Impact of a Pharmacist-led Educational Intervention on knowledge of antibiotics among mothers of under-five children attending vaccination clinics in Delta State, Nigeria

Background. The extent of mothers’ knowledge about antibiotics largely determines their use in children. Objectives. This study assessed knowledge of antibiotics among mothers’ of under-fives and the immediate impact of a pharmacist-led educational intervention on knowledge scores Methods. A prospective interventional study was conducted among mothers of under-five children. The preintervention knowledge scores were determined with the aid of an antibiotic knowledge questionnaire which was interviewer-administered. An educational intervention which focused on all aspects of knowledge of antibiotic use covered by the questionnaire was administered by a pharmacist; thereafter the post intervention knowledge scores were determined using the same knowledge questionnaire. Overall knowledge scores were categorized into poor, moderate and good. The percentage change in the proportions of mothers who had good scores was determined, Chi square test were performed to determine the relationship between knowledge scores and having a family member as a healthcare professional and paired t-test was done to determine impact of the intervention on the mean scores on each knowledge question. P values ≤ 0.05 were statistically significant.Results. A total of 253 mothers participated in the study from two centres. Twenty-one mothers (7.7%) had good knowledge on antibiotics at baseline which increased to 138 (50.6%) after an educational intervention. Knowledge scores for each item also improved post-intervention with least pre-intervention mean scores increasing from 0.25(SD=0.44) to 0.67(SD=0.47), p<0.0001 and 0.18(SD=0.39) to 0.73 (SD=0.44),p<0.0001 at the Warri and Ughelli centres respectively post-intervention. The knowledge questions with the highest scores also increased from mean score of 0.79 (SD= 0.41) to 0.90 (SD= 0.30) at p=0.0041 in the Warri centre and 0.83 (SD= 0.26) to 0.93 (SD=0.26) at p=0.0448 in the Ughelli centre post- intervention. Other items such as knowledge of diarrhoea being a side effect of some antibiotics, completing full course of antibiotics for a child if symptoms improved also improved significantly. Conclusion. This study found out that a pharmacist-led educational intervention had a measurable impact on mothers’ knowledge of antibiotics use in children

Antibiotics use in children: Practice predictors among mothers of under–fives

In the developing countries, drug administration in children under the age of five is a task mostly undertaken by mothers. Parental practices in the use of antibiotics   in children can determine the extent of the therapeutic benefit and the development of resistance. This study investigated mothers’ practices on use of antibiotics in children and determined the possible socio-demographic predictors of good practice. Mothers of at least a child under the age of five were interviewed to determine their use of antibiotics in children and summary and inferential statistical analysis were conducted. Of the 313 mothers interviewed, 119(38%) had overall poor practice. One hundred and eighty-eight (60.1%) used antibiotics when their children had catarrh and sore throats, 195(62.3%) stopped giving antibiotics when their children felt better before completing the dose, 260(83.1%) saved some antibiotics at home in case of future use, 126(40.3%) gave antibiotics without the doctor’s prescription. Older mothers had a greater likelihood to save some antibiotics at home in case of future use, OR=1.087,95%CI-1.016-1.163,  increasing age of first child decreases the odds of requesting antibiotics from the doctor OR=0.989, 95% CI:0.981-0.997 while increasing number of children had almost a two-fold increase on the likelihood to request for antibiotics, OR=1.624,95% CI=1.05-2.386. Attaining a tertiary level of education had over a two-fold (OR=2.337, 95% CI=1.063-5.137) and a three-fold (OR=3.262,95% CI= 1.566-6.802) increase on the odds of giving antibiotics to a child without a doctor’s advice and reading information leaflets respectively. There was a significant difference between self- perceived practice level and actual practice level (P=0.01). A good proportion of mothers had less than adequate antibiotics practice levels and some demographic factors predicted practice. Advocacy should be employed to improve practices associated with antibiotics use in children in the developing countries

Drug utilisation in renal patients being treated in Central Hospital Warri and Delta State University Teaching Hospital Oghara

Chronic kidney disease is a major public health burden because the incidence, prevalence and the associated cost of therapy is on the increase. The objective of the study therefore was to determine the use of drugs in patients with chronic kidney disease. This prospective cross-sectional study was conducted in the Renal Unit of the Warri Central Hospital and Nephrology Department of the Teaching Hospital Delta State University Oghara. A data collection form was used to collect data on drug use patterns. Patient information on socio-demographic characteristics, medication use patterns, as well as clinical and biochemical parameters were extracted from the patients’ case folders. A comprehensive study of case folders and follow up was also conducted. Angiotensin converting enzyme inhibitors 179 (98.4%), diuretics 128 (70.3), and calcium channel blockers 49 (26.9%) were the most frequently prescribed classes of antihypertensive medications. Quinolones 58(31.9) and penicillins 22(12.1) were the most frequently prescribed classes of antibiotics. On the other hand, phosphate binders and proton pump inhibitors were prescribed in the proportion of 74 (40.7%) and 31 (17%) respectively. Metformin 11.5% and Gliclazide 2.7% were the most frequently prescribed oral antidiabetic agents. However, mixtard insulin was prescribed in the proportion of 12.6%. The most frequently prescribed medications were antihypertensive drugs, followed by antibiotics and haematinics, while the most frequently prescribed antihypertensive drugs were angiotensin converting enzyme inhibitors and diuretics. The most frequently prescribed antidiabetic medications were insulins and biguanides. Additionally, quinolones and penicillins were the most frequently prescribed antibiotics

Adherence to International Guidelines in the Management of Hypertension in a Tertiary Hospital in Nigeria

Purpose: The role of physicians in the overall management of hypertension and their adherence to the JNC VII, WHO/ISH and ESH guidelines were examined in this study. Method: Case notes of hypertensive patients diagnosed between 1 January 2004 and 30 September 2005, in the Cardiology Clinic of University of Benin Teaching Hospital were retrieved for evaluation. They were assessed for adherence to the JNC VII, WHO/ISH and ESH guidelines, in the management of hypertension. Result: Five hundred and one case notes were used in the study. Prevalence of hypertension was highest in the Grade 2 category (36%). More women (60%) than men (40%) were affected, with a diagnostic mean systolic blood pressure (SBP); male (164.0mmHg ± 21.9), female (163.7 mmHg ± 18.8) and mean diastolic blood pressure (DBP); male (100.1 mmHg ± 13.2), female (97.3 mmHg ± 13.1). After commencing treatment, mean SBP and DBP for male and female were (131.8 mmHg ± 11.6; 84.3 mmHg ± 7.5), and (132.3 mmHg ± 11.5 83.2 mmHg ± 7.6), respectively. The commonest co-morbidity was diabetes mellitus (18%). Co-morbidity was commonest in Grade 2 (34%) and Grade 3 hypertension (34%). Almost half of the subjects (49%) were on a two-drug combination while 14% were on monotherapy. Calcium channel blockers were the most commonly prescribed anti-hypertensive drug (31%) followed by diuretics (30%). In combination drug regimen, diuretics were the commonest (74%). There was no evidence of body weight management in hypertension. Conclusion: Physicians in this hospital fairly complied with the stated guidelines, but do not appear to have recommended lifestyle modifications to their hypertensive patients