Magnitude and leading causes of in-hospital mortality at Aminu Kano Teaching Hospital, Kano, northern Nigeria: A 4-year prospective analysis

Background: Population based mortality data are scarce especially in developing countries including Nigeria. Despite its limitations, hospital mortality analysis assesses the quality of health-care delivery and provides a proximate measure of mortality. We reviewed the magnitude and causes of death among in-patients in a tertiary hospital in northern Nigeria. Methods: Analysis of mortality rate and causes of death for the period 20052008 (inclusive) in Aminu Kano Teaching Hospital. Causes of death were prospectively entered on a database and classified according to the International Classification of Diseases (ICD-10).Results: Out of 51,975 patients admitted to the hospital, 4,029 of them died. This gives a mortality rate of 7.8% (95% Confidence Interval of 7.5% to 8.0%). Specifically, of the 15,484 males admitted, 2,361 died giving a mortality rate of 15.2% while of the 36,491 females admitted, 1,668 died giving a mortality rate of 4.6%. The median age for all patients that died was 32.4 years (range: less than 1 day to 101 years), but 36.1 years (range: less than 1 day to 101 years) for the male and 29.3 (range: less than 1 day to 87 years) for the female subsets. The ten most common causes of mortality were HIV/AIDS (8.3%), Septicaemia (6.8%), cerebrovascular disease (6.3%), chronic renal failure (3.9%) chronic liver disease (3.3%), diabetes mellitus (3.2), neonatal jaundice (2.9%), severe birth asphyxia (2.6%), prematurity (2.5%) and bronchopneumonia (2.4%). Conclusion: The mortality rate and causes of death are comparable to similar centres. Regular mortality audits could identify management errors and prevent recurrence of avoidable deaths.Key words: Mortality, causes, Teaching hospital, Kano, Nigeri

Malaria among antenatal clients attending primary health care facilities in Kano state, Nigeria

Background: Malaria in pregnancy remains a major public health problem especially in sub-Saharan Africa. However, the prevalence of clinical and asymptomatic infection among antenatal client (ANC) attendees is largely unknown, especially at primary health care (PHC) level in northern Nigeria. This study assessed the prevalence of fever, malarial parasitemia and anemia among pregnant women attending PHC facilities in Kano, northern Nigeria.Methods: A cross-sectional descriptive study was conducted among 360 ANCs attending PHC facilities in two Local Government Areas (LGAs) in Kano state. Data were collected using a pre-tested semi-structured interviewer administered questionnaire. Blood samples were also obtained for thin blood smear for malaria parasite using Giemsa staining technique. Hemoglobin was estimated from the Packed Cell Volume (PCV) determined using hematocrit.Results: Age of the subjects ranged from 15 to 42 years with a mean } SD of 24.0 } 6.0. Up to 39.2% (n = 141) (95% Confi dence Interval = 34.1.44.4%) of the subjects were found to have malarial parasitemia. Exactly 36.2% (n = 51) of those with parasitemia had fever (temperature . 37.5oC) while 63.8% (n = 90) of them were asymptomatic. Anemia,(hemoglobin of .11 g/dl) was found in 48.1% (n = 173) of the  respondents. A higher proportion of primigravid and secondigravid clients (61% vs. 39%) and younger pregnant women (54.6% vs. 45.4%) had malarial parasitemia compared to multigravid and older women, respectively. Similarly, a signifi cantly higher proportion (67.6%) ofanemic ANC clients had malarial parasitemia. (ƒÔ2 = 113.25, df = 1, P < 0.05).Conclusion: Malarial infection is common among the ANC clients attending PHC facilities in Kano state and the infection is commonly associated with anemia. Intermittent Preventive Treatment (IPT) should be provided especially among primigravid, secondigravid and younger mothers at PHC centres

Awareness of occupational hazards and use of safety measures amongst welders in northern Nigeria.

