Knowledge and awareness of hepatitis B amongst students of Pamo University of Medical Sciences (PUMS), Port Harcourt, Rivers State, Nigeria

Background: Globally, 296 million people were infected by hepatitis B in 2019, with 1.1 million deaths. Africa is one of the endemic regions. Good knowledge and awareness of hepatitis B remain pivotal to the biosafety of medical students. This study sought to determine the levels of knowledge and awareness of hepatitis B among students of Pamo University of Medical Sciences (PUMS), Port Harcourt, Nigeria, and the predicting factors associated with this knowledge and awareness. The is with the aim of providing recommendations for improving and sustaining biosafety levels for medical and other health-related students of the University. Methodology: The study was a descriptive cross-sectional design conducted amongst 528 randomly selected medical students of PUMS, Port Harcourt, Nigeria. Structured questionnaires were interviewer-administered to collect socio-demographic information and participants' responses to questions on knowledge and awareness of hepatitis B. Data were analysed using SPSS version 26.0 and relationships of socio-demographic characteristics and predictive factors with knowledge and awareness of hepatitis B were tested using binary logistic regression analysis with p value for statistical significance set at <0.05. Results: A total of 528 students participated in the study, 202 (38.3%) males and 326 (61.7%) females. Most participants (296, 56.1%) were between 15-19 years of age with mean age of 19 ±2.43 years. The mean (±SD) of participants responses with good knowledge of hepatitis B was 249±121.5 while for good awareness, it was 181±88.3. The percentage average for good knowledge and good awareness was 47.2% and 34.2% respectively, with positive correlation between knowledge and awareness of hepatitis B (r=0.720, p<0.0001). Age was significantly associated with participants percentage average knowledge (OR=0.77, 95% CI 0.70-0.84, p<0.0001) and awareness of hepatitis B (OR=0.84, 95%CI 0.78-0.90, p=0.004). No other factor was significantly associated with knowledge and awareness of hepatitis B except Ijaw tribe (OR=0.4, 95%CI 0.24-0.66, p=0.034) and attendance of Federal Government College (OR=0.4, 95% CI 0.24-0.68, p=0.046). Conclusion: The percentage average good knowledge of 47.2% and awareness of 34.2% for hepatitis B in this study are low, although most participants in the study were between the ages of 15-19 years and in their first and second year of study. This gives room for improvement in knowledge and awareness of hepatitis B with progression in age and year of training. Good knowledge and awareness of hepatitis B are central to the biosafety of medical students. It is recommended that the National Universities Commission (NUC) and the Medical and Dental Council of Nigeria (MDCN) review the current medical school curriculum to increase the teaching of medical and health-related students that will impact more on knowledge and awareness of infectious diseases and infection prevention and control.

Prevalence, pattern and factors associated with workplace violence against healthcare workers in Nigeria: A systematic review

Objective:This study aimed to describe the prevalence, pattern, and predictors of WPVagainst HCWs in Nigeria. Methods:Asystematic review was conducted using pre-defined keywords. The review was performed in line with the PRISMAguidelines on PubMed, Google Scholar, Scopus, and Web of Science. The population, intervention, comparator, and outcome (PICO) elements for this study were as follows: Population:Nigerian Healthcare workers; Intervention: Exposure to WPV; Comparator: Non-exposure to WPV; Outcome: Mental and Physical health outcomes of exposure to WPV. Of the 18,140 articles retrieved, 15 cross-sectional studies met the inclusion criteria and were included in the review. In all, 3,245 HCWs were included, and consisted majorly of nurses and doctors. Results:The overall prevalence of WPV(Physical > Verbal/Psychological > Sexual) against HCWs ranged between 39.1%-100%. The predictors of WPVare younger ages (AOR = 2.513, p = 0.012), working in psychiatric unit (AOR = 11.182, p = 0.006), and increased frequency of interaction with patients, and mostly perpetrated by patients and their relatives. Many health facilities lacked a formal reporting system and policies to protect HCWs from WPV. Conclusion:WPVagainst HCWs is a public health problem in Nigeria with dire implications on HCWs; the victims, and the aggressor. Administrators of health facilities should design protocols for WPVreporting, recognition, and management. Patient and 'relatives' education on the 'facilities' policy against WPVshould be undertaken, while orientation sessions on the risk factors for HCWs are scheduled.

