MORBIDITY, COMORBIDITY AND MULTIMORBIDITY AS PORTALS FOR SUBJECTIVE WELL-BEING AMONG OLDER PERSONS IN A RURAL NIGERIAN ENVIRONMENT: A CROSS-SECTIONAL HOSPITAL-BASED STUDY.

Background: Subjective well-being (SWB) has been described as a new vital sign that predicts the overall health and future health status of individuals. Despite the process of natural ageing, older persons in addition suffer morbid, comorbid and multimorbid medical conditions that affect their SWB. Aim: The aim of the study was to determine the morbidity, comorbidity and multimorbidity as predictors of SWB among older persons in a rural environment of Nigeria. Methods: This was a cross-sectional study that was carried out on 214 older persons from January to December 2022 in Nigeria. Data collection was done using structured, pretested and interviewer guided questionnaire. Subjective well-being was assessed with self-rated health status questionnaire. Morbidity was determined by self-reported health problems, clinical, laboratory and radio-diagnostic methods. Co-morbidity was assessed using Self-Reported Comorbidity Questionnaire (SCQ) while multimorbidity was evaluated using multimorbidity Assessment Questionnaire for Primary Care (MAQ-PC). Results: The study participants were aged 60-99 years with mean age of 68±4.5 years. There were 123(57.5%) females. Ninety-three(43.5%) of the study participants had good SWB. The three most common morbidities were malaria(97.2%), hypertension(69.2%) and musculo-skeletal disorders(67.8%). The commonest cardiovascular comorbidity was musculoskeletal disorders(56.1%) and one hundred and five(49.1%) of the study participants had three co-morbid chronic conditions. The prevalence of multimorbidity was 45.3%. The independent predictors of poor SWB were age≥75 years(ORs=2.103; 95%CI(1.215-4.214), P=.026); poor healthseeking behaviour(ORs=2.005; 95%CI(1.351-5.090), P=.041); presence of ≥ 3 comorbidities(ORs=3.111; 95%CI(1.465-6.910); P=.019) and presence of ≥ 3 multimorbidities(ORs=3.309; 95%CI(1.899- 7.921); P= .001). Conclusion: The study has shown the overall SWB of the study participants. The independent predictors of poor SWB were age ≥ 75 years, poor health seeking behaviour, presence of ≥ 3 comorbidities and multimorbidities. Health-seeking behaviours, comorbidities and multimorbidities should be explored during clinical consultations with older persons with poor SWB.

COVID-19 Vaccine Hesitancy in a Medically-Challenged Context: A Cross-Sectional Study of Drivers, Dangers and Corrective Measures for Vaccine Hesitancy and Potential Penalties for Declining Vaccination among Adults in South-Eastern Nigeria.

BACKGROUND: COVID-19 vaccine hesitancy is a global public health problem. It is a complex and context-specific phenomenon that varies within and across nations. Despite COVID-19 vaccine programmes in Nigeria, there are possibilities that vaccine uptake and coverage among adult citizens will suffer setbacks amidst various interventions by the Federal Government of Nigeria. AIM: The study aimed to determine the drivers, dangers, and corrective measures for COVID-19 vaccine hesitancy and potential penalties for declining vaccination among adults in South-eastern Nigeria. METHODS: A descriptive study was carried out from March to April, 2021 on a cross section of 400 adults in South-eastern Nigeria. Data collection was done using a structured, pretested, and interviewer administered questionnaire. The questionnaire elicited information on drivers, dangers and corrective measures for COVID-19 vaccine hesitancy and potential penalties for declining vaccination. RESULTS: The study participants were aged 18-86 (51±14.2) years. There were 227(56.8%) females. The most common driver of refusal of COVID-19 vaccination was the safety of COVID-19 vaccines(100.0%). The most perceived dangers of refusing the COVID-19 vaccine were the risks of contracting COVID-19 infection(100.0%) and dying from its complications(100.0%). The most common corrective measure for refusal of the COVID-19 vaccine was public health information and education on vaccine safety(100.0%). The predominant potential penalty for declining the COVID-19 vaccine was restricting access to air travel (100.0%). CONCLUSION: This study has shown that the most common driver of vaccine hesitancy was vaccine safety while the most commonly perceived dangers were risks of contracting COVID-19 infection and dying from its complications. The most common corrective measure for refusal of the COVID-19 vaccine was public health information and education on vaccine safety. The most preeminent penalty for declining the COVID-19 vaccine was restricting access to air travel. There is a need to address these context-specific drivers and dangers that promote vaccine hesitancy. Public health information and education strategies to reduce vaccine hesitancy should be the focus of intervention to improve uptake of COVID-19 vaccination and safeguard the health of Nigerians.