Background: Welders are exposed to a variety of occupational hazards with untoward health effects. However, little is known of welders’ awareness of health hazards and their adherence to safety precautions in developing countries. This study assessed the awareness of occupational hazards andadherence to safety measures among welders in Kaduna metropolis in northern Nigeria. Methods: A structured questionnaire was administered on a cross-section of 330 welders in Kaduna metropolis in northern Nigeria. Information was sought on their socio-demographic characteristics,their awareness of occupational hazards and adherence to safety measures. Results: All welders were males with a mean age of 35.7 ± 8.4 years. The illiteracy rate was 7.6%. Overall, 257 (77.9%) of the welders were aware of one or more workplace hazards. This was positivelyinfluenced by educational attainment, age, nature of training and work experience. Of the 330 respondents, 282 (85.3%) had experienced one or more work-related accidents in the preceding year. The most common injuries sustained were cut/injuries to the hands and fingers (38.0%), back/waist pain (19%), arc eye injuries/foreign bodies (17.0%), burns (14.0%), hearing impairment (7.0%), fractures (4.0%) and amputation (1.0%). Only 113 (34.2%) welders used one or more types of protective device with eye goggles (60.9%), hand gloves (50.3%) and boots (34.5%) being more frequently used. Regular use of safety device, shorter working hours and increasing experience were protective of occupational accidents.Conclusions: The level of awareness of occupational hazards was high with sub optimal utilization of protective measures against the hazards. There is therefore need for health and safety education of these workers for health and increased productivity

Survey of Umbilical Cord care and Separation time in Healthy Newborns in Kano

Background: The interval between delivery and umbilical cord separation varies worldwide. Some maternal, foetal and perinatal factors includingcord care practices are known to affect this interval. Objectives: To establish the mean umbilical cord separation time and the effect of maternal and infant characteristics, perinatal factors and cord care practices on this time among healthy babies in northern Nigeria. Methods : An interviewer questionnaire was administered on mothers of healthy babies at Child Welfare Clinics of a tertiary and secondary level hospital in Kano.In each case, information was obtained about mother's parity, place of antenatal care and delivery, gestational age, birth weight, time of umbilical cord separation after birth and cord treatment practices. Results: Five hundred and seventy seven (96.2 percent) of 600 mothers interviewed, took part in the study, four of these mothers had twin gestation. Responses showed that cord separation time ranged from 2 -14 days (4.20 1.70)Three hundred and forty nine (60.9. percent ) mothers applied methylated spirit, 145 (25.3 percent) used hot compress, while50 (8.7 percent) applied toothpaste on the cord. Twenty (3.5 percent)others applied herbs, while nine (1.6 percent) applied dusting powder to the umbilical stump. Cord s epa r a t ion t ime wa s significantly shorter among babies whose mothers were of high parity, unbooked, and of low educational status. In addition, the use of razor blade, thread, hot compress or application of herbal preparations or toothpas te s igni f icant ly shortened the separation time (P<0.05). Conclusions: Cord separation time and cord care practices varied. Nigerian mothers often use unorthodox interventions to shorten cord separation time; however, therisk of omphalitis that may result from this is real. We recommendthat each centre should adopt and teach mothers a standard hygieniccord care practice while discouraging the use of herbs and untested materials.Keywords: Umbilical cord, Separation time, Cord care, Kan

Compliance to medication among hypertensive patients in Murtala Mohammed Specialist Hospital, Kano, Nigeria

Background: Non-compliance to blood pressure-lowering medication is a major reason for poor control of hypertension worldwide. We assessed the level of compliance to anti-hypertensive therapy and identified factors contributing to poor compliance among hypertensives in Kano. Methodology: Three hundred and sixty outpatients were interviewed using a pre-tested, structured, mostly closed ended questionnaire in Murtala Mohammed Specialist Hospital in Kano, Nigeria. Results: Good compliance with drug treatment was observed in 54.2% of the respondents and poor compliance among the remainder. Poor compliance was found to be mainly due to ignorance on need for regular treatment (32.7%), lack of funds to purchase drugs (32.7%) and side effects of drugs (12.1%). Patients with formal education, and higher monthly income were more compliant to treatment. In addition, those on single drugs were more compliant compared to those on two or more drugs. Poor compliance was found to be mainly due to ignorance and lack of funds to purchase drugs. Conclusion: Based on the findings of this study, there is a need for launching a comprehensive approach involving health care providers, patients and the general public to educating patients on the need to take their drugs regularly and in the manner prescribed. Doctors should consider the financial status of their patients in prescribing antihypertensive drugs to enable affordability. Prices of anti-hypertensive drugs should be subsidized where possible. Prescribing an effective, inexpensive, single dose daily medication with minimal side effects will improve patient compliance considerably. Key Words: Hypertension; Medication; Compliance; Kano Journal of Community Medicine & Primary Health Care Vol.16(1) 2004: 16-2

