Psychoactive substance abuse among commercial bus drivers in Umuahia, Abia State, South-Eastern Nigeria: an uncontrolled "epidemic" with attendant road traffic crashes.

BACKGROUND INFORMATION: The unprecedented depletion of the productive workforce has been majorly attributed to road traffic crashes (RTCs). The attendant consequences of this depletion have been found to constitute a serious global public health challenge, with the use of psychoactive substances among drivers implicated in every three of five motor vehicle accidents. Hence, this study assessed the pattern and explored the determinants of substance abuse among commercial bus drivers in Umuahia, Abia State. METHODS: A descriptive cross-sectional design was used for the study. Four hundred commercial bus drivers were recruited from selected motor parks in Abia-state, using a multistage sampling technique from October to December 2020. A pretested, interviewer-administered questionnaire was administered to obtain socio-demographics and information on substance abuse. Data were analyzed using IBM SPSS version 25; bivariate analysis was done using Chi-square. The level of significance was at 5%. RESULTS: The mean age of the respondents was 40.03 ± 10.50 years. The proportion of respondents who had ever abused a psychoactive substance was 74.6%. The most commonly abused substances among drivers include alcohol (51%), cigarettes (27%), and alcoholic herbal mixtures (16%). The study participants had poor knowledge (54.5%) and poor perception (63.2%) about psychoactive substance abuse. Among the factors found to be significantly associated with substance abuse among respondents were ethnicity (p = 0.002), religion (p = 0.009) and monthly income (p = 0.013) of the respondents, poor knowledge (p < 0.001) and poor perception (p < 0.001). However, this study found religion (p = 0.031; OR = 5.469; CI = 1.170 to 25.555), knowledge (p < 0.001; OR = 4.21; CI = 2.201 to 8.287) and perception (p < 0.001; OR = 9.828; CI = 15.572 to 65.052) as factors that were associated with the higher likelihood of psychoactive substance abuse. CONCLUSION: Religion, poor knowledge and perception were associated with the higher likelihood of psychoactive substance abuse among commercial bus drivers. Targeting commercial bus drivers for educational interventions and using religious leaders as conveyor belts may reduce the use of psychoactive substances among them.

The Prevalence and Pattern of Anaemia in Type 2 Diabetics in Ogbomosho, An Urban Community in Southwestern Nigeria.

Anaemia is a frequent finding in type 2 diabetes, but it is typically seen with established chronic kidney disease and renal insufficiency. Cases, where anaemia predates renal insufficiency, are associated with a worse prognosis for the type 2 diabetes patient and an increased susceptibility to complications. This study aims to determine the prevalence and type of anaemia in persons living with type 2 diabetes without established chronic kidney disease in our environment. The study was a hospital-based cross-sectional study that involved 141 people with known type 2 diabetes as the study group and 140 healthy persons as controls. The study population and the controls were selected using a multistage sampling technique. Data were collected using an interviewer-administered semistructured questionnaire at the Endocrinology clinic, Bowen University Teaching Hospital, Ogbomosho. The data obtained were analyzed using the IBM SPSS version 23.0 (p value ≤0.05 was considered significant). The biochemical (fasting lipids, HBA1C, FBG, serum albumin, creatinine, urea, uric acid, and insulin) and haematological (FBC and red cell indices; PVC, MCV, MCH, MCHC, and RCDW) parameters of the respondents were analyzed using standard methods. The study showed a statistically significant difference in the prevalence of anaemia among subjects, 69.2% as compared to 30.8% of the control group. Normochromic normocytic anaemia was predominant among the subjects, whereas microcytic hypochromic anaemia was the predominant type in the controls. There was no statistically significant difference between MCV and MCHC of both subjects and controls. There was a positive correlation between the incidence of anaemia and the duration of diabetes among the subjects. More people with type 2 diabetes are now living longer, and the addition of haematological parameters should be part of their baseline investigations to aid in the early detection of complications.

Health insurance in private and public health facilities in Southwestern Nigeria: what determines clients´ satisfaction with quality of service?

