Medical Science Liaisons (MSL) in Africa: a perspective

The role of a Medical Science Liaison (MSL) is of growing importance to pharmaceutical, biotechnology, diagnostic and medical device companies. Through scientific engagement MSLs add value to clinical practice, ultimately benefiting patients. The MSL role is dynamic and encompasses in-depth product and disease knowledge together with the ability to communicate relevant, unbiased scientific information concisely and timely. Tasks are focussed on contributing towards the advancement of medical knowledge, scientific data generation and dissemination. Professional relationships are developed, fostering collaboration between external experts and typically the medical affairs departments of pharmaceutical companies through a credible liaison. Through such relationships, critical insights are shared that shape the development pipeline, promote successful clinical translation and guide the market deployment strategy of therapeutic interventions through-out their life cycle. Despite the rising number of MSLs in the field and the implicit medical value of the role, there remains a lack of understanding for what the roles of an MSL entails. In Africa, where exponential growth of the pharmaceutical industry is expected, the number of MSLs will increase rapidly. Given the complexities of the African continent, the MSLs in this burgeoning environment will face various challenges including remote locations, time-constraints, regulatory and bureaucratic hurdles and importantly physician misperception of the MSL role that collectively may thwart the goal of meaningful scientific engagement; but these challenges can be surmounted through astute proactive planning and utilization of opportunities including digital communication strategies

Occupational therapy students' use of social media for professional practice

Background. The use of social media for professional practice is an emerging trend for healthcare professionals; however, limited literature exists on the phenomenon. Social media usage is prevalent among students, as it is incorporated into many health professions education curricula. This poses potential ethical dilemmas.Objective. To examine the nature of social media usage and knowledge of ethical considerations by occupational therapy (OT) students for professional purposes.Methods. A quantitative, cross-sectional survey was administered to the entire cohort of OT students (N=128) enrolled at the University of KwaZulu- Natal, Durban, South Africa in 2016. Data were analysed descriptively using Microsoft Excel 2013 (Microsoft, USA).Results. The most commonly used device to access social media was mobile phones, with WhatsApp and YouTube frequently used for both general and professional purposes. Uses included accessing social media for developing professional skills and knowledge, and in fulfilling academic requirements. Ethical dilemmas were evident among students, who indicated that social media ethical considerations should be incorporated into the curriculum.Conclusion. The study highlighted that most students use some form of social media as part of their professional practice, which has the potential to be used effectively to enhance learning opportunities. Future studies of a qualitative nature could shed light on students' perceptions of social media and practical implications for practice

Occupational health problems and work practices of hairdressers in Uyo, Akwa Ibom State, Nigeria

There are several million hairdressers worldwide who are chronically exposed to various chemicals used in hairdressing business. This study aimed at determining the occupational health problems and work practices of hairdressers in Uyo, Nigeria. This was a cross-sectional descriptive study carried out in March 2017.The study participants consisted of all consenting hairdressers in Uyo metropolis, Nigeria who had been working for at least 6 months prior to the study. Data obtained was analyzed using STATA 12.1 software. Level of significance was set at 5%. A total of 429 hairdressers participated in the study. The mean age of respondents was 28.5 �7.5 years. Majority, (88.3%) were females and 63.9% were single. Ninety percent had at least secondary education, while 47.6% had worked for > 3years. Health problems reported included back pain 61.5%, tiredness 57.1%, Itching/ redness of hands 43.1%, eye itching 26.1%, catarrh 22.8% and hearing difficulty 17.7%. Injuries included needle pricks 59.0% and cuts 46.9%. Standing for > 8 hours was reported by 33% of respondents. Use of any personal protective equipment (PPE) was 67.6%. The most commonly used was glove 42.7%. Awareness about PPE increased with respondent's level of education (p<0.05).Hand lesions were significantly less among those who used gloves as 95.6% had no chemical burns and rashes, 95.1% experienced no dryness and 63.4% had no itching/redness (p<0.05). The respondents reported several health problems. Work practices included poor use of PPE and prolonged standing. Regular workplace safety training, shift duty and use of ergonomically suitable chairs are advocated for hairdressers

The accuracy of nurse performance of the triage process in a tertiary hospital emergency department in Gauteng Province, South Africa

