The magnitude of abdominal adiposity and atherogenic dyslipidemia among geriatric Nigerians with arterial hypertension in a rural hospital in South.eastern Nigeria

Background: As the case detection rate of arterial hypertension increases daily in rural Nigeria, screening for its associated abdominal obesity and dyslipidemia is an important healthcare challenge. Of great concern in rural Nigeria is that most geriatric hypertensives with abdominal obesity and dyslipidemia are not routinely diagnosed and therefore do not receive appropriate management.Objective: This study was aimed at describing the magnitude (prevalence and pattern) of abdominal adiposity using waist circumference (WC) index and dyslipidemia among geriatric Nigerians with arterial hypertension in a rural hospital in South.eastern Nigeria.Materials and Methods: A descriptive hospital.based study was carried out from June 2008 to June 2011 on 122 consecutive geriatric patients with systemic hypertension who met the selection criteria at St. Vincent De Paul Hospital, Amurie.Omanze, a rural Mission General Hospital in Imo state. Abdominal obesity was defined as WC .102 cm and .88 cm for men and women, respectively. Dyslipidemia was defined using the third report of National Cholesterol Education Panel in adult (ATP III). The data collected included basic demographic variables, blood pressure, waist circumference, fasting lipid profile, and blood sugar.Results: The prevalence of abdominal obesity was 50.8% and was the most common pattern of abdominal adiposity. Fifty.four (44.3%) out of 122 patients had at least one dyslipidemia with the most frequent being low high.density lipoprotein cholesterol (HDL.C, 38.5%). There was statistically significant difference between male and female genderbased on abdominal adiposity (X2 = 5.406, P value = 0.04) while their mean lipid differentials were not statistically significant.Conclusion: This study has shown that abdominal adiposity and dyslipidemia exist among geriatric hypertensives in the study area with abdominal obesity being the most common abdominal adiposity and low HDL.C being the most frequent lipid abnormality. This study therefore urges the necessity to consider abdominal obesity and dyslipidemia ingeriatric hypertensives in rural Nigeria alongside the complex of other cardiovascular risk factors

Evaluation of patients' satisfaction with quality of care provided at the National Health Insurance Scheme clinic of a tertiary hospital in South-Eastern Nigeria

Background: The umpteenth threats to change of healthcare provider by dissatisfied patients on formal sector health insurance are well known and can be a proxy indicator for the need for quality improvement in service delivery.Objective: This study was aimed at evaluating patientsf satisfaction with quality of care provided at the National Health Insurance Scheme (NHIS) clinic of a tertiary hospital in South.Eastern Nigeria.Materials and Methods: This was a descriptive study carried out on 400 NHIS patients from April 2011 to October 2011 at the general outpatient department of Federal Medical Centre, Umuahia. Patients were selected by simple random sampling using every second NHIS patient that registered to see the clinicians and who met the selection criteria. Data were collected using pretested, structured interviewer.administered questionnaire. Each satisfaction item was scored in a five.point Likert scale ordinal response, which was converted to percentage scale response. Satisfaction wasmeasured from the following domains: accessibility, patient waiting time, patient.provider communication, patient. provider relationship, hospital bureaucracy, and hospital environment. Operationally, patients who scored 50% and above in the assessed domain were considered satisfied while those who scored less than 50% were dissatisfied.Results: The overall satisfaction score of the respondents was 66.8%. Specifically, the respondents expressed satisfaction with patient.provider relationship (81.5%), patient.provider communication (79.9%), accessibility (74.2%), and hospital environment (68.2%) and dissatisfaction with hospital bureaucracy (48.8%) and patient waiting time (48.3%).Conclusion: This study has shown that the overall patients satisfaction with the services provided was very good with patient.provider relationship rated highest and patient waiting time the lowest. There is need to improve on the current level of patients satisfaction while effort should be made to address the identified domains of dissatisfaction

The Magnitude of Atherogenic Dyslipidaemia among Geriatric Nigerians with Systemic Hypertension in a Rural Hospital in Eastern Nigeria

