Assessment of the health related quality of life in children with asthma in a tertiary hospital in North Central, Nigeria.

Introduction: asthma is a chronic inflammatory disorder of the airways with over 339 million people affected worldwide. Asthma can impair the quality of life (QoL) in its various bio-psycho-social domains causing poor concentration, poor school performance and impaired daily activities. This study assessed the QoL in asthmatic children aged 7- 17 years. Methods: a descriptive cross-sectional study of 46 children with asthma. Relevant bio-data and medical history were documented and the QoL assessment was carried out using the paediatric asthma quality of life questionnaire. Asthma severity and asthma control were defined based on the global initiative for asthma protocol. The data was analysed with IBM SPSS version 22. Results: the mean age was 12.4 ± 3.3 years, with a male to female ratio of 1: 1.9. About 61% of the study population were moderately impaired in their QoL and 41.3% had uncontrolled asthma. The mean QoL score was 5.80 with the activity domain and the emotion domain having the lowest mean scores (5.78 ± 1.0 and 5.91 ± 1.2 respectively). There was a significant association between QoL and age, asthma severity, asthma control and social class (p< 0.05) but not Gender. The logistic regression did not identify any of these factors as being predictors of QoL in the children. Conclusion: the study participants had moderately impaired QoL with the 7-10 year-olds more severely affected. The activity and emotion domains are more impaired. Therefore in addition to providing medical intervention, the treatment of children with asthma should include psychological support and counselling.

Level of utilization and provider-related barriers to the use of hydroxyurea in the treatment of sickle cell disease patients in Jos, North-Central Nigeria.

BACKGROUND: Hydroxyurea is underutilized by sickle cell health-care providers in Nigeria despite available evidence of its effectiveness in reducing the manifestations and complications of sickle cell disease (SCD). OBJECTIVES: To assess the level of utilization and provider-related barriers to the use of hydroxyurea in SCD therapy in Jos, Nigeria. METHODS: A cross-sectional study conducted among 132 medical doctors providing care for SCD patients. Data on sociodemographics, utilization and barriers to hydroxyurea use were obtained. The barriers were fed cumulatively into the logistic regression model as predictors of utilization. RESULTS: Of the 132 care providers, 88 (67%) had been in medical practice for ≥6years. The level of utilization of hydroxyurea was 24.2%. The significant barriers that predicted the non-utilization of hydroxyurea included lack of expertise (OR=5.1; 95% CI=2.65-9.05), lack of clinical guidelines (OR=3.84; 95% CI=2.37-14.33), fear of side-effects (OR=0.50; 95% CI=0.22-0.68) and doubt about its effectiveness (OR=0.30; 95% CI=0.20-0.90). CONCLUSION: The level of utilization of hydroxyurea in the treatment of SCD among the care providers is sub-optimal with the lack of expertise in its use identified as the most prominent barrier. There is an urgent need for the training of sickle cell care-providers and the development of clinical guidelines on hydroxyurea use.

Use of an inexpensive magnifier with light source in the diagnosis of trichiasis among community-based case finders in Nigeria.

PURPOSE: Trichiasis case finding is challenging in many trachoma endemic countries. We sought to determine how the use of an inexpensive hand-held magnifier with light source aids in the diagnosis of people with trichiasis. METHODS: We undertook a study on the use of the "Wilson", an inexpensive hand-held magnifier with light source between two groups of trained case finders: community drug distributors (CDD) volunteers and non-health volunteers. Each group was randomly allocated to be provided a Wilson or not. We compared the number of people with suspected trichiasis and the proportion of true cases referred by each group. Focus group discussions explored the perceptions of the case finders that used the Wilson on its utility in the diagnosis of trichiasis and its ease of use. RESULTS: Among the 121 case finders, 61 were CDD volunteers (31 were provided the Wilson) and 60 were non-health worker volunteers (30 were provided the Wilson). Case finders that used the Wilson were 4.57 times (95% CI 2.46-8.47) more likely to have patients presenting confirmed as trichiasis compared to those not using the Wilson. Case finders that used the Wilson felt the instrument was easy to use, enlarged the eyelashes and made diagnoses of trichiasis easier. DISCUSSION: In Nigeria it appears that the Wilson is easy to handle and use among trichiasis case finders enhances the diagnosis of trichiasis.

Prevalence of Trachoma in Jigawa State, Northwestern Nigeria.

PURPOSE: To determine the magnitude of trachoma and the prevalent forms of the disease, and to provide baseline data for the establishment of a trachoma control program in Jigawa State, northwestern Nigeria. METHODS: A population-based cross-sectional survey was conducted in Jigawa State in May 2007 using a 2-stage cluster random sampling technique to select 4598 persons from 40 villages based on probability proportional to size. All participants were examined using a penlight and a 2.5 × binocular loupe for signs of trachoma, and graded using the World Health Organization (WHO) simplified grading system. RESULTS: A total of 4598 people were seen with 99.96% coverage. Of these, 2460 (53.5%) were female and 2138 (46.5%) were male. Mean age was 21.6 years ( ± 19.8 years). The prevalence of follicular trachoma in children aged ≤9 years was 20.5% (95% confidence interval, CI, 18.7-22.4%) with no difference between the sexes. The prevalence of trichiasis in adults aged ≥15 years was 5%, and the prevalence was higher in females than males (odds ratio 2.60, 95% CI 2.06-3.28; p < 0.001). CONCLUSION: Trachoma is a major problem in Jigawa State; there is a need to train trichiasis surgeons and empower them to carry out community-based surgery. District-level prevalence of trachoma needs to be determined to know which aspects of the WHO SAFE strategy (surgery, antibiotics, facial cleanliness and environmental improvements) need to be emphasized in each district.