INTRODUCTION: insured-persons have complained about poor quality of services rendered by health care providers, which has consequently affected their satisfaction with care received. The objectives of this study aimed to identify the determinants of satisfaction and compare the level of clients´ satisfaction with quality of care received in both public and private health care facilities, in Oyo-State, Nigeria. METHODS: this was a cross sectional study, comparative in design. A total number of 300 clients were recruited from selected public and private health facilities in Oyo-state, using a multistage sampling technique. Data were analyzed using IBM SPSS version 24, and the level of significance was set at p-value < 0.05. RESULTS: the mean age of the respondents in private and public health facilities was 39.9 ± 10.0 years and 42.4 ± 10.1 years respectively. About 74% and 41.3% of the enrolees in the public and private health facilities respectively were dissatisfied with waiting time before receiving care with a statically significant difference of p=0.002. Majority of the respondents (82.7%) in the public health facilities and only 42.7% of those using private health care facilities were satisfied with the quality of drugs given to them at their respective pharmacies. This finding was statistically significantly different with p=0.001. Overall level of satisfaction with quality of care was 60% and 40% among enrolees using public and private health facilities respectively. There was a statistically significance difference (p=0.028) between the overall level of satisfaction and the type of health facility used by the clients. The determinants of clients´ satisfaction with quality of care in both private and public health facilities in this study were mainly socio-demographic characteristics; age (p=0.007), level of education (p=0.046) and occupation (p=0.004), the waiting time experience and the type of facility where services were accessed. CONCLUSION: clients attending public health facilities were more satisfied with care received under NHIS, compared with those using private health facilities. Efforts should be made to reduce waiting time and improve quality of drugs in the public and private facilities respectively.

Prevalence of hepatitis B virus infection among children attending the outpatient clinic of a tertiary health centre in Southwest Nigeria.

Introduction: hepatitis B virus (HBV) infection is a global health disease. One-third of the world´s population is reportedly infected with the virus. Infections in children are mostly perinatal and therefore acquired early in life, with a propensity to evolve into chronic diseases and their attendant life-threatening complications. Early diagnosis can, however, improve outcomes in this group of children. The study aimed to determine the prevalence of HBV among children attending the outpatient clinic of a tertiary hospital in Southwest Nigeria. Methods: we recruited a total of one hundred and ninety-eight children aged 6 months to 18 years from the children´s outpatient clinic of a tertiary health centre, using the systematic sampling technique. HBsAg was tested using the HBsAg test kit (PRO-med®, China), and the anti-HBs antibody was tested using the ELISA method. Data were analysed using SPSS version 26. Results: of the 198 children that were screened, 2 (1.0%) were positive. Of these, one (50.0%) had a Hepatitis B positive mother and was HBeAg positive. Two-thirds of the children had received the hepatitis B vaccine, as evidenced by caregivers´ recall, or sighting of the immunization record. There was no statistically significant relationship between the hepatitis B status of the children and the sociodemographic parameters. Conclusion: the study supports the fact that paediatric HBV infections are transmitted from mother to child. Though the prevalence of HBsAg in the study population was lower than the national average for the country, routine immunization program should be strengthened for further control of HBV. Age and gender were not significantly associated with HBV infection in this study.

Chronic Kidney Disease and Its Clinical Correlates in a Rural Community in Southwestern Nigeria.

Chronic kidney disease (CKD) is a burgeoning problem globally, and more than a billion adults were affected as of 2016, with 1.2 million people dying from renal failure in 2017. To arrest the seemingly relentless progression of CKD to renal failure, there is a need to detect CKD early in the community. A community-based study was carried out to look at the prevalence and risk factors of CKD. Anthropometric and other clinical variables were measured. Blood samples were taken for determining creatinine, uric acid, urea, and lipids. CKD was defined as an estimated glomerular filtration rate of ≤60 mL/min/1.73 m2. Electrocardiograms and renal ultrasound scans were performed. In total, 201 people were recruited. Those with CKD had a male:female ratio of 1:3.9 and were older. The prevalence of autosomal-dominant polycystic kidney disease and CKD was 531.9 persons/100,000 population and 46.3%, respectively. Systolic blood pressure, pulse pressure, total cholesterol, triglycerides, high-density lipoprotein (HDL), uric acid, QTc interval, and electrocardiographic left ventricular hypertrophy were higher in those with CKD. Age, female sex, and HDL were independently associated with CKD. There was a steep rise in CKD at the community level. Increased awareness of CKD and prompt interventions are therefore imperative.

