Screening for diabetes mellitus and humanimmunodefiency virus infection in personswith tuberculosis

Introduction. Nigeria is a country saddled with a high tubercu- losis (TB) and human immunodeficiency virus (HIV) burden but the possible combination of these communicable diseases with diabetes mellitus (DM) has been overlooked. We undertook to determine the burden of HIV and DM in persons with TB by docu- menting the prevalence rates of these disorders. Methods. This is a cross-sectional Study that was conducted within 54TB/DOT centers in Lagos State. A total of 3,376 persons with TB who were on antiTB drugs were screened for HIV and DM using standardized tests. Statistical analysis was performed using Students t test and chi square. Results. The frequency of occurrence of DM in TB and that of HIV in TB were comparable (4.8% Vs 3.5%). The Study subjects with DM were older, had higher waist circumference measure- ments and had higher proportions of hypertension compared to the subjects without DM. The combination of HIV and DM in TB was found in (0.3%). We also noted that DM in TB and HIV in TB occurred more frequently in the third and fourth decades of life. Conclusion. This study demonstrated the potential co existence of HIV, DM and Tuberculosis. It is therefore important that these two diseases are sought for in patients with TB considering the changing epidemiology of these diseases particularly in develop- ing countries like Nigeria

Assessment of the Quality of Packaged Water on Sale in Onitsha Metropolis

Background: In recent years, sale of packaged water has been on the increase in most urban cities in Nigeria. In order to safe guard public health, it is essential that the available packaged water is of the highest quality. Objective: To assess the physical, chemical and bacteriological quality of packaged water on sale in Onitsha metropolis Methodology: Two samples each of 60 brands of packaged water were randomly obtained from six different commercial locations within two LGAs in Onitsha metropolis. The samples were analysed for colour, odour, turbidity, pH, fluoride and coliform count. Membrane filtration technique was used for coliform count. Results: Forty five (75%) of samples were of high aesthetic value. All samples recorded fluoride levels within recommended WHO range of 0.5- 1.5 mg/dl. . Majority (70% ) of all samples of water were found to have coliform count of 10 or more per 100ml. 34% of samples were faecally contaminated with Klebsiella and E.coli being the major organisms.. Packaged water that was registered by NAFDAC had a higher bacteriological quality compared to unregistered ones.( Odds'ratio 6.05 CI : 1.37-36.4, p< 0.01.) Conclusion: Majority of the packaged water on sale in Onitsha metropolis were bacteriologically unsafe though most were of acceptable physical quality. There is a need for continuous monitoring of packaged water products by NAFDAC which should ensure strict enforcement of regulations to promote availability of potable packaged water. Keywords: Assessment, Quality, Packaged Water NQJHM Vol. 16 (2) 2006: pp. 56-5

A Comparison of Client Perception of the Quality of Child Welfare Service at the Lagos University Teaching Hospital and a Primary Health Centre in Mushin LGA, Lagos State

The objective of this study was to compare client perception of the quality of child welfare service at Lagos University Teaching Hospital (LUTH) and Palm Avenue health centre in Mushin LGA. A descriptive cross sectional study was carried out in March 2004. Study instrument was an interviewer–administered questionnaire. Exit interviews were conducted at Community Health Outpatient Clinic, (CHOP) LUTH and at the Palm Avenue Primary School Health Care Centre over a 3-week period. Data was analyzed with EPI-INFO. A total of 100 respondents and 99 respondents were interviewed at CHOP and Palm Avenue Health Centres respectively. The mean age at CHOP was 30.2yrs while it was 29.1yrs at Palm Avenue. The mean waiting time to see the primary care giver at CHOP was 92.4 mins. compared to 55.9mins at Palm Avenue Health Centre. Overall, majority of clients (above 80%) were satisfied with service at both centers, through the proportion was higher at Palm Avenue. Age of respondents was significantly associated with client satisfaction with the staff attitude.; the older respondents were more satisfied than the younger ones. Majority of clients were satisfied with services at the health centre. However, there is a need for client flow analysis and a plan of action to reduce the time spent at these clinics to further improve client satisfaction with health services. Keywords: client, perception of child welfare service.NQJHM Vol. 15 (4) 2005: pp. 150-15

Factors Determining Correct Case Management of Acute Respiratory Infections in Children by Primary Health care in Ibadan

