BackgroundThe incidence of abdominal pregnancy is considerably lower than that of other forms of ectopic pregnancy and becomes life-threatening when it occurs. It has a high maternal mortality rate and foetal mortality rate; however, some abdominal ectopic pregnancies have been carried to term. Case PresentationWe present a case of a 30-year-old G2P1+0, 1 alive woman who presented at our health facility at a gestational age of 37 weeks following a fall at home while taking her bath. She underwent an emergency caesarean section due to suspected placental abruption and transverse lie with a live foetus. However, the intra-operative findings revealed an abdominal ectopic pregnancy with a healthy female neonate. The placenta was attached to the uterine fundus and the greater omentum. An omentectomy was performed without compromising the blood supply to the bowels. Also, the loose membranous attachment to the uterine fundus was carefully excised and replaced with a suture. Both the patient and her baby girl were discharged home on the seventh day post-operation without complications. No gross congenital anomaly was detected on the baby. DiscussionLive neonate in abdominal ectopic gestation is a rare occurrence, and a high index of suspicion with early diagnosis of abdominal ectopic pregnancy is necessary to avoid a potential maternal disaster. Fortunately, our patient had a favourable outcome despite the missed diagnosis. ConclusionThere is a need for improved health resource allocation with training and retraining of radiologists and non-radiology professionals involved in obstetric ultrasound to avoid misdiagnosis, as it occurred in this case.
BackgroundNigeria, the most populous country in Africa and the leading nation in sub-Saharan Africa, is facing a severe healthcare crisis. Its life expectancy of 62.2 years and other worsening health indicators, such as a maternal mortality rate of 814 maternal deaths per 100,000 live births, highlight a weakened health system. Although Family Physicians are the largest group of physicians in developed countries and have transformed primary healthcare, their role and involvement in Nigeria's health system are not yet fully realised. This review examines the main barriers to effective primary healthcare (PHC) and universal health coverage (UHC), and the role Family Physicians could play in achieving a strengthened PHC system. MethodologyWe conducted a systematic review of the literature across multiple electronic databases, including AJOL, PubMed, Scopus, and ResearchGate. The findings from the literature review were compiled into a comprehensive report, designed to provide clear and actionable insights. ResultThe main cause of PHC failure in Nigeria is the shortage of healthcare professionals, especially doctors, to provide necessary care, further worsened by the emigration of professionals seeking better pay and opportunities. Other significant challenges include chronic underfunding, with health expenditure consistently below the 15% target set by the Abuja Declaration, and out-of-pocket expenses making up to 70% of health costs. Infrastructure gaps are extensive, as only about 20% of PHC facilities are fully operational, further strained by critical shortages of water, sanitation, and reliable electricity. A lack of policy direction, poor coordination and implementation among the three tiers of government, insurgency, and banditry in some areas are key factors limiting access. ConclusionNigeria's progress towards establishing robust PHC and UHC faces a complex journey that requires expanding the insurance scheme to enrol all Nigerians. Increased budgetary allocation to develop and maintain infrastructure, alongside competitive salaries and allowances, will motivate staff and enhance the quality of services. Aligning donor agencies' vertical programmes and reporting systems with the National Health Plan and a unified electronic record system (EMR) will produce better results. Investing in the training and deployment of Family Physicians to lead the PHC team will significantly improve primary healthcare and ultimately help the country achieve UHC.
