Knowledge and practice assessment, and self reported barriers to guideline based asthma management among doctors in Nigeria.

BACKGROUND AND OBJECTIVE: Doctors' knowledge contributes to practice and quality of care rendered to patients. To assess the knowledge and practice assessment and self reported barriers to guideline-based management among doctors. SUBJECTS AND METHODS: This was a cross-sectional study among doctors from various part of the country attending a continuing medical education (CME) program in Lagos, Nigeria. We used a self-administered, pretested, semistructured, validated questionnaire based on the Global Initiative for Asthma (GINA) guideline. RESULTS: Of the 98 participants, 41 (42%) and 18 (18.4%) had good level of asthma knowledge and practice, respectively. There was no relationship between level of knowledge and practice and the level of knowledge was not associated with the practice (X2 = 6.56, P = 0.16). The most reported barriers to good guideline-based practice were the unavailability of diagnostic and treatment facilities (44.3%), poor medication adherence (25.7%), and high cost of asthma medications (18.6%). CONCLUSION: The level of asthma knowledge and practice, respectively, among doctors in Nigeria is low and there is no relationship between level of knowledge and practice. Unavailability of diagnostic and treatment facilities, poor medication adherence, and high cost of medications are important barriers to good practice. There is a need to improve asthma education among doctors in Nigeria. Addressing barriers to good practice is essential for the translation of knowledge into practice.

Pattern and outcome of postneonatal pediatric emergencies in Nnamdi Azikiwe University Teaching Hospital, Nnewi, South East Nigeria.

BACKGROUND: Nigeria is still battling with preventable childhood deaths, being one of the six countries in which 50% of all global child deaths occur. Regular community and health facility audits are needed to determine morbidity and mortality patterns in children which will guide preventive and therapeutic interventions. OBJECTIVES: The objective was to determine morbidity and mortality patterns, and identify factors influencing poor outcome of the disease in children seen in the emergency room of Nnamdi Azikiwe University Teaching Hospital, Nnewi. MATERIALS AND METHODS: This was a 2-year retrospective study (March 2012 to February 2014) involving all children admitted into the children emergency room (CHER). Information on the patients' biodata, diagnosis, and outcome were retrieved from the CHER doctors' log. Analysis was done using Microsoft Office Excel 2007 and Statistical Package for Social Sciences version 20. RESULTS: The total of 1964 patients were seen (1088 males, 845 females, 31 unspecified) with a male to female ratio of 1.3:1. Under-fives constituted 78.8% of the study population. Mean duration of illness before presentation was 18.71 ± 71.94 days. Malaria, diarrheal disease, and respiratory tract infections were the most common morbidities. Sepsis had the highest case fatality rate (CFR) and was the most common cause of death among the 247 patients that died - mortality rate of 12.6%. Most deaths were in under-fives (CFR = 13.9, χ2 = 25.553, P = 0.000), with 74.1% of the mortalities occurring within 24 h of presentation. Patients who presented within a day and those that presented in the 2 nd and 3 rd weeks of onset of symptoms had CFR of 6.4-15.2%, respectively. CONCLUSION: Infectious diseases remain a menace in our environment with the eventual outcome worsened by late presentation to an appropriate health facility. There is an urgent need to create public awareness on the need to seek prompt medical attention for sick children.

Determinants of undernutrition among primary school children residing in slum areas of a Nigerian city.

BACKGROUND: Undernutrition remains the largest contributor to the global disease burden. Different factors affecting the nutritional status of children need to be studied to determine those to be targeted in a country like Nigeria, characterized by widespread poverty and inequitable distribution of wealth. OBJECTIVE: This study was aimed at ascertaining the relationship between prevailing socioeconomic and environmental factors, and the nutritional status of children residing in a typical urban slum. MATERIALS AND METHODS: A cross-sectional descriptive study of 788 children aged 6-12 years selected by stratified, multistage random sampling method from public primary schools in slum and non-slum areas of Onitsha was carried out. Their nutritional status was determined using anthropometric measures. The socioeconomic and environmental variables of interest were analyzed to determine their relationship with undernutrition in the children. RESULTS: Socioeconomic status was the major determinant of nutritional status in this study. Poor housing also affected the nutritional status of the slum children who were significantly from poorer families than those residing in non-slum areas (χ2 = 66.69, P = 0.000). CONCLUSION: This study highlights the need for an effective nutrition program targeted at school children in urban slums surrounded by factors predisposing them to undernutrition.

Determinants of Undernutrition among Primary School Children Residing in Slum Areas of a Nigerian City

Background: Undernutrition remains the largest contributor to the global disease burden. Different factors affecting the nutritional status of children need to be studied to determine those to be targeted in a country like Nigeria; characterized by widespread poverty and inequitable distribution of wealth. Objective: This study was aimed at ascertaining the relationship between prevailing socioeconomic and environmental factors; and the nutritional status of children residing in a typical urban slum. Materials and Methods: A cross-sectional descriptive study of 788 children aged 6-12 years selected by stratified; multistage random sampling method from public primary schools in slum and non-slum areas of Onitsha was carried out. Their nutritional status was determined using anthropometric measures. The socioeconomic and environmental variables of interest were analyzed to determine their relationship with undernutrition in the children. Results: Socioeconomic status was the major determinant of nutritional status in this study. Poor housing also affected the nutritional status of the slum children who were significantly from poorer families than those residing in non-slum areas (?2 = 66.69; P = 0.000). Conclusion: This study highlights the need for an effective nutrition program targeted at school children in urban slums surrounded by factors predisposing them to undernutrition