Leadership Styles versus Health Workers' Job Satisfaction: Relationships, Correlates and Predictors in Tertiary Hospitals in Ekiti State, Southwest Nigeria.

BACKGROUND: The healthcare delivery in Nigeria operates in a turbulent environment with professional rivalry leading to job dissatisfaction among players. This lack of cohesion, which has shown the need for appropriate leadership, has made healthcare professionals function in an environment of uncertainty, disorder, and ambiguity. AIMS: This study assessed leadership styles and health workers' job satisfaction in tertiary hospitals in Ekiti State, Nigeria. METHODS: This is a cross-sectional study. Multistage sampling technique was used to select respondents. Data were analyzed using IBM SPSS version 20.0 statistical software. Level of statistical significance was set at P < 0.05. RESULTS: More than half, 205 (51.8%), of the employees were found to be within the third decade of life with a mean of 33.2 ± 7.2 years. Among the employees, only 6 (1.5%) had high job satisfaction; laissez faire style had negative relationship with job satisfaction (r = -0.084; P = 0.094). Age of the leader (r = -0.095), duration of tenure by the heads of units (r = -0.003) exhibited negative correlation with job satisfaction. Age of employees and contingent reward were found to be significantly predictive of job satisfaction (P < 0.05). CONCLUSION: Very few of the employees had high job satisfaction and leadership styles impacts health workers' job satisfaction differently. Transformational styles were more related to health workers' job satisfaction than the transactional styles. Laissez-faire exhibited a negative relationship with job satisfaction. There is need for leadership skills on the part of the healthcare leaders; age of leader and duration of tenure needs to be further benchmarked to improve job satisfaction among the healthcare workers.

Practice of safety measures among inter-city commercial vehicle drivers in Kwara State, Nigeria.

INTRODUCTION: The incidence of Road Traffic Crashes (RTC) is rising world-wide, with 1.24 million people killed on the world's roads in 2010 due to non-compliance with safety measures. The objectives of the study was to determine the practice of safety measures and prevalence of road crashes among inter-city commercial vehicle drivers in Kwara State, Nigeria. METHODS: A descriptive cross-sectional study done by interviewer-administered questionnaire and blood alcohol concentration of respondents was determined using Breathalyzers. A total of 410 respondents were involved by multi-stage sampling technique; data analysis was done using EPI INFO version 3.5.1 software package. Level of significance was < 0.05 at 95% confidence level. RESULTS: More than eighty per cent of the respondents practiced safety measures and checked their vehicles before embarking on a journey. More respondents who practiced safety measures carried out driving test before issuance of license compared with those who did not (p = 0.001). Some respondents tested positive for alcohol with mean blood alcohol concentration of 23.28 ± 23.32 µg/dl. About a third of the respondents had road traffic crashes in the past. CONCLUSIONS: The drivers demonstrated good safety measures and practices before embarking on a journey. Safety practices were influenced by driving test before issuance of license. Sensitization and orientation of drivers on relevance of driving test before issuance of driving license should be promoted by all stakeholders in road safety. The enforcement of laws by government is critical to addressing challenges of road safety and security by ensuring appropriate driving test before licensing.

A 5-year review of pattern of placenta previa in Ilorin, Nigeria.

BACKGROUND: Placenta previa, a major cause of obstetric hemorrhage, is potentially life-threatening to the mother and frequently results in high perinatal morbidity and mortality. METHODOLOGY: This is a retrospective study of all cases of placenta previa managed at the University of Ilorin Teaching Hospital over a 5-year from January 2011 to December 2015. A pro forma template was used to harvest information from case notes of patients involved in the study. RESULTS: There were a total of 10,250 deliveries over the 5-year study and 164 cases of placenta previa were managed during this period; giving an incidence of 1.6% of the total deliveries. Of these patients, 65.9% were unbooked while 34.1% were booked. 110 (67%) were above 30 years of age and 51.2% were grand multiparous women. The majority (81.7%) of the patients belonged to the low socioeconomic class. Painless vaginal bleeding (62.2%), intrapartum hemorrhage (22.6%), and abnormal lie presentation (8.5%) were the most common mode of presentation. Vaginal delivery occurred in (29.3%) of patients while 70. 7% were delivered through cesarean section. There was a significant association between patients' age, parity, booking status, and types of placenta previa (P < 0.05). Similarly, there was a significant association between gestational age at delivery, mode of delivery, intraoperative blood loss, and birth weight at delivery and types of placenta previa (P < 0.05). Perinatal mortality was 12.2%, 15.6% of babies had severe birth asphyxia, and there was no maternal mortality. CONCLUSION: From this study, the risk factors for placenta previa are advanced maternal age above 35 years, grand multiparity, and booking status. Early recognition, appropriate referral of these patients and availability of ultrasound facilities, blood transfusion facilities, improvement in neonatal facilities and trained personnel will go a long way in reducing the perinatal mortality from placenta previa.

Molecular detection of human papillomavirus from abnormal cervical cytology of women attending a tertiary health facility in Ido-ekiti, southwest Nigeria.

