West African Journal Of Medicine[JOURNAL]
Sun
200 papers
The Value of Targeted Screening for Glaucoma: The University of Ilorin Teaching Hospital Experience.
Obajolowo TS, Yusuf IA, Adeoti SG … +3 more , Owoeye JFA, Taiwo MA, Olatunji FO
West Afr J Med · 2024 Jul · PMID 39356302
BACKGROUND: Glaucoma is an irreversible silent and dangerous eye condition that leads to damage of the optic nerve head. This study aimed to determine the outcome of targeted glaucoma outreaches done in the University of...
BACKGROUND: Glaucoma is an irreversible silent and dangerous eye condition that leads to damage of the optic nerve head. This study aimed to determine the outcome of targeted glaucoma outreaches done in the University of Ilorin Teaching Hospital over three years with a view to early detection and timely institution of management. METHODS: The study is a retrospective review of 3 targeted hospital-based glaucoma screenings, World Sight Day of 2019 (140 participants), World Glaucoma Week of 2020 (176 participants), and World Glaucoma Week of 2022 (183 participants). The criteria for diagnosing glaucoma and glaucoma suspects were taken from the national study of prevalence and types of glaucoma from the Nigerian national blindness survey and International Society for Geographical and Epidemiological Ophthalmology criteria. RESULTS: The study population had a mean age of 45.54 years (SD 16.92) with individuals within the age group of 51-60 years comprising the majority of the participants (26.4%). Most participants had normal vision or mild visual impairment in the right eye (411, 86.1%) and left eye (405, 84.9%) while blindness was recorded in the right eye of 37 (7.7%) participants and left eye of 36 (7.5%). The prevalence of glaucoma cases and suspects among study participants was 29.4% and 42.5%, respectively. There was a statistically significant relationship between the diagnosis of glaucoma and older age, family history of glaucoma and elevated intraocular pressure. CONCLUSION: This study showed that targeted screening for glaucoma is an invaluable tool for ensuring early detection of the disease.
Stress-Related Quality of Life Among Healthcare Professionals, and the Urgent Need for Systemic Reforms Towards Bridging Gaps in Healthcare Delivery.
Erhabor GE
West Afr J Med · 2024 Jul · PMID 39356284
Abstract loading — click title to view on PubMed.
Ebstein's Anomaly in a Young Nigerian Lady.
Antia SE, Isiguzo GC, Ajaero CC … +2 more , Okpala PO, Ugwu CN
West Afr J Med · 2024 Jun · PMID 39342421
BACKGROUND: Ebstein's anomaly (EA) is a rare congenital heart disease with a wide spectrum of presentation from the womb to adulthood characterized by apical displacement of tricuspid valve leaflets into the right ventri...
BACKGROUND: Ebstein's anomaly (EA) is a rare congenital heart disease with a wide spectrum of presentation from the womb to adulthood characterized by apical displacement of tricuspid valve leaflets into the right ventricle. This is due to defects in embryological processes of uncertain etiology. CASE SUMMARY: A 28-year-old woman who presented with palpitations from childhood occurring in short paroxysms daily and limiting her from strenuous activities. Physical examination findings revealed a small stature with no associated birth defects. The cardiovascular system revealed tachycardia, a small volume irregular pulse with a split S2 heart sound. ECG showed premature atrial complexes, fragmented QRS with Sodi-Pallares sign, and echocardiographic features in keeping with atrialization of right ventricle with apical displacement of septal leaflet of the tricuspid valve into the right ventricle in keeping with EA. The patient was placed on anti-arrhythmics and anticoagulants. CONCLUSION: The diagnosis of EA in adults is often delayed in low-resource settings for multifaceted reasons. However, medical therapy offers a conservative measure to preserve life while surgical correction is advocated for the majority of cases when picked up early.
Knowledge of Helping Babies Breathe Programme and the Determinants among Trainees in Edo State.
Enato IG, Olaniyi OK, Uduebor OJ … +7 more , Oriaifo S, Idemudia E, Enadeghe IA, Okhamafe F, Ezomo O, Osazee EM, Effiong VS
West Afr J Med · 2024 Jun · PMID 39342419
BACKGROUND: Neonatal deaths contribute up to 32% of early childhood deaths in Nigeria. Most neonatal deaths (75%) occur during the first week of life. Helping Babies Breathe (HBB) programme is an intervention launched in...
