Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 30.567
Filtrar
1.
BMC Res Notes ; 14(1): 250, 2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34193253

RESUMO

OBJECTIVE: This study was designed to explore the patterns of financial incentives received by some frontline health workers (including nurses, midwives as well as community health workers in paid employment) and the implications for their productivity within rural settings in Nigeria. A cross-sectional quantitative design in two States in Nigeria was adopted. Structured interviews were conducted with 114 frontline health workers. Bivariate analysis and multivariate regression analysis were carried out to explore relationships between the satisfaction of frontline health workers with the financial incentives received and their productivity in rural settings as well as the extent of any such relationships. RESULTS: Bivariate analysis demonstrated a statistically significant relationship (P = 0.013) between satisfaction with incentives received by frontline health workers and their productivity in rural settings. When other predictors were controlled for within a multivariate regression model, those who received incentives and were satisfied with the incentives were about three times more likely to be more productive at work than those who were unsatisfied with incentives (AOR: 3.3; P = 0.009, 95% CI = 1.3-8.2). In conclusion, the determination of type and content of incentives should be done in consultation with all relevant stakeholders, including possibly a cross-section of health workers themselves.


Assuntos
Pessoal de Saúde , Motivação , Estudos Transversais , Mão de Obra em Saúde , Humanos , Nigéria , Atenção Primária à Saúde
2.
Otol Neurotol ; 42(7): 1031-1038, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34260507

RESUMO

OBJECTIVE: To assess the prognostic value of the Japanese Otological Society (JOS), EAONO-JOS, and STAMCO classifications in predicting the severity of acquired cholesteatoma and to identify other factors that could influence residual and recurrent cholesteatoma, as well as adverse events (AE). METHOD: A retrospective chart review of patients undergoing primary cholesteatoma surgery in our tertiary referral center. Primary outcome measures were based on three groups of follow-up (FU): Group A, studying residual cholesteatoma, FU > 52 weeks of last-look surgery or magnetic resonance imaging, diffusion-weighted imaging; group B, studying recurrent disease, FU > 52 weeks of last outpatient clinic visit; and group C, studying AE, FU > 12 weeks after surgery. Cholesteatomata were staged according to the JOS, EAONO-JOS, and STAMCO classifications. Kaplan-Meier curves were used to determine the prognostic value of the various classifications and to identify other determining factors, while correcting for FU. RESULTS: FU was found to be a significant confounder. No correlation was found between staging and the occurrence of residual or recurrent disease, nor the occurrence of AE. Type of surgery was a significant determinant of all three primary outcome measures. A higher age was associated with a lower risk of residual disease. CONCLUSION: In our population the JOS, EAONO-JOS, and STAMCO classifications have limited prognostic value. Three main confounders were identified that pose a challenge in developing a universal classification: FU, surgery type, and age. Cholesteatoma staging should be postponed until a system is developed which significantly correlates cholesteatoma stage to cholesteatoma severity, to have implications for management strategies.


Assuntos
Colesteatoma da Orelha Média , Reincidência , Colesteatoma da Orelha Média/diagnóstico por imagem , Colesteatoma da Orelha Média/cirurgia , Humanos , Nigéria , Prognóstico , Estudos Retrospectivos
3.
BMC Health Serv Res ; 21(1): 685, 2021 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-34247604