Background. Triage in the emergency department (ED) is necessary to prioritise management according to the severity of a patient's condition.The South African Triage Scale (SATS) is a hospital-based triage tool that has been adopted by numerous EDs countrywide.Many factors can influence the outcome of a patient's triage result, and evaluation of performance is therefore pivotal.Objectives. To determine how often patients were allocated to the correct triage category and the extent to which they were incorrectly promoted or demoted, and to determine the main reasons for errors in a nurse-led triage system.Methods. Triage forms from a tertiary hospital ED in Gauteng Province, South Africa, were collected over a 1-week period and reviewed retrospectively.Results. A total of 1 091 triage forms were reviewed. Triage category allocations were correct 68.3% of the time. Of the incorrect category assignments, 44.4% of patients were promoted and 55.6% demoted. Patients in the green category were most commonly promoted (29.4%) and patients who should have been in orange were most commonly demoted (35.0%). Trauma patients were more likely to be incorrectly promoted and non-trauma patients to be incorrectly demoted. Mistakes were mainly due to discriminator errors (57.8%), followed by numerical miscalculations (21.5%). The leading omitted discriminators were 'abdominal pain', 'chest pain' and 'shortness of breath'.Conclusions. Mis-triaging using the SATS can be attributed to incorrect or lack of discriminator use, numerical miscalculations and other human errors. Quality control and quality assurance measures must target training in these areas to minimise mis-triage in the ED

Telemedicine and e-health in Algeria facing challenges in medical practice

The Algerian health system operates in a demographic, economic, environmental, and societal specific context to meet the challenges of epidemiological transition. Development of information and communication technologies in this atmosphere allow telemedicine and e-health emergence in the vast country of Algeria. Thus, the country may face these challenges by including them in a national telemedicine plan and making a major focus of global action for the prevention and control of prevalent diseases. The interest to adopt this tool in daily practice stems from an improvement in the quality of communication between practitioners and in the doctor­patient relationship with a possibility of quick access to care and more efficient care pathways. Thus, national goals in fight plans against diseases will be achieved. Telemedicine and e-health projects that methodologically well-defined, respecting regulations and using all means and all available resources, including WHO mobile health, are to be designed and implemented in all areas, especially in the national plan against not-communicated diseases, maternal and child health, old aging health, and mental health. This approach will integrate telemedicine in the health care system whose inevitable implementation can be done on solid foundations and will be actively supported by SATeS

Medical and dental students' attitude and practice of prevention strategies against hepatitis B virus infection in a Nigerian university

Introduction: medical and dental students are a high-risk group for hepatitis B virus (HBV) infection which is an occupational hazard for them and a leading cause of death globally. Prevention strategies include vaccination and observance of standard precaution. However, available reports claim utilization of the prevention strategies is low. This study evaluated the attitude of the students towards HBV vaccine and cross-infection practices.Methods: this study was a cross-sectional study carried out at the College of Health Sciences, Obafemi Awolowo University, Nigeria. Using the convenience sampling method, anonymous self-administered questionnaires were distributed to the first 120 participants that volunteered to participate in the study. Data analysis was done using IBM's Statistical Package (SPSS) version 20 software. Statistical level of significance was set at p < 0.05.Results: over eighty percent (83.2%) of the participants had at least a dose of the HBV vaccine while 79.65% completed the three doses. Majority (94.7%) of the students that did not receive the vaccine cited their busy schedule as the reason for their failure to be vaccinated. Taking every patient as a contagious disease risk (86.5%), washing hands after contact with patients' body fluids (82.1%) and wearing gloves before touching mucous membranes and non-intact skin (74.1%) were the most practiced universal standard precaution items.Conclusion: the uptake rate of HBV vaccination and practice of standard precaution among the students are commendable. However, there is need for improvement considering the level of HBV infection in Niger

Perceptions and practice of health care workers regarding hepatitis B vaccination, Bouaké, Côte d'Ivoire, 2016

