Willingness of Family Caregivers to Consent to Relative’s Postmortem Examination that Die Suddenly in a Nigerian Tertiary Hospital

BACKGROUND: Postmortem examination is necessary to diagnose the cause of sudden death, and family caregivers are expected to consent to this examination. This study assessed knowledge, attitude, practices and willingness of family caregivers to consent to postmortem examination of their relative if they die suddenly in a Nigerian tertiary hospital.METHODS: Descriptive cross-sectional study of family caregivers of our patients that completed an interviewer administered semistructured questionnaire assessing their knowledge, attitude, practices and willingness to consent to postmortem examination of their relative if they die suddenly. Data were analyzed using descriptive and inferential statistics.RESULTS: A total of 224 caregivers were interviewed. The mean age (SD) was 34.95 (11.74), ranging 22-75 years. They were parents (32.6%), siblings (37.9%), spouses (11.2%) and other relatives (18.3%). Only 17% had adequate knowledge, 44.6% positive attitude and 11.2% good practices to postmortem examination of sudden death. The majority (75.9%) would consent to postmortem examination of their relatives if they die suddenly. Sociodemographic variables associated with willingness to consent to postmortem examination after relative’s sudden death include being male (AOR 3.61; 95%CI 3.09-8.92; p=0.001), having tertiary education (AOR 4.83; 95%CI 1.01-8.29; p=0.034), Christianity (AOR 2.59; 95%CI 1.25-5.35; p=0.010) and skilled worker (AOR 1.43; 95%CI 1.33-3.80; p=0.020).CONCLUSION: Some family caregivers would not consent to postmortem examination of their relatives when they die suddenly. Sensitization programs targeting family caregivers are necessary to increase knowledge and enhance prevention of sudden death as well as improve willingness to consent to postmortem examination when their relatives die suddenly

Co-endemicity of Loiasis and Onchocerciasis in Rain Forest Communities in Southwestern Nigeria

<div><p>Background</p><p>Loiasis is currently receiving attention as a disease of public health importance because of the possibility of increased risk of developing neurologic serious adverse event following mass ivermectin treatment against onchocerciasis in individual co-infected with <i>Onchocerca volvulus</i> and <i>Loa loa</i>.</p><p>Methodology/Principal Findings</p><p>Rapid assessment procedure for loiasis (RAPLOA) was conducted in 12 communities covering the 3 senatorial districts of Osun State, Nigeria. A total of 960 people were interviewed for history of eye worm using the WHO guidelines for rapid assessment. The survey confirmed the presence of loiasis in all the 12 communities with 4 in Osun East/Ife south senatorial district being at high risk with a prevalence of over 40%. Based on the RAPLOA results, communities within Osun East/Ife south senatorial district were selected for microfilaraemic assessment of <i>L</i>. <i>loa</i> and <i>O</i>. <i>volvulus</i>. A total of 1115 and 1091 individuals were screened for <i>L</i>. <i>loa</i> and <i>O</i>. <i>volvulus</i> microfilaria worms respectively. 160 (14.3%) had <i>L</i>. <i>loa</i> microfilaria detected in their blood with 8 (5.0%) individuals having <i>L</i>. <i>loa</i> loads above 8000 mf/ml. 166 (15.2%) subjects had <i>O</i>. <i>volvulus</i> microfilaria (range 4-504 mf/ml) detected in their skin snip. 30 (2.69%) subjects were co-infected with both <i>L</i>. <i>loa</i> and <i>O</i>. <i>volvulus</i>. There was a significant variation in the prevalence (2.1% to 33.3%) of onchocerciasis in the communities studied (p = 0.001). Five (41.7%) of the studied communities had a prevalence that is equal to or greater than 20%.</p><p>Conclusions/Significance</p><p>Low prevalence of onchocerciasis and loiasis co-infection in this study suggests that loiasis may not pose a serious epidemiological threat to the continuous distribution and sustainability of ivermectin for the treatment of onchocerciasis. Evaluation of the interruption of onchocerciasis transmissions in this region using all the indicators set forth by WHO is therefore suggested.</p></div

Distribution of <i>Loa loa</i> microfilaraemia and <i>O</i>.<i>volvulus</i> by age and sex.

<p>Distribution of <i>Loa loa</i> microfilaraemia and <i>O</i>.<i>volvulus</i> by age and sex.</p

Clinical spectrum observed from filarial infected members of the surveyed population.

<p>Clinical spectrum observed from filarial infected members of the surveyed population.</p

The prevalence of loiasis and onchocerciasis in the selected rural communities in Osun State.

<p>The prevalence of loiasis and onchocerciasis in the selected rural communities in Osun State.</p

Map of Osun State showing the three senatorial districts and the communities within the districts that were selected for the study.

<p>Map of Osun State showing the three senatorial districts and the communities within the districts that were selected for the study.</p

Number of villages surveyed and number of people interviewed in 12 villages of Osun State for RAPLOA.

<p>Number of villages surveyed and number of people interviewed in 12 villages of Osun State for RAPLOA.</p