RESUMO

BACKGROUND: In sub-Saharan Africa, there is increasing mortality and morbidity of adolescents due to poor linkage, retention in HIV care and adherence to antiretroviral therapy (ART). This is a result of limited adolescent-centred service delivery interventions. This cost-effectiveness and feasibility study were piggybacked on a cluster-randomized trial that assessed the impact of an adolescent-centred service delivery intervention. The service delivery intervention examined the impact of an incentive scheme consisting of conditional economic incentives and motivational interviewing on the health outcomes of adolescents living with HIV in Nigeria. METHOD: A cost-effectiveness analysis from the healthcare provider's perspective was performed to assess the cost per additional patient achieving undetected viral load through the proposed intervention. The cost-effectiveness of the incentive scheme over routine care was estimated using the incremental cost-effectiveness ratio (ICER), expressed as cost/patient who achieved an undetectable viral load. We performed a univariate sensitivity analysis to examine the effect of key parameters on the ICER. An in-depth interview was conducted on the healthcare personnel in the intervention arm to explore the feasibility of implementing the service delivery intervention in HIV treatment hospitals in Nigeria. RESULT: The ICER of the Incentive Scheme intervention compared to routine care was US$1419 per additional patient with undetectable viral load. Going by the cost-effectiveness threshold of US$1137 per quality-adjusted life-years suggested by Woods et al., 2016, the intervention was not cost-effective. The sensitivity test showed that the intervention will be cost-effective if the frequency of CD4 count and viral load tests are reduced from quarterly to triannually. Healthcare professionals reported that patients' acceptance of the intervention was very high. CONCLUSION: The conditional economic incentives and motivational interviewing was not cost-effective, but can become cost-effective if the frequency of HIV quality of life indicator tests are performed 1-3 times per annum. Patients' acceptance of the intervention was very high. However, healthcare professionals believed that sustaining the intervention may be difficult unless factors such as government commitment and healthcare provider diligence are duly addressed. TRIAL REGISTRATION: This trial is registered in the WHO International Clinical Trials Registry through the WHO International Registry Network ( PACTR201806003040425 ).


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Entrevista Motivacional , Adolescente , Fármacos Anti-HIV/uso terapêutico , Análise Custo-Benefício , Estudos de Viabilidade , Infecções por HIV/tratamento farmacológico , Humanos , Motivação , Nigéria , Avaliação de Resultados em Cuidados de Saúde , Qualidade de Vida
4.
Artigo em Inglês | MEDLINE | ID: mdl-34200305

RESUMO

Public-private partnerships (PPP) represent an alternative model of health management focused on improving the quality of health services, particularly in emerging countries. To date, a systematic method to improve the perceived quality of health services by healthcare users in Peru has not been established. The purpose of this study was to evaluate the quality of health services in two PPP hospitals in Peru using the Kano model. A prospective cross-sectional descriptive observational study was carried out through a health service satisfaction survey using the Kano model methodology, measuring six categories of attributes. A total of 250 users of the health services were surveyed in the two PPP hospitals, located in Lima and Callao, using non-probability convenience sampling. Of the 31 attributes evaluated by the patients, 27 (81%) were classified as having a one-dimensional-type attribute, 3 (10%) were reported as mandatory, and 1 (3%) was considered as inverse. These results suggest that the presence of most of the attributes evaluated was relevant to maintaining the level of user satisfaction and that the absence of these attributes generated dissatisfaction in the users. The results showed that the users' evaluation of health services was multidimensional-namely, their evaluation was focused not only on the interaction space between the patient and medical personnel but also addressed other interaction services.


Assuntos
Serviços de Saúde , Satisfação do Paciente , Estudos Transversais , Humanos , Nigéria , Peru , Estudos Prospectivos , Qualidade da Assistência à Saúde
5.
Global Health ; 17(1): 79, 2021 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-34243790

RESUMO

BACKGROUND: Lagos state is the industrial nerve centre of Nigeria and was the epicentre of the 2014 Ebola outbreak in Nigeria as it is now for the current Coronavirus Disease (COVID-19) outbreak. This paper describes how the lessons learned from the Ebola outbreak in 2014 informed the emergency preparedness of the State ahead of the COVID-19 outbreak and guided response. DISCUSSION: Following the Ebola outbreak in 2014, the Lagos State government provided governance by developing a policy on emergency preparedness and biosecurity and provided oversight and coordination of emergency preparedness strategies. Capacities for emergency response were strengthened by training key staff, developing a robust surveillance system, and setting up a Biosafety Level 3 laboratory and biobank. Resource provision, in terms of finances and trained personnel for emergencies was prioritized by the government. With the onset of COVID-19, Lagos state was able to respond promptly to the outbreak using the centralized Incident Command Structure and the key activities of the Emergency Operations Centre. Contributory to effective response were partnerships with the private sectors, community engagement and political commitment. CONCLUSION: Using the lessons learned from the 2014 Ebola outbreak, Lagos State had gradually prepared its healthcare system for a pandemic such as COVID-19. The State needs to continue to expand its preparedness to be more resilient and future proof to respond to disease outbreaks. Looking beyond intra-state gains, lessons and identified best practices from the past and present should be shared with other states and countries.