CONTEXTE: L'hésitation à se faire vacciner contre le COVID-19 est un problème de santé publique mondial. Il s'agit d'un phénomène complexe et spécifique au contexte qui varie au sein d'une même nation et d'une nation à l'autre. Malgré les programmes de vaccination contre le COVID-19 au Nigeria, il est possible que l'adoption et la couverture vaccinale chez les adultes subissent des revers malgré les diverses interventions du gouvernement fédéral du Nigeria. OBJECTIF: L'étude visait à déterminer les moteurs, les dangers et les mesures correctives de l'hésitation à se faire vacciner contre le COVID- 19 et les sanctions potentielles en cas de refus de vaccination chez les adultes du sud-est du Nigeria. MÉTHODES: Une étude descriptive a été menée de mars à avril 2021 sur un échantillon de 400 adultes du sud-est du Nigeria. La collecte des données a été effectuée à l'aide d'un questionnaire structuré, testé au préalable et administré par un enquêteur. Le questionnaire a permis d'obtenir des informations sur les facteurs, les dangers et les mesures correctives de l'hésitation à se faire vacciner par le COVID-19 et les sanctions potentielles en cas de refus de la vaccination. RÉSULTATS: Les participants à l'étude étaient âgés de 18 à 86 ans (51±14,2). Il y avait 227 (56,8 %) femmes. Le motif le plus courant de refus de la vaccination par le COVID-19 était l'innocuité des vaccins COVID-19 (100,0 %). Les dangers les plus perçus du refus du vaccin COVID-19 étaient les risques de contracter une infection au COVID-19 (100,0%) et de mourir de ses complications (100,0%). La mesure corrective la plus courante pour le refus du vaccin COVID-19 était l'information et l'éducation en matière de santé publique sur la sécurité du vaccin (100,0%). La pénalité potentielle prédominante pour le refus du vaccin COVID-19 était la restriction de l'accès aux voyages aériens (100,0 %). CONCLUSION: Cette étude a montré que le facteur le plus courant de l'hésitation à se faire vacciner était la sécurité du vaccin, tandis que les dangers les plus couramment perçus étaient les risques de contracter l'infection au COVID-19 et de mourir de ses complications. La mesure corrective la plus courante pour le refus du vaccin COVID-19 était l'information et l'éducation de la santé publique sur la sécurité du vaccin. La sanction la plus prééminente pour le refus du vaccin COVID-19 était la restriction de l'accès aux voyages aériens. Il est nécessaire de s'attaquer à ces facteurs et dangers spécifiques au contexte qui favorisent l'hésitation à se faire vacciner. Les stratégies d'information et d'éducation en matière de santé publique visant à réduire l'hésitation à se faire vacciner devraient être au centre de l'intervention afin d'améliorer l'adoption de la vaccination par le COVID-19 et de préserver la santé des Nigérians. Mots clés: Vaccin COVID-19, Dangers, Facteurs d'incitation, Hésitation, Nigeria, Pénalités.

Point-of-Care Anti-Counterfeit Medicines Technologies: Awareness and Utilization among Medical Practitioners in Eastern Nigeria.

