West African Journal Of Medicine[JOURNAL]
Sun
200 papers
The Impact of Diabetes Self-Management Education (DSME) on the Quality of Life of patients living with type-2 Diabetes Mellitus in Nigeria.
Osonuga A, Olufemi K, Osonuga O … +3 more , Osonuga A, Okoye G, Osonuga A
West Afr J Med · 2024 Aug · PMID 39736162
BACKGROUND: Type 2 diabetes mellitus (T2DM) significantly affects the quality of life (QoL), necessitating comprehensive management strategies. In resource-limited settings such as Nigeria, managing diabetes can be chall...
BACKGROUND: Type 2 diabetes mellitus (T2DM) significantly affects the quality of life (QoL), necessitating comprehensive management strategies. In resource-limited settings such as Nigeria, managing diabetes can be challenging due to limited access to medications, which impacts patients' QoL. Diabetes Self-Management Education (DSME) empowers patients through knowledge and skills, potentially improving their QoL. This study aimed to assess the impact of DSME on the QoL of T2DM patients in Nigeria. METHODOLOGY: A quasi-experimental (pre-test and post-test) design was employed at the Olabisi Onabanjo University Teaching Hospital in Nigeria. Adult patients with uncomplicated T2DM who regularly attended the diabetic clinic were systematically sampled. Data was collected using a structured questionnaire covering demographics, QoL, self-monitoring knowledge, and self-management competence. A DSME program, including modules on nutrition, exercise, and foot care, was implemented. Pre- and post-intervention measurements were taken, and the data was analyzed. RESULTS: The study revealed significant improvements in all QoL domains after the DSME intervention, including physical functioning, role-physical, bodily pain, general health, social functioning, role-emotional, and mental health (p<0.001 for most domains). Postintervention, self-management competence scores showed a significant increase (mean difference: -9.655, p<0.001), and fasting blood glucose levels decreased significantly following DSME (mean difference: 14.897 mg/dL, p<0.001). Multivariate regression analysis demonstrated that DSME significantly enhanced post-intervention QoL scores (coefficient: 3.5054, p=0.001). Higher baseline QoL and education levels were positively associated with better outcomes. CONCLUSION: The findings highlight that DSME significantly enhances the QoL, self-management competence, and glycemic control among T2DM patients in Nigeria. These results underscore the importance of structured educational interventions in diabetes care, particularly in resource-limited settings.
Effectiveness of Monthly Versus Two-Dose Regimen of Sulphadoxine-Pyrimethamine for Intermittent Preventive Treatment of Malaria in Pregnancy in Southeastern Nigeria: A Randomised Controlled Trial.
Odoh GU, Agu PU, Ugwu EO … +9 more , Dim CC, Obi SN, Nnagbo JE, Eze MI, Eleje GU, Ekwuazi KE, Ugwu AO, Ekwueme PC, Anigbo CS
West Afr J Med · 2024 Aug · PMID 39736161
BACKGROUND: There are reports of a high prevalence of maternal peripheral and placental malarial parasitaemia (MP) in southeastern Nigeria following the two-dose regimen of sulphadoxine-pyrimethamine (SP) for intermitten...
BACKGROUND: There are reports of a high prevalence of maternal peripheral and placental malarial parasitaemia (MP) in southeastern Nigeria following the two-dose regimen of sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment (IPT) of malaria in pregnancy. OBJECTIVE: To compare the effectiveness of monthly versus two-dose regimens of SP for IPT of malaria in pregnancy in Enugu, south-eastern Nigeria. METHODS: A randomized controlled trial involving antenatal clinic attendees at the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria. Pregnant women at gestational ages between 13 - 24 weeks were randomized into two groups; intervention group and control group to receive monthly dosing and a two-dose regimen of IPT-SP respectively. Peripheral and placental malaria parasitaemia (MP) and other outcome measures were compared between the two groups. RESULTS: Prevalence of placental parasitaemia ( 18% vs. 40.6%; RR: 0.44; 95% CI: 0.27 - 0.72; P < 0.001) and maternal peripheral parasitaemia (10.0% vs. 31.7%; RR: 0.32; 95% CI: 0.16 - 0.61; P < 0.001) were significantly lower in the intervention compared to the control group. Similarly, maternal anaemia (39.0% versus 57.4%, p<0.05), neonatal malaria parasitaemia (5.0% versus 16.8%, p < 0.05) and neonatal anaemia (10.0% versus 23.8%, < 0.05) were all significantly lower in the intervention than the control group. However, the incidence of low birth weight (LBW) did not differ between the two groups (P=1.0). CONCLUSION: Monthly IPT-SP is more effective in preventing malaria in pregnancy than the standard two-dose regimen. We recommend the universal adoption of this regimen in all obstetric care units.
Prevalence of Acute Kidney Injury (AKI) in Children with Severe Malaria Using a Novel Biomarker: Serum Neutrophil Gelatinase Associated Lipocalin (NGAL) in Enugu.
