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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.
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Riscos Ocupacionais , Violência no Trabalho , Saúde Ocupacional , Pessoal de Saúde , Revisão SistemáticaRESUMO
Background: Mitigating the risk of nosocomial infection is one of the core functions of healthcare managers in hospital environments. This study aimed to describe the COVID-19 outbreak response in a tertiary healthcare facility in Nigeria. Methods: A qualitative cross-sectional study was conducted among representatives of Heads of Infection Control Committees and units, the Accident and Emergency unit, Family Medicine unit, and Private Suites on the COVID-19 outbreak response at the University College Hospital, Ibadan, Nigeria. Data were analyzed using Colaizzi's phenomenological method. Results: Overall, seven (six physicians and one nurse) HCWs were interviewed; six (71.4%) males and two (28.6%) females. The average age of the key informants was 45 ± 4.73 years. Four themes were identified. Theme one "Essentials of screening protocol and screening area" described the development of screening protocol, and dedication of a triage area. Theme two "Infection prevention and control within consultation premises" detailed adequate spacing; hand hygiene, use of personal protective equipment; environmental sanitation; and waste management. Theme three "Mounting up surveillance in the response activity" specified communication with the Disease Surveillance Unit; and surveillance activities. Theme four "Training and psychosocial support for staff " described staff training, and provision of psychosocial care to infected staff. Conclusion: The COVID-19 outbreak measures implemented by the management of the University College Hospital, Ibadan were aimed at ensuring that the hospital does not get overwhelmed by the surge in COVID-19 cases. In order to improve outbreak response in hospital settings, it is important to undertake training, modify hospital practices, and evaluate implemented measures.
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Linear IgA bullous dermatosis (LABD) is an auto-immune disease affecting young children and adults, characterized by the linear deposition of IgA at the basement membrane zone with resultant complement activation and a cascade of immune reactions. There is a loss of adhesion at the dermo-epidermal junction and subsequent blister formation. It is a rare disease that has a good prognosis with adequate therapy. However, the underlying depressed immunity associated with the disease may expose them to such infections as tuberculosis. We report the case of an 11-years-old Nigerian female adolescent with LABD, diagnosed at the age of four years but defaulted on follow-up, who developed disseminated tuberculosis (pulmonary, lymph nodes, abdominal and pericardial effusion) seven years after the appearance of the initial blistering skin lesions. She commenced anti-tuberculosis drugs, steroids, and a tube pericardiostomy for the pericardial effusion. Dapsone was initiated for the LABD during the continuation phase of anti-tuberculosis therapy, with subsequent disappearance of the skin rash within two weeks.
La dermatose bulleuse linéaire à IgA (DBL) est une maladie auto-immune affectant les jeunes enfants et les adultes, caractérisée par le dépôt linéaire d'IgA dans la zone de la membrane basale, avec l'activation du complément qui en résulte et une cascade de réactions immunitaires. Il y a une perte d'adhérence à la jonction dermo-épidermique et une formation ultérieure de vésicules. C'est une maladie rare qui a un bon pronostic avec un traitement adéquat. Cependant, l'immunité déprimée sous-jacente associée à la maladie peut les exposer à des infections telles que la tuberculose. Nous rapportons le cas d'une adolescente nigériane de 11 ans atteinte de la LABD, diagnostiquée à l'âge de quatre ans mais en défaut de suivi, qui a développé une tuberculose disséminée (pulmonaire, ganglions lymphatiques, épanchement abdominal et péricardique) sept ans après l'apparition des lésions cutanées vésiculeuses initiales. Elle a commencé à recevoir des médicaments antituberculeux, des stéroïdes et une péricardiostomie par sonde pour l'épanchement péricardique. La dapsone a été initiée pour la DLB pendant la phase de continuation du traitement antituberculeux, avec une disparition de l'éruption cutanée en deux semaines. Mots clés: IgA linéaire, dermatose bulleuse, tuberculose disséminée, adolescent.
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Dermatose Linear Bolhosa por IgA , Derrame Pericárdico , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Imunoglobulina A/uso terapêutico , Dermatose Linear Bolhosa por IgA/diagnóstico , Dermatose Linear Bolhosa por IgA/tratamento farmacológico , Dermatose Linear Bolhosa por IgA/patologia , NigériaRESUMO
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.
