BACKGROUND:Asthma management prioritises symptom control, typically assessed using standardized questionnaires. However, comparative data on their performance and agreement remain scarce in Sub-Saharan Africa. METHODS:In a cross-sectional study of 100 adults [79% females, mean age 38.1±14.6 years] with physician-diagnosed asthma at a Nigerian tertiary hospital, asthma control was evaluated using Global Initiative for Asthma (GINA), Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ-7), Royal Society of Physicians 3 Questions (RCP-3Qs) and Asthma Therapy Assessment Questionnaire (ATAQ). Agreement was measured with Cohen's kappa statistics. Diagnostic accuracy for GINA-defined well-controlled asthma was analysed using ROC-derived thresholds, with GINA serving as the reference standard to assess the performance of ACT, ACQ, RCP-3Qs, and ATAQ. RESULTS:The level of controlled asthma ranged from 73% to 83% across tools. Agreement among control tools was low; GINA showed slight agreement with others (κ = 0.018-0.107), while ACT and ACQ had moderate agreement (κ = 0.546). ACT, ACQ, and RCP-3Qs demonstrated strong diagnostic accuracy for identifying GINA-defined well-controlled asthma (AUC 0.90; 95% CI: ACT 0.76-0.95; ACQ 0.75-0.94; RCP-3Qs 0.78-0.92), whereas ATAQ performed poorly (AUC 0.5; 95% CI: 0.29-0.59). At pre-specified thresholds of >20, ≤1.57, ≤1 and 0.5, the specificity of ACT, ACQ, RCP-3Qs, and ATAQ was 92.6%, 70.4%, 70.4%, and 85.2%, respectively; while sensitivity was 73.7%, 94.7%, 100%, and 26.3%. CONCLUSION:ACT, ACQ, and RCP-3Q effectively identified GINA-defined well-controlled asthma, while ATAQ showed poor diagnostic value. Low agreement among the tools suggests they are not interchangeable for assessing asthma control.
BACKGROUND:Patient satisfaction is the extent to which a healthcare facility fulfils patients' expectations. It is a critical and integral part of patient-oriented healthcare, serving as a key indicator for measuring the quality of care provided to patients. Assessing patients' satisfaction with care is a way of obtaining feedback from patients, which can be a measure of the effectiveness of healthcare services. This study aimed to assess the level of patient satisfaction with services received at the Bingham University Teaching Hospital in Jos, Plateau State, to improve healthcare services. METHODS:The study was a descriptive, cross-sectional study conducted in the Bingham University Teaching Hospital (BHUTH). The BHUTH is a private tertiary hospital located in Plateau State's capital city of Jos, the North-central region of Nigeria. Participants were selected conveniently from the outpatient clinics and wards. The data was collected using the Long-form Patient Satisfaction Questionnaire (PSQ-III) and included the participants' sociodemographic characteristics. There are seven domains in the PSQ-III, namely General satisfaction, Technical quality, Interpersonal care, Communication, Financial aspects, Time spent with the doctor, and Access/availability/convenience. Data collected was analyzed using IBM SPSS Statistics for Windows, version 27. RESULTS:There were 236 respondents. A little more than half (51.7%) of the patients were in the 18 - 39 years age group, and more (59.7%) were females. A majority (62.7%) of the responders had attained a tertiary level of education. The overall patient satisfaction rate was 67.6%. Only 52.5% of patients reported having a high general satisfaction, 56.4% were highly satisfied with the financial aspects of healthcare services, and 86.0% had high satisfaction with the communication. CONCLUSION:This study has revealed an overall average patient satisfaction. Among the domains of satisfaction assessed, communication had the highest rate of satisfaction, and the financial aspect of healthcare services was among the lowest rates of patient satisfaction. These findings can help prioritize strategies for improving healthcare services.
