Prevalence, pattern and factors associated with workplace violence against healthcare workers in Nigeria: A systematic review

Objective:This study aimed to describe the prevalence, pattern, and predictors of WPVagainst HCWs in Nigeria. Methods:Asystematic review was conducted using pre-defined keywords. The review was performed in line with the PRISMAguidelines on PubMed, Google Scholar, Scopus, and Web of Science. The population, intervention, comparator, and outcome (PICO) elements for this study were as follows: Population:Nigerian Healthcare workers; Intervention: Exposure to WPV; Comparator: Non-exposure to WPV; Outcome: Mental and Physical health outcomes of exposure to WPV. Of the 18,140 articles retrieved, 15 cross-sectional studies met the inclusion criteria and were included in the review. In all, 3,245 HCWs were included, and consisted majorly of nurses and doctors. Results:The overall prevalence of WPV(Physical > Verbal/Psychological > Sexual) against HCWs ranged between 39.1%-100%. The predictors of WPVare younger ages (AOR = 2.513, p = 0.012), working in psychiatric unit (AOR = 11.182, p = 0.006), and increased frequency of interaction with patients, and mostly perpetrated by patients and their relatives. Many health facilities lacked a formal reporting system and policies to protect HCWs from WPV. Conclusion:WPVagainst HCWs is a public health problem in Nigeria with dire implications on HCWs; the victims, and the aggressor. Administrators of health facilities should design protocols for WPVreporting, recognition, and management. Patient and 'relatives' education on the 'facilities' policy against WPVshould be undertaken, while orientation sessions on the risk factors for HCWs are scheduled.

Perception and Learning Satisfaction of Resident Doctors Amid COVID-19 Pandemic: Adaptation Experience at a Virtual Educational Course in Internal Medicine.

OBJECTIVES: This study aimed to assess the perception of the significance of the revision course and satisfaction of resident doctors with the West African College of Physicians (WACP) revision course in internal medicine. METHODS: This was a post-training evaluation of resident doctors who had enrolled for the 2021 membership revision course in internal medicine between August 9-13, 2021. Data were collected through an electronic questionnaire composed of five sections: Sociodemographic characteristics, involvement in research, perception on the significance/expectations from the course, lessons learnt, and perception of the overall coordination of the revision course/recommendations. Descriptive statistics were summarized using frequency tables. Chi-square tests were conducted to determine the association between participants' sociodemographic characteristics and satisfaction with the WACP revision course. RESULTS: The mean age (±SD) of the 119 resident doctors was 34.30 (± 4.81) years and the median duration (range) of residency training was 7 (4-10) years. All participants were currently in medical practice either in teaching hospitals (104,87.4%) or secondary health facilities (15, 12.6%). Overall, 108 (90.8%) doctors were satisfied with the course. Variables that were associated with satisfaction with the WACP revision course included: duration in residency training (doctors that had spent two years or less in the residency training programme) (Chi-square = 21.703, p = <0.001), place of residency training (teaching hospitals) (Chi-square = 67.461, p = <0.001), and participation in research (Chi-square = 47.976, p = <0.001). CONCLUSION: The WACP revision course in internal medicine met its objectives. Engagement of resident doctors in research activities should be undertaken intensely.

