Asymptomatic falciparum Malaria and its Effects on Type 2 Diabetes Mellitus Patients in Lagos, Nigeria.

BACKGROUND: Asymptomatic malaria (ASM) constitutes a reservoir of malaria parasites that sustain transmission and threaten elimination efforts. Studies have also shown a significant relation between insulin resistance and malaria infection. However, data on the clinical effects of ASM and its patterns of carriage among adult malaria patients is limited. OBJECTIVES: To determine the prevalence of ASM due to Plasmodium falciparum among adult type 2 diabetes (T2DM) patients in Lagos, Nigeria; to assess the diagnostic performance of light microscopy and histidine-rich protein 2 rapid diagnostic test (HRP-2 RDT); and to determine the effects of ASM on glycemic control and anemia. MATERIALS AND METHODS: This cross-sectional study enrolled 208 afebrile, nonobese, nonhypertensive T2DM patients, aged 40-70 years, undergoing treatment (adherence, ≥95%) at six private health facilities in Lagos, Nigeria, between March and August 2015. Sociodemographic data were obtained using a semi-structured questionnaire and clinical case files. Venous blood samples were collected and processed for fasting blood sugar estimation, packed cell volume determination and malaria parasite detection by HRP2-RDT, light microscopy and polymerase chain reaction (PCR). RESULTS: The mean age of the patients was 54.5 years. ASM was diagnosed in 16.8%, 7.2% and 4.3% of the patients by PCR, light microscopy and HRP2-RDT, respectively. ASM was significantly (P < 0.05) associated with poor glycemic control, anemia and insulin resistance. The overall parasitemia ranged from 85 to 3789 parasites/µL (median, 1580 parasites/µL). Benchmarking against the PCR results, light microscopy and rapid diagnostic tests were found to have a sensitivity (95% confidence interval) of 42.9% (26.5-59.3) and 22.9% (12.1-39), respectively, in diagnosing ASM. CONCLUSION: This study revealed that T2DM patients in Lagos, Nigeria, are potential reservoirs of asymptomatic Plasmodium falciparum, which has a significantly negative effect on glycemic control and anemia. The study also found PCR to be the most effective diagnostic method.

Sociodemographic Factors Affecting the Quality of Life of Elderly Persons Attending the General Outpatient Clinics of a Tertiary Hospital, South-South Nigeria.

BACKGROUND: In the last few decades, the evaluation of the quality of life (QoL) among older adults has become increasingly important in health as well as in social sciences. There has been growing emphasis on the need to understand what influences older people's QoL as it is argued to be of greater value than the traditional outcome measures, such as health status. AIM AND OBJECTIVE: The aim of this study was to determine the sociodemographic factors affecting the QoL of elderly patients attending the General Outpatient Clinics of the University of Uyo Teaching Hospital (UUTH), Uyo. METHODOLOGY: The study was a cross-sectional descriptive study. Three hundred and ten elderly persons attending the General Outpatient Clinics of the UUTH for medical conditions between July and September 2014 were consecutively recruited for the study. Details of sociodemographic information were taken, and QoL of respondents was assessed using the older persons' QoL questionnaire. Data were analyzed using the Statistical Package for Social Sciences-17.0, and the level of statistical significance was set at P < 0.05. RESULTS: Of the three hundred and ten respondents recruited for the study, One hundred and seventy-seven (57.1%) were female and one hundred and thirty-three (42.9%) were male. The female-to-male ratio was 1.3:1. The age range of the respondents was between 60 and 90 years and the mean age (±standard deviation) was 67.4 (±6.6) years. Two hundred and thirty-two respondents (74.8%) had at least primary level of education and one hundred and sixty-one (51.9%) were married. The median monthly income was ₦ 25,500.00 with interquartile range of ₦ 10,000.00 to ₦ 50,000.00. From the study, 85.5% of the elderly reported an overall good QoL. High-income grade (P = 0.019), high social class (P = 0.036), and high level of education (P < 0.001) were the factors associated with good QoL in this study on univariate analysis. CONCLUSION: A high percentage of respondents reported an overall good QoL. High-income grade, high social class, and high level of education were the factors associated with good QoL.