BACKGROUND:In Nigeria, the burden of critical illness and risk factors for mortality remains poorly described. This study describes the epidemiology of patients admitted at the children's emergency ward (EW) and risk factors for Paediatric intensive care unit (PICU) admission and in-hospital mortality (IHM). METHODS:This was a retrospective study of patients admitted to the Children's EW of the University College Hospital, Ibadan, Nigeria, from 1st December 2022 to 30th November 2023. Patient's demographics, presenting clinical features and diagnosis at admission were extracted. The primary outcome was PICU admission. Secondary outcomes were duration of hospital stay and IHM. RESULTS:There were 649 patients; 421(64.9%) were <5 years old. Median age was 2.3 (interquartile range 0.8-7.0) years. Most common presenting features were dyspnoea [269 (41.4%)], vomiting [182 (28%)] and hypoxaemia [188 (29%)]. At presentation, 51 (7.9%) and 63 (10.3%) had altered mental status and seizures, respectively, while the most common diagnoses were sepsis [250 (39%)], malaria [192 (30%)], and pneumonia [165(26%)]. At presentation, 217 (33.5%), 110 (16.9%), 48 (7.4%), and 32 (4.9%) required oxygen, blood transfusion, fluid bolus, and inotropes, respectively. Twenty (3.1%) patients required cardiopulmonary resuscitation (CPR), and 101 (15.6%) required PICU admission. Median duration of hospital stay was 5 (interquartile range 3-9) days, while IHM was 74 (6.6%) patients. On bivariate analysis, gender, dehydration, breathlessness, dyspnoea, cyanosis, cold extremities, thready pulses and altered mental state were associated with mortality, while breathlessness, hypoxaemia, dyspnoea, dehydration, cyanosis, thready pulses, cold extremities, convulsion and altered mental status were associated with PICU admission. CONCLUSION:Shock state and hypoxaemia were associated with poor outcomes in paediatric emergencies. The introduction of basic critical care services will reduce the burden of adverse outcomes.
BACKGROUND:Chronic heart failure is an increasing cause of morbidity and mortality across sub-Saharan Africa, yet contemporary data from large African cohorts remain limited. OBJECTIVES:To characterise the clinical profile, management, and short-term outcomes of patients with chronic HF enrolled in the Ibadan Heart Failure Project. METHODS:The Ibadan Heart Failure Project is a real-life, pragmatic, prospective, hospital-based cohort of adults with chronic heart failure being conducted at University College Hospital, Ibadan, Nigeria. The present report is based on participants recruited between September 1, 2016, and December 31, 2022. Baseline sociodemographic, clinical, and echocardiographic data were obtained, and participants were followed for six months. The primary outcomes were all-cause mortality and hospital readmission. RESULTS:Among 1,290 patients (mean age 56.7 ± 15.4 years; 55.8% men), hypertensive heart disease was the leading cause, followed by dilated cardiomyopathy and rheumatic heart disease. Women were younger and more likely to have preserved or mildly reduced ejection fraction. The use of sodium-glucose cotransporter-2 inhibitors (3.3%) was low. The cumulative incidence of readmission, death, and a composite of these events at six months was 4.9%, 12.9%, and 17.8%, respectively. The use of beta blockers was associated with 43% reduction in the risk of readmission (HR-0.57, 95%CI-0.33-0.97), while the use of renin -angiotensin-aldosterone axis inhibitors was associated with 62% and 46% reduction in the risk of death and composite of readmission and death, respectively. A unit increase in serum creatinine is associated with 11% and 32% increase in readmission and death, respectively (HR-1.11, 95%CI-1.00-1.23 and HR-1.32, 95% CI-1.21-1.45, respectively) In addition, a unit increase in tricuspid annular plane systolic excursion is associated 64% and 53% lower risk of death and composite of readmission and death, respectively. (HR-0.36, 95%CI-0.22-0.60, HR-0.47, 95%CI-0.30-0.73 respectively). No significant sex or age-related differences were observed in adjusted risks of hospitalization or death. CONCLUSIONS:Hypertensive heart disease remains the predominant cause of chronic heart failure in Nigeria. Despite similar short-term outcomes across sexes, suboptimal use of newer evidence-based therapies underscores the need for system-level interventions to improve HF care in sub-Saharan Africa.
