Pharmacy students' perceptions on the health and pharmaceutical care needs of older adults.

INTRODUCTION: Perceptions of pharmacy students as future health care providers can enhance the health and pharmaceutical care (PC) needs of older adults. The objective of this study was to investigate pharmacy students' awareness and perceptions of the health and PC needs of older adults. METHODS: A cross-sectional survey was conducted among pharmacy students in Southwest, Nigeria for four weeks using a 39-item structured questionnaire. Unpaired t-tests and one-way analysis of variance were performed. A P < .05 was considered significant. RESULTS: Based on 422 completed questionnaires, 299 (70.9%) were females, 283 (67.1%) were 20 to 24 years, 123 (29.2%) were in 200 Level, 402 (95.3%) had heard of PC with their first source of information being pharmacy school, 352 (83.4%). Reliability of the instrument was 0.92 (Cronbach's alpha). Mean + SD of pharmacy students' perceived health and PC needs of older adults were 3.73 ±â€¯1.176 and 4.21 ±â€¯1.031, respectively. The majority, 355 (84.2%), agreed on the importance of health care providers understanding their geriatric patients' family circumstances and social environment and 381 (90.3%) perceived that such will strengthen their professional relationship with older adults. CONCLUSIONS: Pharmacy students were aware of PC and indicated positive attitudes towards caring for older adults but few had provided care. Reinforcement of PC training and emphasis on geriatric topics in pharmacy curriculum are reiterated.

Prevalence and factors associated with the use of antibiotics in non-bloody diarrhoea in children under 5 years of age in sub-Saharan Africa.

OBJECTIVES: To estimate the prevalence and determine the factors associated with the use of antibiotics in the management of non-bloody diarrhoea in children under 5 years of age in sub-Saharan Africa (SSA). METHODS: We conducted a meta-analysis of demographic and health survey data sets from 30 countries in SSA. Pooled prevalence estimates were calculated using random effects model. Χ2 tests were employed to determine the factors associated with the antibiotic use. RESULTS: The pooled prevalence of antibiotic use among cases of non-bloody diarrhoea in children under 5 years of age was 23.1% (95% CI 19.5 to 26.7). The use of antibiotics in children with non-bloody diarrhoea in SSA was associated with (p<0.05) the source of care, place of residence, wealth index, maternal education and breastfeeding status. CONCLUSION: We found an unacceptably high use of antibiotics to treat episodes of non-bloody diarrhoea in children under the age of 5 in SSA.

Health-care workers' occupational exposures to body fluids in 21 countries in Africa: systematic review and meta-analysis.

OBJECTIVE: To estimate the lifetime and 12-month prevalence of occupational exposure to body fluids among health-care workers in Africa. METHODS: Embase®, PubMed® and CINAHL databases were systematically searched for studies published between January 2000 and August 2017 that reported the prevalence of occupational exposure to blood or other body fluids among health-care workers in Africa. The continent-wide prevalence of exposure was estimated using random-effects meta-analysis. FINDINGS: Of the 904 articles identified, 65 studies from 21 African countries were included. The estimated pooled lifetime and 12-month prevalence of occupational exposure to body fluids were 65.7% (95% confidence interval, CI: 59.7-71.6) and 48.0% (95% CI: 40.7-55.3), respectively. Exposure was largely due to percutaneous injury, which had an estimated 12-month prevalence of 36.0% (95% CI: 31.2-40.8). The pooled 12-month prevalence of occupational exposure among medical doctors (excluding surgeons), nurses (including midwives and nursing assistants) and laboratory staff (including laboratory technicians) was 46.6% (95% CI: 33.5-59.7), 44.6% (95% CI: 34.1-55.0) and 34.3% (95% CI: 21.8-46.7), respectively. The risk of exposure was higher among health-care workers with no training on infection prevention and those who worked more than 40 hours per week. CONCLUSION: The evidence available suggests that almost one half of health-care workers in Africa were occupationally exposed to body fluids annually. However, a lack of data from some countries was a major limitation. National governments and health-care institutions across Africa should prioritize efforts to minimize occupational exposure among health-care workers.

