Respiratory health in Africa: Strides and challenges

The challenges of Respiratory Medicine in Africa go beyond the coronavirus disease 2019 (COVID-19). Communicable diseases such as Pneumonia and Tuberculosis are still important public health challenges, although considerable strides in the management have been made. Non-communicable respiratory diseases are also increasing in burden and the risk factors are pervasive in Africa. The COVID-19 pandemic had exposed the weakness of the health system in most parts of Africa and this is an opportunity for stakeholders to come together to develop sustainable strategies to build resilient health systems. A number of African initiatives such as the Pan African Thoracic Society are at the forefront to improve Respiratory health in Africa and must work in collaboration with the global community to achieve this objective

Challenges of diagnosing and managing bronchiectasis in resource-limited settings: a case study

Bronchiectasis, once an orphan disease is now gaining renewed attention as a significant cause of morbidity and mortality. It is a morphologic term used to describe abnormal, irreversibly dilated and thick-walled bronchi, with many etiologies. The management of bronchiectasis can be challenging because its pathogenetic mechanisms is still evolving. Its diagnosis and management is particularly more demanding especially in resource-limited settings like Nigeria because of delayed diagnosis and improper management with devastating consequences, hence this case study

Knowledge of spacer device, peak flow meter and inhaler technique (MDIs) among health care providers: an evaluation of doctors and nurses.

Background: Metered dose inhalers are cornerstone in effective management of bronchial asthma when correctly used. Most studies hitherto have focused on assessing patient’s knowledge of inhaler technique. We sought to assess the knowledge of inhaler technique, spacer device and peak flow meter among doctors and nurses in a tertiary healthcare institution in Nigeria.Method: A cross sectional survey of nurses and doctors from emergency department, family and internal medicine; who were attending a continuous professional development lecture, was carried out. From a total of 100 questionnaires administered, we retrieved 87 of which 75 were completed, giving a response rate of 75%. It was a selfadministered questionnaire. Data was analysed with SPSS version 21.0. Descriptive statistics were done. Associationwas examined using chi-square test.Result: Mean age of respondent was 35.8 years ± 8.7, 47(62.7%) were < 40 years, 33(44%) were male, nurses were 30(40.0%). Only 28(37.3%) had ever used a peak flow meter. Only 4(14.3%) used peak flow meter frequently, while 12(26.7%) checked patient’s inhaler technique often. Only 9 out of the 75 (12%) participants all of who are doctors knew at least 3 essential steps of the techniques in using the metered dose inhaler correctly. None of the participants got all the steps for the use of pMDI totally correct.Conclusion: Knowledge regarding the use of the metered dose inhaler and spacer device was poor. Health practitioners should have constant reminders in the form of continuous medical education to update their knowledge regarding correct inhaler technique.Funding: self-fundedKeywords: asthma, inhalers, knowledge, doctors, nurse

The risk of obstructive sleep apnea and its association with indices of general and abdominal obesity in a Nigerian family practice clinic: a cross-sectional study

Introduction: Obstructive sleep apnea (OSA) is associated with considerable morbidity and mortality. This study assessed the prevalence of high risk of OSA and investigated which anthropometric measure best predicts the OSA risk among patients attending a family practice clinic in a tertiary hospital. Methods: We conducted a descriptive cross-sectional study of 362 consecutive patients (64% females; median age of 54 years). OSA risk was assessed by the Berlin Questionnaire and the patients were divided into two groups according to OSA risk: high and low risk. Anthropometric measurements were conducted as stated in the protocol established in the 3rd National Health and Nutrition Examination Survey. Results: Out of 362 participants, 84 [23.2% (95% CI 19.0%, 28.0%)] had high risk of OSA. Subjects with a high risk of OSA had significantly higher body mass index, waist circumference, hip circumference, and waist-to-height ratio (24.9 vs 23.8, p = 0.002; 89.0 vs 84.0, p < 0.001; 95.0 vs 91.0, p < 0.001; 0.56 vs 0.52, p < 0.001, respectively). Body mass index, waist circumference, hip circumference, and waist-to-height ratio performed similarly in predicting high risk of OSA with Area Under the Curve (AUC) of 0.661, 95% CI (0.592,0.730); 0.659, 95% CI (0.596,0.723); 0.668, 95% CI (0.604,0.733); 0.659 95% CI (0.592,0.725) respectively. The AUCs were similar when the analysis was restricted to those who were overweight. Conclusion: High risk of OSA is moderately prevalent in this population, with measures of central and abdominal adiposity equally predicting the risk