BACKGROUND:Sexual and Reproductive Health (SRH) literacy influences young people's health behaviours and outcomes. Mobile health (mHealth) technologies are potential tools for the delivery of health education and services, but evidence on their effectiveness in strengthening SRH literacy is limited in the study setting. This study assessed the effect of an mHealth intervention on SRH literacy and service utilisation among in-school young people in Osun State, Nigeria. METHODS:A quasi-experimental design was employed among undergraduate students aged 18 - 24 years in two tertiary institutions in Osun State. Participants were allocated by institution into intervention (n = 60) and control (n = 60) groups. The intervention group received a six-week mHealth SRH literacy programme delivered through a mobile application. Data was collected at baseline and post-intervention. Paired t-tests, analysis of covariance and regression analyses were done. RESULTS:Post-intervention, the intervention group demonstrated a significant increase in mean SRH literacy scores compared with baseline (p = 0.018). The post-test SRH literacy scores were significantly higher in the intervention group than in the control group (p = 0.002), with a large effect size (partial η² = 0.84). The mHealth intervention independently increased the odds of good SRH literacy (AOR = 3.69; 95% CI: 1.54 - 8.86), SRH service utilisation (AOR = 6.25; 95% CI: 1.29-30.16), and the intention to use SRH services in the future (AOR = 2.86; 95% CI: 1.03 - 7.95). CONCLUSION:The mHealth-based intervention significantly improved SRH literacy and service utilisation among young people. The deployment of mHealth interventions to strengthen health literacy competencies in the study setting should be considered.
BACKGROUND:Low-energy open tibial shaft fractures present a clinical challenge, particularly in resource-limited settings. While high-energy injuries have been widely studied, the long-term outcomes of low-energy mechanisms remain underreported. This study assessed the clinical outcomes and long-term complications of cast immobilization following surgical debridement in patients with low-energy open tibial shaft fractures. METHODS:A prospective study was conducted over ten years at UNIOSUN Teaching Hospital, Osogbo, Nigeria. Sixty-six patients with Gustilo-Anderson type I or II open tibial shaft fractures caused by low-energy mechanisms were enrolled. Data were collected on demographics, injury characteristics, treatment timelines, and outcomes. Follow-up assessments were performed at 1, 5, and 10 years post-treatment to evaluate bone union, joint stiffness, and chronic osteomyelitis. RESULTS:The majority of patients were male (77.3%) and young adults (57.6%). Most injuries were due to road traffic accidents (78.8%). All patients were managed by surgical debridement followed by plaster cast immobilization. Primary wound closure was delayed in 59.1% of cases. Bone union complications were observed in 16.7% of patients at 1 year, decreasing to 10.6% at 5 years, and 6.1% at 10 years. Joint stiffness was reported in 3.0% at 1 year but resolved by year 5. Chronic osteomyelitis occurred in 7.6% at 1 year and declined to 4.5% at 10 years. Overall, the majority of patients achieved satisfactory wound healing and functional outcomes. CONCLUSION:Cast immobilization following timely debridement remains a viable treatment for low-energy open tibial shaft fractures in low-resource settings, with a low rate of long-term complications. Early intervention and adequate follow-up are critical to optimizing outcomes.
BACKGROUND:Castleman disease (CD) is a rare lymphoproliferative clinicopathological entity characterized by non-neoplastic lymph node hypertrophy with distinct histopathology. It has a wide spectrum of presentation ranging from benign localized unicentric CD to idiopathic multicentric CD and human herpes virus (HHV) associated disease which are potentially life-threatening. Treatment includes steroids, chemotherapy and immunotherapy. It has not been reported in Nigerian children. CASE SUMMARY:A 13-year-old boy presented with fever and body swelling of four weeks, cough of one week and difficulty in breathing of three days duration. On examination he was acute on chronically ill-looking, in respiratory distress, with significant generalized lymphadenopathy, bilateral pedal oedema and hepatosplenomegaly. Disseminated tuberculosis (TB) and lymphoproliferative disease were considered. He had leucocytosis with predominant neutrophils, elevated erythrocyte sedimentation rate and inflammatory cells on bone marrow cytology. GeneXpert and retroviral screen were negative. Chest X-ray showed mediastinal shadows. Abdominal ultrasound scan showed hypoechoic lobulated masses with branching margins. Lymph node biopsy showed encapsulated lymphoid tissue composed of proliferating large-sized atretic lymphoid follicles with expanded mantle zones and lymphocytes arranged in strata giving an onion-skin appearance characteristic of CD. HHV was not excluded. Caregivers were counselled on chemotherapy but defaulted. CONCLUSION:CD is rare but presents similarly to disseminated TB or lymphoma clinically. Efforts and provisions should be made for early histological diagnosis in suspected cases.
