Predictors of 30 days outcome of patients with acute stroke in Sokoto

Background: Though the epidemiologic profile of patients with acute stroke has been described in the sub Sahara African region, little is known about predictors of mortality in patients with acute stroke. This study aimed to determine the predictors of 30-day mortality of acute stroke so that early therapeutic measures could be instituted to improve functional outcome.Methods: Case records of patients admitted from January 2007 to December 2009 with clinical diagnosis of stroke were retrieved. Relevant clinical data were extracted using structured questionnaire. Results: A total of 370 case files with clinical diagnosis of stroke were traced but only 260 had complete information.The mean age of patients was 55.7±14.3 years; Hypertension was the most common modifiable risk factor for stroke followed by diabetes mellitus. The 24-hour and 30-day case fatalities were 11.9% and 38.4%, respectively. Predictors of 30-day mortality were admission blood glucose, level of consciousness and age at stroke. Conclusion: The 30-day case fatality of acute stroke was high and predictors of outcome included old age reduced level of consciousness and elevated blood glucose at presentation

The Impact of Training on Malaria Treatment Practices: a Study of Patent Medicine Vendors in Birnin-kebbi

Background: Patent medicine vendors are major providers antimalaria treatment in Nigeria. The management of malaria by this informal sector of healthcare delivery is however dominated by negative practices. This study determines the influence of training on antimalaria treatment practices of patent medicine vendors. Methods: Fifty-five patent medicine vendors selected through a multistage sampling technique in Birnin-Kebbi were recruited into the study. Their baseline treatment practices were determined and the negative ones identified. Intervention training was instituted and its impact assessed using a interviewer-administered questionnaire. Simulated visit mystery client survey which involved direct observation of patent medicine vendors practice was conducted after the intervention and the results compared with self reported post intervention practices. Results: The negative practices identified included inappropriate dosage regimen; frequent unnecessary use of injectables and alteration of physicians' prescriptions. Following the intervention training of the patent medicine vendors; the overall appropriate treatment practice score rose from baseline value of 3.6to 45.5(p0.05) and significantly lower than the post training values (p0.05) and was significantly lower than the post intervention values (p