Okafor HU, Mbanefo N, Nnakenyi I … +4 more , Ayuk AC, Nnajekwu UC, Ossai EN, Chinawa JM
West Afr J Med · 2024 Aug · PMID 39736157
OBJECTIVES: This study aims to determine the prevalence of Acute Kidney Injury (AKI) among children with severe malaria who present to the emergency room, using serum creatinine and NGAL levels as biomarkers. It also aim...
OBJECTIVES: This study aims to determine the prevalence of Acute Kidney Injury (AKI) among children with severe malaria who present to the emergency room, using serum creatinine and NGAL levels as biomarkers. It also aims to ascertain which biomarker (serum creatinine and NGAL) detects AKI earliest, especially at day 0. The study is also aims to determine the relationship between parasite density and levels of serum NGAL. METHODS: This was a cross-sectional and observational study carried out in the Children's emergency room (CHER) of two tertiary institutions which also served as referral centres for children with renal disease in Enugu metropolis. RESULTS: The prevalence of AKI using NGAL at day 0 was 74.4% while with NGAL at day 2, it was 35.9%. The prevalence of AKI using serum creatinine at day 0 was 7.7% while with that at day 2 was 5.1%. There was a very weak negative correlation between parasite density count and serum creatinine at 48 hours but this was not found to be statistically significant, (n=38, r=-0.156, p=0.499). There was a moderate positive correlation between creatinine at 0 hours and NGAL at day 2, r = 0.483; p = 0.017). There was also a moderate positive correlation between creatinine at 48 hours and NGAL at day 2, (r (21) = 0.565; p = 0.005). A significant regression equation was found F (1, 21) = 5.844, p < 0.025 with an adjusted R2 of 0.180. Participants predicted serum creatinine at day 2 was equal to - 1.96 + 0.179 x (serum NGAL at day 48). Serum creatinine at day 2 increased by 0.179 for every unit increase in NGAL. CONCLUSION: This study has documented a high prevalence of AKI using NGAL. It also showed the importance of NGAL in predicting AKI earlier than creatinine at day zero and 48 hours.
Evaluating the Factors Influencing Bacterial Vaginosis in Pregnant Women: An Analytical Cross-Sectional Study.
Oyedeko OM, Olumodeji AM, Adewunmi AA … +2 more , Ottun TA, Rabiu KA
West Afr J Med · 2024 Aug · PMID 39736155
INTRODUCTION: Bacterial Vaginosis (BV) has consistently been associated with adverse obstetric and gynaecological outcomes. It is a common vaginal condition. This study determined the prevalence and factors associated wi...
INTRODUCTION: Bacterial Vaginosis (BV) has consistently been associated with adverse obstetric and gynaecological outcomes. It is a common vaginal condition. This study determined the prevalence and factors associated with BV among pregnant women. METHODS: This study was a prospective analytical cross-sectional study in which 350 pregnant women, attending the antenatal clinic of the Lagos State University Teaching Hospital, over 6 months, had high vaginal swab samples taken aseptically and examined for Bacterial Vaginosis using the Nugent scoring system. Relevant sociodemographic, obstetric and gynaecologic data were obtained with a structured interview-based questionnaire. The odds ratio (OR) and 95% confidence intervals (CI) for possible risk factors for BV were determined. RESULTS: The prevalence of bacterial vaginosis in pregnancy was 32%. Bacterial vaginosis was independently associated with no formal education [OR 4.19, 95% CI 2.47-4.56, p= 0.001]; primary education (OR 3.50, 95% CI 2.42-4.14, p<0.001); secondary education (OR 1.75, 95% CI 1.16- 2.41, p=0.009); increased coital frequency (OR 1.78, 95% CI 1.24-2.31, p=0.003); douching with water (OR 2.69, 95% CI 1.41- 4.43; p=0.004); douching with Dettol (OR 7.19, 95% CI 2.51- 8.61, p=0.004); douching with soap (OR 5.76, 95% CI 3.54-7.41, p< 0.001); HIV infection (OR 2.75, 95% CI 1.65-3.15, p=0.003) and obesity (OR 1.77 95% CI 1.20- 2.33, p=0.006). CONCLUSION: The prevalence of bacterial vaginosis is high in pregnancy. It is significantly associated with low levels of education, increased coital frequency, douching, HIV infection, and obesity in pregnancy.
From Prevention to Early Diagnosis: Tackling Acute Kidney Injury in Children, and Other Critical Health Challenges.
Erhabor GE
West Afr J Med · 2024 Aug · PMID 39736153
Abstract loading — click title to view on PubMed.
INTIMATE PARTNER VIOLENCE IN PREGNANCY: A UNIVERSAL HEALTH IMPEDIMENT.
Chiejine GI, Ezeama N, Ebima CO … +3 more , Egbe E, Ajator C, Okeke IU
West Afr J Med · 2024 Nov · PMID 39535379
BACKGROUND: Intimate partner violence in pregnancy is a hidden global pandemic, a hindrance to universal health. It interferes with the Sustainable Development Goals 3 and 5. OBJECTIVE: This study investigated the preval...