Birth Preparedness, Complication Readiness and Fathers’ Participation in Maternity Care in a Northern Nigerian Community

The role of men in maternity care in Africa is understudied, despite their economic dominance and decision making power. In a patriarchal society like northern Nigeria, pregnancy and childbirth are often regarded as exclusively women’s affairs. Using data from interviewer administered questionnaires and in-depth interviews; we assessedbirth preparedness, complication readiness and male participation in maternity care in Ungogo, a northern Nigerian community. Majority of pregnancies were unplanned (96%). Only 32.1% of men ever accompanied their spouses for maternity care. There was very little preparation for skilled assistance during delivery (6.2%), savings foremergencies (19.5%) or transportation during labour (24.2%). Young paternal age (adjusted odds ratio [AOR] =1.5, 95% confidence interval [CI]=1.2-2.6), formal education (AOR=1.9, 95%CI=1.1-3.4) and non-Hausa Fulani ethnicity (AOR=2.3, 95%CI=1.4-3.3) were independent predictors of male participation in maternity care. There isa need to increase involvement of men in their partner’s maternity care through peer-led, culturally-sensitive community education and appropriate health system reforms.(Afr J Reprod Health 2010; 14[1]:21-32)

Digital habits and use of the internet as source of sexual and reproductive health information among undergraduates in northern Nigeria

Background: Surfing the internet and networking via social media have evolved at a startling pace. Objectives: To determine internet and social media habits and identify predictors of their use as sexual and reproductive health resource among Bayero University students. Study Design: A cross section of 385 students was interviewed using pre-tested anonymous structured self-completed questionnaires. Results: Nearly all students 98.4% (n=377) had accessed the internet and most 96.3% (n=363) had visited social media sites. Face book 57.3% (n=208), Twitter 22.3% (n=81) and Blackberry Messenger 8.8% (n=32) were the most popular among students. Of those with internet access,51.2%,46.2%, 39.2% and 38.5% mainly searched for information on HIV/AIDS, STI, sexual activities and menstrual problems respectively. There was more than two-fold likelihood of accessing online sexual information among female students compared to males, adjusted Odds ratio (aOR=2.52); 95% Confidence Interval (95%CI= 2.41-4.86). Similarly, ever-married students had more than twice the chance relative to single students (aOR=2.2, 95%CI=1.17-4.28). Furthermore, younger students (<20 years) were twice more likely to have used online resources compared to their older colleagues (≥30 years) (aOR=2.12, 95%CI=1.32-4.17). Conclusion: Undergraduate students are increasingly turning to the internet for sexual and reproductive health information. This presents an opportunity for programming.Key words: Internet, Social media, Reproductive, Sexual health, information source

Patients' satisfaction with services obtained from aminu Kano Teaching Hospital, Kano, Northern Nigeria

No Abstract

Awareness of Occupational Hazards and Utilization of Safety Measures Among Welders in Kaduna Metropolis, Northern Nigeria