BACKGROUND: Neonatal deaths contribute up to 32% of early childhood deaths in Nigeria. Most neonatal deaths (75%) occur during the first week of life. Helping Babies Breathe (HBB) programme is an intervention launched in 2010 by The American Academy of Paediatrics and found to be effective in reducing neonatal mortality by 47%. The aim of this study was to assess the knowledge of HBB training programme and their determinants among Health Care Workers (HCWs) attending a training programme in Benin City. METHOD: This was a cross-sectional study involving 134 HCWs attending a HBB training programme in Edo State. A standardized questionnaire was used to assess knowledge of trainees prior to and at post-training. Chi-square and binary logistic regression were used to test association and identify determinants of HBB knowledge. RESULTS: A total of 134 trainees participated in the study. The majority of The HCWs (62.7%) had good knowledge. Following training, all HCWs (100%) had good knowledge of HBB training Programme. Job title/Profession (p=0.007) and qualification (p=0.030) of HCWs were significant determinants of knowledge of HBB. However, after controlling for confounders; Job title was the only significant determinant of knowledge of HBB (OR: 0.603; p=0.014; CI:0.403-0.902), with medical officers more likely to have good knowledge, compared to other HCWs, including paediatric resident doctors. Community health extension workers and nurse assistants had very poor knowledge compared to other HCWs. CONCLUSION: Job title was the only significant determinant of knowledge of HBB, as doctors working as medical officers are more likely to have good knowledge than other HCWs, including paediatric resident doctors. Community health extension workers and nurse assistants had very poor knowledge compared to other HCWs.
Trends in Dermatological Diagnoses During Covid-19 Pandemic in Nigeria: A Retrospective Study.
Anaje CC, Ezejiofor OI, Enechukwu NA … +3 more , Okpala CI, Onyekonwu CL, Nkesi JC
West Afr J Med · 2024 Jun · PMID 39342417
INTRODUCTION: Coronavirus disease (COVID-19) quickly became a pandemic causing a global concern affecting public health directly and indirectly. Dermatology outpatient services were not an exception to the impact of COVI...
INTRODUCTION: Coronavirus disease (COVID-19) quickly became a pandemic causing a global concern affecting public health directly and indirectly. Dermatology outpatient services were not an exception to the impact of COVID-19, especially in Sub-Saharan Africa. To the best of our knowledge, no similar study has been done in this region, and identifying patterns of dermatological diseases would help prepare adequately for future crises. OBJECTIVE: This study examined the changes in diagnostic patterns at the dermatology clinic before the COVID-19 pandemic and during the pandemic. METHODS: This retrospective study was conducted on dermatology outpatients seen at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. Diagnoses were compared during the pandemic (March to August 2020) with the corresponding period of the previous year. RESULTS: A total of 534 patients with 559 diagnoses were included. The average weekly dermatology clinic visits remained unchanged during the pandemic, although there was a 25.8% reduction in dermatology outpatients. The most common reasons for visiting the outpatient clinic during the COVID-19 pandemic were acne vulgaris, scabies, atopic dermatitis, dermatophytosis, and pityriasis versicolor. While the percentage of scabies significantly decreased during the pandemic; the percentage of allergic contact dermatitis, prurigo nodularis, candidiasis, hemangioma, and lupus erythematosus increased respectively. CONCLUSION: Although the COVID-19 pandemic had a negligible impact on the average weekly number of skin clinic visits, it caused a change in diagnostic patterns. Understanding the pattern of skin diagnoses may help hospitals better prepare for future pandemics.
Total Thyroidectomy versus Subtotal Thyroidectomy as a Suitable Surgery for Benign Thyroid Disorders.
El-Sayed WM, Elhariri S, Mekhaeel MSF … +1 more , Burud I
West Afr J Med · 2024 Jun · PMID 39340827
BACKGROUND: Surgical treatment of benign thyroid disease varies from lobectomy, subtotal thyroidectomy, and total thyroidectomy (TT). OBJECTIVE: The current study aimed to compare complications of both total and subtotal...
BACKGROUND: Surgical treatment of benign thyroid disease varies from lobectomy, subtotal thyroidectomy, and total thyroidectomy (TT). OBJECTIVE: The current study aimed to compare complications of both total and subtotal thyroidectomy (STT) for patients with bilateral benign thyroid disorders. METHODS: Sixty patients with benign goiter, 32 for TT and 28 for STT, where indications for surgery, operating time, hospital stay, and complications were studied. RESULTS: The incidence of transient recurrent laryngeal nerve (RLN) palsy was (6.25%) for TT vs (3.57%) for STT, and temporary hypoparathyroidism was (9.38%) in TT patients compared to (7.14%) in STT patients. Permanent RLN palsy and hypoparathyroidism occurred only in one case (3.12%) from the TT group. No permanent complications occurred in STT patients. Recurrence of goiter occurred in two patients (7.14%) undergoing STT. Incidental papillary carcinoma was (7.14%) in STT patients and (3.13%) for follicular carcinoma in TT patients. There was no postoperative mortality. CONCLUSION: TT is a suitable surgical procedure in patients with bilateral benign thyroid disease as complication rate, operative time, and hospital stay are less comparable to STT. It will give a permanent cure without recurrences, and incidental thyroid malignancies can be avoided.