BackgroundSeveral factors such as obesity and smoking, among others, have been associated with deranged glycated haemoglobin (HbA1c) in TB patients. Hyperglycaemia, measured by HbA1c, showed a significantly higher risk of unfavourable TB treatment outcomes. This study examined the influence of some factors on HbA1c among TB patients attending the DOTS clinic of the University of Ilorin Teaching Hospital. MethodologyA hospital-based cross-sectional study involving 180 consenting TB patients that were selected using systematic sampling technique from February to July 2022. Those with diagnosed Diabetes Mellitus were excluded. Data were collected using semi-structured questionnaires. Blood samples were collected for HbA1c estimation using turbidimetric method. HbA1c was categorized as DM (≥ 6.5%), prediabetes (HbA1c ≥ 5.7%–6.4%) and normal (< 5.7%) using American Diabetes Association criteria. Statistical Product and Service Solutions, version 23, was used to analyse data. P-value was < 0.05. ResultsThe pattern of the HbA1c was normal (75%), pre-diabetes (8.9%), and DM (16.1%). The pattern of HbA1c was significantly associated with smoking (p = 0.037). Logistic regression analysis showed that smoking (OR = 0.240, 95% CI: 0.069–0.826) is less likely to predict suboptimal HbA1c (HbA1c ≥ 5.7%), but physical activity (OR = 1.877, 95% CI: 0.914–3.854) showed that those who are inactive were about two times at risk of developing suboptimal HbA1c. Body mass index, duration of treatment, HIV status, family history of DM, and type of TB had no statistically significant association with HbA1c. ConclusionA quarter of TB patients had deranged HbA1c (pre-diabetes and undiagnosed DM). This suggests the need for regular screening to mitigate the potential effects on their health. Physical activity protects against developing deranged HbA1c, and this emphasizes the need for TB patients to be active.
Background: The intensive care unit (ICU) represents the pinnacle of patient care, and subjects healthcare professionals to heightened job-related stress, emotional fatigue, and a diminished sense of personal achievement, collectively known as burnout syndrome. This global phenomenon poses risks and potential impacts on the Quality of Life of healthcare providers. Aim: This study aimed to assess the prevalence of Burnout syndrome (BOS) among healthcare workers in the Intensive Care Units (ICUs) and other selected 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 multistage sampling method. Data were collected with a structured self-administered questionnaire adopted from the Maslach Burnout Inventory (MBI) and analysed using Statistical Package for Social Sciences (SPSS) version 25.0. The level of significance was set at p < 0.05. Results: The prevalence of burnout among participants was 53.7%. Further analysis of the domains of burnout shows that 34.4% of respondents have a high degree of emotional exhaustion, 18.6% show a high degree of depersonalization, and 52.7% of respondents show a poor degree of personal accomplishment. Female health workers have a higher burnout prevalence, 57.1% than their male counterparts, 48.8%. Conclusion: This study reveals a high prevalence of burnout among healthcare personnel in ICUs and other selected units at NAUTH, with significant emotional exhaustion, depersonalisation, and low personal accomplishment, indicating that many healthcare workers feel emotionally drained, detached from patients, and lack fulfilment in their roles.
BackgroundChronic musculoskeletal pain (CMP) is a prevalent condition among older adults globally, contributing significantly to reduced quality of life, functional limitations, and healthcare burden. In low- and middle-income countries like Nigeria, the complexity of managing chronic pain is exacerbated by sociocultural factors, underreporting, and limited access to healthcare services. However, there is a paucity of local data on the prevalence and pattern of CMP in the elderly. The purpose of this study is to determine the prevalence, pattern, and sociodemographic correlates of chronic musculoskeletal pain among older adults attending a tertiary hospital in North Central Nigeria. MethodsThis was a hospital-based cross-sectional study conducted at the General Outpatient Clinic of the Federal Medical Centre, Bida, between September and November 2022. A total of 244 elderly participants aged ≥ 60 years were recruited using systematic random sampling. Data were collected via interviewer-administered questionnaires, including sociodemographic characteristics and pain-related variables. Analysis was performed using SPSS version 24, with statistical significance set at p ≤ 0.05. ResultsThe prevalence of CMP was 44.7%. Low back pain (36.7%) and knee pain (29.4%) were the most common locations, and most respondents reported mild pain intensity. There were no significant associations between CMP and any sociodemographic factors. However, significant associations were found between CMP and the use of analgesics (p < 0.001), herbal remedies (p < 0.001), and other alternative treatments (p < 0.001). ConclusionCMP is highly prevalent among elderly patients in this setting. While sociodemographic factors showed no significant associations, analgesic and alternative therapy use was widespread. Targeted, culturally sensitive interventions are essential to improve pain management outcomes in this population.