OBJECTIFS: Cette étude visait à évaluer la perception de l'importance du cours de révision et la satisfaction des médecins résidents à l'égard du cours de révision en médecine interne du West African College of Physicians (WACP). MÉTHODES: Il s'agissait d'une évaluation post-formation des médecins résidents qui s'étaient inscrits au cours de révision en médecine interne pour les membres de 2021 entre le 9 et le 13 août 2021. Les données ont été recueillies au moyen d'un questionnaire électronique composé de cinq sections : Caractéristiques sociodémographiques, implication dans la recherche, perception de l'importance/attentes du cours, leçons apprises, et perception de la coordination globale du cours de révision/recommandations. Les statistiques descriptives ont été résumées à l'aide de tableaux de fréquence. Des tests de Chi-carré ont été effectués pour déterminer l'association entre les caractéristiques sociodémographiques des participants et la satisfaction du cours de révision WACP. RÉSULTATS: L'âge moyen (±SD) des 119 médecins résidents était de 34,30 (± 4,81) ans et la durée médiane (fourchette) de la formation en résidence était de 7 (4-10) ans. Tous les participants exerçaient actuellement la médecine dans des hôpitaux universitaires (104, 87,4%) ou des établissements de santé secondaires (15, 12,6 %). Dans l'ensemble, 108 (90,8%) médecins étaient satisfaits de la formation. Les variables qui étaient associées à la satisfaction du cours de révision du WACP comprenaient : la durée de la formation en résidence (les médecins ayant passé deux ans ou moins dans le programme de formation en résidence) (Chi-carré = 21.703, p = <0.001), le lieu de formation en résidence (hôpitaux universitaires) (Chi-carré = 67.461, p = <0.001), et la participation à la recherche (Chi-carré = 47.976, p = <0.001). CONCLUSION: Le cours de révision WACP en médecine interne a atteint ses objectifs. L'engagement des médecins résidents dans des activités de recherche devrait être entrepris de manière intensive. Mots-clés: Pratique médicale, Enseignement médical, Formation des résidents, Médecine interne, Afrique.

Ten-Year Review of Paediatric Endocrine Disorders at Uniosun Teaching Hospital, Osogbo, Nigeria.

BACKGROUND: Paediatric endocrinology is a nascent subspecialty in Nigeria.Previous reports suggest a poor awareness of paediatric endocrine disorders resulting in late presentation, missed diagnosis and unnecessary death. OBJECTIVES: The study aims to report the prevalence of paediatric endocrine disorders at UNIOSUN Teaching Hospital (UTH) and to provide essential information to enhance early presentation and management. METHODS: This is a 10-year retrospective study of all children managed for paediatric endocrine disorders at UTH from March 2010 to March 2020. Relevant data were extracted from patients' records, entered into and analyzed with SPSS. RESULTS: Forty (0.42%) of 9,520 new consultations at UTH paediatric specialist clinic during the study period had endocrine disorders. There were 13 males and 27 females (M:F=1:2), with ages ranging from 1 month to 15.5years and 23 (57.5%) of them were under the age of 5 years. The four most common endocrine disorders were Rickets (45%), Diabetes (15%), Thyroid disorders (15%) and disorders of puberty (12.5%). There was a progressive yearly increase in the number of paediatric endocrine cases seen. At the time of this report, 34 (85%) of the patients were alive and doing very well, 5 (12.5%) has been lost to follow up and 1 (2.5%) mortality was recorded. CONCLUSION: Rickets, diabetes, thyroid disorders and disorders of puberty are the four leading paediatric endocrine disorders seen at UTH. Attrition is a notable challenge in paediatric endocrine disorders. Reasons for attrition and ways to terminate these challenges need to be identified and put into practice.