BACKGROUND: Human papillomavirus (HPV) has been implicated as one of the principal causes of cervical cancer, which is the second highest cause of cancer deaths among Nigerian women. OBJECTIVE: This study was aimed at determining the presence of HPV DNA in abnormal cervical cytology of a group of women who were screened using Papanicolaou staining technique. METHODOLOGY: A total of 200 women attending the Obstetrics and Gynaecology clinic of the Federal Teaching Hospital, Ido-Ekiti, were screened by means of conventional Pap smear screening, while positive samples underwent molecular analyses by means of DNA isolation techniques and polymerase chain reaction (PCR). RESULT: Results revealed that 14 (7%) of the subjects were positive for abnormal cytology. Abnormalities found among the subjects included: low-grade squamous intraepithelial lesions (LSIL), which constituted 50% of the total abnormal smears, high-grade squamous intraepithelial lesion (HSIL) and atypical squamous cells of undetermined significance (ASCUS), which were 28.6% and 21.4%, respectively. Molecular analyses showed that all the samples from abnormal cervical cytology subjected to HPV DNA extraction and gene amplification contained HPV DNA. CONCLUSIONS: The high prevalence of HPV DNA in abnormal cytology gives credence to the fact that the presence of HPV is a critical indicator of the development of cervical cancer. Thus more effort should be put into vaccine production and distribution in order to reduce the incidence of cervical cancer in Nigeria.

Knowledge and prevalence of risk factors for arterial hypertension and blood pressure pattern among bankers and traffic wardens in Ilorin, Nigeria.

BACKGROUND: High job strain, mental stress, sedentary lifestyle, increase in BMI are among the factors associated with significantly higher incidence of hypertension. The job of bank employees is both sedentary in nature and accompanies high mental stress. The aim of this study is to assess the level of knowledge of risk factors among respondents and to compare the blood pressure pattern of bankers and traffic wardens. METHODOLOGY: The study design is a descriptive cross-sectional conducted among bankers and traffic wardens in Ilorin to determine the pattern and knowledge of blood pressure. Self-administered questionnaires, weighing scale (Omron Digital scale), stadiometer and sphygmomanometer were used as the research instruments. Simple random sampling was used to select respondents involved in the study. RESULTS: The prevalence of hypertension in this study was 34.4% in bankers and 22.2% in traffic wardens. The risk factors the bankers commonly had knowledge of are alcohol, obesity, high salt intake, certain drugs, stress, emotional problems and family history while the traffic wardens commonly had knowledge of all these in addition to cigarette smoking. Also, more bankers (32.2%) than traffic wardens (13.3%) were smoking cigarette and more of these cigarette smokers that are bankers (17.8%) had elevated blood pressure compared to the traffic wardens (3.3%). CONCLUSION: Workers in the banking industry as well as traffic wardens should be better educated about the risk factors of hypertension and bankers should be encouraged to create time for exercise.

Prevalence of anaemia at booking in a semi-urban community in north-central Nigeria.

AIMS AND OBJECTIVES: This study was carried out to determine the prevalence of anaemia at booking clinic, describe the antenatal booking pattern, and categorize the degree of anaemia with certain demographic features. SUBJECTS AND METHODS: This is a descriptive cross-sectional study carried out over a six month period between 1st April and 30th September 2008. A questionnaire was used to obtain demographic information and venous blood samples were collected from 1,086 consecutive patients who consented to participate in the study. The blood samples were tested for haemoglobin levels, genotype and blood group. RESULTS: Seven hundred and thirty two (67.4%) of the women anaemic at booking. Anaemia was more prevalent among multgravidae than primigravidae (p<0.05). Six hundred and sixty nine (61.6%) had mild anaemia while 40(4.4%) had moderate anaemia and 15 (1.4%) were severely anaemic, of which 8 (53.3%) were below 18 years of age. Varied degrees of anaemia were more common among women aged 24-28 years and in the 3rd trimester of pregnancy (80.7%) (p<0.05). One hundred and seventy (15.7%) of the enrolled booked for antenatal care in the 1st trimester, while 703(64.7%) booked in the 2nd trimester and 213 (19.6%) in the 3rd trimester of their pregnancies. Thirteen (1.2%) had sickle cell anaemia. CONCLUSION: Prevalence of anaemia at booking remains high in our society. Urgent need for public health education on early antenatal booking and improved literacy level of women is suggested to reduce the burden of anaemia in pregnancy.

Prevalence and risk factors of cervical cancer among women in an urban community of Kwara State, north central Nigeria.

BACKGROUND: Cervical cancer is the second most common malignancy in women worldwide with a high incidence in under-developed countries and Nigeria is one of these countries. This study aimed at screening for cervical cancer using Papanicolaou smear and to identify risk factors for cervical cancer among women in Olufadi community, Kwara State, North-central Nigeria. METHODS: This was a cross-sectional study involving the screening of women aged 25-64 years for cervical cancer using Papanicolaou smear. Respondents were selected through systematic random sampling of households. Interviewer- administered questionnaire and clinical report form were also used to collect data. In addition, Pap smear samples were taken. Data was analyzed using SPSS version 15. RESULTS: Only 10 (5.0%) respondents had positive cytology result, while the rest were normal. Of the 10 positive cytology results, 1 (10.0%) was high grade squamous intraepithelial lesion (HGSIL) while the remaining 9 (90.0%) were low grade squamous intraepithelial lesion (LGSIL) which corresponds to 0.5% and 4.5% of the total respondents respectively. Risk factors for cervical cancer identified included coitarche, tobacco smoking, number of sexual partners and family history of cervical cancer. CONCLUSION: The findings from this study attest to the increasing burden of cervical cancer. The high number of positive results obtained from the study coupled with the presence of risk factors was an indication of how useful regular screening will be in the early detection of cervical cancer.