Clinical Profile and Determinants of Loss to Follow-Up in Patients Enrolled in an Urban Antiretroviral Treatment Programme in Northwestern Nigeria.

INTRODUCTION: Loss of follow up in patients enrolled on antiretroviral treatment programmes has the potential to reduce their quality of life. We set out to describe the profile and risk factors for loss to follow up in patients enrolled on our programme. MATERIALS AND METHODS: In this retrospective study, we reviewed the records of patients who were identified as lost to follow up between August 2008 to July 2018. Determinants of loss to follow-up were identified by the use of binary logistic regression with SPSS to compare the data of patients lost to follow-up with randomly selected patients who were still in care. RESULTS: A total of 4,250 patients were enrolled on our programme during the study period. Of these, 965 patients were identified as lost to follow-up, giving a loss to follow up rate of 22.7%. Compared to patients still in care, patients who were lost to follow up were significantly male (male, n =395, 56% versus female, n= 310, 44%, p<0.0001), of younger age (33.53+9.05 versus 34.48+9.25 years, p = 0.028), married (married, n = 669, 58.9% versus not married n = 467, 41.1%, p<0.0001) and with evidence of low crude weight at the time of recruitment (58.58+12.12 versus 60.09+14.58 kg, p = 0.018). CONCLUSION: Our study showed that patients who are young, male, married, recently enrolled, with evidence of the low crude weight, with WHO Clinical Stages III and IV and anaemia at enrolment are commonly lost to follow-up. Clinicians need to target this population to reduce the loss of follow up in patients on antiretroviral therapy.

INTRODUCTION: La perte de suivi des patients inscrits dans des programmes de traitement antirétroviral peut réduire leur qualité de vie. Nous avons entrepris de décrire le profil et les facteurs de risque de perte de suivi chez les patients inscrits à notre programme. MATERIEL ET METHODES: Dans cette étude rétrospective, nous avons examiné les dossiers des patients qui ont été identifiés comme perdus de vue entre août 2008 et juillet 2018. Les déterminants de la perte de suivi ont été identifiés par l'utilisation d'une régression logistique binaire avec SPSS pour comparer les données des patients perdus de vue avec des patients sélectionnés au hasard qui étaient encore en soins. RESULTATS: Au total, 4 250 patients ont été inscrits à notre programme au cours de la période d'étude. Parmi eux, 965 patients ont été identifiés comme perdus de vue, soit un taux de perte de suivi de 22,7%. Comparés aux patients encore en soins, les patients perdus de vue étaient significativement des hommes (hommes, n =395, 56% contre femmes, n= 310, 44%, p<0.0001), plus jeunes (33.53+9.05 contre 34.48+9. 25 ans, p = 0.028), mariés (mariés, n = 669, 58.9% versus non mariés n = 467, 41.1%, p<0.0001) et avec un faible poids brut au moment du recrutement (58.58+12.12 versus 60.09+14.58 kg, p = 0.018). CONCLUSION: Notre étude a montré que les patients jeunes, de sexe masculin, mariés, récemment recrutés, présentant une insuffisance pondérale brute, des stades cliniques III et IV de l'OMS et une anémie au moment du recrutement sont souvent perdus de vue. Les cliniciens doivent cibler cette population pour réduire les pertes de suivi chez les patients sous thérapie antirétrovirale. Mots clés: Perte de suivi; VIH; Thérapie antirétrovirale.

Knowledge, risk perception and practices related to antibiotic resistance among patent medicine vendors in Sokoto metropolis, Nigeria.

BACKGROUND: Resistance to antibiotics is now a serious threat to global health, and inappropriate use of drugs has been identified as a major contributing factor in the developing countries. OBJECTIVES: The aim of this study is to assess the knowledge, risk perception, and practices related to antibiotic resistance among patent medicine vendors (PMVs) in Sokoto metropolis, Nigeria. MATERIALS AND METHODS: A cross-sectional study was conducted among 200 PMVs selected by multi-stage sampling technique. Data were collected with a set of pretested, self administered, semi structured questionnaire. RESULTS: A larger proportion (83, 42.1%) of the 197 respondents who completed the questionnaire were aged 20 29 years. Most of them were males (80.2%) and had tertiary education (80.7%). Most of the respondents had adequate knowledge of the causes of antibiotic resistance (94.9%), and its prevention (98.0%). Most of the respondents also perceived antibiotic resistance as a serious threat to their own health (95.4%), and the health of their clients (89.4%). Practices favorable to the development of antibiotic resistance were very prevalent among the respondents. Majority of respondents (59.9%) consistently sell antibiotics to clients without doctor's prescription, and close to half of them (49.2%) consistently practice self-medication. CONCLUSION: Despite high levels of knowledge of the causes, prevention, and perception of the risks associated with antibiotics resistance, practices favorable to its development were very prevalent among PMVs in Sokoto, Nigeria. Government should regulate and closely monitor PMVs' practices in order to avert the looming crisis in medical practice that will become inevitable if there are no potent antibiotics.

