Health-related quality of life and its contributory factors in allergic rhinitis patients in Nigeria

OBJECTIVES : To determine the health-related quality of life (HRQoL) in allergic rhinitis patients as well as identify contributory factors to patient's well-being. METHODS : Cross-sectional study by multistage sampling. Four-month study duration (October 2013 to January 2014). The setting of the study was Kwara State, Nigeria, which has 16 local government areas with 3 senatorial districts, total land mass of 36,825km(2) with a population of 2,591,555. 132 consenting adults; 66 of them have allergic rhinitis (AR) using Score for Allergic Rhinitis (SFAR) instrument and 66 were age- and gender-matched controls (χ(2)=0, d.f.=1, P=1 and χ(2)=1.24, d.f.=2, P=0.54, respectively). Information on HRQoL was obtained using the 14-parameter mini-rhinoconjunctivitis quality of life questionnaire (mini-RQLQ). Socio-demographic variables possibly contributory to patient's well-being were obtained. Kruskal-Wallis and Mann-Whitney U tests were used to compare means. RESULTS : The overall Total Symptom Score (TSS) was 3.37±0.9, while male and female allergic patients and control TSS were 3.61±1.0; 3.16±0.8, and 0.98±0.2; 0.95±0.2, respectively. Effects of gender, marital status, senatorial districts, residential area and duration of symptoms had significant impact on the quality of life. The highest correlation with TSS and components of mini-RQOL questionnaire existed between nasal problems and other symptoms (r=0.866; 0.868). CONCLUSION : AR had appreciable impact on HRQoL of the participants. Gender, number of dependents, marital status, senatorial districts, residential area and duration of symptoms were major identifiable contributory factors to the patient's well-being.http://www.elsevier.com/locate/anl2017-04-30hb2016Agricultural Economics, Extension and Rural Developmen

Safety and efficacy of Anti-Microbial Photodynamic Therapy (aPDT) in patients with recalcitrant chronic rhinosinusitis : a pilot study

Introduction: This pilot study intended to test the feasibility of addressing problems of recalcitrance with management of patients with Chronic Rhinosinusitis (CRS). The study explored the level of response and determined the safety of a novel treatment option for recalcitrant CRS patients. Methods: The primary outcome was to assess the efficacy of antimicrobial photodynamic therapy (aPDT). Improvements with Alsaleh-Javer Endoscopic Symptom score (AJESS) by 1-point; Sinonasal Outcome Test 22 (SNOT-22) by 9-points and culture swab results over a 45-day period. The Secondary outcome was to evaluate the safety of the aPDT. Presence of adverse events, increase in pain and discomfort scores, smell test (UPSIT) and Nasal Mucociliary test (Saccharin test), were determined over the same period. Results: A total of 7 participants completed the pilot study. There was a slight male preponderance (1.3:1, M: F) and age ranged from 47 to 78 years with mean age ± SD, 60.3 years ± 10.1. Two (2) out of the 7 participants (28.6%) had co-morbid conditions (Asthma), while all of the 7 participants were non-smokers. Patients with a clinical diagnosis of Chronic sinusitis without polyps (CRSsNP) accounted for more than half of the participants (57.2%). Mean AJESS reduction was maximal between completion of the aPDT treatment (day 7) and one-week post-treatment (day 14), 3.00 to 1.50 points. While mean SNOT-22 scores reduction was maximal between day-0 (44.53) and day-7 (35.57), about 9 points. A marked reduction in laboratory cultures within a week of treatment completion (days 7 and 14) noted but not sustained. No adverse events recorded, with mild-moderate discomfort noted with treatment. The NMCT results showed significant improvement in 2/7 participants (28.6%), while smell test did not record appreciable improvement. Conclusion: This study showed that aPDT was able to improve the endoscopic scores (AJESS) and sinus-specific questionnaire (SNOT-22) by at least 1 point and 9 points or 1 MCID, respectively. No adverse events noted identified during the study period. Olfaction (using UPSIT), showed dysfunction not worsened with the procedure. Future research may involve sinonasal microbiota transplants use via nasal lavage post aPDT to treat refractory CRS patients from suitably healthy donors.Medicine, Faculty ofSurgery, Department ofGraduat

