Knowledge, attitude, and practice of diabetic retinopathy among physicians in Northwestern Nigeria.

BACKGROUND: Diabetic retinopathy (DR) is the leading cause of preventable blindness in the productive population that poses a considerable global public health burden. OBJECTIVE: The objective of this study is to assess the knowledge, attitude, and practice of DR screening among physicians in Northwestern Nigeria. Materials and Methods: Survey responses were obtained from 105 physicians in 4 tertiary hospitals using a Likert scale questionnaire. The internal consistency of the questionnaire was calculated using Cronbach's alpha coefficient. Principal component analysis was used for data reduction and grouping with the varimax rotation method, and the factors were extracted based on an Eigenvalue> 1. RESULTS: Most of the respondents (78.8%) were aware of the most effective method of delaying the onset of DR and frequency of eye examination (94.1%). Lack of ophthalmoscopes (70.6%) and dilating eye drops (50.6%) form important barriers to performing a good eye examination. CONCLUSION: DR screening among physicians practicing in Northwestern Nigeria was suboptimal, which prompts the need for improved training of physicians managing persons with diabetes on eye examination in a bid to strengthen DR screening and reduce the burden of visual impairment in our environment.

Prevalence of psychoactive substance use among commercial motorcyclists and its health and social consequences in Zaria, Nigeria.

BACKGROUND: In recent years commercial motorcyclists (Okada riders) have come to bridge the huge public transport gap in most cities across the country. However, this is not without the dangers they pose to themselves, passengers and to other road users. It is claimed that some of these Okada riders operate under the influence of drugs and other substances. But there are few community-based studies that have investigated the problem in this part of Nigeria. Therefore, this study was conducted to determine the prevalence, health and social consequences of psychoactive substance use among commercial motorcyclists (Okada) in Zaria, northern Nigeria. METHOD: Multi-stage sampling technique was used to sample commercial motorcyclists registered with commercial motorcyclists union in Zaria city, Kaduna state, Nigeria. Structured, closed ended and interviewer administered questionnaires were used to collect information on socio-demographic characteristics, factors influencing psychoactive substance use, impact on health status, motor cycle riding experience and work performance. RESULTS: Two hundred commercial motor cyclists were intervi ewed, majority of them were in the age group 21-25 years (55.5%) with a mean age of 25.4 +/- 3.9 years. All the motorcyclists were male, (60.5%), had no formal education, (79.5%) are of Hausa extraction and (69%) worked for more than 10 hours per day. A high prevalence of 59.5% of road traffic accident that was associated with the use of psychoactive drugs was found among the motorcyclists. Commonly identified psychoactive substance/drugs used were: marijuana [Indian hemp] 25.8%, solution 24.5%, caffeine (Kola) 15.8%, and coffee 4.8%. Keeping awake, suppression of fatigue, and peer group effect were the identified factors influencing psychoactive substance use. The commonest types of injuries sustained were bruises and lacerations (62.5%) and fractures of upper and lower limbs (10.5%). CONCLUSION: Road traffic accidents among commercial motorcyclists are a frequent occurrence in this part of the country. There is need for public awareness campaigns on road safety education and health consequences of psychoactive substance use among commercial motorcyclists. It is further recommended that law enforcement agencies (NAFDAC, NDLEA and FRSC) need to work in tandem so as to curb the problem of substance abuse in our society and reduce the rate of accidents on Nigerian roads.

Prevalence of psychoactive substance use among commercial motorcyclists and its health and social consequences in Zaria, Nigeria

Background: In recent years commercial motorcyclists (Okada riders) have come to bridge the huge public transport gap in most cities across the country. However, this is not without the dangers they pose to themselves, passengers and to other road users. It is claimed that some of these Okada riders operate under the influence of drugs and other substances. But there are few community-based studies that have investigated the problem in this part of Nigeria. Therefore, this study was conducted to determine the prevalence, health and social consequences of psychoactive substance use among commercial motorcyclists (Okada) in Zaria, northern Nigeria. Method: Multi-stage sampling technique was used to sample commercial motorcyclists registered with commercial motorcyclists union in Zaria city, Kaduna state, Nigeria. Structured, closed ended and interviewer administered questionnaires were used to collect information on socio-demographic characteristics, factors influencing psychoactive substance use, impact on health status, motor cycle riding experience and work performance. Results: Two hundred commercial motor cyclists were interviewed, majority of them were in the age group 21-25 years (55.5%) with a mean age of 25.4 ± 3.9 years. All the motorcyclists were male, (60.5%), had no formal education, (79.5%) are of Hausa extraction and (69%) worked for more than 10 hours per day. A high prevalence of 59.5% of road traffic accident that was associated with the use of psychoactive drugs was found among the motorcyclists. Commonly identified psychoactive substance/drugs used were: marijuana [Indian hemp] 25.8%, solution 24.5%, caffeine (Kola) 15.8%, and coffee 4.8%. Keeping awake, suppression of fatigue, and peer group effect were the identified factors influencing psychoactive substance use. The commonest types of injuries sustained were bruises and lacerations (62.5%) and fractures of upper and lower limbs (10.5%). Conclusion: Road traffic accidents among commercial motorcyclists are a frequent occurrence in this part of the country. There is need for public awareness campaigns on road safety education and health consequences of psychoactive substance use among commercial motorcyclists. It is further recommended that law enforcement agencies (NAFDAC, NDLEA and FRSC) need to work in tandem so as to curb the problem of substance abuse in our society and reduce the rate of accidents on Nigerian roads

