Knowledge, attitude, perceptions of adult males towards childhood immunizations in southwest Nigeria

Background: Immunisation is a cost effective public health intervention in reducing morbidity and mortality from vaccine preventable diseases worldwide. In Nigeria, childhood immunisation against poliomyelitis is still bedeviled by setbacks which are multifactorial. Objectives: The objective of the study was to determine the knowledge, attitude and perceptions of adult males towards childhood immunizations in Nigeria. Methods: The research was a descriptive crosssectional study of adult males in the Ido-Osi local government area of Ekiti state, southwest Nigeria. Multistage sampling method was used to select 320 adult males for the study, and a pre-tested semi-structured questionnaire was used to collect quantitative data. Statistical analysis was done using the Epi Info 4. P value <0.05 was considered asstatistically significant. Results: Mean age (±SD) of the respondents was 48.4±12.6 years with range of 20-95 years. About half (50.6%) of the respondents were in the age group 40-59 years. 79.7% were married while only 2 were single with about two-thirds of the married respondents in monogamous family type. 82.3% were willing to support childhood immunization. The association between respondents’ religion and education, and willingness to support childhood immunization was found to be statistically significant: (x 2 =51.53; df=6; p=0.0000) and (x 2 =65.48; df=6; p=0.0000) respectively. Conclusion: The study showed that the knowledge of adult males about childhood immunization was high. The perception of childhood immunization as a means of protection from certain illnesses was also common and most men were willing to support it. The support for childhood immunization was significantly affected by religionand level of education

Five-year analysis of clinical presentations and predictors of stroke mortality in rural Southwestern Nigeria: A retrospective observational study

Introduction: Stroke mortality and its predictors are important outcome measures in stroke epidemiological studies and clinical trials. There is an observed paucity of data regarding the clinical presentations and predictors of stroke mortality in Southwestern Nigeria. Few available related studies have centred on hospitals in the urban and sub-urban areas; however, none in the rural settings. This study, therefore, focuses on the clinical presentations and predictors of stroke mortality at the adult Emergency Centre of a tertiary hospital situated in rural Southwestern Nigeria. Methods: A retrospective survey, using data form and standardized questionnaire, was used to study the patients admitted for stroke between January 2015 and December 2019. The data were analysed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. Results: A total of 276 patients were studied. Their mean age was 67.3 ± 11.1 years. The most common clinical presentations were hemiparesis and cranial nerve deficit. The case of fatality was 10.1%. The predictors of stroke mortality were age ≥65 years [(AOR = 12.752; 95% CI: (1.022–159.190), p = 0.048)], Glascow coma score <8 [(AOR = 50.348; 95% CI: (7.779–325.866), p < 0.001)], uncontrolled blood pressure [(AOR = 23.321; 95% CI: (2.449–221.927), p = 0.006)], presence of atrial fibrillation [(AOR = 16.456; 95% CI: (2.169–169.336), p = 0.009)], convulsion [(AOR = 25.889; 95% CI: (2.374–282.296), p = 0.008)], heart failure [(AOR = 30.284; 95% CI: (3.265–256.347), p < 0.001)], and a repeat stroke [(AOR = 32.617; 95% CI: (2.410–441.381), p = 0.009)]. Conclusion: The 7-day fatality was 10.1%. The predictors of stroke mortality were poor Glascow coma score, uncontrolled blood pressure, atrial fibrillation, heart failure, convulsion and a repeat stroke. This study strengthens the argument on the higher prevalence of stroke and its mortality in rural Southwestern Nigeria. Our findings may provide an impetus for prospective research on this outcome

The Clinical Correlates And Self-Management Of Insomnia Among Patients Presenting In A Tertiary Health Institution, South West Nigeria

