Evaluation of Inhaler Techniques among Asthma Patients Seen in Nigeria: An Observational Cross Sectional Study

Background: An Adequate and an effective dose of inhalation drugs can be administered only if the correct inhaler-specific technique is followed by asthma patients. There is paucity of data on this subject among Nigerians and Africans. Aims: This observational study was to assess the inhaler techniques among asthma patients in Nigeria and also to identify the factors related to an inaccurate or poor inhaler use. Subjects and Methods: Consenting asthma patients on inhalers; who attended medical out-patients clinic; of two university hospitals in Nigeria were asked to use their inhalers while an inhaler-administration checklist was used to assess each patients inhaler technique. Information on demographics; asthma symptoms history and history of technique education were obtained. Data was analyzed using standard statistical methods. Results: A total of 140 asthma patients participated out of which 75 were females. All the patients used pressurized metered dose inhalers (pMDI) type; 51 of them used dry powder inhalers (DPI) in addition. For pMDI; 22.1 (31/140) completed all required steps while 37.3 (19/51) did so for DPI (P = 0.04). Patients with higher educational qualification (P 0.01) and those with less frequent asthma symptoms (P 0.01) are more likely to use the pMDI inhalers more accurately while patients who have been taught previously by a Doctor were more likely to use the DPI better. Conclusion: Majority of asthma patients use their inhalers inaccurately. Patient-dependent factors were identified as the cause of incorrect technique of inhaler use. Asthma patients on inhalation medications should have routine assessment of their inhaler technique at every visit and corrected if found to be poor

Secondhand Smoke Exposure among Nonsmoking Adults in two Nigerian Cities

Background: Tobacco control policy can only succeed if the burdens of smoking are known. The objective of this study was to determine the prevalence and correlates of secondhand smoke (SHS) exposure among nonsmoking adults in two Nigerian cities. Materials and Methods: We carried out a cross-sectional study from October 2009 to April 2010 among adult population of two Nigerian cities: Enugu and Ilorin. A semi-structured questionnaire was administered by interviewers to obtain socio-demographic information; and information regarding pattern of SHS exposure; wareness of tobacco control policy and the harmful effects of SHS. SHS exposure was defined as regular exposure to tobacco smoke in the previous 30 days in a nonsmoking adult. Results: Of the 585 nonsmoking adults that completed the study; 38.8had regular exposure to SHS; mostly; in public places (24.4). More men were exposed at public places when compared with women (27.0vs. 19.5). The strongest factor associated with exposure to SHS in women was having a smoking spouse [prevalence rate (PR) ratio-7.76; 95confidence interval (CI); 3.08-9.42]; and in men; it was lack of home smoking restriction (PR ratio-6.35; 95CI; 4.51-8.93). Among men; SHS exposure at any location was associated with lack of secondary school education; residing in slum apartment (house with many households); living with a smoking family member (non-spouse); lack of home smoking restriction; and alcohol intake. Among women; SHS exposure at any location was associated with having a smoking spouse; residing in slum apartment and lack of home smoking restriction. Seventy-two percent of respondents were aware of the harmful effects of SHS on their health. Lack of awareness of the harmful effects was significantly associated with increasing age (r= +0.45; P = 0.01); lack of secondary school education (rof the employees reported availability of outdoor smoking area at their workplaces. Conclusion: Our results show that prevalence of SHS exposure was the highest in public places. These findings underscore the need for enactment of comprehensive smoke-free legislation and implementation of educational strategies to reduce SHS exposure in homes

Gender Perspectives of Sexual and Reproductive Practices of People Living With HIV/AIDS in Enugu; South East Nigeria

Nigerian major focus of attention in the efforts at controlling the spread of HIV infection has become the role of gender inequality.1; 2 The objective of the study was to compare the sexual practices of HIV-positive male and female patients who received counselling and treatment at an Anti-retroviral Clinic in Enugu; South-East Nigeria. Method: A comparative cross-sectional descriptive study of patients attending the free anti-retroviral clinic at the University of Nigeria Teaching Hospital Enugu was done. Results: A total of 146 males (30.8) and 328 females (61.9) were studied. Although there was no significant difference in the prevalence of sexual activity between the sexes; the reasons for sexual practices differed. Females indulged in risky sexual activity principally in obedience to the demands of their male partners and were more likely to have sexual partners who were unaware of their seropositivity than males. Conclusion: Risky sexual behaviour among women living with HIV/AIDS in Enugu despite exposure to intensive counselling was still mainly driven by the subordinate traditional gender roles of women in this culture.: