Socio-demographic determinants of cigarette smoking among adults attending a community based health screening program in Lagos, Nigeria

Background: Socio-demographic factors and knowledge of harmful health effects of tobacco are important factors that may influence smoking behavior. We aimed to determine the socio demographic factors associated with cigarette smoking among adults who voluntarily attended a free health screening program.Methods: We recruited consecutive participants and used a structured questionnaire to obtain their socio-demographic profile, cigarette smoking behavior and their knowledge of the harmful health effects of tobacco smoking. We determined the factors associated with cigarette smoking by stepwise logistic regression.Results: There were 238 participants (age range 25 years to 64.years, mean=43.2±9.6 years, 55% male). There were 45 (18.9%) ever cigarette smokers and 44 (97.8%) of all ever smokers were males. Prevalence of current cigarette smoking was 12 (5%) among all participants. All current smokers were males, 50% had tertiary education and over 80% were in occupational class 3-5. 83.3% of current smokers desired to quit but did not have access to smoking cessation services. 10.9% of all participants had good knowledge of the harmful health effects of cigarette smoking, 29.4%had some knowledge and 59.7%had little knowledge. There was no significant relationship between the level of knowledge and smoking behavior. Male gender and not taking alcohol regularly were significant determinants of being an ever smoker.Conclusion: Social factors such as older age, higher education and lower occupational class influence tobacco smoking behavior among adults in Lagos and the level of knowledge of harmful health effects of tobacco is low among all participants. There is need to design tobacco control programs targeted at adults in the community and the establishment of smoking cessation clinics and support groups to assist smokers to quit.Keywords: Tobacco, Smoking, Prevalence, Knowledge, Communit

Peak Expiratory Flow as a Surrogate for Health Related Quality of Life in Chronic Obstructive Pulmonary Disease: A Preliminary Cross Sectional Study

Background: Health Related Quality of Life (HRQL) measures can capture the non-respiratory effects of Chronic Obstructive Pulmonary Disease (COPD). However the relationship with Peak Expiratory Flow (PEF) is not well understoodAim: To determine the relationship of PEF and quality of life measurements in patients with COPD Settings and Design: A cross section of consecutive patients in a university clinicMethods: Stable patients with COPD defined by the Global Initiative on chronic Obstructive Lung Disease (GOLD) criteria, were recruited into the study. Spirometry was done using American Thoracic Society’s standards and  reference equations from African American norms of the US population. Quality of life was measured with the St George’s Respiratory Questionnaire (SGRQ)Results: Out of 50 patients recruited for the study, 48 provided complete data with acceptable spirometry and PEF data. The mean (SD) age and body mass index was 68.4 (8.9) years and 21.4 (4.6) kg/m2 respectively and 96% of the patients were in moderate-severe stages of COPD using the GOLD criteria. Percent predicted PEF correlated with percent predicted FEV1; r= 0.559 p<0.001 and also showed a significant, though moderate correlation between PEF readings and SGRQ scores especially in the activity (r= -0.455 p< 0.01) and total scores (r=-0.415 p<0.01) for pre bronchodilator (BD) percent predicted PEF. In regression analysis, PEF was associated with SGRQ (-0.11 95% CI -0.19, -0.03) after adjusting for age, sex, height, smoking and disease severityConclusions: PEF correlates with SGRQ scores and may be a useful surrogate for HRQL in patients with COPDKey words: Peak expiratory flow, quality of life, spirometry, primary car

Unmet needs in asthma treatment in a resource-limited setting: Findings from the survey of adult asthma patients and their physicians in Nigeria