BACKGROUND: Intimate partner violence in pregnancy is a hidden global pandemic, a hindrance to universal health. It interferes with the Sustainable Development Goals 3 and 5. OBJECTIVE: This study investigated the prevalence and factors contributing to intimate partner violence in pregnancy (IPVP) among antenatal attendees in a tertiary health facility in Anambra state. METHOD: The study was a facility-based descriptive cross-sectional study conducted among 400 respondents at the Ante-Natal clinics of Nnamdi Azikiwe University Teaching Hospital. RESULTS: The mean age of respondents was 30.0 years (±5.3). The overall prevalence of IPVP was 27.3%. The prevalence of psychological, controlling behaviours, physical and sexual IPV were 17.0%, 16.0%, 5.3%, and 1.0% respectively. The factors associated with IPVP were experiencing IPV before pregnancy (OR:21.354, 95%CI:7.329-63.077, P =0.0001), the educational status of the partner (OR: 4.429; 95%Cl:1.616-12.136; P=0.009), justifying husband to beat spouse if she offends him (OR:4.376, 95% CI:1.737-11.024,C P <0.001), witnessed IPV during childhood or adolescence (OR:2.311, 95% CI:1.439-3.711, P <0.001). CONCLUSION: Creating awareness, screening of pregnant women, and effective interventions will reduce IPV in pregnancy.
Cerebral Echinococcosis Mimicking a Brain Tumour in Rural Southwest Nigeria.
Buhari MO, Omoseebi O, Oyeleye OO … +3 more , Folaranmi O, Erinomo OO, Adeniyi OM
West Afr J Med · 2024 Jul · PMID 39357093
Echinococcosis is a zoonosis caused by tapeworms of the genus Echinococcus. Cerebral echinococcosis (CE) poses a significant public health challenge due to its neglected status. It is endemic in Central Asia, Africa and...
Echinococcosis is a zoonosis caused by tapeworms of the genus Echinococcus. Cerebral echinococcosis (CE) poses a significant public health challenge due to its neglected status. It is endemic in Central Asia, Africa and parts of South America, with prevalence estimated to be 1.18-3 per 100,000 population in Iran. We report the case of a 45-year-old male who presented with seizure disorders and was evaluated and treated for a neoplasm, with complete excision of the lesion. Pathologic examination revealed the characteristic echinococcal (hydatid) cyst. The patient recovered fully. As CE is a great imitator of several other conditions in endemic areas, a high index of suspicion must be maintained in endemic countries.
Intramural Pregnancy: An Intriguing Diagnosis in a Resource Constraint Practice.
Lawal OO, Obajimi GO, Okor CM … +1 more , Ogunsola JA
West Afr J Med · 2024 Jul · PMID 39357067
A 30-year-old G4P1+2(1 alive) woman with a history of cervical incompetence initially presented at a gestational age (GA) of 10 weeks and 6 days with lower abdominal pain and was managed conservatively as a case of threa...
A 30-year-old G4P1+2(1 alive) woman with a history of cervical incompetence initially presented at a gestational age (GA) of 10 weeks and 6 days with lower abdominal pain and was managed conservatively as a case of threatened miscarriage. She re-presented two weeks later and was admitted on account of lower abdominal pain and spotting per vagina of 4hrs duration. An obstetric ultrasound revealed an intrauterine pregnancy invading the posterior myometrium with thinning of the uterine wall and hemoperitoneum. She subsequently had an exploratory laparotomy, evacuation of the hemoperitoneum, separation of the fetus from the myometrium, and repair with no. 2 vicryl suture. The patient recovered satisfactorily and had two units of whole blood transfused. She was managed with analgesics, hematinics and broad-spectrum antibiotics. She was discharged on the 4th post-operative day to be followed up at the gynaecological clinic.
Biventricular Hypertrophic Cardiomyopathy in a 26-year-old Nigerian Woman with Noonan Syndrome.
Ogah OS, Aje A, Obasuyi VA … +12 more , Orimolade OA, Nebo IT, Ajao FA, Olawuyi DA, Olalekan VK, Ogah CM, Obiekwe FE, Odenigbo MN, Adebayo OM, Adeoye AM, Oladapo OO, Adebiyi A
West Afr J Med · 2024 Jul · PMID 39357066
BACKGROUND: Cardiac disorders are found in about half of cases of Noonan syndrome (NS). The most common congenital heart diseases in this syndrome include pulmonary valvular stenosis obstructive or nonobstructive hypertr...