BackgroundBefore the advent of conventional medicine, traditional medicine was the mainstay of healthcare in Africa. Health coverage for the elderly is especially important as the percentage of the global population constituted by the elderly is at unprecedented levels and is projected to continue to rise. This group of people are often afflicted by a myriad of diseases, and the concurrent use of orthodox and traditional medicine is not uncommon. The aim of the study is to determine patterns, predictors, and satisfaction with Complementary and Alternative Medicine (CAM) use among elderly citizens in the Pakoto community, Ogun State. MethodsThis was a cross-sectional study carried out among the elderly in Pakoto community in Ogun State. The study was conducted among 197 respondents selected using multi-stage sampling. An interviewer-administered questionnaire was used to obtain data, which was analyzed using Epi Info software version 7.1. The Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) was used to retrieve responses from the participants. Level of significance was set at p < 0.05. ResultsThe mean age of the respondents was 70 years. The most used modalities of CAM were herbal therapy (67%) and faith healing (33%). The factors associated with the use of CAM were: being 60–64 years old, being employed, having low income, being single, having a partner as a caregiver, having secondary level education, and having a polygamous or other non-nuclear family type. More than half of the respondents (58.5%) had a positive attitude to CAM use, while 55.8% were satisfied with CAM use. ConclusionThe variations and use of complementary and alternative medicine among the elderly in the study area is relatively lower compared to reports from similar studies.
BackgroundThe age group designated as young people—that is from 10–24 years of age is a transition period during which young people experience a variety of changes that influence their needs, identities, and behaviour. Gender-based violence (GBV) is an important public health problem. When combined with a lack of empowerment in women, it could severely constrain decision-making on critical issues such as health care seeking among women. This study examined the influence of GBV and women's empowerment on institutional delivery among currently married young women in sub-Saharan Africa. MethodsSecondary data from the latest (2017–date) Demographic and Health Surveys from 11 Sub-Saharan African countries was used. Currently married young women from age 15–24 years were selected, giving a sample size of 22,247. However, only 8,621 respondents were interviewed for violence. ResultsThe results showed the prevalence of GBV to be 35.4%. Less than one fifth of the women were empowered. About 41.9% delivered in a health institution. Binary logistic regression was used to determine how GBV and women's empowerment predict institutional delivery. A statistically significant relationship was seen between emotional and physical GBV (p = 0.002, OR = 0.854, 95% CI: 0.774–0.942) and (p < .001, OR = 0.724, 95% CI: 0.638–0.820) respectively. There was no significant association between sexual GBV and institutional delivery (p = 0.127, OR = 1.198, 95% CI: 0.950–1.510). Total GBV was inversely related to institutional delivery (p < .001, OR = 0.788, 95% CI: 0.719–0.865). The odds of delivering in an institution were twice higher among empowered women (p < 0.001, OR = 2.029, 95% CI: 1.751–2.350). ConclusionThe prevalence of GBV is still high in sub-Saharan Africa, and the proportion of empowered young women is alarmingly low, putting them more at risk of gender-based violence. These two parameters have a significant influence on institutional delivery, which has been proven to be an essential tool for improving maternal and child health outcomes.
