Increased risk of respiratory symptoms and chronic bronchitis in women using biomass fuels in Nigeria.

OBJECTIVE: To determine whether respiratory symptoms and chronic bronchitis are associated with the use of biomass fuels (BMFs) among women residing in rural areas of the Ekiti State, in southwestern Nigeria. METHODS: From January to June of 2009, we carried out a cross-sectional study including 269 adult women. To collect data on sociodemographic status, type of fuel used for cooking in the household, respiratory symptoms, and smoking history, we used a questionnaire adapted from the European Community Respiratory Health Survey. All of the participants were invited to undergo spirometry. RESULTS: Of the 269 women in the study, 161 (59.9%) used BMFs for cooking. The proportion of women who reported respiratory symptoms was greater among those using BMFs than among those using a non-BMF-cough (13.7% vs. 3.7%); wheezing (8.7% vs. 2.8%); chest pain (7.5% vs. 1.9%); breathlessness (11.8% vs. 6.5%); nasal symptoms (9.3% vs. 4.6%); and chronic bronchitis (10.6% vs. 2.8%). Multivariate logistic regression analysis revealed that the use of BMFs was associated with the following variables: cough (OR = 4.82; p = 0.01); chronic bronchitis (OR = 3.75; p = 0.04); wheezing (OR = 2.22; p = 0.23); chest pain (OR = 3.82; p = 0.09); breathlessness (OR = 1.54; p = 0.35); and nasal symptoms (OR = 2.32; p = 0.20). All of the spirometric parameters evaluated (FEV1, FVC, FEV1/FVC ratio, and PEF) were lower in the women using BMFs than in those using a non-BMF. CONCLUSIONS: Our results underscore the need for women using BMFs in their households to replace them with a nontoxic type of fuel, such as electricity or gas.

Risco aumentado de sintomas respiratórios e bronquite crônica em mulheres que utilizam biocombustíveis na Nigéria / Increased risk of respiratory symptoms and chronic bronchitis in women using biomass fuels in Nigeria

OBJETIVO: Determinar a associação de sintomas respiratórios e bronquite crônica com o uso de biocombustíveis entre mulheres habitantes de áreas rurais do estado de Ekiti, sudoeste da Nigéria. MÉTODOS: De janeiro a junho de 2009, realizou-se um estudo transversal com uma amostra de 269 mulheres adultas. Um questionário adaptado do European Community Respiratory Health Survey foi aplicado para a obtenção de dados sobre características sociodemográficas, tipo de combustível utilizado para a preparação de alimentos, sintomas respiratórios e história de tabagismo. Todas as participantes foram convidadas a realizar espirometria. RESULTADOS: Das 269 mulheres no estudo, 161 (59,9 por cento) utilizavam biocombustíveis para a preparação de alimentos. As mulheres que utilizavam biocombustíveis relataram mais sintomas respiratórios que aquelas que não os utilizavam - tosse (13,7 por cento vs. 3,7 por cento); sibilância (8,7 por cento vs. 2,8 por cento); dor no peito (7,5 por cento vs. 1,9 por cento); falta de ar (11,8 por cento vs. 6,5 por cento); sintomas nasais (9,3 por cento vs. 4,6 por cento); e bronquite crônica (10,6 por cento vs. 2,8 por cento). A análise multivariada por regressão logística confirmou que o uso de biocombustíveis está associado às seguintes variáveis: tosse (OR = 4,82; p = 0,01); bronquite crônica (OR = 3,75; p = 0,04); sibilância (OR = 2,22; p = 0,23); dor no peito (OR = 3,82; p = 0,09); falta de ar (OR = 1,54; p = 0,35); e sintomas nasais (OR = 2,32; p = 0,20). Todos os parâmetros espirométricos avaliados (VEF1, CVF, VEF1/CVF e PFE) foram menores nas mulheres que utilizavam biocombustíveis do que naquelas que não os utilizavam. CONCLUSÕES: Nossos resultados enfatizam a necessidade de se substituir o uso de biocombustíveis nos domicílios pelo de um tipo de combustível atóxico, como eletricidade ou gás.

OBJECTIVE: To determine whether respiratory symptoms and chronic bronchitis are associated with the use of biomass fuels (BMFs) among women residing in rural areas of the Ekiti State, in southwestern Nigeria. METHODS: From January to June of 2009, we carried out a cross-sectional study including 269 adult women. To collect data on sociodemographic status, type of fuel used for cooking in the household, respiratory symptoms, and smoking history, we used a questionnaire adapted from the European Community Respiratory Health Survey. All of the participants were invited to undergo spirometry. RESULTS: Of the 269 women in the study, 161 (59.9 percent) used BMFs for cooking. The proportion of women who reported respiratory symptoms was greater among those using BMFs than among those using a non-BMF-cough (13.7 percent vs. 3.7 percent); wheezing (8.7 percent vs. 2.8 percent); chest pain (7.5 percent vs. 1.9 percent); breathlessness (11.8 percent vs. 6.5 percent); nasal symptoms (9.3 percent vs. 4.6 percent); and chronic bronchitis (10.6 percent vs. 2.8 percent). Multivariate logistic regression analysis revealed that the use of BMFs was associated with the following variables: cough (OR = 4.82; p = 0.01); chronic bronchitis (OR = 3.75; p = 0.04); wheezing (OR = 2.22; p = 0.23); chest pain (OR = 3.82; p = 0.09); breathlessness (OR = 1.54; p = 0.35); and nasal symptoms (OR = 2.32; p = 0.20). All of the spirometric parameters evaluated (FEV1, FVC, FEV1/FVC ratio, and PEF) were lower in the women using BMFs than in those using a non-BMF. CONCLUSIONS: Our results underscore the need for women using BMFs in their households to replace them with a nontoxic type of fuel, such as electricity or gas.