BACKGROUND:As childhood cancer survival improves globally, increasing attention is directed toward the emotional and social challenges faced by families, especially caregivers. However, in low- and middle-income countries such as Nigeria, caregivers' coping experiences remain underexplored despite extensive documentation in high-income settings. OBJECTIVES:To explore the psychosocial and health-related experiences of caregivers of childhood cancer survivors after treatment completion in Lagos, Nigeria, focusing on their coping strategies, emotional responses, and perceived family impact. METHODS:A qualitative descriptive design was employed, with 15 caregivers of childhood cancer survivors recruited through purposive sampling. Data collection combined semi-structured focus group discussions with standardized assessments, including the Hospital Anxiety and Depression Scale (HADS), the PTSD Checklist for DSM-5 (PCL-5), and the Connor-Davidson Resilience Scale (CD-RISC). Discussions were audio-recorded, transcribed verbatim, and thematically analyzed using Braun and Clarke's six-phase framework. RESULTS:The analysis revealed three key themes: (1) Physical Consequences, including loss of employment, reduced work efficiency, and financial hardship; (2) Emotional Strain, marked by symptoms of PTSD, feelings of helplessness, and anxiety about potential relapses; and (3) Social Adjustments, such as improved health-seeking behaviours and stronger family relationships. Among participants, 60% demonstrated high levels of resilience, while 73% showed signs of anxiety, and the same proportion exhibited PTSD-related symptoms. All three male caregivers reported experiencing PTSD symptoms. DISCUSSION:Caregivers of childhood cancer survivors in Lagos experience notable physical and emotional strain, including symptoms of anxiety and PTSD. Despite minimal formal support, many adapt through strengthened family ties, improved health practices, and spiritual traditions. These results suggest a need for culturally sensitive, caregiver-focused support within survivorship care. Further research should guide the development of targeted interventions in low-resource settings. CONCLUSION:Caregivers of childhood cancer survivors in Lagos continue to experience significant psychosocial burdens beyond active treatment. There is an urgent need for structured psychosocial support integrated into survivorship care plans, especially in LMIC contexts.
BACKGROUND:Self-medication with antibiotics is a threat to global health and is becoming increasingly observed in both developed and developing countries with prevalence of 32.5 - 81.5% worldwide. This study assessed the socio-demographic, economic factors and use of antibiotic self-medication among dwellers in River State, South-south, Nigeria. METHOD:This was a cross-sectional study among 250 patients who attended the Family Medicine Clinic at the Rivers State University Teaching Hospital, Port Harcourt. Interviewer-administered questionnaires were used for data collection. The data was analyzed using SPSS version 23. Chi-Square test was used to assess the association between socio-demographic and economic characteristics with antibiotic self-medication. A p-value of <0.05 was considered statistically significant. RESULTS:Majority of the respondents were females (65.2%), were within the age group of 20-39 years (59.2%) and had tertiary level of education (64.0%), while about 2.8% had no formal education. The overall prevalence of antibiotic self-medication was 75.2%, males (81.6%) self-medicated more than the females (71.8%) and all the respondents with no formal education (100%) practiced self-medication. The association between self-medication and educational status was statistically significant with a p-value of 0.004. The antibiotic most frequently used for self-medication in this study was Ampiclox (Ampicillin plus Cloxacillin) -an antibiotic class of the Penicillin. CONCLUSION:Self-medication with antibiotics is still prevalent and was associated with a person's educational level. There is need for tailored educational programs to advocate for appropriate antibiotic utilization to mitigate this prevalent misuse.