CONTEXTE: L'endocrinologie pédiatrique est une surspécialité naissante au Nigéria. Les rapports precedents suggèrent une mauvaise connaissance générale des troubles endocriniens pédiatriques entraînant une présentation tardive, un diagnostic manqué et une mort inutile. OBJECTIFS: L'étude vise à examiner la prévalence des troubles endocriniens pédiatriques au UTH et à fournir des informations essentielles pour améliorer la présentation et la prise en charge précoces. METHODES: Il s'agit d'une etude rétrospective de 10 ans de tous les enfants pris en charge pour des troubles endocriniens pédiatriques au UTH de mars 2010 à mars 2020. Les données pertinentes ont été extraites des dossiers des patients, entrées et analysées avec SPSS. RESULTATS: Quarante (0,42%) des 9 520 nouvelles consultations à la Clinique pédiatrique spécialisée UTH au cours de la période d'étude présentaient des troubles endocriniens. Il y avait 13 hommes et 27 femmes (M: F = 1: 2), âgés de 1 mois à 15,5 ans et 23 (57,5%) d'entre eux avaient moins de 5 ans. Les quatre troubles endocriniens les plus courants au UTH étaient le rachitisme (45%), le diabète (15%), les troubles thyroïdiens (15%) et les troubles de la puberté (12,5%). Il y avaitune augmentation annuelle régulière du nombre de cas endocriniens pédiatriques observés. Trente-quatre (85%) des patients sont vivants et se portent très bien, 5 (12,5%) ont été perdus de vue et 1 mortalité (2,5%) a été enregistrée. CONCLUSION: le rachitisme, le diabète, les troubles thyroïdiens et les troubles de la puberté sont les quatre principaux troubles endocriniens pédiatriques observés au UTH. L'attrition est un défi notable dans les troubles endocriniens pédiatriques. Les raisons de l'attrition et les moyens de mettre fin à ce défi doivent être identifiés et mis en pratique. MOTS CLÉS: Pédiatrie, troubles endocriniens, sensibilisation, rachitisme, diabète, Nigéria.

Epidemiological Transition in the Economic Community of West African States (ECOWAS): Evidence from the Global Burden of Disease 1990-2017.

INTRODUCTION: This study sought to explore the pattern of epidemiological transition in the Economic Community of West African States (ECOWAS). METHODS: We extracted data from the global burden of disease study. Countries were grouped using the Sociodemographic Index (SDI). The DisMod-MR 2.1, a Bayesian meta-regression tool, was used as the main method of estimating variations in epidemiologic data sources and other parameters. Examples of these included model predictions, as well as 95% corresponding uncertainty intervals for all death, Years of Life Lost, Years Lived with Disability, and DisabilityAdjusted Life Years (DALYs). RESULTS: The DALYs from Group 1 diseases were higher in all the countries in the region compared to those from non-communicable diseases (NCDs) and injuries, as well as total NCDs in 1990 and this was the same in the subregion in 2017, except in Cape Verde (with the highest SDI), where there were higher DALYs from NCDs/ injuries and the total NCDs than the Group 1 diseases. In 1990, deaths from Group 1 diseases were higher in all the countries in the region than those from the total NCDs except in Cape Verde, while in 2017, deaths from Group 1 diseases were higher than those from Total NCDs except in Cape Verde, the Gambia, Ghana, and Senegal. CONCLUSION: The overall pattern is that of concurrent communicable disease and increasing NCD burden with increasing SDI. Detailed understanding of these patterns and contextual factors are needed to help inform national and regional policies to address the epidemiological transition in the ECOWAS.

INTRODUCTION: Cette étude a cherché à explorer le modèle de transition épidémiologique dans la Communauté économique des États de l'Afrique de l'Ouest (CEDEAO). MÉTHODES: Nous avons extrait les données de l'étude sur la charge mondiale de morbidité. Les pays ont été regroupés à l'aide de l'indice sociodémographique (IDS). Le DisMod-MR 2.1, un outil de métarégression bayésienne, a été utilisé comme principale méthode d'estimation des variations des sources de données épidémiologiques et d'autres paramètres. Des exemples de ceux-ci comprenaient les prédictions du modèle, ainsi que les intervalles d'incertitude correspondants à 95 % pour tous les décès, les années de vie perdues, les années vécues avec une incapacité et les années de vie corrigées de l'incapacité (DALY). RÉSULTATS: Les DALY des maladies du groupe 1 étaient plus élevées dans tous les pays de la région par rapport à celles des maladies non transmissibles (MNT) et des traumatismes, ainsi que le total des MNT en 1990 et il en était de même dans la sous-région en 2017, sauf au Cap. Verde (avec le SDI le plus élevé), où il y avait des DALY des MNT/blessures plus élevées et le total des MNT que les maladies du groupe 1. En 1990, les décès dus aux maladies du groupe 1 étaient plus élevés dans tous les pays de la région que ceux du total des MNT sauf au Cap-Vert, tandis qu'en 2017, les décès dus aux maladies du groupe 1 étaient plus élevés que ceux du total des MNT sauf au CapVert, le Gambie, Ghana et Sénégal. CONCLUSION: Le schéma général est celui d'une maladie transmissible concomitante et d'un fardeau croissant des MNT avec l'augmentation du SDI. Une compréhension détaillée de ces modèles et facteurs contextuels est nécessaire pour aider à éclairer les politiques nationales et régionales pour faire face à la transition épidémiologique dans la CEDEAO. Mots clés: Transition épidémiologique, Afrique de l'Ouest, Maladie non transmissible, Maladie transmissible, Index sociodémographique.