Assuntos
COVID-19/prevenção & controle , Surtos de Doenças/prevenção & controle , Doença pelo Vírus Ebola/prevenção & controle , COVID-19/epidemiologia , Doença pelo Vírus Ebola/epidemiologia , Humanos , Nigéria/epidemiologia
6.
Environ Monit Assess ; 193(8): 477, 2021 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-34232399

RESUMO

Fluoride enrichment of groundwater has been adjudged to be a global environmental challenge in the past decade as most humans depend on groundwater for their domestic needs. This study was conducted to investigate the ionic and fluoride concentrations in borehole water and its associated health risk potentials to residents of Makurdi town and its environs, Benue state, Nigeria. Multivariate statistical techniques were for the first time used to explain the mechanisms of fluoride occurrence in groundwater in the study area. An aggregate of sixty-three (63) groundwater samples were retrieved from boreholes in twenty-one (21) diverse points within the study area and assessed for its physico-chemical composition with emphasis on fluoride content and health risk potentials following standard field and laboratory procedures. It was observed that fluoride content in the sampled water exceeded the stipulated safe limit of 1.5 mg/L in about 33.33% of the total samples and ranged from 0.34 to 2.06 mg/L with an average of 1.26 ± 0.41 mg/L. Moderate affirmative relationships were observed to exist between F- and TDS, F- and EC, F- and Cl-, and F- and NO3- in the water samples indicative of a common source pollution. Principal component analysis (PCA) revealed that high fluoride content in the water samples was associated with the dissolutions from quartzite and shale into the underlying deep aquifers as well as from contributions from anthropogenic activities including fertilizer and pesticide uses. Fluoride risk assessment indicated that the hazard quotient (HQ) for ingestion of fluoride laden water exceeded the threshold value in 66.7, 71.4, 52.4, and 9.5% of the samples for infants, children, teenagers, and adults respectively. It was found that multivariate statistical procedures such as PCA and correlation analysis (CA) are capable of establishing the relationship among groundwater pollutants, while hierarchical cluster analysis (HCA) was found suitable for explaining the likely sources/processes of pollutant enrichment in the groundwater. It is recommended that the findings of this study would serve as a basis for policy makers and regulatory bodies towards ameliorating the menace of groundwater contamination within the study area.


Assuntos
Água Subterrânea , Poluentes Químicos da Água , Adolescente , Adulto , Criança , Monitoramento Ambiental , Fluoretos/análise , Humanos , Lactente , Nigéria , Medição de Risco , Poluentes Químicos da Água/análise
8.
Afr J AIDS Res ; 20(2): 181-188, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34264164

RESUMO

Despite global calls for stronger linkages between family planning and HIV, a growing body of evidence in sub-Saharan Africa suggests that the integration of family planning and HIV service delivery is suboptimal in some countries. In this study, we assess the integration and quality of family planning services in health facilities that provide HIV-related services in Nigeria. This study analysed secondary data from the Performance Monitoring and Accountability 2020 cross-sectional survey conducted between May and July 2016 in seven states in Nigeria. Our study sample was restricted to 290 health facilities providing HIV services. We performed descriptive statistics and binary logistic regression analyses. Ninety-five per cent of the health facilities reported offering family planning counselling, provision of family planning methods, and/or referral for family planning methods to clients accessing HIV services. About 84% of these health facilities with integrated family planning and HIV services reported that they discussed the preferred method, dual methods, instructions and side effects of the chosen method, and the reproductive intentions with clients during an HIV consultation. None of the health facilities' characteristics was significantly associated with the integration of family planning services into HIV services. Private health facilities (aOR 0.3, 95% CI 0.07-0.92), urban health facilities (aOR 3.8, 95% CI 1.64-8.76), and provision of postnatal care (aOR 3.9, 95% CI 1.10-13.74) were statistically associated with the quality of family planning services provided to clients accessing HIV services. Family planning services were integrated into HIV services in a majority of the health facilities in our study. However, our findings indicate the need for improvement in the quality of family planning services provided to clients accessing HIV services.