BACKGROUND:Posterior urethral valve (PUV) is the most common severe obstructive uropathy in boys. We reviewed patients with PUV in our hospital to provide an update on the presentation, management and outcome of PUV in our setting. METHODOLOGY:A retrospective study of patients with PUV admitted in our hospital between January 1, 2016 - December 31, 2022. RESULTS:Fifty-one patients were included, seven (median age 6.4 IQR 2.3, 10.8 years) had undergone valve ablation before presentation, while 44 (median age 1.3 IQR 0.1, 2.9 years) had not. Among the 44, four (9.1%) had abnormal features on antenatal ultrasound. 15.9% and 56.9% presented in the neonatal period and after one year of age respectively. The main complaints were voiding symptoms (45.5%), abdominal swelling (40.9%) and history of fever (38.6%). Wasting occurred in 43.9%. Serum creatinine ranged from 0.2-25.5 (median 1.4, IQR 0.8-3.0) mg/dl. Thiry seven children underwent valve ablation. Additionally, four of the 51 patients underwent repeat valve ablation. End-stage kidney disease (ESKD) occurred in five (9.8%). Dialysis was carried out in six patients (11.7%) including two patients with acute kidney injury. None underwent kidney transplantation. Mortality occurred in 10 (19.6%) and was due to sepsis (n=5) and ESKD (n= 4). CONCLUSION:Posterior urethral valve is an important cause of morbidity and mortality in low resource settings and has 19.6% mortality in our centre over a 7-year period. Enhanced access to antenatal detection, early diagnosis and treatment, and kidney transplantation have the potential to improve outcomes.
BACKGROUND:Higher Education Institutions are expected to lead the paradigm shift in waste management by adopting strategies that will contribute to sustainable development in their operations. The impact of these innovations will expectedly diffuse to their surrounding communities. Waste composition studies in HEIs enables the identification of campus-specific opportunities for waste reduction and recycling. The aim of this study was to assess the quantity, composition of solid waste generated by the staff and students of the Lagos University Teaching Hospital and College of Medicine, University of Lagos (LUTH/CMUL) compound. METHODS:The study was a descriptive cross-sectional study conducted in the LUTH/CMUL compound. Solid waste generated from the commercial, academic and research; administrative and residential areas were quantified and characterized during the study. Solid waste generated in the four activity areas collected were sorted, classified and weighed using a weighing balance. RESULTS:An estimated 14.775 tonnes of waste is generated daily from the compound with a waste generation rate of 0.29/kg/capita/day. Plastic and polythene bags made up majority (31.1%) of the total solid waste generated in the compound followed by organic waste (23%). In the commercial area, organic waste (57.21%) formed majority of the waste, plastics formed the majority (22.95%) of the waste in the residential areas and paper waste was mostly generated in the administrative area (41.22%) and, the academic and research areas (36.10%). CONCLUSION:The quantity and composition of the solid waste generated are affected by the activities ongoing in the different categorized areas. A solid waste management scheme hinged on a zero waste policy should be designed by the LUTH and CMUL authorities. This scheme should tackle reduction of waste at source, efficient waste collection from generation points, waste recovery, recycling and composting, proper training of stakeholders and provision of incentives.
BACKGROUND:The human immunodeficiency virus (HIV) screening protocol for high and low risk for HIV transmission exposed infants needs appraisal. OBJECTIVE:To audit the cost effectiveness of the early HIV infant diagnosis protocol, by the 2020 (recent) and 2016 (previous) Nigerian guidelines screening protocol. METHODS:All babies delivered by HIV infected mothers over 4years at the Wesley Guild Hospital, Ilesa were studied. Their HIV status, risk category and age at early infant diagnosis were analyzed. RESULTS:Seventy-two infants and their mother were studied. Thirteen (18.1%) of the total 72 studied were HIV infected. All HIV infections were in the 21 high risk category compared to none in the 51 low risk category (P <0.01). Fifty (98.0%) low risk infants had HIV DNA Polymerase chain reaction (PCR) testing between 6 -8 weeks compared to one (4.5%) high risk between 6-8weeks. (P <0.01). The 21 (95.5%) high risk infants had their first PCR screening between 3 and 14 months. Rapid screening was conducted at 18months for all the 67 infants that survived till this age. The calculated screening cost by the current protocol is thrice as expensive, but equally sensitive for diagnosis as the year 2016 National screening protocol, for low-risk category infants. More than 95% of infants were well immunized and stopped breast feeding at 12 months. CONCLUSION:The year 2016 HIV screening protocol is cost effective and should be adopted for screening infants at low risk of HIV acquisition. Significantly higher rates of infection occur in the high-risk category at unknown times, thus necessitating very early screening. Rescheduling of the 9th month rapid screening to coincide with MMR vaccination at 15months is advised to allow for cessation of HIV exposure following breast feeding termination at 12 months.
BACKGROUND AND OBJECTIVES:This study investigates the prevalence of the symptoms and risk factors of Digital Eye Syndrome (DES) among tertiary institution students in the post-COVID era. METHODS:This is a cross-sectional observational study conducted in a tertiary institution. Participants included students who use digital screens for academic and recreational activities. Inclusion criteria involved students with at least ten minutes of daily screen time. A structured questionnaire was used to assess screen time, symptoms, and ergonomic practices. Data collection included self-reported symptoms of DES and potential risk factors such as screen duration, posture, and lighting conditions. The primary outcomes were the prevalence of DES symptoms, including eye strain, headaches, dryness, and blurred vision, as well as associated ergonomic and behavioral risk factors. RESULTS:A significant proportion of students reported experiencing symptoms of DES as follows: approximately half of the respondents (49.8%) reported experiencing irritation or a gritty feeling in the eye(s), 26.5% reported a burning sensation in their eyes, eye fatigue (57.6%), sensitivity to bright light (68.7%), and a dry feeling in the eye (25.4%). Additionally, symptoms like blurring of vision (37.1%), itching (41.3%), and tearing (35.8%) were also prevalent among respondents. Statistical analysis (Chi-square test) revealed associations between prolonged screen time (8-11 hours screen time, p = 0.040) which is statistically significant; poor ergonomic practices are not statistically significant (p = 0.444 for lying down, placing the screen below the eye level, p = 0.560) and increased symptom severity. CONCLUSIONS:Symptoms of Digital Eye Syndrome are still prevalent among tertiary institution students in the post-COVID era, exacerbated by prolonged screen use and poor ergonomics. Implementing preventive strategies, such as regular breaks and optimized lighting, may mitigate symptoms. Further studies are recommended to explore the long-term ocular effects of digital devices.
BACKGROUND:COPD comorbidities have a significant impact on prognosis. There is underdiagnosis of comorbidities in sub-Saharan Africa. The study aimed to assess the prevalence and spectrum of comorbidities in stable COPD patients, and compare the pattern of comorbidities in COPD caused by biomass smoke (B-COPD) with tobacco smoking (T-COPD) in a Nigerian hospital's chest clinic. METHODS:This was a cross-sectional clinico-laboratory study. Standardized instruments and questionnaire administration followed by spirometry and laboratory blood tests were used to obtain relevant clinical information and identify comorbidities, and 94 (31.3%) of them were assessed retrospectively. RESULTS:All 75 patients had multiple comorbidities; 8(10.7%) had two comorbidities, and 67 (89.3 %) had ≥ 3 comorbidities. The mean comorbidity count was 4.2 in males and 3.8 in females (p=0.130). The prevalence of haematologic, neurologic, cardiovascular, psychological, musculoskeletal, and infectious conditions were 86.7%, 76.0%, 61.3%, 49.7%, 34.7%, and 33.3%, respectively. The leading comorbidities were anaemia (65; 86.7%), impaired sleep quality (57; 76%) and systemic hypertension (42; 56%). None of the subjects had polycythemia. One-third (25; 33.3%) had osteoarthritis, 23(30.7%) had anxiety, 26(34.7%) had dyslipidemia, and 13(17%) had depression. 10(13.3%) were underweight, and 9(10.7%) had pulmonary TB. Less than 10% had obesity, HIV infection and renal impairment. Anaemia was more prevalent in male patients compared to female patients (97.7% vs. 71.9%), whereas osteoarthritis was more prevalent in female patients compared to male patients (53.1% vs 18.6%). Systemic hypertension, anxiety, and HIV were significantly more frequent in COPD caused by tobacco (T-COPD) than in COPD caused by biomass smoke (B-COPD). Osteoarthritis was more common in B-COPD than in T-COPD. CONCLUSION:The study shows that most COPD patients had multimorbidity, and anaemia, impaired sleep quality and systemic hypertension were the leading comorbidities. Systemic hypertension is commoner in tobacco-related COPD. This study highlights the need for healthcare providers to be aware of these differences in comorbidity patterns compared to those in developed nations when caring for COPD patients. WAJM 2025; 42 (8): 642-651.