BACKGROUND: Cardiac disorders are found in about half of cases of Noonan syndrome (NS). The most common congenital heart diseases in this syndrome include pulmonary valvular stenosis obstructive or nonobstructive hypertrophic cardiomyopathy (17%). Biventricular hypertrophic cardiomyopathy (HCM) is very rare in this condition. OBJECTIVE: The objective is to report a case of biventricular hypertrophic cardiomyopathy in a 26-year-old Nigerian female with the phenotype. METHODS: This is a descriptive case report. RESULTS: The patient presented with dyspnoea on exertion which started at the age of 7 years and has progressively worsened. There was associated precordial chest pain and palpitation. Clinical examination revealed a young woman, who is small for her age. She had some dysmorphic features such as a webbed neck, lowset ears, low posterior hairline, crowded teeth, high arched palate, a small and asymmetric chin and a high carrying angle at the elbows. The pulses were synchronous and there was no radio-radial or radiofemoral delay and her blood pressures were within normal limits. Cardiac auscultation was unremarkable. The 12-lead ECG showed biventricular hypertrophy with a strain pattern. The echocardiogram showed features in keeping with biventricular hypertrophic cardiomyopathy. CONCLUSION: Biventricular HCM is relatively uncommon in Noonan syndrome. Patients with typical dysmorphia should have a full cardiac evaluation to look for these anomalies.
Analysis of the Factors Affecting the Male-Female Sex Ratio of Babies Born through Assisted Reproductive Technology.
Ugwu AO, Makwe CC, Kay V
West Afr J Med · 2024 Jul · PMID 39357059
BACKGROUND: Until now, the sex ratio in a population is believed to be relatively stable with no male/female preponderance. There has been an increasing amount of evidence to suggest that assisted conception may signific...
BACKGROUND: Until now, the sex ratio in a population is believed to be relatively stable with no male/female preponderance. There has been an increasing amount of evidence to suggest that assisted conception may significantly impact on sex ratio (SR). Several factors have been suggested to affect SR such as parental variables (paternal race, maternal age, and body mass index-(BMI), methods of fertilisation (in-vitro fertilisation/intracytoplasmic sperm injection), stage of embryo transfer (cleavage/blastocyst), type of IVF cycle (fresh/cryopreserved), medications used for controlled ovarian stimulation, poor sperm motility, and even culture media. OBJECTIVES: This study aims to investigate the potential impact of the different ART procedures on sex ratio. It will also explore the relationship between paternal race, maternal age and body mass index BMI on sex ratio. METHODS: A retrospective cohort study from January 2017 to December 2023. Participants were women who had successful ART and delivery at Ninewells Assisted Conception Unit (NACU) Dundee and ART centre of Lagos University Teaching Hospital, Nigeria. RESULTS: Overall, 294 (66.2%) of the case records and 150 (33.8%) were evaluated from NACU and LUTH respectively. More male infants 244 (66.8%) were delivered following pregnancies conceived with blastocyst embryo stage transfer when compared with female infants which stood at 121 (33.2%). Concerning cleavage embryo stage transfer, 56 (70.9%) were in favour of female newborns while males accounted for 23 (29.1%). CONCLUSION: The study revealed that there is an increase in the proportion of male babies born following certain assisted conception techniques such as blastocyst stage embryo transfer and IVF while more female babies were born when cleavage stage embryos were transferred or when ICSI was used as a method of fertilisation.
Use of Prophylactic Parenteral Tranexamic Acid for Reduction of Blood Loss During and After Caesarean Section: A Double-Blind Randomized Controlled Study.
Ndubuisi AV, Agu PU, Ugwu EO … +7 more , Obi SN, Eleje GU, Eze MI, Ekwuazi KE, Ugwu AO, Ekwueme PC, Anigbo CS
West Afr J Med · 2024 Jul · PMID 39356835
BACKGROUND: Haemorrhage is a leading cause of maternal mortality. The prophylactic use of tranexamic acid during vaginal delivery or caesarean section has the potential to reduce blood loss and postpartum anaemia. OBJECT...
BACKGROUND: Haemorrhage is a leading cause of maternal mortality. The prophylactic use of tranexamic acid during vaginal delivery or caesarean section has the potential to reduce blood loss and postpartum anaemia. OBJECTIVE: To determine the effectiveness and safety of tranexamic acid in reducing blood loss during and within twenty-four hours after a caesarean section. METHODS: This was a randomised controlled study of two hundred and eighty-four (284) pregnant women booked for caesarean section at the University of Nigeria Teaching Hospital (UNTH), Ituku Ozalla, Enugu, Nigeria. The women were randomised into two groups: the intervention group (n = 142) that received intraoperative tranexamic acid with routine post-delivery oxytocin injection and the control group (n =142) that received placebo with routine post-delivery oxytocin. Blood loss was assessed both intra and post-operatively using a standard technique. RESULTS: The mean intraoperative blood loss was significantly lower in the intervention group compared to the control group (435.9±34 vs. 918±258.7, P=0.036). Similarly, the postoperative blood loss within twenty-four hours of surgery was significantly less in the intervention compared to the control group (232.71±67.4 vs. 717±317.6, P=0.031). The incidences of postoperative anaemia and blood transfusion intra or postoperatively were also significantly less in the intervention group compared to the control group (33.2% vs. 48.6; RR = 0.623; 95% CI = 0.46-0.84; p = 0.002, and 6.3% vs 24.6%: RR = 0.257; 95%CI = 0.13-0.52; P= < 0.001, respectively). There were no differences in the incidences of maternal and neonatal complications. CONCLUSION: The use of prophylactic parenteral tranexamic acid significantly reduces blood loss during and after caesarean section. It is therefore recommended in our obstetric practice as it has the potential to reduce the incidence of postpartum anaemia.
