Knowledge and Practice of the Referral System under the National Health Insurance Scheme among Medical and Dental Practitioners of A Large-Accredited Facility in Kano, Nigeria.

BACKGROUND: Studies on healthcare professionals' knowledge about the National Health Insurance Scheme (NHIS) are scarce. Therefore, we assessed the knowledge and practice of the NHIS referral system among Medical and Dental practitioners in a tertiary hospital in Northwest Nigeria. METHODS: This cross-sectional study involved 242 medical and dental practitioners randomly selected from nine departments for over 6-weeks. A structured self-administered questionnaire was used to collect data. Data were analyzed using descriptive and inferential statistics. RESULTS: The respondents' mean age was 35.7±6.0 years; they were predominantly males (64.9%). Their mean overall knowledge score was 58.9±23.0%, with 66.9% of respondents having inadequate overall knowledge of the NHIS referral system. Practice department (Fishers 2 exact, P=0.0019), perceived knowledge of the referral system (ꭓ =8.169, P=0.004), and having been referred as an enrolee (ꭓ2 = 6.358, P=0.012) were associated with overall-knowledge. Obstetrics-and-Gynaecology (odds ratio[OR]=0.29, 95% confident interval [CI] [0.88-0.98]), Dental and-Maxillofacial-Surgery (OR=0.08, 95%CI[0.01-0.98]), and Otorhinolaryngology (OR=0.18, 95%CI[0.04-0.80]) respondents were less likely to have adequate overall-knowledge.Although 56.2%, 50.4%, 20.7%, and 89.7% were enrolees, had received treatment as enrolees, had been referred as enrolees and treated other enrolees, respectively, an unimpressive proportion had sighted a referral letter (64.9%) or authorization code on the letter (25.2%), referred an enrolee from their department previously (51.2%) or used the NHIS referral form to write referrals (38.8%). CONCLUSION: The overall knowledge of the NHIS referral system was inadequate. The practice of the referral system was below expectation. Therefore, training medical and dental practitioners on the NHIS referral system is necessary. Training should target those who are least likely to have adequate overall knowledge.

CONTEXTE: Les études sur les connaissances des professionnels de la santé concernant le Régime d'assurance maladie national (NHIS) sont rares. Nous avons donc évalué les connaissances et la pratique du système de référence du NHIS parmi les médecins et dentistes d'un hôpital tertiaire du Nord-Ouest du Nigeria. MÉTHODES: Cette étude transversale a impliqué 242 médecins et dentistes sélectionnés de manière aléatoire dans neuf départements pendant plus de 6 semaines. Un questionnaire structuré auto-administré a été utilisé pour recueillir des données. Les données ont été analysées à l'aide de statistiques descriptives et inférentielles. RÉSULTATS: L'âge moyen des répondants était de 35,7 ± 6,0 ans ; ils étaient principalement des hommes (64,9 %). Leur score moyen global de connaissances était de 58,9 ± 23,0 %, avec 66,9 % des répondants ayant une connaissance globale insuffisante du système de référence du NHIS. Le département de pratique (test exact de Fisher, P=0,0019), la connaissance perçue du système de référence (ꭓ 2 =8,169, P=0,004) et avoir été référé en tant qu'adhérent (ꭓ 2 = 6,358, P=0,012) étaient associés à la connaissance globale. Les répondants en obstétrique-gynécologie (rapport des cotes [OR]=0,29, intervalle de confiance à 95 % [IC] [0,88-0,98]), en chirurgie dentaire et maxillo-faciale (OR=0,08, IC à 95 % [0,01-0,98]), et en oto-rhino-laryngologie (OR=0,18, IC à 95 % [0,04-0,80]) étaient moins susceptibles d'avoir une connaissance globale adéquate. Bien que 56,2 %, 50,4 %, 20,7 % et 89,7 % étaient adhérents, avaient reçu un traitement en tant qu'adhérents, avaient été référés en tant qu'adhérents et avaient traité d'autres adhérents, respectivement, une proportion peu impressionnante avait vu une lettre de référence (64,9 %) ou un code d'autorisation sur la lettre (25,2 %), avait référé un adhérent de leur département précédemment (51,2 %) ou avait utilisé le formulaire de référence du NHIS pour écrire des références (38,8 %). CONCLUSION: La connaissance globale du système de référence du NHIS était insuffisante. La pratique du système de référence était en deçà des attentes. Par conséquent, la formation des médecins et dentistes sur le système de référence du NHIS est nécessaire. La formation devrait cibler ceux qui sont moins susceptibles d'avoir une connaissance globale adéquate. MOTS-CLÉS: Connaissances et Pratiques, Professionnels de la santé, Régime national d'assurance maladie, Nigeria, Renvoi.

Clinical and laboratory profile of patients with epistaxis in Kano, Nigeria: A 10-year retrospective review.