A Comparative Study of Intelligence Quotients of Almajirai Attending Quranic Schools and Pupils of Selected Primary Schools in Zaria, Northwest Nigeria.
Abubakar-Abdullateef A, Mohammed A, Kusi-Mensah K … +2 more , Mohammed HD, Kakangi AS
West Afr J Med · 2024 Jun · PMID 39340822
BACKGROUND: Almajiri is a word that describes a child sent far away from his parents to study the Quran under the tutelage and care of a Muslim scholar, also known as a Mallam. In recent times, the capacity of the Mallam...
BACKGROUND: Almajiri is a word that describes a child sent far away from his parents to study the Quran under the tutelage and care of a Muslim scholar, also known as a Mallam. In recent times, the capacity of the Mallam to cater for these children has declined, leading them to beg on the streets for sustenance. Cognitive capacity has rarely been studied amongst this population. This study was designed to compare the intelligence quotients of Almajirai attending Quranic Schools and that of pupils attending public primary school in Zaria, Northwest Nigeria. METHODS: A comparative cross-sectional study design was employed to compare the intelligence quotients of 401 participants (200 Almajirai and 201 public primary school pupils). All participants were administered a socio-demographic questionnaire and the Wechsler Intelligence Scale for Children Fourth Version (WISC-IV). RESULTS: Public primary school pupils performed significantly better than Almajirai on all administered subtests of the WISC-IV except arithmetic. The mean Full-Scale IQ score of Almajirai was significantly lower than that of public primary school pupils (60.30±11.49 vs. 70.12 ± 11.9, p< 0.001, 95% CI= -12.12-7.52). The intelligence quotient of Almajirai was associated with the age of the child and the father's level of education while that of public primary school pupils was associated with their current class in school. CONCLUSION: Public primary school pupils performed better than Almajirai on intelligence tests indicating a need to reform Almajiri Education. It is recommended that the system be strengthened and its curriculum expanded to include other modules rather than its current restriction to religious education.
Prevalence of High Blood Pressure and Associated Factors among a Population of Apparently Healthy in-School Adolescents in Delta State, Nigeria: A Cross-Sectional Survey.
Umuerri EM, Oyibo P, Oyibo IA … +1 more , Eyawo O
West Afr J Med · 2024 Jun · PMID 39340813
BACKGROUND: Adolescence is a vulnerable phase when risky behaviours like smoking, poor diet, and physical inactivity set the stage for health problems like hypertension. OBJECTIVE: This study assessed the prevalence of h...
BACKGROUND: Adolescence is a vulnerable phase when risky behaviours like smoking, poor diet, and physical inactivity set the stage for health problems like hypertension. OBJECTIVE: This study assessed the prevalence of high blood pressure (HBP) and associated factors among apparently healthy inschool adolescents in Delta State, Nigeria. METHODS: A cross-sectional study was conducted among apparently healthy in-school adolescents aged 10 to 19 years, using a multi-stage random sampling technique. HBP was defined using the 2016 European Society of Hypertension Guidelines. Factors associated with HBP were determined using binary logistic regression. A p-value less than 0.05 was taken as significant. RESULTS: Of the 574 participants surveyed, 331 (57.7%) were females and 243 (42.3%) were males, with a female-to-male ratio of 1.36. The mean age of the study participants was 14.7 years. The mean systolic and diastolic blood pressure of the study participants were 118.81 (±12.703) and 70.16 (±9.972) mmHg respectively. Prehypertension and hypertension were present in 14.8% and 18.3% of the study population, respectively. Age 10-13 years (AOR = 7.70; 95% CI: 2.26-26.22; p = 0.001) and 14-16 years (AOR = 4.62; 95% CI: 1.40 -15.25; p = 0.001), upper socioeconomic status (AOR=1.19; 95% CI: 0.57-2.48; p = 0.020), and obesity (AOR = 2.14; 95% CI: 1.08-4.25; p = 0.039) were factors associated with HBP. CONCLUSION: The prevalence of hypertension among the study participants was significant. Factors associated with HBP include younger age (specifically 10-16 years old), higher socioeconomic status, and obesity.
Assessment of Rifampicin Indeterminate Results among Adult Patients attending a Tertiary Tuberculosis Treatment Center in Port Harcourt Rivers State using Shewhart control Charts: Implications for patients and Tuberculosis Control Programs.
Abaate TJ, Alali AA
West Afr J Med · 2024 Jun · PMID 39340811
BACKGROUND: Antimicrobial resistance is a growing global public health concern, and multidrug-resistant Tuberculosis is responsible for roughly one-quarter of all antimicrobial-resistant infection-related deaths worldwid...
BACKGROUND: Antimicrobial resistance is a growing global public health concern, and multidrug-resistant Tuberculosis is responsible for roughly one-quarter of all antimicrobial-resistant infection-related deaths worldwide. GeneXpert is a rapid, automated molecular test that detects multi-drug-resistant Tuberculosis using Rifampicin as a predictor. The World Health Organization (WHO) in 2010 recommended GeneXpert for national tuberculosis programs in developing countries; however, it has limitations. Indeterminate results for Mycobacterium tuberculosis indicate that the test could not determine whether the bacteria were resistant to Rifampicin. This study used the Shewhart Control Chart, which has action limits, to investigate the causes of indeterminate results. METHODS: GeneXpert indeterminate results obtained between January and December 2019 in a tertiary hospital in a low and middle-income country were plotted. The control limits on the Shewhart chart are central, upper, and lower. Points above the upper control limit and successive points occurring in one zone were used to determine whether or not the process was under control. RESULT: The resultant p-chart showed five points that were within the control limit, two points above the upper control limit, and five points consecutively in one zone on the plot. The former was characteristic of a stable process, while the latter was indicative of a special course variation respectively. The majority of the laboratory findings indicated an out-of-control signal. CONCLUSIONS: GeneXpert indeterminate results impact patient management by preventing accurate diagnosis and delaying the start of anti-tuberculosis medication. Machine malfunctions, low bacterial load, poor-quality samples, operator errors, or faulty laboratory materials could all be to blame. Regular equipment checks by laboratory personnel, program sponsors, or leadership will be highly beneficial in achieving the desired results and initiating appropriate treatment. A large sample size or a multicenter study, could provide more data and yield more robust findings about nonconforming laboratory processes in diagnosing Rifampicin resistance.
Heart Rate Variability in Healthy Young Adult Nigerians.
Adamu DB, Chori BS, Onaadepo O … +2 more , Ogedengbe JO, Odili AN
West Afr J Med · 2024 Jun · PMID 39340793
OBJECTIVE: Heart rate variability (HRV) is a reliable, non-invasive indicator of autonomic balance. Its application in research and clinical medicine is hindered by the lack of consensus on normal values. This study soug...
OBJECTIVE: Heart rate variability (HRV) is a reliable, non-invasive indicator of autonomic balance. Its application in research and clinical medicine is hindered by the lack of consensus on normal values. This study sought to bridge this gap by providing normative values for short-term HRV measures in apparently healthy young adults. METHODS: A descriptive cross-sectional study was carried out to determine short-term HRV measures using a 5-minute ECG recording among 840 healthy young adult Nigerians. RESULTS: A total of 840 subjects between the ages of 15 - 40 years participated in the study, the majority of whom were women (56%). Mean (±SD) RR (ms), SDNN (ms), RMSSD (ms), LF (ms2), HF (ms2), LF (nu), HF (nu), and LF/HF were 831 (±138), 48 (±35), 57 (±49), 949 (±2598), 1802(±5135), 41 (±19), 58.90 (±19), and 1.42 (±4.6) respectively. Male participants had significantly higher mean RR (890.8 v 782.0, p<0.001), SDNN (52.4 v 43.8, p<0.005), RMSSD (63.6 v 50.9, p<0.005), LF (1218.5 v 731.8, p<0.001) and HF (2260.5 v 1429.5, p=0.002) than the female participants. No significant differences were found across age groups. CONCLUSION: Short-term resting HRV shows gender differences and higher vagally-mediated components among healthy young adults of native African descent. Interpretation of HRV parameters should take into account the age, gender, context, spectral analysis method, and duration of recording, among other factors.
Prevalence of Intestinal Parasitic Infections Among Pregnant Women: A Multi-Centre Survey.
Ocheja SE, Adesina O, Makanjuola O
West Afr J Med · 2024 Jun · PMID 39340789
BACKGROUND: Intestinal parasitic infection (IPI) is a serious public health challenge often neglected in most developing countries. Pregnant women are a high-risk population for these infections which can result in adver...
