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2.
Mali méd. (En ligne) ; 36(2): 1-7, 20210812.
Article in French | AIM | ID: biblio-1283654

ABSTRACT

La COVID-19 est une infection virale qui s'est propagé dans tout le monde. Pour la prise en charge des cas, le Mali a créé des sites de traitement dont celui du CHU Gabriel Touré. Objectif : C'était d'analyser les prescriptions médicamenteuses pour le traitement de la COVID-19 au CHU Gabriel Touré. Méthodologie : L'étude était rétrospective et descriptive et a concerné la période d'avril à septembre 2020. Elle s'est déroulée au Centre de Traitement COVID-19 du CHU Gabriel Touré et à la Pharmacie Hospitalière de cet hôpital. Les ordonnances et les registres d'hospitalisation ont servi à collecter les données. Résultats : Au total, 29 patients ont été hospitalisés. L'âge médian était de 44ans, 75,90% des patients présentaient au moins une pathologie associée à la COVID-19. Le nombre d'ordonnances était de 333 comportant 870 lignes de prescriptions dont 33,21% de traitements standards et 66,79% pour les pathologies associées avec 86,23% disponibles à la Pharmacie Hospitalière. Le phosphate de chloroquine, dosé à 250mg, était administré à 500mg deux fois quotidiennement. Dans les directives nationales le phosphate de chloroquine était à 100mg pour 200mg trois fois quotidienne. La vitamine C non prévue dans les directives a été prescrite à tous les patients. La classe des médicaments du sang et des organes hématopoïétiques a été les plus prescrits (31,49%). Le coût moyen des traitements était de 65602±106858 FCFA avec maximum de 567860 FCFA. Une évaluation des prescriptions dans les autres sites de traitement est nécessaire.


COVID-19 was declared a pandemic in March 2020. For case management, Mali has created several treatment sites including the site of the CHU Gabriel Touré. Aims: The objective of the study was to analyse drug prescriptions for the COVID-19 treatment at the CHU Gabriel Touré. Methods: We performed a retrospective and descriptive study from April to September 2020. Drug prescriptions and hospital records were used to collect data. Prescriptions and hospital records were used to collect data. Results: A total of 29 patients were hospitalized. The median age was 44 years, 75.90% of patients had at least one pathology associated with COVID-19. The number of prescriptions was 333 comprising 870 lines of prescriptions including 33.21% for standard treatments, and 66.79% for associated pathologies. with 86.23% available at the Hospital Pharmacy. Chloroquine, dosed at 250mg, was administered at 500mg twice a day. The national guidelines from the treatment of COVID19 recommends 200mg of chloroquine in two doses. Vitamin C was prescribed for all patients although not included in the national guidelines. The class of drugs for the blood and blood-forming organs was the most prescribed (31.49%). The average cost of treatments was 65,602 ± 106,858 FCFA with a maximum of 567,860 FCFA. An evaluation of prescriptions in other treatment sites is necessary.


Subject(s)
Drug Prescriptions , COVID-19 , Guideline , Cost of Illness
3.
Mali méd. (En ligne) ; 36(2): 23-26, 20210812.
Article in French | AIM | ID: biblio-1283662

ABSTRACT

Le Burkina Faso a enregistré son premier cas de Covid-19 le 09 mars 2020 mais c'est au premier avril 2020 que le service de chirurgie générale et viscérale du Centre Hospitalier Universitaire Sourô SANOU (CHUSS) de Bobo-Dioulasso a enregistré son premier cas de COVID-19 et pathologie chirurgicale. En six mois, soit entre avril et septembre 2020, notre service a enregistré quatre cas, tous des malades de sexe masculin et testés positifs à la maladie de la Covid-19 après un prélèvement oropharyngé techniqué à l'aide de la trousse de RT-PCR Detection kit for 2019-n COV RNA (Da An Gene Co) et la Plate forme AriaMx (Real-Time PCR System).Les quatre malades étaient âgés respectivement de 63 ans, 70 ans, 60 ans et 66 ans et étaient pris en charge pour un traumatisme fermé du thorax, une gangrène de jambe, une tumeur vésicale et un adénocarcinome gastrique. Deux patients étaient décédés dans le service. Les deux autres avaient été transférés dans le centre régional spécialisé dans la prise en charge de la maladie COVID-19 avec une évolution favorable. L'impact de la Covid-19 en 2020 constaté dans le service de chirurgie générale et viscérale du CHUSS, a été une diminution de 82% des activités chirurgicales.


Burkina Faso recorded its first case of Covid-19 on March 09, 2020 but it was on April 1, 2020 that the general and visceral surgery department of the Center Hospitalier Universitaire Sourô SANOU (CHUSS) in Bobo-Dioulasso recorded its first case of COVID-19 and surgical pathology. From April to September 2020, our service recorded four cases, all male patients and tested positive for Covid-19 disease after an oropharyngeal sample performed using the RT- kit. PCR Detection kit for 2019-n COV RNA (Da An Gene Co) and the AriaMx (Real-Time PCR System) platform. The four patients were aged 63, 70, 60 and 66, respectively, and were being treated for blunt chest trauma, leg gangrene, bladder tumor and gastric adenocarcinoma. Two patients died in the ward. The other two had been transferred to the regional center specializing in the management of the COVID-19 with a favorable outcome. The impact of Covid-19 in 2020, observed in the general and visceral surgery department of the CHUSS, was a 82% decrease in surgical activities.


Subject(s)
Comorbidity , COVID-19 , General Surgery , Surgical Procedures, Operative
5.
Brazzaville; World Health Organization. Regional Office for Africa; March, 26 2021. 8 p. (WHO Regional Office for Africa COVID-19 rapid policy brief series, 015-01). (WHO/AF/ARD/DAK/34/2021). (WHO/AF/ARD/DAK/36/2021).
Monography in English | AIM | ID: biblio-1283102
6.
Malawi med. j. (Online) ; 33(2): 82-84, 2021.
Article in English | AIM | ID: biblio-1290527

ABSTRACT

Background Stenotrophomonas maltophilia is a significant opportunistic pathogen that is associated with high mortality in immunocompromised individuals. In this study, we describe a multidrug-resistant (MDR) S. maltophilia clinical isolate from Kamuzu Central Hospital (KCH), Lilongwe, Malawi. Methods: A ceftriaxone and meropenem nonsusceptible isolate (Sm-MW08), recovered in December 2017 at KCH, was referred to theNational Microbiology Reference Laboratory for identification. In April 2018, we identified the isolate using MALDI Biotyper mass spectrometry and determined its antimicrobial susceptibility profile using microdilution methods. Sm-MW08 was analysed by S1-PFGE, PCR, and Sanger sequencing, in order to ascertain the genotypes that were responsible for the isolate`s multidrug-resistance (MDR) phenotype. Results Sm-MW08 was identified as S. maltophilia and exhibited resistance to a range of antibiotics, including all ß-lactams, aminoglycosides (except arbekacin), chloramphenicol, minocycline, fosfomycin and fluoroquinolones, but remained susceptible to colistin and trimethoprim-sulfamethoxazole. The isolate did not harbour any plasmid but did carry chromosomally-encoded blaL1 metallo-ßlactamase and blaL2 ß-lactamase genes; this was consistent with the isolate's resistance profile. No other resistance determinants were detected, suggesting that the MDR phenotype exhibited by Sm-MW08 was innate. Conclusion : Herein, we have described an MDR S. maltophilia from KCH in Malawi, that was resistant to almost all locally available antibiotics. We therefore recommend the practice of effective infection prevention measures to curtail spread of this organism


Subject(s)
Stenotrophomonas maltophilia , Therapeutics , Ceftriaxone , Carbapenems , Drug Resistance, Multiple, Bacterial
7.
Niger. j. med. (Online) ; 30(4): 419-425, 2021.
Article in English | AIM | ID: biblio-1290695