Barriers to immunization are seen in both the general population and the health care workforce. We conducted this study to determine the perception of health workers on vaccination and the immunization of their patients. This cross-sectional descriptive analytical study was carried out among the medical staff in Bouaké, from 10 January to 07 March 2016. The data collected from the interviews were analyzed using Epi info 2000 software and SPSS 17.0. The Chi-2 test and logistic regression were performed and the significance threshold of the tests was 5%. The vaccination status of the 291 health care workers (HCWs) for the hepatitis B virus (HBV) was statistically related to their participation in the course in vaccination during their training (ORa = 1.69, 95% CI: 1.04-2.75 P<0.05) and the systematic verification of the vaccination status of the patient was statistically related to the vaccination status of the HCW (ORa = 4.33, 95% CI: 2.97-8.18, P<0.05). Promoting the vaccination among the population should be dependent on the promotion among HCWs

Current Practice of adolescent preventive services among paediatric residents in Nigeria

Background. There has been a growing recognition of the challenge of Nigerian adolescents' health issues and the need to address it. Adolescent preventive services (APS) constitute an effective mechanism to reduce adolescent morbidities. Objective. To evaluate the current practice of APS among Nigerian paediatric residents. Methods. For this cross-sectional survey, we designed an anonymous questionnaire based on Guidelines of APS of the American Medical Association to elicit information on residents' current practice regarding screening adolescents for specific morbidities. Results. A total of 103 residents participated in the study; nearly 60% were from federal teaching hospitals. The majority (78.6%) attended to adolescents at least once a week. In the last month, the adolescent medicine service most commonly provided by respondents was general health guidance (66.7%). Altogether, less than one-fifth of the residents have recently asked at least two specific questions to screen adolescents for eating disorders, violence, safety issues, depression, substance or sexual abuse. Senior registrars were more likely than registrars to screen adolescents for hypertension (75.0% v. 29.1%, p=0.032), depression (50.0% v. 16.5%, p=0.043) and abuse (62.5% v. 22.1%, p=0.023). Also, residents with <5 years in practice were more likely to screen for relationship issues (p=0.045).Conclusion. The current level of practice of APS is low among paediatric residents in Nigeria. There is a need to restructure their ongoing practice and training to emphasise preventive paediatrics and other issues pertinent to adolescent care

Exploration of the Affordances of Mobile Devices in Integrating Theory and Clinical Practice in an Undergraduate Nursing Programme

Background: Promoting the quality and effectiveness of nursing education is an important factor; given the increased demand for nursing professionals. It is important to establish learning environments that provide personalised guidance and feedback to students about their practical skills and application of their theoretical knowledge. Objective: To explore and describe the knowledge and points of view of students and educators about introduction of new technologies into an undergraduate nursing programme. Method: The qualitative design used Tesch's (1990) steps of descriptive data analysis to complete thematic analysis of the data collected in focus group discussions (FGDs) andindividual interviews to identify themes.Results: Themes identified from the students' FGDs and individual interviews included:mobile devices as a communication tool; email; WhatsApp and Facebook as methods of communication; WhatsApp as a method of communication; nurses as role-models in the clinical setting; setting personal boundaries; and impact of mobile devices in clinical practice on professionalism. Themes identified from the FGD; individual interviews and a discussion session held with educators included: peer learning via mobile devices; email; WhatsApp and Facebook as methods of communication; the mobile device as a positive learning method; students need practical guidance; and ethical concerns in clinical facilities about Internet access and use of mobile devices.Conclusion: The research project established an understanding of the knowledge and points of view of students and educators regarding introduction of new technologies into an undergraduate nursing programme with the aim of enhancing integration of theory and clinical practice through use of mobile devices

Profile and outcome of medical emergencies in a tertiary health institution in Port Harcourt, Nigeria