BACKGROUND: The relevance of dyslipidaemia in the management of cardiovascular diseases especially hypertension is an important health care challenge that is increasing worldwide. Of great concern in Nigeria is that most geriatric hypertensives with dylipidaemia are not routinely diagnosed and therefore do not receive appropriate treatment.OBJECTIVE: This study is aimed at describing the magnitude (prevalence and pattern) of atherogenic dyslipidaemia among geriatric Nigerians with systemic hypertension in a rural hospital in Eastern Nigeria.METHODS: A descriptive hospital-based study was carried out from June 2008 to June 2011 on 122 consecutive geriatric patients with systemic hypertension who met the selection criteria at St Vincent De Paul hospital, Amurie-Omanze, a rural Mission General Hospital in Imo state. The fasting lipid profile was determined by enzymatic method. Dyslipidaemia was defined using the third report of National Cholesterol Education Panel in adult (ATP III). The data collected included age and sex.RESULTS: Fifty-four (44.3%) out of 122 patients had at least one dyslipidaemia. The age of the patients ranged from 65 years to 91 years with mean age of 69±2.10 years. There were 51(41.8%) males and 71(58.2) females with male to female ratio of 1: 1.4. The commonest lipid abnormality was low high density lipoprotein-cholesterol (38.5%). Others included high low density cholesterol (23.8%), high total cholesterol (17.2%) and high triglyceride (14.8%). CONCLUSION: This study has shown that dyslipidaemia exist among geriatric hypertensives in the study area with low HDL-C being the most frequent lipid abnormality suggesting that low HDL may be the major form of dyslipidaemia and a marker of dyslipidaemic cardiometabolic risk among them. Screening for dyslipidaemia should therefore form an important part of clinical care of geriatric hypertensives and those with dyslipidaemia should become target for lipid lowering treatment in addition to lifestyle modification. KEY WORDS: Hypertension, Geriatrics, Dyslipidaemia, Prevalence, Pattern, Rural, Hospital, Nigeria

Blood pressure control among geriatric Nigerians with essential hypertension in a rural hospital in South- Eastern Nigeria

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Satisfaction with quality of care: a comparative study of National Health Insurance Scheme and non-National Health Insurance Scheme patients of a tertiary hospital in South-Eastern Nigeria

Background: The current trend towards consumer satisfaction driven healthcare services have been viewed as the compass for assessing quality of care in hospitals.  Aim: To compare satisfaction with quality of care received by national health insurance scheme (NHIS) and non-national health insurance scheme (non-NHIS) patients of a tertiary hospital in South- Eastern Nigeria.Methods: A comparative cross sectional study carried out on 400 NHIS and 400 non-NHIS patients from April 2011 to October 2011 at the Department of Family Medicine of Federal Medical Centre, Umuahia.  Adult patients seen within the study period who met the inclusion criteria were selected by systematic sampling using every second patient that registered to see the clinicians.  Data were collected using pretested, structured interviewer-administered questionnaire. Each satisfaction item was scored on a five points Likert scale ordinal response which was converted to percentages.Results: The overall average satisfaction score of the NHIS respondents was significantly higher than that for non-NHIS (66.8% vs 62.0%)(p=0.04). The NHIS respondents' satisfaction with patient-provider relationship (81.5% vs 78.0%) (p=0.062), patient-provider communication(79.9% vs 76.0%)(p=0.070) and accessibility(74.2% vs 72.8%)(p=0.072) were higher than that of non-NHIS patient. These relative differences were not statistically significant.  NHIS patients' satisfaction with waiting time (48.3% vs 48.0%)(p=0.224) and hospital bureaucracy (48.8% vs 47.0%)(p=0.213) were higher than that of non-NHIS patients. This difference was also not statistically significant. Conclusion: Overall NHIS respondents' satisfaction with the services provided was significantly higher than non-NHIS patients. There is need to improve on the current level of satisfaction in addition to addressing the identified domains of dissatisfaction with quality of care.Keywords: Comparative satisfaction, NHIS, Non-NHIS, Patients, Nigeria, Tertiary hospita

Burden of cardio-metabolic co-morbidities among geriatric Nigerians with essential hypertension in a primary care clinic of a tertiary hospital in a resource-limited setting of Eastern Nigeria

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