Determinants of Low Back Pain among Health‑care Providers in a Federal Tertiary Hospital in Ekiti State, SouthWestern Nigeria

Introduction: Low back pain (LBP) is a usual musculoskeletal system disorder among the working population, especially among health‑care providers (HCPs). It is a significant contributor to work disability, work absenteeism, and lost hours globally. The study objectives are to find the prevalence and determinants of LBP among HCPs in a Federal Tertiary Hospital in Ido‑Ekiti, Ekiti State, Nigeria. Subjects and Methods: A cross‑sectional study was done among HCPs in a Federal Tertiary Hospital, Ido‑Ekiti, Ekiti State, Nigeria. The study included 336 participants working in the hospital. The respondents were selected using stratified sampling. Data were collected through an adapted questionnaire, which was pretested, semi‑structured, and self‑administered. The data were analyzed using STATA  version 12. Univariate, bivariate, and binary logistic analysis was used to find the prevalence and determinants of LBP. The significance level was set at 95% confidence interval and P ≤ 0.05. Results: The point prevalence, period prevalence, and lifetime prevalence were 39.9%, 44.6%, and 67.6%, respectively. The findings showed that the prevalence of LBP was higher among respondents who turn patient on the bed regularly (>3 times weekly) (odds ratio [OR] =18.46, 95% CL [6.84–49.81], P < 0.0001); and pulls and pushes object or people (more than 10 kg thrice a week) (OR = 8.22, 95% CL  [3.46–19.56], P < 0.0001) were statistically significant. Conclusion: The study revealed that HCPs suffered from a high prevalence of LBP, and the identified risk factors (turning of the patient and pulling and pushing of an object or  people) can be modified using an informed health intervention program (health education and ergonomics)

Analysis of household energy consumption in Nigeria

Energy plays a vital role in the development of any country. In the context of the developing economies, the growth in energy consumption is associated with urbanisation and economic development through the transfer of mobile factors of production from rural to urban areas, and by the transition of the economy from a dominantly agricultural based economy to a relatively more industrialised type. Nigeria as one of the key economies in the African continent faces many challenges in this transitionary path; population growth and the growing movement of population from rural to urban areas creates a challenge for policy makers in terms of planning energy and other infrastructure needs. Planning for future may involve accurate estimation of energy needs and while there are some attempts made at understanding the patterns of demand for energy in industrial sectors, there is a scant amount of research into the patterns of consumption by households. Sources of energy for households are numerous and many traditional sources of energy are commonly used for their availability, low or no cost. However, such energy sources can be harmful for the environment and are gradually being replaced by the use of electricity due to its convenience and compatibility with the modern style of living in cities. Following an initial literature review of the most commonly used simulation modelling techniques in the field of energy consumption this paper will report on the outcomes of a model of energy consumption for the residential sector, followed by a large survey of the household behaviour in selected parts of Nigeria. The research reported here challenges the use of traditional models used for estimation of energy consumption in developed countries for countries such as Nigeria. The existence and size of the black economy as relating to the use and abuse of electricity is highlighted and various hypotheses of this research reject the Energy Ladder theory which assumes a stepwise transition into more sophisticated types of energy (i.e. electricity). The paper makes a number of contributions which are important in the debate on planning for energy in developing countries

Public perceptions and experiences of COVID-19 pandemic in Ekiti: A qualitative study using thematic analysis

Background: COVID-19 pandemic has been a turbulent crisis that took the globe by surprise, killing thousands of people. Nonetheless, individuals with underlying conditions are considered to be at risk. Aim: The study examined public perceptions of the vulnerability influencing the spread of COVID-19 in Ekiti State, Nigeria. Materials and Methods: The study used a qualitative method in which 65 participated in focus group discussions to elicit information about the subject matter. Thematic analysis was used to analyse field data. Results: The study found that vulnerability to COVID-19 was based on the following themes: immunity, imported, complications, lack of knowledge, recklessness and anyone. As a result, the study concluded that individuals can be vulnerable to COVID-19 if the person has weakened or impaired immunity and that the virus was imported from other countries. Conclusion: In addition, having any of the following underlying conditions such as asthma, diabetes, heart or liver or being ignorant of the spread of the virus, and failing to follow COVID-19 containment guidelines can make people more vulnerable to the virus. Recommendations: The study, therefore, recommends that health education about the virus be implemented. This could be directed towards strengthening beliefs that conform to accepted scientific views of COVID-19 and weakening those that do not. Notably, the public should be encouraged to follow COVID-19 containment guidelines, which include wearing a face masks, washing and sanitising our hands, and social distancing

Accuracy of the Siriraj Stroke Score in Differentiating Cerebral Haemorrhage and Infarction in African Nigerians (English)