BACKGROUND: Intestinal parasitic infection (IPI) is a serious public health challenge often neglected in most developing countries. Pregnant women are a high-risk population for these infections which can result in adverse pregnancy outcomes such as maternal anaemia, preterm delivery and low birth weight. OBJECTIVE OF THE STUDY: To assess the prevalence and factors associated with the risk of acquisition of intestinal parasitic infections among pregnant women attending antenatal clinics in selected public hospitals in Ibadan, South Western Nigeria. METHODS: A hospital-based cross-sectional study was carried out among 598 pregnant women attending antenatal clinics in selected public hospitals in Ibadan, South Western Nigeria. Five public hospitals were purposively selected based on their antenatal clinic client attendance before this study. Data was collected to assess sociodemographic characteristics, health-seeking behaviours, water sanitation and hygiene practices (WASH). Stool samples from each pregnant woman were examined for the presence of intestinal parasites by microscopy using the direct wet mount and Ziehl Neelsen staining technique. RESULTS: The overall prevalence of intestinal parasites was (96, 16.1%). Ascaris lumbricoides were the most prevalent parasites (68, 71.0%) followed by Enterobius vermicularis (16, 17.0%), Entamoeba histolytica (8,8.0%) and the least identified parasite was hookworm (4, 4.0%). At bivariate analysis level, level of education, maternal income and type of waste disposal system in use were significantly associated with IPI infection. Using multivariate logistic regression, the age range of 30-34 years (AOR= 0.24, CI 0.08, 0.70) and having a degree (AOR=0.21 CI 0.05-0.85) were independent predictors of IPIs. CONCLUSION: This study highlights a high prevalence of intestinal parasitic infection among pregnant women in our setting. The main predictive factors were the educational status and age of the pregnant women. There is therefore need for continuous health education to prevent intestinal parasitic infections in the at-risk population.
Relationship Between Blood Pressure Control and Self-Care Practices Among Hypertensive Patients Attending Family Medicine Clinic of Lagos State University Teaching Hospital, Lagos, Nigeria.
Odunaye-Badmus SO, Sodipo OO, Malomo SO … +2 more , Oluwatuyi OE, Odiana RN
West Afr J Med · 2024 Jun · PMID 39340787
BACKGROUND: Hypertension is one of the most prevalent chronic diseases worldwide and poses a global health challenge. Self-care practices are essential for blood pressure control and reduction of complications of hyperte...
BACKGROUND: Hypertension is one of the most prevalent chronic diseases worldwide and poses a global health challenge. Self-care practices are essential for blood pressure control and reduction of complications of hypertension such as cardiovascular and renal diseases. AIM: The study aimed to assess the relationship between blood pressure control and hypertension self-care practices among hypertensive patients attending the Family Medicine clinic of Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria. METHODOLOGY: A descriptive, hospital-based, cross-sectional study was conducted among 407 hypertensive patients attending the outpatient clinic. The participants were recruited using systematic sampling with a sampling interval of 1 in 4. An interviewer-administered questionnaire was used to obtain relevant data. Data analysis was performed using SPSS version 23. RESULTS: A total of 407 participants were enrolled in the study. In this study, 56.8% of the participants had good blood pressure control. On hypertension self-care practices, only 1 % of the participants adhered to low salt diet; 45% adhered to recommended physical activity; 52.8% adhered to weight management; 71.5% had good medication adherence; 93.9% abstained from alcohol and 96.8% of participants abstained from smoking. Overall, none of the domains of hypertension self-care practice was associated with blood pressure control even though there was a trend that those who adhered to the domains of self-care practice had better blood pressure control. CONCLUSION: Hypertension self-care practice among participants could be better. Participants who had good self-care practice had better blood pressure control however; this was not statistically significant.
Risk Factors Associated with Under Five Children Mortality in Northeast Nigeria; A Retrospective Analysis of National Demographic and Health Survey Data.
Misau YA, Bashir MF, Dabo MM … +8 more , Adamu AS, Dattijo LM, Musa AZ, Ahmad SM, Yaya J, Meremikwu M, Usman BM, Abdulhamid NK
West Afr J Med · 2024 Jun · PMID 39340779
BACKGROUND: Under-five children mortality rate (U5MR) remains a crucial indicator of a nation's child healthcare and socioeconomic development. This study aims to identify and quantify significant maternal, child, family...
BACKGROUND: Under-five children mortality rate (U5MR) remains a crucial indicator of a nation's child healthcare and socioeconomic development. This study aims to identify and quantify significant maternal, child, family, and environmental risk factors contributing to under-five mortalities in the Northeast geopolitical zone of Nigeria. METHODS: Retrospective analysis of secondary data from the 2018 National Demographic and Health Survey (NDHS) in six northeastern Nigerian states. Maternal factors (age, education, health-seeking behavior), child variables (weight, sex, vaccination status), family factors, and environmental factors (water source, residence, wealth index) were analyzed to determine their association with the under-five mortality rate (U5MR). Logistic regression models and population-attributable risk estimates were used to identify key contributors to U5MR in the region. RESULTS: A total of 26,293 mothers were surveyed, of which the majority (93.6%) were married, employed (70.7%), and had no insurance (99%). Most of the mothers were above 35 years of age, uneducated and with first birth between ages 15-19. Adjusted odds ratios show unmarried mothers 1.67 (P=0.015), small birth size 1.37 (P=0.022), never breastfeeding 1.83 (P=0.000), short birth intervals 1.50 (0.005), higher parity 1.5 (P=0.005), lack of any family planning method 1.43(P=0.040), twin siblings 3.95 (P=0.000) and place of residence 1.21 (P=0.000) were associated with higher U5MR odds ratios. Maternal age 21-25 years showed a protective effect AOR 0.59 (95% CI: 0.36-0.98, P=0.040) and age > 31 years AOR 0.44 (95% CI: 0.24-0.81, P=0.009). CONCLUSION: This study provides crucial insights into the multifaceted determinants of under-5 mortality in Northeast Nigeria. The findings underscore the importance of tailored interventions addressing maternal, child, and family factors to improve child health outcomes in the region.
