Exercise Induced Bronchospasm and associated factors in primary school children: a cross-sectional study

Abstract Background Exercise Induced Bronchospasm(EIB) is not equivalent to asthma. As many as 20%of school aged children are estimated to have EIB. In Nigeria, there is still a dearth of information on EIB as a clinical entity. This study determined the presence of EIB(using pre and post-exercise percentage difference in peak expiratory flow rate(PEFR) and associated factors such as age, gender, social class and nutritional status in primary school children in Nnewi, Anambra state, South-East Nigeria. The study also grouped those with EIB into those with asthma(EIBA) and those without asthma(EIBWA). Methods This was a community based cross-sectional study involving 6–12 year olds. The PEFR was taken at rest and after a 6 min free running test on the school play-ground using a Peak Flow Meter. A diagnosis of EIB was made if there was a decline of ≥ 10%. Those who had EIB were grouped further based on the degree of decline in post-exercise PEFR (a decline ≥ 10% < 25% → Mild EIB, ≥ 25% < 50% → Moderate EIB and ≥ 50% → Severe EIB) and then categorized as those with EIBWA/EIBA. Results EIB in the various minutes post-exercise was as follows: 19.2%(1stmin), 20.9%(5thmin), 18.7%(10thmin), 10%(20thmin), 0.7%(30thmin). Mild EIB accounted for the greater proportion in all minutes post-exercise and none of the pupils had severe EIB. Using values obtained in the 5thmin post-exercise for further analysis, EIBWA/EIBA = 84.1%/15.9% respectively. Mean difference in the post-exercise PEFR of EIB/no EIB and EIBWA/EIBA was -48.45(t = -7.69, p =  < 0.001) and 44.46(t = 3.77, p = 0.01) respectively. Age and gender had a significant association to the presence of EIB and 58% of the pupils with EIB were of high social class. The BMI for age and gender z-scores of all study subjects as well as those with EIB was -0.34 ± 1.21, -0.09 ± 1.09 respectively. Other features of allergy(history of allergic rhinitis: OR–5.832, p = 0.001; physical findings suggestive of allergic dermatitis: OR–2.740, p = 0.003)were present in pupils diagnosed with EIB. Conclusion EIB has a high prevalence in primary school children in Nnewi and the greater proportion of those with EIB had EIBWA. EIB therefore needs to be recognized as a clinical entity and stratified properly based on the presence or absence of asthma. This will help the proper management and prognostication

Knowledge and Compliance with Standard Precaution Among Healthcare Workers in A South-East Nigerian Tertiary Hospital

Background: Adherence to standard precautions (SP) is critical to reducing the burden of nosocomial infections. Objective: We assessed the knowledge and practice of SP among healthcare workers (HCWs). Methodology: A cross-sectional study was conducted among HCWs in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi Anambra State, Nigeria using self-administered questionnaire and key informant interview. Results: Mean age and employment duration of subjects were 33.4±11.9 and 6.0 ± 6.7 years, respectively. Majority of the 341 HCWs had heard about SP (82.1%) and agreed that it should be applied to all patient care (78.0%). Only 45.7% of them correctly cited ≥2 components of SP. Two-third of participants reported that SP was poorly practiced in their unit mainly due to inadequate supply of materials (63.1%), inadequate staff training/retraining (62.2%), inadequate support by management (51.4%) and unavailable standard operating procedures (SOPs) on SP (37.8%). Compliance with SP and specifically, personal protective equipment (PPE) use were 65.1% and 76.2%, respectively. Profession (p=0.023), awareness about SP (p&lt;0.001), SOP display in prominent places (p&lt;0.001) and regular supply of running water (p&lt;0.001) were significantly associated with SP compliance. Key informant interview revealed lack of written SP policies or its communication to HCWs, lack of training/retraining of HCWs and lack of materials required for SP practice. Conclusion: Knowledge of basic concept and practice of SP was not satisfactory among HCWs. Major barriers to SP were lack of materials, training and active support by hospital management. Awareness, SOP display in prominent places and regular supply of running water positively influenced SP compliance. Having written policies and communicating such to all HCWs, consistent supply of necessary materials, intensified training, and regular supervision are recommended Keywords: Universal precautions, Nosocomial infections, Tertiary hospitals, Health Personnel, Nigeri