The COVID-19 Crisis in Sub-Saharan Africa: Knowledge, Attitudes, and Practices of the Nigerian Public.

Within a short period of time, COVID-19 has spread globally, wreaking havoc in various facets of life. This study sought to measure the level of COVID-19 knowledge, attitudes, and practices of the Nigerian public. This was a cross-sectional online survey of the general population of educated Nigerians who had Internet access. Sociodemographic data and participants' knowledge, attitudes, and practices relating to COVID-19 were collected. Scores assessing knowledge, attitudes, and practices were allocated and graded based on specific stratified demarcations. Student's t-test, analysis of variance, and logistic regression analysis were used where appropriate. Of the total 1,015 respondents, most of them exhibited good knowledge of COVID-19, with a mean knowledge grade of 78%; this significantly affected their attitude and practice grades (66% and 60.4%, respectively). Most respondents expressed positive attitudes toward foreigners and other stigma-prone groups, while also practicing appropriate preventive measures. Those aged 21-30 years and those with medical-related occupations had significantly higher knowledge scores (P < 0.001); and having a medical-related occupation increased the likelihood of having good knowledge compared with being unemployed (odds ratio [95% CI]: 6.6 [2.5-17.3]). Male participants aged 21-30 years and those with medical-related occupations had significantly higher attitude scores (P < 0.05). Engaging literate Nigerians on various media platforms, particularly social media, will result in wider reach for the purpose of COVID-19 education. Further studies on other sociodemographic groups within the country (e.g., the less educated) would give a clearer picture of the Nigerian situation as regards COVID-19 knowledge, attitudes, and practices (coronavirus, COVID-19, Public health, Nigeria, Africa).

A case of thyroxine (T4) toxicosis complicated by thyroid storm with an unusual precipitant.

BACKGROUND: Thyrotoxicosis, though commonly encountered in endocrinology practice in Nigeria, seldom presents solely as thyroxine (T4) toxicosis. Thyroid storm, a known life-threatening complication of thyrotoxicosis, can be precipitated by myriad factors. Fine need aspiration for cytology is not known, and has not been previously reported (to the best of our knowledge) to precipitate thyroid storm. CASE PRESENTATION: The case described is that of a 55 year old woman who presented with a neck swelling and features of hyperthyroidism, with biochemical parameters in keeping with T4 toxicosis. Investigating the patient necessitated a fine needle aspiration of the thyroid swelling. The patient thereafter developed hyper-metabolic features, and subsequently progressed to confusion and loss of consciousness few hours following the procedure. Close monitoring and medical management with anti-thyroid and other supportive therapies, resulted in an improved clinical condition. CONCLUSION: T4 toxicosis is a distinct biochemical entity of clinical significance. Physicians should bear in mind that micro-trauma from an investigation such as fine needle aspiration of the thyroid gland can tilt a thyrotoxic patient into thyroid storm, and this risk should be considered and prepared for by physicians and patients.

Patterns and Impact of Consultations to an Endocrinology Unit in a Tertiary Hospital in Southwestern Nigeria.

BACKGROUND: The dearth of endocrinologists in Nigeria, coupled with a paucity of data on patterns of endocrine consultations pose a challenge in evaluating the impact of consultations on patients' management and eventual outcomes. The objectives of this study were to determine the frequency, sources of referrals, the common cases referred, the reasons for consultation requests, and the outcome of patients who benefitted from endocrine consultations. MATERIALS AND METHODS: This study was carried out in the Endocrinology unit of Babcock University Teaching Hospital, over 9 months. All patients referred to the unit were sampled (total sampling). Their sociodemographic parameters, sources, and reasons for consultations were documented. The patients' case notes were then retrospectively reviewed, to determine the impact of the consultation on their management and outcome. RESULTS: A total of 108 consults were received throughout the study. Most consultations were requested by the general outpatient clinic (37%) followed by cardiology clinic (12%). The most common reason was to take over management of the patients. Diabetes mellitus accounted for 68.7% of the cases seen. Diagnosis made by the referring physician was confirmed in most cases, new diagnoses or change in diagnosis was reached in 9.3% and 3.7%, respectively. About 39.8% of the patients were lost to follow-up, while 53.8% were in good and fair clinical condition. CONCLUSION: Most of the cases referred for specialist care were from the general outpatient clinic, had diabetes mellitus, and benefitted from specialist care by the way of advanced investigations and treatments, though about a third were lost to follow-up. It is imperative that a good referral system is maintained among physicians, to ensure that patients get the best care available. Attention must be paid to common causes of patient attrition such as lack of widespread health insurance coverage, to ensure continuity of care.

Patterns and Correlates of Serum Magnesium Levels in Subsets of Type 2 Diabetes Mellitus Patients in Nigeria.

BACKGROUND: Magnesium (Mg) is the 4th most common mineral and the 2nd most abundant intracellular cation in the body. It plays major roles in various physiological activities and has been implicated in many disease states. AIM: The aim of this study was to study the patterns and correlates of serum Mg in cohorts of type 2 diabetic patients in Nigeria. SUBJECTS AND METHODS: One hundred and twenty-five patients comprising 63 with type 2 diabetes mellitus (T2DM) alone and 62 with diabetes and hypertension (HT) were compared with fifty controls matched for sex and age. Basic data, HbA1c, and fasting blood glucose (FBG) were obtained while serum Mg was measured by colorimeter. Relationship between serum Mg and glucose control was considered while serum Mg < 1.6 mg/dl was considered as hypomagnesemia. RESULTS: The mean serum Mg of all patients was 2.06 ± 0.49 mg/dl, not statistically different from controls at 2.22 ± 0.48 mg/dl. About » (23.2%) of the patients had hypomagnesemia which was significantly more than 12% of controls. Although the patients with diabetes and HT were older and more of females than those with DM alone, the mean serum Mg was comparable (2.03 ± 0.49 vs. 2.09 + 0.50 mg/dl). Twenty-seven percent (27%) of patients who had DM alone was more than 19.3% with HT and diabetes combined. Whereas the FBG was comparable in patients with hypomagnesemia and normal serum Mg, HbA1c was significantly higher in the hypomagnesemia group (8.39 ± 0.98 vs. 6.75 ± 1.22%, P = 0.021). CONCLUSION: Hypomagnesemia is common in T2DM outpatients occurring approximately one in four patients. It is associated with poor long-term control.

Physical activity among type-2 diabetic adult Nigerians.

BACKGROUND: Regular participation in physical activity (PA) programs is a key concept included in current public health guidelines. Therefore, this study was aimed to determine PA level among adult with type 2 diabetes. METHODS: A cross-section of 122 participants selected consecutively were categorized as physically inactive or active using International Physical Activity Questionnaire. Data was assessed using descriptive and inferential statistics. RESULTS: About 31% of the respondents were physically inactive. Residential areas were significantly associated with PA. A high proportion of those who lived in the metropolitan area were physically inactive. Less likely to be physically inactive were married (odds ratios [OR] =0.29, confidence interval [CI] =0.09-0.93) and living in an urban area (OR = 0.19, CI = 0.40-0.87). The degree holders are least physically inactive while the primary school leavers are highest. The median energy expenditure for walking, moderate and vigorous PA was 280.5, 80 and 0 MET-min/week respectively. The sedentary behavior of the respondents was 288 min/day, behavior which increases with age. CONCLUSION: This study suggests that the prevalence of physical inactivity was high among type 2 diabetics and their sedentary behavior is over 4 h/day. This group of people should be encouraged to participate regularly in PA.