Drug use indicators at a secondary health care facility in Lagos, Nigeria

Objective: Drug-use indicators were measured in a secondary health care facility in Lagos, Nigeria. Method: Retrospective prescribing data was used and patient records were selected using a systematic sampling method. Results:The average number of drugs per patient was 3.5=1= 1.4, 14% of patients received at least one injection and 55% of patients were prescribed at least one antibiotic. The injections were prescribed for a variety of indications where oral therapy could have been used. Antibiotics were prescribed largely for presumed infections. Conclusion: These indicators show that the level of drug use at the hospital is sub-optimal and need to be improved upon. Key Words: Drug-use; Indicators; Secondary health facilities; Lagos Journal of Community Medicine & Primary Health Care Vol.16(1) 2004: 21-2

Fertility and Occupational hazards: Review of the Literature

Workplace exposures and hazards have detrimental effects on many organ systems in the body including the reproductive system. The evidence of the reproductive effects of occupational hazards is obtainedthrough a synthesis of the available literature. These effects vary and overlap due to the multiple nature of exposures in the workplace. Hazardous agents include pesticides, solvents and heavy metals. Thereproductive effects include reduced fecundity, abnormal sperm quality, increased risk of low birth weight, miscarriages and permanent sterility. These problems are not readily identified as having occupational causes in developing countries such as Nigeria where infertility has a high family and social consequence. Epidemiological studies in Nigeria are needed to evaluate the reproductive effects of workplace exposures. Protective measures such as proper house keeping, education and the use ofpersonal protectives at the workplace are advocated (Afr J Reprod Health 2009; 13[1]:159-165)

A comparative assessment of public and private dots laboratories in the Lagos state TB control programme

Background: The purpose of the laboratory services within the framework of the NTP is to provide bacteriologic evidence for the diagnosis, follow-up of TB patients and to document cure at the end of treatment. However to be fully functional, laboratory commodities should be available as needed. This study compared the laboratory hygiene practices and availability of laboratory equipment and other consumables for making diagnosis of TB in public and private DOTS laboratories in Lagos State.Methods: A descriptive comparative cross sectional study comparing availability of commodities in public and private laboratories involved in TB services in Lagos State.Results: Seventeen DOTS laboratories and 34 laboratory scientist/technician were recruited for this study. About three quarter and two thirds of the public and private DOTS laboratories respectively had reagents for smear microscopy. A significantly higher proportion of the public DOTS laboratories had separate area for TB work and separate table for smear preparation (p <0.05). A higher proportion (71.4%) of the laboratory scientist/ technicians at the public compared with 38.5% of those at the private DOTS laboratories had good knowledge of the laboratory diagnosis of TB.Conclusion: Laboratories involved in TB service are not functioning optimally and need to be strengthened.Key Words: Laboratory, DOTS, Consumables, Hygiene.French AbstractContexte : L’objet des services des laboratoires dans le cadre du NTP est de fournir les preuves bactériologiques pour le diagnostic, de suivre les patients tuberculeux et de documenter la guérison a la fin du traitement. Toutefois, pour être pleinement fonctionnel, les produits de laboratoire devraient être disponibles au besoin. Cette recherche comparait les pratiques hygiènes de laboratoire et la disponibilité des équipements de laboratoire et autres consommables pour faire le diagnostic de la tuberculose aux laboratoires de DOTS publics et prives dans l’État de Lagos.Méthodes : Une étude transversale comparative et transversale descriptive comparant la disponibilité des produits aux laboratoires publics et prives  concernes a fournir aux services tuberculeux dans l’état de Lagos.Résultats : Dix – sept laboratoires de DOTS et 34 scientifiques/techniciens ont été recrutés pour cette recherche. Environ trois quarts et deux tiers des laboratoires de DOT publics et prives ont eu réactif respectivement pour la microscopie des frottis. Une proportion significativement plus élevée des laboratoires de DOTS publics a eu un espace séparé pour les travaux de la tuberculose et une table séparée pour la préparation des frottis (p<0,05). Une proportion élevée(71,4%) des scientifiques/techniciens des laboratoires publics comparativement a 38,5% de ceux des laboratoires de DOTS prives avaient une bonne connaissance de diagnostic laboratoire de la tuberculose.Conclusion : Les laboratoires qui ont concerné a fournir les services tuberculeux ne fonctionnent pas de la façon optimale et doivent être renforcés.Mots– clés : Laboratoire, DOTS, consommables, Hygiène

Knowledge, attitudes and practice of breast cancer screening among female health workers in a Nigerian urban city