Assuntos
Prestação Integrada de Cuidados de Saúde/estatística & dados numéricos , Serviços de Planejamento Familiar/estatística & dados numéricos , Infecções por HIV/terapia , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Estudos Transversais , Prestação Integrada de Cuidados de Saúde/métodos , Serviços de Planejamento Familiar/métodos , Infecções por HIV/epidemiologia , Instalações de Saúde/estatística & dados numéricos , Humanos , Nigéria/epidemiologia , Encaminhamento e Consulta/estatística & dados numéricos , Educação Sexual/estatística & dados numéricos
9.
Trials ; 22(1): 470, 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34289884

RESUMO

BACKGROUND: Knee osteoarthritis (OA) is a common painful and disabling condition that affects older individuals. Proprioceptive training programs in the form of kinesthesia, balance and agility (KBA) exercises have been reported to be beneficial for individuals with knee OA. However, the most optimal training dosage of KBA exercises is still unclear. The aim of this study is to determine the effects of different frequencies of KBA training (i.e., twice-weekly or thrice-weekly) in adults with knee OA. METHODS: A single (assessor) blind, three-arm parallel, multi-center randomized controlled trial will be conducted. One hundred twenty adults with knee OA will be recruited from four tertiary hospitals in Northwestern Nigeria and randomly assigned into one of three intervention groups; twice-weekly KBA (n = 40), thrice-weekly KBA (n = 40), and conventional physiotherapy (n = 40) in the ratio of 1:1:1. Participants in the conventional physiotherapy group will receive two sessions of brief patient education, and sixteen sessions of ultrasound therapy, and stretching and strengthening exercises for 8 weeks. Participants in the two different KBA groups will receive KBA training according to the designed sessions for 8 weeks in addition to the conventional physiotherapy program. All groups will be assessed pre-intervention, immediately post-intervention and at 3 months, 4 months, and 6 months post-randomization. The primary outcome will be physical function (Ibadan Knee and Hip Osteoarthritis Outcome Measure) whereas the secondary outcomes will be pain intensity (Visual Analogue Scale for pain), knee stability (Knee Outcome Survey-Activities of Daily Living Scale), proprioception (electronic goniometer), and quality of life (Osteoarthritis Knee and Hip Quality of Life Questionnaire). DISCUSSION: The findings of this study may provide evidence on the effectiveness of KBA exercise training and the ideal number of sessions needed to achieve the highest effectiveness in adults with knee OA. TRIAL REGISTRATION: Pan African Clinical Trials Registry ( PACTR201810713260138 ). Registered on 28 November 2017.


Assuntos
Osteoartrite do Joelho , Atividades Cotidianas , Adulto , Exercício Físico , Terapia por Exercício , Humanos , Cinestesia , Estudos Multicêntricos como Assunto , Nigéria , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/terapia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
10.
BMC Health Serv Res ; 21(1): 711, 2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34284785

RESUMO

BACKGROUND: Scaling up continuous quality improvement (CQI) processes could be key in achieving the 95:95:95 cascade and global HIV targets. This paper describes the experiences and outcomes related to implementing CQI processes to help reach these targets, with particular focus on clinical and programmatic settings in 6 countries from the global south. METHODS: The HIV program at the University of Maryland, Baltimore (UMB) implemented an adapted CQI model in Kenya, Tanzania, Botswana, Zambia, Nigeria and Rwanda that included the following steps: (1) analysing the problem to identify goals and objectives for improvement; (2) developing individual changes or 'change packages', (3) developing a monitoring system to measure improvements; and (4) implementing and measuring changes through continuous 'plan-do-study-act' (PDSA) cycles. We describe country-level experiences related to implementing this adaptive design, a collaborative learning and scale-up/sustainability model that addresses the 95:95:95 global HIV targets via a CQI learning network, and mechanisms for fostering communication and the sharing of ideas and results; we describe trends both before and after model implementation. RESULTS: Our selected country-level experiences based on implementing our CQI approach resulted in an increased partner testing acceptance rate from 21.7 to 48.2 % in Rwanda, which resulted in an increase in the HIV testing yield from 2.1 to 6.3 %. In Botswana, the overall linkage to treatment improved from 63 to 94 %, while in Kenya, the viral load testing uptake among paediatric and adolescent patients improved from 65 to 96 %, and the viral load suppression improved from 53 to 88 %. CONCLUSIONS: Adopting CQI processes is a useful approach for accelerating progress towards the attainment of the global 95:95:95 HIV targets. This paper also highlights the value of institutionalizing CQI processes and building the capacity of Ministry of Health (MoH) personnel in sub-Saharan Africa for the effective quality improvement of HIV programs and subsequent sustainability efforts.