HEALTH WORKERS' PERCEPTIONON THE QUALITY OF SERVICE AND CORPORATE CULTURE OF A TEACHING HOSPITAL IN NIGERIA.

BACKGROUND: Quality of service delivery remains the most important issue in hospitals since patients expect higher standard care and services. This quality service is rooted in the culture of the health care organization. Therefore,this study seeks to determine health workers' perception on the quality of service and corporate culture at University of Uyo Teaching hospital, Uyo, Nigeria. METHOD: A cross-sectional descriptive study was carried out. Using structured questionnaire and convenient sampling technique, data were collected from 250 hospital workers.The responses on questions to elicit the hospital's quality of service and corporate culture were rated on a five-point Likert Scale as follows; Strongly Agree (SA), Agree (A), Neutral(N), Disagree (D) and Strongly Disagree (SD). Data entry and analysis were performed using Epi Info 3.2.2 (CDC, Atlanta, Georgia, USA). RESULTS: The minimum and maximum ages of the respondents were 21 years and 60 years respectively. The mean, median and mode ages in the respondents were 34.6 (± 7.88) years, 33 years, and 30 years respectively. Majority of the study respondents were in the age group of 31-40 years (30%), female (56.8%) and Doctors (36%). The respondents' positive perception on quality of service offered by the hospital was 69.2% (OR 5.05, 95% CI 3.39-7.52, P < 0.00001). The subjects' positive perception on the organization values for the individual worker was 54.4% (OR 1.42, 95% CI 0.99- 2.06, P = 0.049). However, only 43.2% of the subjects accepted that the management of the hospital was flexible and understands the important of balancing their work/personal life (OR 0.58, 95%CI 0.40-0.84), P = 0.002).Thirty-eight percentages (38%) accepted that top management of the hospital communicates changes in decisions that affect employees (OR 0.38, 95% CI 0.26-0.55), P < 0.00001). Majority of the workers in the various professions accepted that the hospital offer quality services as obtained in other hospitals. Majority of the workers in all the professions except Medical Doctors accepted that the hospital values the individual workers. Majority of the Pharmacists and Non-clinical staff accepted that the hospital management was flexible and understands the importance of balancing their work and personal life. Majority of the Doctors, Pharmacists and laboratory/image scientists did not accept that top management communicates changes in decisions that affect employees. CONCLUSION: The perception of health workers on the quality of service rendered by the University of Uyo Teaching Hospital was satisfactory. However, the hospital needs to improve on its corporate culture to achieve a higher quality of service.

Risk factors for diabetes mellitus among rural adults in Nigeria.

BACKGROUND: Diabetes mellitus remains a high burden for individuals all over the world. Identification of adults at risk for diabetes mellitus provides potential opportunities for early diagnosis and prevention of diabetes mellitus. This study sought to determine the risk factors for diabetes mellitus among adults in a rural Nigerian community. METHOD: A cross sectional descriptive study of 750 subjects age > or = 15 years using a systematic sampling technique. Data were collected with a structured questionnaire. Subjects were examined for weight, height, waist circumference and hip circumference; body mass index and waist-hip ratio were calculated. Blood samples were collected from subjects for estimation of plasma glucose concentration using the glucose oxidase method of Trinder. Diabetes mellitus was diagnosed according to standard WHO/IDF criteria. RESULTS: Subjects consisted of 385 (51.3%) males and 365 (48.7%) females (male: female 1.05:1) with mean age of 39.42 +/- 16.17 years. Physical inactivity and body mass index were not identified as risk factors for diabetes mellitus. In multiple logistic regression, the prevalence of diabetes mellitus was independently associated with age (OR 1.03, 95% CI 1.00-1.05, p = 0.03), alcohol intake (OR 9.04, 95% CI 1.68-48.8l, p = 0.1), parental history of diabetes mellitus (OR 57.02, 95% CI 7.88-432.9, p < 0.001) and waist-hip ratio (OR 22175.12.95% CI 19.38-253736.1, p < 0.001). CONCLUSION: We established that advancing age, alcohol intake, parental history of DM and increasing waist-hip ratio were risk factors for diabetes mellitus among rural adults in Nigeria. Identification of these risk factors in rural adults would be an important step in prevention and early diagnosis of diabetes mellitus in the rural population.