Knowledge of and practices related to smoking cessation among physicians in Nigeria / Conhecimento e práticas para a cessação do tabagismo entre médicos nigerianos

OBJECTIVE: To evaluate the knowledge and practices of smoking cessation among physicians in Nigeria. METHODS: We conducted a cross-sectional survey in Lagos and three geopolitical zones of Nigeria. A self-administered structured questionnaire was used to obtain information on tobacco use and its health effects, as well as on the knowledge and practices of smoking cessation, from 436 physicians. RESULTS: Of the 436 physicians, 292 (67.0 percent) were aware of smoking cessation, but only 132 (30.3 percent) showed good knowledge on this topic. The prevalence of smoking among the physicians was 17.7 percent. In addition, 308 physicians (70.6 percent) reported that tobacco education in the medical school curriculum was inadequate. Of the 436 physicians, 372 (86.2 percent) asked their patients whether they smoked, and 172 (39.4 percent) asked their patients the reasons for using tobacco. As a means of smoking cessation intervention, 268 (61.5 percent) used brief advice/counseling (2-5 min), 12 (3.7 percent) prescribed antidepressants, 16 (2.8 percent) prescribed nicotine replacement therapy (NRT), and 76 (17.4 percent) arranged follow-up visits. When the physicians were questioned regarding the obstacles to smoking cessation interventions, 289 (66.3 percent) cited poor knowledge of the issue, 55 (12.6 percent) cited a lack of time, and 20 (4.6 percent) cited unavailability of NRT. CONCLUSIONS: The results of this study highlight the lack of knowledge among physicians in Nigeria in terms of smoking cessation, as well as their failure to apply appropriate practices. The results of this study can further the evaluation and formulation of guidelines on smoking cessation and smoking education programs for physicians. Our findings also underscore the need to offer smoking cessation programs in all treatment facilities.

OBJETIVO: Avaliar o conhecimento e as práticas para a cessação do tabagismo entre médicos na Nigéria. MÉTODOS: Um inquérito transversal foi realizado na cidade de Lagos e em três zonas geopolíticas da Nigéria. Um questionário estruturado de autopreenchimento foi respondido por 436 médicos para a obtenção de informações a respeito do uso de tabaco e de seus efeitos na saúde, seu conhecimento e as práticas para cessação do tabagismo. RESULTADOS: Dos 436 médicos, 292 (67,0 por cento) estavam informados a respeito da cessação do tabagismo, mas somente 132 (30,3 por cento) demonstraram bons conhecimentos sobre esse assunto. A prevalência de tabagismo entre os médicos foi de 17,7 por cento. Além disso, 308 médicos (70,6 por cento) relataram que a educação sobre tabagismo nos currículos de medicina era inadequada. Dos 436 médicos, 372 (86,2 por cento) questionavam seus pacientes quanto ao tabagismo, e 172 (39,4 por cento) os questionavam quanto aos motivos para o fumo. Como forma de intervenção para a cessação do tabagismo, 268 (61,5 por cento) utilizavam breve aconselhamento (2-5 min), 12 (3,7 por cento) prescreviam antidepressivos, 16 (2,8 por cento) prescreviam terapia de reposição nicotínica (TRN), e 76 (17,4 por cento) agendavam consultas de acompanhamento. Quando os médicos eram questionados quanto aos obstáculos para as intervenções para a cessação do tabagismo, 289 (66,3 por cento) citaram pouco conhecimento do assunto, 55 (12,6 por cento) citaram a falta de tempo, e 20 (4,6 por cento) a indisponibilidade de TRN. CONCLUSÕES: Os resultados deste estudo destacam a falta de conhecimento dos médicos na Nigéria quanto à cessação do tabagismo, assim como a sua falha em aplicar práticas adequadas. Os resultados deste estudo podem auxiliar na avaliação e na formulação de diretrizes sobre cessação do tabagismo e de programas de educação em tabagismo para médicos. Nossos achados também destacam a necessidade da oferta de programas para cessação ...

Knowledge of and practices related to smoking cessation among physicians in Nigeria.

OBJECTIVE: To evaluate the knowledge and practices of smoking cessation among physicians in Nigeria. METHODS: We conducted a cross-sectional survey in Lagos and three geopolitical zones of Nigeria. A self-administered structured questionnaire was used to obtain information on tobacco use and its health effects, as well as on the knowledge and practices of smoking cessation, from 436 physicians. RESULTS: Of the 436 physicians, 292 (67.0%) were aware of smoking cessation, but only 132 (30.3%) showed good knowledge on this topic. The prevalence of smoking among the physicians was 17.7%. In addition, 308 physicians (70.6%) reported that tobacco education in the medical school curriculum was inadequate. Of the 436 physicians, 372 (86.2%) asked their patients whether they smoked, and 172 (39.4%) asked their patients the reasons for using tobacco. As a means of smoking cessation intervention, 268 (61.5%) used brief advice/counseling (2-5 min), 12 (3.7%) prescribed antidepressants, 16 (2.8%) prescribed nicotine replacement therapy (NRT), and 76 (17.4%) arranged follow-up visits. When the physicians were questioned regarding the obstacles to smoking cessation interventions, 289 (66.3%) cited poor knowledge of the issue, 55 (12.6%) cited a lack of time, and 20 (4.6%) cited unavailability of NRT. CONCLUSIONS: The results of this study highlight the lack of knowledge among physicians in Nigeria in terms of smoking cessation, as well as their failure to apply appropriate practices. The results of this study can further the evaluation and formulation of guidelines on smoking cessation and smoking education programs for physicians. Our findings also underscore the need to offer smoking cessation programs in all treatment facilities.