A Survey of What Healthcare Professionals Consider as Relevant for Decisional Autonomy in Health and Treatment in Nigeria.
Sorinmade O, Elugbadebo O, Bello T
West Afr J Med · 2024 Jun · PMID 39340766
BACKGROUND: Autonomy is one of the key ethical principles enshrined in Part II of the Nigerian National Health Act 2014. To ensure compliance with this principle, it is pertinent that Health Care Professionals (HCPs) und...
BACKGROUND: Autonomy is one of the key ethical principles enshrined in Part II of the Nigerian National Health Act 2014. To ensure compliance with this principle, it is pertinent that Health Care Professionals (HCPs) understand and know what it entails to ensure that patients are empowered to pursue their decisional autonomy. This survey seeks to explore what HCPs consider as relevant for empowering patients to exercise decisional autonomy, in line with the Nigerian Health Act. METHODS: An online survey, targeted at Nigerian HCPs, was conducted to explore what they consider as relevant in enabling an individual to make autonomous decisions about their health and treatment. RESULTS: HCPs consider patients' soundness of mind as relevant in making autonomous decisions about their health and treatment. Factors such as patients' current health status, their understanding of treatment options, risks, benefits, and patients' ability to understand and retain information were considered relevant in making informed decisions about their health. Factor analysis of the study questionnaire revealed that the designed questionnaire can be used to audit how well HCPs empower their patients with their decisional autonomy. The reliability coefficient of the questionnaire was found at 0.718. CONCLUSIONS: Our study found a convergence of views by HCPs and the Nigerian Health Act on enabling the decisional autonomy of patients regarding their health and treatment. Competent patients should be given the necessary knowledge about their condition, available diagnosis, and available treatment as well as support to empower them to make truly autonomous decisions regarding their health and treatment.
Physicians' Perception on the Relevance of Healthcare Marketing in a Tertiary Hospital, South-West, Nigeria.
Adebawojo TO, Adekiya VA, Abesin OO … +4 more , Ugwuchukwu NH, Adeniji OI, Adekanle MD, Esan TO
West Afr J Med · 2024 Jun · PMID 39340763
BACKGROUND: Developing nations like Nigeria lose an appreciable percentage of their revenue through medical tourism. The majority of the elite class is not even aware that some of the Medical care sourced in the western...
BACKGROUND: Developing nations like Nigeria lose an appreciable percentage of their revenue through medical tourism. The majority of the elite class is not even aware that some of the Medical care sourced in the western climes can readily be accessed locally in some of the healthcare facilities around, amounting to a load of missed opportunities some of which would have been avoided through effective healthcare marketing. This study assessed the perception of healthcare providers on healthcare marketing in Obafemi Awolowo University Teaching Hospital, Ile Ife, Osun State, Nigeria. METHODOLOGY: This is a cross-sectional study. Data collection was by simple random sampling with the aid of a self-administered questionnaire among 190 medical doctors working at Obafemi Awolowo University Teaching Hospital, Ile-Ife. The quantitative data were entered and analyzed using IBM SPSS Statistics version 22. Univariate and bivariate modes of analysis were employed to determine associations between socio-demographic characteristics and the perception of healthcare providers on healthcare marketing. The level of significance was defined at a 95%, confidence interval (p<0.005). RESULTS: The majority of the respondents (79.6%) had good knowledge about services rendered in the facility and a good perception (86.9%) about healthcare marketing with significant association with their specialties as more of the surgically related specialties (93%) recommended healthcare marketing. Among the respondents, (85.6%) agreed that public hospitals have to provide information about the services they offer; (93.4%) agreed that patients have the right to receive information about the services offered, and (63.5%) did not agree that marketing in healthcare is unethical. More than sixty percent of the respondents (62.3%) agreed that healthcare marketing will reduce medical tourism and improve service quality (74.3%). Majority (85%) of the respondents recommended that their healthcare facility should invest in healthcare marketing. CONCLUSION: The study revealed that a high proportion of healthcare providers have a good perception of healthcare marketing and will support their facility's investment in it as this will improve the quality services and increase patients patronage within the health sector.