Nutritional Vulnerability Transitions among Rural Households in Nigeria

Aims: It has long been considered that specific age/gender groups, such as women and children, are predisposed to nutritional vulnerability. Thus, nutritional vulnerability among agricultural households is neglected and understudied. This study aims at an empirical assessment of nutritional vulnerability dynamics among rural households in Nigeria. Study Design: Secondary data used for this study was waves 2 and 3 of the general household survey panel data. The sampling design consisted of two stages of sampling: the selection of enumeration areas based on probability proportionate to the size of the enumeration areas and the systematic random selection of ten households from each enumeration area. There were 3370 households selected in rural areas and 1630 households selected in urban areas. 2090 rural households with the required information for this study were included in the analysis. Methodology: Descriptive statistics, nutritional vulnerability score, logit regression model, Markov model, and multinomial logit regression models were used to analyse nutritional vulnerability transitions among rural households in Nigeria. Results: Nutritionally vulnerable households in rural Nigeria include those with aged heads, little or no formal education, limited assets, and no access to land or credit. Nutritional vulnerability in rural Nigeria is primarily transient, with around two-fifths of households experiencing transient nutritional vulnerability and nearly one-third experiencing chronic nutritional vulnerability. While the age of the household head, tertiary education, and access to credit all had a substantial impact on transient nutritional vulnerability, gender, tertiary education, asset value, and access to credit all had an impact on chronic nutritional vulnerability. Conclusion: Support mechanisms such as initiatives to promote access to healthy food, credit, land, and education are critical. To successfully address the issues affecting the nutrition and health of persons facing vulnerabilities, social welfare programs with interventions based on the characteristics of each vulnerable group and the predisposing factors should be adopted.

Bacteriological Assessment of Smoked-Dried White Shrimp (Nematopalaemon hastatus Aurivillius, 1898) Sold in Calabar, Nigeria

Aim: Enumeration of bacterial counts is an important index of assessing the safety and quality of food products. This study aimed to investigate the occurrence of pathogenic bacteria in white shrimp samples obtained from major markets serving consumers in Calabar. Study Design: This study was a cross sectional study conducted between April 2017 and April 2018. Methodology: One hundred and twenty (120) samples of smoked dried Nematopalaemon hastatus (white shrimp) were analyzed for the presence of bacterial pathogens. Bacterial loads and identification of isolated organisms was determined using standard microbiological methods. Results: The results showed that 66.7% of the analyzed shrimps had aerobic bacterial counts exceeding the upper permissible limit (<1.0x106Cfu/g) and 56.7% had unsatisfactory (?20Cfu/g) Vibrio counts. The study revealed the presence of different bacteria genera namely Klebsiella, Salmonella, Pseudomonas, Serratia, Vibrio, Citrobacter, Proteus, Aeromonas, Streptococcus, Escherichia, Coagulase-negative Staphylococci (CoNS), Enterobacter and Bacillus. Predominant organism was Salmonella spp (26.7%), followed by Vibrio spp (21.7%) while the least isolated organisms were Bacillus spp and Coagulase-Negative Staphylococci (1.7%) each. The occurrence of high counts of pathogens in seafood may cause food poisoning; especially in individuals who consume this seafood raw, or lightly or insufficiently cooked. Conclusion: Hence, seafood should be processed and packaged under standard hygienic conditions to reduce the risk of microbial contamination. In addition, public health awareness campaign targeted at consumers and vendors should be optimized with frequent monitoring by regulatory agencies.

Etiology of Chronic Kidney Disease in Nigeria and Management Challenges

The prevalence of chronic kidney disease (CKD) is increasing globally and is one of the noncommunicable diseases associated with increase mortality globally in the last two decades. The prevalence of CKD in Nigeria, it is 1.6% to 12.4%. Ninety percent of end-stage renal disease (ESRD) patients are said to die within 3 months of commencing dialysis. Indices are even worse in resource poor countries like Nigeria where prevention and adequate intervention are usually hampered by funds. In regions like Nigeria, it will be cheaper to prevent CKD than treating its complications. Hence, it is important to identify the common etiologies of CKD in Nigeria and prevent or promptly address them before causing irreversible damage to the kidneys. The most common cause of CKD in Nigeria includes hypertension, glomerulonephritis and diabetes mellitus. Many of these etiologies are preventable/treatable and should be looked for as a major way to reduce the incidence of CKD in Nigeria. Challenges identified in Nigeria, propagating CKD include westernization, inadequate manpower, late presentation, diagnostic challenge and poorly equipped facilities. Interventions like encouraging healthy lifestyle, making available essential drugs, training of health personnel, subsidized cost of treatment, legislation and policies to curb drug abuse. Therefore, resource-poor settings should focus on creating more awareness and making legislations and/or policies focused on these preventable causes of CKD as this is more realistic and effective in these settings.