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Carga Global da Doença , Expectativa de Vida , Teorema de Bayes , Saúde Global , Humanos , Anos de Vida Ajustados por Qualidade de VidaRESUMO
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.
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COVID-19/prevenção & controle , Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , SARS-CoV-2 , Adulto , COVID-19/epidemiologia , Feminino , Recursos em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Equipamento de Proteção Individual , Pesquisa Qualitativa , Medição de RiscoRESUMO
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.
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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.
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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.
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BACKGROUND: Co-morbid depression poses a challenge to the successful management of pulmonary tuberculosis (TB). This study assessed the prevalence of depression and its associated factors among patients receiving treatment for TB in a tertiary health care facility in southwestern Nigeria. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted among all the pulmonary TB patients presenting in the initiating or continuous phase of treatment and they were consecutively recruited between January and December, 2017. The Mini International Neuropsychiatric Interview (MINI) tool was used for the diagnosis of depression. The severity of depression was assessed using Hamilton Rating Scale for Depression (HAMD). RESULTS: Of the 152 patients, 85 (55.9%) were males with a mean age of 41.7 ±15.5 years and 71 (46.7%) had depression of which 64(90.1%) had mild depression and 2 (2.8%) had severe depression. Among female 38(56.7%) were depressed compared to 33 (38.8%) male (p=0.028). Fifty-nine (55.1%) of those on continuous phase of treatment were depressed compared to 12 (27.3%) initiating treatment (p=0.002). In those with HIV co-morbidity 36 (66.7%) were depressed while 35 (35.7%) were depressed among those without HIV co-morbidity (p <0.001). Among those who had poor perception of treatment outcome, 7 (87.5%) were depressed compared to 64 (44.4%) with good perception, p=0.018. Overall, predictors of depression were having poor perception about outcome of treatment (AOR: 12.9; CI 95%: 1.4-118.4), having HIV co-morbidity (AOR: 2.9; CI 95%: 1.4-6.3) and being on continuous phase of TB treatment (AOR: 2.5; CI 95%: 1.1- 5.9). CONCLUSION: The care of patients with TB should be more comprehensive. Health care workers should actively seek for evidence of depression among patients diagnosed with Tuberculosis and appropriate help offered to them.
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Infecções por HIV , Tuberculose Pulmonar , Tuberculose , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/epidemiologiaRESUMO
The impacts of COVID-19 have cut across both developed and developing countries alike. This has prompted different coping mechanisms for survival through these trying times. The reality of stigmatization in this period has negatively affected health-seeking behavior and public response to the outbreak. Challenges exist at both the community and the healthcare providing facilities. We present a review of best practices in coping with COVID-19. Our focus is on how to cope with the challenges and strategies to improve the response to the pandemic in Nigeria. It is required that safety measures be fully adopted and practiced by individuals and groups. Collaborative efforts are required by all stakeholders, government, healthcare workers, and private organizations to mitigate the negative effects of the pandemic, avoid stigmatization, and ease the return journey to normalcy.