Medical emergencies are a daily occurrence in medical practice. The profile and outcome medical emergencies are a reflection of the prevailing pattern of disease and the responsiveness of the healthcare system. This study seeks to evaluate the pattern and outcome of medical emergencies presenting to the university of Port Harcourt teaching hospital (UPTH); Port Harcourt.METHODS: A retrospective study of medical records of the accident and emergency unit of UPTH was assessed over a twelve month period (June 2008 May 2009).RESULTS: A total of 7246 patients presented to the emergency room; with 1256 (17.3) medical emergencies. Infectious diseases accounted for 274 (21.8) of emergencies while non-communicable diseases in the cardiovascular 195 (15.5); renal 105 (8.4); neurological 224 (17.8); endocrine 163(13.0) and gastrointestinal/ hepatobiliary 163(13.0) systems were the other prevalent emergencies. The crude mortality rate was 127 deaths (10.2). The major contributors to mortality were HIV/AIDS related infectious diseases (22.4); hypertension related heart disease (18.4) and stroke (15.7). Other contributors to mortality were renal failure (8.8); diabetic emergencies (8.8); chronic liver disease (12.8) and haematological malignancies (9.6).CONCLUSION: The spectrum of medical emergencies and the pattern of mortality indicate a mixed disease burden of infective and non-communicable diseases; with cardiovascular and cerebrovascular diseases and HIV/AIDS related infectious as the most significant contributors. There is need for action to improve on the responsiveness of our healthcare systems to cope with this trend of disease pattern in our emergency rooms and reduce mortality from medical emergencies

Caring as a Core Concept in Educating Midwifery Learners: A qualitative Study

Caring is the core business of nursing and midwifery; involving a relationship in which the carer is committed to the needs of the one being cared for (Mason-Whitehead; Mcintosh; Bryan et Mason). Caring is the emotion which drives a midwife to care; the motive aimed at assisting someone to grow and self-actualise (Watson). The concern in midwifery is that irrespective of caring being central to the midwifery profession; caring taught in theoretical learning does not always translate into caring behaviour in practice. A qualitative exploratory study examined how midwifery educators impart the skill of caring during theoretical learning and clinical accompaniment; in order to respond to the general complaint made both locally and internationally that midwives are uncaring. The aim was to explore caring during theoretical learning and clinical accompaniment from the perspective of midwifery educators. Participants in the study were midwifery educators teaching midwifery in institutions of learning in Tshwane; South Africa. The naive sketch was used to gather data; wherein one central question was asked and the educators were invited to narrate and respond. Three themes emerged: the meaning of caring; how caring was conveyed during theoretical learning; and how it was conveyed during clinical accompaniment. Although the midwifery educators expressed how they conveyed caring to the learner midwives; it was not evident how caring competencies were assessed in order to ensure caring midwives at the end of training

The Status of Academic Integrity amongst Nursing Students at a Nursing Education Institution in the Western Cape

Honesty is regarded as a basic ethical value in all educational programmes; and academic integrity is of undisputed importance in educational environments. The literature reviewed revealed that academic dishonesty is wide-ranging and also encountered in the nursing education environment. This phenomenon is of concern to the nursing fraternity because of the proven positive correlation between unethical academic practices and future unethical professional behaviour. Limited research data regarding academic dishonesty at nursing education institutions in South Africa and this correlation motivated the present study. The purpose was to examine the status of academic integrity amongst nursing students at a nursing education institution in the Western Cape. Formulated bjectives guided investigation of several variables which impact upon academic integrity; for example the incidence of and student perceptions around academic dishonesty. A quantitative; descriptive survey design was used; with a self-reported questionnaire (based on literature review and study objectives) designed to obtain information about academic dishonesty. Provision was also made for qualitative input from the respondents by including three open-ended questions. It was found that academic dishonesty was a reality at the nursing education institution where this study was done. Cheating associated with plagiarism and assignments was identified as the main problem area. An unacceptably high level of dishonesty in completion of practical records was also an area of concern. The main recommendations are development and implementation of a code of honour and implementation of comprehensive academic integrity policies at the nursing education institution; with practical measures aimed at combating cheating in tests and examinations

Migraine-Associated Vertigo and Dizziness as Presenting Complaint in a Private General Medical Practice

Migraine-associated vertigo (MV) remains a developing entity because accepted diagnostic criteria are unavailable. Patients present with debilitating dizziness without experiencing headache; and are often misdiagnosed as anxious. The condition is manageable in primary care without the need for neurological referral. The aim of this study was to investigate the prevalence of MV and migraine-associated dizziness (MD) as presenting complaints. Methods: Patients presented with dizziness probably or definitely associated with migraine history based on the criteria of the International Headache Society. Patients with other vestibulopathies and medical conditions were excluded. Patients were evaluated over a period of nine months. Seven hundred and seventeen patients were examined. The numbers of patients were recorded as a percentage of the population visiting a general practitioner. Response to migraine prophylactic medications was regarded as supporting evidence of the diagnosis. Response was regarded as a complete resolution of symptoms. Results: Of the 717 patients seen; 12 were identified as having probable or definite MV. Five patients were treated with migraine prophylactic medications; namely amitriptyline 25 mg nocte and/or sodium valproate CR 300 mg bd; and all showed a response to the treatment. Conclusions: We conclude that the prevalence of MV as presenting complaint may be as high as 1.67. This figure does however not reflect the total patient population that suffers from the condition - this figure may be much higher. Of those patients treated for MV the response was 100; further supporting the diagnosis. MV is a relevant complaint that is often misdiagnosed as psychogenic in origin