Effectiveness of Self-directed Virtual Learning on Retention of Cardiopulmonary Resuscitation Knowledge and Skills among Hospital Nurses in North-western Nigeria: Protocol Paper

@#Introduction: The instructor-led CPR training method has been used for over 4 decades. However, nurses’ knowledge and skills are still low. Instructor-led CPR training is an extremely capital-intensive programme that requires more time, workforce, and space, thus serving as an impediment to effective learning among the prospective nurses’ trainees. Self-directed training method is suggested to improve the knowledge and skills of CPR among healthcare practitioners due to the low cost and flexibility. This study aims to evaluate the effectiveness of self-directed method in improving nurses’ knowledge and skill retention from baseline to post-test, one, three-, and six months. Method: A two-arm double-blinded randomised controlled trial will be conducted in two referral hospitals. The control group training consists of a one-day session taught by AHA-certified instructors, whereas the intervention group training entails participants learning on computers in a simulation lab for seven days. A generalised estimated equation model will be used for statistical analysis. Discussion: Through the self-directed training method, participants will have significantly better knowledge and skills of CPR compared to the conversational training method across the time points. Self-directed training method is a simple, cost-effective and flexible method, which can facilitate the training of more nurses in the acquisition and retention of knowledge and skills, especially for those who prefer to learn at their own pace. Trial Registration: Registration Code: UDUTH/NHREC/30/012/2019 and NHREC/28/01/2020/AKTH/EC/2934

Geriatrics studies in Nigeria: systematic review and quality assessment protocol / Estudos de geriatria na Nigéria: revisão sistemática e protocolo de avaliação da qualidade

INTRODUCTION: Geriatrics, a specialized medical branch focusing on the health and well-being of older individuals, has gained increasing attention due to the global demographic shift towards an aging population. Despite the significant growth of the older adult population in Nigeria, limited empirical studies hinder the translation of research findings into health and well-being improvements for older adults in the region. OBJECTIVE: This systematic review will synthesize geriatrics research conducted in Nigeria over the past 6 decades, identifying temporal patterns and research priorities. METHODS: Four electronic databases will be searched to identify studies from published and grey literature on geriatrics in Nigeria between 1960 and 2023 and will be reviewed from inception to 2023: PubMed, MEDLINE, Google Scholar, and African Journal Online. The population of interest is older adults aged ≥60 years. The review team comprises primary investigators, content experts, and a subject librarian. Data extraction and analysis will be conducted independently by review authors, and statistical analysis will be performed by experts. EXPECTED RESULTS: Depending on the results, we anticipate that this systematic review will help clarify the state of geriatrics studies and services in Nigeria. RELEVANCE: The review will fill research gaps to inform policy directives and interventions in geriatric care by developing evidence-based clinical and policy documents to improve the health and well-being of older adults in Nigeria. (AU)

INTRODUÇÃO: A geriatria, um ramo médico especializado com foco na saúde e no bem-estar dos indivíduos mais velhos, tem ganhado cada vez mais atenção por conta de uma mudança demográfica global diante do envelhecimento da população. Apesar do crescimento significativo da população idosa na Nigéria, estudos empíricos limitados dificultam a tradução dos resultados das pesquisas em melhorias na saúde e no bem-estar dos idosos na região. OBJETIVO: Esta revisão sistemática visa sintetizar a pesquisa em geriatria realizada na Nigéria nas últimas seis décadas, identificar padrões temporais e prioridades de investigação. METODOLOGIA: Pesquisas foram realizadas em quatro bases de dados eletrônicas (PubMed, Medical Literature Analysis and Retrieval System Online - MEDLINE, Google Scholar e African Journal Online - AJOL) para identificar estudos sobre geriatria na Nigéria, englobando literatura publicada e literatura cinzenta entre 1960 e 2023. Esses estudos foram revisados desde o início até 2023. A população de interesse é de idosos com idade ≥60 anos. A equipe de revisão é composta de investigadores principais, especialistas em conteúdo e um bibliotecário especializado no assunto. A extração e a análise de dados foram conduzidas de forma independente pelos autores da revisão, e a análise estatística foi realizada por especialistas. RESULTADOS ESPERADOS: Dependendo dos resultados, prevemos que esta revisão sistemática contribuirá para a compreensão do estado dos estudos e serviços de geriatria na Nigéria. RELEVÂNCIA: A revisão irá, através do desenvolvimento de documentos clínicos e políticas baseados em evidências, preencher lacunas das pesquisas que informam as diretivas políticas e as intervenções nos cuidados geriátricos, para assim melhorar a saúde e o bem-estar dos idosos na Nigéria.