ABSTRACT

Background: Globally, there is still much to learn about the evolving coronavirus disease 2019 (COVID-19) virus, its transmission, prevention, and treatment. Therefore, this study investigates the knowledge, perception, and screening practices of COVID-19 infection in the ophthalmology practice in Nigeria. Materials and Methods: This survey was a descriptive, cross-sectional survey conducted among practising ophthalmologists and ophthalmologists in training in Nigeria in an online survey. Data compiled were then analyzed using the IBM SPSS software version 22.0 with two-tailed P < 0.05 considered to indicate statistical significance. Results: A total of 206 ophthalmologists/ophthalmologists in training were recruited for this study. Most of the respondents, 97 (47.1%), practiced in centres in South-West Nigeria and were board-certified ophthalmologists 96 (46.6%). In general, the majority of the respondents, 182 (88.3%), had good knowledge regarding the COVID-19 virus, its transmission, prevention as it regards the ophthalmic practice, 134 (74.8%) either agreed or strongly agreed that the ophthalmologist is at a higher risk of contracting the virus from infected patients even if the patient is asymptomatic. COVID-19 infection was perceived as very serious by the majority of the respondents, 135 (65.5%), although 128 (62.1%) felt that all routine cases should be seen only following a low-risk assessment. Conclusion: As the world races toward complete vaccination of the population against this fatal infection, continued training is required to ensure the best practices among ophthalmologists to bridge the present knowledge gaps, corrects myths, misconceptions, and ensure the safety of both the patient and the ophthalmologist.


Subject(s)
Ophthalmologists , COVID-19 , Perception , Health Knowledge, Attitudes, Practice
8.
Article in English | AIM | ID: biblio-1290693

ABSTRACT

Background: COVID-19 quickly assumed a global epidemic with its attendant health, socio-political and economic impacts. Healthcare workers are particularly at increasing risk of being infected and transmitting the virus. This study assessed knowledge, attitude, practice and predictors of preventive practices toward COVD-19 among healthcare workers in Ogbomoso, Nigeria. Study Design: Cross-sectional study. Data were collected online among health workers across health facilities in Ogbomoso. Factors associated with good practices were analyzed using Chi-square. Predictors of good preventive practices were determined by multivariate binary logistic regression. The level of statistical significance was determined to be at P < 0.05. Results: There were 132 study participants; with an average age of 31 years. Fifty-eight percent were medical laboratory scientists. Levels of good knowledge, attitude, and practices were 59.1%, 58.3%, and 38.6%, respectively. Eight-seven percent of respondents sourced COVID-19 related information via the mass media. Ninety-four percent of respondents will not stay at home if sick because of work. Age, profession, and knowledge are significantly associated with COVID-19 preventive practices. The predictors (Model II) of good COVID-19 preventive practices include being a laboratory scientist (odds ratio [OR]: 2.44 [95% confidence interval (CI): 1.05, 6.71]; P = 0.039), working in primary health facility (OR: 4.72 [95%CI: 1.08, 20.67]; P = 0.039) and having good COVID-19 knowledge (OR: 3.71 [95%CI: 1.49­9.925]; P = 0.005). Conclusion: Our study has shown the predictors of good COVID-19 preventive practices among healthcare workers and the need for policy and practice change as it relates to COVID-19 infection prevention and mitigation among healthcare workers.


Subject(s)
Humans , Male , Female , Health Knowledge, Attitudes, Practice , COVID-19 , Social Change , Health Personnel , Nigeria
9.
Niger. j. med. (Online) ; 30(4): 394-399, 2021. Tables
Article in English | AIM | ID: biblio-1290637

ABSTRACT

Background: Maternal attitude to health-seeking behavior of their under-five children in the COVID-19 pandemic is not well-known. Objectives: This study is aimed at determining mothers' perception of COVID-19 pandemic among their under-five children and associated factors. Methodology: This is a prospective and observational study carried out in two health institutions in South-East Nigeria. Results: Most subjects, 243 (65.3%) noted that someone without showing symptoms of COVID-19 could transmit the virus. Of the mothers of children under-five, 271 (72.8%) highlighted the possibility of COVID-19 infection in the under-five. A small number of participants 53 (14.2%) showed awareness that people should cough into their elbows as a way of preventing the transmission of COVID-19. A small number of participants, 160 (43.0%) had a good perception of COVID-19. Majority of mothers who were married, 148 (44.7%) showed a good perception of COVID-19 when compared with those who were single, 12 (29.3%); however, this is not significant, (χ2 = 3.550, P = 0.060). A large number of participants who have attained tertiary education, 92 (48.9%) had a good perception of COVID-19 which is higher than that seen in mothers with secondary education 68 (37.0%) (χ2 = 5.444, P = 0.020). Participants who were 30­34 years had 1.8 times higher odds of good perception of COVID 19 compared with mothers who were more than 35 years (adjusted odds ratio = 1.803, 95% confidence interval = 1.026­3.170). Conclusion: Although most mothers affirm that a child could be infected by COVID-19, a small number of them actually had a good perception of COVID-19 infection. Good perception of COVID-19 among the under-five is enhanced by the high level of education and age of 32­34 years.