Assuntos
Infecções por HIV , Melhoria de Qualidade , Adolescente , Baltimore , Botsuana , Criança , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Institucionalização , Quênia/epidemiologia , Nigéria , Ruanda , Tanzânia , Zâmbia
11.
Niger J Clin Pract ; 24(7): 978-985, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34290172

RESUMO

Background: Self-care practices in individuals with diabetes are important skills required to effectively prevent, manage, and limit complications associated with diabetes since patients spend considerably less time with health care providers than spend alone to manage their diabetes condition. Aims: The aim of the study was to assess self-cate practices and their determinants among patients with type 2 diabetes. Hence, this study aimed at assessing self-care practices and their determinants among patients with type 2 diabetes. Materials and Methods: This cross-sectional, descriptive, multi-center study was conducted among 348 type 2 diabetes patients selected from six tertiary hospitals in Southwest Nigeria. Descriptive statistical analysis was employed for categorical and continuous variables and multivariable logistic regression assessed association between determinant factors and adherence to self-monitoring of blood glucose (SMBG). Results: Of the study participants, 83.1%, 66.9%, 28.4%, and 27.9% adhered to prescribed medications, physical exercise, had meal plans incorporated into their diabetes management and SMBG, respectively. There was a statistically significant association between male gender, duration of diabetes, and previous episode of hypoglycemia with adherence to SMBG practices while lower educational level and use of insulin were associated with less likelihood of adherence to prescribed medications. Conclusion: The degree to which individuals with diabetes adhered to recommended self-care practice components were less than satisfactory especially SMBG, physical activity, and having meal plans.


Assuntos
Diabetes Mellitus Tipo 2 , Glicemia , Automonitorização da Glicemia , Estudos Transversais , Diabetes Mellitus Tipo 2/terapia , Humanos , Masculino , Nigéria , Autocuidado
12.
Niger J Clin Pract ; 24(7): 1015-1021, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34290177

RESUMO

Background: The relationship between body mass index (BMI) and health-related quality of life (HRQoL) in adolescence is important but there is a dearth of this information among developing countries such as Nigeria. To assess the relationship between BMI and HRQoL among healthy schooling adolescents in Southwestern Nigeria. Aims: We assessed the relationship between BMI and HRQoL among healthy schooling adolescents in southwestern Nigeria. Methods: In a cross-sectional study design, 650 adolescents were selected and interviewed about their quality of life in the preceding 1 month using a validated instrument with contents adapted from the Pediatric Quality of Life Inventory (PedsQLTM) questionnaire. The BMI was calculated and plotted on the Center for Disease Control and Prevention percentile chart to categorize as underweight, normal, overweight, or obese. Comparisons were made using Student's t-test, ANOVA, and linear regression model at P = 0.05. Results: Participants mean BMI and overall HRQoL score was 19.0 ± 3.0 kg/m2 and 73.7 ± 11.7, respectively. The prevalence of underweight, overweight, and obesity was 6.9%, 2.3%, and 0.6%, respectively. Females (72.3 ± 12.2) had a significantly lower overall mean HRQoL score than males (75.0 ± 11.1), P = 0.048. Post-hoc ANOVA showed that obese adolescents had significantly lower mean HRQoL in school functioning domain (55.0 ± 20.8) than underweight (83.5 ± 14.), and normal BMI (81.3 ± 16.3) participants (P < 0.05). Conclusion: Obesity reduces HRQoL in the school functioning domain among adolescents in Ibadan, Nigeria. Our finding buttresses the need to monitor body mass and size in high schools for enhancing quality of life.


Assuntos
Obesidade , Qualidade de Vida , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria/epidemiologia , Obesidade/epidemiologia , Instituições Acadêmicas
13.
Niger J Clin Pract ; 24(7): 1022-1027, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34290178