Background Scoring systems based on discriminant analysis technique and multivariate logistic regression have been developed to distinguish cerebral haemorrhage (CH) from cerebral infarction (CI). This distinction is necessary in the acute management of stroke patients. Objectif The Siriraj stroke score (SSS) was evaluated in Siriraj hospital, Bangkok, and the Western Infirmary, Glasgow, and needs to be validated in an African setting. Methodology The computerised tomography (CT) brain scans of all patients referred with clinical diagnosis of stroke at the University College Hospital (UCH), Ibadan, and RADMED diagnostic centre, Lagos were retrieved and reviewed as well as the case notes of the patients at the referral hospitals. The SSS was computed and the stroke subtype classified. This was compared with the CTscan diagnosis using the latter as the gold standard. Data analysis was performed with Epi-info software and by standard statistical methods. Results Ninety-six patients had complete clinical records and CT scan features consistent with stroke. Of these, 52 had cerebral infarction (CI) and 44 had cerebral haemorrhage (CH). SSS had sensitivity of 50% for CH and 58% for CI with an accuracy of 54.2%. Conclusion In this study, the SSS was not sufficiently sensitive to differentiate between CH and CI in Africans. A prospective study with larger sample size and modification of the discriminant variables is suggested. For now, while efforts must continue to find a simple clinical scoring system to differentiate between CH and CI, we contend that CTscan should remain the investigative technique of choice and should be made affordable and available. Keywords: Africa, cerebral haemorrhage, cerebral infarction, Nigeria, stroke, CT-scan, Accident vasculaire cérébral hemorragique, Accident vasculaire cérébral ischémique, A frique, Nigeria, tomodensitométrie Résumé  Introduction Dans le but d\'agir avec efficacité dans la prise en charge thérapeutique des accidents vasculaires cérébraux un score discriminant à l\'aide de variables multiples a été élaboré afin de distinguer les accidents vasculaires hémorragiques (AVCH) des accidents vasculaires ischémiques (AVCI). Objective Le Siriraj stroke score (SSS) a été évalué au Siriraj hospital, Bangkok et au Western infirmary, Glasgow. Il importait de le valider dans le cadre africain. Méthodologie Les dossiers des malades hospitalisés au Centre Hospitalier Universitaire d\'Ibadan et au centre diagnostic RADMED à Lagos ont été étudiés rétrospectvement de même que les CT-scan. Les données scannographiques ont été comparées au SSS. Les informations ont été analysées grâce au logiciel Epi-info et à l\'aide de différentes méthodes stastistiques. Résultats 96 patitents ont été retenus. 52 malades avaient un infarcissement cérébral et 44 une hémorragie cérébrale. Le SSS avait une sensiblité de 50% pour les AVC hémorragiques et 58% pour les AVCI avec une spécificité de 54,2%. Conclusion Cette étude permet de conclure en l\'absence de spécificité du SSS dans la distinction des AVCH et AVCI chez les Africains. Une étude prospective est préconisée en modifiant certaines variables. Actuellement le CT-scan reste la technique de choix pour différencier les AVCI des AVCH. Af J Neuro Sci: 2002 20(1

ACCURACY OF THE SIRIRAJ STROKE SCORE IN DIFFERENTIATING CEREBRAL HAEMORRAGHE AND INFARCTION IN AFRICAN NIGERIANS

Background: Scoring systems based on discriminant analysis technique and multivariate logistic regression have been developed to distinguish cerebral haemorrhage (CH) from cerebral infarction (CI). This distinction is necessary in the acute management of stroke patients. The Siriraj stroke score (SSS) was evaluated in Siriraj hospital, Bangkok, and the Western Infirmary, Glasgow, and needs to be validated in an African setting. Methodology: The computerised tomography (CT) brain scans of all patients referred with clinical diagnosis of stroke at the University College Hospital (UCH), Ibadan, and RADMED diagnostic centre, Lagos were retrieved and reviewed as well as the case notes of the patients at the referral hospitals. The SSS was computed and the stroke subtype classified. This was compared with the CT scan diagnosis using the latter as the gold standard. Data analysis was performed with Epi-info software and by standard statistical methods. Results: Ninety-six patients had complete clinical records and CT scan features consistent with stroke. Of these, 52 had cerebral infarction (CI) and 44 had cerebral haemorrhage (CH). SSS had sensitivity of 50% for CH and 58% for CI with an accuracy of 54.2%. Conclusion: In this study, the SSS was not sufficiently sensitive to differentiate between CH and CI in Africans. A prospective study with larger sample size and modification of the discriminant variables is suggested. For now, while efforts must continue to find a simple clinical scoring system to differentiate between CH and CI, we contend that CT scan should remain the investigative technique of choice and should be made affordable and available

The Role of International Flights in Covid-19 Pandemic: Global, Africa and Nigeria’s Narratives

The World Health Organization (WHO) officially declared the novel Coronavirus outbreak a pandemic on the 11th of March, 2020. International flights from the epicenter of the outbreak (Wuhan, China) were identified as a key driver of the current pandemic. About 231 international flights were reported to have left China to other parts of the world in January, 2020. Exposed individuals who travelled from the epicenter of the outbreak to different countries by international flights for one reason or the other were responsible for exporting the virus to their various country of destination. In order to prevent the spread of the virus, many countries took some strict measures including the closing down of their airports and air spaces to international flights from high risk countries as the number of confirmed cases and fatalities began to rise. Lack of activities resulted to huge financial losses in the aviation industry with many airline operators laying off their workers. In other to ameliorate the negative impacts of the pandemic on the global economy after several months of lockdown; many countries have now re-open their airports and resume international flight operations; without recourse to the possibility of a second wave. In the absence of strict adherence to the COVID-19 safety guidelines, accidental exposure to the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) can occur at any point: pre-boarding, boarding or post-boarding. SARS-CoV-2 may be contracted from infected airport workers, cabin crew members or passengers, whether they show symptoms or not. In view of the renewed upsurge of the virus globally, the need to optimize disease surveillance system at various international airports across the globe, as well as ensuring strict compliance to the international travel advisory cannot be overemphasized. This paper seeks to examine the role of international flights in COVID-19 pandemic; including the associated impacts, risk of exposure and guidelines for safe flight operations in the aviation industry amidst the pandemic

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways