Prevalence and control of hypertension among people living with HIV receiving care at a Nigerian hospital.

Introduction: with the introduction of newer and safer antiretroviral drugs, HIV positive persons are now living longer. Consequently, cardiovascular diseases associated with ageing and chronic low grade inflammation due to the presence of the virus are increasingly found in this population. This study aimed to assess the prevalence and control of hypertension among people living with HIV (PLHIV) receiving care at a Nigerian hospital. Methods: this cross-sectional study was conducted as part of the Patient´s HIV Knowledge Questionnaire (PHKQ) validation study among HIV positive outpatients at the University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria. Hypertension was self-reported and confirmed by a documented physician diagnosis in the patient´s case notes and/or self-reported use of antihypertensive medication. For each participant, the average of two close blood pressure (BP) measurements obtained using an automatic upper arm BP monitor was taken as the BP. Hypertension control was defined as SBP <140 mmHg and DBP <90 mmHg. Data were analysed using the Statistical Product and Service Solutions (SPSS) v.21.0. Results were considered significant at p < 0.05. Results: prevalence of hypertension among PLHIV was 24.9%. Age (OR = 1.112, CI = 1.074 - 1.151, p < 0.001), body mass index (OR = 1.087, CI = 1.024 - 1.154, p = 0.004) and duration on antiretroviral therapy (OR = 1.169, CI = 1.090 - 1.254, p < 0.001) significantly predicted hypertension. Only 19 (24.4%) participants had controlled hypertension. Conclusion: hypertension is common among PLHIV seeking care at a Nigerian hospital. However, its control remains suboptimal. Regular screening for hypertension, its appropriate treatment and optimal control are essential in PLHIV.

Cross-sectional survey of mental health literacy among undergraduate students of the University of Nigeria.

OBJECTIVE: This study sought to assess knowledge of schizophrenia and help-seeking behaviour among undergraduate students of a Nigerian university. Sociodemographic predictors of correct recognition were also explored. DESIGN: The study was a cross-sectional descriptive survey. SETTING: The study was carried out at the University of Nigeria, a pioneer university located in Southeastern Nigeria. PARTICIPANTS: Undergraduate students of the University of Nigeria. METHODS: All consenting male and female students of three purposively selected faculties were recruited for the study. Self-administered vignette-based questionnaires were distributed to students of the selected faculties between September and November 2018. Data were analysed using the IBM Statistical Product and Services Solution for Windows V.21.0. RESULTS: Out of the 400 questionnaires that were distributed, 389 were completed and returned (97.3% response rate). Respondents were mainly female (64.9%, n=252) and were between the ages of 18 and 24 years (75.8%, n=294). One in eight respondents (12.1%, n=47) correctly identified and labelled the schizophrenia vignette. Hallucination was the most identified symptom of distress for schizophrenia (47.9%, n=186). The most common alternative label for schizophrenia was 'mental illness' (24.7%, n=96). Schizophrenia was also mislabelled as depression (11.6%, n=45). More than a 10th of the respondents used stigmatising labels such as 'crazy' and 'mad' (11.1%, n=43). Psychiatrists were the most recommended source of help for the vignette character (36.3%, n=141). There was a strong association between the faculty of study and the ability to correctly identify and label the schizophrenia vignette (χ2=44.557, p<0.001). CONCLUSION: Mental health literacy among students of the University of Nigeria was poor. Research on culturally sensitive interventions to improve mental health literacy should be embarked on.

Engaging Nigerian community pharmacists in public health programs: assessment of their knowledge, attitude and practice in Enugu metropolis.

OBJECTIVES: The Nigerian health sector battles with control of infectious diseases and emerging non-communicable diseases. Number of healthcare personnel involved in public health programs need to be boosted to contain the health challenges of the country. Therefore, it is important to assess whether community pharmacists in Nigeria could be engaged in the promotion and delivery of various public health interventions. This study aimed to assess level of knowledge, attitude and practice of public health by community pharmacists. METHODS: The cross sectional survey was carried out in Enugu metropolis. Questionnaire items were developed from expert literature. Percentage satisfactory knowledge and practice were obtained by determining the percentage of community pharmacists that were able to list more than 2 activities or that stated the correct answer. Attitude score represents the average score on the 5 point Likert scale for each item. Chi square and Fisher's exact test were used to test for statistically significant difference in knowledge, attitude and practice of public health between different groups of community pharmacists. RESULTS: Forty pharmacists participated in the survey. About one third of the participants had satisfactory knowledge of public health. With the exception of one item in attitude assessment, average item score ranged from 'agreed' to 'strongly agreed'. Study participants scored below satisfactory on practice of public health. Knowledge, attitude and practice of public health were not influenced by years of practice, qualification and prior public health experience. Reported barriers to the practice of public health include inadequate funds, lack of time, lack of space, cooperation of clients, inadequate staff, government regulation, insufficient knowledge, and remuneration. CONCLUSIONS: Level of knowledge and practice of public health by community pharmacists were not satisfactory although they had a positive attitude towards practice of public health. The findings highlight the importance of educational interventions targeted towards practicing community pharmacists to improve their knowledge level on public health issues. Providing incentives for public health services rendered could increase community pharmacists' engagement in public health activities.