Preferências de carreira entre graduandos de medicina no sudoeste da Nigéria / Career preferences of final-year medical students in south-west Nigeria

Resumo Estudantes de medicina possuem diferentes opções de trajetórias acadêmicas ou profissionais após a graduação. Este estudo busca determinar as preferências de carreira entre graduandos de medicina e os fatores que contribuem para tal decisão. Pesquisa descritiva e transversal foi realizada com graduandos de medicina da Afe Babalola University, localizada em Ekiti State, Nigéria. Dados foram coletados por um questionário bem estruturado e analisados usando SPSS versão 21.0. A estatística descritiva inclui tabelas de frequência, gráficos, médias e desvios padrão. Um total de 100 graduandos participaram do estudo, dos quais 29 (29,0%) homens e 71 (71,0%) mulheres, com relação homem/mulher de 0,4 para 1. A faixa etária dos participantes foi de 21 a 30 anos, com média (±SD) de 23,5 (±1,4). Do total de participantes, 72% planejavam ingressar na pós-graduação após a faculdade de medicina, a maioria no Reino Unido, sendo o mestrado em Saúde Pública a qualificação de maior interesse. Da mesma forma, 76% dos entrevistados planejavam buscar uma bolsa de pós-graduação após a faculdade, também em sua maioria no Reino Unido. A especialidade mais procurada é Obstetrícia e Ginecologia (43%), seguida por Cirurgia (40%), Medicina de Família (34%), Medicina Comunitária (33%), Pediatria (25%) e Medicina Interna (23%), enquanto a especialidade menos procurada é Patologia Química (28%), seguida por Microbiologia Médica (27%) e Anatomia Mórbida (24%). O principal fator considerado para esta escolha é o interesse pessoal pela especialidade, seguido por perspectivas financeiras, estilo de vida confortável e horário de trabalho flexível. Mestrado em Saúde Pública e especialização em Obstetrícia e Ginecologia são as carreiras mais buscadas por graduandos de medicina, escolha majoritariamente pautada em seus interesses pessoais.

Abstract Medical students have many different options of academic and professional undertakings after graduation. The aim of this study is to determine the career preferences of students in their final year of medical school and to determine the factors that contributed for such decision. This is a descriptive cross-sectional study involving the final-year medical students of Afe Babalola University, Ekiti State, Nigeria. A well-structured questionnaire was used for data collection. The data was analysed using the Statistical Package for the Social Sciences (SPSS) version 21.0. Descriptive statistics included frequency tables, charts, means and standard deviations. A total number of 100 final-year medical students participated in the study, out of which 29 (29.0%) were males and 71 (71.0%) were females, with a male to female ratio of 0.4 to 1. The age range of the respondents was 21 to 30 years, with a mean(±SD) of 23.5(±1.4). 72% of the respondents planned to pursue a postgraduate academic qualification after graduating from medical school, mostly in the United Kingdom, and a Master of Public Health was the most sought qualification. Similarly, 76% of the respondents planned to pursue a postgraduate medical fellowship after medical school, also mostly in the United Kingdom. The specialty most sought-after is Obstetrics and Gynaecology (43%), followed by Surgery (40%), Family Medicine (34%), Community Medicine (33%), Paediatrics (25%), and Internal Medicine (23%) while the least sought-after specialty is Chemical pathology (28%), followed by Medical Microbiology (27%) and Morbid Anatomy (24%). The most important factor considered by the respondents in choosing a particular specialty is their personal interest in that specialty, followed by financial prospects, comfortable lifestyle, and flexible working hours. Master of Public Health degree and postgraduate fellowship in Obstetrics and Gynaecology specialty are the career preferences for most of the final-year medical students in this study, and this is largely informed by their personal interest in these fields.

Testing the efficacy of group cognitive-behavioral therapy for pathological internet use among undergraduates in Nigeria

Abstract Introduction The aim of this study was to examine the effect of group cognitive-behavioral therapy (GCBT) on pathological internet use (PIU). Method The study applied a group randomized controlled trial design to assign participants to intervention and control groups. A total of 40 college students aged 18 to 30 who were pathological internet users (PIUs) participated in this study and were randomly assigned to treatment and control groups. Participants completed a self-report scale entitled the Problematic Internet Use Scale (PIUS) at three time points. The intervention lasted 8 weeks. The data collected were statistically analyzed using repeated-measures analysis of variance (ANOVA). Results The results showed that GCBT has significant efficacy, decreasing the symptoms of PIU among the GCBT participants compared to those in the control group and that the improvements were maintained at follow-up. We also found a significant interaction effect by time for PIU. Conclusion From the study findings, we can conclude that GCBT has significant benefit for mitigating the severity of PIU in college students. Therefore, mental health professionals are encouraged to explore the benefits of GCBT in treating symptoms associated with PIU in school settings and beyond.