BackgroundDepression is a common mental disorder, it is a significant contributor to the global burden of disease, and has been associated with suicidal tendencies even among students. This study aimed to assess the prevalence and factors associated with depression among undergraduate health students in Usmanu Danfodiyo University Sokoto, Nigeria. MethodsA cross-sectional study was conducted among 363 undergraduate health sciences students selected by stratified sampling technique. Data were collected using the Patient Health Questionnaire-9 (PHQ-9). Data were analysed using the IBM SPSS version 22 computer statistical software package. ResultsThe mean age of the respondents was 23.39 ± 3.44 years. About a third, 105 (30.0%) of the 363 respondents were depressed. Of these, 84 (80%) had mild depression, while about a fifth (21%) had moderate to severe depression. The factors that were found to be associated with depression were respondents' course of study, history of major life events, history of chronic illness, having a family or social problem, concerns about future career, staying off campus, not having family support, not engaging in regular physical exercise, and having less than 50% punctuality at lectures. ConclusionThis study showed a relatively high prevalence of depression among the respondents, and it was associated with their social lifestyle, medical history, and accommodation problems. The primary care facility in the University and family practice physicians should routinely screen undergraduate health students for depression, and the University management should provide adequate accommodation and promote healthy social lifestyles among them (such as participating in extracurricular activities and engaging in regular physical exercise).
Background and Aim: There is a high incidence of multiple morbidities, the tendency to take many drugs at a time, the use of potentially inappropriate medications (PIM), the use of over-the-counter medications (OTC's) and doctor-shopping among the elderly. This research studied inappropriate drug use (IDU) pa erns and their relationship with the health-related quality of life (HRQoL) in elderly patients. Methods: This was a descriptive cross-sectional study of 322 elderly patients a ending the Family Medicine clinic of a tertiary hospital. The patients were recruited using a systematic sampling method, and their data was obtained using a structured questionnaire that incorporated Beer's criteria and SF 36 questions. Results: The respondents' prevalence of IDU was high (n=284; 88.20%). The frequency of engagement in polypharmacy, the use of OTC drugs, and PIM among the respondents were 177(55%), 137 (42.5%), and 164 (50.9%), respectively. The overall HRQoL of the respondents was found to be good (>50 scores) in seven out of eight domains. The majority of the respondents who had poor HRQoL (n=81; 89.0%) were observed to also engage in IDU. However, the rela onship was not sta s cally significant (X2 = 0.080, p = 0.777). Conclusion and recommendation: A regular medication review by a ending physicians and educating elderly patients and their caregivers on appropriate drug use is recommended.
Background: Elder abuse refers to any intentional act or neglect that causes harm or distress to an older adult. It affects a significant number of older adults globally and can occur in homes, nursing homes, or assisted living facilities. Abuse can be financial, physical, emotional, or even take the form of neglect. The consequences of elder abuse are usually devastating and may affect the individual's quality of life. This study sets out to assess the abuse among older adults a ending the General Outpatient Clinic and its relationship to social support. Methods: It was a cross-sectional study of 259 participants. The Elder Abuse Suspicion Index (EASI) was used to assess for abuse among the participants. It is a validated tool developed specifically to help primary care physicians detect victims of elder abuse. The Oslo Social Support Scale-3 (OSSS-3) was used to assess social support among the participants. It provides a brief measure of social functioning and covers different levels of social support. Results: At the end of the study, 7.7% of the participants relied on caregivers for their basic activities of daily living, and less than half (37.7%) of the participants had emotional abuse, though it accounted for the highest form of abuse. Physical abuse was reported in 19% of our study participants, while 10.1% experienced financial abuse. Only 2.7% complained of neglect. There was a significant association between social support and emotional abuse (chi-square 13.79, p=0.001) and financial abuse (Chi-square = 11.39, p = 0.003), suggesting that the level of social support is correlated with these forms of abuse. Conclusion: The consequence of elder abuse is severe and can result in psychological trauma. A multidisciplinary approach is needed in the management of abuse in older persons. It is important to raise awareness, provide social support, and implement preventive measures to combat this menace and ensure the well-being and dignity of older adults.