10-year risk for cardiovascular diseases using WHO prediction chart: findings from the civil servants in South-western Nigeria.

BACKGROUND: Globally, cardiovascular diseases (CVDs) have continued to ravage the human existence through the premature deaths of its workforce. Despite this burden, many studies in Nigeria have focused on determining the prevalence of risk factors which alone are insufficient to assess the risk of future cardiovascular events. Therefore, we determined the pattern and predictors of 10-year risk for CVDs in South-western Nigeria. METHODS: We conducted a cross-sectional study among workers at the local government areas (LGAs) of Oyo State. Using a multi-stage sampling technique, we recruited 260 respondents from the LGA secretariats. A pre-tested, interviewer-administered questionnaire was administered to obtain information on the socio-demographics and behavioural attributes. Lipid analysis, anthropometric, blood pressure, fasting blood glucose measurements were done using standard protocols. The respondents' CVD risk was assessed using WHO prediction chart. Data were analyzed using IBM SPSS version 25; bivariate analysis was done using Chi-square and binary logistic regression was used to identify the predictors of 10-year risk for CVDs at 5% level of significance. RESULTS: The mean age of respondents was 46.0 + 6.7 years. The proportion of respondents with good knowledge of risk factors was 57.7%. The prevalence of CVD risk factors were as follows: systolic hypertension (29.6%), visceral obesity (35.8%), diabetes mellitus (18.8%), smoking (5.8%), elevated total cholesterol (55.4%) and physical inactivity (84.6%). The proportion of respondents with low, moderate and high risk of developing CVDs within 10 years was 76.9, 8.5 and 14.6% respectively. Respondents with age ≥ 40 years (aOR = 2.6, 95% CI = 1.3-8.5), management cadre (aOR = 3.8, 95% CI = 1.6-9.6), obesity (aOR = 4.8, 95% CI = 1.2-120), abnormal waist circumference (aOR = 2.8, 95% CI = 1.3-5.2) and physical inactivity (aOR = 2.4, 95% CI = 1.2-4.7) were associated with the higher likelihood of developing CVDs. CONCLUSION: About one-sixth of the respondents had high risk of developing CVDs within the next 10 years and it is likely that it will reduce the productivity of the State. Lifestyle modification and early detection of risk factors through regular screening programmes for those with high CVD risk is therefore recommended.

Age-specific nomograms for follicle stimulating hormone and anti-Mullerian hormone: A pilot study in Ile-Ife, Nigeria.

BACKGROUND: Assessment of ovarian reserve is one of the steps in the management of infertile couples. Follicle Stimulating hormone (FSH) and anti-Müllerian hormone (AMH) are commonly used ovarian reserve markers in Africa. However, there is paucity of age-specific reference values for FSH and AMH among the African population. OBJECTIVE: This study aimed at conducting a pilot study for generation of age-specific nomograms for FSH and AMH among fertile women in Ile-Ife, Nigeria. MATERIALS AND METHODS: A pilot cross-sectional study that involved 65 fertile women within the age range of 18-45 yr were prospectively and consecutively recruited from November 2014 to January 2015. Peripheral blood samples were taken for basal serum FSH and random serum AMH. The samples were processed using enzyme linked immunosorbent (ELISA) assays. RESULTS: Age-specific FSH nomogram showed a gradual increase which became steeper at age 35 yr with an average yearly increase of 0.2 IU/L in basal serum FSH, while age-specific AMH nomogram showed a peak at 25 yr and then; an average yearly decrease of 0.11 ng/ml in random serum AMH from 25 yr. CONCLUSION: The age-specific nomograms generated by this pilot study suggest that AMH may be an earlier marker of reduced ovarian reserve; which if validated by future multicenter population based studies may facilitate counseling of women on their reproductive potentials.