Treatment of malaria in pregnancy: Knowledge of community pharmacists in Ibadan, Nigeria

Purpose: To evaluate the knowledge of community pharmacists in the management of malaria in pregnancy and their adherence to the World Health Organisation (WHO) treatment guidelines. Methods: Questionnaires were administered to obtain information on knowledge and adherence to WHO guidelines. Respondents’ scores on a 12-item knowledge question on the management of malaria in pregnancy were categorized as good knowledge if ≥ 10, and poor knowledge if < 10. Descriptive statistics were used to summarise the data. Chi-square test was used to explore the association between sociodemographic characteristics and knowledge. Results: Pharmacists qualified within 10 years of the study period were 29 (48.3 %). Only 25 (31.3 %) of the pharmacists possessed an additional qualification to Bachelor of Pharmacy degree. Rapid diagnostic test kits (RDT) and light microscopy test (LMT) have been used by 51 (76.2 %) and 17 (28.8 %), respectively, to diagnose malaria. About three-quarters (71.3 %) had poor knowledge of the medication for the treatment of malaria in pregnancy. Knowledge score was neither significantly associated with the pharmacists’ years of qualification (p = 0.174) nor with possession of additional qualification (p = 0.334). Conclusions: There is a substantial gap in pharmacists’ knowledge on the management of malaria in pregnancy, revealing an urgent need for training and adherence of community pharmacists to World Health Organisation treatment guidelines to ensure the safety of pregnant women and the unborn baby

Evaluation of the effect of border closure on COVID-19 incidence rates across nine African countries: an interrupted time series study

Background: Border closure is one of the policy changes implemented to mitigate against coronavirus disease 2019 (COVID-19). We evaluated the effect of border closure on the incidence rate of COVID-19 across nine African countries. Methods: An interrupted time series analysis was used to assess COVID-19 incidence rates in Egypt, Tunisia, Democratic Republic of the Congo (DRC), Ethiopia, Kenya, Ghana, Nigeria, Senegal and South Africa (SA). Data were collected between 14 February and 19 July 2020 from online data repositories. The linear trend and magnitude of change were evaluated using the itsa function with ordinary least-squares regression in Stata with a 7-d deferred interruption point, which allows a period of diffusion post-border closure. Results: Overall, the countries recorded an increase in the incidence rate of COVID-19 after border closure. However, when compared with matched control groups, SA, Nigeria, Ghana, Egypt and Kenya showed a higher incidence rate trend. In contrast, Ethiopia, DRC and Tunisia showed a lower trend compared with their controls. Conclusions: The implementation of border closures within African countries had minimal effect on the incidence of COVID-19. The inclusion of other control measures such as enhanced testing capacity and improved surveillance activities will reveal the effectiveness of border closure measures

PATENT MEDICINE VENDORS’ PREPAREDNESS AND RESPONSE FOR THE PREVENTION AND CONTROL OF COVID-19 INFECTION IN A NORTH-CENTRAL STATE IN NIGERIA

Objective: This report aimed to determine the immediate effect of the IPC training on the knowledge and role of patent medicine vendors (PMV) in the COVID-19 outbreak response in Nigeria. Methods: We conducted a quasi-experimental study before and after the IPC training among 1076 PMV in Ilorin, Kwara state, Nigeria. Data analysis was done using SPSS version 23. Eight questions were asked, for which each was assigned a score of “1”. Participants who had scored<50% were categorized as “Fail”, while those with scores ≥50% were categorized as “Pass” in both the pre and post-tests. The Chi-square test was used to test for the association between sociodemographic characteristics and performance of respondents in the pre-and post-IPC knowledge results, and paired t-test to test for significant differences between the pre and post-tests mean scores. The level of significance was set at p<0.05 for all statistical tests. Results: The mean age of the 1076 respondents was 37.06±10.96, 463(43%) passed the pre-test, while 617 (57.3%) passed the post-test. The mean pre-test IPC training score was 3.1310±1.5631, while the mean post-test IPC training score was 3.7351±1.6028 (t=-11.337, p=<0.001). In all, 617(57.3%) scored higher in posttest. Overall, 560 (92.41%) identified community sensitization and health education on COVID-19 preventive measures as roles of PMV. Conclusion: Regular trainings on COVID-19 preventive practices among PMV should be conducted. PMV should be empowered to sensitize and educate their clients on the prevention of COVID-19

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

Health Problems and Health Seeking Behaviour of Hospital Cleaners in a Tertiary Health Facility in South West Nigeria

