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1.
BMC Infect Dis ; 21(1): 1031, 2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34600477

RESUMO

BACKGROUND: Human Immuno-Deficiency Virus (HIV) remains one of the world's significant public health challenges. Viral suppression is the key indicator for treatment success in People living with HIV (PLHIV). We determined the level of viral suppression, and its associated factors among PLHIV attending Federal Medical Centre Katsina (FMC Katsina), Nigeria. METHODS: This retrospective descriptive cross-sectional study was conducted on 913 HIV positive adults enrolled in care between January 2009 and December 2019. Information on socio-demographics, clinical, immunological, Viral load (VL), and other relevant parameters were extracted from the patients' care records. The primary outcome was the proportion of patients that achieved viral suppression. We also analyzed variables that were associated with VL suppression. RESULTS: Of 913, records of 831 (91.0%) registered patients were analyzed. During the period, 751 (90.4%) achieved viral suppression, 427 (51.4%) had CD4 counts ≥ 500 and 477 (57.4%) were on HAART for ≥ 5 years. Majority, 793 (95.4%) were on first-line HAART regimen (Tenofovir-Lamivudine-Dolutegravir or Abacavir-Lamivudine-Dolutegravir), and 809 (97.4%) in the non-advanced stage (WHO stages 1 and 2). The median (interquartile range) of viral load was 20 (20-40) vs 19,989 (3311-110,340) cp/ml in virally suppressed, and unsuppressed  respectively. Factors associated with viral suppression included being unemployed (Adjusted OR [AOR] 4.9, 95% CI 2.771, 8.539), educated (AOR 4.2, 95% CI 1.098, 16.223), having a baseline CD4 count ≥ 500 cells/µl (AOR 2.7, 95% CI 1.588, 4.625), and being on first line HAART regimen [AOR 7.0, 95% CI 3.220, 15.648]. CONCLUSIONS: Our study demonstrated a good viral suppression among PLHIV on HAART. Variables associated with viral suppression included unemployment, formal education, high baseline CD4 count, and first line HAART regimen.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Contagem de Linfócito CD4 , Estudos Transversais , Infecções por HIV/tratamento farmacológico , Humanos , Nigéria , Estudos Retrospectivos , Centros de Atenção Terciária , Carga Viral
2.
BMC Oral Health ; 21(1): 493, 2021 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-34607593

RESUMO

BACKGROUND: The impact of the COVID-19 pandemic on the world is unprecedented, posing greater threats to vulnerable healthcare systems, especially in developing countries. This study aimed to assess the knowledge of dental healthcare providers in Nigeria about the disease and evaluate their responses to the preventive measures necessitated by COVID-19. METHODS: This was an online self-administered questionnaire-based study conducted among dentists practicing in Nigeria. A message containing the link to the survey was sent widely via social medial platforms and electronic mails to dentists practicing in Nigeria. The data collection was done between the 2nd of June and 3rd of July 2020. RESULTS: A total of 314 responses was recorded. Fever was the most specified generalized symptom (97.5%), while the use of masks (100%), hand hygiene (99.7%), social distancing (97.7%) and surface cleaning (99.4%) were the most commonly employed general preventive methods. The main identified risk of transmission in the clinic was aerosol generating procedures (98.7%). CONCLUSION: The general knowledge of dental personnel in our study population appears to be adequate on the common clinical features of COVID-19 but less adequate regarding the less common features. The COVID-19 pandemic has also modified some aspects of dental service delivery but more needs to be done in this regard. Preventive measures against the transmission of COVID-19 in dental practice settings include proper utilization of teledentistry, clinical triage, preprocedural 1% hydrogen peroxide oral rinses, and the use of appropriate Personal Protective Equipment (PPE) which should always be encouraged.


Assuntos
COVID-19 , Humanos , Nigéria/epidemiologia , Pandemias , SARS-CoV-2
3.
Medicine (Baltimore) ; 100(39): e27376, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34596155

RESUMO

ABSTRACT: Bullying is a growing problem in the workplace. This study investigated the bullying experience of building and construction industry artisans.We employed a cross-sectional analytic design to study 240 artisans in respect of workplace bullying (WPB) experience using a self-report questionnaire. Percentage, mean and standard deviation were used for data analysis and interpretation.According to the study, a significant percentage (96.1%) of the artisans perceived themselves as victims of WPB within the past 6 months and these experiences also occurred once or more times weekly.WPB is a considerable problem among building and construction industry artisans in Nigeria. Further studies that can influence the construction industry to create valuable programs to minimize bullying among artisans are required.


