The prevalence of hypertension and its modifiable risk factors among lecturers of a medical school in Port Harcourt, south-south Nigeria: Implications for control effort

Background: Hypertension and other noncommunicable diseases are currently responsible for at least 20% of all deaths in Nigeria, and constitute up to 60% of the patients admitted into the medical wards of most tertiary hospitals in Nigeria. Yet, the treatment outcomes for the diseases have remained very poor, prompting calls for better patienteducation. It has however been established that the effectiveness of patient education is linked to the healthy habits of the doctor. This study was conducted to find out the prevalence of hypertension and its modifiable risk factors among the lecturers of the University of Port Harcourt Medical School.Materials and Methods: A descriptive cross-sectional study design was used, with the data collected using a modified form of the WHO STEPS instrument that consists of a questionnaire component and the  measurement of body mass index (BMI) and blood pressure. The questionnaire was used to collect information on the sociodemographiccharacteristics of the respondents, the use of tobacco, the consumption of alcohol, the type of diet, and the amount and types of physical activities undertaken.Results: A total of 75 lecturers participated fully in the study, out of an eligible total of 109. They were mostly males (65.33%), married (88.33%), and had an average age of 46.06 ± 9.62 years. The prevalence of hypertension was 21.33%; out of which 12 (75.00%) were already aware of their status, and were on appropriate therapy. Only 13 (17.33%) of thelecturers were of normal weight, 45 (60.00%) were overweight, while 17 (22.67%) were obese. Only 2 (2.67%) currently smoke, while most (94.67%) drank less than three standard units of alcohol in a day, mainly in social occasions.Conclusion: The prevalence of hypertension among the lecturers in the medical school was lower than that in the general population, mainly due to their better health-seeking behavior and healthy lifestyle.Key words: Epidemiological transition, hypertension, medical lecturers, modifiable risk factors, Nigeria, Port Harcour

Incidence and reasons for Discharge Against Medical Advice in a tertiary health care facility in Port Harcourt, south-south Nigeria

Background;  Disease pattern in Nigeria is changing from communicable diseases to non-communicable diseases. However, the approach to patient care has not changed; neither has the expectations of the general public for quick recovery. These have resulted in poorer treatment outcome and patients' dissatisfaction that sometime result in discharge against medical advice. This study is to ascertain the reasons for the growing incidence of discharges against medical advice in the medical wards of the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.Materials and Methods:  A two year review of the records of all the patients discharged against medical advice in the medical wards of the hospital was carried out. Data collected included the number and socio-demographic characteristics of the patients, the main medical condition they were treated for, the duration of their stay in hospital, the stated principal reasons for the discharge and signatories to the discharge document.Results:  The proportion of patients discharged against medical advice during the study period was 5.4%. Out of the 118 patients whose records were available for analysis, 55.1% were males; they had an average age of 45.6 +/- 12.6 years, and half were within the middle socio-economic class. The patients spent an average of 12.9 +/- 7.6 days in the hospital before asking for the discharge; and most (75.4%) were managed for non-communicable diseases. The main reasons for asking for discharge included poor treatment outcome (42.4%), financial constraints (28.0%) and a desire to seek other treatment options (22.0%). The signatories for the discharge were mainly the relatives (22.0%), children (22.9%), spouse (25.4%), and others, including the friends and religious leaders of the patients (17.0%).Conclusion: Discharge against medical advice is often due to poor treatment outcome. Serious efforts should be made to correct this, with the immediate adoption of the WHO's Innovative Care for Chronic Condition (ICCC) framework.Keywords: Healer shopping, Discharge Against Medical Advice, Noncommunicable diseases, epidemiological transition, Port Harcourt, Nigeri

An evaluation of the volume and concentration of alcoholic beverages offered for sale in Port Harcourt, South-South Nigeria

