Psychoactive substance abuse among commercial bus drivers in Umuahia, Abia State, South-Eastern Nigeria: an uncontrolled "epidemic" with attendant road traffic crashes.

BACKGROUND INFORMATION: The unprecedented depletion of the productive workforce has been majorly attributed to road traffic crashes (RTCs). The attendant consequences of this depletion have been found to constitute a serious global public health challenge, with the use of psychoactive substances among drivers implicated in every three of five motor vehicle accidents. Hence, this study assessed the pattern and explored the determinants of substance abuse among commercial bus drivers in Umuahia, Abia State. METHODS: A descriptive cross-sectional design was used for the study. Four hundred commercial bus drivers were recruited from selected motor parks in Abia-state, using a multistage sampling technique from October to December 2020. A pretested, interviewer-administered questionnaire was administered to obtain socio-demographics and information on substance abuse. Data were analyzed using IBM SPSS version 25; bivariate analysis was done using Chi-square. The level of significance was at 5%. RESULTS: The mean age of the respondents was 40.03 ± 10.50 years. The proportion of respondents who had ever abused a psychoactive substance was 74.6%. The most commonly abused substances among drivers include alcohol (51%), cigarettes (27%), and alcoholic herbal mixtures (16%). The study participants had poor knowledge (54.5%) and poor perception (63.2%) about psychoactive substance abuse. Among the factors found to be significantly associated with substance abuse among respondents were ethnicity (p = 0.002), religion (p = 0.009) and monthly income (p = 0.013) of the respondents, poor knowledge (p < 0.001) and poor perception (p < 0.001). However, this study found religion (p = 0.031; OR = 5.469; CI = 1.170 to 25.555), knowledge (p < 0.001; OR = 4.21; CI = 2.201 to 8.287) and perception (p < 0.001; OR = 9.828; CI = 15.572 to 65.052) as factors that were associated with the higher likelihood of psychoactive substance abuse. CONCLUSION: Religion, poor knowledge and perception were associated with the higher likelihood of psychoactive substance abuse among commercial bus drivers. Targeting commercial bus drivers for educational interventions and using religious leaders as conveyor belts may reduce the use of psychoactive substances among them.

Health insurance in private and public health facilities in Southwestern Nigeria: what determines clients´ satisfaction with quality of service?

INTRODUCTION: insured-persons have complained about poor quality of services rendered by health care providers, which has consequently affected their satisfaction with care received. The objectives of this study aimed to identify the determinants of satisfaction and compare the level of clients´ satisfaction with quality of care received in both public and private health care facilities, in Oyo-State, Nigeria. METHODS: this was a cross sectional study, comparative in design. A total number of 300 clients were recruited from selected public and private health facilities in Oyo-state, using a multistage sampling technique. Data were analyzed using IBM SPSS version 24, and the level of significance was set at p-value < 0.05. RESULTS: the mean age of the respondents in private and public health facilities was 39.9 ± 10.0 years and 42.4 ± 10.1 years respectively. About 74% and 41.3% of the enrolees in the public and private health facilities respectively were dissatisfied with waiting time before receiving care with a statically significant difference of p=0.002. Majority of the respondents (82.7%) in the public health facilities and only 42.7% of those using private health care facilities were satisfied with the quality of drugs given to them at their respective pharmacies. This finding was statistically significantly different with p=0.001. Overall level of satisfaction with quality of care was 60% and 40% among enrolees using public and private health facilities respectively. There was a statistically significance difference (p=0.028) between the overall level of satisfaction and the type of health facility used by the clients. The determinants of clients´ satisfaction with quality of care in both private and public health facilities in this study were mainly socio-demographic characteristics; age (p=0.007), level of education (p=0.046) and occupation (p=0.004), the waiting time experience and the type of facility where services were accessed. CONCLUSION: clients attending public health facilities were more satisfied with care received under NHIS, compared with those using private health facilities. Efforts should be made to reduce waiting time and improve quality of drugs in the public and private facilities respectively.

10-year risk for cardiovascular diseases using WHO prediction chart: findings from the civil servants in South-western Nigeria.

BACKGROUND: Globally, cardiovascular diseases (CVDs) have continued to ravage the human existence through the premature deaths of its workforce. Despite this burden, many studies in Nigeria have focused on determining the prevalence of risk factors which alone are insufficient to assess the risk of future cardiovascular events. Therefore, we determined the pattern and predictors of 10-year risk for CVDs in South-western Nigeria. METHODS: We conducted a cross-sectional study among workers at the local government areas (LGAs) of Oyo State. Using a multi-stage sampling technique, we recruited 260 respondents from the LGA secretariats. A pre-tested, interviewer-administered questionnaire was administered to obtain information on the socio-demographics and behavioural attributes. Lipid analysis, anthropometric, blood pressure, fasting blood glucose measurements were done using standard protocols. The respondents' CVD risk was assessed using WHO prediction chart. Data were analyzed using IBM SPSS version 25; bivariate analysis was done using Chi-square and binary logistic regression was used to identify the predictors of 10-year risk for CVDs at 5% level of significance. RESULTS: The mean age of respondents was 46.0 + 6.7 years. The proportion of respondents with good knowledge of risk factors was 57.7%. The prevalence of CVD risk factors were as follows: systolic hypertension (29.6%), visceral obesity (35.8%), diabetes mellitus (18.8%), smoking (5.8%), elevated total cholesterol (55.4%) and physical inactivity (84.6%). The proportion of respondents with low, moderate and high risk of developing CVDs within 10 years was 76.9, 8.5 and 14.6% respectively. Respondents with age ≥ 40 years (aOR = 2.6, 95% CI = 1.3-8.5), management cadre (aOR = 3.8, 95% CI = 1.6-9.6), obesity (aOR = 4.8, 95% CI = 1.2-120), abnormal waist circumference (aOR = 2.8, 95% CI = 1.3-5.2) and physical inactivity (aOR = 2.4, 95% CI = 1.2-4.7) were associated with the higher likelihood of developing CVDs. CONCLUSION: About one-sixth of the respondents had high risk of developing CVDs within the next 10 years and it is likely that it will reduce the productivity of the State. Lifestyle modification and early detection of risk factors through regular screening programmes for those with high CVD risk is therefore recommended.