A study of clinical teachers' attitude to teaching and perceived learning needs in a medical college in Nigeria.

BACKGROUND AND PURPOSE: Debates on medical educational reform initiatives in Nigeria have gradually shifted from access to medical colleges to improving learning quality. Understandably, clinical teachers are being encouraged to acquire basic teaching pedagogical knowledge through learning activities. Considering the fact that the concept of faculty development for medical teachers' is still evolving in Sub-Saharan Africa, this study aims to explore clinical teachers' attitude to teaching and perceptions of continuing education in teaching knowledge and skills in a medical college in Nigeria. METHODS: Using a mixed-method research approach, quantitative data were collected from a sample of teachers through survey questionnaires, and qualitative data were obtained through face-to-face individual semi-structured interviews of teachers from the same institution. RESULTS: Sixty-one survey questionnaires (response rate of 88%) and 10 interviews were completed and analyzed. Findings revealed that teachers' derived satisfaction from teaching and maintain a strong commitment to teaching. Bedside teachings (64%) and lectures (21%) were reported to be the most frequent mode of teaching. Although four out of every five respondents (80%) reported not having previous training in teaching, a large proportion (97%) self-assessed their teaching abilities to be average or above average, with most indicating that the experience of teaching observed during undergraduate medical training may be sufficient preparation for their teaching roles. The majority of the teachers' were of the opinion that there is a need to improve their individual teaching skill. However, in the absence of formal faculty development programs in the college, most of the teachers indicated that their teaching skills are currently being improved through sporadic informal community of practice involving interested colleagues and modeling identified good teachers. CONCLUSION: A catalyst of learning by teachers' may come from their belief and self-rating of teaching ability. In this under-resourced context, explicit classifications of existing informal learning opportunities coupled with greater institutional support could improve teaching and teachers' development.

Distribution of Kell phenotype among pregnant women in Sokoto, North Western Nigeria.

INTRODUCTION: Kell antigen is highly immunogenic and is the common cause of antibody production in mismatched blood transfusions, haemolytic transfusion reaction (HTR) and maternal alloimmunization, which causes severe anaemia in neonates. The aim of this study is to determine the prevalence and ethnic variation of the Kell phenotype among pregnant women in Sokoto, Nigeria. METHODS: Kell antigen status of 150 pregnant women aged 18-45 years and mean age 27.19 ±4.69 years attending antenatal clinic in UDUTH Sokoto Nigeria was determined using the conventional tube method and anti-Kell reagents (Lorne Laboratories, UK). RESULTS: Among the 150 subjects studied, 3 (2.0%) of subjects were positive and 147 (98.0) were negative for K antigen. Of the 150 pregnant subjects; 32 (21.3%) were primigravidae while 118 (78.7%) were multigravidae. Kell phenotype was more prevalent among primigravidae (3.1%) compared to multigravidae (1.7%) women. The distribution of Kell phenotype among the pregnant subjects was compared based on ethnicity. The prevalence of Kell antigen was significantly higher among the Hausa ethnic group (3.2%) compared to other ethnic groups which indicated zero prevalence (p = 0.001). Kell negative phenotype was ≥ 96.8% among all the ethnic groups. CONCLUSION: Our observed prevalence of Kell phenotype is consistent with previous studies among Blacks and Asians but significantly lower than values observed in previous studies among Caucasians. We recommend that all pregnant women should be screened for the presence clinically significant red cell antigens including Kell antigen on their first antenatal visit. Kell negative red cell should be routinely provided for all pregnant women and women with child bearing potential to reduce the risk of Kell-associated HDFN. There is need to introduce routine screening of pregnant women for clinically significant red cell antibodies to facilitate the effective management of HDFN as well as prevent HTR. There is also need for sustained health education of pregnant women in the area to encourage early booking for antenatal care.