BACKGROUND: Substandard and falsified medicines pose a serious threat to public health throughout the world but disproportionately afflict under-resourced nations with weak pharmaceutical regulatory mechanisms. The prescription of medicines is an event in which a medical practitioner(MP) is a decision maker for the ultimate consumer who is the patient. AIM: The study was aimed at describing awareness, identification, utilization, and barriers to utilization of point of-care overt anti-counterfeit medicine technologies(ACMTs) and the drivers, dangers and preventive measures of substandard and falsified medicines among MPs in Abia State. METHODS: This was a cross-sectional study done on 178 MPs in Abia State, Nigeria. Data were collected using a self-administered questionnaire that elicited information on awareness, identification, utilization of overt ACMTs and its barriers. The drivers, dangers and preventive measures for substandard and falsified medicines were also studied. RESULTS: The mean age±SD of the respondents was 34±8.2 (Range 24-72 years). There were 159(89.3%) males. All the respondents (100%) were aware of the point-of-care overt ACMTs with the most commonly identified types being labelling (100%), packaging (100%), printing graphics (100%), and mobile authentication numbers(MAN) (100%). The most commonly utilized ACMTs were labelling (100%), packaging (100%) and printing (100%) technologies. Time constraint (100%) was the predominant predisposing barrier to utilization of overt ACMTs. The commonest classes of falsified and substandard medicines were anti-malarial (100%), anti-bacterial (100%) and analgesics (100%). The most common driver and danger of substandard and falsified medicines alluded to by the respondents were poor pharmaceutical products regulatory systems (100%) and treatment failures (100%), respectively. The most recommended preventive measure was securing supply chain of medicines (100%). CONCLUSION: Awareness of point-of-care overt ACMTs was very high but did not appear to translate to comparable utilizations for all types. The most commonly utilized overt ACMTs were labelling, packaging and printing technologies. Time constraint was identified as a possible predominant barrier to utilization of overt ACMTs. The commonest classes of substandard and falsified medicines were anti-malarial, anti-bacterial and analgesic medicines. It was believed that the commonest driver of substandard and falsified medicines was poor pharmaceutical products regulatory system and all these could result in treatment failures. Securing supply chain of medicinal products may serve as an effective preventive measure.

CONTEXTE: Les médicaments de qualité inférieure et falsifiés constituent une menace sérieuse pour la santé publique dans le monde entier, mais touchent de manière disproportionnée les pays disposant de peu de ressources et de mécanismes de réglementation pharmaceutique faibles. La prescription de médicaments est un événement au cours duquel un praticien médical (PM) est un décideur pour le consommateur final qu'est le patient. OBJECTIF : L'étude visait à décrire la sensibilisation, l'identification, l'utilisation et les obstacles à l'utilisation des technologies de lutte contre la contrefaçon de médicaments (ACMT) au point de service, ainsi que les facteurs, les dangers et les mesures préventives des médicaments de qualité inférieure et falsifiés parmi les médecins de l'État d'Abia. MÉTHODES: Il s'agit d'une étude transversale menée auprès de 178 députés de l'État d'Abia, au Nigeria. Les données ont été collectées à l'aide d'un questionnaire auto-administré qui a permis d'obtenir des informations sur la sensibilisation, l'identification, l'utilisation des ACMT et ses obstacles. Les moteurs, les dangers et les mesures préventives des médicaments non conformes aux normes et falsifiés ont également été étudiés. RÉSULTATS: L'âge moyen±SD des répondants était de 34±8,2 (fourchette 24-72 ans). Il y avait 159 (89,3%) hommes. Toutes les personnes interrogées (100 %) connaissaient les ACMT sur le lieu de soins, les types les plus fréquemment identifiés étant l'étiquetage (100 %), l'emballage (100 %), l'impression de graphiques (100 %) et les numéros d'authentification mobile (MAN) (100 %). Les ACMT les plus couramment utilisées étaient les technologies d'étiquetage (100%), d'emballage (100%) et d'impression (100%). Le manque de temps (100 %) était l'obstacle prédominant à l'utilisation des ACMT manifestes. Les classes les plus courantes de médicaments falsifiés et non conformes aux normes étaient les antipaludéens (100%), les antibactériens (100%) et les analgésiques (100%). La cause et le danger les plus courants des médicaments falsifiés et non conformes aux normes auxquels les personnes interrogées ont fait allusion sont, respectivement, la faiblesse des systèmes de réglementation des produits pharmaceutiques (100%) et les échecs de traitement (100%). La mesure préventive la plus recommandée était la sécurisation de la chaîne d'approvisionnement des médicaments (100%). CONCLUSION: La connaissance des ACMT visibles au point de service était très élevée mais ne semble pas se traduire par une utilisation comparable pour tous les types. Les techniques d'étiquetage, d'emballage et d'impression sont les plus utilisées. Les contraintes de temps ont été identifiées comme un obstacle prédominant possible à l'utilisation des ACMT ouvertes. Les classes les plus courantes de médicaments non conformes aux normes et falsifiés étaient les antipaludéens, les antibactériens et les analgésiques. Il a été estimé que la cause la plus fréquente des médicaments non conformes aux normes et falsifiés était la faiblesse du système de réglementation des produits pharmaceutiques et que tous ces éléments pouvaient entraîner des échecs thérapeutiques. La sécurisation de la chaîne d'approvisionnement des médicaments peut constituer une mesure préventive efficace. MOTS CLÉS: Technologies de lutte contre la contrefaçon de médicaments, barrières, identification, praticiens médicaux, Nigeria, utilisations.