Background: Welders are exposed to a variety of occupational hazards with untoward health effects. However, little is known of welders\u2019 awareness of health hazards and their adherence to safety precautions in developing countries. This study assessed the awareness of occupational hazards and adherence to safety measures among welders in Kaduna metropolis in northern Nigeria. Methods: A structured questionnaire was administered on a cross-section of 330 welders in Kaduna metropolis in northern Nigeria. Information was sought on their socio-demographic characteristics, their awareness of occupational hazards and adherence to safety measures. Results: All welders were males with a mean age of 35.7 \ub1 8.4 years. The illiteracy rate was 7.6%. Overall, 257 (77.9%) of the welders were aware of one or more workplace hazards. This was positively influenced by educational attainment, age, nature of training and work experience. Of the 330 respondents, 282 (85.3%) had experienced one or more work-related accidents in the preceding year. The most common injuries sustained were cut/injuries to the hands and fingers (38.0%), back/waist pain (19%), arc eye injuries/foreign bodies (17.0%), burns (14.0%), hearing impairment (7.0%), fractures (4.0%) and amputation (1.0%). Only 113 (34.2%) welders used one or more types of protective device with eye goggles (60.9%), hand gloves (50.3%) and boots (34.5%) being more frequently used. Regular use of safety device, shorter working hours and increasing experience were protective of occupational accidents. Conclusions: The level of awareness of occupational hazards was high with sub optimal utilization of protective measures against the hazards. There is therefore need for health and safety education of these workers for health and increased productivity.Fond: Des soudeuses sont expos\ue9es \ue0 une vari\ue9t\ue9 de risques professionnels avec des effets de sant\ue9 impropices. Cependant, peu est connu conscience de soudeuses' des risques sanitaires et de leur adh\ue9rence aux mesures de s\ue9curit\ue9 dans les pays en voie de d\ue9veloppement. Cette \ue9tude a \ue9valu\ue9 la conscience des risques professionnels et de l'adh\ue9rence aux mesures de s\ue9curit\ue9 parmi des soudeuses dans la m\ue9tropole de Kaduna au Nig\ue9ria nordique. M\ue9thodes: Un questionnaire structur\ue9 a \ue9t\ue9 administr\ue9 sur une section transversale de 330 soudeuses dans la m\ue9tropole de Kaduna au Nig\ue9ria nordique. L'information a \ue9t\ue9 cherch\ue9e sur leurs caract\ue9ristiques socio-d\ue9mographiques, leur conscience des risques professionnels et adh\ue9rence aux mesures de s\ue9curit\ue9. R\ue9sultats: Tous les soudeurs \ue9taient des m\ue2les avec un \ue2ge moyen de 35.7 \ub1 8.4 ann\ue9es. Le taux d'analphab\ue9tisme \ue9tait 7.6%. De fa\ue7on g\ue9n\ue9rale, 257 (77.9%) des soudeuses se rendaient compte d'un ou plusieurs risques de lieu de travail. Ceci a \ue9t\ue9 franchement influenc\ue9 par accomplissement \ue9ducatif, \ue2ge, nature de la formation et exp\ue9rience professionnelle. Des 330 r\ue9pondants, 282 (85.3%) avaient \ue9prouv\ue9 un ou plusieurs accidents travailler-connexes par ann\ue9e pr\ue9c\ue9dente. Les dommages les plus communs soutenus ont \ue9t\ue9 coup\ue9s/dommages aux mains et aux doigts (38.0%), douleur arri\ue8re/taille (19%), dommages d'oeil d'arc/corps \ue9trangers (17.0%), br\ufblures (14.0%), affaiblissement d'audition (7.0%), ruptures (4.0%) et amputation (1.0%). Seulement 113 (34.2%) soudeuses ont employ\ue9 un ou plusieurs types de dispositif protecteur avec des lunettes d'oeil (60.9%), des gants de main (50.3%) et des initialisations (34.5%) plus fr\ue9quemment \ue9tant employ\ue9es. L'utilisation r\ue9guli\ue8re du dispositif de s\ue9curit\ue9, les heures de travail plus courtes et l'exp\ue9rience croissante \ue9taient protectrices des accidents professionnels. Conclusions: Le niveau de la conscience des risques professionnels \ue9tait \ue9lev\ue9 avec l'utilisation optimale secondaire des mesures de sauvegarde contre les risques. Il y a donc besoin d'\ue9ducation de salubrit\ue9 et de s\ufbret\ue9 de ces ouvriers pour la sant\ue9 et la productivit\ue9 accrue