KNOWLEDGE, ATTITUDE AND RISK PERCEPTION OF COVID-19 AMONG NIGERIANS

Background: COVID-19 emerged as a novel disease with global health importance. Personal and collective behaviours have been modified to prevent the spread of this pandemic. Objectives: To assess the knowledge, attitude and risk perception of Nigerians towards COVID-19. Method: A cross-sectional survey was conducted between the 30th of April and 17th of May 2020 with a national representative across Nigerians using a combination of online and interviewer administered questionnaire. Results: A total of 1,135 respondents participated in the study with a slight male preponderance (M: F=1.5:1). The mean age of the participants was 42±12.2 years with the majority (77%) between the ages of 26 and 55 years. The majority were aware of the pandemic, mostly through mass and social media. Most of the respondents demonstrated good knowledge of COVID-19 but the unaware minority (0.6%) were likewise uneducated. Educational status had no significant association with attitude towards hand washing and wearing of facemask (p>0.05). Risk perception was however low to moderate despite their concerns on COVID-19 and lack of trust in the governments’ response to the disease. Conclusion: The risk perception of COVID is not encouraging, hence more advocacy and public orientation must be done to curb further spread of COVD-19 in our setting

Point-of-Care Testing for Anaemia in Children Using Portable Haematocrit Meter: A Pilot Study from Southwest Nigeria and Implications for Developing Countries

BACKGROUND: Prompt and accurate diagnosis is needed to prevent the untoward effects of anaemia on children. Although haematology analyzers are the gold standard for accurate measurement of haemoglobin or haematocrit for anaemia diagnosis, they are often out of the reach of most health facilities in resource-poor settings thus creating a care gap. We conducted this study to examine the agreement between a point-of-care device and haematology analyzer in determining the haematocrit levels in children and to determine its usefulness in diagnosing anaemia in resource-poor settings.METHODS: EDTA blood samples collected from participants were processed to estimate their haematocrits using the two devices (Mindray BC-3600 haematology analyzer and Portable Mission Hb/Haemotocrit testing system). A pairwise t-test was used to compare the haematocrit (PCV) results from the automated haematology analyzer and the portable haematocrit meter. The agreement between the two sets of measurements was assessed using the Bland and Altman method where the mean, standard deviation and limit of agreement of paired results were calculated.RESULTS: The intraclass and concordance correlation coefficients were 0.966 and 0.936. Sensitivity and specificity were 97.85% and 94.51% respectively while the positive predictive and negative predictive values were 94.79% and 97.73%. The Bland and Altman`s limit of agreement was -5.5 ̶ 5.1 with the mean difference being -0.20 and a non-ignificant variability between the two measurements (p = 0.506).CONCLUSION: Haematocrit determined by the portable testing system is comparable to that determined by the haematology analyzer. We therefore recommend its use as a point-of-care device for determining haematocrit in resource-poor settings where haematology analyzers are not available.KEYWORDS: Child health, Anaemia, Point-of-Care devices, Early diagnosis and treatment, Nigeri

UNCOVERING THE REALITY OF EVIDENCE-BASED MEDICINE IN SOUTHWEST NIGERIA: A CROSS-SECTIONAL SURVEY OF SURGERY DEPARTMENTS IN FIVE TERTIARY HOSPITALS

INTRODUCTION: There is no emphasis on evidence-based medicine (EBM) in either the undergraduate or postgraduate curriculum in Nigeria. EBM training is based on ad hoc programs. OBJECTIVE: To determine the knowledge, attitude, and barriers to EBM and compare them to their competence in EBM MATERIALS AND METHOD: A composite questionnaire consisting of the McAllister knowledge and attitude questionnaire, the Zwolsman barrier questionnaire and 5 questions from the competence in EBM Berlin Questionnaire (BQ) was administered to 185 surgeons and trainees in five hospitals in SW Nigeria. RESULT: 169 of the questionnaires were deemed suitable for inclusion in the study. The respondents were 57 surgeons and 112 trainees. This consisted of 122 EBM-users who always/often use EBM in their practice and 47 nonusers who rarely/never use EBM. The majority of both groups still rely on traditional sources of information in their clinical practice. Even though EBM-users (28.0 % points) scored significantly higher on the BQ than nonusers (23.8 %points), there was no difference in their performance on the McAllister and Zwolsman questionnaires. Paradoxically, those with prior training in EBM were not more likely to use EBM than those without training, and there were no significant differences in their BQ scores CONCLUSION: Surgeons in Nigeria have a reasonable level of awareness and use of EBM, but their knowledge and confidence in its application is low. Our findings indicate that the quality of EBM training in the region needs to be reevaluated