COVID-19 Biosecurity Protective Items Utilization at the Point of Care: A CrossSectional Study of Drivers, Barriers, Benefits and Perceived Dangers among Frontline Medical Doctors in Non-COVID-19 Hospitals in Abia State, Nigeria.

BACKGROUND: Globally, COVID-19 is an emerging health problem. As the spread of COVID-19 infection continues worldwide, measures to protect frontline doctors have been in the spotlight on international biosecurity discussions especially in countries with weak health system and infrastructure. AIM: The study was aimed at describing the drivers, barriers, benefits and perceived dangers of utilization of COVID-19 biosecurity protective items at the point of care among frontline doctors in non-COVID-19 hospitals in Abia State. METHODS: This was a cross-sectional study on 220 frontline doctors in Abia State. Data were collected using self-administered questionnaire that elicited information on utilization of COVID-19 biosecurity items (face masks, face shields, hand sanitizers, disinfectant sprays, hand gloves). The drivers, barriers, benefits, and perceived dangers of utilization of biosecurity items were also studied. Utilization was assessed in the preceding 7 days and graded using utilization ordinal scoring system of 0-4 as follows: Always=4 points; most times=3 points; occasional=2 points, rarely=1 point and never=0 point. Those that scored 1 and above were graded as users while 0 score was graded as non-user. RESULTS: The study participants were aged 24-68 years (mean=32±8.4 years). There were 162(73.6%) males. All the respondents (100%) had used at least one of the biosecurity protective items in the previous 7 days. The most commonly used biosecurity items were face masks (100%) and hand-gloves (100%). Others included hand sanitizers (90.0%), face shields (55.5%) and disinfectant sprays (43.2%). The most common driver was availability of biosecurity items (100.0%). The commonest barrier was physical discomfort and fatigue (100.0%). The commonest benefits were self-protection from contracting COVID-19 (100.0%) and prevention of transmission to patients, colleagues and significant others (100.0%). The most commonly perceived dangers were suffocation (87.7%) and skin irritation (76.4%) for face masks and hand sanitizers respectively. CONCLUSION: The most commonly used biosecurity items were face masks and hand gloves while the least utilized was disinfectant sprays. The commonest driver was availability of biosecurity protective items. The most common barrier was physical discomfort and fatigue while the predominant benefits were protection from contracting COVID-19 and transmission to patients, colleagues, and significant others. The most commonly perceived dangers were suffocation and skin irritation for face masks and hand sanitizers respectively.