Assuntos
Bullying/estatística & dados numéricos , Indústria da Construção/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Autorrelato , Local de Trabalho/estatística & dados numéricos
4.
Trop Anim Health Prod ; 53(5): 500, 2021 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-34613460

RESUMO

Rift Valley fever (RVF) is an emerging mosquito-borne zoonosis that threatens public health and animal agriculture in the endemic areas causing devastating epizootics characterized by abortion storms and high mortalities, especially in newborn animals. A cross-sectional study was conducted to determine the seroprevalence and investigate risk factors associated with exposure to the virus in camels slaughtered in Maiduguri abattoir, Borno State of Nigeria. Camels presented for slaughtered were sampled and data on age, sex, source or origin, utility, presence of post-mortem lesions, body weights and body condition score were collected. Blood samples were collected and sera were harvested and stored at - 20 °C until tested. The sera were tested using a commercial ELISA kit based on the manufacturer's instructions. The overall seroprevalence in the study was 20.7% (95% CI, 13.6-30.0). The analysis showed no significant differences between the presence of antibodies and variables that included the sex of camels (χ2 = 0.015, df = 1, p = 0.904) and the presence of post-mortem lesion on the carcass (χ2 = 0.009, df = 1, p = 0.925). There were significant differences between presence of antibodies and three variables that included the age (χ2 = 4.89, df = 1, p = 0.027), the source (χ2 = 7.077, df = 2, p = 0.029) and the main utility (χ2 = 8.057, df = 3, p = 0.045) of the camels. It was concluded that camels presented for slaughter at the Maiduguri abattoir have evidence of exposure to the RVF virus and maybe means of transmission of the virus. Regular monitoring and control of transboundary animal movements were recommended in the study area.


Assuntos
Vírus da Febre do Vale do Rift , Matadouros , Animais , Camelus , Estudos Transversais , Nigéria/epidemiologia , Fatores de Risco , Estudos Soroepidemiológicos
5.
Glob Health Sci Pract ; 9(3): 682-689, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593590

RESUMO

Lessons learned from one global health program can inform responses to challenges faced by other programs. One way to disseminate these lessons is through courses. However, such courses are often delivered by and taught to people based in high-income countries and thus may not present a truly global perspective. The Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) is a consortium of 8 institutions in Afghanistan, Bangladesh, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, and the United States that seeks to carry out such a transfer of the lessons learned in polio eradication. This short report describes the collaborative process of developing content and curriculum for an international course, the learnings that emerged, the barriers we faced, and recommendations for future similar efforts. Various parts of our course were developed by teams of researchers from countries across South Asia and sub-Saharan Africa. We held a series of regional in-person team meetings hosted in different countries to improve rapport and provide a chance to work together in person. The course content reflects the diversity of team members' knowledge in a variety of contexts. Challenges to this effort included team coordination (e.g., scheduling across time zones); hierarchies across and between countries; and the coronavirus disease (COVID-19) pandemic. We recommend planning for these hierarchies ahead of time and ensuring significant in-person meeting time to make the most of international collaboration.


Assuntos
Currículo , Erradicação de Doenças/métodos , Saúde Global/educação , Programas de Imunização/métodos , Internacionalidade , Poliomielite/prevenção & controle , Afeganistão , Bangladesh , República Democrática do Congo , Etiópia , Humanos , Índia , Indonésia , Nigéria , Poliomielite/tratamento farmacológico , Estados Unidos
6.
Pan Afr Med J ; 39: 195, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34603576

RESUMO

Introduction: active ageing is the process of optimizing opportunities for health in order to enhance quality of life and wellbeing. It is influenced by physical activity, social participation and social network, cognitive and continuous learning and socio-economic factors. It involves disease prevention and promotion of healthy behaviours that can reduce the risk and occurrence of non-communicable diseases in middle age and also at old age. The study aimed to determine and compare the active ageing process and its determinants among middle-aged men in rural and urban areas in Nigeria. Methods: this was a comparative cross-sectional study among middle-aged men 40-60 years using mixed methods. A multi-stage sampling technique was used to select 720 respondents. A structured interviewer administered questionnaire and Key informant interviews were used to collect data. Results: respondents in the rural area were a little older compared to the respondents in the urban area with a mean age of 49.6 ± 6.3 years and 48.6 ± 6.2 years respectively. A higher proportion of the respondents in the rural area (83.2%) than the respondents in the urban area (73.8%) practice good active ageing processes in their lives. There was a significant association between education of respondent and the practice of active ageing among respondents in the urban and rural areas. Multivariate logistic regression showed that physical activity (aOR 7.62, 95% CI: 243-23.94, P = 0.001), life-long learning (aOR 51.73, 95% CI: 12.14-220.49, P = 0.000) and community participation (aOR 3.46, 95% CI: 2.51-4.77, P=0.000) are predictors of active ageing. Conclusion: the study showed that respondents in the rural area practice good active ageing compared to the respondents in the urban area and hence engaged more in sufficient active life in their daily activities, reducing the risk of non-communicable diseases.


Assuntos
Envelhecimento Saudável/fisiologia , Qualidade de Vida , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Envelhecimento/fisiologia , Estudos Transversais , Comportamentos Relacionados com a Saúde , Promoção da Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Fatores Socioeconômicos , Inquéritos e Questionários
7.
Pan Afr Med J ; 39: 200, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34603581

RESUMO

Introduction: cervical cancer is the second most frequent cancer among women in Nigeria. With proper screening, the disease can be detected early enough and properly managed. However, there seems to be limited knowledge of cervical cancer among women and several barriers might prevent them from accessing the screening services. We determined the awareness, knowledge and screening for cervical cancer among women of a faith-based organization in Nigeria. Methods: we employed descriptive survey research design and purposively sampled a Catholic Parish in Nsukka Local Government Area of Enugu State, Nigeria. All consenting women in the Parish were used for the study. We utilized researchers' structured instrument titled 'Awareness and knowledge about Cervical Cancer and Screening' to collect data. Frequencies, percentages and logistic regression were employed for data analysis. Results: awareness of cervical cancer (70.8%) and its screening (68.1%) are high but there is generally poor level of knowledge (65.3%) of different aspects of cervical cancer among the women. Age (aOR: 7.183, 95% CI 1.769-29.168; p=.006), number of children (aOR: .074, 95% CI .009- .631; p=.017), and occupation (aOR: .032, 95% CI .004-.260; p= .001 and aOR: .050, 95% CI .007-.347; p=.002) were significantly associated with knowledge of cervical cancer. Majority of the women studied had never been screened for cervical cancer (91.7%) and the reasons for not screening ranged from lack of knowledge of; where to go for screening (69.7%) and the importance of being screened (40.9%) to not feeling susceptible to cervical cancer (18.2%). Conclusion: there was generally poor knowledge of cervical cancer and its screening; and very poor screening practice. There is, therefore, an urgent need to improve women´s knowledge of cervical cancer and address the identified barriers in order to improve screening practices of the women.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Programas de Rastreamento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Adulto , Detecção Precoce de Câncer/estatística & dados numéricos , Organizações Religiosas , Feminino , Humanos , Pessoa de Meia-Idade , Nigéria , Inquéritos e Questionários , Adulto Jovem
8.
Pan Afr Med J ; 39: 201, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34603582

RESUMO

Introduction: health-related quality of life (HRQoL) can be affected by the existence of long-term medical conditions. This study compared the HRQoL of male and female patients living with the human immunodeficiency virus (HIV) who sought care at the antiretroviral clinic in a tertiary hospital. Methods: a comparative cross-sectional study with 512 female and 512 male HIV outpatients receiving care at the antiretroviral clinic in the University of Port Harcourt Teaching Hospital. The WHOQoL-HIV-BREF which conceptualized HRQoL as a function of six factors - physical, psychological, social, environment, independence and spiritual health was administered. The gender difference in HRQOL was determined by the independent sample t-test, mean difference and standardized mean difference in items and domain scores. Meta-analytic approach was used to deduce the overall potential effect of gender on HIV infection. Multivariate linear regression analyses were used to control for potential confounders of HRQoL among the study participants. Results: the mean age of the sampled population was 35.9 ± 11.8 years for the male and 35.3 ± 9.8 years for the female category. Male HIV patients reported significantly higher mean HRQoL scores across all domains of the scale except the spiritual domain. The 4.51% (95% CI of 3.63 to 5.39%) overall difference was statistically significant (p<0.001). Other factors associated with good HRQoL were marriage status, monogamous family type and a higher level of education. Conclusion: the significantly lower HRQoL among female HIV patients calls for a multiprong approach towards strengthening gender mainstreaming in the management and control of HIV patients in Nigeria.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Infecções por HIV/psicologia , Qualidade de Vida , Adulto , Estudos Transversais , Escolaridade , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Nigéria , Fatores Sexuais , Inquéritos e Questionários , Centros de Atenção Terciária , Adulto Jovem
9.
BMJ Glob Health ; 6(10)2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34615663

RESUMO

INTRODUCTION: Access to emergency obstetric care can lead to a 45%-75% reduction in stillbirths. However, before a pregnant woman can access this care, she needs to travel to a health facility. Our objective in this study was to assess the influence of distance and travel time to the actual hospital of care on stillbirth. METHODS: We conducted a retrospective cross-sectional study of pregnant women who presented with obstetric emergencies over a year across all 24 public hospitals in Lagos, Nigeria. Reviewing clinical records, we extracted sociodemographic, travel and obstetric data. Extracted travel data were exported to Google Maps, where typical distance and travel time for period-of-day they travelled were extracted. Multivariable logistic regression was conducted to determine the relative influence of distance and travel time on stillbirth. RESULTS: Of 3278 births, there were 408 stillbirths (12.5%). Women with livebirths travelled a median distance of 7.3 km (IQR 3.3-18.0) and over a median time of 24 min (IQR 12-51). Those with stillbirths travelled a median distance of 8.5 km (IQR 4.4-19.7) and over a median time of 30 min (IQR 16-60). Following adjustments, though no significant association with distance was found, odds of stillbirth were significantly higher for travel of 10-29 min (OR 2.25, 95% CI 1.40 to 3.63), 30-59 min (OR 2.30, 95% CI 1.22 to 4.34) and 60-119 min (OR 2.35, 95% CI 1.05 to 5.25). The adjusted OR of stillbirth was significantly lower following booking (OR 0.37, 95% CI 0.28 to 0.49), obstetric complications with mother (obstructed labour (OR 0.11, 95% CI 0.07 to 0.17) and haemorrhage (OR 0.30, 95%CI 0.20 to 0.46)). Odds were significantly higher with multiple gestations (OR 2.40, 95% CI 1.57 to 3.69) and referral (OR 1.55, 95% CI 1.13 to 2.12). CONCLUSION: Travel time to a hospital was strongly associated with stillbirth. In addition to birth preparedness, efforts to get quality care quicker to women or women quicker to quality care will be critical for efforts to reduce stillbirths in a principally urban low-income and middle-income setting.