Molecular detection of SARS-CoV-2 infection in three geo-political zones of Nigeria: a cross-sectional study

Introduction: sequel to the emergence of the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) and its subsequent spread to all continents of the world, humans have continued to experience severe devastation to their health and economies. To control the spread of this virus, it is important to detect the infection in recently infected and asymptomatic individuals who are capable of infecting others. This study was designed to detect ongoing SARS-CoV-2 Infection among asymptomatic individuals in open markets across three geopolitical zones in Nigeria. Methods: nasal and oropharyngeal swab samples were collected from 2,158 study participants between December 20th, 2020 and March 20th, 2021 from large open markets across three geo-political zones (Southwest, Northwest and Southeast) of Nigeria. Virus RNA was extracted from these swab samples and real time RT-PCR was carried out for the detection of SARS-CoV-2 specific genes. Data was analysed using descriptive statistics. Results: a total of 163 (7.6%) of the 2,158 participants enrolled for the study tested positive for SARS-CoV-2 by RT-PCR. The rate of infection was significantly higher in the North-western states of the country when compared to the western and Eastern regions (P=0.000). Similarly, the rate of infection was higher among buyers than sellers (P=0.000) and among males when compared with females, though the difference was not significant (p=0.31). Conclusion: this study shows that there is a continuous spread of SARS-CoV-2, especially among active, asymptomatic individuals across many states in the country. There is therefore need to continuously educate citizens on the need to adhere to both the non-pharmaceutical and pharmaceutical preventive measures to protect themselves and ultimately curb the spread of the virus.

Profile of gynecological cancers in a tertiary hospital, Eastern Nigeria

Introduction: there is a great diversity in the profile of cancers in the world. This study set out to analyze the profile of gynecological cancer in Federal University Teaching Hospital, Owerri, [FUTHO] (former Federal Medical Centre, Owerri, Imo state, Nigeria). Methods: this was a retrospective cross sectional descriptive study of the records of women admitted in the gynecological ward in FUTHO from January 2020 to November 2022. It was analyzed using SPSS version 23.0 and reported in simple percentages for categorical variables and measures of central tendency for quantitative variables. Results: a total of 1,378 gynecological patients were admitted into the Gynaecological ward of the hospital, out of which 242 (17.6%) were cancer cases. The most common cancer over the three years in review, was ovarian, 81(33.5%), followed by cervical, 66 (27.3 %), endometrial, 65 (26.8 %), choriocarcinoma, 22 (9.1%), vulvar, 6 (2.5%) and vagina, 2(0.8%). The most common gynecological cancers in this study is very different from previous reports from Nigeria and other African countries. The pattern looks like that seen in the developed countries where endometrial and ovarian cancers top the list. Conclusion: this report shows a possible change in lifestyle and improved access to cervical cancer prevention strategies. It is also assumed that all the facilities who have recorded cervical cancer as the most common cancer can actually have a similar result as ours if a more current review is done.

Assessment of COVID-19 vaccine hesitancy among people living with HIV/AIDS: a single-centered study

Introduction: as the coronavirus disease 2019 (COVID-19) vaccines are distributed and administered globally, hesitancy towards the vaccine hinders the immunisation of a significant number of vulnerable populations, such as people living with HIV/AIDS. Hence, this study aims to assess COVID-19 vaccine hesitancy among people living with HIV/AIDS (PLHIV) attending clinicaloutpatient follow-up at State Specialist Hospital Maiduguri (SSHM), Borno State, Nigeria. Methods: a hospital-based cross-sectional study design was conducted to assess COVID-19 vaccine hesitancy among 344 PLHIV receiving antiretroviral therapy (ART) at the United States President´s Emergency Plan for AIDS (PEPFAR) clinic in SSHM from 4 th January to 25th February 2022. Data were collected using a structured and pretested interviewer-administered questionnaire. The results were presented using frequencies and percentages. The factors that are associated with COVID-19 vaccine hesitancy were identified using the Chi-square statistical test. Results: among the 344 respondents of the study, only 88 (26.6%) received the COVID-19 vaccine. Out of the 256 respondents that did not receive the vaccine, only 10.5% (27/256) are willing to be vaccinated, while the majority; 57.8% (148/256) are not willing to be vaccinated and 31.7% (81/256) of the respondents are uncertain, thus resulting in a hesitation rate of 89.45%. There was no statistically significant association between COVID-19 vaccine hesitancy and the study´s independent variables; where p-value is greater than 0.05. Conclusion: hesitancy towards COVID-19 vaccine is high among PLHIV and there is no any statistically significant association between COVID-19 vaccine hesitancy and the independent variables of the study where p-value is greater than 0.05. Hence, it is necessary to develop targeted strategies to boost vaccine uptake among this vulnerable population.

Cord Blood Lipid Profile of Term and Preterm Newborns in a Tertiary Hospital in South East Nigeria: Relationship with Gestational Age and Birth Weight

Background: Early-onset atherosclerosis is a marker of future cardiovascular diseases. However, indicators of early dyslipidemia for primary prevention are generally lacking in sub-Saharan Africa. This study aimed at describing the cord blood lipid profile among apparently healthy newborns in a tertiary hospital in Southeast Nigeria, and its relationship with gestational age and birth weight.Methods: Cross-sectional study of 167 consecutively recruited apparently well newborns in a tertiary hospital whose cord blood lipid profile parameters (total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL ­C), low-density lipoprotein cholesterol (LDL ­C) and very low-density lipoprotein cholesterol (VLDL ­C)) were assessed using an autoanalyzer (BiOLis 24i). Lipid variables were presented with descriptive statistics whereas their relationship with gestational age and birth weight was highlighted using Spearman's rank correlation analysis. Dunnett's T3 Post Hoc analysis was used for pairwise comparisons.Results: The 167 newborns recruited included 15 (9%) moderate preterm, 46 (27.5%) late preterm and 106 (63.5%) term babies of which 79 (47.3%) were males and 88 (52.7%) were females. The number of recruited SGA, AGA and LGA were respectively 13 (7.8%), 142 (85%), 12 (7.2%). Mode of delivery was majorly vaginal delivery (69.5%) while the rest (30.5%) was by caesarean section. The median values (in mg/dL) of TC, TG, HDL ­C, LDL ­C and VLDL ­C were 60.0, 30.5, 29.0, 25.8 and 6.1 respectively, all within the normal international ranges. Triglycerides and VLDL-C had a moderate positive correlation with gestational age (rs = 0.4;p < 0.001) and were significantly higher in small-for-gestational-age newborns. Total cholesterol, HDL ­C, and LDL-C had a weak negative correlation with gestational age and birth weight (spearman rs˂-0.3). Birth weight, gestational age, and paternal age were the common predictors of lipid profile variability.Conclusion: The finding of a significant relationship between lipid variables with gestational age and birth weight underscores the need to clinically interpret these given the relationship. The relationship with paternal age is another interesting finding which needs to be replicated and the mechanism(s) elucidated.

Quality of Life of Type 2 Diabetic Patients attending a Tertiary Hospital in South-South Nigeria

Background: Type 2 Diabetes mellitus affects the quality of life of individuals and their ability to function. It affects the physical, social and mental well-being of patients with immediate and delayed complications.This study determined the quality of life of type 2 diabetic patients attending a tertiary hospital in south-south Nigeria.Methods:This was a descriptive cross-sectional study conducted among type 2 diabetic patients attending the medical outpatient clinic of the University of Port Harcourt Teaching Hospital between September and November 2019. Purposive sampling technique was used to select a total of 347 participants for the study following ethical approval. WHOQOL-BREF questionnaire was used to measure the QoL of the participants. Data were analyzed using SPSS version 23.0. Descriptive data were presented in frequency distribution tables while summary statistics were done using mean and standard deviation for continuous variables and in proportions for categorical variables. Results:Results revealed that majority of the type 2 diabetic patients were females (53.3%) and between the ages of 51-60 years. 27.2% of them had poor overall QoL with the score of <45% while 65.7% had fair overall QoL with a score of 45-65 %. 7.1% had good overall QoL with a score of ≥65%. Conclusion:Majority of the type 2 diabetic patients had fair QoL while the least had good QoL. There is urgent need for increased health awareness and education of diabetic patients regarding diabetic care.