Effect of Dietary Phosphate Restriction in Pre-Dialysis Chronic Kidney Disease Patients with Hyperphosphataemia in Southern Nigeria.
Edeki IR, Unuigbe EI, Okaka EI
West Afr J Med · 2024 Jun · PMID 39340208
BACKGROUND: Hyperphosphataemia is a common cardiovascular risk factor in chronic kidney disease (CKD). Dietary counseling and control are key aspects in the management of CKD. Although some studies have shown the benefic...
BACKGROUND: Hyperphosphataemia is a common cardiovascular risk factor in chronic kidney disease (CKD). Dietary counseling and control are key aspects in the management of CKD. Although some studies have shown the beneficial effects of dietary phosphate restriction on cardiovascular and bone health in haemodialysis patients, little is known about its effect in pre-dialysis CKD patients. AIM: To determine the effect of dietary phosphate restriction in predialysis CKD patients with hyperphosphataemia. METHODS: A hospital-based interventional study involving 72 predialysis CKD patients with hyperphosphataemia randomly allocated into 2 groups. Group 1 had nutritional counseling on dietary phosphate restriction while group 2 had no form of dietary phosphate restriction. All participants were placed on a phosphate binder throughout the study period of 3 months. At the end of the third month, a repeat of baseline tests (serum phosphate, calcium, albumin, creatinine and serum lipids) and anthropometric measurements were done and compared between the 2 groups. RESULTS: The mean age in the treatment and control groups were 54.6±14.7 years and 54.9±14.5 years, respectively. The mean serum phosphate (5.7±0.5 vs. 5.5± 0.4mg/dl), calcium (7.9±0.9 vs. 7.8± 0.7mg/dl), albumin (3.8±0.4 vs. 3.9±0.7g/dl), creatinine (3.9±1.3 vs. 3.7±1.2mg/dl) and body mass index (BMI) (25.0±3.9 vs.25.4±3.1kg/m2) were similar in both groups. Serum phosphate, potassium, fasting blood glucose (FBG), total cholesterol, triglycerides and BMI were significantly reduced while there was no significant change in serum calcium-phosphate product and haematocrit following dietary phosphate restriction in addition to use of phosphate binders. However, on comparison of the changes between the treatment and control groups preand post- intervention, there was no significant change in serum phosphate but there was significant decrease in serum potassium, triglyceride and FBG. CONCLUSION: The use of phosphate binders in pre-dialysis CKD significantly reduced serum phosphate while additional dietary phosphate restriction had no significant effect on serum phosphate lowering and there was no significant change in nutritional status in predialysis CKD patients with hyperphosphataemia.
Early Versus Delayed Oral Feeding in Emergency Gastrointestinal Surgeries.
Akanbi OO, Oguntola AS, Adeoti ML … +3 more , Olaogun JG, Idris OL, Fadiora SO
West Afr J Med · 2024 Jun · PMID 39340200
BACKGROUND: Early postoperative oral feeding has been documented to improve outcomes in patients who have undergone open or laparoscopic elective bowel surgeries. Available data on the safety and outcomes of early postop...
BACKGROUND: Early postoperative oral feeding has been documented to improve outcomes in patients who have undergone open or laparoscopic elective bowel surgeries. Available data on the safety and outcomes of early postoperative oral feeding in patients who underwent emergency gastrointestinal surgeries are inconclusive. OBJECTIVE: This study was conducted to compare and determine the safety, benefits and outcomes of early postoperative oral feeding and delayed oral feeding after emergency gastrointestinal surgeries. METHODS: Sixty patients who underwent emergency gastrointestinal surgeries were randomized either into the early feeding group (EFG) or the delayed feeding group (DFG). The patients in EFG commenced a graded oral liquid diet on postoperative day 1 (POD 1) while patients in DFG were commenced on a graded oral diet after the return of bowel function. The main endpoints were the need to re-insert the nasogastric tube and the overall length of hospital stay. RESULTS: The mean age of patients in the EFG and DFG were similar ((33.2±8.94 versus 33.9±8.91; p= 0.7407). Seventeen (56.7%) patients in EFG failed to tolerate early oral feeding compared to 8 (26.7%) patients in DFG who failed to tolerate feeding following the commencement of oral feeding (p= 0.036). Of the patients that were unable to tolerate oral feeding; thirteen (76.5%) of the 17 patients in EFG required re-insertion of NG tube for stomach decompression as compared to two (25%) of the 8 patients in DFG (p=0.0441). The mean length of hospital stay was longer in EFG (9±2.34 vs 6.5±1.04; p<0.001). CONCLUSION: Early postoperative oral feeding in patients who underwent emergency gastrointestinal surgeries was associated with a high failure rate and increased risk of postoperative complications with a prolonged length of hospital stay.
