Rural-urban disparities in health and health care in Africa: Cultural competence, lay-beliefs in narratives of diabetes among the rural poor in the Eastern Cape Province of South Africa

Rural-urban disparities in health and health care in Africa have been well described; yet, they remain relatively of less concern among many issues in health and health care in Africa. The disparities have been documented to exist in the utilization of cardiac diagnostic and therapeutic procedures, prescription of analgesia for pains, treatment of diabetes (e.g. gym exercise). Among the fundamental root causes of these disparities, which, can be gathered through studies of the health care systems (biomedical and African health systems) are variations in patients’ health beliefs, values, preferences and behaviour. Informed by the need to address the seemingly wide rural-urban disparities in health and health care in Africa, this paper brings to the fore rural patients’ recognition of symptoms, threshold for seeking care and the ability to understand disease management strategy, all of which are part of the variations in patients’ health beliefs and values. The strategy adopted for foregrounding these disparities is through narratives of diabetes by patients in a rural context in South Africa. The chief aim is to contribute towards improving the quality of health care through incorporating patients’ understanding of health. The narrative is subsumed under cultural competence and lay beliefs

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Editorial

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The Nigerian Secondary School Graduate and National Development: A Case of Re-Education of Teachers

The objectives of Secondary Education were evaluated vis-à-vis National progress. Inadequacies in the process of rearing these Secondary School graduates for the realization of national development were critically examined. Expectations of teachers regarding teaching and learning were highlighted and the justification for the re-education of teachers as role models was suggested. Efficiency, effectiveness and responsiveness of teachers were noted as desirable hallmarks of teachers. Therefore, teacher traits, attitudes, beliefs and actions must be upright. If teachers shall be reference points of their students in the 21st century and beyond. Keywords: Secondary school, Graduate, National development, Re-educatio

Glycemic Control in an Undiagnosed Diabetes Mellitus Patient with Coronavirus Disease 2019

Diabetes mellitus in coronavirus disease 2019 (COVID‑19) patients is associated with poor outcomes due to poorly understood reasons inclusive of blood sugar patterns. Hence, we report a case of a 52‑year‑old Nigerian man known hypertensive heart disease patient, previously undiagnosed diabetes mellitus patient with difficulty in blood sugar control, heart failure, and persistent severe acute respiratory syndrome coronavirus 2 8 weeks after he tested positive. A 52‑year‑old male civil servant obese, known hypertensive heart disease patient presented with complaints of fever, cough, difficulty with breathing, headache, and generalized body weakness. At presentation, he had respiratory distress with low oxygen saturation of 78% and hyperglycemia (blood sugar of 40 mmol/l). His body mass index was 35.9 kg/m2 . Chest radiography showed ground‑glass appearance with cardiomegaly. Over the next 10 days on  admission, his blood sugar fluctuated between hyperglycemia and an episode of hypoglycemia with occasional euglycemia and had glycated hemoglobin of 10.8%. The full blood count was normal, electrolyte, urea and creatinine showed mild elevation of the urea and creatinine, other parameters were normal, while the lipid profile showed hypercholesterolemia. He received multiple doses of insulin, anti‑hypertensive, lopinavir/ ritonavir, methylprednisolone, and azithromycin. The patient was weaned off oxygen after 10 days and discharged home 15 days after admission. This case report highlighted the challenges that may face a patient with undiagnosed diabetes mellitus and COVID‑19. It also brings forth the need to expand research options in COVID‑19 and risk factors associated with the disease as the world strives to control the global pandemic. Keywords: Coronavirus disease 2019, glycemic control, undiagnosed diabetes mellitu

Epidemiology of COVID-19 and Predictors of Outcome in Nigeria: A Single-Center Study.

There is a paucity of information regarding the epidemiology and outcome of COVID-19 from low/middle-income countries, including from Nigeria. This single-center study described the clinical features, laboratory findings, and predictors of in-hospital mortality of COVID-19 patients. Patients admitted between April 10, 2020 and June 10, 2020 were included. Forty-five patients with a mean age of 43 (16) years, predominantly male (87%), presented with fever (38%), cough (29%), or dyspnea (24%). In-hospital mortality was 16%. The independent predictors of mortality were hypoxemia (adjusted odds ratio [aOR]: 2.5; 95% CI: 1.3-5.1) and creatinine \u3e 1.5 mg/dL (aOR: 4.3; 95% CI: 1.9-9.8)