RESUMO

Background: Infertility is a public health challenge and it is a distressing personal tragedy for couples, more so for the female partners. Risk factors and causes of infertility vary from region to region. Reactive species is of current interest in the pathogenesis and management of infertility, especially in the Niger-Delta Region of Nigeria where environmental hazards of oil exploration exists. Aim: The overall goal of this study was to determine and compare the serum reactive species levels (nitric oxide) in fertile and infertile women attending the infertility clinic at the Delta State University Teaching Hospital, Oghara, and Central Hospital, Warri. Methods: This was a prospective case-control study in which 70 women evaluated for infertility were recruited into the study. A fertile patient matched for age and body mass index (BMI) attending family planning clinic was selected as control. Serum nitric oxide estimation was done using the BioVision Nitric Oxide Colorimetric Assay Kit. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS). Student's t-test was applied to compare the serum levels of nitric acid and the differences were considered significant if P < 0.05. Results: Infertile women had significantly higher mean serum nitric oxide levels than fertile women: 34.33 (SD 5.93) µmol/L versus 18.27 (SD 2.63) µmol/L (P < 0.001). Women with secondary infertility had significantly higher mean levels of nitric oxide than those with primary infertility: 38.13 (SD 3.39) µmol/L versus 22.72 (SD 4.36) µmol/L (P < 0.001). Conclusion: The study showed that serum nitric oxide level was significantly elevated in women with infertility compared to women of proven fertility. Hence, oxidative stress from reactive species may be a contributory factor to infertility in women in the Niger-Delta Region of Nigeria.


Assuntos
Infertilidade Feminina , Óxido Nítrico , Estudos de Casos e Controles , Feminino , Humanos , Infertilidade Feminina/epidemiologia , Níger , Nigéria , Estudos Prospectivos
14.
Niger J Clin Pract ; 24(7): 1044-1051, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34290181

RESUMO

Background: Body mass index is a major determinant of cardiac annular valvar dimension and left ventricular mass index in children with sickle cell anemia. Objectives: The study is aimed at ascertaining the impact of Body Mass Index on Left ventricular mass index, right ventricular function and cardiac dimension of children with sickle cell anemia. Methods: A case control study in which echocardiographic measurement of cardiac function and structures were ascertained among children with sickle cell anemia compared with hemoglobin AA genotype. Results: There were 51 subjects and 50 controls. The subjects comprised 54.9% males and controls, 52.0% male. There was a strong positive correlation between BMI and most cardiac structure diameters among children with normal hemoglobin genotype (Pearson's correlation coefficient value, P < 0.001) There was also statistically significant positive correlation between BMI and LV mass among the subjects (n = 50, r = 0.5, P < 0.001). There was significant positive correlation between BMI and TAPSE in both subjects and controls as well as between BMI and RVSP among the subjects, but not the controls (p < 0.001). There was no significant difference in the number with left ventricular hypertrophy (LVH) based on their nutritional status (n = 51, χ^2 = 7.03, P = 0.32). The BMI correlated negatively with left ventricular mass index (LVMI) among the subjects, but the correlation was not statistically significant (r = -0.1, P = 0.53). Conclusion: There was significant positive correlation between BMI and TAPSE in both subjects and controls as well as between BMI and RVSP among the subjects, but not the controls. Body mass index correlated negatively with left ventricular mass index (LVMI) among the subjects.


Assuntos
Anemia Falciforme , Função Ventricular Direita , Anemia Falciforme/complicações , Anemia Falciforme/epidemiologia , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Nigéria
15.
Niger J Clin Pract ; 24(7): 1072-1076, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34290185

RESUMO

Background: Colonoscopy is an investigation modality used for colorectal examination; it is the most accurate technique for the diagnosis and surveillance of important colorectal diseases such as cancers (colorectal cancer) and polyps. Aims: Most studies on colonoscopy in Nigeria were conducted in southwest such as Ilorin, Ife, Ibadan, and Lagos. We therefore feel the need to get information from other regions such as northwest, the area of this study. The aim of this study was to identify the common indications as well as colonoscopic findings among patients who had colonoscopy in Aminu Kano Teaching Hospital, Kano. Methodology: It was a 10-year retrospective descriptive study of patients who had colonoscopy between January 2008 and December 2017 at the study center. Colonoscopy register was used to extract information concerning the patient's age, gender, symptoms that necessitated the request for the procedure, and the endoscopic findings. Results: A total of 839 patient records were reviewed, males constituted 62.2% of the patients. The mean age ± standard deviation was 43.86 ± 18.36 years, with a range of 8-96 years. The 30-39 years constituted the modal age group, followed by 40-49 years and 50-59 years. The commonest indications for the procedure were rectal bleeding (52.4%), chronic abdominal pain (51.3%), and diarrhea (48.8%). The cecal intubation rate was 98.2% with hemorrhoids as the commonest finding (42.3%) followed by suspected inflammatory bowel disease lesions (18.1%) and suspected colorectal tumors (16.2%). Conclusion: The commonest reason for colonoscopy was rectal bleeding while the commonest colonoscopic finding was hemorrhoids.


