Patients’ Knowledge of Diabetes Mellitus in a Nigerian City

Purpose: To assess the knowledge of diabetes mellitus among diabetes patients and to identify knowledge deficits and patient specific characteristics that are associated with this knowledge.                              Methods: This was a descriptive cross sectional observational clinic study conducted among previously diagnosed patients with diabetes attending the Consultant Outpatient Departments (COPD) of the University of Benin Teaching Hospital (UBTH). The study employed the use of a 14-item Diabetes Knowledge Test (DKT), developed by the University of Michigan Diabetes Research and Training Centre (MDRTC) and a demographic questionnaire to assess patient’s knowledge and its association with some patient specific variables.Results: The overall mean knowledge score of the subjects was 5.54 ± 2.3 (39.5 % ± 16.7 %) range 7 - 79 %. There was no statistically significant difference in knowledge scores with respect to family history of the disease, recent training in DM, age and sex p > 0.05. Respondents without any formal education scored significantly higher in the DKT (7.0 ± 2.27) followed by those with post graduate and University education 6.67 ± 2.41 and 6.65 ± 2.41 respectively. Higher score on the DKT was significantly correlated with duration of disease awareness (r = 0.217; 95 %CI = 0.02 – 0.39, p < 0.05) but not associated with improved glucose control as measured by FBG levels. (r = -0.073; 95 %CI = -0.277 - 0.137, p > 0.05). Only 12 (13.5 %) of the respondents had FBG levels with the normal range of 5.6 – 6.9 mmole/L.Conclusion: Respondents’ knowledge of diabetes mellitus based on the DKT was very poor. There were knowledge deficits which relate to misconceptions in the diabetics diet and knowledge of blood glucose monitoring with glycosylated haemoglobin test. Longer duration of diabetes, irrespective of educational status, was associated with higher knowledge score.Keywords: Diabetes, knowledge, Patient’s characteristics

Prevalence of hypertension amongst persons with diabetes mellitus in Benin City, Nigeria

Objective: To determine the prevalence of hypertension amongst persons with diabetes mellitus (DM) in Benin city.Materials and Methods: Four hundred and fifty diabetic subjects were evaluated for hypertension by measuring their blood pressure using a sphygmomanometer at the diabetes clinics of the University of Benin Teaching Hospital and Central Hospital, both in Benin City, Nigeria. Other data obtained included age, sex, type of DM, weight, height, body mass index and waist hip ratio.Results: Two hundred and forty-four out of 450 subjects had hypertension, thus giving a prevalence rate of 54.2%. 124 males (50.8%) were hypertensive compared with 120 (49.2%) females, but this difference was not significant (χ2 = 0.1, df = 1, P > 0.05). Thirteen (22.4%) of the 58 Type 1 subjects had hypertension, while 231 (58.9%) of the Type 2 subjects had hypertension, and this difference was statistically significant (χ2 = 27, df = 1, P < 0.05).Conclusions: Hypertension is prevalent in persons with DM. Studies have shown that adequate control of the blood pressure reduces the microvascular and macrovascular complications of DM. DM care providers must prescribe appropriate antihypertensive therapy to control hypertension in persons with DM

Timeliness and Completion Rate of Immunization among Nigerian Children Attending a Clinic-based Immunization Service

To achieve maximal protection against vaccine-preventable diseases, a child should receive all immunizations within recommended intervals. Clinic records of 512 Nigerian children were evaluated for timeliness in receiving vaccines and the completion rates of the schedule. About 30% of the children presented after four weeks of age for their first immunization; 18.9-65% of the children were delayed in receiving various vaccines compared to the recommended ages for receiving the vaccines. Only 227 (44.3%) children were fully immunized. Health education and mass mobilization of the community and health workers are recommended to improve the uptake of vaccines and to encourage timely receipt of vaccines

Conjoined twins in Edo state of Nigeria; a report of the first surviving set

The term conjoined twins refers to babies who are physically joined at some point. It is a rare condition with an estimated incidence of 1 per 200,000live births. We report our experience with conjoined twins over a twelve year period in tertiary hospital in Nigeria and a case of the first set of conjoined twin survivors in Benin City, Nigeria. Over the last twelve years  (1999-2011), three cases of conjoined twin have been recorded in our teaching hospital. A set of thoracoomphalopagus twins (females) were delivered in 1999 and they survived for only 36hrs. Another set of female omphalopagus twins were delivered in 2009 and survived a separation surgery. A third set of female thoracoomphalopagus was delivered in another institution same year and referred to our unit but they only survived for 48 hours. The first surviving twins were omphalopagus, sharing a single liver, and common bile duct emptying into a common duodenum. The stomach, as well as the jejunum was normal and unshared. Surgicalseparation of the liver was done and biliary reconstruction procedure performed for twin II. A three -year follow up showed good outcome