Evaluating the factor structure, reliability and validity of the Copenhagen Burnout Inventory-Student Survey (CBI-SS) among faculty of arts students of Ekiti State University, Ado-Ekiti, Nigeria

Abstract The Copenhagen burnout inventory-student survey (CBI-SS) has shown promising psychometric properties in diverse student populations. This study aims to investigate the psychometric properties of the Nigerian version of the CBI-SS. This was a cross-sectional study of 635 students from Ekiti State University, Ado-Ekiti, Nigeria. Confirmatory factor analysis (CFA) was utilized to assess the CBI-SS validity. The reliability score of the CBI-SS was 0.957, ranging from 0.862 to 0.914 for the subscales. Correlation coefficients among the four CBI-SS factors ranged from 0.507 to 0.713. The CFA indicated an adequate goodness-of-fit for the four-factor model of the CBI-SS with the sample data. However, Item 10 was removed due to unacceptably low Average Variance Extracted score. The four factors demonstrated a negative correlation with both General Academic Self-Efficacy Scale and Cumulative Grade Point Average. Furthermore, both self-reported burnout and perceived course stress showed associations with the CBI-SS, where lower levels of burnout corresponded with lower median scores on the CBI-SS scales. This study underscores the significance of the CBI-SS in evaluating student burnout within our student population. The findings indicate that the CBI-SS is a highly reliable and valid instrument for assessing student burnout, suggesting its potential for effective utilization in the Nigerian academic context

Resultados de tratamento cirúrgico da pseudoartrose de fratura diafisária do úmero com placa de compressão dinâmica e enxerto de osso esponjoso Results of surgical treatment of nonunion of humeral shaft fracture with dynamic compression plate and cancellous bone grafting

OBJETIVO: Avaliamos o tratamento da pseudoartrose de fratura diafisária do úmero com placa de compressão dinâmica de janeiro de 2002 a dezembro de 2009. MÉTODOS: Vinte e dois pacientes foram tratados durante o período do estudo. O trauma foi a causa predominante de lesão em 86,4% dos pacientes. RESULTADOS: A pseudoartrose foi atrófica em 81,8% e hipertrófica em 18,2% dos indivíduos. Havia lesão primária do nervo radial nervo em 27,3% dos pacientes. Todos os participantes tinham fratura fechada à apresentação e 81,2% deles tinham recebido tratamento anterior de traditional bone setters (pessoa que faz a redução de ossos quebrados ou deslocados, geralmente sem ser médico licenciado) e 18,8% tinham falha do tratamento conservador com gesso. O tempo médio até a união foi 16 semanas. O tratamento anterior com traditional bone setters afetou significantemente o tempo de consolidação da fratura (p < 0,05). Todas as fraturas tiveram consolidação bem-sucedida. CONCLUSÃO: Concluímos que o uso de placa de compressão dinâmica continua a ser uma opção eficaz de tratamento da pseudoartrose de fratura diafisária do úmero. Nível de evidência III, Estudo retrospectivo.<br>OBJECTIVE: We evaluated the treatment of nonunion of humeral shaft fracture with dynamic compression plate from January 2002 to December 2009. METHODS: Twenty two patients were treated over the study period. Trauma was the predominant cause of injury in 86,4% of the patients. RESULTS: Nonunion was atrophic in 81,8% and hypertrophic in 18,2% of the individuals. There was a primary injury of the radial nerve in 27,3% of the patients. All the participants had closed fracture at presentation, and 81,2% had received previous treatment from traditional bone setters and 18,8% had failure of the conservative cast management.The average time to healing was 16 weeks. Previous treatment from traditional bone setters significantly affected the time to fracture healing (p<0,05). All fractures had successful union. CONCLUSION: It was concluded that dynamic compression plating remains an effective treatment option for nonunion of humeral shaft fracture. Level of Evidence III, Retrospective study

The high cost of healing and teaching: a cross-sectional survey of burnout among academic physicians in Nigeria