Assuntos
Pólipos do Colo , Colonoscopia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ceco , Criança , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Estudos Retrospectivos , Adulto Jovem
16.
Niger J Clin Pract ; 24(7): 1082-1085, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34290187

RESUMO

Background: Inguinal hernia is a common pathology seen by the general surgeon in the outpatient clinic. Its spectrum of clinical features on presentation significantly varies from the asymptomatic to the complicated. Objective: To identify and audit the common clinical presentation and presence of known risk factors for inguinal hernia among adult patients with inguinal hernias presenting to an outpatient clinic. Methods: The study involved adults presenting over 1 year at a surgical clinic with a clinical diagnosis of inguinal hernia. Data on age, sex, family history, abdominal pain, constipation, chronic cough, previous hernia surgery as well as features of bladder outlet obstruction and intra-abdominal mass were recorded into a format. Analysis into a simple percentage, mean, and standard deviation was done with SPSS version 17 (SPSS Inc. Chicago, IL, USA). Results: Sixty-five patients were enrolled in the study, comprising 49 males (75.4%) and 16 females (24.6%), M:F = 3:1. The mean age was 45.6 years (SD ± 16.9). The 16-40-year age group had the highest incidence of 29 cases (44.6%) of inguinal hernia. A family history of inguinal hernia (31 cases [47.7%]) and history of previous inguinal hernia surgery (15 cases [23.1%])) was observed. Ten patients with previous surgery presented with a contralateral hernia and 5 with a recurrence. Other factors were chronic constipation 10 cases, smoking 9 cases, chronic cough 8 cases, dysuria 7 cases, enlarged prostate 6 cases, abdominal mass 4 cases, and urethral stricture 1 case. Conclusion: Inguinal hernia is common among young and middle-aged adults in our series. Many patients have features suggestive of complications at presentation. Family history and past inguinal hernia surgery were important risk factors.


Assuntos
Hérnia Inguinal , Adulto , Feminino , Hérnia Inguinal/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Recidiva , Fatores de Risco , Fumar
18.
Environ Monit Assess ; 193(8): 514, 2021 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-34304332

RESUMO

Coal mining activities have been ongoing in Okaba for years without adequate attention paid to pollution and reclamation. Soil and plants were sampled from Okaba coal mine to determine the metal content in the soil and to identify the plants that have potential for phytoremediation. The samples were prepared, separated into various tissues, and labeled and taken to the laboratory. Digestion was carried out using acid mixture of nitric acid (HNO3): perchloric acid (HCLO4) for the plants, while the mixture of nitric acid (HNO3): hydrochloric acid (HCl): perchloric acid (HCLO4) was used for the soil. The concentrations of metals from the samples were determined using EDX3600B X-ray fluorescence spectrometer (Sky ray Instruments Inc., USA), a World Bank Assisted Project, Nigeria. Bioconcentration factor (BCF), translocation factor (TF), and bioaccumulation coefficient (BAC) or extraction coefficient (EC) were determined to identify the plants that have potential for hyperaccumulation, phytoextraction, and phytostabilization and ability to store up these metals for harvesting. Hierarchical cluster analysis was performed to highlight the relationship between the variables. This study has revealed that Ageratum conyzoides Linn (ACL), Desmodium velutinum (DV), Triumfetta rhiomdoidea Jacq. (TRJ), Gleichenia linearis (Burns) (GL), Selaginella myosurus (SM), and Sida linifolia juss.excav. (SL) had potential as hyperaccumulators of nickel. Eleven (11) plants have potential for phytoextraction of manganese (Mn), and six (6) plants have stabilization potential for the same metal. Eight (8) phytoextractors and seven (7) stabilizers plants were recorded for Ni. Eclipta alba (L) Hassk (EAH) (location 4) and TRJ were phytostabilizers plants for Pb. Six (6) other plants have potential as phytoextractors of Pb. Eight (8) of the studied plants were suitable for phytoextraction of Ni, and five (5) plants were suitable as phytostabilizers. Most of the plants were found to be useful for phytoremediation of the soil.