Assuntos
Hospitais , Natimorto , Estudos Transversais , Feminino , Humanos , Nigéria , Gravidez , Estudos Retrospectivos , Natimorto/epidemiologia
10.
J Med Case Rep ; 15(1): 504, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34625105

RESUMO

BACKGROUND: The occurrence of acute leukemia in patients with sickle cell anemia is uncommon. The Philadelphia chromosome is the hallmark of chronic myeloid leukemia. However, it may also be associated with acute lymphoblastic leukemia and acute myeloblastic leukemia. The common BCR-ABL1 transcripts seen in acute lymphoblastic leukemia are e1a2, e13a2, and e14a2, while other transcripts such as e1a3, e13a3, and e6a2 occur rarely. This report describes the presentation, management, and outcome of the occurrence of B-cell acute lymphoblastic leukemia with the rare e1a3 BCR-ABL1 transcript in a patient with sickle cell anemia. CASE PRESENTATION: A 19-year-old male Nigerian, a known sickle cell anemia patient was admitted on account of severe vaso-occlusive crisis. Examination revealed fever, palor, and jaundice. Full blood count showed anemia and leukocytosis. Peripheral blood and bone marrow smears revealed numerous large and small lymphoblasts in keeping with the L2 subtype of acute lymphoblastic leukemia based on the French-American-British classification. Further evaluation was in keeping with a diagnosis of BCR-ABL1-positive mature B-cell acute lymphoblastic leukemia associated with the rare e1a3 transcript. He was commenced simultaneously on induction chemotherapy and Imatinib while being prepared for allogeneic stem cell transplantation. However, he died  six  months after diagnosis from meningoencephalitis. CONCLUSION: The occurrence of acute lymphoblastic leukemia with a rare BCR-ABL1 e1a3 transcript in association with sickle cell anemia is uncommon and associated with poor prognosis.


Assuntos
Anemia Falciforme , Leucemia-Linfoma Linfoblástico de Células Precursoras , Adulto , Anemia Falciforme/complicações , Anemia Falciforme/genética , Linfócitos B , Proteínas de Fusão bcr-abl/genética , Humanos , Masculino , Nigéria , Cromossomo Filadélfia , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Adulto Jovem
11.
Environ Monit Assess ; 193(11): 709, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34625850

RESUMO

This study assessed the contamination of streams with potentially toxic elements (PTEs) in sediments around mining, quarrying, and cultivation areas in Akamkpa and environs Southeastern Nigeria. Analysis done using ICP MS technique shows that barium (Ba) and lead (Pb) recorded mean concentrations above their average shale content (ASC) in stream sediments. Chromium (Cr) exceeded Canadian Interim Sediment Quality Guideline (ISQG) and US Environmental Protection Agency (USEPA) screening benchmark value. Pb exceeded Canadian ISQG value but tallies with USEPA benchmark value. Pearson's correlation exhibited significant correlation (p < 0.01) of molybdenum (Mo) with copper (Cu) and Pb; Cu with Pb, vanadium (V), and Ba; V with Cu, Pb, iron (Fe), Ba, and beryllium (Be); and Fe with Be and V. Principal component (PC 1) consists of Pb, Mo, cobalt (Co), Cu, arsenic (As), Cr, V, and nickel (Ni) and showed significant correlation. Geo accumulation index (I-geo) values for Mo, Cu, V, Pb, Zn, Ni, Co, Mn, and Ba fall under unpolluted (0) to moderately polluted (1-2) classes. Maximum enrichment factor (EF) values show extremely high and significant enrichment of Ba and Pb in few locations. Co, Cr, Cu, Mn, and Zn possess maximum EF values classified as moderate enrichment. Ni, Mo, As, and V obtained maximum EF values classified as depleted to minimal enrichment. Modified pollution index (MPI) values showed high PTEs contamination in mostly cultivation locations. Single element potential ecological risk (EiR) mean values trend EiR (As) > EiR (Pb) > EiR (Co) > EiR (Cr) > EiR (Cu) > EiR (V) > EiR (Ni) > EiR (Zn). Comprehensive potential ecological risk (RI) shows medium risk "B" and strong risk "C" levels in few locations. The use of multiple pollution indices such as I-geo, EF, EiR, and RI in pollution assessment indicated similar trend of PTEs contamination of stream sediments. Levels of PTEs contamination are elevated in cultivation areas more than in granite quarrying and mining areas. This study serves as a benchmark for conducting suitable environmental management strategies to scientists in Nigeria and other parts of the world.