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Burnout among physicians is a global phenomenon which has been under-reported in middle and low-income economies. The importance of burn-out on the physicians' well-being, patient care and overall health care system cannot be overemphasized. In Nigeria, few studies are specific to burnout, with most of the available studies exploring psychosocial issues at physicians' workplace stress and job dissatisfaction. This present review of literature is assessing burnout among Nigerian Physicians. This review is designed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The review identified observational, review, longitudinal and experimental studies on Nigerian physicians between 1970- 2017, which have the full text in the English language. The articles were searched from online databases such as PUBMED, Directory of Open Access Journals (DOAJ), African Journals Online (AJOL) and Google Scholar by researchers. The keywords used include "Physician", "Nigeria", "burn-out" syndrome. The prevalence of 23.6% to 51.7% burnout was reported among physicians in the selected studies, with young age being a strong predictor for burnout. High burden of emotional exhaustion, depersonalization and personal accomplishment were reported in the study carried out among resident doctors who are early career doctors. The prevalence of burnout reported from these studies in Nigeria is very high, although they are within the globally reported range of physician burnout. Nevertheless, there is a dearth of information on the subject matter among Nigerian Physicians. There is a need to carry out more studies on burnout among Nigerian Physicians
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Esgotamento Psicológico , Nigéria , MédicosRESUMO
INTRODUCTION: Neurocognitive dysfunction is a detrimental complication of HIV infection. In this study we attempt to characterize the pattern of cognitive dysfunction in a sample of Nigerian patients with newly diagnosed HIV infection. METHODS: We conducted a prospective study in which 50 patients with newly diagnosed HIV infection were studied along with 50 normal control subjects. The participants were evaluated with the medical history, general, physical and neurological examination. Laboratory evaluation and chest X-Ray were done for all patients. The Community Screening Interview for Dementia (CSID) questionnaire was administered to all the study participants. RESULTS: About 70% of the patients were in advanced disease stage. The mean age (SD) of the patients and controls in years were 36.44 ± 8.22 and 35.40 ± 11.53 respectively. More than half (56%) of the patients had secondary level of education (12 years of education). About 20% of the patients had severe neurocognitive impairment while 48% had minor neurocognitive disorder. The patients with HIV infection performed poorly in the domains of language, memory, orientation, attention/calculation and praxis relative to controls (p < 0.05).There were no significant effect of gender, age, sex and level of education on cognitive functions in the patients (p > 0.05) but the presence of opportunistic infections had negative impact on the performances on orientation and total CSID scores in the patients with HIV infection (p < 0.05). CONCLUSION: Patients with newly diagnosed HIV infection have poor cognitive functions when compared to normal controls and some presence of opportunistic infections in the patient is a significant risk factor for cognitive impairment.
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INTRODUCTION: Adequate knowledge of asthma management and adherence to international guidelines are known to increase the quality of care offered by Physicians. We conducted this study to assess the level of asthma knowledge and quality of care among physicians practicing in Ondo State. METHODS: We conducted a cross sectional survey of 96 physicians from various specialties participating in a continuous professional development (CPD) lecture using adapted questionnaires. RESULT: Respondents ranged in age from 23-62years (42.5±19.4). There were more male (70%). The minority (17%) had additional postgraduate medical qualifications. There was a high distribution of correct answers for individual knowledge questions. The greatest areas of knowledge gaps appeared in diagnostic instruments, asthma severity and drugs. We observed gaps regarding the use of GINA guidelines (6%) and prescribing combined inhaled steroid and long acting bronchodilator for patients who are not controlled on inhaled steroid alone (29%). A large number of the respondents do not confirm the diagnosis of asthma by spirometry (32%). Only 8% of the respondents with high knowledge reported a corresponding high quality of Asthma care. CONCLUSION: We concluded that although physicians in South-West Nigeria appear to have good knowledge, there are areas of gap in the quality of asthma care with regards to standard guideline. There is need for constant training and re-training of physicians in order to keep them up to date with international guidelines. In addition, increase access to diagnostic facilities and adapting international guideline to local realities will help improve standard of Asthma care.
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Asma/terapia , Conhecimentos, Atitudes e Prática em Saúde , Médicos/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , EspirometriaRESUMO
INTRODUCTION: The role of Medical Audit in patient care needs to beexplored. This study aimed to determine doctors' knowledge and practice of Medical Audit in a tertiary health facility in South West Nigeria. METHODS: Across-sectional study of 115 consenting doctors at Federal Medical Centre Owo was conducted. A semi-structured, self-administered questionnaire was used. Data was analyzed using SPSS version 21. Descriptive statistics were presented using frequency tables and bar chart, age and year of practice were summarized as mean and standard deviation. Chi square-test was used to compare sociodemographic variables with doctor's knowledge of MedicalAudit. Level of statistical significant was 5%. RESULT: The mean age of the respondents was 32.5 ± 5.8 years. Males were 78%, and 61.7% were married. The mean duration of practice was 3.3 ± 2.2 years. Adequate knowledge of Medical Audit was found in 79% of the respondents while only 53% had practiced it. Formal training on Medical Audit has not been received by 91.3% of the respondents, 80.9% requested for training on Medical Audit. In all, 88.0% who had ≥ 3-years of practice had adequate knowledge compared with only 72.3% of those who had less than three years of practice (p = 0.040). CONCLUSION: Practice of MedicalAudit is low though adequate knowledge exist.Training of doctors on Medical Audit is required.
