Attitude, practice orientation, benefits and barriers towards health research and publications among medical practitioners in Abia State, Nigeria: A cross-sectional study.

BACKGROUND: Health research is an essential component of medical training, education, and practice and is fundamental in establishing the scientific basis of health care. Aim: The study was aimed at describing the attitude, practice, benefits, and barriers towards health research and publications in a cross-section of medical practitioners in Abia State, Nigeria. MATERIALS AND METHODS: This was a cross-sectional descriptive study carried out on 210 medical practitioners in Abia State. Data collection was done using pretested, self-administered questionnaire that elicited information on attitude, practice, benefits, and barriers toward health research. Awareness of research misconduct, types of published research articles, and factors considered in selection of journals for publication of research were also studied. RESULTS: The age of the participants ranged from 26 to 77 years. There were 173 (82.4%) men. The overall attitude toward research was moderate (x = 5.02 ± 0.96). All the respondents (100%) were involved in undergraduate research projects while 72 (34.3%) had at least one journal publication with the most commonly published articles being descriptive studies. The commonest barriers to research were financial and time constraints while the greatest benefits of research were advancement of medical knowledge and keeping practitioners abreast with evidence-based medicine. The commonest research misconduct was plagiarism while the most common factor considered in selection of journals for publication was article publication charges. Middle age group and years of practice more than 10 years were significantly associated with publication of journal articles (P < 0.05). CONCLUSION: This study has shown that the study participants had moderate positive attitude toward research with all the participants previously involved in undergraduate research and only one third had at least one journal publications. The commonest barriers were financial and time constraints and greatest benefits of health research was advancement of medical knowledge and keeping practitioners abreast with evidence-based medicine. Choice of journal for publications is preeminently determined by article publication charges. The most common article published and research misconduct was descriptive studies and plagiarism, respectively.

The provision of potable water in eradication of Guinea worm infection in Ezza North, Southeastern, Nigeria.

Guinea worm is a parasite found in unprotected drinking water sources, causes considerable morbidity and loss of agricultural production among rural people. The study was to determine the current status of Guinea worm infection in Ezza North and to evaluate the impact of control measures on guinea worm infection. A total of 200 individuals in Ezza North Southeastern, Nigeria were examined for guinea worm infection. A standardized questionnaire was used to determine the effect of potable water on guinea worm eradication/control, the source of drinking water, information on the knowledge, attitude, symptom management practices, availability of health facilities and boreholes installation status. The instrument for data collection was well constructed, validated and reliable tested questionnaire by an expert. Data obtained was analyzed using Epi-Info model 3.4 versions. Results of a study indicated majority of the respondents 195 (97.5 %) have access to safe drinking water supply which indicated no case of Guinea worm infection. The active use of potable water supply was found among the age group of 20-30 years 71 (35.5 %) and higher in male (57.5 %) than females (42.5 %). The drastic reduction of Guinea worm infection to zero (0) level in Ezza North were due to multiple factors as health education, availability of functional boreholes, presence of health centers for immediate treatment if any case discovered.

Family biosocial variables driving adherence to the use of insecticide treated nets among under-five children managed for malaria in a rural hospital in eastern Nigeria.

BACKGROUND: As the distribution and awareness of free insecticide treated nets (ITNs) for malaria control continues to grow in Nigeria in order to meet the coverage target for the year 2010, a large gap exists between acquiring them, using them, and adhering to its use by families of under-five children. Therefore, the family biosocial variables driving its adherence need to be explored if the potential benefits of the nets are to be fully harnessed by families of under-five children in Nigeria. This study was aimed at describing family biosocial variables driving adherence to the use of insecticide treated nets among under-five children managed for malaria in a rural hospital in Eastern Nigeria. MATERIALS AND METHODS: This was descriptive hospital-based study carried out from June 2008 to June 2010 on a cross section of 220 mothers of under-five children who were managed for confirmed malaria within the study period and met the selection criteria were interviewed using a pretested, structured researcher administered questionnaire. The questionnaire instrument elicited information on family biosocial variables. Adherence was assessed in the previous 6 months and graded using an ordinal scoring system of 1-4 points: score of 4 points indicated adherence while scores of 1-3 points meant nonadherence. Operationally, an adherent respondent was defined as one who scored 4 points. An under-five child was defined to have malaria if the mother gave complaint of fever, vomiting and other symptoms suggestive of malaria, had body temperature exceeding 37.5 degrees C with the asexual forms Plasmodium falciparum detected on the peripheral blood film. Reasons for nonadherence were also sought. RESULTS: The adherence rate was 33.2%. The family biosocial variables significantly associated with adherence were maternal age =30 years (p-value = 0.03), maternal occupation (house wives) (p-value = 0.03), family size less than 4 (p-value = 0.026) and spouse living together (p-value = 0.01.). Others included family belief, in the benefits of ITNs (p-value = 0.002 and source of ITNs (p-value = 0.03). The most significant predictor of adherence was living together of spouse (p-value = 0.000, OR = 3.851, CI = 1.76-6.01). The commonest reason for non-adherence was forgetfulness (p-value = 0.003). CONCLUSION: Despite high family belief in the benefits of ITNs, adherence to its use was low. Some family biosocial variables played significant roles in driving its adherence. Measures targeted at these variables and widespread family-oriented health promotion programmes are recommended in order to improve on adherence leading to family friendly ITNs communities.