Background: One of the strategies for tackling alcoholrelated problem is education and persuasion on how to drink alcohol in moderation. This is often facilitated by the introduction of a standard alcoholic drink measure, and a recommended daily alcohol consumption limit. The objective of this study was to evaluate the volume and alcohol concentration of alcoholic beverages offered for sale in Port Harcourt, with a view to establishing their suitability in the growing effort to achieve moderation in alcohol intake.Methods: The study was carried out in ten beer bars in various parts of Port Harcourt, using a descriptive crosssectional study design. Data collection was done using a semi-structured questionnaire, and field observations. The questionnaires were administered on the proprietors of the beer bars and their attendants, while the field observations were carried out using a checklist.Results: A total of eight different brands of industrial beer were most commonly offered for sale. All the brands were in 600ml bottles, except the stout variety that also had a smaller 330ml bottle. The alcoholic content of the brands ranged from 4.7% to the 7.5%, while the alcohol concentration per bottle ranged from 19.3g to 35.6g. All the brands had their alcoholic contents written on their labels, but none had any health warning. Only two out of the ten proprietors were aware of the Liquor licensing law, but none obtained a license before opening their businesses.Conclusions: The alcoholic content of the standard bottle of beer sold in Port Harcourt is high. A legislation that would restrict beer bottles to a 330ml capacity is therefore recommended.Keywords: Alcohol content, Standard drink measure, Sales regulation, Port Harcour

Improving skilled attendants at birth: Experience in a primary health care facility in Rivers State, South-South Nigeria.

Background: Skilled attendance at birth has been identified as one of the most cost-effective methods of reducing maternal and neonatal mortality, but in spite of the efforts made to address the poor access in Nigeria, utilization in some communities is surprisingly poor. This study highlighted the experience of a primary health care (PHC) facility in south-south Nigeria, in encouraging the utilization of its maternity services.Methods: The study is a review of the antenatal and delivery records of PHC Aluu, before and after an educational programme, to improve the utilization of its maternity services, especially by patients that had antenatal care (ANC) in the facility. An exit interview of the antenatal patients was also carried out to collect relevant information.Results:  Antenatal registration increased by 15.04% after the programme, but there were no significant differences in the socio-demographic characteristics of the patients (p-value > 0.05). The ANC-Delivery ratio of the health center increased by 3.09% (p-value > 0.05); the patients that had their babies in the facility were mostly (60.71%) non-indigenes, with (61.16%) tertiary education, and several were nulliparous (41.52%), but there were no significant differences in the socio-demographic characteristics of the patients, before and after the programme (p-value >0.05). Most (51.84%) of the respondents of the exit interview registered at the health center, for the privileged access to the teaching hospital; several of them (56.33%) would prefer to give birth in the health center; but most (54.69%) believed that the difficulty in getting to the health center, might discourage several women from having their babies in the health center.Conclusions: The efforts made by the PHC facility to improve the patronage of its maternity services only resulted in a small increase. Patronage can be improved if deliberate effort is made to out-compete the unorthodox birth attendants, and if there is a proper division of labour amongst the three tiers of the health system.Keywords: Skilled Birth Attendant, Basic Obstetric Care,Traditional Birth Attendants, Maternal Mortality, Neonatal Mortality, Primary Health Care, Rivers State, Nigeria

Alcohol consumption among pregnant women attending the ante.natal clinic of a tertiary hospital in South.South Nigeria

Background: As efforts to reduce maternal and childhood mortality rates continue to yield results in Nigeria, it is time to put more emphases on the health of children. Alcohol consumption is one of the few modifiable risk factors for poor pregnancy outcome. This study assessed the consumption of alcohol among pregnant women attending the antenatal clinic of the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.Materials and Methods: This study was carried out using a descriptive cross.sectional study design, with data collected using an  interviewer.administered questionnaire. The questionnaire was used to collect information on the knowledge of the harmful effects of alcohol on the fetus, attitudes toward alcohol use by pregnant women, and alcohol use by the respondents.Results: A total of 221 subjects were studied. The respondents had an average age of 29.5 } 4.6 years, were mostly married (96.83%), Christians (94.57%), and had tertiary education (73.76%). Only, 51.58% of the respondents knew of the harmful effects of alcohol on the fetus; of whom, 62.29% were told by a health professional. More than half (59.28%) of the respondents had taken alcohol during the index pregnancy, about a third (39.40%) of whom drank alcohol on a regular basis, whereas 25.79% were binge drinkers. There were no statistically significant differences in the marital (P = 0.16) and educational status (P = 0.15) of the  respondents who abstained from alcohol in the index pregnancy, compared with those who drank alcohol; although, statistically significant differences were observed in the age (P < 0.001), parity (P = 0.02) and religion (P < 0.001) of the respondents.Conclusion: The level of alcohol consumption among the pregnant women is high. Health education is, therefore, required to change the attitude of the public and the knowledge and behavior of the pregnant women.Key words: Alcohol consumption during pregnancy, fetal alcohol spectrum disorder, Nigeria, Port Harcour

A survey of the community water supply of some communities in Rivers State, south-south Nigeria.