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Competência Clínica , Auditoria Médica , Médicos/normas , Padrões de Prática Médica/normas , Adulto , Estudos Transversais , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Capacitação em Serviço/organização & administração , Masculino , Nigéria , Garantia da Qualidade dos Cuidados de Saúde/métodos , Inquéritos e Questionários , Centros de Atenção Terciária/estatística & dados numéricosRESUMO
BACKGROUND: Tuberculosis remains one of the most infectious diseases worldwide especially with the HIV pandemic. It is a cause of high morbidity and mortality in developing countries including Nigeria. Reasons contributing to high morbidity and mortality include high defaulting rate and treatment interruption. Several studies had evaluated the treatment outcome of tuberculosis but there is paucity of published literature on the outcome of treatment interruption especially in this environment. This study thus assessed the outcome of treatments and interruption among patients assessing DOTS regimen in a tertiary hospital located in asemi urban area in south-western Nigeria. METHODOLOGY: The study was a review of TB register of the federal medical centre, Owo from its inception in 2008 to 2011. All the patients that have completed at least one course of chemotherapy (defined as 8 months of anti-tuberculosis treatment- 2 months intensive phase and 6 months continuation phase) were included. Treatment outcome and interruption were defined in accordance with World Health Organisation (WHO) recommendations. Data were analysed with SPSS version 17. RESULTS: A total of 400 patients were included. The mean age of patients was 36.8 +/- 16.8 years and 56.3% were male. Majority, (79.7%) were adults aged 19-64 years, 12.5% were in the paediatric age group and 7.8% were elderly. Less than half, 45.3% had TB/HIV co-infection. Regarding treatment outcome of tuberculosis, 75.5% were cured, 14.8% died, 4% relapsed and 3% defaulted. A little above one-fifth, 21 (5.3%) had treatment interruption among whom 9 (42.9%) were successfully traced and completed treatment. Significantly, higher proportion of those that had treatment interruption died, 54.1% compared with their counterpart, 14.9%, (p < 0.001) and had relapse. (14.3% versus 3.4%, p = 0.01). CONCLUSION: A high rate of tracking failure among patients with treatment interruption was found in the study. In addition, mortality and morbidity were higher among patients with treatment interruption. A more concerted effort is needed in tracking/tracing patients with treatment interruption in orderto reduce morbidity and mortality among TB patients assessing treatment.
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Antituberculosos/uso terapêutico , Terapia Diretamente Observada , Adesão à Medicação , Tuberculose/tratamento farmacológico , Adolescente , Adulto , Coinfecção , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Distribuição por Sexo , População Suburbana , Centros de Atenção Terciária , Resultado do TratamentoRESUMO
BACKGROUND: Iron overload has been recognized to be a risk factor for numerous acute and chronic illnesses. It is generally assumed to be rare and acknowledgment of iron toxicity is difficult for some nutritional scientists, clinicians and laypersons. There is also a heightened interest to raise body iron through universal iron "fortified" foods. OBJECTIVE: This study investigated the need to examine the policy of unselective iron supplementation in a sub-Saharan African community. METHODS: This is a descriptive study carried out on 98 apparently healthy women attending a Papanicolaou (PAP) smear clinic for routine cervical cancer screening. Information on demographic data and diet were obtained with structured questionnaires and serum samples were analyzed for serum iron (SI) and total iron binding capacity (TIBC) which were used to derive the values for tranferrin saturation (TS%). Iron overload was defined by tranferrin saturation greater than 50%. RESULTS: The prevalence of iron overload was 8.2% in women aged 26-71 years. Skilled workers constituted 44.9% of the population while semi-skilled and housewives were 50% and 5.1% respectively. Eighty four percent of the women had been on iron vitamin supplement at one time or the other. Mild anaemia was present in 25% of the women with iron overload. The prevalence of iron overload between women who were actively reproducing and those who were not was not statistically different. CONCLUSIONS: Iron overload is common, therefore, iron studies may be included in routine investigation and selective iron supplementation should be encouraged. Moreso, iron loading anaemia should be ruled out in patients with anaemia before prescribing iron therapy.