Adherence-Monitoring Practices by Private Healthcare Sector Doctors Managing HIV and AIDS Patients in the eThekwini Metro of KwaZulu-Natal

Background: The danger of poor adherence to treatment by patients with HIV infection is that poor adherence correlates with clinical and virological failure. Understanding how private-sector doctors monitor adherence by their HIV-infected patients could assist in developing interventions to improve adherence by these patients. Information about such practices amongst private-sector doctors in the province of KwaZulu-Natal; however; is limited. This study was; therefore; undertaken to assess the private-sector doctor adherence-monitoring practices of HIV-infected patients in the eThekwini metro of KwaZulu-Natal. Methods: A descriptive cross-sectional study was undertaken amongst private general practitioners (GPs) and specialists managing HIV/AIDS patients in the eThekwini metro. Anonymous semi-structured questionnaires were used to investigate adherence-monitoring practices by these doctors and their strategies to improve adherence. Results: A total of 171 doctors responded; with over 75in practice for over 11 years and 78.9indicating that they monitored adherence. A comparison between the GPs and the specialists found that 82.6of the GPs monitored adherence compared with 63.6of the specialists (p = 0.016). The doctors used several approaches; with 60.6reporting the use of patient self-reports and 18.3reporting the use of pill counts. A total of 68.7of the doctors indicated that their adherence monitoring was reliable; whilst 19.7indicated that they did not test the reliability of their monitoring tools .The most common strategy used to improve adherence by their patients was through counselling. Other strategies included alarm clocks; SMSs; telephone calls to the patients; the encouragement of family support and the use of medical aid programmes. Conclusions: Private-sector doctors managing HIV/AIDS patients in the eThekwini metro of KwaZulu-Natal do monitor adherence and employ strategies to improve adherence

Increasing the Risk of Nosocomial Transmission of HIV: Pitfalls and Practices at a Busy Secondary Level Hospital with a High Burden of HIV

Healthcare professionals working in high HIV prevalence settings are at continuous risk of nosocomial acquisition of HIV. Risk factors for percutaneous injuries include recapping or manipulation of needles following venesection and improper disposal of sharps. Prompt risk assessment and access to antiretroviral post-exposure prophylaxis (PEP) is essential to reduce the risk of HIV seroconversion. This study audits the practice of doctors involved in high risk procedures for acquisition of blood-borne viruses. Forty-two doctors working at GF Jooste Hospital; Cape Town; were polled by anonymous questionnaire as to their venesection practice; sharps disposal; history of at-risk exposures and access to PEP. An observational study of sharps bin use was undertaken concurrently. Thirty-six doctors responded; 92of whom were misusing blood-taking equipment. Five times the number of sharps bins were available in medical wards compared to surgical. Twenty-four doctors sustained a total of 67 blood risk exposures since qualification. Less than half of exposures were reported and only 35of those who reported their incident received post-exposure counselling and appropriate management. Twenty-five exposures led to a course of PEP. Median delay to PEP was two hours and median duration of PEP was 21 days. Incorrect venesection practice; improper sharps disposal and inadequate post-exposure management are directly increasing the risk of nosocomial transmission of HIV. We believe that these practices are widespread within the South African health service and need to be addressed to adequately protect our doctors and nurses

