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Background: Healthcare workers (HCWs) play a vital role in delivering care and are frequently exposed to the risk of acquiring infections within the hospital setting. Around 15% of hospitalized patients suffer from these infections globally. However, the role and awareness of HCWs in the transmission of hospital-acquired infections (HAIs) or nosocomial infections is still unclear. This study aimed to evaluate the knowledge, attitude, and practices (KAP) toward high-risk microbial infections among HCWs on a global scale to identify measures to address this problem. Method: A cross-sectional descriptive study was conducted between 2022 and 2023, with HCWs selected as the study population. Data concerning KAP were collected through a self-administered online survey questionnaire, using a nonprobability convenience sampling method. Descriptive statistics and regression analysis were used to analyze the data. Results: A total of 743 HCWs from various countries participated in the study, with the majority of respondents being doctors (64.9%). Data were mainly obtained from Saudi Arabia (26.78%), Iraq (25.84%), India (15.7%), the United States of America (15.2%), and Africa (Sudan, Nigeria) (13.98%). The frequency of good KAP scores among physicians (KAP: 82.5, 80.66, and 70.5), nurses (KAP: 74.1, 73.07, and 88.7), medical practitioners (KAP: 87.2, 77.58, and 75.1), and technicians (KAP: 76.1, 74.38, and 89.6) were obtained as mentioned. With respect to experience, HCWs showed good KAP scores in 1-5 years (KAP: 82.4, 83.3, and 74.1), 5-10 years (KAP: 80.6, 74.54, 83), 10-20 years (KAP: 74.7, 79.1, and 82.7), and >20 years (KAP: 84.6, 78.8, and 82.8) categories. Conclusion: This study suggests that HCWs have good KAP regarding infection prevention, but there is still room for improvement. Educational seminars and awareness programs can provide better adherence to barrier protection measures such as hand washing, use of gloves, and hand disinfection.
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Introduction: Pediatrics and adolescents are susceptible to illnesses that often necessitate emergency attention. Morbidity and mortality from illnesses in these ages have attracted much interest globally, particularly in Africa. Knowledge of pattern and outcomes of admissions may guide policy and interventions especially in resource constrained settings. The study aimed to determine the pattern of admissions, outcomes and seasonal variations of conditions that presented at the children emergency of a tertiary health institution over a four-year period. Methods: A retrospective descriptive study of children emergency admissions from January 2016 to December 2019. Information obtained included age, diagnosis, month and year of admission, and outcome. Descriptive statistics were used to describe the demographic characteristics and Chi-squared test to assess their associations with the diagnoses made. Results: There were 3,223 admissions. There were more males (1866; 57.9%) and more toddlers (1181; 36.6%). The highest number of admissions were observed in the year 2018 (951; 29.6%) and during the wet season (1962; 60.9%). There was an overall mortality rate of 7%; complicated malaria, gastroenteritis and meningitis were the leading causes of death. Malaria (χ2 = 135.522, p value < 0.001), and gastroenteritis (χ2 = 130.883, p value < 0.001) were predominant among the toddlers while sepsis (χ2 = 71.530, p value < 0.001) and pneumonia (χ2 = 133.739, p value < 0.001) were more among the infants. Typhoid enteritis (χ2 = 26.629, p value < 0.001) and HIV (χ2 = 16.419, p value = 0.012) were commoner among the early adolescents. Conclusion: The major causes of death in the study area are preventable with more of these amongst the children under the age of 5 years. There are seasonal and age-related patterns to admissions and the need for policy formulations and emergency preparations to be tailored towards these observed patterns through the year.
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Introduction: In many low and middle-income countries (LMIC), drug promotional literature (DPL) remains one of the main sources of drug information for physicians. Studies conducted in many LMICs showed poor compliance to the WHO guidelines for ethical drug promotion especially in the area of information about excipients, adverse drug reactions, drug-drug interactions and contra-indications. These inadequacies in the information provided may mislead the prescriber with potential adverse consequences among patients using the medicines. Nigeria has a big pharmaceutical sector which is poorly regulated and we hypothesize that such unethical drug promotional practices may exist. This study therefore set out to assess compliance to the WHO ethical drug promotion (using DPL) at the Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, South-West Nigeria. Methodology: This was a descriptive cross-sectional study conducted in several specialist clinics of EKSUTH, Ado-Ekiti. Printed DPLs (brochures and leaflets) were collected from these clinics, collated using a pre-designed data collection form and analyzed using the WHO ethical criteria for medicinal drug promotion. Results:Two hundred seventy-five DPLs were screened A total of out of which 234 DPLs were selected after screening to after removal of duplications. Only 5 (2.1%) DPLs met all the WHO criteria. DPLs promoting antibiotics, cardiovascular drugs, and vitamins/nutritional supplements were in the majority (22.2%, 17.1%, and 11.5% respectively. Most of the DPLs had the generic (223; 95.3%) and brand (234; 100%) names, active ingredients (209; 89.3%), excipients (149; 63.7%), and indications (232; 99.1%). Information about adverse drug reactions (76; 32.5%), contra-indications (73; 31.2%), and drug interactions (46; 19.7%) was less represented. Only 59 (25.2%) DPLs had references. Fixed-dose combination drugs made up 34.6% of drugs being promoted. Conclusion:The DPLs assessed in this study had low adherence to WHO ethical drug promotion criteria especially those related to adverse drug reaction, drug interactions, and contra-indications.
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Aim Hepatitis B is a preventable infection with transmission of the virus through sex, by blood and from mother to child during childbirth. Young adults are prone to some of these risk factors, yet data on awareness and knowledge of hepatitis B among them is still limited in Nigeria and none from our locality. The purpose of this study was to assess the knowledge and awareness of hepatitis B among young adults attending a tertiary health institution in Nigeria with the aim of giving recommendations based on the findings. Methods A total of 223 young adults who attended the adolescent and young adult clinic of the Family Medicine Department of the Ekiti State University Teaching Hospital, Ado Ekiti between 1 March and 31 May 2023 were analyzed using a predesigned self-administered questionnaire. Knowledge of hepatitis B was assessed by asking 12 questions relating to awareness of the disease, basic knowledge, route of transmission, the seriousness of the disease when compared to human immunodeficiency virus (HIV), complications from the disease, their vaccination status and the number of doses received by the participants. Results The prevalence of awareness of hepatitis B among respondents was 88 (39.5%). Of the 223 respondents studied, 158 (70.9%) had a poor knowledge score of the disease. There was a significant association between the highest educational background of the respondents and awareness of hepatitis B (p=0.05). Awareness of hepatitis B was also associated with previous participation in any health screening (p=0.04) and vaccine awareness (p=<0.001). The majority of the respondents with good knowledge scores of hepatitis B preferred social media for disseminating information about their health (p=0.03). Out of all the participants studied, only one (0.4%) had completed the three doses of the hepatitis B vaccine with 11 (4.9%) of them yet to get fully vaccinated. Conclusion Efforts are needed to target social media platforms with information about hepatitis B and vaccination. With awareness campaigns of hepatitis B directed at various social media platforms, this population at risk could be educated about the disease and the benefits of vaccination. The low vaccination state among the respondents brought to the fore the urgent need for the government to ensure the provision of appropriate interventions for viral hepatitis among young adults.
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INTRODUCTION: Diabetes mellitus (DM) is an important global public health challenge, and the burden of the disease is huge, particularly in low- and middle-income countries (LMICs), where the majority of people with this condition reside. Undiagnosed DM is more prevalent in LMICs. The aim of this study is to determine the prevalence and associated factors for DM in Ekiti State. MATERIALS AND METHODS: A cross-sectional, household-based survey using a four-stage multistage sampling design and the World Health Organization (WHO)-STEPS survey manual was conducted from July to September 2020 as a part of the Ekiti State coronavirus disease 2019 (COVID-19) survey. Of the 5,145 sampled households, 4,726 individuals gave consent to participate in the survey. Out of these, 3043 had fasting plasma glucose results available and were included in the analysis. RESULTS: There were 2257 (74.2%) women and 786 (25.8%) men. The prevalence of DM was 6.5% (6.5% in males and 6.6% in females, P = 0.946). Diabetes was found to be more prevalent among those with a secondary school education or higher (10.9%); employed in the formal sector (13.4%); separated, divorced, or widowed (8.5%); with raised blood pressure (9.3%); and who were aged 30-59 years (all P < 0.05). Multivariable logistic regression showed that age, education, occupation, and hypertension were all positively and significantly associated with an increased risk of DM. CONCLUSION: The prevalence of DM in Ekiti State is high, and its predictors include advancing age, hypertension, education, and occupation. This calls for scaling up public health interventions for controlling DM, targeting the identified risk factors among the people of Ekiti.