Awareness of Primary Care Providers on Genital Schistosomiasis Infection in Northern Nigeria.
Sada YA, Olawumi AL, Tenego M … +4 more , Sidi MS, Dan-Inna MZ, Camanor YFB, Oseni TIA
West Afr J Med · 2024 Jul · PMID 39356825
BACKGROUND: Genital schistosomiasis (GS) is a debilitating neglected tropical disease caused by Schistosoma haematobium. Despite its significant impact on reproductive health, awareness and knowledge of GS among healthca...
BACKGROUND: Genital schistosomiasis (GS) is a debilitating neglected tropical disease caused by Schistosoma haematobium. Despite its significant impact on reproductive health, awareness and knowledge of GS among healthcare providers, especially in Sub-Saharan Africa, remain inadequate, leading to underdiagnosis and mistreatment. METHODS: This study conducted a cross-sectional online survey to assess the awareness and knowledge of GS among 139 primary healthcare providers in Northern Nigeria. A semi-structured self-administered questionnaire was utilized, covering various aspects of GS including its aetiopathogenesis, clinical features, complications, diagnosis, and prevention/treatment. Respondents were scored based on their answers, with an overall score of ≥35 considered indicative of good awareness. RESULTS: Most respondents were aged 31-50 years (41.0%), male (59.7%), married (84.9%), and working in the public sector (97.8%). Mean scores indicated varying levels of awareness across different aspects of GS, with higher awareness regarding aetiopathogenesis (13.99 ±3.275) and prevention/treatment (11.27±1.592). However, awareness of complications remained comparatively lower. Overall, 43.9% of respondents demonstrated good awareness of GS. Regional disparities in awareness were observed, with the North-western region exhibiting the highest awareness (52.6%) followed by the Northeast (40.6%) and Northcentral regions (36.0%). CONCLUSION: The study underscores the urgent need for targeted educational interventions to enhance healthcare providers' knowledge of GS, particularly in regions with lower awareness levels. Improving awareness and knowledge among primary healthcare providers can facilitate early detection, appropriate management, and prevention strategies, thus alleviating the burden of GS on affected communities in Northern Nigeria and beyond.
Perception, Practice and Cost Burden of Medical Tourism Among Physicians in Public Tertiary Health Facilities in Oyo State, South-West, Nigeria.
Olatunde RY, Esan OT
West Afr J Med · 2024 Jul · PMID 39356818
BACKGROUND: Physicians are key to the clinical decision-making of their clients. Their perception and practice of medical tourism could influence their clients' uptake of the same. This study assessed the perceptions abo...
BACKGROUND: Physicians are key to the clinical decision-making of their clients. Their perception and practice of medical tourism could influence their clients' uptake of the same. This study assessed the perceptions about medical tourism among physicians practising in public tertiary health facilities in Oyo state. We then assessed its practice and cost burden among physicians who had ever engaged in medical tourism. METHODOLOGY: This cross-sectional study conducted in 2019 involved 360 physicians working in two public tertiary health facilities in Oyo State, selected via a two-stage simple random sampling technique. Quantitative data was collected using a semi-structured pre-tested self-administered tool. Data collected was analysed using STATA 17.0 with statistical significance inferred at p<0.05. FINDINGS: The physicians' mean score on knowledge of medical tourism was 4.0±0.8 of 5 marks obtainable. Organ transplant was the most commonly known reason for engaging in medical tourism. Destination country hospital facilities and equipment ranked highest and cost considerations ranked least of perceived factors promoting it. Twenty-four (6.7%) of the physicians studied ever engaged in medical tourism, while 258 (71.7%) intend to if the need arose. The most popular destination country was India. The mean direct cost of engaging in medical tourism was $3,351±$4,357. The mean indirect cost was $2,389±$774, while the mean total cost was $5,739.6±$4,841.8. The majority of the 24 physicians (83.3%) who engaged in medical tourism suffered catastrophic health spending from it. CONCLUSION: High burden of medical tourism on the physicians. Funds spent on medical tourism by them could be used to strengthen the delivery of health services, such as ensuring children are fully immunised.
Assessing the Quality of Life of Healthcare Professionals in High-Stress Units at a Tertiary Health Centre in South-eastern Nigeria.