CONTEXTE: À l'échelle mondiale, le COVID-19 est un problème de santé émergent. Alors que la propagation de l'infection au COVID-19 se poursuit dans le monde, les mesures de protection des médecins de première ligne ont été au centre des discussions internationales sur la biosécurité, en particulier dans les pays dotés d'un système et d'une infrastructure de santé faibles. OBJECTIF: L'étude visait à décrire les facteurs, les obstacles, les avantages et les dangers perçus de l'utilisation des articles de protection de biosécurité COVID-19 au point de service chez les médecins de première ligne dans les hôpitaux non COVID-19 de l'État d'Abia. MÉTHODES: Il s'agissait d'une étude transversale portant sur 220 médecins de première ligne dans l'État d'Abia. Les données ont été collectées à l'aide d'un questionnaire auto-administré qui a permis d'obtenir des informations sur l'utilisation des articles de biosécurité COVID-19 (masques faciaux, écrans faciaux, désinfectants pour les mains, sprays désinfectants, gants pour les mains). Les moteurs, les barrières, les avantages et les dangers perçus de l'utilisation des articles de biosécurité ont également été étudiés. L'utilisation a été évaluée au cours des 7 jours précédents et notée à l'aide d'un système de notation ordinale d'utilisation de 0 à 4 comme suit : Toujours = 4 points ; la plupart du temps = 3 points ; occasionnelle=2 points, rarement=1 point et jamais=0 point. Ceux qui ont obtenu un score de 1 et plus ont été classés en tant qu'utilisateurs tandis que le score de 0 a été classé en tant que non-utilisateur. RÉSULTATS: Les participants à l'étude étaient âgés de 24 à 68 ans (moyenne = 32 ± 8,4 ans). Il y avait 162 (73,6 %) hommes. Tous les répondants (100 %) avaient utilisé au moins un des articles de protection de biosécurité au cours des 7 jours précédents. Les articles de biosécurité les plus couramment utilisés étaient les masques faciaux (100 %) et les gants (100 %). Les autres comprenaient des désinfectants pour les mains (90,0 %), des écrans faciaux (55,5%) et des sprays désinfectants (43,2%). Le facteur le plus courant était la disponibilité des articles de biosécurité (100,0 %). L'obstacle le plus courant était l'inconfort physique et la fatigue (100,0 %). Les avantages les plus courants étaient l'autoprotection contre la contraction du COVID-19 (100,0 %) et la prévention de la transmission aux patients, aux collègues et aux proches (100,0 %). Les dangers les plus couramment perçus étaient la suffocation (87,7 %) et l'irritation de la peau (76,4%) pour les masques faciaux et les désinfectants pour les mains respectivement. CONCLUSION: Les articles de biosécurité les plus couramment utilisés étaient les masques faciaux et les gants, tandis que les moins utilisés étaient les sprays désinfectants. Le facteur le plus courant était la disponibilité d'articles de protection de biosécurité. L'obstacle le plus courant était l'inconfort physique et la fatigue, tandis que les avantages prédominants étaient la protection contre la contraction du COVID-19 et la transmission aux patients, aux collègues et aux proches. Les dangers les plus couramment perçus étaient la suffocation et l'irritation de la peau pour les masques faciaux et les désinfectants pour les mains respectivement. Mots-clés: Obstacles, avantages, éléments de biosécurité, dangers, conducteurs, médecins de première ligne, Nigéria.

Attitude, practice orientation, benefits and barriers towards health research and publications among medical practitioners in Abia State, Nigeria: A cross-sectional study.