Perception and willingness to the uptake of COVID-19 vaccine among household-heads in a rural community of South-Western Nigeria

Background:The COVID-19 pandemic and its vaccine have been met with varying perceptions that may have both negative and positive effects on the willingness to uptake the COVID-19 vaccine. The study is set to determine the perception and willingness of the household heads to the uptake of COVID-19 vaccine in a rural community in Southwestern, Nigeria.Materials and Methods:A cross-sectional study was carried out among 409 household heads selected through a multistage sampling technique. The instrument of data collection was a semi-structured interviewer-administered questionnaireusing the Health Belief model constructs. Data were analyzed with IBM SPSS version 21.0 and Pearson's Chi-square test was used to determine the association between perception and willingness to uptake vaccine. P<0.05 was taken as significant at 95% confidence interval.Results:The majority of the unvaccinated respondents in the study were not willing to take the COVID-19 vaccine (60.1%). There was a poor perception of the susceptibility/severity of unvaccinated respondents to COVID-19 infection and a poor perception of the benefit/barrier to the uptake of the COVID-19vaccine. Perception of susceptibility and severity of COVID-19 infection were statistically related to the willingness to uptake the COVID-19vaccine.Conclusion:There should be an increase in awareness campaigns to change the perception of people positively to COVID-19 infection and uptake of the COVID-19vaccine.

Compliance and perception towards COVID-19 preventive protocols among hospital staff in a tertiary health facility, Southwest Nigeria

Background: The COVID-19 outbreak response in Nigeria was challenged by the existing weak health sector and the frontline health workers for COVID-19 pandemic response are exposed to the pathogen. One militating factor undermining the control and prevention of COVID-19 in Nigeria was poor compliance to preventive measures. This study assessed the compliance with COVID-19 prevention protocols among healthcare workers in Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria. Methods: A cross sectional study and subjects were selected through a multi-stage sampling technique. Data collection was done using interviewer-administered semi-structured questionnaire over a period of five months (JuneOctober, 2021). Data was analyzed using IBM, Statistical Package for Social Sciences (SPSS) version 27.0 and p value was set at <0.05 as the threshold for statistical significance. Results: Majority (60.1%), of the respondents got information on COVID-19 protocols through seminars and workshops. However, more than a quarter (28.8%) of the respondents said the use of available PPE was suboptimal. More than one-third, (35.8%), of respondents believe the protocols are too strict. There is, however, good perception (93.3%), but relatively lower compliance (58.7%) of COVID-19 protocols among the staff. Age, marital status and sex were associated with compliance towards COVID-19 protocols in this study (P<0.05). Identified significant predictors (p<0.05) of compliance include age (AOR=1.944), female sex (AOR=7.829). Conclusion: Most respondents had good knowledge of availability, perception of effectiveness, but relatively lower compliance with the COVID-19 protocols in this facility. The government or hospital authority make sure that necessary steps to further boost compliance are taken

Determinants of enrolment in health insurance scheme among HIV patients attending a clinic in a tertiary hospital in South-eastern Nigeria

Objective: The study aimed to assess the determinants of enrolment in health insurance schemes among people living with HIV. Design: The study was a cross-sectional study. A pre-tested interviewer-administered questionnaire was used to collect information from 371 HIV clients attending the clinic. Chi-square statistic was used for bi-variate analysis, and analytical decisions were considered significant at a p-value less than 0.05. Logistic regression was done to determine predictors of enrolment in health insurance. Setting: The study was carried out in the HIV clinic of Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria Participants: HIV clients attending a clinic Result: Mean age of respondents was 45.4±10.3, and 51.8% were males. Almost all the respondents were Christians. Only 47.7% were married, and most lived in the urban area. Over 70% had at least secondary education, and only 34.5% were civil servants. About 60% of the respondents were enrolled in a health insurance scheme. Being single (AOR: 0.374, CI:0.204-0.688), being self-employed (AOR: 4.088, CI: 2.315-7.217), having a smaller family size (AOR: 0.124, CI: 0.067-0.228), and having the higher income (AOR: 4.142, CI: 2.07-8.286) were predictors of enrolment in a health insurance scheme. Conclusion: The study has shown that enrolment in a health insurance scheme is high among PLHIV, and being single, self-employed, having a smaller family size, and having a higher monthly income are predictors of enrolment in the health insurance scheme. Increasing the number of dependants that can be enrolled so that larger families can be motivated to enrol in health insurance is recommended

Determinants of COVID-19 vaccine acceptance amongst doctors practising in Cross River State, Nigeria

