Hand hygiene knowledge, training and practice: A cross-sectional study in a tertiary health institution, North-central Nigeria.

BACKGROUND: Hand hygiene (HH) is the single most important means of preventing hospital-acquired infections. We set out to determine the knowledge, training gaps, and practice of HH in a tertiary health institution in a resource constrained setting. METHODS: This cross-sectional study was conducted among health care workers in a 600-bed capacity tertiary health centre. The study was conducted between April and November 2013. A multi-stage randomized sampling method was used to self-administer 322 WHO HH knowledge questionnaires. Information on HH training in the past 3 years, knowledge and practice of HH were obtained, and data were analysed using Epi-Info version 3.5.1. RESULTS: A response rate of 98.5% was obtained for the HH knowledge assessment. Mean age of the study population was 39 ± 9.8. About 64% were females. Of all the respondents, only 16% had good knowledge of HH, 52% had moderate knowledge while 32% had poor knowledge. About 24% had formal training on HH. In terms of practice, only about 22% of the respondents self-reported routine practice of HH. CONCLUSIONS: The findings in this study suggest that there is sub-optimal HH knowledge, practice and training. It is imperative to improve the HH training and retraining of health care workers with a focus on attendants. Administrative controls and bold signage in healthcare institutions are also recommended.

SPUTUM SMEAR PATTERN AMONG PATIENTS DIAGNOSED WITH PULMONARY TUBERCULOSIS IN MAKURDI, NORTH CENTRAL NIGERIA.

BACKGROUND: Tuberculosis (TB) is endemic in Nigeria due mainly to the high burden of HIV/AIDS and especially in Benue state which has the highest prevalence of HIV in Nigeria. Sputum smear examination is of importance in the diagnosis of pulmonary TB and can be smear-positive or negative. In this study, we analyzed the sputum smear results of all patients diagnosed to have PTB during the time under review. METHODS: The study was a retrospective study done with records of patients diagnosed with PTB between July 2009 and July 2011. The sample size was 305. AIM: To determine the smear patterns in pulmonary tuberculosis and its relationship with HIV status. RESULTS: There was slight male preponderance among the study group. 37% were found to be smear positive, out of which 63.7% and 36.3% were males and females respectively. The highest frequency was between 21-40 years and in this age group there were more males than females.72.1% wereTB/HIV co-infected and 29.1% of the TB/HIV co-infected patients had smear-positiveTuberculosis. CONCLUSION: There is a high burden of TB/HIV co-infection affecting predominantly the youths. Sputum smear results in TB/HIV co-infection are largely negative. There is the need for provision of other diagnostic tests to improve the diagnosis of TB in our environment and targeted intervention among the youth to reduce the burden of TB/HIV.

Frequency of cryptococcal meningitis in HIV-1 infected patients in north central Nigeria.

BACKGROUND: Cryptococcal meningitis (CM) is the most common severe life threatening fungal infection in AIDS patients. It is an important cause of morbidity and mortality There is paucity of data on the prevalence of CM in Nigeria. We aimed to determine the frequency of CM, the clinical presentation and immunological profile. METHODS: A cross sectional study was carried out at the Jos University Teaching Hospital (JUTH). A total of 100 HIV-1 infected patients suspected of having meningitis or meningoencephalitis were subjected to cerebrospinal fluid (CSF) analysis (including Indian ink preparation and fungal culture by conventional methods) and CD4 count was determined using flow cytometry (count bit Y-R 1004 Partec Muster Germany). RESULTS: The freguency of CM was 36% in our cohort. The commonest clinical presentation included headache (100.0%), neck stiffness (77.8%), fever (72.0%), vomiting 55.6%), personality changes (55.6%), photophobia (27.8%) and convulsions (27.8%). The mean duration of symptoms was 24 +/- 22 days with a median of 17 days. The mean CD4 count was 89 +/- 60 cells/mm3 with a median of 82 cells/mm3. CONCLUSION: The high prevalence of CM and the associated severe immunosuppression underscores the importance of early diagnosis of HIV infection which may reduce the incidence of CM. There is the urgent need for access to Amphotericin B and fluconazole in resource constrained settings in addition to a wide access to HAART.