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Pan Afr Med J ; 33: 277, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692880


Introduction: Adherence is vital to effective antiretroviral therapy (ART) for reducing viral load and HIV/AIDS-related morbidity and mortality. This study was aimed at evaluating the adherence of HIV seropositive patients to ART in a tertiary institution in Nigeria. Methods: A cross sectional observational study was conducted among 400 HIV seropositive patients. The study was carried out between December 2016 and February 2017 at the HIV clinic of the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Results: The mean age of the HIV patients was 42.2±9.5 years with a predominant female gender (Male:Female = 1:2.8). The median CD4 counts increased from 302.1±15.0cells/mm3 at diagnosis to 430.8±13.3cells/mm3 at the time of the study. Majority of participants were unaware of their spouses' HIV status (59.3%) while 32.5% of participants had a serodiscordant spouse. Poverty was a major challenge as 73.3% earned less than 140 dollars per month. Depressive symptoms, anxiety disorder and insomnia were also reported in 40.7%, 33.2% and 47.2% respectively. Poor adherence to ART was observed in almost 20% of the patients. Logistic regression indicated that predictors of poor adherence were depression, anxiety and low CD4 counts. Conclusion: Adherence to anti-retroviral therapy was good amongst the majority of HIV seropositive patients. Depression, anxiety disorder and low CD4 count were however associated with poor adherence. This emphasizes the role of the psychology units as integral part of the HIV clinic to assist patients' adherence to anti-retroviral regimens.

Fármacos Anti-HIV/administração & dosagem , Contagem de Linfócito CD4 , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Adulto , Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Infecções por HIV/psicologia , Humanos , Masculino , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Nigéria , Inquéritos e Questionários
ERJ Open Res ; 4(1)2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29450202


Learn about the @ERStalk course on acute respiratory pandemics

Ethiop J Health Sci ; 27(4): 331-338, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29217935


Background: Bronchoscopy is a vital diagnostic and therapeutic procedure in pulmonological practice. The aim of this study was to determine the perception, use and challenges encountered by Nigerian medical doctors involved in this procedure. Materials and Methods: A cross-sectional study was conducted among 250 medical doctors recruited from three major tertiary institutions in Nigeria between September 2013 and June 2014. A semi-structured questionnaire was self-administered to adult physicians, paediatricians, and surgeons as well as their trainees to obtain their perception, use and associated challenges in the use of bronchoscopy in clinical practice. Results: The majority (91.6%) of the respondents perceived bronchoscopy as a beneficial procedure to respiratory medicine. However, 59.2% of them were not aware of the low mortality rate associated with this procedure. The commonest indications for bronchoscopic use were foreign body aspiration (88.8%) and management of lung tumors (75.6%). Only 21 (8.4%) of the respondents had received formal training in bronchoscopy. Very few procedures (1-5 cases per month) were performed. The respondents identified the lack of formal training in the art of bronchoscopy as the foremost challenge facing its practice in Nigeria. In addition, availability of bronchoscopes, level of awareness, knowledge of the procedure among medical doctors and the cost of the procedure were the challenges faced by the medical doctors. Conclusion: There is an urgent need to equip training centers with modern bronchoscopic facilities. In addition,well-structured bronchoscopic training programme is imperative to enhance the trainees' proficiency for the furtherance of bronchoscopic practice.

Atitude do Pessoal de Saúde , Broncoscopia , Competência Clínica , Padrões de Prática Médica , Adulto , Conscientização , Broncoscópios/economia , Broncoscópios/estatística & dados numéricos , Broncoscopia/educação , Broncoscopia/estatística & dados numéricos , Estudos Transversais , Feminino , Corpos Estranhos , Recursos em Saúde , Humanos , Neoplasias Pulmonares , Masculino , Pessoa de Meia-Idade , Nigéria , Percepção , Médicos , Pneumologia/economia , Pneumologia/educação , Inquéritos e Questionários
Niger Med J ; 57(6): 339-346, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27942102


BACKGROUND: To audit the quality of acute asthma care in two tertiary hospitals in a state in the southwestern region of Nigeria and to compare the clinical practice against the recommendations of the Global Initiative for Asthma (GINA) guideline. PATIENTS AND METHODS: We carried out a retrospective analysis of 101 patients who presented with acute exacerbation of asthma to the hospital between November 2010 and October 2015. RESULTS: Majority of the cases were females (66.3%), <45 years of age (60.4%), and admitted in the wet season (64.4%). The median duration of hospital stay was 2 days (interquartile range; 1-3 days) and the mortality was 1.0%. At admission, 73 (72.3%) patients had their triggering factors documented and 33 (32.7%) had their severity assessed. Smoking status, medication adherence, serial oxygen saturation, and peak expiratory flow rate measurement were documented in less than half of the cases, respectively. Seventy-six (75.2%) patients had nebulized salbutamol, 89 (88.1%) had systemic corticosteroid, and 78 (77.2%) had within 1 h. On discharge, 68 (67.3%) patients were given follow-up appointment and 32 (31.7%) were reviewed within 30 days after discharge. Less than half were prescribed an inhaled corticosteroid (ICS), a self-management plan, or had their inhaler technique reviewed or controller medications adjusted. Overall, adherence to the GINA guideline was not satisfactory and was very poor among the medical officers. CONCLUSION: The quality of acute asthma care in our setting is not satisfactory, and there is a low level of compliance with most recommendations of asthma guidelines. This audit has implicated the need to address the non-performing areas and organizational issues to improve the quality of care.

N Am J Med Sci ; 5(5): 325-9, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23814764


BACKGROUND: Left ventricular hypertrophy (LVH) as a marker of cardiac damage in hypertension has important prognostic implications. With high prevalence of hypertension in Nigeria and the untoward effect of LVH, it is essential that the prevalence of LVH be determined. AIMS: To determine prevalence of LVH and its severity in clinical practice among hypertensive patients referred for echocardiographic assessment in Nigeria. MATERIALS AND METHODS: Devereux and Troy formulae were used to calculate echocardiographic LV mass (LVM) in 401 subjects and thereafter normalized to body surface area (BSA), heigth(2) (ht(2)) and height(2.7) (ht(2.7)) to define LVH to standard gender-specific thresholds. RESULTS: Mean age was 53.22 ± 16.56 years (male = 53.18 ± 15.80; female = 53.27 ± 17.43; P = 0.958) with a male:female ratio of 1.13:1. Prevalence rates of LVH ranged between 38.9-51.3% using the Devereux Formula and 62.4-71.1% using the Troy formula. LVM/(ht(2.7)) using the Troy formula gave the highest prevalence rate of LVH. Majority of the patients with LVH had severe form of hypertrophy with the prevalence rates ranging from 22.3% (LVM/BSA; Devereux formula) to 47.1% (LVM/ht(2.7); Troy formula). CONCLUSION: Prevalence of LVH by any echocardiographic criteria is high. There is a need to come to a consensus on the best formula and indexing variables, that will unify the reporting of LVH.

Pan Afr Med J ; 16: 20, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24498469


INTRODUCTION: The prevalence of asthma in our society is rising and there is need for better understanding of the asthma patients' perception and treatment practice of physicians. The study was aimed at determining asthma attitudes and treatment practices among adult physicians and patients in Nigeria, with the goal of identifying barriers to optimal management. METHODS: To assess asthma attitudes, treatment practices and limitations among adult physicians and patients in Nigeria, a questionnaire survey was conducted among 150 patients and 70 physicians. RESULTS: Majority (66.7%) of the patients reported their asthma as moderate to severe, 42.7% had emergency room visit and 32% had admission due to asthma in the previous 12 months. Physicians and patients perceptions significantly differed in the time devoted to educational issues (31.4% vs.18.7%) and its contents: individual management plan (64.3% vs.33.3%), correct inhaler technique (84.0% vs.71.0%), medication side effects (80.0% vs.60.0%) and compliance 100% of time (5.7% vs. 18.7%). Patients reported that non-compliance with medication causes increased symptoms (67.0%), exacerbations (60.0%), bronchodilator use (56.0%), urgent physician visit (52.0%) and hospitalizations /ER visits (38.7%). Asthma medication in patients caused short term (10.7%) and long term side effects (20.0%). Due to side effects, 28.0% skipped and stopped their medications. Most physicians (85.7%) and patients (56.0%) agreed on the need for new medication options. The need for new medication in patients was strongly related to asthma severity, limitation of activities, side effects, cost and lack of satisfaction with current medication. With the exception of pulmonologists, physicians did not readily prescribe ICS and their prescriptions were not in line with treatment guidelines. CONCLUSION: This study has highlighted the gaps and barriers to asthma treatment which need to be addressed to improve the quality of care in Nigeria.

Asma/terapia , Recursos em Saúde/provisão & distribução , Necessidades e Demandas de Serviços de Saúde , Percepção , Pobreza , Prática Profissional/estatística & dados numéricos , Adulto , Asma/economia , Asma/epidemiologia , Asma/psicologia , Estudos Transversais , Feminino , Recursos em Saúde/economia , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Relações Médico-Paciente , Prática Profissional/economia , Adulto Jovem