Assuntos
Metais Pesados , Poluentes Químicos da Água , Sulfato de Bário , Canadá , Monitoramento Ambiental , Sedimentos Geológicos , Metais Pesados/análise , Nigéria , Medição de Risco , Rios , Dióxido de Silício , Estados Unidos , Poluentes Químicos da Água/análise
12.
J Int Med Res ; 49(10): 3000605211044040, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34632841

RESUMO

OBJECTIVE: We determined the prevalence of poor glycemic control and associations with sociodemographics, comorbid conditions, and medication adherence among patients with type 2 diabetes mellitus (T2DM) at a tertiary hospital in southwestern Nigeria. METHODS: We conducted a retrospective observational study among 300 patients with T2DM using systematic random sampling. We used a semi-structured questionnaire to collect information on respondents' sociodemographic profile, lifestyle, comorbid conditions, and antidiabetic medications. Adherence was determined using the Morisky Medication Adherence Scale. Fasting blood samples were tested using a glycated hemoglobin marker. Multivariate logistic regression was used to identify factors associated with poor glycemic control. RESULTS: Respondents' mean age was 61.9 ± 11.8 years. The prevalence of poor glycemic control was 40.0% (95% confidence interval [CI]: 34.4%-45.8%). The adjusted odds ratio (95% CI) for factors associated with poor glycemic control was 2.522 (1.402-4.647) for older age, 1.882 (1.021-3.467) for low income, 1.734 (1.013-3.401) for obesity, 2.014 (1.269-5.336) for non-initiation of insulin therapy, and 1.830 (1.045-3.206) for poor medication adherence. CONCLUSION: Older age, lower income, obesity, non-initiation of insulin, and poor medication adherence were associated with poor glycemic control. These variables may help clinicians identify patients at high risk of poor glycemic control.


Assuntos
Diabetes Mellitus Tipo 2 , Idoso , Glicemia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Controle Glicêmico , Humanos , Adesão à Medicação , Pessoa de Meia-Idade , Nigéria
13.
Lancet Glob Health ; 9(10): e1431-e1441, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34474001

RESUMO

BACKGROUND: 30 years after the introduction of the levonorgestrel-releasing intrauterine device in Europe, several sub-Saharan African countries are seeking to broaden access to this contraceptive method. In this study, we aimed to assess 12-month continuation of the hormonal intrauterine device, copper intrauterine device, and implants, as well as to assess women's experiences and satisfaction using these methods in the private sector in Nigeria and the public sector in Zambia. METHODS: We did a prospective cohort study of long-acting reversible contraceptive users across 40 private sector clinics in Nigeria and 21 public sector clinics in Zambia. Eligible women were aged 18-49 years in Nigeria and 16-49 years in Zambia, had chosen to receive the hormonal intrauterine device, copper intrauterine device, or implant (either a 5-year levonorgestrel-releasing subdermal implant or a 3-year etonogestrel-releasing subdermal implant), and, in Nigeria only, had access to a telephone. Women were interviewed within 100 days of receiving their contraceptive method either via telephone in Nigeria or in person in Zambia, with follow-up surveys at 6 months and 12 months. The primary outcomes were method-specific, 12-month continuation rates-ie, continuation rates of the hormonal intrauterine device, copper intrauterine device, and implant across Nigeria and Zambia. We used Kaplan-Meier methods to estimate the cumulative probabilities of method-specific continuation and a log-rank test to compare contraceptive methods. We analysed self-reported satisfaction and experiences as a secondary outcome. FINDINGS: Between June 25 and Nov 22, 2018, we enrolled a total of 1542 women (n=860 in Nigeria and n=682 in Zambia) receiving a long-acting reversible contraceptive. In total, 835 women (266 [32%] hormonal intrauterine device users, 274 [33%] copper intrauterine device users, and 295 [35%] implant users) in Nigeria and 367 (140 [38%] hormonal intrauterine device users, 149 [40%] copper intrauterine device users, and 78 [21%] implant users) in Zambia were included in the study analysis. The 12-month cumulative continuation rates were 86·8% (95% CI 82·1-90·4) for the hormonal intrauterine device, 86·9% (82·1-90·4) for the copper intrauterine device, and 85·0% (80·2-88·7) for implants in Nigeria. In Zambia, the 12-month cumulative continuation rates were 94·7% (89·2-97·4) for the hormonal intrauterine device, 89·1% (82·3-93·4) for the copper intrauterine device, and 83·1% (72·2-90·1) for implants. At least 71% of respondents across the timepoints were very satisfied with their method, and at least 55 (79%) of 70 reported having recommended their contraceptive method to someone else. Across the methods, the most commonly self-reported positive aspect of long-acting reversible contraceptive use at 12 months was effectiveness in Nigeria (range 93-94%) and long-lasting duration in Zambia (48-60%). Between 124 (50%) of 248 and 136 (59%) of 230 Nigerian participants and 26 (42%) of 62 and 66 (57%) of 117 Zambian participants reported nothing negative about their contraceptive method. INTERPRETATION: Our study showed high continuation rates and satisfaction across long-acting reversible contraceptives, including the hormonal intrauterine device, a method that has been largely underused in sub-Saharan Africa. This finding supports the inclusion of the hormonal intrauterine device as a valuable addition to the mix of contraceptive methods in Nigeria and Zambia. FUNDING: Bill & Melinda Gates Foundation.


