Patients' Satisfaction with the Healthcare Services at a North Central Nigerian Tertiary Hospital

BACKGROUND: This study sought to determine the level of satisfaction of patients with the healthcare services at Federal Medical Centre, Bida (FMCB) Nigeria and the factors associated with patients' satisfaction.METHODS: The study utilized exit interview of 480 patients, sampled at the 9 service points of the Centre. The questions covered socio-demographic factors and the 3 core elements of healthcare service deliverynamely quality, access and interpersonal issues. The evaluation of satisfaction on the 5 point Likert scale were categorized into dissatisfied {very dissatisfied, dissatisfied and Neutral}and satisfied {satisfied andvery satisfied}, setting the threshold for satisfaction at a relatively higher level.RESULTS: On the overall, 78.5% of them were satisfied with the hospital services and 78.3% had their expectations met. Satisfaction was lowest (72.7%) at the revenue section and highest (96.1%) at the maternity section. Nine of every 10 respondents (91.7%) would recommend the facility to a friend. The patients' satisfaction had significant positive correlation with promptness of staff, communication level of staff, staffrelationship with patients, environmental cleanliness and comfort facilities. Cost of services and delay in obtaining services had negative but relatively weak correlation with satisfaction.CONCLUSION: The observed level of patients' satisfaction at FMC Bida is high. This can be maintained and enhanced by improvement in waitingtime, sustenance of the satisfactory hospital ambiance and staff attitude/aptitude. However, enlightenment of the hospital patients on the status of the hospital and the nature of services offered is necessary.KEYWORDS: patient satisfaction; quality of healthcare; tertiary hospital; Nigeri

Knowledge, Attitude and Practice of Confidentiality of Patients' Health Records among Health Care Professional at Federal Medical Centre, Bida

No Abstrac

The epidemiology of HIV and HSV-2 infections among women participating in microbicide and vaccine feasibility studies in Northern Tanzania.

OBJECTIVES: To prepare for future HIV prevention trials, we conducted prospective cohort studies among women working in food and recreational facilities in northern Tanzania. We examined the prevalence and incidence of HIV and HSV-2, and associated risk factors. METHODS: Women aged 18-44 years working in food and recreational facilities were screened to determine their eligibility for the studies. Between 2008-2010, HIV-negative women were enrolled and followed for 12 months. At enrolment and 3-monthly, we collected socio-demographic and behavioural data, and performed clinical examinations for collection of biological specimens that were tested for reproductive tract infections. Risk factors for HIV and HSV-2 incidence were investigated using Poisson regression models. RESULTS: We screened 2,229 and enrolled 1,378 women. The median age was 27 years (interquartile range, IQR 22, 33), and median duration working at current facility was 2 years. The prevalences of HIV at screening and HSV-2 at enrolment were 16% and 67%, respectively. Attendance at the 12-month visit was 86%. HIV and HSV-2 incidence rates were 3.7 (95% confidence interval, CI: 2.8,5.1) and 28.6 (95% CI: 23.5,35.0)/100 person-years, respectively. Women who were separated, divorced, or widowed were at increased risk of HIV (adjusted incidence rate ratio, aRR = 6.63; 95% CI: 1.97,22.2) and HSV-2 (aRR = 2.00; 95% CI: 1.15,3.47) compared with married women. Women reporting ≥3 partners in the past 3 months were at higher HIV risk compared with women with 0-1 partner (aRR = 4.75; 95% CI: 2.10,10.8), while those who had reached secondary education or above were at lower risk of HSV-2 compared with women with incomplete primary education (aRR = 0.42; 95% CI: 0.22,0.82). CONCLUSIONS: HIV and HSV-2 rates remain substantially higher in this cohort than in the general population, indicating urgent need for effective interventions. These studies demonstrate the feasibility of conducting trials to test new interventions in this highly-mobile population

Seroprevalence, predictors and estimated incidence of maternal and neonatal Herpes Simplex Virus Type 2 infection in semi-urban women in Kilifi, Kenya

Background: Herpes Simplex Virus type 2 (HSV-2) has public health importance as a leading cause of genital ulcers, a co-factor in HIV-1 acquisition and transmission and as a cause of neonatal herpes infections. Little is known of its epidemiology and burden in Coastal Kenya. Methods: We screened plasma samples for HSV-2 infection from 826 women aged 15-34 years who participated in an HIV-1 survey in Kilifi in 2004. The sample comprised 563 women selected randomly from a demographic surveillance system (DSS) and 263 women who presented for voluntary counseling and testing (VCT). Predictors for HSV-2 seropositivity were determined using multivariate logistic regression. The incidence of HSV-2 infection and risk of neonatal herpes were estimated by a simple catalytic model fitted to age-seroprevalence data. Results: HSV-2 prevalence was 32% in the DSS recruits vs. 44% in the VCT recruits (P < 0.001), while, HIV-1 prevalence was 8% in the DSS recruits vs. 12% in the VCT recruits (P = 0.12). Independent risk factors for HSV-2 infection in all women were: older age (30-34 years; odds ratio (OR) 10.5, 95% confidence interval (CI): 5.2 - 21.0), recruitment from VCT (OR 1.5, 95% CI: 1.1 - 2.1), history of genital ulcers (OR 1.7, 95% CI: 1.2 - 2.3) and HIV infection (OR 2.7, 95% CI: 1.6-4.6). Education beyond primary (OR 0.7, 95% CI: 0.5 - 0.9) was inversely associated with HSV-2 infection. In the DSS sample, HSV-2 incidence was estimated at 4 cases (95% CI: 3.3 - 4.4) per 100 women per year, 17 cases (95% CI: 16-18) per 1,000 pregnancies per year and 33 neonatal cases (95% CI: 31-36) per 100,000 births per year. Conclusions: HSV-2 transmission is rapid following the onset of sexual activity and likely to result in a significant burden of genital ulcer disease. Nevertheless, the burden of neonatal HSV-2 can be predicted to be low. Educating young women about HSV-2 infection may help in reducing its burden in this semi-urban population

Globally significant greenhouse-gas emissions from African inland waters

Carbon dioxide emissions to the atmosphere from inland waters-streams, rivers, lakes and reservoirs-are nearly equivalent to ocean and land sinks globally. Inland waters can be an important source of methane and nitrous oxide emissions as well, but emissions are poorly quantified, especially in Africa. Here we report dissolved carbon dioxide, methane and nitrous oxide concentrations from 12 rivers in sub-Saharan Africa, including seasonally resolved sampling at 39 sites, acquired between 2006 and 2014. Fluxes were calculated from published gas transfer velocities, and upscaled to the area of all sub-Saharan African rivers using available spatial data sets. Carbon dioxide-equivalent emissions from river channels alone were about 0.4 Pg carbon per year, equivalent to two-thirds of the overall net carbon land sink previously reported for Africa. Including emissions from wetlands of the Congo river increases the total carbon dioxide-equivalent greenhouse-gas emissions to about 0.9 Pg carbon per year, equivalent to about one quarter of the global ocean and terrestrial combined carbon sink. Riverine carbon dioxide and methane emissions increase with wetland extent and upland biomass. We therefore suggest that future changes in wetland and upland cover could strongly affect greenhouse-gas emissions from African inland waters