Assuntos
Metais Pesados , Poluentes do Solo , Biodegradação Ambiental , Carvão Mineral , Monitoramento Ambiental , Metais Pesados/análise , Nigéria , Solo , Poluentes do Solo/análise
19.
Afr J Prim Health Care Fam Med ; 13(1): e1-e8, 2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-34212738

RESUMO

BACKGROUND: The responsibility of caring for patients with advanced cancer in sub-Saharan Africa is mostly shouldered by family members because of paucity of institutional facilities. There is a growing concern that the number of women needing treatment for advanced breast cancer is rising at an unprecedented rate in Nigeria. AIM: To assess the caregiver burden and its associated factors amongst family caregivers of women with advanced breast cancer. SETTING: The study was conducted at the radiation oncology clinic of the University College Hospital, Ibadan, Nigeria. METHODS: A cross-sectional descriptive study was conducted amongst 157 eligible family caregivers of women with advanced breast cancer. The family caregivers completed an interviewer-administered questionnaire, which included the socio-demographic data, the caregiving process and the Zarit Burden Interview (ZBI). Logistic regression was used to identify factors, and ethical approval was obtained. RESULTS: Over half (53%) of the respondents were males with spousal caregivers dominantly constituting 27.4% of all respondents, closely followed by daughters (25.5%) of the care recipients. The mean ZBI score was 29.84 ± 13.9. Most (72%) of the caregivers experienced burden. Factors associated with caregiver burden were previous hospitalisation of the care recipient (odds ratio [OR] = 3.74, confidence interval [CI]: 1.67 to 8.38) and perceived dysfunction in patients activities of daily living (OR = 2.57, CI: 1.14 to 5.78). CONCLUSION: Family caregivers of women with advanced breast cancer experience burden of care. Recognition of this vulnerable population and the care recipient as a dyad is a sine qua non in mitigating the burden associated with their caregiving role.


Assuntos
Neoplasias da Mama/radioterapia , Fardo do Cuidador , Cuidadores/psicologia , Radioterapia (Especialidade) , Atividades Cotidianas , Adulto , Idoso , Neoplasias da Mama/patologia , Efeitos Psicossociais da Doença , Estudos Transversais , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Nigéria , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença
20.
Afr J Prim Health Care Fam Med ; 13(1): e1-e8, 2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34212741

RESUMO

BACKGROUND: There is a rising burden of non-communicable diseases (NCDs) in the sub-Saharan Africa, and calls for integration of management of selected NCDs with primary healthcare (PHC) have been unrelenting. Cost-effective interventions for the prevention and control of NCDs can be delivered at PHC facilities in low-resource settings by clinical healthcare workers (HCWs). AIM: This study compared the knowledge of HCWs in PHC facilities regarding the prevention and control of NCDs in rural and urban local government areas (LGAs) of Osun State. SETTING: A comparative cross-sectional study was conducted amongst 400 eligible HCWs recruited using a multistage sampling technique in PHC facilities of six rural and six urban LGAs. METHODS: A pretested self-administered case-scenarios questionnaire was used to assess the knowledge of HCWs regarding the prevention and control of three selected NCDs (diabetes, hypertension and chronic respiratory diseases). Both descriptive and inferential statistics were conducted. RESULTS: The mean knowledge scores of HCWs regarding the prevention and control of the three NCDs were 17.76 ± 4.41 in rural and 17.62 ± 4.02 in urban LGAs out of 30 maximum scores. The proportion of HCWs with adequate knowledge in the rural LGAs (31.0%) was slightly higher than the urban LGAs (23.0%); however, it was not statistically significant (χ2 = 3.247; p = 0.072). The major determinants of adequate knowledge include cadre of HCWs, location, years in practice with professional certificate, NCD training course attendance and reported experience managing diabetic patients. CONCLUSION: The HCWs in PHC facilities in rural and urban LGAs of Osun State, Nigeria, had a poor knowledge regarding the prevention and control of NCDs. Training and re-training of less-skilled HCWs in the PHC facilities using relevant WHO NCD protocols and guidelines are imperatives to improve their knowledge about the prevention and control of NCDs.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Doenças não Transmissíveis/prevenção & controle , Atenção Primária à Saúde/organização & administração , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , População Rural , População Urbana
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...