Assuntos
Anticoncepcionais Femininos , Dispositivos Intrauterinos de Cobre , Dispositivos Intrauterinos , Anticoncepção , Feminino , Humanos , Nigéria , Estudos Prospectivos , Zâmbia
14.
PLoS One ; 16(9): e0257567, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34547038

RESUMO

INTRODUCTION: The COVID-19 pandemic continues to overwhelm health systems across the globe. We aimed to assess the readiness of hospitals in Nigeria to respond to the COVID-19 outbreak. METHOD: Between April and October 2020, hospital representatives completed a modified World Health Organisation (WHO) COVID-19 hospital readiness checklist consisting of 13 components and 124 indicators. Readiness scores were classified as adequate (score ≥80%), moderate (score 50-79.9%) and not ready (score <50%). RESULTS: Among 20 (17 tertiary and three secondary) hospitals from all six geopolitical zones of Nigeria, readiness score ranged from 28.2% to 88.7% (median 68.4%), and only three (15%) hospitals had adequate readiness. There was a median of 15 isolation beds, four ICU beds and four ventilators per hospital, but over 45% of hospitals established isolation facilities and procured ventilators after the onset of COVID-19. Of the 13 readiness components, the lowest readiness scores were reported for surge capacity (61.1%), human resources (59.1%), staff welfare (50%) and availability of critical items (47.7%). CONCLUSION: Most hospitals in Nigeria were not adequately prepared to respond to the COVID-19 outbreak. Current efforts to strengthen hospital preparedness should prioritize challenges related to surge capacity, critical care for COVID-19 patients, and staff welfare and protection.


Assuntos
COVID-19/epidemiologia , Hospitais/estatística & dados numéricos , Pandemias , Inquéritos e Questionários , Hospitais/provisão & distribuição , Humanos , Nigéria/epidemiologia , Capacidade de Resposta ante Emergências
15.
BMJ Open ; 11(9): e050138, 2021 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-34580097

RESUMO

OBJECTIVES: Healthcare workers (HCWs) are at the frontline of efforts to treat those affected by COVID-19 and prevent its continued spread. This study seeks to assess knowledge, attitude and practice (KAP) as well as training needs and preferences related to COVID-19 among frontline HCWs in Nigeria. SETTING: A cross-sectional survey was carried out among 1852 HCWs in primary, secondary and tertiary care settings across Nigeria using a 33-item questionnaire. PARTICIPANTS: Respondents included doctors, nurses, pharmacy and clinical laboratory professionals who have direct clinical contact with patients at the various healthcare settings. ANALYSIS: Exploratory factor analysis (EFA) was used to establish independent factors related to COVID-19 KAP. Analysis of variance was used to identify any differences in the factors among different categories of HCWs. RESULTS: EFA identified four factors: safety and prevention (factor 1), practice and knowledge (factor 2), control and mitigation (factor 3) and national perceptions (factor 4). Significant group differences were found on three factors: Factor 1 (F(1,1655)=5.79, p=0.0006), factor 3 (F(1,1633)=12.9, p<0.0.0001) and factor 4 (F(1,1655)=7.31, p<0.0001) with doctors scoring higher on these three factors when compared with nurses, pharmaceutical workers and medical laboratory scientist. The most endorsed training need was how to reorganise the workplace to prevent spread of COVID-19. This was chosen by 61.8% of medical laboratory professionals, 55.6% of doctors, 51.7% of nurses and 51.6% of pharmaceutical health workers. The most preferred modes of training were webinars and conferences. CONCLUSION: There were substantial differences in KAP regarding the COVID-19 pandemic among various categories of frontline HCWs surveyed. There were also group differences on COVID-19 training needs and preferences. Tailored health education and training aimed at enhancing and updating COVID-19 KAP are needed, particularly among non-physician HCWs.