Background: Sleep has important biological functions that are essential for normal restorative, conservative and adaptive functions. The lack or inadequacy of it will alter these normal biological functions in man which may negatively affect various organs and systems. The knowledge of what people with insomnia are using will assist clinician on modality of approach in proper management Aim: To determine the clinical correlates of insomnia and self management among patients presenting with insomnia. Method: A descriptive cross sectional study of three hundred and seventeen adults selected through systematic random sampling technique. An interviewer administered questionnaire was used to collect the data. Result: The following clinical conditions were observed to have positive association with insomnia. This include Hypertension (X2 30.101; P value <0.001), Heart disease (X2 38.040; P value <0.001), Fall/Pains (X2 24.306; P value <0.001), Arthritis/Joint Pains (X2 28.359; P value <0.001), Depression (X2 25.277; P value <0.001), Other Psychiatric diseases (X2 42.639; P value <0.001). Over the counter medication has significant association with presence of insomnia but not with herbal usage (X2 33.399; P value <0.001). a larger proportion of insomniacs who were using over the counter medication have stopped its usage as the time of the study (X2 4.629; P value <0.039) Conclusion: Multiple clinical morbidities are associated with insomnia. The desire to improve the sleep quality and quantity of an insomniac, they tend to embark on self-management. Clinician with this understanding must therefore take proactive approach to find what type of self management the individual is using. This will help to inform, educate and counsel appropriately against dangerous steps and measures that may have been embarked upo

Malaria infection and its association with socio-demographics, preventive measures, and co-morbid ailments among adult febrile patients in rural Southwestern Nigeria: A cross-sectional study

Objectives: The study determined the prevalence of malaria infection and its association with socio-demographics, environmental, housing, and co-morbid ailment factors. Methods: The study was a cross-sectional of 330 consented adult febrile patients who were recruited at a tertiary health facility in rural Southwestern Nigeria. The standardized interviewer-administered questionnaire sought information on their socio-demographics, environmental, housing, and co-morbid ailment factors. Venous blood samples were collected and processed for malaria parasite detection, retroviral screening, glycated hemoglobin, and hemoglobinopathy. Data were analyzed using SPSS version 20. The strength of the association between independent and dependent variables was measured using odds ratio and 95% confidence interval with a significant level (p value <0.05). Results: The prevalence of malaria parasitemia was 63.3% (95% confidence interval: 57.9%–68.5%). Being a farmer (p=0.002), lack of formal education (p=0.043), low-income earners (p=0.031), presence of bushes (p=0.048), stagnant water (p=0.042), not sleeping under long-lasting insecticide-treated nets (p<0.001), and sickle cell disease (p=0.041) were significantly associated with malaria infection. Conclusion: The study revealed that there is a high prevalence of malaria infection in rural Southwestern Nigeria. There may be a need to pay greater attention to adult populations in rural areas for malaria intervention and control programs

A 5‑year analysis of admissions, seasonal variation, and patient outcomes in rural Nigeria: A retrospective observational study

Introduction: In low- and middle-income countries like Nigeria, there is an observed paucity of data on the admission pattern and patient outcomes in health facilities. Few related studies were conducted in the urban centers, but none from the rural areas where the majority of the populace resides. This study is to ascertain the demographic profile, seasonal variations, yearly distribution, admission pattern, and treatment outcomes at the accident and emergency department (AED). Materials and Methods: A retrospective survey was used to review the data of patients admitted to the AED of the institution between January 2015 and December 2019. The data obtained were analyzed using SPSS Version 20.0. The results were presented in descriptive and tabular formats. Results: Five thousand nine hundred and forty-four patients were studied with a mean age of 49.8 ± 19 years. There were 53.9% males and 46.1% females. Many (60.1%) were admitted from April to October. There were 58.9% medical and 41.1% surgical cases. Among the medical cases were 18.6% noncommunicable and 18.5% communicable diseases. Out of 5944 patients, 9435 disease patterns were diagnosed with infectious diseases 15.5%, and orthopedic 14.4% being the most frequently diagnosed medical and surgical cases, respectively. The treatment outcome revealed that the mortality rate was 3.7%. Conclusions: The number of admissions increased over 5 years. Although most patients were treated and discharged successfully, the number discharged against medical advice was high. Therefore, appropriate hospital and community interventions should be implemented to improve admission outcomes. The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge, and Systems-based practice