BACKGROUND:Kidney transplantation in Nigeria has witnessed remarkable advancements. Availability of suitable and willing living donors is one of the major factors leading to its success. The aim of this study was to identify and analyze the reasons for exclusion of potential living kidney donors in a transplant program at a tertiary hospital in Southeast Nigeria. This is important in order to improve donor screening, maximize the living donor pool and ensure donor safety. METHODS:This was a retrospective study of kidney transplant register and medical records at the transplant clinic of Federal Medical Center Umuahia, Southeast Nigeria. Relevant clinical data of potential living kidney donors who presented for pre-donation evaluation over a period of 8 years were collated in excel sheet and analyzed using SPSS version 23.0. Tables, charts and graphs were used to illustrate some data. RESULTS:Pre-donation evaluation records of sixty four potential living donors were retrieved. Median age was 23 (IQR=19-39) years There were 62 males and 2 females with M:F ratio of 31:1. Majority were unskilled workers (83%) and unrelated to prospective recipients (61%). Among those related to the patients (39%), there were more second-degree relatives (22%) than first degree relatives (17%). Out of the 64 potential kidney donors, 13 (20%) eventually donated while 51(80%) did not. Factors that prevented eventual kidney donation included immunological incompatibility (32.8%), albuminuria (11%), hypertension (9%), financial motivation (9%), nephrolithiasis (4.7%), donor withdrawal from donation process (4.7%), Hepatitis B infection (3%), prediabetes (3%) and abnormal cardiac function (1.5%). CONCLUSION:The potential living donors evaluated were mostly young males that were unrelated to their potential recipients. Immunologic incompatibility was the leading cause of failure to donate a kidney; mainly from donor-recipient significant HLA mismatches.
BACKGROUND AND OBJECTIVES:This study aimed to assess the knowledge and perception of Nigerian paediatricians regarding paediatric sleep disorders and their management. It also assessed the state of their current practice with screening, evaluating and treating sleep disorders in children and the perceived barriers and facilitators to the provision of quality care for sleep disorders for Nigerian children. METHODS:This descriptive cross-sectional study was conducted among 153 Paediatricians who practice in Nigeria and attended the Annual Scientific Meeting of the Paediatrics Association of Nigeria (PAN) held in January 2023 at Akure, Ondo state, Nigeria. We utilized a pilot-tested, semi-structured questionnaire adapted from the Paediatrics sleep survey questionnaire. Data was analysed with the IBM SPSS software, version 20. RESULTS:The 153 respondents were from the six geopolitical zones in Nigeria. More than two-thirds (66.7%) had a poor knowledge score (<6). The majority of the respondents rated their confidence in diagnosing sleep disorders as fair (63.4%), while 22.2% rated it as poor. Almost all (98.7%) reported the lack of sleep laboratory in their centre of practice. Also, about two-thirds (68.0%) had no paediatric sleep clinic. The main barriers to the management of paediatric sleep disorders were lack of training (119; 77.3%) and lack of sleep laboratory (102; 66.7%). Having a sleep laboratory in the centre of practice was significantly associated with the knowledge of the paediatricians (p = 0.044). CONCLUSION:There is a need for interventions to improve the knowledge of Nigerian paediatricians on sleep medicine and the provision of Paediatric sleep laboratory facilities in Nigeria.
BACKGROUND:Hypertension is a major chronic comorbidity among people living with HIV (PLHIV), and it remains a significant risk factor for cardiovascular disease in this group. The study identified risk factors for hypertension among PLHIV and assessed their cardiovascular risk. METHODS:A cross-sectional study of 284 adults attending the Special Treatment Clinic, National Hospital Abuja (June-August 2021) collected hypertension risk-factor data using an interviewer-administered questionnaire. Analysis was conducted with EPI Info 7.1, and logistic regression identified factors associated with hypertension at a significance level of p < 0.05. RESULT:Two hundred and eighty-four (284) patients met the inclusion criteria and were recruited. The mean ±SD age of the respondents was 43.2±8.8 years, with a range of 20 to 67 years. The prevalence of hypertension among HIV sero-positive patients was 19.7%. After logistic regression, the independent determinants of hypertension were age group 45-54 years (OR 0.9, CI 0.8-1.0, P=0.007), female gender (OR 3.4, CI 1.3-8.5, P 0.009), secondary level of education (OR 2.9, CI 1.5-5.6, P 0.002), physical inactivity (OR 0.4, CI 0.2-0.9, P 0.033), and CD4 count >500 cells/mm³ (OR 0.4, CI 0.2-0.8, P 0.013). CONCLUSION:Hypertension is common among PLHIV. Older age, female gender, secondary level of education, physical inactivity, and CD4 count >500cells/mm³ were significantly associated with hypertension. Most participants had a low cardiovascular risk. Incorporating routine hypertension screening and risk factor assessment into HIV care is crucial to lessen the burden of this condition in this population.
BACKGROUND AND OBJECTIVES:To assess the pattern of eye diseases among newborn infants in newborn units in Calabar, Nigeria. MATERIALS AND METHODS:This cross-sectional study of the eyes of newborns in 5 newborn units in Calabar, Cross River State, Nigeria was undertaken over a 10-week period extending from February 28, 2018 through May 9, 2018. Newborn whose parent gave informed consent were included, whereas those not consented for or too ill were excluded. The study was conducted with the help of a structured questionnaire and study protocol. Each newborn had basic ophthalmic examination. Ethical approval was obtained from the Health Research and Ethics Committee of the University of Calabar Teaching Hospital and the Cross River State Ministry of Health. Categorical variables were compared using Chi-Square Test and Fishers's Exact Test (FET). RESULTS:A total of 410 newborn were studied. The male: female ratio was 1:1.2 and the mean age was 7.02 days. The most common eye disease was sub-conjunctival haemorrhage 47(11.5%). This was followed by conjunctivitis 26 (6.3%), retinal haemorrhage 24(5.9%), congenital cataracts 8(2%) and clinical anophthalmia 2(0.5%). The least frequent findings were congenital glaucoma, congenital eyelid eversion, macular oedema, at 1 (0.2%) each respectively. Eye disease was associated with an abnormal antenatal period (11.218, p-0.001) birth weight (FET: 12.423, 0.007), and or eventful labour history (FET: 26.805, <0.001). CONCLUSIONS:A significant proportion of eye disease in newborn is associated with an eventful perinatal period. Early detection of eye disease through instituted routine eye examinations may aid in preventing permanent disability from adverse sequelae, reducing the incidence of low vision or avoidable blindness.
BACKGROUND:Spirometry provides useful information on lung diseases. The spirometry patterns of patients with lung disease and respiratory symptoms have not been completely identified. This study sought to determine the spirometry patterns of patients presenting with respiratory symptoms and the relationship between the spirometry patterns and the respiratory symptoms. METHODS:This was a cross-sectional descriptive study involving 285 patients at a specialist respiratory laboratory in Enugu, Nigeria. Sociodemographic data, risk factors and respiratory symptoms were collected and spirometry conducted. Spirometry patterns were determined and the relationship between spirometry patterns and respiratory symptoms were determined using ANOVA and Chi-square. p<0.05 was taken as statistically significant. RESULTS:Two hundred and eighty-five subjects were studied. Their mean age was 48.4 ±21.7 years. Male patients were 117 and females 168. The most frequent symptom was cough (58.6%) followed by chest tightness (46.3%), central chest pain (46.0%), and difficulty breathing during physical activity (41.4%). Nine (3.2%) had asthma, whereas chronic obstructive pulmonary disease (COPD) was found in 14(4.9%), asthma-COPD overlap (ACO) 16(5.6%), normal pattern 144(50.53%), and preserved ratio impaired spirometry (PRISm) 63(22.11%). There was statistically significant difference (F = 3.002, p = 0.031) in the mean Forced Expiratory Time (FET) values between the groups. Abnormal ventilatory function, predominantly the obstructive pattern, was significant in patients with cough and sputum production (p=0.001), noisy breathing (p<0.001), and difficulty in breathing out (p=0.012). COPD was poorly diagnosed without spirometry, 2 (14.29%). CONCLUSION:Obstructive spirometry pattern were common in patients with respiratory symptoms in this study.