Awareness of childhood pneumonia in Benin City, Nigeria

Background: Mortality from pneumonia can be prevented by prompt recognition of symptoms of pneumonia by caregivers at home and appropriate seeking for medical care in a health facility. Active participation in pneumonia control by caregivers is dependent on the extent to which the members of the community are aware of  features of pneumonia and recognising that the child needs medical attention.Objective: To document the knowledge of community members about pneumonia using traders (market women and men in a popular market in Benin City, Nigeria).Design: A descriptive cross-sectional study.Setting: Edaiken market, Benin City, Nigeria.Subjects: All traders, women and men in Edaiken market Benin City Nigeria.Results: Of the 1374 respondents, 1220(88.8%) about pneumonia. Of these 1220, 57.9% correctly identified that pneumonia affects the lungs and exposure to breeze was the risk factor of pneumonia (86.7% of respondents). Knowledge score for  pneumonia was generally low with most respondents 1140(93.5%) scoring < 10 (Poor); and 79(6.5%) had scores 10 – 14 (Fair). Only one person (0.1%) had a score ≥ 15 (Good knowledge). Married individuals were five times more likely to have fair knowledge of pneumonia when compared to the unmarried individuals (OR = 5.0, p = 0.01). Also statistical significant proportion of respondents with presence of an under-five year old in the household had fair knowledge of childhood pneumonia when compared with household with no child younger than five years (p = 0.00).Conclusion: General knowledge of the traders in Benin City about childhood pneumonia was poor. There is need for improved public awareness on childhood pneumonia in this community

Traders’ Perception of Cooking Smoke as a Risk Factor for Childhood Pneumonia

Background: Childhood pneumonia is the foremost killer of under-fives. Indoor air pollution by smoke from cooking fuel is a major risk factor for childhood pneumonia. The knowledge of caregivers about risk factors can facilitate the practice of appropriate preventive measures. This study set out to evaluate the perception of traders about cooking smoke as a risk factor for childhood pneumonia.Methodology: A researcher administered, questionnaire based, cross-sectional study was carried out at a major market in Benin City prior to a market rally to celebrate World Pneumonia Day 2014. The respondents were traders. Information on biodata, place of cooking, fuel for cooking and presence of under-fives in the cooking area of homes of respondents was sought.Results: There were 1374 respondents of which 1192(88.5%) were females. Only 67(4.9%) respondents considered smoke from cooking fuel a risk factor for pneumonia while 99(7.2%) considered avoidance of smoke as a method for preventing pneumonia. Firewood (biomass fuel) was utilized by 272(19.8%) respondents. Respondents with no education were significantly more likely to use firewood (p<0.000). All respondents with under-fives reported having them in the cooking area. Having a child who had suffered pneumonia in the past was not significantly associated with knowing that smoke was a risk factor for childhood pneumonia p>0.05.Conclusion: There is poor awareness of smoke as a risk factor for childhood pneumonia while the use of unclean fuel is significant. As part of health education on childhood pneumonia, smoke as a risk factor should be emphasized. Government should make cleaner fuels more available, accessible and affordable.Keywords: Traders, Cooking Smoke, Ris

Effect of training on knowledge about cervical cancer and Human Papiloma Virus vaccine among health care personnel in Benin City

Background: Although the HPV vaccine is available for a fee in Nigeria it is not yet in the National Programme on Immunization (NPI) which is free. Health care workers can play an important role in improving uptake of the vaccine and in advocating for its inclusion in the NPI. However, this role may be limited by lack of knowledge. This study assessed the effect of training on health care workers’ knowledge of HPV, its relationship with cervical cancer and the role of HPV vaccine in prevention.Methods: This quasi-experimental study examined the responses to pre and post test evaluation of the knowledge and practice of health care workers from Benin City with regards to HPV, cervical cancer and HPV vaccines at a workshop organized to create awareness on the subject matter.Results: Of the 53 health care workers at the training, 46 (85%) knew that HPV was the causative agent of cervical cancer while only 13 (28.9%) and 15 (32.6%) knew that it was associated with oral and vaginal cancer, respectively. Majority of participants had heard about the HPV vaccine but only 15 (30.6%) had encouraged its use and 7 (14.3%) had prescribed it. Post test result showed marked improvement in most areas evaluated.Conclusion: The less than satisfactory knowledge of health care workers about HPV and its relationship with anogenital cancers was markedly improved by training. Training of health care workers should be done to address the dearth of knowledge prior to the deployment of the vaccine nationally.Keywords: Knowledge; Healthcare workers; HPV; HPV vaccine; Cervical cancer 

