Non communicable disease and risky behaviour in an urban university community Nigeria.

BACKGROUND: Most developing countries have only limited information on the burden of Non Communicable Diseases (NCDs) even though rapid transitions in these NCDs have been predicted. OBJECTIVES: To describe the burden of selected NCDs and associated risk behaviours in an urban university community in Nigeria. METHODS: A cross-sectional survey of 525 representative staff of a University in a large city in Nigeria was conducted. RESULTS: In all, 27.6% were already diagnosed with at least one NCD (hypertension-21.5%, diabetes-11%, cancer 2.9%) while 67.4% reported at least one risk behaviour (unhealthy diet- 96%, sedentary living- 27.4% excessive alcohol use-5.1% and smoking- 1.9%). Multiple risk behaviours were observed in 29.9% with no significant variation by sex or age. Those 40 years and above had significantly higher prevalence of NCD, particularly for hypertension (p<0.05). Only 7%, considered themselves to be at risk of NCDs. Those whose parents had NCDs OR: 5.9 (2.4-14.5) and those who currently had NCDs OR: 3.9(1.8-8.1) perceived themselves at risk of one or more NCDs, but not those with multiple risk behaviours. CONCLUSION: The high burden of NCDs and risk behaviours in the face of limited self-perceived risk has been demonstrated and calls for urgent intervention.

Experiences of mistreatment among medical students in a university in south west Nigeria.

OBJECTIVE: This study was conducted to assess the experiences of mistreatment and harassment among final-year clinical students in a Nigerian medical school. MATERIALS AND METHODS: A self-administered questionnaire was used to obtain information on the various forms of mistreatment experienced by 269 students in the 2007 and 2008 graduating classes of a medical school in Nigeria. RESULTS: Almost all the respondents (98.5%) had experienced one or more forms of mistreatment during their training. The commonest forms experienced by the students were being shouted at (92.6%), public humiliation or belittlement (87.4%), negative or disparaging remarks about their academic performance (71.4%), being assigned tasks as punishment (67.7%), and someone else taking credit for work done by the student (49.4%). Religious or age discrimination was reported by 34.2%, sexual harassment and other forms of gender-based mistreatment by 33.8%, and threats of harm by 26.4%. These incidents were mainly perpetrated by physicians and occurred mostly during surgical rotations. The effects included strained relationships with the perpetrators, reduced self-confidence and depression. CONCLUSION: Most medical students experienced verbal forms of mistreatment and abuse during their training. Appropriate strategies for the prevention and reduction of medical student mistreatment should be developed.

Hospital-acquired infections in a Nigerian tertiary health facility: An audit of surveillance reports.

BACKGROUND: Hitherto efforts to implement data driven prevention guidelines for hospital-acquired infections (HAI) in Nigeria have been limited by the inadequate knowledge of the risks of these infections. This study evaluated the occurrence of HAI in a foremost tertiary health facility over a 5-year period for the purpose of reinforcing control efforts. MATERIALS AND METHODS: A retrospective survey of records from the infection control unit of the University College Hospital, Ibadan, Nigeria, was done for the years 2005-09. For the 5 years studied 22,941 in-patients were reviewed and the data of those who developed infections during admission were retrieved and analyzed. The prevalence, types, and causative organisms of HAI were determined. The chi-square test was used to evaluate associations. RESULTS: The prevalence of HAI over the 5-year period was 2.6% (95% CI: 2.4-2.8). Surgical and medical wards had the most infections (48.3%) and (20.5%) respectively. Urinary tract infection (UTI) and surgical site infection (30.7%) were the most prevalent (43.9%) HAI. UTIs were significantly higher in surgical and medical wards, surgical site infections in obstetrics and gynecology wards, and soft tissue infections and bacteremia in pediatric wards (P<0.05). Gram-negative infections occurred about four times as often as gram-positive infections with Klebsiella sp. and staphylococcus aureus being the predominant isolates (34.3%) and (20.1%) respectively. CONCLUSION: Efforts to limit HAI should be guided by local surveillance data if progress is to be made in improving the quality of patient care in Nigeria.

Making a case for community screening services: findings from a medical outreach in ibadan, Nigeria.

BACKGROUND: Currently, population based medical check up is yet to be explored as a veritable tool for assessing the burden of non-communicable diseases in Nigeria. OBJECTIVES: This study aimed to assess the prevalence of selected lifestyle related diseases during a free medical rally in an urban community. METHODS: General medical examinations of all participants at a free medical rally in a middle class community in Ibadan, Oyo State was conducted. Body Mass Index (BMI), blood pressure and random blood sugar measurements were done using standardised instruments. BMI classification for children was done using the CDC guidelines for males and females aged 2-20 years. RESULTS: Of the 302 participants examined, 33.1% were males and 32.1% were less than 18 years. Of those aged 2 to 20 years, 22.9% were underweight, while 5.2% were overweight/ obese. In adults 3.6% were underweight and 43.2% were overweight/ obese. Adults were significantly more likely to be overweight/obese (P<0.001). Prevalence of high blood pressure was 29.3% and 9.4% of adults had elevated random blood glucose levels. A higher proportion of obese people (P=0.259), males (P= 0.327) and those older than 40 years (P<0.001) had elevated blood pressure. A weak correlation (spearman rho= 0.3) was found between blood pressure and BMI (P<0.001) and also between BMI and blood sugar level (spearman rho= 0.2) P=0.05. CONCLUSION: There is a need for greater emphasis on community based screening programmes to aid early diagnosis and treatment of non communicable diseases in the country.

Supplementation of micronutrient in community micronutrient deficiency prevention programmes.

Micronutrient deficiency affects about 2 billion people all over the world. The major micronutrient deficiencies which are of public health importance include vitamin A, iron and iodine deficiencies. The deficiencies of these micronutrients cause a variety of morbidities and increased mortality which are most severe in children, adolescent girls and pregnant women. Despite the magnitude of these deficiencies, research has shown that they are correctable using simple strategies. This review examines the strategies employed to reduce micronutrient deficiencies worldwide by reviewing bibliographic databases, monograms and journals up to the year 2007. These strategies include food based and micronutrient supplementation. Although micronutrient supplementation is widely embraced as a strategy to combat micronutrient deficiencies, they are most suitable when used as a measure to combat severe deficiencies. Food based strategies such as food fortification and dietary diversification are more effective than micronutrient supplementation which should only be used as a short term measure. Supplementation programmes should be evidence based, multi-nutrient in approach and backed up with other complementary public health interventions.