Prevalence and correlates of complementary and alternative medicine use among cancer patients in usmanu danfodiyo university teaching hospital, Sokoto, Nigeria.

BACKGROUND: The rate of complementary and alternative medicine (CAM) use among cancer patients is on the increase worldwide. This is due to the innate urge among humans to try new and alternative ways of medicine, especially where conventional medicine failed to provide satisfactory solution such as in sickle cell disease and cancer. OBJECTIVE: To assess the prevalence and correlates of CAM use among cancer patients in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. MATERIALS AND METHODS: A cross-sectional study was conducted among 240 cancer patients selected by systematic sampling technique from July to September 2016. Data were collected using a semi-structured standardized questionnaire. RESULTS: The mean age of the study participants was 45 ± 13.7 years. Majority, 159 (66.3%) of the 240 respondents, were CAM users, with the most common methods being prayer (30.8%) and herbal therapy (28.3%). Majority of CAM users (64.2%) did not derive any benefit from CAM use, but rather reported adverse effects such as nausea and vomiting (52.5%) and diarrhea (44.2%). Physicians were unaware of CAM use in most cases (87.4%), and this was majorly attributed to the physicians not asking them about CAM use. Male sex and absence of comorbidities were the predictors of CAM use identified. CONCLUSION: The prevalence of CAM use is high among cancer patients in UDUTH, Sokoto, Nigeria, but the physicians were largely unaware of CAM use due to communication gap. These findings underscore the need for physicians to consistently ask their patients on CAM use, while government should enact laws regulating CAM use in Nigeria.

Knowledge of Radiation Hazards, Radiation Protection Practices and Clinical Profile of Health Workers in a Teaching Hospital in Northern Nigeria.

INTRODUCTION: Use of ionizing radiation in medical imaging for diagnostic and interventional purposes has risen dramatically in recent years with a concomitant increase in exposure of patients and health workers to radiation hazards. AIM: To assess the knowledge of radiation hazards, radiation protection practices and clinical profile of health workers in UDUTH, Sokoto, Nigeria. MATERIALS AND METHODS: A cross-sectional study was conducted among 110 Radiology, Radiotherapy and Dentistry staff selected by universal sampling technique. The study comprised of administration of standardized semi-structured pre-tested questionnaire (to obtain information on socio-demographic characteristics, knowledge of radiation hazards, and radiation protection practices of participants), clinical assessment (comprising of chest X-ray, abdominal ultrasound and laboratory investigation on hematological parameters), and evaluation of radiation exposure of participants (extracted from existing hospital records on their radiation exposure status). RESULTS: The participants were aged 20 to 65 years (mean = 34.04 ± 8.83), most of them were males (67.3%) and married (65.7%). Sixty five (59.1%) had good knowledge of radiation hazards, 58 (52.7%) had good knowledge of Personal Protective Devices (PPDs), less than a third, 30 (27.3%) consistently wore dosimeter, and very few (10.9% and below) consistently wore the various PPDs at work. The average annual radiation exposure over a 4 year period ranged from 0.0475mSv to 1.8725mSv. Only 1 (1.2%) of 86 participants had abnormal chest X-ray findings, 8 (9.4%) of 85 participants had abnormal abdominal ultrasound findings; while 17 (15.5%) and 11 (10.0%) of 110 participants had anemia and leucopenia respectively. CONCLUSION: This study demonstrated poor radiation protection practices despite good knowledge of radiation hazards among the participants, but radiation exposure and prevalence of abnormal clinical conditions were found to be low. Periodic in-service training and monitoring on radiation safety was suggested.