Detection and molecular characterization of a first isolate of rabbit haemorrhagic disease virus in Nigeria.

Rabbit haemorrhagic disease virus (RHDV) was recovered from necropsied rabbits that died during an outbreak characterized by epistaxis, incoordination, paralysis, and multi-organ haemorrhages in Ilorin, Nigeria. The haemagglutination test (HA) and RT-PCR assay targeted against a fragment of the RHDV VP60 gene were performed on liver, spleen, and kidney homogenates; faeces; and urine obtained from the rabbits. Amplicons were purified, sequenced, and phylogenetically analysed. The liver homogenates yielded the highest HA titres while RT-PCR of liver, spleen, and kidneys yielded the expected 1252 bp band. Sequence and phylogenetic analyses revealed that the Nigerian RHDV strain (RHDV/NGR/ILN/001) was 98.57%, 97.95%, and 96.70% homologous with RHDV2 (RHDVGI.2) strains from the Netherlands, Germany, and France, respectively. RHDV/NGR/ILN/001 induced tracheal, intestinal, and mediastinal lymph node haemorrhages, pulmonary oedema and congestion, and enlarged, necrotic liver in experimentally inoculated rabbits. The implications of this study, which is the first report of RHDV in Nigeria, are discussed.

Infection prevention and control during COVID-19 pandemic: realities from health care workers in a north central state in Nigeria.

Health care workers (HCWs) are vulnerable to the risk of infections and could become vectors of onward transmission of coronavirus disease 2019 (COVID-19). Little is known about the factors which could contribute to increased COVID-19 infection among HCWs in Nigeria. We aimed at assessing the causes of COVID-19 infection among HCWs. We used a qualitative study design to conduct in-depth interview among 16 frontline HCWs participating in the COVID-19 response in Kwara State, Nigeria. Colaizzi's phenomenological method was used in the qualitative analysis of data. We found that HCWs were aware of their vulnerability to the COVID-19 infection, and the reasons attributed included poor knowledge of IPC measures for COVID-19, inadequate supply of personal protective equipment (PPE), poor political will and inadequate health facilities (HFs) management support. Improved political will and better involvement of HFs management teams in infection prevention and control (IPC) systems are needed to reduce the risk for COVID-19 infection among HCWs. We recommend scale-up training on IPC measures particularly hand washing and use of PPE as well as the development of effective points of care risk assessment with a high index of suspicion in HFs.

PREVALENCE AND PREDICTORS OF EXCLUSIVE BREASTFEEDING AMONG MOTHERS IN A SEMI-URBAN NIGERIAN COMMUNITY: A CROSS-SECTIONAL STUDY.