Ezemenah SI, Ibe CC, Okonkwo OS … +4 more , Anusi CS, Ezemenahi SC, Eseigbe P, Alabi AN
West Afr J Med · 2024 Jul · PMID 39356806
INTRODUCTION: Work serves as a fundamental pillar of human life, shaping both individual livelihoods and societal engagements. The intricacies of the work environment play a pivotal role in determining the Quality of Lif...
INTRODUCTION: Work serves as a fundamental pillar of human life, shaping both individual livelihoods and societal engagements. The intricacies of the work environment play a pivotal role in determining the Quality of Life (QoL), with increasing emphasis on creating conducive workspaces that enhance employee satisfaction and productivity. Healthcare professionals, in particular, face various factors that contribute to occupational stress and such stressors can adversely affect their health and diminish their QoL. OBJECTIVE: This study sought to assess the quality of life of healthcare professionals in the Intensive Care Units (ICUs) and other stressful units in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi. METHODOLOGY: A cross-sectional study was conducted involving 296 consenting participants after approval from the ethics and research committees at NAUTH, Nnewi. They were selected using a two-stage sampling approach. Data were collected with a structured self-administered questionnaire adopted from the World Health Organization Quality of Life scale (WHOQOL-BREF) and analysed using Statistical Package for Social Sciences (SPSS) version 25.0. The level of significance was set at P < 0.05. RESULTS: The results showed the mean overall quality of life score was 74.62 ± 14.0, the mean score for the physical domain (59.15 ± 12.49), the psychological domain (70.16 ± 13.46), the social domain (65.82 ± 18.19), and the environmental domain (53.90 ± 15.49). The majority 268 (90.5%), of the respondents had good quality of life. The profession (X2 =12.44, p<.05), years of work experience (X2 = 25.85, p<.05), and income level (X2 = 19.56, p<.05), show a statistically significant association with quality of life. CONCLUSION: The result obtained from this study shows that the majority of the respondents report a good quality of life. Most respondents with poor quality of life were attributed to their profession, years of work experience and income.
Opinions of Dental Technologists in Nigeria on Quality of Work Authorization for Removable Dental Prosthesis.
Adenuga-Taiwo OA, Omosebi TO, Bowale MO … +2 more , Awotile AO, Dike I
West Afr J Med · 2024 Jul · PMID 39356728
BACKGROUND: When fabricating a removable dental prosthesis, clear and sufficient communication between the dentist and dental laboratory technologist is crucial to ensure a successful outcome. OBJECTIVES: To evaluate the...
BACKGROUND: When fabricating a removable dental prosthesis, clear and sufficient communication between the dentist and dental laboratory technologist is crucial to ensure a successful outcome. OBJECTIVES: To evaluate the quality of communication between dentists and dental laboratories via work authorizations for the fabrication of removable prosthesis across the six geographical zones in Nigeria. MATERIALS AND METHODS: A cross-sectional descriptive study was conducted among dental technologists in Nigeria. A 22- item, online survey questionnaire was sent to all the participants through their respective states and the National Dental Technologist Association across the six geographical zones in the country. Data obtained were analyzed. Association between variables was carried out using the Chi-square test. Binary logistic regression was used to predict group membership. RESULTS: A total of 62 dental technologists participated in this study; the highest percentage of respondents, 29.1% was from South West. Only 21% of the respondents reported that they received work authorizations with adequate information to complete a denture setup most time. Also, 16.1% of the technologists received casts with adequate rest seats and guide planes prepared on the abutment teeth. Eighteen respondents (29%) stated that the authorization card does not contain all the required information. Fabrication of more than 7cast RPDs could be used to predict dental technologists who hold a positive view on the provision of quality work authorization by dentists. (P≤0.05).
Gaps in Management of Dyslipidaemia among Physicians in Nigeria: Report of a Web-Based Survey.
Ayoola YA, Adejumo OA, Oiwoh SO … +17 more , Akande JO, Adebayo O, Oseni TIA, Inofomoh FO, Mamza AA, Edeki IR, Enikuomehin AC, Oni OO, Junaid OA, Shogade TT, Yusuf IA, Yakubu MM, Yusuf AO, Oyedepo DS, Adebayo SO, Akintunde AA, Nigeria Clinical Lipid Research (NiCLiR) Network
West Afr J Med · 2024 Jul · PMID 39356655
BACKGROUND: Dyslipidaemia contributes significantly to globalcoronary artery disease (CAD) and cardiovascular disease. Effective use of statins precludes adequate knowledge of its benefits. This study aimed to determine...