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Background: The use of drugs with anticholinergic effects among elderly patients is associated with adverse clinical outcomes. There is paucity of information about anticholinergic drug burden among Nigerian elderly population. Objectives: To determine the anticholinergic drug burden among elderly Nigerian patients. Methods: This was a retrospective cross-sectional study conducted among elderly patients (aged 65 and above) who visited the Family Medicine outpatients' clinics of the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria between July 1 and October 31, 2018. Information extracted from the case files included patient's age, sex, diagnoses, and list of prescribed medications. Medicines with anticholinergic effects were identified and scored using the anticholinergic drug burden calculator (http://www.acbcalc.com). Results: The medical records of 400 patients were analyzed with females accounting for 60.5% of the study population. The mean age of participants was 73 ± 7.4 years with only 28 (7%) of patients having more than two co-morbid conditions. Polypharmacy was identified in 152 (38%) of the patients while 147 (36.7%) had drugs with anticholinergic effects prescribed. The anticholinergic burden was high in 60 (15%) patients. Polypharmacy was significantly associated with having more than two diagnosed conditions and high anticholinergic burden (p value of < 0 .001 and 0.013 respectively). There was significant correlation between total number of prescribed drugs and count of diagnoses (r = 0.598; p < 0 .000) and between total number of prescribed drugs and number of drugs with anticholinergic effects (r = 0 .196; p < 0 .000). Conclusion: The anticholinergic burden in this group of elderly Nigerian patients was low; majority (67%) had no exposure to drugs with anticholinergic effects with only 15% having high anticholinergic burden. Polypharmacy and multiple diagnosed conditions were positively associated with high anticholinergic burden. Based on the positive and significant correlations found in this study, a reduction in the number of prescribed medicines especially those with significant anticholinergic effects used for secondary indications may lessen the anticholinergic burden among the elderly.
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INTRODUCTION: Prescription medicines constitute a significant proportion of total healthcare expenditure in many countries of the world. Nonrational prescribing by healthcare providers contributes significantly to this relatively high proportion. In many developing countries of the world, a significant proportion of the population pays "out of pocket" to access healthcare, sometimes leading to catastrophic healthcare expenditure. Healthcare insurance is a form of healthcare financing that promotes judicious use of the resources and ensuring the cost-effectiveness of interventions through the use of affordable drugs. The main objective of this study was to compare concurrently the prescribing practices in the general outpatients' clinic (noninsured patients) and the National Health Insurance Scheme (NHIS) clinic (patients with insurance coverage). MATERIALS AND METHODS: A cross-sectional study was conducted in the general outpatients' and the "NHIS" clinics of the Ekiti State University Teaching Hospital, Ado-Ekiti, South-western Nigeria. The medical records of patients, who attended these two clinics between the 1(st) March and 30(th) June 2014 were retrieved and used for the study. RESULTS: The average number of prescribed drugs for patients attending the general outpatients' clinic was 3.9 ± 2.0 while that from the NHIS clinic was 4.1 ± 1.6 (P = 0.24). Prescribing by generic names was done in 48.2 ± 23.8% and 45.8 ± 22.9% of prescriptions from the general outpatients' and NHIS clinic, respectively. Percentage of encounters with antibiotics was 49.4% and 33.6% of patients who attended the NHIS and general outpatients' clinics, respectively. CONCLUSION: There was a trend to having more medicines prescribed and more encounters with antibiotics among patients enrolled under the health insurance scheme.
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BACKGROUND: Inappropriate medication prescription among the elderly is a major problem with significant negative health consequences. The Beers and STOPP (Screening Tool of Older Persons' potentially inappropriate Prescription) criteria are common tools used for screening of potentially inappropriate medications. The primary objective of the study was to estimate the incidence of PIM among elderly Nigerian patients using the earlier mentioned tools. METHODOLOGY: This prospective study was conducted among elderly patients attending the general outpatients' clinics of two tertiary healthcare institutions in the South-Western part of Nigeria. The patients' age, gender, diagnosis for which the patient was receiving treatment and prescribed drugs were the information retrieved from the medical records. The WHO drug use indicators were applied in the drug utilization aspect of the study while the Beers and STOPP criteria were used to define the inappropriateness or otherwise of the prescribed medications. RESULTS: The mean number of drugs per prescription was 4.1 ± 1.2 while the median number of drugs prescribing by generic name was 46.5% (IQR: 35). Using Beers criteria for the assessment of prescription of potentially inappropriate medications, 106 (30.3%) of all patients had at least one inappropriate medication prescribed with a total of one hundred and twenty six cases recorded. Screening for PIM using the STOPP criteria, we found 55 (15.7%) of the study participants with at least one potential encounter. Female sex, number of prescribed medications and co-morbidities were positively associated with prescription of a PIM using both tools. CONCLUSION: Prescription of PIM is highly prevalent among elderly Nigerian patients. There is a need for continuing education of prescribers on rational prescribing in the elderly using some of the screening tools.