Background: The uptake of exclusive breastfeeding (EBF) is low globally including Nigeria despite its benefits and interventions. This study aimed to assess the prevalence and predictors of EBF among mothers in a semiurban Nigerian community. Methods: We conducted a cross-sectional study among nursing mothers attending the immunization clinic at the Federal Medical Centre, Owo, Ondo State. A semi-structured questionnaire containing the World Health Organization's indicators for assessing breastfeeding practices was used for data collection. Results: A total of 386 mothers were recruited with a mean age of 30.8 ± 5.0 years. Among them, 149 (36.8%) were below 30 years, 345 (89.4%) have had ANC visit at least four times, and 259 (67.1%) had initiated breastfeeding immediately after delivery. The prevalence of EBF was 52.6%. Natural feeds were the common feeds introduced after 6 months among 159 (78.3%) mothers. One hundred and forty-four (62.1%) nursing mothers aged 30 years or older practiced EBF compared to 72 (48.3%) persons below 30 years (X2 = 6.290, p = 0.012). Also, 38 (70.3%) mothers who have delivered four or more children practiced EBF compared to 180 (54.2%) with fewer children (X2 = 5.437, p = 0.020). Nursing mothers aged 30 years or older had 36% higher odds of practicing EBF compared to younger persons (Adjusted Odds Ratio = 1.358, 95%CI = 0.886 - 2.081, p = 0.160). Conclusion: To achieve the WHO recommended target of ensuring that 90% of nursing mothers practice EBF, advocacy and health education must be intensified.

RISK PERCEPTION, KNOWLEDGE, ATTITUDE AND PRACTICES TOWARDS COVID-19 AND LASSA FEVER PREVENTION AMONG DOCTORS AND NURSES IN A TREATMENT CENTRE IN NIGERIA.

BACKGROUND: Infection Prevention and Control practices are required to manage COVID-19 and Lassa fever (LF). We aimed to assess COVID-19 and LF risk perception and knowledge, attitude, and practices (KAP) towards prevention among doctors and nurses in a treatment centre in Ondo State, Nigeria. METHODS: We conducted a comparative cross-sectional study using semi-structured interviewer-administered questionnaires. We computed KAP scores with "+1" for correct response and "0" for incorrect response. Cumulative scores >80% implied good KAP of LF and COVID-19. Chi-square test was used to assess associations between sociodemographic characteristics and COVID-19 and LF KAP. P-values<0.05 were statistically significant. RESULT: The mean age of respondents was 37.81±8.46 years. Risk perception scores were 2.82±0.53 for LF and 2.76±0.58 for COVID-19 (p=0.002). Mean overall knowledge scores towards prevention were 18.48±2.08 for LF and 15.59±3.22 for COVID-19 (p<0.001). Practices towards prevention scores were 18.18±2.27 for LF and 15.89±1.47 for COVID-19 (p<0.001). Concerning LF, 72.8% of doctors had good knowledge of prevention compared to 42.9% nurses (p<0.001), 18.3% of doctors had good attitude to LF prevention compared to 27.2% nurses (p=0.039). Also, 84.8% nurses had good LF preventive practices compared to doctors (64.5%) (p<0.001). A strong positive correlation (r=0.72) existed between COVID-19 and LF risk perception (p<0.001). CONCLUSION: Continuous on-the- job trainings are needed among doctors and nurses in LF and COVID-19 treatment centres.

REOPENING OF EDUCATIONAL INSTITUTIONS AMID THE COVID-19 OUTBREAK: NIGERIA'S PREPARATION FOR THE MITIGATION OF SCHOOL-ASSOCIATED COVID-19 RISKS.

The global spread of the novel Coronavirus disease (COVID-19) has necessitated the implementation of non-pharmaceutical public health measures globally, including school closure. After five months of school closures, the Nigerian government is planning towards the suspension of school lockdown. However, in a bid to ensure that schoolchildren are academically equipped, and measures such as adequate ventilation, handwashing, social distancing, and increased infrastructure need to be implemented to ensure that school reopening does not result to a spike in COVID-19 cases and fatalities in Nigeria.

Atopy in HIV-infected children attending the pediatric antiretroviral clinic of LAUTECH Teaching Hospital, Osogbo.