BACKGROUND: Dyslipidaemia contributes significantly to globalcoronary artery disease (CAD) and cardiovascular disease. Effective use of statins precludes adequate knowledge of its benefits. This study aimed to determine the gaps in the management of dyslipidaemia among physicians in Nigeria. METHODS: This was a web-based survey of physicians across Nigeria regarding the management knowledge and practice of dyslipidaemia. Analysis was done by SPSS 23.0. P<0.05 was taken as statistically significant. RESULTS: Three hundred and thirteen physicians across Nigeria consisting of 65.4% males responded to the survey. The majority, 57.5% were 25-40 years. While most of the participants (98.3%) believe that elevated LDL-C is an important cause of CAD, there were concerns about statins use and associated increased risk of muscle disorder (63.2%), hepatic disease (37.4%), hemorrhagic stroke (27.2%), cognitive impairment (12.6%) and new-onset diabetes mellitus (19.2%). Similarly, 41.9% of participants have concerns about hemorrhagic stroke while 32.2% also expressed concerns about lowering LDL-C and ischaemic stroke. More than a third (38.2%) indicated that >20% of their patients cannot use statins continuously due to adverse effects such as muscle symptoms, etc. The results obtained when asked about the target of LDLC in patients with or without a history of CAD and diabetes mellitus were as varied as 3-200 mg/dl. CONCLUSION: This study highlights there exist significant gaps in knowledge and practice of the management of dyslipidaemia among experts in Nigeria. Concerted efforts by relevant authorities and societies may be needed to enhance the knowledge and practice of the management of dyslipidaemia in reducing the CV risk among Nigerians.
Molecular Subtypes of Breast Cancer in a Tertiary Centre in Edo State: South-South Nigeria.
Ugiagbe EE, Owolabi DO
West Afr J Med · 2024 Jul · PMID 39356615
BACKGROUND: Breast cancer constitutes a significant public health issue in most resource-constrained nations due to its high morbidity and mortality rates. There is a paucity of knowledge of the molecular subtypes of bre...
BACKGROUND: Breast cancer constitutes a significant public health issue in most resource-constrained nations due to its high morbidity and mortality rates. There is a paucity of knowledge of the molecular subtypes of breast cancer in Nigeria primarily due to the lack of immunohistochemistry. This study aims to identify the molecular subtypes of histologically confirmed breast cancer cases at the University of Benin Teaching Hospital, Benin City, Nigeria, using ER, PR and HER2/neu as immunohistochemical biomarkers. MATERIALS AND METHOD: Breast cancer specimens received in the Histopathology department of the University of Benin Teaching Hospital between 2019 and 2021 were used for this study. Representative sections of paraffin-embedded blocks were recut for histological typing, tumour grading, and immunohistochemistry. RESULTS: A total of 330 cases were evaluated in this study. The average age was 49 years, with a M:F of 40.3:1. The most frequent histological type was invasive breast cancer (92.1%). Two hundred and forty-two (73.3%) cases were categorized as grade II tumours. The steroid hormone receptor positivity was 39.4%. Oestrogen and Progesterone receptor positivity were 39.4% and 22.1%, respectively. HER2/neu was positive in 16.4% of the cases. Triple-negative breast cancer (TNBC) was the most common molecular subtype, accounting for 49.4% of cases. Luminal A, Luminal B, and HER2/neu enriched subtypes were each found in 34.2%, 5.2%, and 11.2% of cases, respectively. CONCLUSION: Triple-negative breast cancers predominated among the study population and were more common in high-grade tumours with unfavourable histological types and among women who were younger than their Caucasian counterparts.
A 7-Month Review of Clinical and Demographic Predictors of Childhood Mortality in a Tertiary Children Hospital in Freetown, Sierra Leone.
Akhigbe IE, Ikhurionan PE, Bell NVT … +5 more , Luke RDC, Bah AB, Geissler-Jalloh A, Mustapha AM, Ofovwe GE
West Afr J Med · 2024 Jul · PMID 39356580
BACKGROUND: Sierra Leone ranks among nations with unacceptably high infant and under-5 mortality rates. Understanding the clinical and demographic dynamics that underpin paediatric mortalities is not only essential but f...
BACKGROUND: Sierra Leone ranks among nations with unacceptably high infant and under-5 mortality rates. Understanding the clinical and demographic dynamics that underpin paediatric mortalities is not only essential but fundamental to the formulation and implementation of effective healthcare interventions that would enhance child survival. SUBJECTS AND MATERIAL: This was a 7-month review of all mortalities from May 24th 2021 to December 31st 2021 at Ola During Children's Hospital in Freetown, Sierra Leone. Information on biodata, presenting complaints, illness duration, diagnoses, treatment given inclusive of point-of-care investigations, and duration of hospital stay retrieved from all mortalities were entered into Excel spreadsheets and were analyzed using SPSS version 25.0 for IBM. Multivariable regression analysis was done to determine factors independently associated with mortalities within 24 hours of admission. All associations were considered significant if p < 0.05. RESULTS: There were 840 deaths out of 5920 children admitted during the period giving a mortality of 14.2% with a male-to-female ratio of 1:1. Three hundred and four (36.2%) of these deaths occurred in the neonatal age group while 63.8% occurred in the post neonatal age group. Perinatal asphyxia was the leading cause of neonatal deaths while acute respiratory infections and severe malaria were the leading causes of post neonatal deaths. The majority (64.8%) of the mortalities occurred within the first 24 hours of admission. In a multivariable regression, only transfusion status and use of respiratory support were independently associated with mortality within 24 hours of admission (P<0.05). CONCLUSION: Paediatric mortality in Sierra Leone is high and is caused mainly by preventable morbidities such as perinatal asphyxia and infections. Most of the deaths occurred within 24 hours of admission. It is recommended that patients should be brought to the hospital early and preventive measures be instituted to address these causes.