Assuntos
COVID-19 , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Humanos , Nigéria , Pandemias , SARS-CoV-2 , Inquéritos e Questionários
16.
BMC Health Serv Res ; 21(1): 1000, 2021 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-34551779

RESUMO

BACKGROUND: Non-adherence to recommended therapy remains a challenge to achieving optimal clinical outcome with resultant economic implications. OBJECTIVE: To evaluate the effect of a pharmacist-led intervention on treatment non-adherence and direct costs of management among patients with type 2 diabetes (T2D). METHOD: A quasi-experimental study among 201-patients with T2D recruited from two-tertiary healthcare facilities in southwestern Nigeria using semi-structured interview. Patients were assigned into control (HbA1c < 7%, n = 95) and intervention (HbA1c ≥ 7%, n = 106) groups. Baseline questionnaire comprised modified 4-item Medication Adherence Questions (MAQ), Perceived Dietary Adherence Questionnaire (PDAQ) and International Physical Activity Questionnaire, to assess participants' adherence to medications, diet and physical activity, respectively. Post-baseline, participants were followed-up for 6-month with patient-specific educational intervention provided to resolve adherence discrepancies in the intervention group only, while control group continued to receive usual care. Subsequently, direct costs of management for 6-month pre-baseline and 6-month post-baseline were estimated for both groups. Data were summarized using descriptive statistics. Chi-square, McNemar and paired t-test were used to evaluate categorical and continuous variables at p < 0.05. RESULTS: Mean age was 62.9 ± 11.6 years, and 160(79.6%) were females. Glycated haemoglobin (HbA1c) was 6.1 ± 0.6% (baseline) and 6.1 ± 0.8% at 6-month post-baseline (p = 0.094) for control group, and 8.7 ± 1.5% (baseline) versus 7.8 ± 2.0% (6-month), p < 0.001, for the intervention. Post-baseline, response to MAQ items 1 (p = 0.017) and 2 (p < 0.001) improved significantly for the intervention. PDAQ score increased significantly from 51.8 ± 8.8 at baseline to 56.5 ± 3.9 at 6-month (p < 0.001) for intervention, and from 56.3 ± 4.0 to 56.5 ± 3.9 (p = 0.094) for the control group. Physical activity increased from 775.2 ± 700.5 Metabolic Equivalent Task (MET) to 829.3 ± 695.5MET(p < 0.001) and from 901.4 ± 743.5MET to 911.7 ± 752.6MET (p = 0.327) for intervention and control groups, respectively. Direct costs of management per patient increased from USD 327.3 ± 114.4 to USD 333.0 ± 118.4 (p = 0.449) for the intervention, while it decreased from USD 290.1 ± 116.97 to USD289.1 ± 120.0 (p = 0.89) for control group, at baseline and 6-month post-baseline, respectively. CONCLUSION: Pharmacist-led intervention enhanced adherence to recommended medications, diet and physical activity among the intervention patients, with a corresponding significant improvement in glycaemic outcome and an insignificant increase in direct costs of management. There is a need for active engagement of pharmacists in management of patients with diabetes in clinical practice. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04712916 . Retrospectively-registered.


Assuntos
Diabetes Mellitus Tipo 2 , Farmacêuticos , Idoso , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Nigéria , Estudos Retrospectivos
17.
Afr J Prim Health Care Fam Med ; 13(1): e1-e8, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34476972

RESUMO

BACKGROUND: Although shreds of evidence are emerging to show the role of illness perceptions in the health outcomes of patients, most of the previous studies have been on single chronic conditions. AIM: To assess the illness perceptions and the associated factors amongst adults with multimorbidity. SETTING: General outpatient clinics of the University College Hospital, Ibadan, Nigeria. METHODS: A cross-sectional study was conducted amongst a systematic sample of 403 adults with multimorbidity. Data on illness perception and other variables were collected using interviewer-administered questionnaires. Descriptive statistics, chi-square test, t-test and analysis of variance were employed for analyses. RESULTS: The age of the participants ranged from 18 to 97 years, with a mean of 60.9 years (standard deviation [s.d.] ± 14.3 years). The majority of participants (57.3%) were women. Ninety-four (23.3%) respondents had only two morbid conditions, whilst 31.2% had at least four morbid conditions. Prioritisation sub-domain of illness perception recorded the highest score (mean = 2.0, s.d. ± 0.8), whilst the treatment burden sub-domain was the lowest (mean = 0.8, s.d. ± 0.7). A significant bivariate relationship was observed between emotional representation (p = 0.001), prioritisation (p = 0.013) and causal relationship (p = 0.013) sub-domains and age group of study participants. Emotional burden associated with illnesses declined as educational level increased (p = 0.039). CONCLUSION: Patient's characteristics such as age, education and the number of morbidities are associated with illness perception. Healthcare providers should pay attention to these factors whilst addressing illness perception as a way to achieve better clinical outcomes.