Concordance Between Clinical and Histopathological Diagnosis of Skin Diseases in South-South Nigeria: A Two-Center Study.
Ogunbor OE, Madubuko CR, Okoye CA … +1 more , Imasogie DE
West Afr J Med · 2024 Jun · PMID 39340193
BACKGROUND: An accurate diagnosis is the bedrock of the treatment of skin diseases. This study aimed to evaluate the correlation between clinical and pathological diagnosis of patients with skin disorders seen in dermato...
BACKGROUND: An accurate diagnosis is the bedrock of the treatment of skin diseases. This study aimed to evaluate the correlation between clinical and pathological diagnosis of patients with skin disorders seen in dermatology units of Federal Medical Centre (FMC), Asaba, Delta State, and the University of Benin Teaching Hospital (UBTH), South-South Nigeria between 2019 - 2021. MATERIAL AND METHODS: This was a retrospective study of the charts of all patients seen in the dermatology units of FMC Asaba and UBTH who had skin biopsies for various skin diseases from 2019 to 2021. Biodata, clinical information, diagnosis, and histology results of these patients were collected using a questionnaire. One hundred and sixty-two (162) patients were excluded on account of the absence of a clinical diagnosis and a pathological conclusion of insufficient tissue sample. RESULTS: 356 skin biopsies were included. The male-to-female ratio was 1:1.18 and most patients were aged 40 to 49 years 74 (20.8%) with a mean age of 38.28± 19.19. Papulosquamous skin disorders accounted for 141 of the clinical diagnoses (39.0%) Among the histology request forms filled, only 69 (19.4% ) had detailed clinical history. Clinico-pathological concordance (CPC) was recorded in 214 (60.1%) cases and discordance in 142 (39.9%), both the highest concordance and discordance percentages were among papulosquamous diseases (45.1% and 31.5% respectively). There was no significant association between the completeness of documentation of patient's clinical information and clinicopathological concordance. CONCLUSION: Although the CPC was above 50% in this study, better modalities of communication between dermatologists and pathologists is desired.
Addressing the Persistent Burden of Under-Five Mortality, and the Growing Importance of Healthcare Marketing.
Erhabor GE
West Afr J Med · 2024 Jun · PMID 39340189
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The Respiratory Effects of Chronic Exposure to Gas Faring Among Residents of Some Communities in the Niger Delta Region of Nigeria.
Ekwere EM, Umoh IO, Peters GE … +4 more , Udo AI, Effiong AE, Peters EJ, Bandele EA
West Afr J Med · 2024 May · PMID 39212619
BACKGROUND: This study presents the pattern of respiratory effects seen among residents chronically exposed to gas flaring in some communities in the Niger Delta Region, Nigeria. The other health challenges associated wi...
BACKGROUND: This study presents the pattern of respiratory effects seen among residents chronically exposed to gas flaring in some communities in the Niger Delta Region, Nigeria. The other health challenges associated with this chronic exposure to gas were also evaluated in the study. METHODS: A total of three hundred and eighty-six 386 adult residents in Ibeno, Niger Delta Region who have been residents for at least two years. Four hundred and fourteen (414) age, sex, and height-matched control unexposed residents in Etinan were recruited for a cross-sectional survey study comparing their respiratory symptoms and other related health challenges. Past and current smokers were excluded from the study in both groups. The study was conducted using a questionnaire as the investigative tool. Both descriptive and inferential statistics were used to analyze the data. RESULTS: Most of the respondents in both exposed and control communities were aged 18-30 years, with a height range of 161-170 cm. Both exposed and control subjects experienced similar symptoms suggestive of respiratory disorders, however, the prevalence was significantly higher among exposed subjects than controls: Cough 57(14.8%) vs. 39(10.1%); breathlessness 58(15%) vs. 28(7.3); wheezing 22(5.7) vs. 12(3.1). The respondents from the exposed community were mostly traders and fishermen while the controls were predominantly farmers. CONCLUSION: There is substantial evidence from the data presented that prolonged exposure to air pollution from gas flaring has significant respiratory and other health implications on residents in these communities reflected as increased frequency of symptoms of cough, chest pain, difficulty in breathing, wheezing, chest tightness, Skin and eye irritation. There is therefore an urgent need for intensified efforts and commitment by the government to speed up the implementation of policies regarding the reduction of flaring of natural gas associated with oil production and the adoption of measures to mitigate the effect of the exposure on human health.
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