Influence of Family Dynamics on Medication Adherence among Hypertensive Patients in a Tertiary Hospital in South-West Nigeria

INTRODUCTION Hypertension is an overwhelming global challenge estimated to cause 7.5 million death, which is about 12.8% of all deaths.1 The emerging pandemic of non-communicable diseases (NCDs) is creating major health challenges worldwide. Of the 56 million global deaths in 2012, 38 million (68%) were attributed to NCDs, with almost three quarters (74%) of these deaths occurring in low and middle income countries.2 Indeed, it is estimated that up to three-quarters of the world's hypertensive population will be in economically developing countries by the year 2025.3,4 Nigeria, like most other developing countries is undergoing epidemiological transition and faces the double burden of communicable and noncommunicable diseases.3,4 Of the latter, hypertension is one of the most important treatable causes of morbidity and mortality

Community-acquired pneumonia and its predictors of mortality in rural southwestern Nigeria: A-five year retrospective observational study

Introduction: The predictors of community-acquired pneumonia (CAP) mortality are important outcome measures in epidemiological studies and clinical trials. There is an observed paucity of data regarding the predictors of mortality of CAP in Nigeria. Few studies from the urban centres have been reported in the literature, with none from the rural centres. The objective of this study is to ascertain the clinical presentations, risk factors, and predictors of mortality among patients admitted for CAP in rural Southwestern Nigeria. Methods: A retrospective observational study using a data form and a standardised questionnaire reviewed the 176 patients admitted to Southwestern Nigeria hospital between January 2015 and December 2019. The data were analysed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. Results: A total of 176 patients were studied. Their mean age was 53.3±16.8 years. There were more males, 112 (63.6%), than females. The most common clinical presentations were cough, fever and sputum expectoration. The case fatality rate was 9.1% and its predictors were older aged patients [Adjusted Odds Ration (AOR), 4.135: 95% Confidence Interval (CI) (1.389-12.315); p =0.005], hypoxia [AOR, 11.118: 95% CI (2.607-47.405); p<0.001], tobacco smoking [AOR, 3.632: 95% CI (1.459-9.039); p=0.008], chronic obstructive pulmonary disease (COPD) [AOR, 10.111: 95%CI (2.370-43.139); p <0.001], and human immunodeficiency virus (HIV) [AOR, 9.444: 95% CI (4.304-20.725), p<0.001]. Conclusion: The case -fatality rate was 9.1%, and its predictors were older age patients, patients with hypoxia, tobacco smoking, COPD, and HIV. This study strengthens the argument on the higher prevalence of CAP and its mortality in rural Southwestern Nigeria. The findings may provide an impetus for prospective research on these outcomes

Blood pressure control and its associated factors among hypertensive patients in federal teaching hospital, ido- ekiti, Southwest Nigeria

