Quality of life of family caregivers of children with orofacial clefts in Nigeria: a mixed-method study.

BACKGROUND: Orofacial clefts (OFCs) are common birth defects that may impose a large burden on the health and psychosocioeconomic well-being of affected individuals and families. This study aims to identify qualitative factors that affect the quality of life (QOL) of family caregivers of children with OFCs. METHODS: A mixed-method study in which family caregivers of OFCs children were consecutively recruited from cleft clinics over a 3-month period. Quantitative data were analyzed using SPSS version 17 and focus group discussion by framework analysis. RESULTS: A total of 107 caregivers participated in the entire study, and 24 caregivers participated in the focus group discussions. About 50% of the children had cleft lip and palate (CLP), 28% with cleft lips only (CL) and 23.4% with cleft palate only (CP). Poor access to specific information and lack of empathy of professionals affected the quality of life and delivery of family-centered care. CONCLUSIONS: To improve the quality of life of family caregivers, individual-focused counseling sessions should be organized for caregivers soon after birth. This will provide an opportunity to discuss the laid out plans for supportive care. It will also be as an avenue to address the arising social issues by health professionals and counselors.

Evaluation of a health resources management course for Nigerian doctors.

AIMS AND OBJECTIVES: This study aimed to evaluate the March 2010 edition of the regular biannual two-week course on health resources management organised by the National Postgraduate Medical College of Nigeria. The main objectives were to assess participants' perception of the course and to measure change in their knowledge brought about by the course. SUBJECTS AND METHODS: This is a primarily cross-sectional study but with a before and after component. The study population comprised all participants who attended the course. Data were collected using pre-tested structured self- administered questionnaires. Data analysis was done with Epi Info 3.5.1. Student's T-test was used to compare mean scores at pre-test and post-test and the p-value of <0.05 was considered statistically significant. RESULTS: Majority (95.8%) of the participants were senior registrars from teaching hospitals and most of them (70.5%) claimed the course met their needs a great deal/to a large extent. The participants were satisfied to a varying degree with different aspects of the course but overall 50.9% claimed they got value for their money. There was a statistically significant difference in the knowledge score at pre- and post-test (t = 3.19, p = 0.002). CONCLUSION: The course met the needs of the participants largely and was able to improve their knowledge of health resources management as intended. A behaviour evaluation is recommended in order to assess the usefulness of the course to participants' practice.

Screening for diabetes mellitus and human immunodefiency virus infection in persons with tuberculosis.

INTRODUCTION: Nigeria is a country saddled with a high tuberculosis (TB) and human immunodeficiency virus (HIV) burden but the possible combination of these communicable diseases with diabetes mellitus (DM) has been overlooked. We undertook to determine the burden of HIV and DM in persons with TB by documenting the prevalence rates of these disorders. METHODS: This is a cross-sectional Study that was conducted within 54TB/DOT centers in Lagos State. A total of 3,376 persons with TB who were on antiTB drugs were screened for HIV and DM using standardized tests. Statistical analysis was performed using Students t test and chi square. RESULTS: The frequency of occurrence of DM in TB and that of HIV in TB were comparable (4.8% Vs 3.5%). The Study subjects with DM were older, had higher waist circumference measurements and had higher proportions of hypertension compared to the subjects without DM. The combination of HIV and DM in TB was found in (0.3%). We also noted that DM in TB and HIV in TB occurred more frequently in the third and fourth decades of life. CONCLUSION: This study demonstrated the potential co existence of HIV, DM and Tuberculosis. It is therefore important that these two diseases are sought for in patients with TB considering the changing epidemiology of these diseases particularly in developing countries like Nigeria.

An observational survey of child car safety practices in private pre-primary and primary schools in two local government areas of Lagos State, Nigeria.