Subject(s)
Humans , Child, Preschool , Attitude to Health , COVID-19 , Perception , Maternal Health , Maternal Behavior , Mothers
10.
Niger. j. med. (Online) ; 30(4): 356-361, 2021.
Article in English | AIM | ID: biblio-1290631

ABSTRACT

Coronavirus disease 2019 (COVID­19) accounts for over 92 million confirmed cases worldwide, with over 2.06 million deaths. In the past year, more than 290 candidate vaccines have been tested; COVID-19 vaccine development was sped up, with shortened timeline, due to the urgent global need in the face of the pandemic. In addition, people with the highest risk of contracting the disease, such as health workers with a high risk of exposure, elderlies, and people with underlying comorbidities, were prioritized with vaccination rollout. The article narratively reviewed original and review articles available on PubMed and Google Scholar related to the theme to provide up­to­date information. The different templates developed and studied for COVID-19 vaccines include the whole-virus vaccine, viral vector vaccine, nucleic acid (deoxyribonucleic acid and ribonucleic acid), and protein subunit vaccine. Myths impede vaccine uptake in this part of the globe. Adopting these myths leads to sharing and spreading, which negatively impacts the prevention of COVID-19 and vaccine uptake. Adverse event following immunizations (AEFIs) is classified based on severity, from minor to severe. The minor ones are common events that pose no potential health risks to the receiver of the vaccine. The type determines the safety profile, severity, and frequency of AEFIs observed with the vaccine administration. Overall, this pandemic has heightened the global level of threat awareness; it has also provided motivation to prepare for future pandemics by developing new vaccines.


Subject(s)
Humans , COVID-19 Vaccines , COVID-19 , Vaccines, DNA , Protein Subunits , Nigeria
11.
Afr. j. AIDS res. (Online) ; 20(2): 117-124, 2021. tables
Article in English | AIM | ID: biblio-1284622

ABSTRACT

By the end of the first year of the COVID-19 pandemic, in February 2021, the numbers of cases and deaths in southern Africa were low in absolute and relative numbers. The BBC ran a story (which was later retracted) headlined "Coronavirus in Africa: Could poverty explain mystery of low death rate?". A heading in the New York Post said: "Scientists can't explain puzzling lack of coronavirus outbreaks in Africa". Journalist Karen Attiah concluded: "It's almost as if they are disappointed that Africans aren't dying en masse and countries are not collapsing". We wondered if the knowledge that southern African countries have acquired in their struggle against AIDS has contributed to a more effective approach against COVID-19. The viral origins of the diseases through zoonotic events are similar; neither has a cure, yet. In both diseases, behaviour change is an important prevention tool, and there are specific groups that are more vulnerable to infection. Equally, there are important differences: most people with COVID-19 will recover relatively quickly, while people living with HIV will need lifelong treatment. COVID-19 is extremely infectious, while HIV is less easily transmitted.


Subject(s)
Humans , SARS-CoV-2 , COVID-19 , South Africa , Tuberculosis , HIV Infections
12.
Malawi med. j. (Online) ; 33(2): 108-113, 2021.
Article in English | AIM | ID: biblio-1284526

ABSTRACT

Introduction:Diabetes Mellitus (DM) has become a disease of public health importance in Nigeria. Early identification of DM risk is important in the reduction of this disease burden. This study assessed ten-year risk of developing type 2 DM among some medical doctors in Ondo State. Methods:This was a cross-sectional study that assessed ten-year risk of developing type 2 DM among some doctors using the Finland Diabetic Risk Score form. Known diabetics were excluded from the study. Body mass index (BMI), waist circumference (WC), blood pressure and total DM risk score were determined for each participant.Results: One hundred and ninety-two doctors participated in the study with a male: female ratio of 1.3:1. Majority (92.2%) were below 55 years, 22 (11.5%) were obese, 32(16.7%) had central obesity, 46(24%) reported physical inactivity, 49(25.5%) had family history of DM, 141(73.4%) do not take fruits and vegetables regularly. Forty-three (22.4%) were found to have elevated blood pressure while 6(3.1%) had elevated blood glucose. Fifty-seven (29.7%) of the participants had increased ten-year DM risk. Significant predictors of increase DM risk were age ≥ 45 years (AOR:9.08; CI 3.13-26.33; p = <0.001 ) ; BMI ≥25kg/m2(AOR:11.41; CI:4.14-31.45; p = <0.001) ; family history of DM (AOR:9.93; CI:3.25-30.39; p = <0.001) ; abdominal obesity (AOR:6.66; CI:2.08-21.29; p= < 0.001); and infrequent dietary intake of fruits and vegetable(AOR:3.11;CI:1.03:9.37: p = 0.04) Conclusion:There was increased 10-year DM risk in about 30% of the participants. Lifestyle modification such as physical activity and regular consumption of fruits and vegetables should be encouraged among doctors


Subject(s)
Humans , Male , Female , Middle Aged , Disease Management , Diabetes Mellitus, Type 2 , Quality of Life , Professional Review Organizations , Malawi
13.
Malawi med. j. (Online) ; 33(2): 73-81, 2021.
Article in English | AIM | ID: biblio-1284523

ABSTRACT

Background:Untreated surgical conditions may lead to lifelong disability in children. Treating children with surgical conditions may reduce longterm effects of morbidity and disability. Unfortunately, low- and middle-income countries have limited resources for paediatric surgical care. Malawi, for example, has very few paediatric surgeons. There are also significantly inadequate infrastructures and personnel to treat these children. In order to strengthen resources that could provide such services, we need to begin by quantifying the need.Aim: To estimate the approximate prevalence of surgical conditions among children in Malawi, to describe the anatomical locations and diagnoses of the conditions and the presence of injuries. Methods A cross-sectional, nationwide survey of surgical needs was performed in 28 of 29 districts of Malawi. Villages, households and household members were randomly selected. A total of 1487 households were visited and 2960 persons were interviewed. This paper is a sub analysis of the children in the dataset. Information was obtained from 255 living children and inquiry from household respondents for the 255 children who had died in the past year. The interviews were conducted by medical students over a 60-day period, and the validated SOSAS tool was used for data collection. Results:There were 67 out of 255 (26.3%) total children living with a surgical condition at the time of the study, with most of the conditions located in the extremities. Half of the children lived with problems due to injuries. Traffic accidents were the most common cause. Two-thirds of the children living with a surgical condition had some kind of disability, and one-third of them were grossly disabled. There were 255 total deceased children, with 34 who died from a surgical condition. The most prevalent causes of death were congenital anomalies of the abdomen, groin and genital region. Conclusion: An extrapolation of the 26% of children found to be living with a surgical condition indicates that there could be 2 million children living with a condition that needs surgical consultation or treatment in Malawi. Congenital anomalies cause significant numbers of deaths among Malawian children. Children living with surgical conditions had disorders in their extremities, causing severe disability. Many of these disorders could have been corrected by surgical care.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Surgical Procedures, Operative , Wounds and Injuries , Quality of Health Care , Ancillary Services, Hospital , Malawi
14.
Malawi med. j. (Online) ; 33(2): 114-120, 2021.
Article in English | AIM | ID: biblio-1284520