Background: Hypertension is a modifiable risk factor for cardiovascular disease, stroke and renal disease worldwide. Despite improvement in treatment modality and therapeutic intervention, with proven benefits in reducing the burden of uncontrolled hypertension, majority of peoples’ blood pressure still remain uncontrolled.&nbsp;Aim: To assess the patterns of blood pressure control and its associated factors among hypertensive patients on follow-up.Setting: This study was done at the general out-patient department of Federal Teaching Hospital, Ido- Ekiti, Southwest Nigeria, which is a referral centre for private and government owned - health facility in the state and its environs.Methods: Hospital-based cross sectional study was conducted from June 4 – August 31, 2019. Systematic random sampling method was used to select the 320 participants. Semi-structured interviewer- administered questionnaire was used to seek information on participants’ socio-demographic characteristics, lifestyle changes and level of adherence to antihypertensive medication. Blood pressure was measured and recorded. Data was analyzed using SPSS 20. Multivariate logistic regression analysis was used to identify the factors associated with poor blood pressure control.Results: Mean age of the participants was 63.9± 11.5 years. 56.6% had their blood pressure controlled within the recommended limits. In multivariate analysis, civil servant (OR =45.160, 95% CI: 6.143 – 332.000) and adherence to medication (OR=15.35, 95% CI: 6.303 – 37.391) were the independent associated factors with good blood pressure control while old age (OR= 0.894, 95% CI: 0.837- 0.955) and diabetes (OR= 0.072, 95% CI: 0.016-.0,318) were independent associated factors with poor blood pressure control.Conclusions: Old age and diabetes are the predictors of poorly controlled blood pressure and therefore, clinicians and other stakeholders should provide close attention and targeted blood pressure control among this set of patients.</p

Papanicoleau Smear Usage and Prevalence of Premalignant Cervical Lesion among Women Living with HIV Attending a Federal Teaching Hospital in South-West Nigeria: A Comparative Study

Aim: Cancer of the cervix is the third most common cancer among women worldwide, and in Nigeria it is the second most common female cancer. Infection with the Human immunodeficiency virus (HIV) is associated with an increased risk of prevalent, incident and persistent squamous intraepithelial lesions (SILs) of the cervix. The aim was to determine the level of awareness of cervical cancer screening test and the development of premalignant cervical lesions among HIV positive women. Study Design: A Hospital based comparative cross-sectional study. Place and Duration of the Study: The study was carried out in the HIV clinic and general outpatient clinic of Federal Teaching Hospital Ido-ekiti, Ekiti state Nigeria. It was carried out from July to September 2015. Methodology: The study was carried out among 65 HIV-positive and 65 HIV-negative women. Data were collected from the interviewees. Participants also had Pap smear. Data collected were analyzed using statistical package for social sciences version 19. Results: The mean age was 39.73 (±8.57) and 40.98 (±10.68) among the HIV positive and negative women respectively. Only 27.7% of the HIV-positive women compared to 56.9% of the HIV negative women had heard of cervical cancer with P= 0.001. The level of awareness of cervical cancer screening test was 15.4% and 50.8% among the HIV positive and negative women respectively (P= 0.001). The prevalence of premalignant cervical lesions among the study and control groups was 26.2% and 16.9% respectively. This showed that premalignant cervical lesion was more prevalent among HIV-positive women though not statistically significant (P=0.201). However, using risk ratio (RR), the risk of developing cervical lesions is 1.55 times more in HIV exposed women than HIV negative women. Conclusion: There is therefore need for the Physicians to use every opportunity to counsel their clients on the need for routine cervical cancer screening especially in adult HIV clinics

Awareness and practice of self breast examination among female nurses at the Federal Teaching Hospital Ido-Ekiti, Nigeria

Breast cancer is the most common female malignancy linked with high levels of morbidity and mortality in developing countries due to delayed diagnosis. This research assessed the knowledge of signs and risk factors of breast cancer and practice of self breast examination (SBE) among female nurses in a rural tertiary Hospital. Eighty-five nurses ages 20 to 60 years were sampled by simple randomization over a period of eight weeks through a self-administered semi-structured questionnaire. The analysis was done using statistical package for social science version 17. Sixteen (15.3%) nurses had adequate knowledge of breast cancer, having a relative with breast cancer (51.8%) and a woman of any age (56.5%) were recognized by majority as risk factors for breast cancer. Majority (68.2%) were not practicing monthly SBE and not confident on how to do it. This study pointed out the gaps in the knowledge and awareness of breast cancer and practice of SBE among the nurses. Opportunity should therefore be sought in various health facilities to educate nurses who are supposed to be closer to the patients