The population is ageing globally. Therefore, with an increasing population of older persons in Nigeria, there is socioeconomic inequality with extreme poverty and elder abuse coupled with non-implementation of the adopted and published National Policy on Ageing. In addition, evidence has shown the impact on Nations' workforce, healthcare, and educational system. Other challenges of ageing in Nigeria are ageism, multi-morbidities, changing family dynamics, human rights policy issue and lack of an age-friendly environment. This paper aims to review these challenges witch are diverse and inexhaustible hence, a multipronged approach must be employed to address them.
Background: Abnormal vaginal discharge, a common gynecological issue in reproductive-age women, is primarily caused by microbial pathogens. Since these organisms have been linked to cause severe consequences for the fetus and mother, it is crucial to determine their microbiome pa erns. This study, therefore assessed the microbial pattern of abnormal vaginal discharge in reproductive-age women presenting in a tertiary health facility in Imo State Nigeria Methods: This was a cross-sectional study conducted among 368 women between 18-45 years who attended the General Outpatient Clinic of the Federal University Teaching Hospital, Owerri between February and April 2023 recruited via systematic sampling technique. Demographic data were obtained using a pre-tested, structured interviewer-administered questionnaire. Two vaginal swab samples were collected from each participant for wet mount and Gram staining, while an endocervical swab was collected for microbial culture. Gram staining and culture were for identification and characterization of the microorganisms. Data were analyzed using SPSS version 25. Quantitative variables were summarized using means and standard deviation while categorical variables were summarized using frequencies and percentages. Results: The mean age of the participants was 30 ± 4.5 years. Majority of the participants (95.6%) reported a past history of abnormal vaginal discharge while 20.1% reported current history of abnormal vaginal discharge. The associated symptoms reported were vulval itching (81.1%), burning sensation (64.9%), dysuria (37.8%), and dyspareunia (27%). The commonest aetiologic agents isolated from the vaginal discharge specimen were Candida albicans (63.5%), Group B Streptoccocus (6.8%), and Trichomonas vaginalis (2.7%). Polymicrobial agents accounted for 10.8%. Conclusions: The identification of the common aetiologic agents and associated symptoms of abnormal vaginal discharge in reproductive-age women will improve early diagnosis and prompt treatment of abnormal vaginal discharge in reproductive-age women.
Background: Diabetes mellitus (DM) is a chronic non communicable disease that has reached a global pandemic proportion with increasing prevalence, morbidity and mortality, especially in low and middle-income countries. An important component of modern therapy for DM is self-monitoring of blood glucose (SMBG) to inform changes for an improved glycaemic control. However, despite the fact that SMBG is one of the most effective monitoring and control measures for DM, the prevalence of poor glycaemic control among diabetics in this environment still calls for concern, hence the impetus for this study. The purpose of this study was to assess the prevalence and pattern of SMBG practice among adult type 2 diabetics attending General Out-Patient Clinic (GOPC) in Osun State University (UNIOSUN) Teaching Hospital, Osogbo, Osun state, Nigeria. This was to determine the frequency, timing and level of SMBG practice among the participants. Methods: It was a descriptive cross-sectional study that used a pre-tested interviewer administered questionnaire to obtain information on the socio-demographic and clinical characteristics, prevalence and pattern of SMBG practice. One hundred and seventy five adult type 2 diabetics who a ended the GOPC between November 2019 and January 2020 who met the inclusion criteria were recruited. The data was analyzed using Statistical Package for Social Science (SPSS). Results: A total of 175 participants took part in this study and 49.1% of them practiced SMBG. Among the participants that practiced SMBG, 56.9% checked their fasting blood glucose on daily basis while others checked it on weekly or monthly basis. Conclusion: This study revealed that the level of SMBG practice among the study participants was fair with a structured pa ern of practice, therefore advocacy on SMBG practice with emphasis on knowledge of the structured pattern of practice is strongly recommended for improved glycaemic control.
