Discriminatory Attitudes of Pharmacy Students and Pharmacists against People Living with HIV/AIDS

Purpose: To evaluate the level and predictors of discriminatory attitudes of pharmacy students and pharmacists towards people living with HIV/AIDS (PLWHA).Methods: A cross-sectional survey of pharmacy students and pharmacists (n = 523) to assess discriminatory attitudes towards PLWHA was conducted using a self completed questionnaire. Correlation and regression analyses were conducted.Results: Pharmacists were more knowledgeable and had less negative perceptions than students towards PLWHA. Level of professional training (p < 0.0001), knowledge status (p < 0.0001) and five negative perception items, namely, (a) people who got HIV through sex deserve it (p = 0.003), (b) PLWHA would make their colleagues apprehensive (p < 0.0001), (c) PLWHA have poor hygiene (r = 0.082, p = 0.032), (d) PLWHA should feel ashamed of themselves (p < 0.0001), and (e) people who behave promiscuously should be blamed for AIDS (p = 0.031), were all significantly associated with higher discrimination. However, being a student and having negative perceptions such as “PLWHA should feel ashamed of themselves and “PLWHA would make their colleagues apprehensive” were independent predictors of discrimination.Conclusions: Discriminatory attitudes against PLWHA among pharmacy students and pharmacists who participated in this study were high and level of training and their perceptions were contributory.Keywords: Discrimination, HIV/AIDS, Pharmacists, Perception, Professionalism, Stigmatization

The Construct Validity of an Instrument for Measuring Type 2 Diabetes Self-Care Knowledge in Nigeria

Purpose: To develop an instrument (DSCKQ-30) for measuring type 2 diabetic patients’ knowledge of self-care practices.Methods: A 30-item questionnaire (DSCKQ-30) consisting of close ended questions was developed for this study. DSCKQ-30 was self administered to a cross-section of randomly selected 400 ambulatory adult diabetic patients (≥ 18 years), who were attending endocrinology clinics at the hospitals included in this study. The sex distribution for female and male was 56.7 and 43.3% respectively. Factor analysis and item analysis were performed to test the construct validity and reliability of the instrument. Item performance was measured by item discrimination (item-to-total correlation) and percent correctness (%C).Results: The response rate was 78.5%. Factor analysis identified three scales of knowledge of self-care management. Chronbach’s alpha of the 30 questionnaire items was found to be 0.89. The item-to-total correlation coefficients and ranges for component 1 - 3 were 0.36 (0.25 - 0.48), 0.28 (0.23 - 0.35), and 0.34 (0.23 - 0.41), respectively, with overall average of 0.33 (0.23 - 0.48). Items percent correctness (% C) ranged from 16.7 to 86.7 % with an overall average of 55.6 %. Item factor loadings averaged 0.62 for the total items; averages of the three scales ranged from 0.59 to 0.68.Conclusion: The DSCKQ-30 provided a quantitative measure of patient's knowledge of self-care practices.Keywords: Diabetes self-care knowledge, DSCKQ-30, Knowledge instrument, Nigeria

Therapeutic efficacy of artemether-lumefantrine for treatment of uncomplicated plasmodium falciparum malaria in Enugu, Nigeria

Purpose: To review current therapeutic efficacy of artemether-lumefantrine (AL) for the treatment of uncomplicated Plasmodium falciparum malaria in patients in Enugu State, Nigeria.Methods: One hundred and fifty four malaria patients from three different Local Government Areas (LGA) of Enugu State, southeastern Nigeria, that fulfilled the inclusion criteria were recruited through rapid diagnostic testing and blood film microscopy. The patients received a 3-day complete dose of AL treatment; they were monitored and 3 mL of blood in EDTA bottle was sampled on days 0, 3, 7, 14 and 28. The samples were  evaluated by real-time polymerase chain reaction (RT-PCR) for  identification and quantification of Plasmodium falciparum. Clinical and parasitological responses were recorded and analyzed statistically.Results: There was significant decrease (p > 0.002) in patient’s  temperature (from 40 to 37 ºC) from day 0 to day 28. There was significant decrease (p < 0.001) between parasite mean density on day 0 and the values on days 3,7,14 and 28, with high prevalence of delayed parasite clearance. There was no early treatment failure, while 4 (3.4 %), 30 (25.4 %), and 84 (75.1 %) had late clinical failure, late parasitological response and adequate clinical and parasitological response, respectively.Conclusion: Artemether – lumefantrine combination therapy reduced fever in malaria patients but failed to totally clear parasitemia density, indicating its reduced therapeutic efficacy in Enugu State, Nigeria

Self-reported adherence to HAART in South-Eastern Nigeria is related to patients’ use of pill box

The aim of this study was to assess levels of adherence and predictors of adherence to HAART in South-Eastern Nigeria. Selfreported adherence to HAART was assessed at 4-week intervals for a period of 3 months. A 10-item questionnaire was used to assess hypothesised factors in adherence to HAART. The average adherence score for the 3 months of follow-up was correlated with 10-item hypothesised factors and patient demographic variables. Linear regression was used to model the relationship between self-reported adherence and factors found to be correlated with adherence. The average adherence level of subjects that took part in the study was86.1% ± 30.1%. Use of an adherence aid (pill box) was correlated with adherence (r=0.22,