Limitations to the dynamics of pharmaceutical care practice among community pharmacists in Enugu urban, southeast Nigeria.

BACKGROUND: The introduction of pharmaceutical care in Nigeria has been faced with many challenges in addition to limited information regarding the practice. OBJECTIVE: This study aimed to determine the barriers encountered by community pharmacists in Nigeria in the provision of pharmaceutical care. METHODS: A cross-sectional descriptive survey was carried out in Enugu urban, southeast Nigeria. Data were collected using pretested and structured 5-point Likert scale questionnaires that were self-administered to the respondents. Data were analyzed using descriptive statistics. RESULTS: The 78 community pharmacists comprised 62 males and 16 females. Out of the 78 respondents, 69 (88.5%) had the basic Bachelor of Pharmacy degree while three (3.9%) had Fellowship, Master's, and Doctor of Pharmacy degrees respectively. The mean number of years of practice was 8.2 (±0.6). The key limitations to the implementation of pharmaceutical care were: pharmacists' attitude and lack of pharmaceutical care skills, as well as resource and system-related constraints. Others challenges were interprofessional and academic obstacles like lack of collaboration (66.6%) and lack of role models (42.1%). Most of the respondents (81%) were strongly willing to adopt and implement pharmaceutical care, while 19.2% were not strongly willing to practice pharmaceutical care. CONCLUSION: Despite limitations to practice, community pharmacists in the area are very inclined to implement pharmaceutical care in the private sector to improve patients' quality of life.

Drugs use pattern for uncomplicated malaria in medicine retail outlets in Enugu urban, southeast Nigeria: implications for malaria treatment policy.

BACKGROUND: Malaria treatment policy recommends regular monitoring of drug utilization to generate information for ensuring effective use of anti-malarial drugs in Nigeria. This information is currently limited in the retail sector which constitutes a major source of malaria treatment in Nigeria, but are characterized by significant inappropriate use of drugs. This study analyzed the use pattern of anti-malarial drugs in medicine outlets to assess the current state of compliance to policy on the use of artemisinin-based combination therapy (ACT). METHODS: A prospective cross-sectional survey of randomly selected medicine outlets in Enugu urban, southeast Nigeria, was conducted between May and August 2013, to determine the types, range, prices, and use pattern of anti-malarial drugs dispensed from pharmacies and patent medicine vendors (PMVs). Data were collected and analyzed for anti-malarial drugs dispensed for self-medication to patients, treatment by retail outlets and prescription from hospitals. RESULTS: A total of 1,321 anti-malarial drugs prescriptions were analyzed. ACT accounted for 72.7%, while monotherapy was 27.3%. Affordable Medicines Facility-malaria (AMFm) drugs contributed 33.9% (326/961) of ACT. Artemether-lumefantrine (AL), 668 (50.6%) was the most used anti-malarial drug, followed by monotherapy sulphadoxine-pyrimethamine (SP), 248 (18.8%). Median cost of ACT at $2.91 ($0.65-7.42) per dose, is about three times the median cost of monotherapy, $0.97 ($0.19-13.55). Total cost of medication (including co-medications) with ACT averaged $3.64 (95% CI; $3.53-3.75) per prescription, about twice the mean cost of treatment with monotherapy, $1.83 (95% CI; $1.57-2.1). Highest proportion 46.5% (614), of the anti-malarial drugs was dispensed to patients for self-treatment. Treatment by retail outlets accounted for 35.8% while 17.7% of the drugs were dispensed from hospital prescriptions. Self-medication, 82%, accounted for the highest source of monotherapy and a majority of prescriptions, 85.6%, was adults. CONCLUSION: Findings suggest vastly improved use of ACT in the retail sector after eight years of policy change, with significant contributions from AMFm drugs. However the use of monotherapy, particularly through self-medication remains significant with increasing risk of undermining treatment policy, suggesting additional measures to directly target consumers and providers in the sector for improved use of anti-malarial drugs in Nigeria.