<p>Abstract</p> <p>Background</p> <p>Late presentation has been observed as the hallmark of breast cancer in Nigerian women and an earlier onset has been reported in this population. This study was designed to assess the awareness of female health workers about risk factors and screening methods for early detection of breast cancer.</p> <p>Methods</p> <p>A cross-sectional descriptive study was carried out among female health workers in the two major government health institutions in Benin City, Edo State capital in Nigeria.</p> <p>Data analysis was by SPSS version 10 and test of significance was done with differences considered significant at p < 0.05.</p> <p>Results</p> <p>Three hundred and ninety-three (393) female health workers out of five hundred and five eligible subjects completed and returned the questionnaires, giving a response rate of 77.8%. One hundred and two (26%) were Doctors, two hundred and fifty-four (64.6%) Nurses, and thirty-seven (9.4%) were Radiographers, Laboratory Scientists and Pharmacists. A high proportion of our respondents had very poor knowledge about risk factors for breast cancer (55%). The awareness of mammography as a diagnostic method was very high (80.7%), but an extremely low knowledge of mammography as a screening method was found. Mammography practice of only 3.1% was found among those above 40 years of age who qualify for routine annual screening. Relatively low knowledge (45.5%) about Breast Self Examination (BSE) as a screening method was found.</p> <p>Conclusion</p> <p>These female health workers who are expected to act as role models and educate the public had poor knowledge of risk factors for breast cancer and practice of breast cancer screening. There is very urgent need for regular update courses for health workers concerning breast cancer education including screening methods.</p

Knowledge of breast cancer and its early detection measures among rural women in Akinyele Local Government Area, Ibadan, Nigeria

BACKGROUND: Breast cancer is the commonest cancer among women in Nigeria and globally. In Nigeria, late presentations of breast cancer cases have also been consistent for three decades. In an environment where there is no established national screening program for breast cancer, it is pertinent to assess the knowledge of breast cancer and its early detection measures. The objective of this study therefore, was to assess rural women's level of knowledge of breast cancer and its early detection measures. METHODS: The knowledge of various aspects of breast cancer; etiology, early warning signs, treatment modes and early detection measures; was assessed among women in two randomly selected health districts in Akinyele Local Government in Ibadan. The assessment was performed with the use of a self-structured validated questionnaire administered by trained interviewers to 420 women randomly selected from the two health districts. The various aspects of facts about breast cancer were scored and added together to determine respondents' level of knowledge RESULTS: The mean score of knowledge of breast cancer was 55.4 SD 5.4 (range of scores obtainable was 26–78), while the mean score for knowledge of early detection of breast cancer was 24.8 SD 2.3 (range of scores obtainable was 12–36). The leading source of information about breast cancer was "elders, neighbors and friends" and 63(15.4%) acknowledged this source, while only 18 (4.4%) respondents acknowledged health workers as source. Only 54 (13.3%) claimed to have heard about breast self- examination (BSE) however, and the leading source of information about BSE were health workers. Nine (2.2%) of respondents claimed this source. CONCLUSION: This study revealed that respondents lacked knowledge of vital issues about breast cancer and early detection measures. It also revealed that health workers were not forthcoming with information to the public thereby constituting a challenge to community health nurses and other health workers, to provide vital information to the public

The African Vaccine-Preventable Diseases Network: a vaccine advocacy initiative

Achieving high and equitable childhood immunisation coverage in Africa will not only protect children from disability and premature death, it will also boost productivity, reduce poverty and support the economic growth of the continent. Thus, Africa needs innovative and sustainable vaccine advocacy initiatives. One such initiative is the African Vaccine-Preventable Diseases Network, formed in 2009. This association of immunisation practitioners, vaccinologists, paediatricians, and infectious disease experts provides a platform to advocate for the introduction of newly available vaccines (e.g. 10-valent and 13-valent pneumococcal conjugate and rotavirus vaccines) into the Expanded Programme on Immunisation (EPI) as well as increased and equitable coverage for established EPI vaccines.Key words: Vaccine preventable diseases, vaccine, network, Africa, awareness, child healt

Assessing computer skills in Tanzanian medical students: an elective experience.

BACKGROUND: One estimate suggests that by 2010 more than 30% of a physician's time will be spent using information technology tools. The aim of this study is to assess the information and communication technologies (ICT) skills of medical students in Tanzania. We also report a pilot intervention of peer mentoring training in ICT by medical students from the UK tutoring students in Tanzania. DESIGN: Cross sectional study and pilot intervention study. PARTICIPANTS: Fourth year medical students (n = 92) attending Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania. MAIN OUTCOME MEASURES: Self-reported assessment of competence on ICT-related topics and ability to perform specific ICT tasks. Further information related to frequency of computer use (hours per week), years of computer use, reasons for use and access to computers. Skills at specific tasks were reassessed for 12 students following 4 to 6 hours of peer mentoring training. RESULTS: The highest levels of competence in generic ICT areas were for email, Internet and file management. For other skills such as word processing most respondents reported low levels of competence. The abilities to perform specific ICT skills were low - less than 60% of the participants were able to perform the core specific skills assessed. A period of approximately 5 hours of peer mentoring training produced an approximate doubling of competence scores for these skills. CONCLUSION: Our study has found a low level of ability to use ICT facilities among medical students in a leading university in sub-Saharan Africa. A pilot scheme utilising UK elective students to tutor basic skills showed potential. Attention is required to develop interventions that can improve ICT skills, as well as computer access, in order to bridge the digital divide