ABSTRACT

Introduction: Diabetes Mellitus (DM) has become a disease of public health importance in Nigeria. Early identification of DM risk is important in the reduction of this disease burden. This study assessed ten-year risk of developing type 2 DM among some medical doctors in Ondo State. Methods: This was a cross-sectional study that assessed ten-year risk of developing type 2 DM among some doctors using the Finland Diabetic Risk Score form. Known diabetics were excluded from the study. Body mass index (BMI), waist circumference (WC), blood pressure and total DM risk score were determined for each participant. Results: One hundred and ninety-two doctors participated in the study with a male: female ratio of 1.3:1. Majority (92.2%) were below 55 years, 22 (11.5%) were obese, 32(16.7%) had central obesity, 46(24%) reported physical inactivity, 49(25.5%) had family history of DM, 141(73.4%) do not take fruits and vegetables regularly. Forty-three (22.4%) were found to have elevated blood pressure while 6(3.1%) had elevated blood glucose. Fifty-seven (29.7%) of the participants had increased ten-year DM risk. Significant predictors of increase DM risk were age ≥ 45 years (AOR:9.08; CI 3.13-26.33; p = <0.001 ) ; BMI ≥25kg/m2 (AOR:11.41; CI:4.14-31.45; p = <0.001) ; family history of DM (AOR:9.93; CI:3.25-30.39; p = <0.001) ; abdominal obesity (AOR:6.66; CI:2.08-21.29; p= < 0.001); and infrequent dietary intake of fruits and vegetable(AOR:3.11;CI:1.03:9.37: p = 0.04) Conclusion: There was increased 10-year DM risk in about 30% of the participants. Lifestyle modification such as physical activity and regular consumption of fruits and vegetables should be encouraged among doctors.


Subject(s)
Humans , Male , Female , Aged , Risk Factors , Diabetes Mellitus, Type 2 , Physicians
15.
Malawi med. j. (Online) ; 33(2): 85-107, 2021.
Article in English | AIM | ID: biblio-1284519

ABSTRACT

The Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has triggered an international pandemic that has led to significant public health problems. To date, limited evidence exists to suggest that drugs are effective against the disease. As possible treatments are being investigated, herbal medicines have shown potential for producing novel antiviral agents for the COVID-19 disease. Aim This review explored the potential of Malawi's traditional medicinal plants for the management of COVID-19. Methods:The authors searched on PubMed and Google scholar for medicinal plants that are used in Malawi and published in openly available peer reviewed journals. Plants linked with antiviral treatment, anti-COVID-19 activity or COVID-19 symptoms management were targeted. These included activity against pneumonia, inflammation, cough, difficulty in breathing, pain/aches, fever, diarrhoea, rheumatism, fatigue, asthma, immunocompromised and cardiovascular diseases.Results:11 studies were found with 306 plant species. 127 plant species had at least one COVID-19 related pharmacological activity. Of these plant species, the number of herbal entities used for each indication was: pain/aches (87), fever (2), pneumonia (9), breathing/asthma problems (5), coughing (11), diarrhoea (1), immunosuppression (8), blood issues (10), fatigue (2), heart problems (11), inflammation (8), rheumatism (10) and viral diseases (12). Thirty (30) species were used for more than one disease and Azedarachta indica topped the list (6 of the 13 COVID-19 related diseases). The majority of the species had phytochemicals known to have antiviral activity or mechanisms of actions linked to COVID-19 and consequent diseases' treatment pathways.Conclusion:Medicinal plants are a promising source of compounds that can be used for drug development of COVID-19 related diseases. This review highlights potential targets for the World Health Organization and other research entities to explore in order to assist in controlling the pandemic.


Subject(s)
Humans , Medicine, African Traditional , COVID-19 , Plant Preparations , Malawi , Medicine, Traditional
16.
Article in English | AIM | ID: biblio-1284410

ABSTRACT

Background: Understanding the mental health needs of healthcare workers during coronavirus disease 2019 (COVID-19) pandemic with a view of mitigating its impact on occupational functioning is vital. Aim: To determine the prevalence and correlates of psychological distress amongst healthcare workers. Setting: The study was carried out in Nigeria during COVID-19 pandemic. Methods: A cross-sectional quantitative study using a convenience sample was conducted amongst healthcare workers. The survey comprised of two Google formatted self-report questionnaires, a 12-item General Health Questionnaire and a questionnaire containing socio-demographic, work related and knowledge of COVID-19 variables. Questionnaires were distributed via closed professional WhatsApp platforms. Data were analysed using descriptive statistics, chi-square test and logistic regression. Results: There were 313 respondents and prevalence of psychological distress was 47.0%. Females were almost twice as likely to have psychological distress as males (OR = 1.92, 95% CI: 1.21­3.04, p = 0.006). Healthcare workers who had no contact with COVID-19 positive patients had an 87% reduced risk of psychological distress (OR = 0.13, 95%CI: 0.23­0.25, p = 0.018) compared with those who had contact with COVID-19 positive patients. Healthcare workers with poor knowledge of COVID-19 had a 44% reduced risk of psychological distress compared with those with good knowledge (OR = 0.56, 95% CI: 0.34­0.93, p = 0.025). Conclusion: Findings revealed that healthcare workers in Nigeria reported psychological distress during COVID-19 pandemic. Greater risk was amongst females and those who had contact with COVID-19 positive patients whilst poor knowledge was protective.


