An Assessment of the Knowledge and Attitudes of Graduating Medical Students in Lagos, Nigeria, Regarding Obstructive Sleep Apnea.

RATIONALE: Symptom scores show that a significant proportion of Nigerians are at high risk of developing obstructive sleep apnea; however, the diagnosis is rarely made in this country. The knowledge of medical students regarding sleep apnea may provide insight into their future ability to recognize patients with sleep apnea and can also inform student education on this disease. OBJECTIVES: To assess the knowledge and attitudes of graduating medical students in Nigeria regarding obstructive sleep apnea using a standard validated questionnaire. METHODS: This descriptive, cross-sectional survey study was performed at the College of Medicine of the University of Lagos, Nigeria. The Obstructive Sleep Apnea Knowledge and Attitude (OSAKA) instrument was self-administered by the subjects. This validated questionnaire consists of 18 knowledge assessment questions and 5 attitude assessment questions. MEASUREMENTS AND MAIN RESULTS: The response rate was 99%, and our final sample comprised 143 participants. The maximum achievable knowledge score was 18. Obtained scores ranged from 0 to 15; the mean ± SD score was 7.6 ± 3.2 (42.2%); and the median score was 8 (interquartile range, 6-10). Four participants (2.8%) had a score of 0, and 56 (39.2%) had a score corresponding to ≥50%. There was no significant difference in knowledge scores by sex or age. Regarding attitudes, over 80% considered obstructive sleep apnea an important disorder; 41% were confident in identifying patients with the condition; 16.1% were confident in managing the disease; and 16.8% expressed confidence in managing patients receiving continuous positive airway pressure therapy. The total attitude score ranged from 1 to 5 (mean, 2.9 ± 0.7). There was a significant correlation between the total attitude score and the total knowledge score (r = 0.22, P = 0.01) and the age of the participants (r = 0.18, P = 0.04). CONCLUSIONS: The level of knowledge of obstructive sleep apnea among medical students at the Nigerian university in our study was not optimal. This study demonstrates a need to formally incorporate evaluation of sleep disorders into the undergraduate medical curriculum with the clear objective of enabling recognition of clinical features of common sleep disorders such as sleep apnea.

Burden and pattern of micro vascular complications in type 2 diabetes in a tertiary health institution in Nigeria.

INTRODUCTION: Diabetes mellitus (DM) afflicts at least 5 million people in Nigeria, with more than 80% having type 2 diabetes mellitus (T2DM). Microvascular complications increase both morbidity and mortality inpatients with T2DM. The aims of this study were to report the burden of various microvascular complications in T2DM and to identify various factors associated with these complications in patients with T2DM attending the diabetes outpatients' clinic. METHODS: Ninety (90) patients with T2DM who have attended diabetes clinic for at least 3 months were recruited for this study. Detailed history, physical examination and biochemical analysis was done in each of the patients. All patients underwent a detailed standard evaluation to detect diabetic retinopathy (fundoscopy), neuropathy (10g monofilament and/or diabetes neuropathy scores), and nephropathy (microalbuminuria, macroalbuminuria, serum creatinine and estimated glomerular filtration rate). RESULTS: There was high prevalence of microvascular complications among patients with T2DM. Almost half of patients with T2DM had some form of microvascular complications; diabetic neuropathy being the commonest (69.6%),followed by nephropathy (54.5%) and retinopathy (48.9%). The factors associated with developing these complications were increasing age, duration of diabetes, hypertension and dyslipidaemia for nephropathy and neuropathy. CONCLUSION: There is a high burden of microvascular complications in patients with type 2 diabetes. Age, male gender, hypertension, glycaemic control, BMI and duration of diabetes, and glycaemic control were factors associated with microvasular complications.