BACKGROUND: Health research is an essential component of medical training, education, and practice and is fundamental in establishing the scientific basis of health care. Aim: The study was aimed at describing the attitude, practice, benefits, and barriers towards health research and publications in a cross-section of medical practitioners in Abia State, Nigeria. MATERIALS AND METHODS: This was a cross-sectional descriptive study carried out on 210 medical practitioners in Abia State. Data collection was done using pretested, self-administered questionnaire that elicited information on attitude, practice, benefits, and barriers toward health research. Awareness of research misconduct, types of published research articles, and factors considered in selection of journals for publication of research were also studied. RESULTS: The age of the participants ranged from 26 to 77 years. There were 173 (82.4%) men. The overall attitude toward research was moderate (x = 5.02 ± 0.96). All the respondents (100%) were involved in undergraduate research projects while 72 (34.3%) had at least one journal publication with the most commonly published articles being descriptive studies. The commonest barriers to research were financial and time constraints while the greatest benefits of research were advancement of medical knowledge and keeping practitioners abreast with evidence-based medicine. The commonest research misconduct was plagiarism while the most common factor considered in selection of journals for publication was article publication charges. Middle age group and years of practice more than 10 years were significantly associated with publication of journal articles (P < 0.05). CONCLUSION: This study has shown that the study participants had moderate positive attitude toward research with all the participants previously involved in undergraduate research and only one third had at least one journal publications. The commonest barriers were financial and time constraints and greatest benefits of health research was advancement of medical knowledge and keeping practitioners abreast with evidence-based medicine. Choice of journal for publications is preeminently determined by article publication charges. The most common article published and research misconduct was descriptive studies and plagiarism, respectively.

Family biosocial variables driving adherence to the use of insecticide treated nets among under-five children managed for malaria in a rural hospital in eastern Nigeria.

BACKGROUND: As the distribution and awareness of free insecticide treated nets (ITNs) for malaria control continues to grow in Nigeria in order to meet the coverage target for the year 2010, a large gap exists between acquiring them, using them, and adhering to its use by families of under-five children. Therefore, the family biosocial variables driving its adherence need to be explored if the potential benefits of the nets are to be fully harnessed by families of under-five children in Nigeria. This study was aimed at describing family biosocial variables driving adherence to the use of insecticide treated nets among under-five children managed for malaria in a rural hospital in Eastern Nigeria. MATERIALS AND METHODS: This was descriptive hospital-based study carried out from June 2008 to June 2010 on a cross section of 220 mothers of under-five children who were managed for confirmed malaria within the study period and met the selection criteria were interviewed using a pretested, structured researcher administered questionnaire. The questionnaire instrument elicited information on family biosocial variables. Adherence was assessed in the previous 6 months and graded using an ordinal scoring system of 1-4 points: score of 4 points indicated adherence while scores of 1-3 points meant nonadherence. Operationally, an adherent respondent was defined as one who scored 4 points. An under-five child was defined to have malaria if the mother gave complaint of fever, vomiting and other symptoms suggestive of malaria, had body temperature exceeding 37.5 degrees C with the asexual forms Plasmodium falciparum detected on the peripheral blood film. Reasons for nonadherence were also sought. RESULTS: The adherence rate was 33.2%. The family biosocial variables significantly associated with adherence were maternal age =30 years (p-value = 0.03), maternal occupation (house wives) (p-value = 0.03), family size less than 4 (p-value = 0.026) and spouse living together (p-value = 0.01.). Others included family belief, in the benefits of ITNs (p-value = 0.002 and source of ITNs (p-value = 0.03). The most significant predictor of adherence was living together of spouse (p-value = 0.000, OR = 3.851, CI = 1.76-6.01). The commonest reason for non-adherence was forgetfulness (p-value = 0.003). CONCLUSION: Despite high family belief in the benefits of ITNs, adherence to its use was low. Some family biosocial variables played significant roles in driving its adherence. Measures targeted at these variables and widespread family-oriented health promotion programmes are recommended in order to improve on adherence leading to family friendly ITNs communities.

Evaluation of patients' satisfaction with quality of care provided at the National Health Insurance Scheme clinic of a tertiary hospital in South- Eastern Nigeria.