Subject(s)
Psychological Distress , COVID-19 , Mental Health , Health Personnel , Nigeria
17.
Niger. j. med. (Online) ; 30(4): 464-469, 2021.
Article in English | AIM | ID: biblio-1290778

ABSTRACT

Background: The governments of many countries have taken steps to avert the spread of COVID 19. The gradual relaxation of the lockdown in Nigeria might be counter-productive if not properly managed. The best means to reduce and stop transmission is for the public to be adequately informed about the disease and its preventive measures. This research assessed the knowledge of COVID-19 and practice of preventive measures along with its predictors among Nigerian residents during the ease of the lockdown. Methodology: A cross-sectional study was conducted among 1421 adult residents of Nigeria. Data were collected between 6th and 20th September, 2020, using a semi-structured online questionnaire adapted from previous studies. IBM SPSS version 26 was used for data analysis. Pearson's Chi-square and logistic regression were used to determine the predictors of preventive practices. Results: The mean age of the respondents was 27.5 ± 9.1 years. A very large proportion (98.8%) of the respondents had a good knowledge of the disease (score of ≥4 out of 6 variables) and the internet (70.1%) was the major source of their information. However, only 57.6% of them had good practice of preventive measures of the disease (score of ≥3 out of 4). Predictor of good practice of preventive measure included female sex (adjusted odds ratio [AOR] = 2.626; 95% confidence interval [CI] = 2.078­3.319), being married (AOR = 2.177; 95% CI = 1.568­3.023), and possessing tertiary and postgraduate level of education (AOR = 1.813; 95% CI = 1.082­3.036 and AOR = 2.102; 95% CI = 1.206­3.664, respectively). However, residents in local government headquarters and other villages as well as towns (AOR = 0.541; 95% CI = 0.388­0.756 and AOR = 0.587; 95% CI = 0.350­0.983, respectively) have less likelihood of engaging in good practice of preventive measures. Conclusion: Majority of the research participants had good knowledge of the disease, while about half take part in good preventive practices measures. Predictors of the practice measures included sex, level of education, place of residence, as well as marital status. Therefore, targeted interventions should be directed to the males, those who reside outside the Federal Capital Territory and state capitals, and other high-risk groups as found by this study to reduce the risk of disease contraction during this period.


Subject(s)
COVID-19 , Health Knowledge, Attitudes, Practice
18.
S. Afr. j. obstet. gynaecol ; 26(1): 4-7, 2020. tab
Article in English | AIM | ID: biblio-1270788

ABSTRACT

Background. Maternal intravenous immunoglobulin (IVIG) may delay the onset and severity of fetal anaemia in Rhesus D (RhD)- sensitised pregnancies, thereby minimising the need for intrauterine transfusion and its associated complications. Objective. To compare the pregnancy outcomes of RhD-sensitised women who received antenatal IVIG with those who did not receive antenatal IVIG. Methods. This was a retrospective cross-sectional analysis of RhD-sensitised women who attended the Wits Fetal Medicine Centre (Johannesburg) from 1 January 2008 to 31 May 2018. Criteria for maternal IVIG administration were: (i) previous adverse pregnancy outcome (early neonatal death, intrauterine fetal death or miscarriage related to RhD sensitisation), (ii) women with high antibody titre levels (≥1:64) in the absence of fetal anaemia; and (iii) rising antibody titre levels. Maternal antibody titre levels, pregnancy and neonatal outcomes were compared in women who received IVIG v. those who did not receive IVIG. Results. Of the 42 RhD-sensitised women, 14 received IVIG. A greater proportion of women experienced a decrease in antibody titres in the IVIG v. no-IVIG group (43% v. 11%, respectively; p=0.04). Nine of the 10 women in the IVIG group with a previous adverse pregnancy outcome had a successful pregnancy outcome following IVIG treatment. Conclusion. Maternal IVIG may provide a successful pregnancy outcome in RhD-sensitised women with previous adverse pregnancy outcomes related to Rh disease, or women with raised or increasing maternal antibody titre levels who present in the first or early second trimester