Medication adherence in type 2 diabetes patients in Nigeria.

BACKGROUND: Medication adherence is a major universal factor influencing patient health outcomes, particularly in chronic diseases such as diabetes. Poor adherence to antidiabetes medication can cause therapeutic failure, leading to manifestation of diabetes-related complications, such as retinopathy, neuropathy, nephropathy, etc., reduced quality of life, and increased healthcare costs. To forestall these, likely predictors of medication nonadherence should be assessed and addressed appropriately. The purpose of this work was therefore to assess medication adherence among type 2 diabetes patients and to identify patient characteristics and probable factors associated with nonadherence. SUBJECTS AND METHODS: A descriptive, cross-sectional research design was used. The study was conducted on 360 ambulatory type 2 diabetes patients attending an endocrinology clinic between June 2012 and February 2013. The eight-item Modified Morisky Adherence Scale was used to assess medication adherence; sociodemographic information and respondents' opinion on the possible barrier(s) to medication adherence were also obtained. Data were analyzed using SPSS version 14.0 software (SPSS, Inc., Chicago, IL). RESULTS: Of the 303 patients included in the final analysis, 19.8% of respondents were judged to be highly adherent. Medium and low adherers were 30.0% and 50.2%, respectively. The median adherence score was 5.75 (interquartile range, 4.5-7.0). Adherence to medication correlated with low literacy level (P=0.008), forgetfulness (P=0.009), high cost of medication (P=0.014), limited access to care (P=0.001), complexity of regimen (P=0.001), poor patient-provider communication (P=0.000), lack of trust in the provider (P=0.046), and depression (P=0.031). No statistically significant relationship was found between patients' characteristics and medication adherence. CONCLUSIONS: Medication adherence was generally poor among the cohorts studied.

Knowledge of self-care among type 2 diabetes patients in two states of Nigeria.

OBJECTIVE: To assess the knowledge of self-care practices, as well as factors responsible for such knowledge among type 2 diabetes patients in two states of Nigeria. METHODS: Descriptive, cross sectional survey research design was employed. The study was conducted on type 2 diabetes out-patients attending Endocrinology Clinic at the University of Uyo Teaching Hospital (UUTH) and University of Calabar Teaching Hospital (UCTH) between June 2012 and February 2013. The Diabetes Self-care Knowledge (DSCK-30) was used in evaluating knowledge of self-care practices. Socio-demographic information and respondents' opinion on the possible barrier(s) to knowledge of self-care were also obtained. Data were analysed using Microsoft Excel and SPSS version 14.0. Statistical significance for all analyses was defined as a p value less than 0.05. RESULTS: A total of 303 out of 380 questionnaires distributed were completed and returned (response rate =79.7%). The majority of the study sample (79.5%) had 70% or more overall knowledge level about self-care. Self-care knowledge was associated with level of education (p<0.001), monthly income (p<0.001) and duration of diabetes (p=0.008). Negative attitude to disease condition was the only factor associated with knowledge (chi-square value at one degree of freedom =6.215; p=0.013). CONCLUSION: Diabetes self-care knowledge was generally high among the population studied. Educational status, monthly income, duration of diabetes and negative attitude to disease condition predicted knowledge level.

Herb drug interaction: effect of Manix® on pharmacokinetic parameters of pefloxacin in rat model.

OBJECTIVE: To evaluate the effect of Manix®, the commonly used polyherbal formulation on pefloxacin pharmacokinetic parameters. METHODS: Microbiological assay was employed using clinical isolate of Escherichia coli samples from hospitalized patients. RESULTS: Manix® altered the bioavailability parameters of pefloxacin as thus, maximal concentration (Cmax) of pefloxacin (0.91±0.31) µg/mL occurred at time to reach maximal concentration (tmax) 4.0 h while in the group that received Manix® alongside pefloxacin Cmax was (0.22±0.08) µg/mL at tmax 1.0 h respectively. The area under curve of pefloxacin alone was (7.83±5.14) µg/h/mL while with Manix® was (2.60±0.08) µg/h/mL. There was a significant difference between Cmax, tmax and area under curve between pefloxacin alone and pefloxacin after Manix® pre-treatment (P<0.05). CONCLUSIONS: The concurrent use of Manix® and pefloxacin has been found to compromise the therapeutic effectiveness of pefloxacin which could lead to poor clinical outcomes in patients.