BACKGROUND: Atopy is poorly researched in HIV children living in the developing countries. There is no previous report on this subject in Nigeria and this pioneering study is undertaken to create an awareness of the burden of this disease among health practitioners. AIMS: The aim of this study was to document the atopic diseases present among HIV-infected children attending the antiretroviral (ARV) clinic of a Nigerian tertiary hospital. METHODS: Information was obtained from consecutive consenting caregiver/HIV-infected child attending the pediatric ARV clinic, by the use of a proforma specifically designed for the study. The data obtained were analyzed using Statistical Package for the Social Sciences (SPSS) software program, version 16.0. RESULTS: Seventy patients were studied and their ages ranged between 2 and 17 years. These 70 were constituted by 34 (48.6%) boys and 36 (51.4%) girls. Ten (14.3%) of the 70 studied, had atopic diseases. Nine (12.9%) patients had allergic conjunctivitis and 1 (1.4%) had allergic rhinitis. The single patient with allergic rhinitis also had bronchial asthma. No case of atopic eczema, or food allergy was recorded. Atopic disease conditions were more commonly recorded among the male sex and those whose parents have atopic diseases (P < 0.05). Atopic diseases were also more common among children without advanced HIV diseases and those with eosinophilia. Cosmetic and psychological embarrassment from eye discoloration and itching were the negative impacts on the quality of living. CONCLUSION: Allergic conjunctivitis is common in HIV-infected Nigerian children. Atopies are more common in boys and children with parental atopies.

Roles of family dynamics on adherence to highly active antiretroviral therapy among people living with HIV/AIDS at a tertiary hospital in Osogbo, south-west Nigeria.

BACKGROUND: Adherence to highly active antiretroviral therapy (HAART) has been proven to be the only effective treatment for HIV/AIDS worldwide. Good adherence to HAART might require good family support. OBJECTIVE: To determine the family dynamics and social support of people living with HIV/AIDS (PLWHA) and its roles on HAART adherence at an ARV treatment clinic in Osogbo, Nigeria. METHOD: Descriptive cross-sectional study. Consenting PLWHA on HAART were interviewed using pre-tested semistructured questionnaire incorporating Perceived Social Support- Family Scale and Family APGAR. HAART adherence was measured using patient self report. RESULTS: A total of 379 PLWHA were interviewed. Their mean age was 40.8 (SD=9.9) years. Most (60.7%) were females. More than half (55.7%) were currently married and the majority (72.1%) had secondary education and were Yoruba (86.3%). Most respondents (95.5%) were adherent to HAART. Over 90% were satisfied with support received from their family while 82.3% were treated like other family members. Most attributed their HAART adherence to the care and support received from their family. CONCLUSION: Most PLWHA had good social support and were adherent to HAART.

Colon and rectal cancer in Ibadan, Nigeria: an update.

INTRODUCTION: Colorectal cancer was hitherto a rarity in the rural African in general and in Nigerians inclusive. Ibadan is a sprawling city in Western Nigeria with a population of about 2.5 million inhabitants. Lately, several publications from surgeons in this city have alluded to an increase in the number of colorectal cancer cases managed in the teaching hospital. OBJECTIVES: To examine the incidence of this disease over 10 years in order to confirm or exclude the apparent significant increase in colorectal cancer cases in Ibadan, Nigeria. METHOD: This is a retrospective study highlighting the age, sex, clinical features, operations performed and histopathological subtypes of patients who had surgery for colorectal cancer in the University College Hospital Ibadan between July 1995 and August 2004. RESULTS: Two and sixty-eight patients were seen over 10 years. The male:female ratio was 1.16:1. The mean age was 41 years and the peak age was the 51- to 60-years group. Fourteen per cent of the patients were 30 years and below. Sixty-two per cent of the patients had rectal carcinoma while 33.2% had colonic carcinoma. Around 60.7% of colonic lesions were right-sided. The most common histopathological subtype was adenocarcinoma (78.8%), mucinous adenocarcinoma was 10.8% and signet ring type was 2.6%. CONCLUSION: Colorectal cancer is a disease on the increase in Ibadan. The mean age of 41 years is much lower than in the Western world. The male:female ratio still favours male patients slightly. About one in seven patients are 30 years and below. Adenomatous polyps were absent in the resected specimens.