Background: Water is essential for health, and therefore considered a fundamental human need that as a matter of right should be provided for all. The provision of quality portable water is therefore one of the millennium development goals. The objective of this study is to examine the water situation in some communities in the oil rich Niger delta region of Nigeria.Method: The study was carried out in 14 rural and semiurban communities in Rivers State, south-south Nigeria, using a descriptive cross-sectional study design. Data was collected using key informant interviews, field observations and focus group discussions. An inventory of the community water supply facilities in the communities was done, and information collected on the functionality, access and quality of the facilities.Results: There were a total of 89 community water supply facilities in the communities, an average of 6.4 per community. However, only three of the communities had piped water supply, but with very few household connections. Most of the facilities were either provided by government and its agencies (73.03%), or provided by the oil companies operating in the communities (24.72%). Only (34.83%) of the facilities were however noted to be functional. Even as 32.43% of the water samples were found to contain significant numbers of Escherichia coli; all the samples collected from the rivers in the communities were found to be heavily contaminated. The median time spent in a round trip to a water facility was found to be 7.8 minutes, with 75.37% of the drawers spending less than 15 minutes for the trip.Conclusions: Most of the oil bearing communities had easy access to improved water supply, but most of the facilities were nonfunctional, with little community input in their operation and maintenance.Keywords: Community Water Supply, Niger delta, Nigeria

The Environmental Health Condition of The New University of Port Harcourt Teaching Hospital.

Introduction: The hospital plays a significant role in modern health care delivery; while it provides an avenue for the treatment of patients, it can also encourage the transmission of several disease agents. Environmental interventions are routinely used to make the hospital safe. This study examined the facilities at the permanent site of the University of Port Harcourt Teaching Hospital (UPTH), a 510 bed multi-specialist hospital in Port Harcourt, south-south Nigeria.Method: The study was carried out using an assessment checklist originally developed by the WHO. Data collected include the quantity and quality of water provided for services in the hospital; the number, types and maintenance of the toilet facilities; the building design as it relates to ventilation; and the methods used in the hospital for the control of mosquitoes.Results: The hospital was built on a marshy ground, and was heavily infested with mosquitoes. It needed 24, 776 liters of water daily for its services, which was provided from an underground source, though the water was not routinely disinfected. Although the hospital had an average of 5 toilets in its out-patient clinics, and one toilet for every 12.75 in-patients; open defecation was however common, especially close to the in-patient wards. The in-patient wards had large windows, but the out-patient clinics had poor natural lighting, small windows and had to rely on massive air conditioning sets for ventilation.Conclusion: The permanent site of the hospital had all the facilities required for the safety and comfort of clients and staff, but maintenance has been an expensive and difficult task. Technologies and designs suitable for the tropical environment, hard-wearing, durable and culturally sensitive are hereby recommended.Keywords: Patient safety, environmental health condition, University of Port Harcourt Teaching Hospital, Port Harcour

Sanitation facilities and hygiene practices in a semi-urban community in Rivers State, south-south Nigeria.

