Medication history documentation in referral letters of children presenting at the emergency unit of a teaching hospital in Lagos, Nigeria

Background: Medical literature has demonstrated that referral hospitals often receive inadequate information about the care and medications their patients received from referring hospitals.Objectives: This study aimed to assess the completeness of referral letters, especially the medication history, for patient presenting at the children emergency room of a teaching hospital in Lagos, Nigeria.Methods: A pro forma form was developed to obtain from the referral letters the demographic information of children referred to the emergency room of the Lagos University Teaching Hospital (LUTH), Idiaraba, over a period of three months. The nature of the referring centre, tentative diagnoses made at the referring centre, duration of illness prior to referral, vital signs and  hysical examination findings, investigation results, and treatment given were also extracted from the letters. In addition, we extracted from the letters the name, dosage, frequency and duration of use of medicines administered at the referring centres. Parents were also interviewed about the details of medicines used prior to presentation of their child at the referring centres.Results: Among those referred with a letter, 100 patients met the inclusion criteria and constituted those evaluated in this study. Most of the patients were referred from general hospitals (31%), another tertiary hospital (29%), and private hospitals/clinics (24%). Gender (30%) and tentative diagnoses (12%) were omitted in the referral letters. However, information about the weight (82%), vital signs (57%), physical examination findings (44%), treatment given (92%), and medication history (71%) were much more omitted in the referral letters.Conclusion: Medication history as well as many other data points is infrequently reported in referral letters to a tertiary care hospital in Lagos, Nigeria. Standard referral guidelines may be useful to improve documentation of medication history.Keywords: Medication, History, Referral letters, Children, Emergency unit, Tertiary hospita

Comparative study of Bacteriological Contents of Commercially Smoked Fish and Aseptically Smoked Fish sold in Awka and Environs, Anambra State Nigeria

The study was carried out to determine the bacteriological contents of smoked fish sold in Awka markets and environs. A total number of 80 samples of smoked and frozen fish were purchased from three different markets in Awka and its environs. 60 smoked fish and 20 frozen fish of four different species of panla, sardine, mackerel and catfish 15each and 5 each respectively. The samples were collected labeled appropriately and kept in sterile polyethylene bags and were taken to the microbiology laboratory of Nnamdi Azikiwe University, Awka and Anambra State Polytechnic, Mgbakwu for microbial analysis, biochemical and molecular characterization were used for identification of bacteria and fungi isolates. The frozen fishes were taken to the fishery department of Anambra State Polytechnic, Mgbakwu for smoking, the fishes were aseptically smoked using the traditional kiln and oven drying methods.  Nutrient agar, Sabouraud dextrose agar, Salmonella shigella agar, Eosin methylene blue agar and Mannitol egg yolk polymyxin (MYP) agar were used for the isolation of organisms. The isolated organisms are Bacillus spp, Staphylococcus Saprophiticus, Enterobacter spp., Staphylococcus aureus, Eschericia coli, Klebsiella Aerogenes. Delftia Tsuruhatensis, Proteus mirabilis, Comamonas Thiooxydans, Stenotrophomonas maltophilia, Crocinitomicaceae bacterium, Klebsiella pneumonia, Micrococcus spp. the fungi isolated are Aspergillus fumigate, Aspergillus oryzae, Fusarium spp. Mucor, Rhizopus sp. Saccharomyces cerevisiae and Penicillum spp. the total viable counts (TVC in CFU/g) of smoked mackerel, sardine,  panla and catfish  ranges from 1.7x102 to 40.3x102 , 0.6x102-66x102, 11x102-98x102, 2.5x102 -54x102 respectively. TVC (CFU/g) of fungi isolates from catfish ranges from 10x102 to 33x102  TVC (CFU/g). In aseptically smoked fish no organism was isolated from fish samples except in smoked and oven-dried panla fish. Their TVC ranges from 0.2x102-0.8x102. The findings indicate that smoked fish sold in Awka markets and environs are all contaminated, proper awareness should be done to educate the fish vendors on proper and hygienic methods of processing and selling their products

High Prevalence of Urinary Schistosomiasis in a Nigerian Community

The prevalence of urinary schistosomiasis in Ogbadibo Local Government Area, Benue State, Nigeria was investigated. Out of 657 urine samples examined, 300 (46.6%) showed the presence of Schistosoma haematobium . Of the 300 positive samples, 152 (23.13%) were from males and 148 (22.52%) were from females. Owukpa and Eha zones showed higher prevalence 10.8% and 10.35% respectively than the other three zones. Statistical analysis showed that the prevalence of the disease in the study is neither sex, nor age dependent, hence there was no observed significant difference (p>0.05), though the age group 11-20 years (9.56%) has a slightly higher prevalence than other age groups. There was a close relationship between haematuria and positive urine samples. The presence of many snail species especially the Bulinus species, and increased contact time with the Schistosoma haematobium infested freshwater habitat were thought to be responsible for the prevalence of the disease in the area