitudes and practices regarding safe motherhood in Ekiadolor, Southern Nigeria.

The main study objectives were to highlight male attitudes and practices regarding safe motherhood, and to demonstrate the usefulness of qualitative research methods in studying behaviour-related health problems. The setting was Ekiadolor, a semi-urban Nigerian community with an under-resourced district hospital. The study design was a qualitative research, using Focus Group Discussions (FGDs) with females and the local hospital staff as participants, triangulated with Free Listing Interviews (FLIs) and group interviews of males. The FGD findings showed a consensus that male practices and attitudes were generally unsatisfactory, as exemplified by physical violence against females, delay in enabling access to emergency obstetric care and a general perception that males were uncaring. However, many males paid parts of their partners' routine obstetric care bills. These findings were largely corroborated and enriched by those of the FLIs and group interviews, albeit with differing emphases; they provided vital inputs into health education of the community males. In conclusion, the wide range of attitudes and practices described, and the socioeconomic settings in which they occur, pose challenges and opportunities for behaviour change interventions primarily targeting males, poverty reduction and health service reforms. Health researchers are challenged to draw from the varied strengths of qualitative research methods.

Prison deprivation and protein nutritional status of inmates of a developing community prison.

OBJECTIVE: This study assesses the protein nutritional status of inmates of a small prison, in the light of a changing serum protein pattern in the environment. DESIGN: Survey of prison inmates. SETTING: A male prison and low social class hospital workers. SUBJECTS: 81 inmates and 62 randomly selected controls, of which 42 of the former and 28 of the latter were further randomly selected. METHODS: Nutritional and confinement history were obtained by a questionnaire, Weights and heights were measured and serum and urine samples collected for protein estimations. RESULTS: The prisoners were confined for 229.1 (SD 210.1) days. 48.1% had BMI < 20 kg/m2 compared to 28.6% of controls (p = 0.04). Their diet was predominantly carbohydrate. Mean total serum protein was 81.5gm/L (6.1) (95% CI = 79.3-83.5) (prisoners); 88.7 gm/L (8.1) (95% CI = 85.7-91.7) (controls). Serum globulin was 44.9 gm/L (6.3) (95% CI = 42.9-46.9) (prisoners); 55.4 gm/L (8.2) (95% CI = 52.3-58.5) (controls) (p <0.001 respectively). More prisoners than controls had severe hypo- albuminaemia (p =0.001). All values were lower in those awaiting trial compared to convicted inmates. Total protein and albumin weakly correlated with duration of confinement (r = -0.23 and -0.15, respectively). CONCLUSION: The study suggest that the prisoners might be undernourished with lower serum proteins than controls, within an average of seven months confinement. The picture appears worse in those awaiting trial and with prolonged duration of confinement.