This study aimed to determine the prevalent health problems and also investigate the health seeking behavior among hospital cleaners of Federal Medical Center, Owo, Ondo State. Nigeria. A cross-sectional study of 249 hospital cleaning staff was conducted. Semi-structured interviewer administered questionnaires were used to obtain information. Descriptive statistics were done and associations were explored with the chi square test at 5% level of significance. The mean age of respondent was 34 ±7 years, 142(57.0%) attended secondary school. The workplace health problems of the cleaning staff in the month preceding the study included low back pains 63.1%, muscular and joint pains 38.6% and skin rashes 14.9%, 15.7% had eye problems. The chronic health problems reported among the cleaners were hypertension 5.6%, asthma (0.8%) and epilepsy (0.4%). Some ( 3.2%) of the respondents did not seek healthcare at FMC, Owo because they felt they were not being cared for while 3.6% believed they were healthy and others 4.4% believed the services were too expensive. Like other health workers, hospital cleaners as shown in this study, also have health needs which must be met. Services of the hospital can be made available to the cleaners at subsidized costs. DOI: 10.5901/ajis.2014.v3n6p18

Pulmonary involvement in Lassa fever: a scoping review

INTRODUCTION: Lassa fever (LF) affects all body systems, however, inadequate knowledge exists on the involvement of the pulmonary system in LF infections. This scoping review, therefore, aimed to describe the pulmonary involvement of LF. MATERIAL AND METHODS: We conducted an extensive search of the literature on two databases, namely PubMed and Google Scholar. Overall, 5,217 articles were retrieved from a database search, out of which 107 duplicates were removed. Overall, 12 articles were included: four review articles, three case reports, three experimental inoculation studies, one retrospective study, and a prospective case-control study. RESULTS: Symptoms experienced included fever, pharyngitis, retrosternal pain, respiratory distress, and proteinuria. Complications included unique pulmonary arteritis, pulmonary embolization, mucosal bleeding, pleural or pericardial effusion, pulmonary edema, and interstitial pneumonitis. Consequences of the effect of Lassa virus infection were impairment of the immune system alongside continual replication of Lassa virus infection in affected tissues and death of affected individuals. LF has varied but serious effects on the pulmonary system. CONCLUSIONS: These symptoms, particularly in areas where LF is known to be endemic, should prompt clinicians to request LF polymerase chain reaction for confirmatory diagnosis. These features should promote the provision of respiratory support for patients in need of such

The global, regional, and national burden of stomach cancer in 195 countries, 1990-2017 : a systematic analysis for the Global Burden of Disease study 2017

Background: Stomach cancer is a major health problem in many countries. Understanding the current burden of stomach cancer and the differential trends across various locations is essential for formulating effective preventive strategies. We report on the incidence, mortality, and disability-adjusted life-years (DALYs) due to stomach cancer in 195 countries and territories from 21 regions between 1990 and 2017. Methods: Estimates from GBD 2017 were used to analyse the incidence, mortality, and DALYs due to stomach cancer at the global, regional, and national levels. The rates were standardised to the GBD world population and reported per 100 000 population as age-standardised incidence rates, age-standardised death rates, and age-standardised DALY rates. All estimates were generated with 95% uncertainty intervals (UIs). Findings: In 2017, more than 1·22 million (95% UI 1·19–1·25) incident cases of stomach cancer occurred worldwide, and nearly 865 000 people (848 000–885 000) died of stomach cancer, contributing to 19·1 million (18·7–19·6) DALYs. The highest age-standardised incidence rates in 2017 were seen in the high-income Asia Pacific (29·5, 28·2–31·0 per 100 000 population) and east Asia (28·6, 27·3–30·0 per 100 000 population) regions, with nearly half of the global incident cases occurring in China. Compared with 1990, in 2017 more than 356 000 more incident cases of stomach cancer were estimated, leading to nearly 96 000 more deaths. Despite the increase in absolute numbers, the worldwide age-standardised rates of stomach cancer (incidence, deaths, and DALYs) have declined since 1990. The drop in the disease burden was associated with improved Socio-demographic Index. Globally, 38·2% (21·1–57·8) of the age-standardised DALYs were attributable to high-sodium diet in both sexes combined, and 24·5% (20·0–28·9) of the age-standardised DALYs were attributable to smoking in males. Interpretation: Our findings provide insight into the changing burden of stomach cancer, which is useful in planning local strategies and monitoring their progress. To this end, specific local strategies should be tailored to each country's risk factor profile. Beyond the current decline in age-standardised incidence and death rates, a decrease in the absolute number of cases and deaths will be possible if the burden in east Asia, where currently almost half of the incident cases and deaths occur, is further reduced. Funding: Bill & Melinda Gates Foundation