A telephone survey of cancer awareness among frontline staff: informing training needs

Background: Studies have shown limited awareness about cancer risk factors among hospital-based staff. Less is known about general cancer awareness among community frontline National Health Service and social care staff. Methods: A cross-sectional computer-assisted telephone survey of 4664 frontline community-based health and social care staff in North West England. Results: A total of 671 out of 4664 (14.4%) potentially eligible subjects agreed to take part. Over 92% of staff recognised most warning signs, except an unexplained pain (88.8%, n=596), cough or hoarseness (86.9%, n=583) and a sore that does not heal (77.3%, n=519). The bowel cancer-screening programme was recognised by 61.8% (n=415) of staff. Most staff agreed that smoking and passive smoking ‘increased the chance of getting cancer.’ Fewer agreed about getting sunburnt more than once as a child (78.0%, n=523), being overweight (73.5%, n=493), drinking more than one unit of alcohol per day (50.2%, n=337) or doing less than 30 min of moderate physical exercise five times a week (41.1%, n=276). Conclusion: Cancer awareness is generally good among frontline staff, but important gaps exist, which might be improved by targeted education and training and through developing clearer messages about cancer risk factors

Knowledge of risk factors, beliefs and practices of female healthcare professionals towards breast cancer in a tertiary institution in Lagos, Nigeria

<p>Abstract</p> <p>Background</p> <p>Breast cancer is the leading female malignancy in Nigeria. Screening for early detection has led to reduction in mortality from the disease. It is known that attitudes of physicians and motivation by community nurses influence uptake of screening methods by women. This study aims to investigate knowledge of breast cancer risk factors, beliefs about treatment and practice of screening methods among a cohort of female healthcare professionals in Lagos, Nigeria.</p> <p>Methods</p> <p>A cross-sectional study was conducted using a self-administered questionnaire to assess the knowledge of breast cancer risk factors, beliefs about treatment and practice of screening methods among 207 female doctors, nurses and other healthcare professionals working in a university teaching hospital in Lagos, Nigeria. Stratified random sampling method was employed. Chi square test, analysis of variance and Mantel-Haenszel test were performed in data analysis using SPSS v10.0 and Epi Info version 6 statistical packages.</p> <p>Results</p> <p>Female doctors obtained a mean knowledge score of 74% and were the only professional group that had satisfactory knowledge of risk factors. Majority (86%) believed that early breast cancer is curable while half of participants believed that prayer can make breast cancer disappear from the affected breast. Eighty three percent practice breast self-examination (BSE) once a month and only 8% have ever had a mammogram. Age, knowledge of risk factors, profession and beliefs were not significantly associated with rate of BSE in this study.</p> <p>Conclusion</p> <p>Results from this study suggest the need for continuing medical education programmes aimed at improving knowledge of breast cancer among female healthcare providers other than doctors.</p

Maternal education is associated with vaccination status of infants less than 6 months in Eastern Uganda: a cohort study

<p>Abstract</p> <p>Background</p> <p>Despite provision of free childhood vaccinations, less than half of all Ugandan infants are fully vaccinated. This study compares women with some secondary schooling to those with only primary schooling with regard to their infants' vaccination status.</p> <p>Methods</p> <p>A community-based prospective cohort study conducted between January 2006 and May 2008 in which 696 pregnant women were followed up to 24 weeks post partum. Information was collected on the mothers' education and vaccination status of the infants.</p> <p>Results</p> <p>At 24 weeks, the following vaccinations had been received: bacille Calmette-Guérin (BCG): 92%; polio-1: 91%; Diphteria-Pertussis-Tetanus-Hepatitis B-Haemophilus Influenza b (DPT-HB-Hib) 3 and polio-3: 63%. About 51% of the infants were fully vaccinated (i.e., had received all the scheduled vaccinations: BCG, polio 0, polio 1, DPT-HB-Hib1, polio 2, DPT-HB-Hib 2, polio 3 and DPT-HB-Hib 3). Only 46% of the infants whose mothers' had 5-7 years of primary education had been fully vaccinated compared to 65% of the infants whose mothers' had some secondary education. Infants whose mothers had some secondary education were less likely to miss the DPT-HB-Hib-2 vaccine (RR: 0.5, 95% CI: 0.3, 0.8), Polio-2 (RR: 0.4, 95%CI: 0.3, 0.7), polio-3 (RR: 0.5, 95%CI: 0.4, 0.7) and DPT-HB-Hib-3 (RR: 0.5, 95%CI: 0.4, 0.7). Other factors showing some association with a reduced risk of missed vaccinations were delivery at a health facility (RR = 0.8; 95%CI: 0.7, 1.0) and use of a mosquito net (RR: 0.8; 95%CI: 0.7, 1.0).</p> <p>Conclusion</p> <p>Infants whose mothers had a secondary education were at least 50% less likely to miss scheduled vaccinations compared to those whose mothers only had primary education. Strategies for childhood vaccinations should specifically target women with low formal education.</p