Assessment, Management and Quality of Care of Patients Presenting with Non-Traumatic Acute Chest Pain in the Emergency Room who had Acute Coronary Syndrome.
Oladapo OO, Ojifinni KA, Adebayo O … +4 more , Orimolade OA, Oluwasanjo O, Obasuyi VA, Adeyanju AT
West Afr J Med · 2024 Jul · PMID 39356553
BACKGROUND: Non-traumatic Acute Chest pain (NTACP) is a common presentation in the emergency services of many hospitals and a key presenting symptom of acute coronary syndrome (ACS). However, there is a dearth of data on...
BACKGROUND: Non-traumatic Acute Chest pain (NTACP) is a common presentation in the emergency services of many hospitals and a key presenting symptom of acute coronary syndrome (ACS). However, there is a dearth of data on the system of care of ACS patients in our facilities. OBJECTIVE: Our objective was to evaluate the process of care of patients presenting with NTACP at a Tertiary Hospital emergency department (ED) in sub-Saharan Africa, using quality indicators of a universal chain of survival to identify any care gaps in the diagnosis and management of those with life-threatening ACS. METHODS: This was a retrospective cross-sectional study of adult patients ≥18 years of age, seen between July 2020 and June 2023 at the ED of the University College Hospital (UCH), Ibadan, Nigeria. We used this information to determine the frequency of ACS amongst those presenting with NTACP. From this subset, we assessed the main domains of quality indicators of the universal chain of survival in ACS care. These were, early symptom recognition and call for help; emergency medical service (EMS) evaluation and treatment; ED evaluation and treatment; and reperfusion therapy. RESULTS: We assessed a total of 4,306 patients who presented to the ED during the study period. Of these, 225 patients presented with NTACP. The mean ± SD age of these patients was 45.9 ± 18.4 years, with most between the ages of 40-49 years (20.9%) and males (50.7%). More than 80% of the patients presented to ED 12 hours after the onset of chest pain. Only 4.0% presented via an ambulance service which offered no prehospital guideline-directed medical treatment, and 70.7% were non-referred patients. Only 37.3%, 57.8%, 12.4%, and 8.9% had ECG, chest x-ray, echocardiography, and cardiac enzyme evaluation, respectively, in the acute phase of care. There were 29 (12.9%) patients who had a diagnosis of ACS. Two (6.9%) had medical revascularization with thrombolytic agents, while 8 (27.6%) and 19 (65.5%) were referred for primary and secondary PCI respectively. CONCLUSION: We found a high burden of late presentation and significant barriers to recommended guideline management of ACS patients, presenting with clinical features of NTACP in our hospital's ED.
Research Participation and Feedback: Perception of Adolescents and Young Adults Living with HIV in Lagos, Nigeria.
Salako AO, Musari-Martins T, Akinsolu FT … +9 more , Odubela OO, Ezemelue PN, Opaneye B, Bankole S, Rahman NO, Idigbe IE, Abubakar AR, David NA, Gbaja-Biamila TA
West Afr J Med · 2024 Jul · PMID 39356498
BACKGROUND: Evidence-based research remains the cornerstone in changing the narrative of wholesome health among Adolescents and Young Adults Living with HIV (AYALHIV). However, little is known about the perceptions of AY...
BACKGROUND: Evidence-based research remains the cornerstone in changing the narrative of wholesome health among Adolescents and Young Adults Living with HIV (AYALHIV). However, little is known about the perceptions of AYALHIV in research participation and outcomes, in low- and middle-income countries, especially in sub-Saharan Africa. This study describes the perception of AYALHIV in research participation and outcome in Lagos, Nigeria. METHODS: The study population was drawn from a cohort of participants in a cross-sectional study at the Nigerian Institute of Medical Research. The survey questions were on perceptions of the importance of research participation, the frequency, understanding of participation in research, the interest in the outcome, the knowledge of the interpretation of the outcome and the willingness to participate in future studies. Data obtained was analyzed using SPSS version 26.0. RESULTS: The mean age of the AYALHIV was 15.7(±3.1) years, with a male-to-female ratio of (0.8:1), and 85.7% on antiretroviral drugs for at least five years. Seventy-two percent (46/63) have been involved in previous studies at least once, with only 27% (17/63) informed on the outcome of the research they have ever participated. Only 30% (19) of participants understood they were involved in research, with 92% interested in the study outcome. 87.3% (55) will request more information before participating in future research activities. CONCLUSION: Educating AYALHIV on research participation is important in promoting concerted efforts by researchers towards improving engagement, patient-centred care, and research dissemination.
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