Prise en charge du paludisme au Benin : evaluation des pratiques professionnelles suite a l'introduction des derives d'artemisinine

la politique de prise en charge du paludisme au Benin a change en 2004 par l'introduction des combinaisons therapeutiques a base d'artemisinine (CTA) par le Programme National de Lutte contre le Paludisme (PNLP) pour le traitement du paludisme simple. Avant cette date; la chloroquine etait le medicament de premiere intention de prise en charge du paludisme simple avec la sulfadoxine pyrimethamine en cas d'echec. Par ailleurs; les derives d'artemisinine etaient utilises en monotherapie au Benin depuis 2002. Afin d'etudier l'evolution des comportements therapeutiques de prise en charge du paludisme par les agents de sante; une etude transversale a ete realisee aupres du personnel de sante du secteur public et prive de la ville de Cotonou du 16 mars au 17 mai 2005. Les formations sanitaires ont ete tirees au sort dans chaque strate apres recensement et stratification de toutes les formations sanitaires selon la pyramide sanitaire. L'enquete a utilise un questionnaire adresse aux agents de sante. Au total 690 agents de sante ont ete enquetes. Les derives de l'artemisinine sont connus de 95;5des agents de sante enquetes mais ne sont prescrits que par 89;6d'entre eux. Les CTA sont moins connues et le Coartemr reste la combinaison la mieux connue des prescripteurs. Un diagnostic biologique etait disponible dans la moitie des cas. Les derives de l'Artemisinine sont prescrits surtout en deuxieme intention et en monotherapie que ce soit pour le traitement du paludisme simple ou du paludisme grave. Ils sont prescrits chez la femme enceinte dans 34;6des cas. Les posologies sont incorrectes dans 26;1des cas chez l'adulte et dans 20;9des cas chez l'enfant. Ces resultats justifient l'intensification de la formation des agents de sante; d'autant plus que le pays envisage dans le cadre du changement de sa politique de prise en charge du paludisme; de rendre disponible les CTA a tous les niveaux de la pyramide sanitaire. Un systeme de communication efficace doit etre mis en place en vue d'une large diffusion de la nouvelle politique de traitement

Knowledge, attitudes and perceptions of HIV/AIDS among traditional birth attendants and herbal practitioners in Lagos State, Nigeria

Recognising the widespread role of traditional birth attendants (TBAs) and herbal practitioners (HPs) in health care at community level in Nigeria, we set out to assess their knowledge, attitudes and practices in relation to HIV infection and prevention. Questionnaires were administered to a convenience sample of 189 participants in 20 local government areas of Lagos State. We found that knowledge of modes of transmission of HIV was less than adequate and included lack of knowledge of the existence of HIV/AIDS amongst some practitioners, claims for the ability to treat HIV/AIDS, failure to name major avenues of transmission and confusion of HIV/AIDS with other conditions. The use of measures to prevent infection of clients and themselves showed that normal standards of infection control are not adhered to. Considering that as many as 60% of children born in Nigeria are delivered by traditional birth attendants and that use of the services of herbal practitioners extends across the entire society in both rural and urban settings, this is seen as reason for concern. It is suggested that better incorporation of TBAs/HPs into the well-developed primary health care system offers not only a way of overcoming the risks of infection posed by traditional health practices but also offers an opportunity to extend the reach of voluntary counselling and testing and prevention of mother-to-child infection programmes. The research has shown the need for appropriate training of TBAs, to enable them to recognise the risk of HIV infection in their own practices and to encourage them to adopt universal precautions against spreading infection. We also recommend that they be more extensively integrated as primary health care workers in VCT and PMTCT programmes in Nigeria. We further suggest that referrals made between the traditional practitioners and professional health care providers can be an effective and successful element of HIV/AIDS prevention and control programmes

Some aspects of blood transfusion practice in West Africa

It is agreed that safe blood transfusion is achieved only through the joint implementation of safe donation; quality in testing and processing and transfusion only when essential. The article throws light on current transfusion practice in West Africa and suggests ways to implement the above three components which together make blood transfusion safe

Occupational health hazards in physiotherapy practice in Nigeria : a survey research

This survey was carried out with the aim of ascertaining the occupational hazards that are speculated to be inherent in the practice of modern physiotherapy. The methodology consisted of preparing a list of injuries or conditions that are sustainable; and circulating a questionnaire to physiotherapists practising in different hospitals across the country. The responses; confirmed the presence of occupational hazards in physiotherapy practice. The limitations of the survey were addressed and the prospect of further studies on this subject was highlighted