Dr Charles Andrew Pearson was born in Shaoyang, Hunan, China, in 1921 to a British Methodist missionary general practitioner. His choice to pursue a lifelong career as a missionary doctor in China had to change because of the prevailing circumstances there at that me. He was redeployed to serve as the Medical Superintendent of Wesley Guild Hospital in Ilesha, Nigeria, by the British Methodist Society in 1952. He worked meritoriously at Ilesha for 23 years. He accepted the appointment as the Chief Medical Officer of the University of Ibadan Medical School Ibarapa project in Igbo-ora 1975. While there, he worked assiduously along with the Dean, Prof B. O. Osuntokun, for the commencement of training in General Practice at both the undergraduate and postgraduate levels. In collaboration with other stakeholders, the National Postgraduate Medical College of Nigeria, NPMCN, successfully started a postgraduate training programme in General Practice in 1980, followed subsequently by the West Africa Postgraduate Medical College. He was appointed the first Director of Training of the GMP Faculty of NPMCN. He served in this capacity passionately, laying a solid foundation for the high-quality training programme that the Faculties of Family Medicine is known for in Nigeria/West Africa today.
Treating acne vulgaris can be a frustrating task as most patients desire to have quick relief from the symptoms. Due to disfiguring nature of the disease, most patients suffer psychological problems. Some patients get worried about their physical appearance and become withdrawn. Some patients seek spiritual healing, and they consider it an affliction or as a curse placed on them by perceived enemies. There is a need to discuss the diagnosis, the management procedure, the expected duration of treatment and the side effects of the drugs with the patients, as this will help patients to cooperate with their care. Thus, treating the physical symptoms may be a solution to the psycho-cutaneous problems associated with skin diseases. We present this case report and review of the literature to highlight both the psychological and physical symptoms of Acne vulgaris and its management. This patient was treated with any need for complex psychiatric or psychological tools.
Introduction: Chronic Obstructive pulmonary Disease (COPD) is increasing in Africa due to multiple risk factors like smoking and use of biomass fuels'. There are challenges in the diagnosis of COPD at primary care due to scarcity of spirometers. Aim: The objective of the study was to evaluate the predictive value of peak flow rate obtained from a hand-held PEFM and questionnaire as a screening tool of COPD among high risk patients. Methodology: A cross-sectional study was carried out from August to November 2018. One hundred and Ninety (190) participants with risk factors for COPD were recruited at the Family Medicine Department in LASUTH, Lagos State. The history of risk factors, International primary airway group (IPAG) questionnaire scores, Peak Expiratory Flow Rate (PEFR) and Spirometry values captured. The best cut-off for PEFM as a screening tool was assessed using ROC curve. Results: PEFM had a Sensitivity of 82.3%, Specificity of 51.1%, and PPV of 63.2% and NPV of 73.8%. The IPAG questionnaire reported sensitivity (44.8%) and specificity (23.4%) indicating poor detection rates of COPD when used as a screening tool. Combining the use of a questionnaire and peak flow meter, less than half (43.8%) of those with COPD would be identified. .ROC revealed best cut off for PEFR as 79.5% of expected which would give a sensitivity of 81.3% and specificity of 57.7%. Conclusion: The mechanical handheld PEFM was determined to have a high sensitivity and PPV, with moderate NPV making it a useful tool in screening for COPD especially in primary care settings where spirometry may not be available.
Background: The introduction of antiretroviral therapy (ART) has transformed the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) pandemic from a deadly disease to a chronic disease. However, recent studies have shown that as the patients live longer, cardiovascular diseases have increasingly emerged as important complications of its treatment. The ongoing expansion of ART programs requires an assessment of patients' risk factors for cardiovascular diseases in resource-poor settings.
Background: Patient satisfaction with health care services especially during consultation is considered an important health care index. This is more peculiar to patients with chronic illness, especially hypertensive and diabetics patients. Studies elsewhere have shown increased patient satisfaction ratings with psychotherapeutic interventions. There is however a paucity of literature on the use the use of
Background: The rate of uptake of COVID-19 vaccines varies from one region of Nigeria to another and is influenced by different factors