BACKGROUND: The umpteenth threats to change of healthcare provider by dissatisfied patients on formal sector health insurance are well known and can be a proxy indicator for the need for quality improvement in service delivery. OBJECTIVE: This study was aimed at evaluating patients' satisfaction with quality of care provided at the National Health Insurance Scheme (NHIS) clinic of a tertiary hospital in South-Eastern Nigeria. MATERIALS AND METHODS: This was a descriptive study carried out on 400 NHIS patients from April 2011 to October 2011 at the general outpatient department of Federal Medical Centre, Umuahia. Patients were selected by simple random sampling using every second NHIS patient that registered to see the clinicians and who met the selection criteria. Data were collected using pretested, structured interviewer-administered questionnaire. Each satisfaction item was scored in a five-point Likert scale ordinal response, which was converted to percentage scale response. Satisfaction was measured from the following domains: accessibility, patient waiting time, patient-provider communication, patient-provider relationship, hospital bureaucracy, and hospital environment. Operationally, patients who scored 50% and above in the assessed domain were considered satisfied while those who scored less than 50% were dissatisfied. RESULTS: The overall satisfaction score of the respondents was 66.8%. Specifically, the respondents expressed satisfaction with patient-provider relationship (81.5%), patient-provider communication (79.9%), accessibility (74.2%), and hospital environment (68.2%) and dissatisfaction with hospital bureaucracy (48.8%) and patient waiting time (48.3%). CONCLUSION: This study has shown that the overall patients satisfaction with the services provided was very good with patient-provider relationship rated highest and patient waiting time the lowest. There is need to improve on the current level of patients satisfaction while effort should be made to address the identified domains of dissatisfaction.

Common geriatric morbidity from communicable diseases in a rural hospital in Eastern Nigeria.

BACKGROUND: The geriatric health, wellness and illness states in Nigeria are largely influenced by communicable diseases. OBJECTIVE: This study was aimed at describing the pattern of common geriatric morbidity from communicable diseases in a rural hospital in Eastern Nigeria. METHODS: This study was a descriptive hospital-based study carried out from June 2008 to June 2010 on geriatric patients at St Vincent De Paul Hospital, Amurie-Omanze, a rural Mission General Hospital in Imo state. The data collected included age, sex and diagnoses made. RESULTS: Eight hundred and seventy two patients out of a total patient population of 9885 were 65 years and above. The geriatric patients' constituted 8.8% of total patients' population. Out of these, 530 (60.8%) had communicable diseases consisting of 235 males and 295 females with a male to female ratio of 1: 1.3. The top five communicable diseases were malaria (67.1%), skin infections (43.6%), urinary tract infections (36.0%), intestinal helminthiasis (20.6%) and gastroenteritis (17.9%). CONCLUSION: This study shows that geriatric patients suffer acute and chronic communicable diseases with the commonest being malaria, skin infections, urinary tract infections and neglected tropical disease such as ascariasis and hookworm infestation. Effective measures are needed to control the scourge of communicable diseases which are largely preventable among the elderly patients particularly in rural Nigeria.

The magnitude of atherogenic dyslipidaemia among geriatric Nigerians with systemic hypertension in a rural hospital in Eastern Nigeria.

BACKGROUND: The relevance of dyslipidaemia in the management of cardiovascular diseases, especially hypertension is an important health care challenge that is increasing worldwide. Of great concern in Nigeria is that most geriatric hypertensives with dyslipidaemia are not routinely diagnosed and therefore do not receive appropriate treatment. OBJECTIVE: This study is aimed at describing the magnitude (prevalence and pattern) of atherogenic dyslipidaemia among geriatric Nigerians with systemic hypertension in a rural hospital in Eastern Nigeria. METHODS: A descriptive hospital-based study was carried out from June 2008 to June 2011 on 122 consecutive geriatric patients with systemic hypertension who met the selection criteria at St Vincent De Paul hospital, Amurie-Omanze, a rural Mission General Hospital in Imo state. The fasting lipid profile was determined by enzymatic method. Dyslipidaemia was defined using the third report of National Cholesterol Education Panel in adult (ATP III). The data collected included age and sex. RESULTS: Fifty-four (44.3%) out of 122 patients had at least one dyslipidaemia. The age of the patients ranged from 65 years to 91 years with mean age of 69 +/- 2.10 years. There were 51 (41.8%) males and 71 (58.2) females with male to female ratio of 1: 1.4. The commonest lipid abnormality was low high density lipoprotein-cholesterol (38.5%). Others included high low density cholesterol (23.8%), high total cholesterol (17.2%) and high triglyceride (14.8%). CONCLUSION: This study has shown that dyslipidaemia exist among geriatric hypertensives in the study area with low HDL-C being the most frequent lipid abnormality suggesting that low HDL may be the major form of dyslipidaemia and a marker of dyslipidaemic cardiometabolic risk among them. Screening for dyslipidaemia should therefore form an important part of clinical care of geriatric hypertensives and those with dyslipidaemia should become target for lipid lowering treatment in addition to lifestyle modification.