Background: Inappropriate case management of Acute Respiratory Infections (ARIs) is one of the factors responsible for the high ARI mortality in developing countries. Identification of factors which influence ARI case management by health workers is key for interventions to improve Quality of case management. Objective: To identify factors which determine correct case management of Acute Respiratory Infections (ARIs) in children by primary health care workers in Ibadan. Design: A descriptive cross sectional study was carried out from June to December 1999 in Ibadan South East LGA and Lagelu LGA. Study materials included observation checklists, validation checklist, and health worker interview questionnaires. Results: Twenty-five health workers and 20 health workers were observed managing 390 children and 386 children in Ibadan South East and Lagelu LGA respectively. More than half of Pneumonia cases were correctly treated in the two LGAs (62.3% and 66.1% respectively). Sex and category of health workers was significantly associated with correct treatment of mild ARI with female workers and Nursing staff doing better (Odds ratio 4.57, 95% CI 2.15, 9.95 and 4.61, 95% CI 2.57, 8.31 respectively). Health workers who had been trained performed better in the management of Pneumonia though it was not statistically significant. Conclusions: There is a need for targeted research to identify the relative contribution of the myriad of factors influencing health worker performance in specific localities in order to improve the quality of care in child health programmes. Keywords: Factors, Case Management, ARI, Health workers.NQJHM Vol. 16 (1) 2005: pp. 14-1

Awareness of workers on Hazards Exposure and Safety Measure in an Aluminum industry in Ojo L.G.A. of Lagos State

A study of workers in an Aluminium industry located in Ojo Local Government Area of Lagos State, was carried out to determine the level of awareness to hazards and the use of preventive and protective measures put in place to control these hazards. Questionnaires were administered to all the staff of the company available during the period of data collection. Of the 150 questionnaires distributed, 120 were returned giving a response rate of 80%. The mean age of the respondents was 32.19 ± 9.3 years while the median age was 30 years. Majority (50%) of the respondents were in the age grouping 25 – 34 years. There was no significant statistical association between age, educational level and hazard awareness in the studied population. Males were more likely to regularly use protective devices compared to females, 4.6.5% and 23.5% respectively. Workers who had tertiary education were less likely to regularly use personnel protective equipment compared to those with secondary education, 32.1% and 50% respectively. The study makes recommendations to further improve knowledge and awareness of hazards in the work place towards safely control measures. Keywords: Knowledge, Hazards, Workers, Aluminum industryNQJHM Vol. 14 (3&4) 2004: pp. 220-22

Quality of life of family caregivers of children with orofacial clefts in Nigeria:A mixed-method study

BACKGROUND: Orofacial clefts (OFCs) are common birth defects that may impose a large burden on the health and psychosocioeconomic well-being of affected individuals and families. The current study aims to identify qualitative factors that affect the quality of life (QOL) of family caregivers of children with OFCs. METHODS: A mixed method study in which family caregivers of OFCs children were consecutively recruited from cleft clinics over a 3-month period. Quantitative data was analyzed using SPSS version 17 and FGD by framework analysis. RESULTS: A total of 107 caregivers participated in the entire study and 24 caregivers participated in the focus group discussions. About 50% of the children had cleft lip and palate (CLP), 28% with cleft lips only (CL) and 23.4% with cleft palate only (CP). Poor access to specific information and lack of empathy of professionals affected the quality of life and delivery of family centered care. CONCLUSIONS: To improve the quality of life of family caregivers, individual focused counseling sessions should be organized for caregivers soon after birth. This will provide an opportunity to discuss laid out plans for supportive care. It will also as an avenue to address arising social issues by health professionals and counselors

Lorcaserin improves glycemic control via a melanocortin neurocircuit

Objective: The increasing prevalence of type 2 diabetes (T2D) and associated morbidity and mortality emphasizes the need for a more complete understanding of the mechanisms mediating glucose homeostasis to accelerate the identification of new medications. Recent reports indicate that the obesity medication lorcaserin, a 5-hydroxytryptamine (5-HT, serotonin) 2C receptor (5-HT2CR) agonist, improves glycemic control in association with weight loss in obese patients with T2D. Here we evaluate whether lorcaserin has an effect on glycemia without body weight loss and how this effect is achieved. Methods: Murine models of common and genetic T2D were utilized to probe the direct effect of lorcaserin on glycemic control. Results: Lorcaserin dose-dependently improves glycemic control in mouse models of T2D in the absence of reductions in food intake or body weight. Examining the mechanism of this effect, we reveal a necessary and sufficient neurochemical mediator of lorcaserin's glucoregulatory effects, brain pro-opiomelanocortin (POMC) peptides. To clarify further lorcaserin's therapeutic brain circuit, we examined the receptor target of POMC peptides. We demonstrate that lorcaserin requires functional melanocortin4 receptors on cholinergic preganglionic neurons (MC4RChAT) to exert its effects on glucose homeostasis. In contrast, MC4RChAT signaling did not impact lorcaserin's effects on feeding, indicating a divergence in the neurocircuitry underpinning lorcaserin's therapeutic glycemic and anorectic effects. Hyperinsulinemic-euglycemic clamp studies reveal that lorcaserin reduces hepatic glucose production, increases glucose disposal and improves insulin sensitivity. Conclusions: These data suggest that lorcaserin's action within the brain represents a mechanistically novel treatment for T2D: findings of significance to a prevalent global disease