Prevalence of needle stick injuries and utilization of post exposure prophylaxis among resident doctors in a tertiary hospital in Port Harcourt, Nigeria ­ a cross-sectional analytical study

Background:Needlestick injuries (NSIs) are percutaneous injuries sustained during delivery of medical care. They are occupational hazards faced by health workers and are a source of transmission of bloodborne pathogens.This study was aimed at determining the prevalence, utilization of post-exposure prophylaxis(PEP) and assessed the association between the sociodemographic, occupational factors, knowledge and attitude towards NSIs to its occurrence among the residents in a Tertiary hospital in Port Harcourt Nigeria.Methods: Descriptive cross-sectional analytical study design Results: The study found a 53.8% prevalence of NSIs. Annual prevalence was 50.9%. The prevalence was significantly higher among senior residents (65.1%) (p=0.006), residents in Paediatrics (75.6%) (p<0.001), and among residents who had worked three years or more (65.7%) (p<0.001). The most frequently reported factors that predisposed to NSIs were excess workload (77.9%), insufficient consumables (72.6%) and long working hours (70.2%). 77.4% of residents recapped needles, 66.1% did not report NSIs. Only 8.9% of the residents utilized PEP after injury. In 51.8% of cases, the needle had been used on a patient prior to the injury. In 25.9% of these cases, the injury involved a high-risk patient (HIV, Hepatitis B or C infected). This study found a risk of transmission of HIV following a needle stick injury to be 0.48%. Conclusion: Needlestick injuries are common among resident doctors. A large number of these injuries go unreported. The attitude toward preventive measures and use of PEP services is sub-optimal necessitating a need for more attention to be drawn to occupational health and safety in the region

Prevalence and Pattern of Pneumonia among Children Admitted into University of Port Harcourt Teaching Hospital: A Two Year Review

ntroduction:Pneumonia is the leading cause of death amongchildren, it accounts for 17.0% of under-five deaths in Nigeria yearly. The aim of this study is to determine the pattern of pneumonia among children in Port Harcourt.Materials and Methods:A 2year retrospective descriptive study was done; the admission and discharge records at the children emergency ward (CHEW) and folders of patients admitted for pneumonia were used to retrieve information.Results:A total of 2169 children were admitted into CHEW from 2017-2018, this comprised of 1089(50.2%) males and 1080(49.8%) females. Of the 2169 children, 286(13.2%) of them had pneumonia. More males (16.9%) compared to females (9.4%) had pneumonia, with a significant gender difference. (2= 26.29, p = < 0.001) Males were twice more likely to have pneumonia compared to the females (OR = 1.95, CI= 1.51-2.54). The highest prevalence of Pneumonia (27.1%) was amongst children < 1 year old (P = <0.001). Thirteen (4.6%) of those that had Original ResearchArticle pneumonia died. Mortality was highest (9.2%) among those who presented late (> 5 days after onset of symptoms.) (2=10.73, p = 0.03).Conclusion:Childhood pneumonia is still a burden among children in Port Harcourt. Early presentation to the hospital may reduce the mortality

Perception of Malaria Transmission and Preventive Strategies among Adolescents in Rivers State, South-South Nigeria

Introduction: Malaria is a cause of mortality in African. Though preventable it has remained a public health issue in sub-Saharan Africa where more than 90% of all malaria cases occur. The study is intended todetermine the perception of malaria transmission and prevention among adolescent in Rivers State.Materials and Methods: A cross-sectional survey was conducted among adolescents in secondary schools in Port Harcourt. A Self-administered questionnaire wasemployed for data collection. Descriptive analysis was carried out. Comparing two mean wasby t-test while test for significance was by chi square. In all a p value of ≤ 0.05 was regarded as significant.Results: Resultsof the 969 subjects 445 (45.9%) were males while 524(54.1%) were females. The mean age was 14.3 ± 1.2 years. All the respondent (100%) had heard of malaria, 957 (98.8%) were aware that mosquito was the vector, 923(95.3%) reported that the mode of transmission was through a bite by mosquito. Misconception regarding transmission of malaria was identified among 46(4.7%) participants. 760 (78.4%) of them possessed Insecticidal Treated Nets(ITN). Factors that enhanced ITN use among the respondents includes being a Junior student (p<0.001, OR=12.48, CI= 8.07-19.31), higher socioeconomic class (p<0.001,OR= 2.39,CI=1.71-3.33) while age and family size were not significantly associated.Conclusion: Adolescents in Rivers State have considerable information on malaria transmission and prevention however utilization of ITN is poor. Health education is needed to enhance the use of ITN among adolescents in Rivers State.

Adherence to Isoniazid Preventive Therapy (IPT) among Children in Close Contact with Adult Pulmonary Tuberculosis (PTB) Patients

Introduction:Tuberculosis (TB) is among the top ten leading cause of morbidity and mortality globally, and studies have shown that adherence to a six Month course of Isoniazid Preventive Therapy (IPT) reducesthe incidence of TB disease in HIV-negative/positive populations at risk of developing active TB disease.Objective:This study was carried out to identify active TB cases among children aged 0-5 years who are in close contact with adult cases of pulmonary TB (PTB), to determine the adherence rate to IPT among these close contacts thatdo not have active TB and to identify factors associated with non adherence if any. Methodology: This study was a prospective descriptive study carried out in Rivers state,Nigeria in two health facilities that offers services for TB diagnosis and treatment.Ethical approval for the study was obtained from the Rivers State Ministry of Health while verbal consent was obtained from the parents/caregivers of the children. Children aged 0-5 years who were in close contact with newly diagnosed PTB cases were recruited for the study. They were screened for HIV and evaluated for TB using clinical features and standard laboratory investigations. Those without active TB disease were commenced on isoniazid preventive therapy (IPT) for six months at a daily dose of 5mg/kg after adherence counselling and followed up at the health centres. Obtained data was analysed using Epi Info Version 7.2.3.1statistical software. Descriptive statistics was used while the test for association between variables was done with chi-square test at p ≤ 0.05 level of significance. Frequency tables were used for presentation of results.Results: A total of Sixty three children were recruited for the study 37 (58.7%) were males while 26 (41.3%) were females. Thirty two (50.8%) were children of index PTB patients while 29 (46.1%) belonged to lower socio-economic class. Their age ranged from 4 months to 4 years with a mean age of 2.84years ±1.27years. Six (16.2%) out of the 37 males and 2 (7.7%) out of the 26 females were confirmed to have active TB, giving a TB prevalence of 12.7%. The gender difference was not statistically significant (p= 0.32). Of the fifty five children that commenced INH in the first Month, only twenty four of them completed the six Month course of INH, giving an IPT adherence rate of 49.6%. Identified reasons for non adherence includes ‘My child is not sick’, ‘No transport Money’, ‘My child is writing exams”.“My child is tired of the drugs”, “the Health workers are not friendly’ and ‘long waiting time before collecting medications”.Conclusion: Early contact tracing is important for early detection of TB cases in children. Adherence to IPT in this study is low and strategies like community tracing of defaulters using trained social workers and community nurses as well as use of well-supervised and convenient ambulatory treatment centres that are manned by trained lower cadre health staff can improve adherence.