Common under-five morbidity in South-Eastern Nigeria: a study of its pattern in a rural mission general hospital in Imo State.

BACKGROUND: The under-five children are the most vulnerable group that bears the burden of diseases to a large extent in Nigeria. This study was aimed at describing the common and pattern of under-five morbidity in a rural Mission General Hospital in Imo state, South-Eastern Nigeria. METHODS: A cross sectional descriptive hospital-based study was carried out from June 2008 to June 2009 on 244 under-five children aged 4 days to 58 months. The under-five children seen within the study period who met the selection criteria were studied. The data collected included age, sex and diagnosis made. RESULTS: One hundred and seven (43.8%) out of a total of 244 under-five children studied were aged 37-60 months, eighty one (33.2%) were aged 13-36 months and fifty six (23.0%) were aged 0-12 months. There were 141 (57.8%)males and 103 (42.2%) females. The three commonest causes of morbidity were malaria infections (80.3%), acute respiratory infections (32.0%) and skin infections (29.1%). The age group 37-60 months bears the greatest burden of malaria infections (49.0%), acute respiratory infections (55.1%) and skin infections (53.5%). CONCLUSION: This study shows that the three commonest causes of under-five morbidity (malaria, acute respiratory infections and skin infections) are largely preventable and infectious diseases still remaining major causes of morbidity; and similar to the under-five morbidity pattern documented at the beginning of the implementation of Primary Health Care and Child Survival Strategies in Nigeria. Identification, implementation, monitoring and evaluation of multidisciplinary and multisectoral intervention strategies targeted at the common under-five morbidity that are culturally acceptable, scientifically proven, patient-, family- and community-friendly and centred are recommended.

Obesity in adult Nigerians: a study of its prevalence and common primary co-morbidities in a semi-urban Mission General Hospital in South-Eastern Nigeria.

BACKGROUND: Obesity is socially and culturally acceptable in Nigeria and therefore not usually recognized as a medical problem. This study is aimed at determining the prevalence of obesity using body mass index (BMI) criterion and its common primary comorbidities among adult Nigerians attending a semi-urban Mission General Hospital in Imo state, SouthEastern, Nigeria. METHODS: A descriptive study using primary data collection technique was carried out from October 2007 to December 2008. A total of 9296 consecutive new adult patients aged 18-88 years were screened for obesity using BMI criterion and 684 patients who had BMI = 30 kg/m2 met the inclusion criteria. The data collected included age, sex, marital status, education, occupation, weight (kilogram), height (meters), and blood pressure; fasting blood sugar and fasting lipid profile. Obese patients' perception of their obese condition and knowledge of lifestyle modification were also assessed. RESULTS: Six hundred and eighty-four (7.4%) out of a total of 9296 patients screened for obesity were obese. Hypertension (18.4%) was the commonest primary comorbidity, others include high triglyceridaemia (9.2%), high total cholesterol (8.2%), high LDL-cholesterol (6.0%) and diabetes mellitus (3.4%). One hundred and one (14.8%) obese patients were aware of their obese condition and majority, 72 (71.3%) of them were informed of their obese condition by healthcare professionals. Forty seven (46.5%) of those who were aware of their obese condition had knowledge of lifestyle modification. However, majority (72.3%) of those who had knowledge of lifestyle modification demonstrated low knowledge level of lifestyle modification. CONCLUSION: This study has shown the existence of obesity and its common primary co-morbidities among the study population. Anthropometric determination of obesity and screening for its common primary comorbidities should be integrated as part of clinic baseline assessment of adult Nigerians attending semi-urban hospitals. Those who had obesity-related primary co morbidities should become secondary target for risk reduction therapy and appropriate management.