RESUMO
Background: Diabetes mellitus is a growing epidemic in Africa. Its diagnosis relies exclusively on laboratory evidence, which differs based on clinical circumstances. Objective: The study described the appropriateness of plasma glucose test requests per the American Diabetes Association criteria. Methods: We reviewed the plasma glucose test requests received by the chemical pathology laboratory of the University College Hospital, Ibadan, Nigeria between June 2018 and November 2018. The American Diabetes Association diabetes diagnostic criteria were used to define the appropriateness of test requests and determine the potential for ill-informed clinical decisions. Results: Four hundred and twenty-three requisition forms were included, with the majority from the medical wards/clinics (72.3%); the most frequent reason for a plasma glucose test was systemic hypertension (28.6%). Fasting plasma glucose was most requested (254; 60.0%). One hundred and sixteen (27.4%) requests were potentially inappropriate, with the 2-h postprandial plasma glucose (2hPPG) test requests (83; 71.6%) being the most inappropriate. The difference in the proportion of inappropriate requests was not statistically significantly between medical or surgical wards/clinics (Odds ratio 1.131, 95% confidence interval 0.709-1.803, p = 0.605). Inappropriate requests in six cases may have triggered inappropriate action. Conclusion: A third of the glucose tests requested for querying diabetes mellitus may have been inappropriate. Results of such testing may trigger inappropriate clinical action. To improve the quality of care and for economic reasons, laboratories should have programmes to improve the appropriate use of their services.
RESUMO
Global health has been thrown into turmoil by the COVID-19 pandemic, which has caused devastating morbidity and unprecedented loss of life in almost all continents of the world. It was predicted that the magnitude of the pandemic in Africa will be high because of poor health structure and intensely poor living condition, but that has not happened, surprisingly. It was hypothesized that the youthful population and a vastly primed immune system were protective, and many people may have been exposed without coming down with the severe disease. Most of them would have presented in hospitals with other medical conditions and possibly transmit COVID-19 to health workers inadvertently. This study is designed to measure serum SARS-CoV-2 IgG levels in health workers as a marker of latent exposure. Asymptomatic frontline health workers were randomly selected from the University College Hospital Ibadan, Nigeria; venous blood samples were obtained from them, and the serum SARS-CoV-2 IgG level was determined using ELISA techniques. A proportion of participants with seropositivity were obtained, and factors associated with seropositivity were determined. A total of 133 participants were recruited for this study, and 60 (45.1%) of them were seropositive for SARS-CoV-2. Among the seropositive participants were doctors, nurses, health assistants, laboratory scientists and technicians, and nonmedical staff. Obstetrics, gynecology, and emergency departments had higher odds of seropositivity. Seroprevalence of SARS-CoV-2 is very high among frontline health workers, though asymptomatic. This calls for a more stringent precaution against further spread within the hospital environment.