The magnitude of abdominal adiposity and atherogenic dyslipidemia among geriatric Nigerians with arterial hypertension in a rural hospital in South-eastern Nigeria.

BACKGROUND: As the case detection rate of arterial hypertension increases daily in rural Nigeria, screening for its associated abdominal obesity and dyslipidemia is an important healthcare challenge. Of great concern in rural Nigeria is that most geriatric hypertensives with abdominal obesity and dyslipidemia are not routinely diagnosed and therefore do not receive appropriate management. OBJECTIVE: This study was aimed at describing the magnitude (prevalence and pattern) of abdominal adiposity using waist circumference (WC) index and dyslipidemia among geriatric Nigerians with arterial hypertension in a rural hospital in South-eastern Nigeria. MATERIALS AND METHODS: A descriptive hospital-based study was carried out from June 2008 to June 2011 on 122 consecutive geriatric patients with systemic hypertension who met the selection criteria at St. Vincent De Paul Hospital, Amurie-Omanze, a rural Mission General Hospital in Imo state. Abdominal obesity was defined as WC ≥102 cm and ≥88 cm for men and women, respectively. Dyslipidemia was defined using the third report of National Cholesterol Education Panel in adult (ATP III). The data collected included basic demographic variables, blood pressure, waist circumference, fasting lipid profile, and blood sugar. RESULTS: The prevalence of abdominal obesity was 50.8% and was the most common pattern of abdominal adiposity. Fifty-four (44.3%) out of 122 patients had at least one dyslipidemia with the most frequent being low high-density lipoprotein cholesterol (HDL-C, 38.5%). There was statistically significant difference between male and female gender based on abdominal adiposity (X 2 = 5.406, P value = 0.04) while their mean lipid differentials were not statistically significant. CONCLUSION: This study has shown that abdominal adiposity and dyslipidemia exist among geriatric hypertensives in the study area with abdominal obesity being the most common abdominal adiposity and low HDL-C being the most frequent lipid abnormality. This study therefore urges the necessity to consider abdominal obesity and dyslipidemia in geriatric hypertensives in rural Nigeria alongside the complex of other cardiovascular risk factors.

Common geriatric emergencies in a rural hospital in South-Eastern Nigeria.

BACKGROUND: Geriatric population in rural Nigeria is often challenged by emergency health conditions that predispose them to higher risk of disability and mortality. OBJECTIVE: This study was aimed at describing the common geriatric emergencies in a rural hospital in South-Eastern Nigeria. MATERIALS AND METHODS: This was a descriptive hospital-based study of 216 geriatric patients who presented between June 2008 and June 2011 with emergency health conditions at St Vincent De Paul hospital, Amurie-Omanze, a rural Mission General Hospital in Imo state, South-Eastern Nigeria. The geriatric patients seen within the study period who met the selection criteria were studied. Data extracted for analysis included biodata and diagnosis made. RESULTS: A total of 216 geriatric emergencies were seen during the study period. The ages of the patients ranged from 65 years to 98 years with mean age of 72 ± 1.14 years. There were 94 males and 122 females with a male to female ratio of 1: 1.3. The three most common causes of geriatric emergencies were acute malaria (33.8%), hypertensive crises syndrome (19.0%), and acute hypertensive heart failure (18.1%). CONCLUSION: This study has shown that the three most common geriatric emergencies were medical emergencies (acute malaria, hypertensive crises syndrome, and acute hypertensive heart failure). Improving the quality of geriatric medical care will help in reduction of these emergency medical conditions. Similarly, health education of the geriatric population to embrace early health-seeking behavior, health maintenance, and promotional practices that are needed to promote longevity is invariably advocated.

