Health careworkers and risk of hospital-related tuberculosis

To determine the incidence and risk of hospital-related TB amongst the health care workers and trainee students of this institution.Retrospective study. Chart review of PTB and EPTB diagnosed byAAFB in sputum, suggestive chest X-ray features of TBand aspiration cytology or tissue histology. Thirty-two (1.5%) of the 2,173 total staff strength developed occupation-related TB in a 15 year period, 15 (47.0%) of which presented as HIV/TB co-infection. Junior HCWs were mostly affected and the male:female ratiowas about 1:2. PTB occurred in 25 staffs (78.1%), EPTB occurred in 5 (15.6%) and 2 (6.3%) had disseminated TB. HCWs directly caring for patients; 24 (75.0%) were mostly affected. They were HCWs from nursing, 15 (47.0%) and clinical services, 9 (28.0%). Duration of employment of the affected HCWs varied from half a year to 11.5 years and the rate of diagnosis of cases varied from nil to 3 per year. Identified risks for acquiring and developing active TB in the hospitalwere; HIVinfection 47.%, diabetesmellitus 9.4%, “alcoholic” liver cirrhosis; 6.3%and chronic obstructive pulmonary disease 3.1%. Incidence of hospital-related TB is low amongst the staffs of UITH; however, all the HCWs of the hospital were at risk of exposure. Staffs at the clinical sections had the highest frequency of developing occupation-relatedTB, and HIV infectionwas the commonest risk factor. . Keywords:Hospital-related TB; Health care workers and Risk factors Nigerian Journal of Clinical Practice Vol. 11 (1) 2008: pp.32-3

Does health-related quality of life in asthma patients correlate with the clinical indices?

Background: Assessment of health-related quality of life (HRQOL) has been shown to be more relevant to patients who have chronic diseases such as asthma, as achieving the best possible quality of life is the  paramount objective in the management of such patients. This study assessed the quality of life of asthma patients and correlated it with the various clinical indices of asthma, such as age, sex, the duration of the asthma, medication used and its severity.Design: The study was a cross-sectional, analytical, case-control design, involving three approaches, i.e. quality of life, clinical assessment and lung function assessment. The patients who participated in this study completed the Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Questionnaire (ACQ). Statistical analysis was performed using Epi Info™ version 6.04.Setting and subjects: The clinical setting was the respiratory unit of the department of Medicine, University of Benin Teaching Hospital, Benin City, Nigeria. The recruited patients held various professions. A diagnosis of asthma was made using the clinical features of asthma and lung function measurements with a spirometer and MicroWright® Peak flow meters.Outcome measures: The outcome measures were the quality of life score scores and clinical indices of asthma in patients attending the respiratory unit of the University of Benin.Results: Subjects had significantly low lung function values when compared with the controls (p-value < 0.05). The quality of life of asthmatics was 4.82 ± 1.16 (1-7) and correlated with the duration of asthma (r = -0.83), body mass index, medication used (r = 0.96), asthma severity (r = 0.96) and gender (r = 1). The difference between male and female quality-of-life values was significant (p-value < 0.05). However, there was no correlation between age and quality of life (r = 0.06).Conclusion: The overall assessment showed that quality of life with regard to asthma was low in this study, and correlated with some clinical asthma indices. The determinants of quality of life in this study included the  duration of asthma, body mass index, asthma severity, medication use and gender

General practitioner reported follow–up visits among asthma patients in North Central Nigeria

