COST-EFFECTIVENESS ANALYSIS OF MICROSCOPY, CULTURE AND SENSITIVITY STUDY AS A DECISION TOOL IN CHOICE OF ANTIBIOTICS IN CLINICAL PRACTICE.

This study evaluated the clinical utility and cost effectiveness of traditional MCS studies as decision tools in choosing antibiotics to treat infections in two tertiary hospitals in Northern Nigeria by retrospective evaluation of MCS records over six consecutive months. Of the 942 MCS studies that included 385(40.9%), 296(31.4%), 144 (15.3%) 45 (4.8%) , 40 (4.3%), 26(3.1%) and 6(0.2%) urine, high vaginal swabs (HVS) , stool, sputum, pus, endocervical swabs (ECS) and urethral swabs specimens performed, respectively on 510(54%) males and 432 (46%) females, only 9 (0.6%) had results that offered demonstrable influence on patients’ treatment at a cost effectiveness ratio of 4260.6 International dollars per 1. The estimated cost of MCS studies to the Nigerian economy (public health care provider) was 39.8million International dollars per annum. Our findings suggest that the traditional algorithm for decision on choice of antibiotic is not cost-effective. We proposed that empirical treatment based on community profiling of bacterial sensitivity to antibiotics may be superior

Frequency of depression among hypertensive patients who developed stroke

Background: The relationship between depression and stroke has been described in different studies. However most of these studies were done in stroke condition arising from different risk factors. Since the risk factor for stroke determine the lesion volume which in turn influences the frequency of depression, it is important to determine the frequency of depression in specific risk factor for stroke. The purpose of this study is therefore to determine the frequency of major depression among patients who developed stroke from hypertension. Methods: This is a retrospective study. Thirty four patients who developed stroke from severe hypertension were included. Using Diagnostic Statistical Manual (DSM) IV criteria, the stroke patients who were diagnosed with depression were identified. Data obtained were analyzed using SPSS Version 11. Results: The age of the patients ranged from 30 to 80 years (mean= 60.2 ±10.5 years). Compared to the males (57.4 ±11.7years), female patients appeared to be older (mean = 62.2 ±9.4 years). However the difference was not statiscally significant (P=0.46). Half of the stroke patients were married while 30% were gainfully employed. Left hemispheric stroke constituted about 70% of stroke site, five patients (14.7%) had depression. Conclusions: This study suggested that depression is not infrequent among hypertensives with stroke. Further studies with larger sample size are recommended to confirm our findings

Prevalence of diabetes mellitus and its risk factors among the suburban population of Northwest Nigeria

>Background: Diabetes mellitus (DM) was previously considered to be rare in sub-Saharan Africa. However, the prevalence is on the increase mainly because of urbanization and changes in lifestyle.Aim: The aim of our study was to determine the prevalence of DM and its correlates in the suburban population of Northwest Nigeria.Materials and Methods: A cross-sectional community-based study was carried out. Two hundred and eighty participants were recruited using a multistage sampling technique. Interviewer-administered questionnaire was utilized in obtaining demographic data from the participants. Anthropometric variables, fasting plasma glucose (FPG), and blood pressure measured using standard guidelines. The diagnosis of DM was based on the WHO guidelines.Results: The mean age was 42.3 ± 10.7 years. The overall prevalence of DM was 4.3% (males 4.5% and females 4.0%). The mean FPG was higher in the females (5.9 ± 1.2 mmol/L) than males (5.8 ± 2.5 mmol/L) though the difference was not statistically significant (P = 0.81). Obesity and increasing age were the major risk factors for DM among the suburban population.Conclusion: DM is common in suburban areas of Northwest Nigeria. We recommend increased awareness of the epidemic potential of this public health problem even in suburban areas