Common geriatric morbidity from communicable diseases in a rural hospital in Eastern Nigeria.

BACKGROUND: The geriatric health, wellness and illness states in Nigeria are largely influenced by communicable diseases. OBJECTIVE: This study was aimed at describing the pattern of common geriatric morbidity from communicable diseases in a rural hospital in Eastern Nigeria. METHODS: This study was a descriptive hospital-based study carried out from June 2008 to June 2010 on geriatric patients at St Vincent De Paul Hospital, Amurie-Omanze, a rural Mission General Hospital in Imo state. The data collected included age, sex and diagnoses made. RESULTS: Eight hundred and seventy two patients out of a total patient population of 9885 were 65 years and above. The geriatric patients' constituted 8.8% of total patients' population. Out of these, 530 (60.8%) had communicable diseases consisting of 235 males and 295 females with a male to female ratio of 1: 1.3. The top five communicable diseases were malaria (67.1%), skin infections (43.6%), urinary tract infections (36.0%), intestinal helminthiasis (20.6%) and gastroenteritis (17.9%). CONCLUSION: This study shows that geriatric patients suffer acute and chronic communicable diseases with the commonest being malaria, skin infections, urinary tract infections and neglected tropical disease such as ascariasis and hookworm infestation. Effective measures are needed to control the scourge of communicable diseases which are largely preventable among the elderly patients particularly in rural Nigeria.

The magnitude of atherogenic dyslipidaemia among geriatric Nigerians with systemic hypertension in a rural hospital in Eastern Nigeria.

BACKGROUND: The relevance of dyslipidaemia in the management of cardiovascular diseases, especially hypertension is an important health care challenge that is increasing worldwide. Of great concern in Nigeria is that most geriatric hypertensives with dyslipidaemia are not routinely diagnosed and therefore do not receive appropriate treatment. OBJECTIVE: This study is aimed at describing the magnitude (prevalence and pattern) of atherogenic dyslipidaemia among geriatric Nigerians with systemic hypertension in a rural hospital in Eastern Nigeria. METHODS: A descriptive hospital-based study was carried out from June 2008 to June 2011 on 122 consecutive geriatric patients with systemic hypertension who met the selection criteria at St Vincent De Paul hospital, Amurie-Omanze, a rural Mission General Hospital in Imo state. The fasting lipid profile was determined by enzymatic method. Dyslipidaemia was defined using the third report of National Cholesterol Education Panel in adult (ATP III). The data collected included age and sex. RESULTS: Fifty-four (44.3%) out of 122 patients had at least one dyslipidaemia. The age of the patients ranged from 65 years to 91 years with mean age of 69 +/- 2.10 years. There were 51 (41.8%) males and 71 (58.2) females with male to female ratio of 1: 1.4. The commonest lipid abnormality was low high density lipoprotein-cholesterol (38.5%). Others included high low density cholesterol (23.8%), high total cholesterol (17.2%) and high triglyceride (14.8%). CONCLUSION: This study has shown that dyslipidaemia exist among geriatric hypertensives in the study area with low HDL-C being the most frequent lipid abnormality suggesting that low HDL may be the major form of dyslipidaemia and a marker of dyslipidaemic cardiometabolic risk among them. Screening for dyslipidaemia should therefore form an important part of clinical care of geriatric hypertensives and those with dyslipidaemia should become target for lipid lowering treatment in addition to lifestyle modification.

Common under-five morbidity in South-Eastern Nigeria: a study of its pattern in a rural mission general hospital in Imo State.