Assessment of knowledge and practice of oxygen therapy among doctors and nurses: A survey from Ondo State, Southwest Nigeria

Objectives: Oxygen is among the commonly used drugs in acute emergencies. Prescription and administration of oxygen in emergencies by healthcare providers are reported to be inappropriate in most settings. There is a huge gap in the knowledge of health-care providers on various aspects of oxygen therapy. The purpose of this study was to assess the knowledge and practice of oxygen therapy among doctors and nurses working in Ondo State, South-West Nigeria and see how it compares with standard practice with a view to improving the quality care in this regard.Materials and Methods: A descriptive cross-sectional study was employed. The data were collected electronically using the Monkey survey application from consenting doctors and nurses through a self-administered validated and structured questionnaire. The questionnaire included the professional characteristics, educational background, awareness and use of oxygen therapy guidelines, knowledge of oxygen, indication for acute oxygen, and oxygen delivery practices. Data were analyzed using descriptive statistics and association between variables explored with Chi-square test at P < 0.05.Results: One hundred and seventy-six health workers participated in the study with mean age of 37.30 ± 8.88 years. One hundred and twelve (63.60%) of the respondents were doctors while 64 (36.40%) of the respondents were nurses. Sixty-eight (60.70%) of the doctors and 19 (29.70%) of nurses had a high level of knowledge of oxygen therapy (p<0.001). About half of both doctors and nurses had a poor practice level of oxygen therapy. The duration of oxygen administration (how long ago the respondent was involved in oxygen use and previous to formal training on oxygen therapy) were significantly associated with level of knowledge of oxygen therapy (p<0.001, 0.017).Conclusion: Results from this study suggest that the level of knowledge was high in about half of the respondents and about the same percentage had poor oxygen therapy practice in hospitals in Ondo State, South West Nigeria. Therefore, regular training of healthcare workers should be encouraged to update their knowledge and practice of oxygen therapy

COP27 climate change conference: urgent action needed for Africa and the world

The 2022 report of the Intergovernmental Panel on Climate Change (IPCC) paints a dark picture of the future of life on earth, characterised by ecosystem collapse, species extinction, and climate hazards such as heatwaves and floods.1 These are all linked to physical and mental health problems, with direct and indirect consequences of increased morbidity and mortality. To avoid these catastrophic health effects across all regions of the globe, there is broad agreement—as 231 health journals argued together in 2021—that the rise in global temperature must be limited to less than 1.5oC compared with pre-industrial levels

COP27 Climate Change Conference: Urgent action needed for Africa and the world

Wealthy nations must step up support for Africa and vulnerable countries in addressing past, present and future impacts of climate change.The 2022 report of the Intergovernmental Panel on Climate Change (IPCC) paints a dark picture of the future of life on earth, characterised by ecosystem collapse, species extinction, and climate hazards such as heatwaves and floods. These are all linked to physical and mental health problems, with direct and indirect consequences of increased morbidity and mortality. To avoid these catastrophic health effects across all regions of the globe, there is broad agreement—as 231 health journals argued together in 2021—that the rise in global temperature must be limited to less than 1.5oC compared with pre-industrial levels. While the Paris Agreement of 2015 outlines a global action framework that incorporates providing climate finance to developing countries, this support has yet to materialise. COP27 is the fifth Conference of the Parties (COP) to be organised in Africa since its inception in 1995. Ahead of this meeting, we—as health journal editors from across the continent—call for urgent action to ensure it is the COP that finally delivers climate justice for Africa and vulnerable countries. This is essential not just for the health of those countries, but for the health of the whole world

COP27 Climate Change Conference: urgent action needed for Africa and the world

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COP27 CLIMATE CHANGE CONFERENCE: URGENT ACTION NEEDED FOR AFRICA AND THE WORLD

Wealthy nations must step up support for Africa and vulnerable countries in addressing past, present and future impacts of climate chang

COP27 climate change conference: Urgent action needed for Africa and the world

No Abstract