OBJECTIVE: To describe child car safety practices among children aged 0-8 years. Eight schools from two local government areas (LGAs) were selected by simple random sampling. Passenger cars were observed for child seating position and restraint use at each selected school as children were being dropped off in the morning. RESULTS: Observed child restraint use was very low, as was the rate of appropriate restraint for age (10.8% and 4.2%, respectively, in Eti-Osa, and 7.0% and 1.8% in Ikeja). Child restraint use decreased with increasing age group from 25% in those below 1 year, to 12% in those aged 1-3 years, and 7.4% in those aged 4-8 years. A large proportion of restrained passengers were inappropriately restrained in a seatbelt alone. Front seating among observed child passengers was not as high as in studies from similar environments (9.4% and 17.5% in Eti-Osa and Ikeja, respectively). Factors associated with child restraint use were number of child passengers in car, and whether or not the driver wore a seatbelt. Seating position of the child was significantly associated with the relationship of the driver to the child, and driver's gender. CONCLUSION: The level of child restraint use observed in this study is unacceptably low. The relatively low prevalence of front seating while riding in cars should however be further reduced. The study recommends the enactment of specific country legislation on the use of child restraints, accompanied by multifaceted intervention programmes to improve the availability and use of child car safety seats and booster seats.

Evaluation of rational prescribing practices of doctors and medical students at the Igbo-Ora Comprehensive Hospital, Nigeria.

This study was done to determine the level of rational drug prescribing practices by doctors and medical students as well as to assess the impact of the teaching of rational drug use on the prescribing skills of students. A checklist, developed according to the key indices of a rational prescription, was used to rate prescriptions obtained from randomly selected case notes in the period 1975, 1985 and 1995 by means of a scoring system. Mean score of students increased from 5.5(out of 10) in 1975 to 7.7 in 1985(p < 0.001) but showed a significant decline to 6.8 in the period 1995(p = 0.117). Mean score of doctors was 7.1 in 1975, 6.8 in 1985(p = 0.616) and 6.8 in 1995(p = 0.910). Comparison of mean scores of doctors and students for each period revealed a significant difference only in 1975(p = 0.012) The teaching of rational drug use had improved the rational prescribing practices of medical students. There is need for a sustained effort to maintain rational drug prescribing by students and doctors in Igbo-ora hospital. Similar efforts should be made in other places in the country.

Students admission grades and their performance at Ibadan University pre-clinical MBBS examinations.

OBJECTIVE: The main objective of this study was to examine the admission grades in Senior School Certificate Examinations (SSCE) and Joint Admission Matriculation Board (JAMB) Examinations in relation to their performance at the pre-clinical class, at the University of Ibadan medical school. A descriptive, cross sectional study was carried out from December 1998-April 1999. Records of students' admitted into the medical school in 1991/92 session were studied. The results showed a stronger correlation in the performance of the students at the 100 level examination and the Part 1 MBBS examination with the SSCE grades than their JAMB scores. Students admitted on merit according to JAMB scores performed averagely better than their other counterpart with lower JAMB scores. This result demonstrated that the SSCE scores are a better predictor of performance at preclinical MBBS examination than the JAMB scores. More attention needs to be placed on the quality of SSCE scores during admission into the medical school.

Prevalence of low back pain among staff in a rural hospital in Nigeria.

A cross-sectional study was carried out in a rural hospital in south-western Nigeria to determine the prevalence of low back pain among its staff. The questionnaire administered to staff sought information on social and demographic characteristics, job history, smoking status, frequency and severity of low back pain and factors predisposing to low back pain. Seventy-four out of a total of 80 workers participated in the study. The prevalence of low back pain among staff was 46%. The highest prevalence of back pain (69%) was recorded among nursing staff, followed by secretaries/administrative staff (55%) and cleaners/aides (47%). Heavy physical work (45%), poor posture (20%) and prolonged standing or sitting (20%) were the most frequent activities reported to be associated with low back pain among these workers. The prevalence of low back pain among these workers is comparable to that of workers in high income countries. Health education on posture and correct lifting techniques can be introduced to reduce the burden of low back pain among these workers.