Knowledge of self-care among type 2 diabetes patients in two states of Nigeria / Conocimiento sobre auto-cuidados entre los pacientes con diabetes tipo 2 en dos estados de Nigeria

Objective: To assess the knowledge of self-care practices, as well as factors responsible for such knowledge among type 2 diabetes patients in two states of Nigeria. Methods: Descriptive, cross sect ional survey research design was employed. The study was conducted on type 2 diabetes out-patients attending Endocrinology Clinic at the University of Uyo Teaching Hospital (UUTH) and University of Calabar Teaching Hospital (UCTH) between June 2012 and February 2013. The Diabetes Self-care Knowledge (DSCK-30) was used in evaluating knowledge of self-care practices. Socio-demographic information and respondents’ opinion on the possible barrier(s) to knowledge of self-care were also obtained. Data were analysed using Microsoft Excel and SPSS version 14.0. Statistical significance for a ll analyses was defined as a p value less than 0.05. Results: A total of 303 out of 380 questionnaires distributed were completed and returned (response rate =79.7%). The majority of the study sample (79.5%) had 70% or more overall knowledge level about self-care. Self-care knowledge was associated with level of education (p<0.001), monthly income (p<0.001) and duration of diabetes (p=0.008). Negative attitude to disease condition was the only factor associated with knowledge (chi-square value at one degree of freedom =6.215; p=0.013). Conclusion: Diabetes self-care knowledge was generally high among the population studied. Educational status, monthly income, duration of diabetes and negative attitude to disease condition predicted knowledge level (AU)

Objetivo: Evaluar el conocimiento de las prácticas de auto-cuidado, así como los factores responsables de ese conocimiento, entre pacientes con diabetes tipo 2 en dos estados de Nigeria. Métodos: Se empleó un diseño de estudio descriptivo transversal. El estudio fue conducido en pacientes ambulatorios con diabetes tipo 2 que acudían a la consulta de endocrinología del Hospital de la Universidad de Uyo (UUTH) y al Hospital de la Universidad de Calabar (UCTH) entre junio-2012 y febero-2013. Para evaluar el conocimiento de las prácticas de auto-cuidado en la diabetes se utilizó el Diabetes Self-care Knowledge (DSCH-30). También se obtuvo la información sociodemográfica y la opinión de los respondentes sobre las posibles barreras al conocimiento sobre auto-cuidados. Se analizaron los datos usando Microsoft Excel y SPSS versión 14.0. La significación estadística para los análisis fue definida como valores de p menores de 0,05. Resultados: Se completaron y devolvieron un total de 303 de los 380 cuestionarios distribuidos (tasa de respuesta =79,7%). La mayoría de la muestra en estudio tuvo 70% o más de conocimiento global sobre auto-cuidados. El conocimiento sobre auto-cuidados estaba relacionado con el nivel de educación (p<0,001), ingresos mensuales (p<0,001) y duración de la diabetes (p=0,008). La actitud negativa con la enfermedad fue el único factor asociado con el conocimiento (chi-cuadrado con un grado de libertad =6,215; p=0,013). Conclusión: El conocimiento del auto-cuidado de la diabetes fue en general alto entre la población estudiada. El nivel educacional, los ingresos mensuales, la duración de la diabetes, y la actitud negativa ante la enfermedad predecían el nivel de conocimiento (AU)

Effects of Zingiber officinale on the plasma pharmacokinetics and lung penetrations of ciprofloxacin and isoniazid.

The study was carried out to determine the effect of ginger on the plasma pharmacokinetics of ciprofloxacin and Isoniazid in a rat model in phase 1. The effects of the herb on the penetration of ciproflacin and Isoniazid into the lung tissues were also determined in phase 2. In phase 1, Albino rats of both sexes (n = 20) were divided into 4 groups of 5 rats per group. Two groups received oral ciprofloxacin (20 mg/kg) and isoniazid (15 mg/kg). Other groups were fed with ginger (5 mg/kg) for 10 days followed by the drug administration on the 11th day. Blood samples were collected from each group at 0-, 0.5-, 1-, 2-, 5-, 8-, 12-, and 24-hour intervals. Plasma concentrations of the drugs were determined by a spectrophotometric method and the pharmacokinetic parameters determined using noncompartmental method as implemented in the winNonlin program. In phase 2, where the effects of the herb on the penetration of the drugs were determined, the concentrations of ciprofloxacin and isoniazid attained in the lung fluid of rats in the presence and absence of the herb were compared after a single oral dose of the drugs used in the same dose range as in phase 1. In the first phase, treatment with ginger significantly increased the area under the concentration-time curve of ciprofloxacin, whereas Vz and Cl were decreased. Ginger significantly decreased the area under the concentration-time curve of isoniazid, whereas Vz and Cl were increased. Ginger enhanced the penetration of ciprofloxacin and Isoniazid into the lung tissues; however, their rates of penetration were delayed.