Ethnicity, family socioeconomic inequalities, and prevalence of vaginal douching among college students: the implication for health.

OBJECTIVE: This study assessed the association between ethnicity and family socioeconomic status (SES) as it relates to the prevalence of vaginal douching among female undergraduates in a university community. PARTICIPANTS AND METHODS: This was a cross-sectional survey conducted between September 2011 and February 2012 among 1,535 female undergraduates using a semistructured behavioral questionnaire adapted by the authors from previous research related to vaginal douching practice. RESULTS: The overall prevalence of vaginal douching was 79.35% and the practice was significantly associated with the mother's age, ethnicity, low SES (educational level, occupation, and monthly income), and area of residence. The father's age and SES were statistically nonsignificant. CONCLUSION: Ethnicity and low SES of mothers were significantly associated with a higher prevalence of douching in daughters. These factors should be considered among others in any intervention to discourage vaginal douching among college women.

Obstetric fistula repair: experience with hospital-based outreach approach in Nigeria.

BACKGROUND: The huge back-log of obstetric fistula and the increasing incidence of the condition in Nigeria is a cause for concern for all stake-holders. This worrisome trend requires concerted effort with innovative strategies to redress the situation. METHODS: Hospital-based outreach programs sponsored by a non-governmental organization with volunteer medical and health personnel were used to repair selected cases of obstetric fistula in Nigeria. RESULTS: Fifty-two relatively simple obstetric fistulas were selected out of 68 (selection rate 76.5%) that presented for repair at 12 outreach programs in 5 different states of Nigeria. All the cases were repaired by one trained gynecological surgeon with a cure rate of 100%. The majority (50.0%) of the women were aged between 16 and 20 years with a mean age of 23.8 years ± 3.6. Most (80.9%) of the women in the study population were primiparous. The majority (50.0%) of the women were divorced at the time of their presentation for repair. A vast majority (76.9%) of the women had either primary level of education or no formal education. There was a preponderance (53.8%) of juxtacervical VVF among women in the study population. CONCLUSION: The use of hospital- based outreach approach to repair simple cases of obstetric fistula if multiplied could help reduce the large number of women living with unrepaired VVF in Nigeria.

Quality of life in people living with HIV/AIDS in Niger Delta Region, Nigeria.

BACKGROUND: Despite the global efforts and huge financial investment in HIV/AIDS, the quality of life in people living with the disease continues to deteriorate, posing serious problems with increased mortality. AIM: The objectives of the study were: (i) to assess the quality of life in people living with HIV/AIDS, and (ii) to compare quality of life in males and females living with the disease. METHODS: A total of 309 people living with HIV/AIDS from the HIV clinic, University of Uyo Teaching Hospital were randomly assessed for quality of life, using HIV/AIDS-Targeted Quality of life (HAT-QOL) questionnaire. RESULTS: A total of 265 (85.8%) respondents consisting of 113 (36.6%) males and 152 (49.2%) females were analyzed. The mean age for males was 36.8 +/- 4.0 years and females 31.9 +/- 3.3 years. The difference in mean was statistically significant (t = 31.831, p < 0.01), occupation was statistically significant (chi(2) = 11.348, p < 0.02). Females showed lower quality of life in comparable domains than males. The differences in life satisfaction (chi(2) = 10.362, p < 0.01) and health worries (chi(2) = 9.944, p < 0.01) were statistically significant. CONCLUSION: The results showed impairment in quality of life, except in medication worries and sexual function in people living with HIV/AIDS. Improvement in HAT-QoL indices will enhance positive quality of life.