BACKGROUND: The under-five children are the most vulnerable group that bears the burden of diseases to a large extent in Nigeria. This study was aimed at describing the common and pattern of under-five morbidity in a rural Mission General Hospital in Imo state, South-Eastern Nigeria. METHODS: A cross sectional descriptive hospital-based study was carried out from June 2008 to June 2009 on 244 under-five children aged 4 days to 58 months. The under-five children seen within the study period who met the selection criteria were studied. The data collected included age, sex and diagnosis made. RESULTS: One hundred and seven (43.8%) out of a total of 244 under-five children studied were aged 37-60 months, eighty one (33.2%) were aged 13-36 months and fifty six (23.0%) were aged 0-12 months. There were 141 (57.8%)males and 103 (42.2%) females. The three commonest causes of morbidity were malaria infections (80.3%), acute respiratory infections (32.0%) and skin infections (29.1%). The age group 37-60 months bears the greatest burden of malaria infections (49.0%), acute respiratory infections (55.1%) and skin infections (53.5%). CONCLUSION: This study shows that the three commonest causes of under-five morbidity (malaria, acute respiratory infections and skin infections) are largely preventable and infectious diseases still remaining major causes of morbidity; and similar to the under-five morbidity pattern documented at the beginning of the implementation of Primary Health Care and Child Survival Strategies in Nigeria. Identification, implementation, monitoring and evaluation of multidisciplinary and multisectoral intervention strategies targeted at the common under-five morbidity that are culturally acceptable, scientifically proven, patient-, family- and community-friendly and centred are recommended.

Obesity in adult Nigerians: a study of its pattern and common primary co-morbidities in a rural Mission General Hospital in Imo state,South-Eastern Nigeria.

OBJECTIVES: This study was generally aimed at determining the prevalence and pattern of obesity using body mass index (BMI) criterion and specifically screening for its common primary co-morbidities among adult Nigerians attending a rural Mission General Hospital in Imo state, South-Eastern Nigeria. MATERIALS AND METHODS: A descriptive study was carried out from June 2008 to May 2009. A total of 2156 consecutive new adult patients aged 18-90 years were screened for obesity using the BMI criterion, and 129 patients had BMI ≥ 30 kg/m² and met the inclusion criteria. The data collected included age, sex, marital status, education, occupation, social class, weight, height and blood pressure, fasting blood sugar and lipid profile. RESULTS: The prevalence of obesity was 6.0%, with class I obesity (86.1%) being the most common pattern. Hypertension (16.3%) was the most common primary co-morbidity; others included low high-density lipoprotein-cholesterol (21.7%), high low-density lipoprotein-cholesterol (9.3%), high total cholesterol (7.8%), high triglyceridemia (4.7%) and diabetes mellitus (3.9%). CONCLUSIONS: This study has shown that obesity and its primary co-morbidities are emerging as a serious health problem among the study population, with class I obesity being the most common pattern and hypertension being the most common primary co-morbidity. Anthropometric determination of obesity and screening for its common primary co-morbidities should be integrated as part of the clinic baseline assessment of adult Nigerians attending rural hospitals to facilitate their early detection and institutionalization of appropriate preventive and therapeutic measures.

Obesity in adult Nigerians: a study of its prevalence and common primary co-morbidities in a semi-urban Mission General Hospital in South-Eastern Nigeria.

BACKGROUND: Obesity is socially and culturally acceptable in Nigeria and therefore not usually recognized as a medical problem. This study is aimed at determining the prevalence of obesity using body mass index (BMI) criterion and its common primary comorbidities among adult Nigerians attending a semi-urban Mission General Hospital in Imo state, SouthEastern, Nigeria. METHODS: A descriptive study using primary data collection technique was carried out from October 2007 to December 2008. A total of 9296 consecutive new adult patients aged 18-88 years were screened for obesity using BMI criterion and 684 patients who had BMI = 30 kg/m2 met the inclusion criteria. The data collected included age, sex, marital status, education, occupation, weight (kilogram), height (meters), and blood pressure; fasting blood sugar and fasting lipid profile. Obese patients' perception of their obese condition and knowledge of lifestyle modification were also assessed. RESULTS: Six hundred and eighty-four (7.4%) out of a total of 9296 patients screened for obesity were obese. Hypertension (18.4%) was the commonest primary comorbidity, others include high triglyceridaemia (9.2%), high total cholesterol (8.2%), high LDL-cholesterol (6.0%) and diabetes mellitus (3.4%). One hundred and one (14.8%) obese patients were aware of their obese condition and majority, 72 (71.3%) of them were informed of their obese condition by healthcare professionals. Forty seven (46.5%) of those who were aware of their obese condition had knowledge of lifestyle modification. However, majority (72.3%) of those who had knowledge of lifestyle modification demonstrated low knowledge level of lifestyle modification. CONCLUSION: This study has shown the existence of obesity and its common primary co-morbidities among the study population. Anthropometric determination of obesity and screening for its common primary comorbidities should be integrated as part of clinic baseline assessment of adult Nigerians attending semi-urban hospitals. Those who had obesity-related primary co morbidities should become secondary target for risk reduction therapy and appropriate management.