Background: COVID-19 vaccine is one of the most effective public health intervention approaches for prevention of COVID-19. Despite its well-known efficacy and safety, significant proportion of frontline COVID-19 healthcare workers remain hesitant about accepting the vaccine for whatever reasons. This study aimed to determine acceptance rate and determinants of vaccine refusal among doctors in Cross River State, Nigeria. Methodology: This was a cross-sectional survey of doctors using structured online questionnaire administered via the WhatsApp platform of the medical doctors' association, in order to assess their rate of acceptance of COVID-19 vaccines, and reasons for vaccine refusal. The predictors of vaccine acceptance were analysed by univariate and multivariate logistic regression analyses. Results: Of the 443 medical doctors targeted on the WhatsApp platform, 164 responded to the questionnaire survey, giving a response rate of 37.0% (164/443). The mean age of the respondents is 38 ±6.28 years, 91 (55.5%) are 38 years old and above, 97 (59.1%) are males and 67 (40.9%) are females, giving a male-to-female ratio of 1.4:1. The greater proportion of the respondents are physicians (70/148, 47.3%) and about three-quarter of the participants (127/164, 77.4%) had received COVID-19 vaccine. The proportion of physicians who had received COVID-19 vaccine (57/70, 81.4%) was more than the proportion of general practitioners (31/42, 73.8%) and surgeons (24/35, 68.6%). Low perceived benefit of vaccination was the main reason given for COVID-19 vaccine refusal (45.9%, 17/37). No significant association was found between vaccine refusal and suspected predictors (p>0.05). Conclusion: Our study revealed high rate of COVID-19 vaccine acceptance among medical doctors especially among the physicians, with the surgeons showing lowest acceptance rate. A significant proportion would not take vaccine because they perceived it lacks much benefits. To raise vaccine acceptance among doctors, more efforts on vaccine literacy that would target doctors from all sub-specialties especially surgeons and incorporate vaccine benefits should be made.

Comparative gender analysis of the seroprevalence of varicella zoster virus among HIV-infected individuals receiving care at Offa, north-central Nigeria

Background: Varicella zoster virus (VZV) infections are common and contribute substantially to morbidity and mortality among HIV-infected patients. This study was conducted to determine the level of exposure, compare the gender distribution pattern and correlate with CD4 count, history of chicken pox and demographics among HIV patients. Methodology: Blood samples were collected from 273 randomly selected HIV-positive patients (93 males and 180 females) receiving care and management at the General Hospital Offa, Kwara State, Nigeria, between September 2019 and March 2020, after obtaining informed consent. Sera were separated from the blood samples and tested for the presence of VZV-specific IgG antibodies using Enzyme Linked Immunosorbent Assay (ELISA). Results: The seroprevalence rate of VZV in the selected HIV patients was 76.9% (210/273), which was similar in both male (83.9%, 78/93) and female (73.3%, 132/180) patients (χ 2=3.265, p=0.071). The seroprevalence rates of VZV in both male and female patients were significantly associated with marital status, occupational status, and CD4+ cell count (p<0.05), however, age group was not significantly associated with VZV seroprevalence in both male (χ2=8.014, p=0.155) and female (χ2=4.689, p=0.455) patients. The seroprevalence of VZV in males (32%) who reported history of chicken pox was about twice that of females (17.4%) (OR=2.235, 95% CI=1.162-4.302, p=0.023). Conclusion: The level of exposure of HIV-infected individuals to VZV in Offa, Nigeria is high and is similarly distributed in both male and female genders. However, more males with VZV exposure reported history of chicken pox (acute infection) than their female counterparts.

Knowledge, attitude and perception of mothers of under-five towards vaccination during supplementary immunization activities in Ibadan North-West Local Government Area, Ibadan, Oyo State, Nigeria

Supplementary immunization activities campaigns provide children with an additional dose of vaccine and deliver other interventions. However, there is dearth of information on knowledge, attitude and perception of mothers of under-five towards vaccination during supplementary immunization activities. A descriptive cross-sectional study which employed multistage sampling technique was designed to fill this gap. Four wards were randomly selected from eleven wards in Ibadan North-West Local Government Area and houses were enumerated from the selected wards, systematic random sampling was used to select houses and then respondents. A semi-structured interviewer administered questionnaire was used to elicit information on three hundred and five respondents. Knowledge scores of ≤4, 5-8, and ≥ 9 were rated poor, fair and good, respectively. Attitude scores of ≤5 and >5 was rated negative and positive attitude, respectively while perception scores ≤4 and >4 were rated negative and positive perception, respectively. Data was analyzed with SPSS version 25 using descriptive statistics and Chi-square test at 5% level of significance. The mean age of respondents was 30.6±6.1years, the highest level of education for most (68.5%) was secondary school. Their mean parity and number of under-five were 2.5±1.4 and 1.2±0.4, respectively. Knowledge was generally poor, more than half (53.1%) had poor knowledge, majority (88.2%) have positive attitude while 84.6% have a positive perception. One-fourth (24.6%) and one-fifth are of the opinion that frequent vaccination will make the vaccine ineffective and overload immune system, respectively. There was generally poor knowledge of supplementary immunizations and mothers need to be educated on the importance.