Abstract Background Globally, the medical and teaching professions are two major professions with the highest prevalence of burnout, and academic physicians bestride the two professions. This study investigated the prevalence and associated factors of burnout among academic physicians working in tertiary hospitals in Nigeria. Methodology This was a self-administered online survey. Burnout was measured using the Maslach Burnout Inventory for Educators (MBI-ES) on Google Form and sent to 256 academic physicians in tertiary hospitals across Nigeria using the WhatsApp broadcast feature. MBI-ES was categorized into two categories (Burnout and No Burnout), and binary logistic regression was used to test the influence of 13 predictors on the three dimensions of MBI-ES as well as MBI in its entirety. Findings A total of 155 academic physicians responded, resulting in a response rate of 60.5%. There were 121 (80.7%) males and 29 (19.3%) females (five cases respondents omitted this detail). Eighty-seven respondents exhibited moderate to high burnout in at least one of the dimensions of the MBI, translating to a prevalence rate of 57.7% in our study. Five variables, number of peer reviewed articles published, hours of weekly teaching, enjoyment of academic writing, apathy to teaching and religion were all significantly associated with burnout. Moderate to high emotional exhaustion was reported by 30.8% (45 respondents), moderate to high depersonalization by 5.5% (8 respondents),, and low to moderate personal accomplishment by 43.5% (67 respondents).Eight variables: religion, geopolitical zone of practice, enjoyment of academic writing, apathy toward teaching, university ownership, number of published peer-reviewed articles, salary, and supplementary income were significantly associated with emotional exhaustion, while the number of weeks spent teaching in a year and teaching hours/week were significantly associated with depersonalization and personal accomplishment, respectively. Age (OR 1.302, CI 1.080–1.570), Teaching hours/week (OR 0.924, CI 0.854–0.999), Salary (OR 0.996, CI 0.993-1.0), and supplementary salary (OR 0.996, CI 0.993–0.999) were found to significantly predict emotional exhaustion. Conclusion The study reveals a high prevalence of burnout (57.7%) among academic physicians in Nigeria, highlighting an urgent need for targeted interventions and policy changes. Given the significant role these professionals play in healthcare and medical education, immediate action is essential to address this issue. Future research should focus on evaluating the effectiveness of preventive measures and exploring the long-term impacts of burnout

The functional outcome after tumor resection and endoprosthesis around the knee: a systematic review.

The evidence for the functional outcome of endo- prosthetic replacement (EPR) after tumour resection has been from few cohort studies. A scoping search revealed no systematic review on patient reported outcome measures after EPR around the knee. The purpose of this study was to evaluate the functional outcome of distal femoral and proximal tibial EPR after tumour resection. A systematic review was conducted using the PRISMA guidelines. The search identified 2560 articles from MEDLINE, EMBASE, CINAHL, and Web of Science. 36 studies satisfying the selection criteria were included for data synthesis. Pooled analysis was performed for homogenous studies. Narrative synthesis was performed for all the studies due to heterogeneity in methodological and statistical analysis. Amongst the overall patient population of 2930, mean ages ranged from 18-66 years and the mean follow up periods in the studies ranged from 12 - 180 months. The weighted mean functional outcome was similar for patients who had DFEPR and PTEPR. The functional outcome scores of Rotating Hinge Knee implants (RHK) were significantly greater than that for Fixed Hinge Knee implants (FHK). The weighted mean functional outcome scores were higher after cemented fixation and after primary EPR procedures. The current evidence suggests that functional out- come after EPR in the knee is good, and RHK implants are better than FHK implants. Functional outcome after primary EPR was significantly better than following revision EPR, and this underscores the importance of minimising complications at the primary surgery

Public perceptions and experiences of COVID-19 pandemic in Ekiti: A qualitative study using thematic analysis

Background: COVID-19 pandemic has been a turbulent crisis that took the globe by surprise, killing thousands of people. Nonetheless, individuals with underlying conditions are considered to be at risk. Aim: The study examined public perceptions of the vulnerability influencing the spread of COVID-19 in Ekiti State, Nigeria. Materials and Methods: The study used a qualitative method in which 65 participated in focus group discussions to elicit information about the subject matter. Thematic analysis was used to analyse field data. Results: The study found that vulnerability to COVID-19 was based on the following themes: immunity, imported, complications, lack of knowledge, recklessness and anyone. As a result, the study concluded that individuals can be vulnerable to COVID-19 if the person has weakened or impaired immunity and that the virus was imported from other countries. Conclusion: In addition, having any of the following underlying conditions such as asthma, diabetes, heart or liver or being ignorant of the spread of the virus, and failing to follow COVID-19 containment guidelines can make people more vulnerable to the virus. Recommendations: The study, therefore, recommends that health education about the virus be implemented. This could be directed towards strengthening beliefs that conform to accepted scientific views of COVID-19 and weakening those that do not. Notably, the public should be encouraged to follow COVID-19 containment guidelines, which include wearing a face masks, washing and sanitising our hands, and social distancing