Background: Water and sanitation projects are synergistic in producing health effects; while there has been massive investment in water projects as part of the effort to achieve the Millennium Development Goal on access to water and sanitation; the same cannot be said for sanitation projects. This study examined the state of sanitation facilities and hygiene behaviour in an oil rich community in the Niger delta region of Nigeria.Method: The study was carried out in Ogbogu, a small semi-urban community in Rivers State, south-south Nigeria, using a descriptive cross-sectional study design. The data was collected using a structured interviewer-administered questionnaire, field observations and focus group discussions. The questionnaire was administered to female heads of households with under-five children; the field observations consisted of direct observations, spot checks and rating checks of sanitation facilities and hygiene behaviour of the respondents; while the focus group discussions were held with executive members of the community's women's association.Results: Only 68% of the households in the community had access to a sanitation facility. The reasons given for not having a sanitation facility include lack of space (85.92%), and cost (12.68%). Most of the facilities were flush toilets (61.07%), and they formed 87.95% of the 83 facilities found to be in good hygienic condition. Of the respondents with sanitation facility, 28.86% would not allow young children to use the facility. Only 21.36% of the respondents routinely disposed the stool of their children into the sanitation facility; human faeces were consequently found around the house of 40% of the respondents. About 22% of the respondents were found to have the appropriate hand washing behaviour; while the two week period prevalence of diarrhea amongst children less than 36 weeks was 14.09%.Conclusions: The access to sanitation facility, and hand washing behaviour in the study community were poor. Hygiene education and social marketing of sanitation facilities are hereby advised.Keywords: Sanitation facility; hygiene practices; Semi-Urban community; Nigeria

Knowledge, attitude, and infection control practices of two tertiary hospitals in Port‑Harcourt, Nigeria

Background: Surgical site infections (SSIs) are a significant cause of morbidity, emotional stress and financial cost to the affected patients and health care institutions, and infection control policy has been shown to reduce the burden of SSI in several health care institutions. This study assessed the effects of the implementation of the policy in a tertiary hospital in Port Harcourt, Nigeria.Materials and Methods: A cross‑sectional, comparative study design was used for the study, with data collected using a structured questionnaire and guided observation of doctors and nurses involved in the management of patients that had caesarean sections in two comparable tertiary hospitals in Port Harcourt‑the University of Port Harcourt Teaching Hospital (UPTH) and the Braithwaite Memorial Specialist Hospital (BMSH).Results: There were no statistically significant differences in the designations and length of practice of the respondents in both hospitals (P = 0.77). However, 63.64% of the respondents in UPTH were aware of the infection control committee, compared with none in BMSH. The appropriate timing for the administration of prophylactic antibiotics, and for the removal of the hair at the incision site were observed by 57.58% and 69.69% respectively of the respondents in UPTH, compared with 22.86% (P = 0.00) and 0.00% (P = 0.02) in BMSH. The reasons given by the respondents in UPTH for nonadherence to the infection control policy include poor supervision (39.39%) and lack of in‑service training (21.21%), while the respondents in BMSH gave reasons that include inadequate supply of consumables (34.29%) and absence of a hospital’s policy on infection control (22.88%).Conclusion: The implementation of the infection control policy resulted in some improvements in certain infection control practices.Keywords: Adherence, hospital infection control committee, hospital infection control policy, Nigeria, Port Harcourt, practice, surgical site infectio

Impact of Oral Diseases on the Quality of Life of Public Service Workers in Port Harcourt, Nigeria

Background: The oral health impact profile-14 (OHIP-14) scale is a valid, reliable and globally accepted tool for comprehensive measure of self-reported dysfunction, discomfort and disability attributed to oral conditions. The objective of this study was to evaluate subjectively the impact of oral disease on the quality of life of public service workers in Port Harcourt, Rivers State, Nigeria. Materials and methods: The study was a cross-sectional study conducted among public service workers in Port Harcourt, Rivers State, Nigeria. A total of 638 participants were selected using multistage sampling technique. Data werecollected using pre-tested self-administered questionnaires containing information on biodemographics, dental service utilization and OHIP-14 variables. Analysis of OHIP-14 was done using the simple count and additive method on statistical package for social sciences spread sheet. Results: About 20% of the participants had OHIP score > 14. A total of 143 (22.4%) participants had utilized dental services in the past, 62.4% of this had OHIP score > 14. The impact as aresult of oral health status experienced among the participants was ‘self-consciousness’, 62.3%; ‘painful aching’, 44.3% and ‘uncomfortable to eat’ 32.8%. There was no significant difference in quality of life in relation to gender, age educational status and salary grade level. Conclusion: Oral disease had a negative impact on quality of life; this impact was greater in the psychological and physical domain of the OHIP-14 scale. Respondents who reported greater impact of oral disease on their quality of life utilized dental services more frequently compared to those who reported less impact