Introduction: The prevalence of asthma in our society is rising and there is need for better understanding of the asthma patients’ perception andtreatment practice of physicians. The study was aimed at determining asthma attitudes and treatment practices among adult physicians andpatients in Nigeria, with the goal of identifying barriers to optimal management.Methods: To assess asthma attitudes, treatment practices and limitations among adult physicians and patients in Nigeria, a questionnaire survey was conducted among 150 patients and 70 physicians.Results: Majority (66.7%) of the patients reported their asthma as  moderate to severe, 42.7% had emergency room visit and 32% had admission due to asthma in the previous 12 months. Physicians and patients perceptions significantly differed in the time devoted to  educational issues (31.4% vs.18.7%) and its contents: individual  management plan (64.3% vs.33.3%), correct inhaler technique (84.0% vs.71.0%), medication side effects (80.0% vs.60.0 %) and compliance 100% of time (5.7% vs. 18.7%). Patients reported that non-compliance with medication causes increased symptoms (67.0%), exacerbations (60.0%), bronchodilator use (56.0%), urgent physician visit (52.0%) and hospitalizations /ER visits (38.7%). Asthma medication in patients caused short term (10.7%) and long term side effects (20.0%). Due to side  effects, 28.0% skipped and stopped their medications. Most physicians (85.7%) and patients (56.0%) agreed on the need for new medication options. The need for new medication in patients was strongly related to asthma severity, limitation of activities, side effects, cost and lack of satisfaction with current medication. With the exception of pulmonologists, physicians did not readily prescribe ICS and their prescriptions were not in line with treatment guidelines.Conclusion: This study has highlighted the gaps and barriers to asthma treatment which need to be addressed to improve the quality of care in Nigeria

Perspectives from the 2nd International Post-Tuberculosis Symposium: mobilising advocacy and research for improved outcomes

In 2020, it was estimated that there were 155 million survivors of TB alive, all at risk of possible post TB disability. The 2nd International Post-Tuberculosis Symposium (Stellenbosch, South Africa) was held to increase global awareness and empower TB-affected communities to play an active role in driving the agenda. We aimed to update knowledge on post-TB life and illness, identify research priorities, build research collaborations and highlight the need to embed lung health outcomes in clinical TB trials and programmatic TB care services. The symposium was a multidisciplinary meeting that included clinicians, researchers, TB survivors, funders and policy makers. Ten academic working groups set their own goals and covered the following thematic areas: 1) patient engagement and perspectives; 2) epidemiology and modelling; 3) pathogenesis of post-TB sequelae; 4) post-TB lung disease; 5) cardiovascular and pulmonary vascular complications; 6) neuromuscular & skeletal complications; 7) paediatric complications; 8) economic-social and psychological (ESP) consequences; 9) prevention, treatment and management; 10) advocacy, policy and stakeholder engagement. The working groups provided important updates for their respective fields, highlighted research priorities, and made progress towards the standardisation and alignment of post-TB outcomes and definitions

Self-reported asthma symptoms among adults aged 20-30 years in a Nigerian university: a cross sectional study

Background: Despite concerns about the increasing incidence of asthma in developing countries, there is insufficient data on burden and risk factors for asthma among adults in sub-Saharan Africa. The aim of thisstudy was to determine the prevalence of asthma among young adults in north-central Nigeria. Methods: This cross-sectional study was carried among 20-30 year old medical undergraduates of the University of Jos, Nigeria. A modified version of the European Community Respiratory Health Survey stage 1questionnaire was administered to subjects to obtain bio data, asthma symptoms, and possible risk factors. Factors associated with current asthma symptoms were evaluated using logistic regression models. Results: A total 177 of 185 questionnaires were returned(response rate 95.7%). Forty two (22.7%) persons reported at least one asthma symptom in the 12 months preceding the study, with 16.4% (29) reporting episodes of recurrent wheeze. Nine persons (5.1%) had a previous diagnosis of asthma; 24.1% among persons with recurrent wheeze in 2 the 12 months preceding the study (x2 =24.59; p<0.01).There was no association between asthma and household smoking, cooking fuel and parental level of education. Conclusions: We found a high frequency of asthma symptoms among persons aged 20-30 years. Risk factors for asthma in this population require further evaluation.Keywords: Bronchial Asthma, Sub-Saharan Africa, Lung disease, Obstructive lung disease, Respiratory disease.High Med Res J 2013;13:8-1

The diagnostic yield and safety of fine needle aspiration of intrathoracic hydatid cysts: A three-year retrospective study

Geneeskunde en GesondheidswetenskappeAnatomiese PatologiePlease help us populate SUNScholar with the post print version of this article. It can be e-mailed to: [email protected]