Improving the assessment of gestational age in a Zimbabwean population

Objectives: To evaluate the performance and the utility of using birthweight‐adjusted scores of Dubowitz and Ballard methods of estimating gestational age in a Zimbabwean population. Method: The Dubowitz and the Ballard methods of estimating gestational age were administered to 364 African newborn infants with a known last menstrual period (LMP) at Harare Maternity Hospital. Results: Both methods were good predictors of gestational age useful in differentiating term from pre‐term infants. Our regression line was Y(LMP gestational age)=23.814+0.301*score for the Dubowitz and Y(LMP gestational age)=24.493+0.420*score for the Ballard method. Addition of birthweight to the regression models improved prediction of gestational age; Y(LMP gestational age)=23.512+0.219*score+0.0015*grams for Dubowitz and Y(LMP gestational age)=24.002+0.292*score+0.0016*grams for Ballard method. Conclusions: We recommend the use of our birthweight‐adjusted maturity scales; the Dubowitz for studies of prematurity, and the Ballard for routine clinical practice.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135611/1/ijgo7.pd

Measuring newborn foot length to identify small babies in need of extra care: a cross sectional hospital based study with community follow-up in Tanzania

BACKGROUND\ud \ud Neonatal mortality because of low birth weight or prematurity remains high in many developing country settings. This research aimed to estimate the sensitivity and specificity, and the positive and negative predictive values of newborn foot length to identify babies who are low birth weight or premature and in need of extra care in a rural African setting.\ud \ud METHODS\ud \ud A cross-sectional study of newborn babies in hospital, with community follow-up on the fifth day of life, was carried out between 13 July and 16 October 2009 in southern Tanzania. Foot length, birth weight and gestational age were estimated on the first day and foot length remeasured on the fifth day of life.\ud \ud RESULTS\ud \ud In hospital 529 babies were recruited and measured within 24 hours of birth, 183 of whom were also followed-up at home on the fifth day. Day one foot length <7 cm at birth was 75% sensitive (95%CI 36-100) and 99% specific (95%CI 97-99) to identify very small babies (birth weight <1500 grams); foot length <8 cm had sensitivity and specificity of 87% (95%CI 79-94) and 60% (95%CI 55-64) to identify those with low birth weight (<2500 grams), and 93% (95%CI 82-99) and 58% (95%CI 53-62) to identify those born premature (<37 weeks). Mean foot length on the first day was 7.8 cm (standard deviation 0.47); the mean difference between first and fifth day foot lengths was 0.1 cm (standard deviation 0.3): foot length measured on or before the fifth day of life identified more than three-quarters of babies who were born low birth weight.\ud \ud CONCLUSION\ud \ud Measurement of newborn foot length for home births in resource poor settings has the potential to be used by birth attendants, community volunteers or parents as a screening tool to identify low birth weight or premature newborns in order that they can receive targeted interventions for improved survival

Neonatal seizures in a rural Kenyan District Hospital: aetiology, Incidence and outcome of hospitalization

<p>Abstract</p> <p>Background</p> <p>Acute seizures are common among children admitted to hospitals in resource poor countries. However, there is little data on the burden, causes and outcome of neonatal seizures in sub-Saharan Africa. We determined the minimum incidence, aetiology and immediate outcome of seizures among neonates admitted to a rural district hospital in Kenya.</p> <p>Methods</p> <p>From 1^stJanuary 2003 to 31^stDecember 2007, we assessed for seizures all neonates (age 0-28 days) admitted to the Kilifi District Hospital, who were resident in a defined, regularly enumerated study area. The population denominator, the number of live births in the community on 1 July 2005 (the study midpoint) was modelled from the census data.</p> <p>Results</p> <p>Seizures were reported in 142/1572 (9.0%) of neonatal admissions. The incidence was 39.5 [95% confidence interval (CI) 26.4-56.7] per 1000 live-births and incidence increased with birth weight. The main diagnoses in neonates with seizures were sepsis in 85 (60%), neonatal encephalopathy in 30 (21%) and meningitis in 21 (15%), but only neonatal encephalopathy and bacterial meningitis were independently associated with seizures. Neonates with seizures had a longer hospitalization [median period 7 days - interquartile range (IQR) 4 to10] -compared to 5 days [IQR 3 to 8] for those without seizures, <it>P </it>= 0.02). Overall, there was no difference in inpatient case fatality between neonates with and without seizures but, when this outcome was stratified by birth weight, it was significantly higher in neonates ≥ 2.5 kg compared to low birth weight neonates [odds ratio 1.59 (95%CI 1.02 to 2.46), <it>P </it>= 0.037]. Up to 13% of the surviving newborn with seizures had neurological abnormalities at discharge.</p> <p>Conclusion</p> <p>There is a high incidence of neonatal seizures in this area of Kenya and the most important causes are neonatal encephalopathy and meningitis. The high incidence of neonatal seizures may be a reflection of the quality of the perinatal and postnatal care available to the neonates.</p