Assuntos
Instituições de Assistência Ambulatorial , Multimorbidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Percepção , Atenção Primária à Saúde , Inquéritos e Questionários , Adulto Jovem
18.
West Afr J Med ; 38(8): 713-718, 2021 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-34499828

RESUMO

Prevention of mother-to-child transmission (PMTCT) of HIV programme provides antiretroviral treatment to HIV-positive pregnant women to reduce the likelihood of transmission to their infants. Despite concerted efforts to scale-up PMTCT services in Nigeria, coverage and uptake of the services by Antenatal Care (ANC) attendees is below the acceptable. Private health facilities provide ANC services to large number of women, but they are sparingly involved in PMTCT capacity enhancement interventions. This study assessed the knowledge and utilization of PMTCT services among women accessing antenatal care in Private Health facilities in Abakaliki, Ebonyi State. It was a descriptive cross-sectional study in ANC clinics of the health facilities. Data was collected using interviewer administered questionnaire and analysed with Statistical Package for Social Sciences (SPSS) version 22.0 and test of association was by Chi square at P<0.05 level of significance. Results showed mean age of the respondents was 27± 4.6 years. Majority of the respondents (83.4%) had good knowledge of PMTCT but only 68.4% accessed HIV Counselling and Testing (HCT) in the index pregnancy, with fear of stigmatization given as the major reason for not doing HCT. Only 54.5% of sero-positive attendees took anti-retroviral drugs (ARVs) during pregnancy though they all used ARVs during labour/ delivery. Utilization of PMTCT services of HIV wassignificantly associated with educational status and occupation. CONCLUSION: There was good knowledge of PMTCT but utilization of the services was suboptimal. Training and mentoring of health care workers in private facilities on HIV testing programmes is important to improve uptake of PMTCT services and allay fears of stigmatization among the pregnant women.


Assuntos
Infecções por HIV , Complicações Infecciosas na Gravidez , Adulto , Instituições de Assistência Ambulatorial , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Humanos , Lactente , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Nigéria , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/prevenção & controle , Cuidado Pré-Natal , Instalações Privadas , Adulto Jovem
19.
West Afr J Med ; 38(8): 719-725, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34499829

RESUMO

INTRODUCTION: Glutathione is a powerful naturally occurring anti-oxidant in the human body and is important in immunological response to infection. Glutathione depletion may play a pivotal role in the pathogenesis and progression of HIV disease. This study was done to compare plasma glutathione levels between HIV infected and uninfected children, correlate their glutathione levels with their WHO immunologic and clinical stages and determine prevalence of glutathione deficiency in HIV infected and uninfected children. METHODS: A cross-sectional study was conducted among 258 HIV infected children and their age and sex-matched controls in the two major hospitals providing paediatric HIV care in Benin City, Nigeria. Information was obtained using questionnaire. Plasma glutathione levels were determined in both groups using the spectrophotometric method involving the Dithio-bis -2-nitrobenzoic acid/Glutathione reductase enzyme (DTNB/GR) technique. Data was analyzed using paired t-test and spearman rank correlation. RESULTS: The mean plasma glutathione level was 8.82 ± 2.39 µmol/l, and 13.11 ± 3.20 µmol/l in HIV infected and uninfected children respectively, p < 0.0001. There was no significant correlation between plasma glutathione and both WHO immunologic staging (r= 0.011, p= 0.869) and clinical staging of HIV (r=0.053, p=0.379). Glutathione deficiency was present in 10.10% of HIV infected children and 0.70% of HIV uninfected children, p = 0.0001. CONCLUSION: Glutathione depletion occurs in children with HIV/AIDS and it has no relationship with clinical and immunologic staging of HIV in this study. Further studies are needed to ascertain the benefit of glutathione supplementation in HIV infected children.


Assuntos
Glutationa , Infecções por HIV , Criança , Estudos Transversais , Infecções por HIV/epidemiologia , Humanos , Nigéria/epidemiologia , Prevalência
20.
West Afr J Med ; 38(8): 726-731, 2021 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-34499830

RESUMO

INTRODUCTION: Although the usefulness of plasma brain natriuretic peptide (BNP) in early diagnosis of heart failure has been extensively studied, its value in predicting outcome of these patients has not been fully determined, particularly among African patients. OBJECTIVE: This study was aimed to evaluating the prognostic implications of pre-discharge BNP among hospitalized heart failure patients in Nigeria. METHODS: One hundred consecutive acutely decompensated heart failure patients managed in our center were recruited into the study. All subjects had clinical and echocardiographic evaluation. All had BNP assayed and were followed-up for six months. RESULTS: Fifteen patients (out of 91 who completed the study) died at the end of the study, giving a 6-month mortality rate of 16.5%. The mean BNP among non-survivors (655.0 ± 142.3pg/ml) was higher than survivors (409.7±178.2pg/ml) P <0.001. A plasma BNP level >525pg/ml was 87% sensitive and 75% specific for predicting death within 6-months (AUC0.854,95% CI 0.756-0.951, p<0.001). Kaplan-Meier survival curve also showed six-month survival to be significantly reduced in patients discharged with BNP levels >525pg/ml (57.6%) than in those with levels <525pg/ml (98.3%), p<0.001. CONCLUSION: Pre-discharge plasma BNP>525pg/ml in heart failure patients is predictive of early death within six months.


Assuntos
Insuficiência Cardíaca , Peptídeo Natriurético Encefálico , Biomarcadores , Insuficiência Cardíaca/diagnóstico , Humanos , Nigéria , Valor Preditivo dos Testes , Prognóstico
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