The knowledge, attitude and practices of food handlers in food sanitation in a metropolis in south eastern Nigeria.

The spread of diseases through food is still a common problem which results in appreciable morbidity and occasional mortality. Food handlers play an important role in ensuring food safety throughout the chain of production, processing, storage and preparation. This study was designed to determine knowledge, attitude and practice of food handlers towards food-borne diseases and food safety. A total of 430 food handlers were randomly selected from Owerri Metropolis of Imo State Nigeria and interviewed using structured pretested questionnaire. Almost half (48.4%) of the respondents had poor knowledge of food sanitation. Multiple logistic regression showed type of premise [Odd Ratio (OR) = 4.0, 95% confidence interval (CI) = 1.8 - 7.5, P = 0.0004], educational level (OR = 0.4, 95% CI = 1.8 -7.4, P = 0.0003) and job status of food handlers (OR = 0.5, 95%, CI = 0.3 - 0.8, P = 0.0031) significantly influenced the score level of knowledge. There was no significant difference in attitude and practice between trained and untrained food handlers. Findings of this study may be important in planning health education intervention programs for food handlers in order to improve their knowledge, attitude and practice towards food borne diseases and food safety. This will help in reducing morbidity and mortality due to food-borne diseases.

Studies on the distribution of clinically diagnosed pulmonary tuberculosis in Ebonyi State, Nigeria

A study was conducted between January; 2005 to December; 2006 to ascertain the prevalence of pulmonary tuberculosis among patients who attended chest clinics in some randomly selected hospitals; Clinics and Health Centers in Ebonyi State; Nigeria. Investigations were carried out using the two popular diagnostic criteria for pulmonary tuberculosis namely the specific Ziehl Neelsen (ZN) methods and chest X-ray. A total of 962 patients with clinical signs and symptoms of tuberculosis were studied. Out of this figure; 559 (58.1) had pulmonary tuberculosis with 1:1 male/female ratio. There was no significant difference between ZN sputum smear positive and chest x-ray in the diagnosis of pulmonary tuberculosis in the studied population at 95confidence level. The possible reasons for the high prevalence of pulmonary tuberculosis may be attributed to increase in the incidence of HIV/AIDS; high rate of poverty; emergence of drug-resistant strains of Mycobacteria and to a lesser extent; smoking and diabetes

Epidemiology, therapeutic agents and cost of management of paediatric malaria in a Nigerian tertiary hospital.

BACKGROUND AND OBJECTIVES: Malaria is the most widespread parasitic disease in sub-Saharan Africa with associated high morbidity and mortality especially among the highly predisposed population of pregnant women and children of age five years and below. Living in malaria endemic regions of the world has become associated with health and economic hazards placing financial and productive burden on affected households. METHODS: A prospective study of children treated for malaria and other associated illnesses at a Nigeria tertiary health institution between May and October 2003 was undertaken. The various malaria-associated diseases treated were determined from their provisional diagnosis, hospital records and causative agents confirmed from their diagnostic laboratory results. Cost of treatment was determined from the patients' guardian and confirmed from relevant hospital departments. Common drugs for malaria treatment, their costs, relative effectiveness and frequency of use were determined through a completed questionnaire by health officers and patients' guidance. RESULTS: Of 5356 paediatric patients suspected of having malaria, 5100 (95.2%) were confirmed positive for malaria parasites microscopically. Of these, 4119 (80.8%) were aged 0 - 6 years, with children aged 1 to 3 years being mostly affected. Eight hundred and twenty (16.1%) of them were in-patients spending an average of six days on hospital bed. Over 22 million naira (dollar 0.22 m) was spent on the treatment of malaria with drugs accounting for the major cost (66.81%). About 33.7% of the patients had malaria complicated with other diseases. INTERPRETATION AND CONCLUSION: The effectiveness of common therapeutic agents used for malaria treatment, their costs and associated side effects is discussed. Recommendations are made for appropriate care and government subsidy for paediatric malaria management in sub-Saharan Africa.