Subject(s)
Immunoglobulins, Intravenous , Pregnancy , Rh-Hr Blood-Group System , South Africa
19.
S. Afr. j. obstet. gynaecol ; 26(1): 8-12, 2020. ilus
Article in English | AIM | ID: biblio-1270789

ABSTRACT

Background. Pregnant patients with Factor V Leiden (FVL) mutation are at an increased risk of venous thromboembolic disease (VTED) and placental-mediated complications. Thromboprophylaxis with low-molecular-weight heparin (LMWH) can potentially mitigate these risks. Objective. To describe the clinical course of a cohort of patients with FVL mutation with different underlying genotypes.Methods. The pregnancy outcomes, occurrence of VTED events and laboratory test results of pregnant women with FVL mutation managed at a quaternary medical centre over a period of 18 years in Johannesburg, South Africa, were analysed. Results. Over the period of analysis, 25 pregnant women with FVL mutation were referred to the haematology department for management. Ten patients (40%) had a family history, and 15 patients (60%) a personal history of VTED. The majority of provoked VTED events (90%) were secondary to combined oral contraceptive exposure. Previous pregnancy loss occurred in 4 (16%) patients, of whom 3 (75%) suffered recurrent losses. All women received prophylactic anti-Factor Xa (anti-FXa) dose-adjusted LMWH during ante- and postnatal periods. All pregnancies resulted in live births with 1 VTED event recorded. Conclusion. Patients with FVL mutation show phenotypical heterogeneity in terms of pregnancy outcomes, VTED events and placental-mediated complications. Confounders contributing to the heterogeneity are not completely defined and deciding on appropriate treatment is not fully standardised but the live birth rate is encouraging


Subject(s)
Heparin, Low-Molecular-Weight , Patients , South Africa
20.
S. Afr. j. obstet. gynaecol ; 26(1): 18-21, 2020. ilus
Article in English | AIM | ID: biblio-1270790

ABSTRACT

Background. Caesarean scar ectopic pregnancy (CSEP) is a rare condition in which the implantation of the gestational sac takes place within the uterine scar of a previous caesarean section (CS). If the pregnancy continues within the uterus, the risk of placenta accrete or uterine rupture is increased.Objective. To investigate four treatment methods, based on each patient's clinical presentation, gestational age of the pregnancy and haemodynamic stability, for the management of CSEP.Methods. CSEP cases (N=30) were diagnosed by ultrasound at the Shatby Maternity University Hospital, Egypt. Various treatment modalities, based on gestational age, were employed to treat the patients. Treatments included suction curettage (n=12), embryo reduction with local methotrexate injection (n=12), laparoscopic excision (n=3) and excision through laparotomy (n=3). Serum levels of beta-human chorionic gonadotrophin (ß-hCG) were measured at diagnosis and weekly following treatment until the levels returned to non-pregnant values.Results. There was a significant positive correlation between gestational age in weeks and the CSEP management strategy employed. ß-hCG levels decreased from before treatment to the end of the follow-up period 3 weeks later.No cases required a hysterectomy, and no maternal complications were reported in this study.Conclusion. The appropriate CSEP management strategy varies according to gestational age. Suction and embryo reduction with local methotrexate injection offers an effective, safe and minimally invasive surgical treatment to remove ectopic pregnancy tissue. Closely monitored follow-up of patients, including serial measurement of ß-hCG levels and ultrasonographic examinations, is recommended after CSEP management


Subject(s)
Cesarean Section , Egypt , Laparoscopy , Pregnancy, Ectopic , Tertiary Care Centers , Vacuum Curettage
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