Effect of a training intervention for finding the missed cases of tuberculosis amongst patent medicine vendors in Delta State, Nigeria.

Context: The undiagnosed and untreated tuberculosis (TB) cases underpin the experience of accelerating deaths. Everyone should be engaged in managing TB patients to revert the current trend. Aims: In this context, we assessed the outcome of an education intervention on the knowledge of TB and referral practice of presumptive TB cases to directly observed therapy strategy amongst patent medicine vendors (PMVs). Settings and Design: The study was quasi-experimental, conducted amongst 647 PMVs in Delta State, Nigeria. Methods: A structured questionnaire was administered to obtain baseline data on knowledge of TB. An educational intervention on knowledge of TB was then given. A post-intervention assessment of TB knowledge was subsequently conducted using the same questionnaire. The exact number of referrals of presumptive TB cases by PMVs and the number that tested positive amongst the referred presumptive TB cases, 3 months before and after the training were obtained from the state TB database. Statistical Analysis Used: SPSS v. 26 was used for data analysis. Results: The pre-training knowledge average score was 15.45 ± 6.45, while the post-training average score was 19.44 ± 7.03 (P < 0.001). The pre-training average number of presumptive cases referred was 146 ± 124.7, and the post-training was 205.67 ± 255.4, P = 0.41. The pre-training average number of cases that turned out positive was 9.5 ± 6.3, and the post-training was 13.5 ± 11.3, P = 0.42. Conclusion: There was a significant improvement in PMVs' knowledge of TB post-intervention. However, while an increase in the number of cases referred and positives detected was observed, this was not significant. Periodic training and updates to PMVs in keeping with current trends and best practices in TB management are recommended.

Medical education in Nigeria and migration: a mixed-methods study of how the perception of quality influences migration decision making.

This article was migrated. The article was marked as recommended. Medical education in Nigeria faces numerous challenges and problems; a lack of a coherent admission policy, inadequate funding, poor planning, and erosion of values have led to a general perception of low standards and quality. In the face of these, questions arise as to their influence on medical students' aspirations and intentions to migrate after graduation. This study uses a sequential mixed-method design to examine the extent to which the perceptions of the quality of medical education in Nigeria affect the aspirations and plans of Nigerian medical students to migrate after graduation. 211 final year students (out of a potential 580) participated in a survey; aged between 20 and 45. While the survey showed that the students perceived medical education to be of sufficiently good quality across a spectrum of variables, interview respondents described a dysfunctional medical education that failed to meet their aspirations. The perception of a declining standard in medical training is a major issue for Nigerian medical students and graduates. The inability to halt the decline in the quality of medical training in Nigeria, therefore, leaves many medical students and graduates feeling inadequately trained, and inadvertently feeds their desires and aspirations to migrate abroad after graduation.