Kidd blood group phenotypes among pregnant women in Sokoto, North Western Nigeria

OBJECTIVE@#To investigate the prevalence of Kidd antigens among pregnant women in Sokoto, North Western Nigeria.@*METHODS@#One hundred and sixty two pregnant women aged 18-45 years [mean age (27.19±4.72) years] attending antenatal clinic in Usmanu Danfodiyo University Teaching Hospital, Sokoto, were screened for the presence of Kidd blood group antigens using the conventional tube method and anti-Jka and Jkb reagents (Lorne Laboratories, UK).@*RESULTS@#Out of the 162 pregnant women tested, 82 (50.6%) were Hausa, 26 (16%) were Igbo, 23 (14.2%) were Fulani and 20 (12.3%) were Yoruba while the minority ethnic groups were 11 (6.8%). The distribution of Kidd antigen was compared based on the ethnic groups of subjects. Jka antigen was the highest among the Yoruba ethnic group (10.0%) followed by the Hausa ethnic group (7.31%). The prevalence of Jkb was highest among Hausa subjects (10.97%) followed by the Yoruba ethnic group (10.0%). Subjects were categorized based on parity. Majority of the subjects were multigravidae, 122 (75.3%) compared to primigravidae 40 (24.7%). Subjects were stratified based on trimester. A significant number of women were in the second trimester, 111 (68.5%) compared to the third trimester 38 (23.5%) and the first 13 (8.0%). The distribution of Kidd antigens among subjects studied indicated a prevalence of Jka, Jkb and Jk(a+b+) with 8 (4.9%), 13 (8.0%) and 0 (0.0%), respectively. A significant number of subject tested were negative for Kidd antigens. Of the 162 pregnant women tested, 154 (95.1%), 149 (75.3%) and 141 (87.04%) tested were negative for Jka, Jkb, and Jk(a-b-), respectively.@*CONCLUSIONS@#This study indicates that blood group antigens can be distributed differently within different nationalities. Kidd phenotypes observed among pregnant women in this study was similar to previous reports among blacks but at variance with report among Caucasians and Asians. We recommend that detailed routine phenotyping for all clinically significant red cell antigen including Kidd antigen being carried out routinely among all pregnant women in Nigeria. There is also the need to routinely screen all pregnant women for alloantibodies to facilitate the selection of antigen negative units for those with clinically significant alloantibodies who require a red cell transfusion. This can potentially optimise the obstetric management of haemolytic disease of foetus and newborn and prevent haemolytic transfusion reaction among pregnant women.

Kidd blood group phenotypes among pregnant women in Sokoto, North Western Nigeria

Objective: To investigate the prevalence of Kidd antigens among pregnant women in Sokoto, North Western Nigeria. Methods: One hundred and sixty two pregnant women aged 18-45 years [mean age (27.19±4.72) years] attending antenatal clinic in Usmanu Danfodiyo University Teaching Hospital, Sokoto, were screened for the presence of Kidd blood group antigens using the conventional tube method and anti-Jka and Jkb reagents (Lorne Laboratories, UK). Results: Out of the 162 pregnant women tested, 82 (50.6%) were Hausa, 26 (16%) were Igbo, 23 (14.2%) were Fulani and 20 (12.3%) were Yoruba while the minority ethnic groups were 11 (6.8%). The distribution of Kidd antigen was compared based on the ethnic groups of subjects. Jka antigen was the highest among the Yoruba ethnic group (10.0%) followed by the Hausa ethnic group (7.31%). The prevalence of Jkb was highest among Hausa subjects (10.97%) followed by the Yoruba ethnic group (10.0%). Subjects were categorized based on parity. Majority of the subjects were multigravidae, 122 (75.3%) compared to primigravidae 40 (24.7%). Subjects were stratified based on trimester. A significant number of women were in the second trimester, 111 (68.5%) compared to the third trimester 38 (23.5%) and the first 13 (8.0%). The distribution of Kidd antigens among subjects studied indicated a prevalence of Jka, Jkb and Jk(a+b+) with 8 (4.9%), 13 (8.0%) and 0 (0.0%), respectively. A significant number of subject tested were negative for Kidd antigens. Of the 162 pregnant women tested, 154 (95.1%), 149 (75.3%) and 141 (87.04%) tested were negative for Jka, Jkb, and Jk(a-b-), respectively. Conclusions: This study indicates that blood group antigens can be distributed differently within different nationalities. Kidd phenotypes observed among pregnant women in this study was similar to previous reports among blacks but at variance with report among Caucasians and Asians. We recommend that detailed routine phenotyping for all clinically significant red cell antigen including Kidd antigen being carried out routinely among all pregnant women in Nigeria. There is also the need to routinely screen all pregnant women for alloantibodies to facilitate the selection of antigen negative units for those with clinically significant alloantibodies who require a red cell transfusion. This can potentially optimise the obstetric management of haemolytic disease of foetus and newborn and prevent haemolytic transfusion reaction among pregnant women.