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Sobrecarga de Ferro/epidemiologia , Ferro/sangue , Adulto , Idoso , Feminino , Humanos , Sobrecarga de Ferro/sangue , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Fatores de RiscoRESUMO
BACKGROUND: There is increasing interest in the choice of health care providing facility in Nigeria. OBJECTIVES: This study aimed to assess the factors influencing choice and satisfaction with health service providers among local government staff. METHODS: A cross sectional survey of all 312 workers in a Local Government Secretariat in South West Nigeria was done. Chi Square and logistic regression analysis was done. RESULTS: The mean age was 38.6 ± 7.5 years, 55% were females and 71.7% had tertiary education. The median monthly family income of the respondents was N 28, 000 (N3,000 - N500,000), with 24.4% earning a monthly income of N21, 000 to N30, 000. Many (72.3%) utilized public health facilities attributing the choice to the low cost of services. Respondents who are satisfied with their usual care providing facilities are 12.2 times more likely to have used public facilities than private facilities (95%, CI 3.431 - 43.114). Respondents who described the quality with ease of getting care/short waiting times as being good are 3.9 times more likely to have private facilities as their chosen health care providing facility (95%, CI 1.755 - 8.742). Cost/payment for service is 2.9 times more likely to predict the use of public health facility as the usual health care provider. CONCLUSION: Private facilities though costlier do not appear to be providing better services than public facilities. To increase access to health care the cost of services and the waiting time are important factors to address.
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BACKGROUND: Quality of life (QoL) is an important measure in the assessment of population well being and health status. However despite locally validated measuring tools, little is known about the quality of life and associated factors in Nigerian adults. OBJECTIVE: This study therefore aimed to assess QoL and contributory factors among adults residing in a sub urban Nigerian community. METHODS: A descriptive cross-sectional study of 527 adults, in Oru community was conducted. An interviewer-administered questionnaire adapted from the WHO quality of life (WHOQOL-BREF) questionnaire was used to obtain information from respondents. Associations were explored with the chi square test; multivariate analysis was done with logistic regression at 5% level of significance. RESULTS: Respondents mean age was 33.3 ±8.1 years. In all, 46.5 % were currently married or cohabiting. Christianity was the dominant religion, 72.7%. In all, 81.6% had good QoL. Predictors of good QoL were respondents less than 25 years [OR: 3.5 (1.264-9.508)], having educational level that is secondary and above [OR: 4.2 (1.810-9.762)]. Being Unemployed [OR: 1.9 (1.099- 3.351)], living in flats and other bigger apartments [OR: 1.8 (1.121- 3.04)], currently ill [OR: 3.7 (2.096- 6.509)], and lack of involvement in religious activities [OR: 3.1 (1.166- 8.045)] were also shown to be predictors of good QoL. CONCLUSION: The majority of those evaluated had good QoL. Further surveys involving larger samples sizes are required to explore the QoL in distinct sub-populations and in currently ill patients to strengthen the results of this study.
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OBJECTIVE: To assess the awareness and knowledge of aflatoxin contamination in groundnut and the risk of its ingestion among health workers in Ibadan. METHODS: The study was a descriptive cross-sectional study. Study instrument was a semi-structured self administered questionnaire. The respondents were health workers from a public health facility. RESULTS: A total of 417 health workers participated out of which males were 60.2%. The mean age of respondents was (28.0±4.9)years old. Doctors made up 83.0% while others were nurses. 95% of the respondents had previous awareness of aflatoxin and class room lectures was the most common source of information (56%). Occupation and religion both showed a significant association with previous awareness of aflatoxin (P<0.05). Knowledge regarding aflatoxin contamination in groundnut and the risk of its ingestion was obtained showing knowledge score range of 0 to 14. In all, 80.6% had good scores of 11 to 14. None of the respondents had ever told their patients about the risk of aflatoxin ingestion. CONCLUSIONS: There is a need to explore the possibility of incorporating aflatoxin awareness into routine health talk to increase the level of awareness of patients and their relatives.