STUDENTS’ KNOWLEDGE AND RISK OF COMMITTING MEDICATION ERRORS IN TWO SCHOOLS OF PHARMACY IN NIGERIA

Objective: The aim of this study was to determine the knowledge of prescription errors, the certainty of such knowledge, and the risk of committing medication errors among pharmacy students in two universities in Nigeria. Methods: This study was a cross-sectional comparative survey between pharmacy students of two universities in Nigeria: University of Nigeria, Nsukka (UNN) and Nnamdi Azikiwe University (NAU), Awka. Study variables were measured using four simulated prescriptions and questionnaires. Chi-square test, independent t-test, and ordinal regression analyses were used to assess study outcomes. Results: A total of 339 pharmacy students (239 in UNN and 100 in NAU), with a mean age of 24 (2.8) years and 57.2% (n=194) male students, participated in this study. Their accurate knowledge of each of the prescriptions were 294 (86.72%), 166 (48.97%), 199 (58.70%), and 248 (73.16%) for prescriptions with error of drug allergy, error of drug interaction, no error, and wrong dose of a drug, respectively. Students from UNN were more likely to commit a statistically significant high risk of error compared to NAU students in prescriptions with a drug allergy and wrong dose, while students in the 4th year class had a statistically significant higher odds of committing a drug interaction prescription error compared to final year students. Conclusion: Pharmacy students evaluated in this study had good knowledge of medication error detection. The risk of these pharmacy students committing a prescription error was evident in nearly all prescriptions tested and the students’ school was the major predictor of these risks

Evaluation of the anti-ulcer activity of aqueous stem-bark extract of Hymenocardia acida (family – Euphorbiaceae)

To assess and establish the scientific basis for the anti-ulcer activity of aqueous stem-bark extract of Hymenocardia acida. Groups of albino rats were pre-treated orally with aqueous stem-bark extract of the plant before administration of indomethacin and induction of cold-restraint stress ulcers by immobilizing each animal in a cylindrical cage maintained at 2 to 4oC in a refrigerator for 3 hours. The animals were sacrificed by a blow on the head, their stomachs removed and examined for ulcers. The extract produced significant (P< 0.05) anti-ulcer activity against the two models studied. The anti-ulcer activity against cold-restraint stress was also dose-dependent. Phytochemical studies revealed the presence of glycosides, saponins and tannins. This study demonstrates that the plant extract has significant anti-ulcer activity against experimentally induced gastric lesions. Key words: Antiulcer activity: Hymenocardia acida; Rats Nig. J. Pharm. Res. 3(1) 2004: 86-9

Anti-ulcer activity of aqueous leaf extract of Persea americana (family-Lauraceae)

The study was carried out to investigate the anti-ulcer activity of aqueous leaf extract of Persea americana. Groups of albino rats were pre-treated orally with aqueous leaf extract of the plant before administration of the ulcerogenic drugs-indomethacin and ethanol. The animals were sacrificed by a blow on the head, their stomachs removed and examined for ulcers. The extract produced significant (

Increasing use of artemisinin-based combination therapy for treatment of malaria infection in Nigerian hospitals

Objectives: This study aimed at describing the pattern of outpatient antimalarial drug prescribing in a secondary and a tertiary hospital, and to assess adherence to the National Antimalarial Treatment Guideline (ATG). Methods: An audit of antimalarial prescription files from the two health facilities for a period of six months in 2008 was conducted. Semi structured questionnaires were used to collect information from the doctors and pharmacists on their awareness and knowledge of the National Antimalarial Treatment Guideline. Results: Artemisinin-based combination therapies (ACTs) were the most prescribed antimalarials. Overall, 81.4% of the total prescriptions contained ACTs, out of which 56.8% were artemether-lumefantrine. However, adherence to the drugs indicated by national guideline within the DU90% was 38.5% for the tertiary and 66.7 % for the secondary hospital. The standard practice of prescribing with generic name was still not adhered to as evidenced in the understudied hospitals. The percentage of health care providers that were aware of the ATG was 88.2% for doctors and 85.1% for pharmacists. However, 13.3% and 52.2% of doctors and pharmacists respectively could not properly list the drugs specified in the guideline. Amodiaquine was the most commonly preferred option for managing children aged 0 – 3 months with malaria infection against the indicated oral quinine.Conclusion: This study showed an increased use of artemisinin-based combination therapy for the treatment of uncomplicated malaria compared previous reports in Nigeria. This study also highlights the need for periodic in-service quality assurance among health professionals with monitoring of adherence to and assessment of knowledge of clinical guidelines to ensure the practice of evidence based medicine

Effect of ciprofloxacin on single dose chloroquine salivary and urinary excretion in healthy volunteers: a pharmacokinetic consideration

The effects of ciprofloxacin on the salivary and urinary concentrations of chloroquine (CQ) were investigated in six healthy volunteers, 20 to 30 years of age. Ciprofloxacin reduced the absorption, excretion rate and t1/2 of chloroquine in urine, Cmax and AUC in saliva but increased the Tmax insaliva. Thus, concurrent administration of chloroquine, especially as chemoprophylactic agent, and ciprofloxacin, may lead to therapeutic failure hence may not be advisable