Knowledge of COVID-19, use of personal protective equipment and other safety practices of healthcare workers in southwest Nigeria

Background:Healthcare workers have a higher risk of SARS CoV2 infection with implications for transmission of infection and the safety of workers and patients. Objective: To assess knowledge on COVID-19 and the safety practices among selected healthcare workers in southwest Nigeria. Methods:A cross-sectional study of 210 workers providing direct care to patients during the COVID-19 pandemic was conducted. Respondents wererecruited through simple random sampling of members of online platforms of healthcare workers in Osun, Ondo and Ekiti States. Information on sociodemographic characteristics, knowledge of PPE and safety practices was obtained through a close-ended questionnaire. Results: The mean age of the respondents was 36.5±7.5 years. About 29% and 30% of respondents were from the State and Federal Government-owned Teaching Hospitals, respectively. A little above half (58.1%) had good knowledge of COVID-19, while 62.1%used PPE always when attending to suspected COVID19 cases. More than half (53.8%) had been trained on infection prevention and control (IPC), but only 34.3% adhered to good safety practices. Healthcare workers in State government-owned teaching hospitals had lower odds of good safety practices than those in Federal Teaching Hospitals (OR = 0.42, 95% CI = 0.19-0.93, p = 0.031).Conclusion: The knowledge of appropriate PPE and practice of safety precautions among healthcare workers is sub-optimal. This may predispose to increased COVID-19 transmission among healthcare workers, patients, and their families. Training and retraining healthcare workers, especially those from hospitals identified by the study as having poor safety practices, should be encouraged.

Implant failure in lower limb long bone diaphyseal fractures at a tertiary hospital in Ile- Ife. Nigeria.

AIMS AND OBJECTIVES: This included determining aetiology of failure and comparing the failure rate in implant fixations using solid intramedullary nail and DCP. PATIENTS AND METHODS: A retrospective study conducted at the Orthopaedic Department, Obafemi Awolowo University Teaching Hospital, Ile-Ife,Nigeria. Records of all operated cases of lower limb long bone diaphyseal fractures including those with failed fixations from August 2006-July 2011 were reviewed. Data retrieved included type of implant used, aetiology and characteristics of Implant failure. Data were analysed using SPSS version 16. Frequency distribution of the variables of interest was done. Difference in failure rate of intramedullary nail versus DCP was tested using chi-square. Statistical significance was inferred at p<0.05. RESULTS: A total of 280 patients were studied out of which two hundred and twenty-one patients had long bone diaphyseal fractures and met inclusion criteria, of which 135 had intramedullary nail fixation and 86 had DCP. The rate of implant failure in intramedullary nail was 1.5% while it was 5.8% in patients with DCP (p=0.113; 0R=4.10; 95% CI=0.65- 43.77). Implant fracture was the commonest type of failure seen (100% versus 60%) and non union was the commonest cause of failure seen (50% versus 40%) in the intramedullary nailing and DCP groups respectively. CONCLUSION: The likelihood of a failed implant is higher in fixations done with DCP compared with intramedullary nail though the difference was not statistically significant. Commonest reason for failure in both groups was non-union. Findings from this study may guide surgeons in choice of implant in the management of long bone fractures.

Comparison of unreamed interlocking nail and external fixation in open tibia shaft fracture management.

BACKGROUND: The management of open tibia fractures remains controversial despite increase in its incidence. Some surgeons avoid internal fixations for fear of infection while others have demonstrated its superiority. Identifying an optimal management modality is of utmost benefit to our patients. Study objectives were to compare the rate of infection and mean duration to healing in the management of open tibia fractures using unreamed interlocking intramedullary nail and external fixation. METHODS: The study was an interventional study comparing two known standard methods of managing open tibia fractures conducted in the orthopaedic and trauma department of a tertiary health institution in South west, Nigeria. Forty patients who presented with open tibia fractures were allocated alternately into primary interlocking nailing group and external fixation group. Follow-up was for two years. RESULTS: Incidences of deep wound infection in both groups were 35% (external fixation) and 11.1% (interlocking nailing) respectively. The relative risk of developing infection in external fixation group was 3.2. Mean duration to union was 14.8 weeks and 14.4 weeks in the external fixation and interlocking nailing groups respectively, difference in mean was not statistically significant, (t=0.133, p=0.895). CONCLUSION: The risk of wound infection was observed to be higher in this study with the use of external fixation in the management of open tibia fractures compared with unreamed interlocking intramedullary nail.

Breastfeeding practices of physician-mothers in Ife and Ilesa zones, Osun State, Nigeria.

BACKGROUND: Physician-mothers' breastfeeding behaviour is being studied because it is believed to impact their anticipatory guidance to their patients, which in turn influences patients' breastfeeding initiation and continuation. Study assessed the breastfeeding practices of physician-mothers; their reasons for stopping exclusive breastfeeding and factors associated with their breastfeeding practices. METHODS: Study design was cross-sectional, conducted in Osun East Senatorial District, Nigeria. A self-administered semi-structured questionnaire was administered to all eligible 56 physician-mothers in public primary, secondary and tertiary health facilities in the reproductive age-group whose youngest child was aged d"five years. Informed consent was obtained. Outcome measures were time breastfeeding was initiated, duration of exclusive breastfeeding; reasons for stopping exclusive breastfeeding and duration of continued breastfeeding. Data was analysed using SPSS version 17, statistical significance was determined at p-value < 0.05. RESULTS: Fifty (89.3%) responded. Seventy per cent initiated breastfeeding within 1 hour after birth; exclusive breastfeeding rate was 28.0% with a mean duration of 4.1 +/- 1.9 months. Mean duration of continued breastfeeding was 14.5 +/- 4.5 months. Commonest reason for stopping exclusive breastfeeding was 'baby old enough' (35.8%). Mode of delivery was statistically significantly associated with time to initiate breastfeeding. Time to initiate breastfeeding was statistically significantly associated with duration of exclusive breastfeeding. CONCLUSION: Breastfeeding practices of physician-mothers do not conform to the standards in the Innocenti Declaration. The impact of this on their professional support to clients' should be measured in further studies. It is recommended that targeted interventions be done to improve the attitude and breastfeeding practices of physician-mothers.