Burnout Among Doctors and Nurses at The University of Uyo Teaching Hospital, South-South, Nigeria: A Comparative Study

BACKGROUND: Burnout remains a crucial occupational health challenge to healthcare professionals given its immediate and remote harmful effects. Doctors and nurses are highly susceptible to burnout due to the essence and demands of their services. The study aimed to determine and compare the prevalence of burnout among doctors and nurses working at the University of Uyo Teaching Hospital, Southern Nigeria. MATERIALS AND METHODS: A comparative, cross-sectional study of 553 doctors and nurses was conducted using a stratified random sampling technique. A pretested, self-administered MBI - Human Services Survey for Medical Personnel - MBI-HSS (MP) was used for data collection and analysis using IBM Statistical Product and Service Solutions (SPSS) software version 23. The Chi-square and Fisher's exact tests were applied with a statistical significance level set at α<0.05. RESULTS: The mean ages for doctors and nurses were 37.1 ± 5.3 and 39.0 ± 9.2 respectively (p=0.003). Burnout prevalence among doctors was 9.7% compared to 5.5% among nurses (p =0.062). Out of 553 respondents, 247 (46.7%) had high emotional exhaustion (EE), 70 (12.7%) had high depersonalization (DP), and 342 (61.9%) had low personal accomplishments (PA). Furthermore, 132 (47.3%) doctors had high EE, 43 (15.4%) had high DP and 159 (57%) had low PA. While 115 (42%) nurses had high EE, 27 (9.9%) had high DP and 183 (66.8%) had a low PA (p=0.041). Excessive workload (p=0.042) and lengthy years in a workplace position (p=0.002) were significantly associated with burnout among doctors compared to family size (p=0.045) and workplace support or community (p=0.005) among nurses. CONCLUSION: The study found burnout prevalence to be higher among doctors than nurses. Work-related factors contributed significantly to burnout development. Recreating and/or modifying workplace environments is essential to mitigating the adverse effects of burnout among healthcare workers.

CONTEXTE: Le burnout demeure un défi crucial pour la santé au travail des professionnels de la santé compte tenu de ses effets immédiats et à distance. Les médecins et les infirmières sont hautement susceptibles au burnout en raison de la nature et des exigences de leurs services. L'étude visait à établir et à comparer la prévalence du burnout parmi les médecins et les infirmières travaillant à l'Hôpital Universitaire de Uyo, dans le sud du Nigéria. MATÉRIEL ET MÉTHODES: Une étude comparative et transversale a été menée auprès de 553 médecins et infirmières à l'aide d'une technique d'échantillonnage aléatoire stratifié. Une enquête préalablement testée, auto-administrée, l'Inventaire d'épuisement professionnel humain pour le personnel médical (MBI-HSS [MP]), a été utilisée pour la collecte et l'analyse des données à l'aide du logiciel IBM Statistical Product and Service Solutions (SPSS) version 23. Les tests du Chi carré et de Fisher ont été appliqués avec un seuil de signification statistique fixé à α<0,05. RÉSULTATS: Les âges moyens des médecins et des infirmières étaient de 37,1 ± 5,3 et 39,0 ± 9,2 respectivement (p = 0,003). La prévalence de l'épuisement professionnel parmi les médecins était de 9,7 % par rapport à 5,5 % parmi les infirmières (p = 0,062). Sur les 553 répondants, 247 (46,7 %) présentaient un épuisement émotionnel élevé (EE), 70 (12,7 %) présentaient une dépersonnalisation élevée (DP) et 342 (61,9 %) présentaient un faible accomplissement personnel (PA). De plus, 132 (47,3 %) médecins avaient un EE élevé, 43 (15,4 %) avaient une DP élevée et 159 (57 %) avaient un PA faible. Tandis que 115 (42 %) infirmières avaient un EE élevé, 27 (9,9 %) avaient une DP élevée et 183 (66,8 %) avaient un PA faible (p = 0,041). Une charge de travail excessive (p = 0,042) et de nombreuses années passées à un poste de travail (p = 0,002) étaient significativement associées à l'épuisement professionnel parmi les médecins, par rapport à la taille de la famille (p = 0,045) et au soutien au travail ou à la communauté (p = 0,005) parmi les infirmières. CONCLUSION: L'étude a révélé une prévalence plus élevée du burnout parmi les médecins que parmi les infirmières. Les facteurs liés au travail ont contribué de manière significative au développement du burnout. Recréer et/ ou modifier les environnements de travail est essentiel pour atténuer les effets néfastes du burnout chez les travailleurs de la santé Mots-clés: épuisement professionnel, épuisement émotionnel, dépersonnalisation, accomplissement personnel, médecins, infirmières, hôpital Universitaire, Uyo, Nigéria.

