ABSTRACT
Aims: Malaria is a major endemic public health problem in Nigeria and its diagnosis is often either missed or over-diagnosed. It is therefore necessary to determine the use of malaria diagnostic tests by the Community Health Physicians in Nigeria to make the appropriate diagnosis. Methodology: A cross sectional study was conducted among Public Health physicians who attended the National Conference of the Association of Public Health Physicians of Nigeria which held in Ilorin, Kwara State, Nigeria, in the year 2013. The structured questionnaire was completed by all consenting physicians and analyzed with Excel and Epi-info. Results: A total of 200 questionnaires were distributed but 125 (62.5%) responded. Majority of the respondents were females 69(55.2%), most physicians fell into the age group 31-40years 69(60%) and a large number were Registrars, 38 (46.6%). Although majority of the respondents said their usual diagnosis of patients for malaria were laboratory tests in adults 80.0% and children 79.5% but in the last diagnosis only 51% in adults and children 48% were made using laboratory tests. Conclusion: The study showed that majority of the physicians would have desired to use diagnostic tests but the actual practice in the last diagnosis was low. This could be due to the urgency of treatment and delayed laboratory results. Laboratory results should be made available and timely in order to be used for diagnosis.
ABSTRACT
Prompt diagnosis and early treatment of Tuberculosis (TB) cases is an important strategy in TB prevention and control. Thus; passive case finding of TB suspects; sputum examination for diagnosis; and prompt treatment using Directly Observed Treatment Short Course (DOTS) are key elements in the national guideline for TB control programme. The aim of this study is to determine the time interval between diagnosis of smear-positive TB cases and the commencement of treatment in DOTS facilities in southern Nigeria. The study was carried out in 20 healthcare facilities supported by TB Control Assistance Program (TB-CAP) involved in TB management in southern Nigeria; which comprised tertiary; secondary; and primary healthcare facilities including public and private facilities. Data were collected through review of clients' and facility records covering July-September 2009. Data collected were sociodemographic characteristics; sputum-smear result; date of diagnosis; and date of commencement of treatment. Data were analyzed using SPSS version 15.0 software. Of the total 2;507 TB suspects examined for Acid-Fast Bacillus (AFB); 323 were diagnosed to be Sputum-Smear-Positive (SS+ve); However; 269 new smear positive cases were commenced on treatment within the period; thus 54 (17.0) of the new SS+ve cases defaulted initially. One hundred and two (38) of them commenced TB treatment within 3 days of smear examination for diagnosis; while 59 (22) commenced 4-6 days after diagnosis. The study revealed significant delay in commencement of TB treatment for most new smear positive TB cases in southern Nigeria and underlines the need to further explore factors responsible for delay in commencement of TB treatment following diagnosis