Background: Despite the benefits of regular follow–up in the long–term care of asthma, no previous study has reported on it among asthma patients in Nigeria. Objective: This survey was designed to evaluate GP–reported follow–up visits among asthma patients in North Central Nigeria. Methods: It was a cross–sectional survey conducted among GPs in three North Central states of Nigeria. Results: Overall, 48.3% of the GPs reported that their patients usually come for follow-up visits. About 63.6%, 40.0%, and 55.3% of the GPs in Kwara, Kogi, and Niger states, respectively, reported that their patients came for follow–up visits in the month prior to this study. Less than two–third of GPs in both private (55.1%) and public (56.8%) hospitals reportedly attended to patients on follow–up visits. About 46.5%, 37.5%, and 52.0% of the GPs who attended to patients 2 weeks prior to the study reported that their patients came for follow–up visits. There was signifi cant difference (P = 0.04) in the reported follow–up visits by GPs who attended to ≥ 10 asthma patients compared to others. None of the nine GPs who reportedly treated ≥ 10 patients in the preceding month of the study attended to any patient on follow–up visits. Conclusion: The GP–reported rates of follow–up visits in patients that are accessing asthma care from GPs practicing in the North Central part of Nigeria are low. Further studies to identify barriers to follow–up visits and how to correct them are therefore recommended.Keywords: Asthma care, follow—up visits general practitioners, NigeriaArrière-plan: Malgré les avantages de suivi régulier–jusqu’à long - term care de l’asthme, aucune étude antérieure n’a signalé sur elle chez les patients asthmatiques au Nigeria. Objectif: Ce sondage a été conçu pour évaluer les GP–signalés suivi–visites chez les patients asthmatiques au Centre Nord du Nigéria. Méthodes: C’est une croix–sectionnelle enquête menée parmi les GPs dans trois États centrale du Nord du Nigéria. Résultats: Dans l’ensemble, 48,3% des GPs a signalé que les patients sont en général pour des visites de suivi. 63,6% Environ, 40,0% 55,3% des GPs dans les États Kwara, Kogi et au Niger, respectivement, rapporte et que leurs patients sont venus pour suivi–visites dans le mois précédant cette étude. Moins de deux - tiers des GPs dans les hôpitaux publics (56,8%) et le privé (55,1%) auraient été assisté aux patients sur suivi–visites. Environ 46,5%, 37,5% et 52,0% le GPS qui ont participé aux patients 2 semaines avant l’étude rapporte que leurs patients sont venus pour suivi–visites. Il y avait une différence signifi cative (P = 0,04) dans le suivi déclaré–up visites par GPs qui ont participé à ≥ 10 patients asthmatiques par rapport aux autres. Aucun des neuf GPs qui auraient été traités ≥ 10 patients dans le mois précédent de l’étude ont assisté à tout patient sur suivi–visites. Conclusion: Le GP–taux signalés de suivi–visites chez les patients qui sont à accéder aux soins de l’asthme de GPs pratiquant dans la partie centrale du Nord du Nigéria sont faibles. D’autres études pour identifi er les obstacles à suivre–visites et comment à correct eux sont donc recommandés.Mots clés: L’asthme care, suivre — up généralistes, des visites, Nigeri

REPEAT PUBLICATION : Aspiration Pneumonia in Acute Stroke

This was a prospective study that was conducted between July 2000 and September 2001. It was designed to determine the incidence and the risk factor(s) of aspiration pneumonia in patients with acute cerebrovascular accident. Aspiration pneumonia was recorded in 23.5% of the 68 patients that were recruited. The major predisposing factors identified were disorder of swallowing which increased the risk of aspiration pneumonia by more than 4 times. The relative risk (RR) was 4.5 and the 95% confidence interval (95%Cl) was 1.25-16.25. Abnormal voluntary cough increased the risk by 3 folds. RR was 3 and (95%Cl) was 0.85-10.63. And depressed level of consciousness had 2.3 times risk with RR of 2.33 and (95%Cl) of 0.83-6.54. Combination of abnormal gag reflex and facial palsy was another significant risk factor; the RR was 2 and (95%Cl) was 0.71 – 5.62. Sahel Med. J. Vol.6(3) 2003: 94-9

Influence of highly active antiretroviral therapy (HAART) on the survival of HIV-infected patients: part report of the Ilorin Trial Center

This report is part of the ongoing highly active antiretroviral therapy (HAART) trial, 167 patients were enlisted, but current analysis was restricted to 107 patients that were about a year old on the programme. The baseline weight, CD4+ cell count and serum albumin of 59 males and 48 females age 15-60 years, were compared with values at 12 months of administration of HAART. Patients mean weight, CD4+ count and serum albumin increased significantly (p-value < 0.05) by 9.7kg, 127.4/uL and 9.1g/L over the enrolment values. Side effects of antiretroviral (ARV) drugs were mild and included; rashes 19.6%, jaundice 7.5% and reactive arthritis 3.5%. Fifty-eight patients (59%) were alive by the end of 1 year, 33 (30%) had died and 11 (10.8%) were lost to follow-up. The risk of death increased 3 times when baseline CD4+ count was less than 116.8/uL (RR= 3.36, 95%CI=1.86– 6.06, P-value = 0.000048). TB/HIV co-infection raised the chance of death twice (RR= 2.33, 95%CI=1.31-4.15, P- value=0.005). In conclusion, the use of triple-drug combination of HAART has led to improved CD4+ cell count and resolution of clinical symptoms in HIV/AIDS patients. These resulted in increased survival. Key Words: HAART, AIDS, CD4+ cells count and survival. Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005:34-3

Prevalence And Socio-Demographic Determinants Of Obesity Among Adults In An Urban Nigerian Population