Knowledge of, and attitudes to, acquired immune deficiency syndrome (AIDS) among traditional birth attendants (TBAs) in rural communities in Cross River State, Nigeria.

AIM: To survey knowledge of, and attitudes to, HIV/AIDS held by traditional birth attendants (TBAs) in rural communities in Cross River State, Nigeria. BACKGROUND: As the HIV/AIDS epidemic continues to spread, undermining development, reversing health gains and exacerbating poverty, TBAs in rural communities in Cross River State, Nigeria are still less informed about this dreadful disease. METHODS: A survey consisting of structured questionnaires was used with 140 randomly selected TBAs to assess their knowledge of HIV/AIDS, source of information on HIV and protective practices. FINDINGS: Results revealed that 62 (44.3%) of the TBAs had no formal education. Forty-four (31.4%) had primary education, while 19 (13.6%) had secondary education. On knowledge of HIV and sources of information, 49 (35.0%) of respondents reported knowing what HIV means. While 26.4% indicated that they received information about HIV from the government health centres, 23.6% had no information about the disease. There was a great disparity between male (73.7%) and female (28.9%) respondents on knowledge about HIV. On the use of protective safety procedures during delivery, 61 (43.6%) used sterilized blades, while 10.7% admitted wearing protective clothes and gloves. Only three (2.1%) of the respondents said that they were aware of the HIV status of their clients prior to delivery. CONCLUSIONS: This survey has demonstrated that few TBAs in the communities studied in Cross River State are informed about HIV/AIDS, and this has revealed the urgency of starting a programme specifically designed for TBAs in rural communities towards a massive educational campaign on HIV/AIDS.

The trend of pulmonary tuberculosis in patients seen at DOTS clinics in the Federal Capital Territory, Abuja, Nigeria.

We evaluated the pattern of sputum smear positivity and assessed the effects of directly observed treatment short course (DOTS) among tuberculosis (TB) patients at the DOTS clinics in the Federal Capital Territory (FCT), Abuja. In total, 1391 patients were seen at six microscopy and treatment centres across the FCT between January and December 2003. Their sputa were screened microscopically for the presence of acid-fast bacilli (AFB) using the Ziehl-Neelsen staining technique. In total, 296 (21.3%) patients were smear positive; 201 (67.9%) were new cases and 95 (32.1%) were follow-up cases. The highest incidence of sputum smear positivity (24.8%) was found in those aged 21-30 years and the lowest incidence (6%) was found in those aged 71 years and above. No incidence of smear positivity was recorded in children aged 0-10 years. In total, 160 of the men screened were AFB positive (75% new cases, 25% follow-up cases). In comparison, 136 women were AFB positive (59.6% new cases, 40.4% follow-up cases). During the 1-year study period, two deaths were recorded. Men pose a serious threat to public health as most of the follow-up cases result in the tubercle bacilli developing resistance to available anti-TB drugs. This study demonstrated a high prevalence of infectious TB in the population screened, and therefore underlines the need for capacity building through a multisectoral approach in the fight against the disease. Cohort analysis should be the cardinal management strategy in evaluating the effectiveness of TB control through systemic follow-up and reporting of certain indicators in treatment progress and success.

Differential release of tumor necrosis factor-alpha from murine peritoneal macrophages stimulated with virulent and avirulent species of mycobacteria.

The ability of Mycobacterium tuberculosis H37Rv and H37Ra, M. bovis BCG and M. smegmatis to induce the secretion of tumor necrosis factor-alpha (TNF-alpha) by cultured murine peritoneal macrophages is inversely related to their virulence. The avirulent species of mycobacteria which were unable to persist in macrophages were capable of inducing significant levels of TNF-alpha compared to that formed in cultures infected with the virulent M. tuberculosis H37Rv. This difference was also associated with an inherent toxicity by live H37Rv for macrophage cultures. Heat-killed H37Rv was non-toxic and induced significant levels of TNF-alpha; in contrast, live and heat-killed suspensions of avirulent mycobacteria had an equivalent ability to trigger TNF-alpha secretion. The TNF-alpha response was dose-dependent, related directly to the percentage of infected cells, and peaked 6-12 h post-infection. An early and vigorous TNF-alpha response appears to be a marker of macrophage resistance, while the downregulation of this response seems associated with macrophage toxicity and unrestricted mycobacterial growth.