Medication adherence and blood pressure control: A preliminary assessment of the role of health insurance in Nigeria and Ghana.

Objectives: This study sought to assess the current impact of health insurance coverage on medication adherence and blood pressure control of patients being managed for hypertension in Ghana and Nigeria. Methods: The study was a prospective study among 109 patients with hypertension in two health facilities with similar population dynamics in Ghana and Nigeria. Patients were systematically selected, categorized as having health insurance coverage or not, and followed up monthly for 6 months. The outcome variables (medication adherence and blood pressure control) were then measured and compared at 6 months. Analysis was done using Stata with level of significance set at p ⩽ 0.05. Results: There was a 90% insurance coverage among participants from Ghana compared to 15% from Nigeria. National Health Insurance Authority enrolees in both countries had better blood pressure control and medication adherence compared to non-enrolees (adjusted odds ratio = 2.6 and 4.5, respectively). Conclusion: National Health Insurance Authority enrolment was found to be poor among respondents in Nigeria compared to Ghana. Enrolment into the National health financing schemes in both countries led to better blood pressure control and medication adherence among patients with hypertension at primary health facilities. There is therefore the need for system strengthening to improve their sustainability.

Assessment of knowledge, perception, preventive practices and effects of COVID-19 among Nigerians: a cross-sectional study.

Introduction: the coronavirus disease 2019 (COVID-19) has become a disease of global public health concern. The current cumulative cases in Nigeria are high. The effective control of the pandemic is dependent on knowledge, attitude and willingness of people to adapt their life to the new reality. The purpose of this study is to determine the knowledge, perception, preventive practice, and effect of COVID-19 on the respondents. Methods: we conducted a cross sectional, online survey-based study (Google form) from May 25th, 2020 to June 25th, 2020. The survey questionnaire consisted of demographic characteristics, 13 items on knowledge, 6 items on preventive practices, 13 items on perception. Descriptive statistics, t-test, one-way ANOVA and bivariate logistic regression were carried out. Results: the correct overall knowledge was 98.03% with average score of 11.7 ± 1.0 (9-13). Knowledge scores were comparable in all demographics except marital status. Most of the participants practiced preventive procedures such as wearing face mask (95.1%), use of alcohol based hand sanitizer (78.9%), avoidance of worship centers (62.4%) and regular hand washing. There were several perceptions ranging from rumors to unfounded scientific claims. Gender, level of education, monthly income and Christian denomination were predictors of use of hand sanitizer while age, level of education, monthly income, Christian denomination and region were predictors of attendance of worship centers during lockdown. Conclusion: the results of this study suggest government should gain trust of citizens to translate knowledge to practice and full compliance of regulations.

A comparative assessment of dry eye disease among outdoor street sweepers and indoor office cleaners.

BACKGROUND: Occupational predisposition to dry eye disease is known. Simultaneous exposure to multiple factors may pose more risk. Street sweepers are exposed to sunlight in addition to dust which all sweepers are exposed to. Tropical climate predisposes to significant exposure to sunlight. Combined exposure to dust and sunlight may lead to a synergy of factors. This study aims to assess the prevalence of dry eye disease (DED) amongst Street sweepers and Office cleaners in Calabar metropolis. METHODS: A cross-sectional study was conducted among street sweepers and office cleaners. A systematic random sampling and multi-stage sampling method were used to select street sweepers (n = 115) and office cleaners (n = 115) respectively for the study. A pretested semi-structured interviewer-administered questionnaire was used to obtain information after which the respondents had an ophthalmic examination. An assessment of DED was done with Ocular Surface Disease Index (OSDI) questionnaire, Schirmer's test, and tear break up time (TBUT). OSDI scores of 33 and above; Schirmer's test readings of < 10 mm wetting in 5 min and a TBUT of less than 10s in either eye were considered as positive dry eye disease. Results The majority of respondents were females 215(93.5%) compared to males 15 (6.5%). The overall mean age of respondents was 40.96 ± 9.8 years. The average OSDI score, Schirmer's test as well as TBUT among participants was 26.4 ± 16.0, 16.44 ± 9.52 mm, and 12.38 ± 4.53 s respectively. The prevalence of DED among Street sweepers was 35.7% compared to 20% among office cleaners using the OSDI questionnaire (p = 0.352). The prevalence of DED among street sweepers was 32.2% compared to 30.4% among Office cleaners using the Schirmer's test. (p = 0.73) The TBUT reported a prevalence of 38.3% of DED among Street sweepers compared to 32.2% in office cleaners. (p = 0.48) Overall; the prevalence of dry eye disease among Street sweepers and office cleaners using OSDI score, Schirmers test, as well as TBUT were not statistically significant (> 0.05) Street Sweepers had higher odds of developing dry eye disease compared to office cleaners (OR = 2.085; C.I. =1.106-3.929; p = 0.02). Negative correlation coefficient was observed between TBUT and OSDI (rs = - 0.102; p = 0.125). This was not statistically significant. CONCLUSION: Street sweepers had a higher prevalence of dry eye disease compared to office cleaners due to a higher risk of increased exposure to environmental factors such as dust, smoke, and sunlight. This effect is possibly due to a synergy of factors. Studies on dose-response are warranted.