Objectives: The aim of this study was to establish the prevalence and socio-demographic determinants of obesity among adults in an urban Nigerian population. Subjects and methods: We recruited 810 subjects between the ages of 18 to 65 years by the multi-stage cluster sampling method. Structured questionnaire was used to collect socio-demographic data's. The body weight (kg) and height (m) of subjects were measured and body mass index (BMI) calculated. Results: The prevalence of obesity was 9.8% and overweight was 35.1 %. Out of the 79 obese subjects, 24.1% were males and 75.9% were females, the male to female ratio was 1:3. Obesity was strongly associated with female gender, subjects age &#8805; 40 years and marriage, while educational attainment and socioeconomic class were not significantly associated with the diagnosis of obesity. The socio-demographic determinants of obesity among adult in this urban Nigerian population were female gender, marriage and age &#8805; 40 years. Conclusion: The prevalence of obesity was low when compared to the developed countries. However, it is imperative to increase the awareness of the disease among the populace. Keywords: Prevalence, Socio-demographic, Determinants, Obesity, Adult, Urban, Nigerian Sahel Medical Journal Vol. 11 (2) 2008: pp. 61-6

An audit of spirometry at the University of Ilorin Teaching Hospital, Ilorin, Nigeria (2002–2009)

Background: Spirometry is a noninvasive and cost-effective physiologic test that greatly complements other investigative procedures in evaluation of respiratory conditions. This study was aimed at auditing the spirometryperformed at the University of Ilorin Teaching Hospital (UITH) Ilorin, Nigeria, and highlighting some of the challenges associated with the procedure.Methods: We reviewed and analyzed the record of spirometry performed at the cardiopulmonary unit of the hospital from June 2002 to December 2009.Results: A total of 119 patients had spirometry tests from 2002 to 2009 and their age ranged from 15 to 85 years with a mean of 47.6 ± 14.8 years. There were 69 (58%) males and the male:female ratio was 1.4:1. More than half (65%) of the tests were in patient

Pattern of lipid profiles in hiv seropositive subjects on antiretroviral therapy

No Abstract

KALA-AZAR IN A NIGERIAN: REPORT OF A CASE WITH A FATAL OUTCOME

A case of visceral leishmaniasis (Kala-azar) in a 60-year-old Nigerian female is presented. The clinical findings were fever, weight loss, lympadenopathy, hepatomegaly, and self-healing cutaneous ulcers. Laboratory findings included severe anaemia, lymphocytosis and amastigotes in the blood smear. The patient died before she could be commenced on the pentavalent antimonial specific for the disease. African Journal Of Clinical And Experimental Microbiology Jan 2004 Vol.5 No.1 40-4

Assessment of Lipid Profile in HIV Seropositive Pregnant Women attending Ante-Natal Clinic in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria

Background: Undesirable changes in lipid metabolism have been reported among HIV-infected individuals undergoing anti-retroviral therapy. Considering the peculiarity of pregnant women who are also faced with similar metabolic changes, it becomes necessary to ascertain lipid changes that occur in them, and assess the effect of anti-retroviral therapy (ART), diet and physical exercise on their lipid profile.Methods: The study was conducted in Nnamdi Azikiwe University Teaching Hospital, Nnewi in Anambra State, Nigeria. One hundred subjects were recruited for this study. This comprised of 50 HIV sero-positive pregnant women (test) and 50matched HIV sero-negative, pregnant women (controls) attending ante-natal clinic. Questionnaires and patient records were used to obtain data and information on the subjects. They were categorized into three groups based on dietary intake (carbohydrate-rich, protein-rich and cholesterol-rich) and into two groups based on exposure to physical activity, at least one hour daily exercising and non-exercising. After an overnight fast, 5mls of blood was collected from all subjects into plain tubes and sera analyzed for total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol (HDL-C) using the VITROS 350 automatic chemistry analyzer.Result: The lipid profile of HIV sero-positive pregnant women were significantly lower than in sero-negative pregnant women (p=0.028).There was no statistically significant difference in lipid profile between those on ART and those not on ART. With physical exercise decreased levels of lipids were observed in both test and control groups (p&lt;0.05). There was significant difference in the TC and LDL-C with respect to the diets for carbohydrate-rich, protein-rich and cholesterol-rich diets (p&lt;0.05) in the control group.Conclusion: Findings from this study suggest that HIV does alter the lipid profile of HIV-infected pregnant women. This, however, causes a deranged lipid profile. Physical activity and diet also play important roles in the regulation of lipid levels