Direct observation therapy-highly active antiretroviral therapy in a resource-limited setting: the use of community treatment support can be effective.

This study examines the use of various direct observation therapy-HAART treatment support modalities in Jos, Nigeria. A 12-month observational study enrolling 175 antiretroviral naïve patients into four arms of direct observation therapy-HAART (highly active antiretroviral therapy); daily observed therapy (DOT), twice weekly observed therapy (TWOT), weekly observed therapy (WOT) and self-administered therapy (SAT), examined community treatment support using family and community members. Treatment outcomes were much better in the treatment-supported groups compared with the control self-therapy group. CD4 cell increases were 218/microL (DOT), 267/microL (TWOT), 205/microL (WOT) versus 224/microL (SAT), whereas plasma HIV-1 RNA reached undetectable levels (<400 copies/mL) in 91%, 88%, 84% versus 79% of patients in the DOT, TWOT, WOT versus SAT groups, respectively, at 48 weeks. We, therefore, strongly support the use of treatment support in our settings.

Utilization of maternal health services by rural Hausa women in Zaria environs; northern Nigeria: has primary health care made a difference?

Background: Expanding coverage; strengthening of; and increasing access and utilization of maternal health services is one of the key components of Nigeria's Primary Health Care (PHC) efforts ; which was started in 1986. A descriptive study was undertaken to document the level and pattern of utilization of selected maternal health services among rural Hausa women in order to assess progress in PHC implementation. Methods: A cross-sectional descriptive; quantitative study using structured interviewer-administered questionnaire was used to collect data on family planning; antenatal; post natal and delivery services utilization pattern from a total population of 655 currently married women in the reproductive age group in two predominantly Hausa villages in north-western Nigeria. The findings were compared with the baseline data obtained in the local government area at the start of PHC in 1986. Results: About two-thirds of the women had heard of family planning. There were statistically significant associations between age (P0.001); education (p0.05); occupation (p 0.001) and level of knowledge of contraceptive methods. However; utilization of modern contraceptives was very low; only 1.8 had ever used a method while 0.9 was using a method at the time of the study. Only 25.9 of the women had modern antenatal care during their last full term pregnancies with the mean age at booking of 6.6 months and an average of 5.4 visits throughout the pregnancy. There was a significant association between education and antenatal care uptake (p 0.05). Only 9 of their last deliveries took place in hospital while skilled attendants attended to 11 of the deliveries. The data showed a decline in most of the rates compared to the baseline data obtained for the local government at the inception of PHC. Conclusion: Utilization of orthodox maternal health services among the rural Hausa women is abysmally low and PHC implementation has not made any appreciable impact on their maternal health services uptake

Glucose metabolism among Norplant users in northern Nigeria.

Twenty-one women who were consecutive acceptors of Norplant were recruited for this study in our centre in August 1997. The patients had baseline (pre-insertion) investigations including a standard oral glucose tolerance test (OGTT). At their regular 3, 6, and 12 months follow-up visits, the OGTT was repeated and results were analyzed. The mean age of the clients was 31.3+/-4.51 years (range 24-40 years). The mean weights were 61.60+/-11.35, 57.63+/-7.51, 62.60+/-11.98, and 62.17+/-11.56 kg at pre-insertion, 3, 6, and 12 months follow-up visits respectively. The differences were statistically insignificant. All OGTT values at pre-insertion and at the follow-up visits were within the normal range. However, in comparison to pre-insertion levels (4.00+/-0.10 mmol/L), the fasting blood glucose concentration at 12 months (3.39+/-0.12 mmol/L) showed a statistically significant decline (p <0.001). The area under the glucose curve (AUC) rose by 5.8% (p = 0.018) at 3 months but declined by 5.8% (p = 0.110) and 7.3% (p = 0.103) at 6 and 12 months, respectively. The peak pre-insertion plasma glucose level following OGTT occurred at 30 min. At 3 months, the peak OGTT glucose level occurred at 30 minutes and plateaued until 60 min while at 6 and 12 months this occurred at 60 and 90 minutes, respectively. The overall trend of OGTT results within the study period showed that 12 months of Norplant use in Northern Nigerian women has no detrimental effect on glucose metabolism.