BACKGROUND: Epistaxis is a common cause of otorhinolaryngological clinic visits and admissions into accident and emergency. Severe epistaxis could remarkably alter the hemodynamic milieu of individuals and results into significant morbidity and occasional mortality. AIMS: To review the clinical pattern and laboratory test results of individuals treated for epistaxis in a tertiary health care center in northern Nigeria. METHODS: This study was a 10-year retrospective review of patients managed for epistaxis in the department of otorhinolaryngology, Aminu Kano teaching hospital, Kano, Nigeria. Case files of patients were retrieved, reviewed, and clinical and laboratory data were extracted. The data were analyzed using Statistical Product and Service Solution version 23. RESULTS: A total of 256 were reviewed with 149 (58.2%) male and 107 (41.8%) female with M: F of 1.4:1. A mean age ± SD of 33.86 ± 20.06 years. Anterior epistaxis was the most prevalent, 126 (49.2%), and majority of the patients presented with severe epistaxis, 75 (29.3%). Most were treated with nasal packing, 93 (36.3%). Majority had abnormal full blood counts and clotting profile results, 158 (61.75) and 104 (40.6%), respectively. There was a significant association between patient's genotype and outcome. Anterior epistaxis and AA genotype were significant positive predictors of outcome. CONCLUSION: Coagulopathies, anaemia, and hemoglobinopathies are common findings among our patients with epistaxis.

A correlation of symptomatology with lung function in patients with allergic rhinosinusitis.

BACKGROUND: Allergic rhinosinusitis is clinically defined as a symptomatic disorder of the nose induced by an IgE-mediated inflammation following allergen exposure to the membrane lining of the nose. It constitutes a global health problem. Both allergic rhinosinusitis and bronchial asthma are systemic inflammatory conditions that often coexist. OBJECTIVE: The objectives of the study are to assess the pattern of allergic rhinosinusitis and to correlate nasal symptom score with lung volumes of patients with allergic rhinosinusitis. METHODS: This is a prospective study of all the adult patients with clinically diagnosed allergic rhinosinusitis at the study center. Patients' biodata, symptoms, and signs were obtained using a specially designed form. The symptoms were scored using nasal symptom scoring protocol and the lung volumes determined using spirometry. The data were collated and analyzed using SPSS Version 15 statistical software. RESULTS: There were 300 patients and another 300 nonallergic individuals as control. The most common presenting symptom was nasal congestion (98%), whereas the most common sign was engorged turbinates (91%). The most common trigger of allergic symptoms was dust (72.3%). Spirometric test results were below 90% on average in both sexes and significantly (P < 0.05) below those of the participants in the control group. A large number of patients with abnormal spirometry results have total nasal symptom scores of above 5 (n = 119), whereas few (n = 7) had symptom scores of 5 and below. There was a statistically significant correlation between high total nasal symptom score and abnormal spirometry (χ2 = 72, P = 0.0001). CONCLUSION: There is a significant correlation between nasal symptom score and reduced lung volumes in patients with allergic rhinosinusitis even in the absence of asthma.

Sleep health of healthcare workers in Kano, Nigeria.

BACKGROUND: The relevance of sleep in the life of a human being cannot be overemphasized in terms of physical and mental well-being. Among several factors that can affect the sleep health of an individual occupation have been found to play a prominent role. The literature is still scanty with regard to sleep studies in our environment. AIM: This study aims to assess the sleep health of tertiary healthcare workers in Kano Nigeria and find, if any, its determining or related factors. MATERIAL AND METHODS: This study was cross-sectional questionnaire-based survey and involved all consenting staff members of Aminu Kano Teaching Hospital, Kano, Nigeria. The Pittsburgh Sleep Quality Index Questionnaire was used to assess the sleep health of the participants. RESULTS: The participants' ages ranged from 18 to 65 years and have a mean age of 38.94 ± 8.07 years. There were 119 (74.4%) males and 41 (25.4%) females with a M:F ratio of 3:1 (χ2 = 19.415; P = 0.000). Among the 155 participants who completed all the aspects of the Pittsburgh Sleep Quality Index questionnaires, the overall sleep quality of the study population was found to be significantly poor [good sleepers = 71 (45.8%), poor sleepers = 84 (54.2%), χ2 = 116.4; P = 0.000]. Considering the various occupational groups working in the hospital, poor sleep was commonest among the nurses 35 (42.7%). Furthermore, among the nurses, poor sleep was significantly commoner in those on shift work 27 (77.1%) than those not on shift work 8 (22.9%); χ2 = 36.2; P = 0.000. Multivariate logistic regression analysis showed that age, sex, and duration in service were not significant predictors of poor sleep quality among the participants [odds ratio (OR) = 1.013, 95% confidence interest (CI) = 0.948-1.084, P = 0.698; OR = 0.691, 95% CI = 0.293-1.631, P = 0.399; and OR = 0.993, 95% CI = 0.932-1.058 P = 0.840, respectively). CONCLUSIONS: Our study found that a significant proportion of healthcare workers and particularly nurses had poor sleep quality. Also, age, sex, and duration in service were not significant predictors of poor sleep quality among the participants.