The direct and indirect impact of COVID-19 pandemic on maternal and child health services in Africa: a scoping review

Introduction The novel coronavirus disease 2019 (COVID-19) continues to disrupt the availability and utilization of routine and emergency health care services, with differing impacts in jurisdictions across the world. In this scoping review, we set out to synthesize documentation of the direct and indirect effect of the pandemic, and national responses to it, on maternal, newborn and child health (MNCH) in Africa. Methods A scoping review was conducted to provide an overview of the most significant impacts identified up to March 15, 2022. We searched MEDLINE, Embase, HealthSTAR, Web of Science, PubMed, and Scopus electronic databases. We included peer reviewed literature that discussed maternal and child health in Africa during the COVID-19 pandemic, published from January 2020 to March 2022, and written in English. Papers that did not focus on the African region or an African country were excluded. A data-charting form was developed by the two reviewers to determine which themes to extract, and narrative descriptions were written about the extracted thematic areas. Results Four-hundred and seventy-eight articles were identified through our literature search and 27 were deemed appropriate for analysis. We identified three overarching themes: delayed or decreased care, disruption in service provision and utilization and mitigation strategies or recommendations. Our results show that minor consideration was given to preserving and promoting health service access and utilization for mothers and children, especially in historically underserved areas in Africa. Conclusions Reviewed literature illuminates the need for continued prioritization of maternity services, immunization, and reproductive health services. This prioritization was not given the much-needed attention during the COVID-19 pandemic yet is necessary to shield the continent’s most vulnerable population segments from the shocks of current and future global health emergencies.Medicine, Faculty ofNon UBCPopulation and Public Health (SPPH), School ofReviewedFacultyResearche

Otologic and audiologic characteristics of type 2 diabetics in a tertiary health institution in Nigeria

ABSTRACT INTRODUCTION: This cross-sectional comparative study was carried out at the Diabetes outpatient clinic of LAUTECH Teaching Hospital (LTH) Ogbomoso, Nigeria. OBJECTIVE: This study assessed patterns of otologic diseases and auditory acuity among type 2 diabetics and determinants of these findings among diabetics. METHODS: Ninety-seven consenting patients with clinical diagnosis of diabetes mellitus (194 ears) were matched for age and sex with ninety non-diabetic patients (180 ears). These patients were screened using otoscopy and pure tone audiometry over a 6-month period. RESULTS: The study reported a crude prevalence rate of 21.6% hearing loss in T2DM patients. The most common type of otologic disease that showed significant association with T2DM patients was otitis media with effusion (p = 0.027). T2DM was significantly associated with abnormal audiometric findings (p = 0.022), particularly sensorineural hearing loss (p = 0.022), of the moderate grade (p = 0.057). There were no differences of the audilogical findings for any particular ear, and no differential affectation of frequency range was observed. Coexisting hypertension and poor glycaemic control were significantly associated with aggravation of the hearing of the T2DM patients (p < 0.001, and p = 0.009 respectively). CONCLUSION: T2DM had appreciable effects on hearing acuity. T2DM was significantly associated with the type and the degree of the hearing loss. The need for screening of hearing acuity of T2DM patients, in order to detect early changes, and promptly offer an adequate management and remedial measures was emphasized in this study

Health-related quality of life and its contributory factors in allergic rhinitis patients in Nigeria

OBJECTIVES : To determine the health-related quality of life (HRQoL) in allergic rhinitis patients as well as identify contributory factors to patient's well-being. METHODS : Cross-sectional study by multistage sampling. Four-month study duration (October 2013 to January 2014). The setting of the study was Kwara State, Nigeria, which has 16 local government areas with 3 senatorial districts, total land mass of 36,825km(2) with a population of 2,591,555. 132 consenting adults; 66 of them have allergic rhinitis (AR) using Score for Allergic Rhinitis (SFAR) instrument and 66 were age- and gender-matched controls (χ(2)=0, d.f.=1, P=1 and χ(2)=1.24, d.f.=2, P=0.54, respectively). Information on HRQoL was obtained using the 14-parameter mini-rhinoconjunctivitis quality of life questionnaire (mini-RQLQ). Socio-demographic variables possibly contributory to patient's well-being were obtained. Kruskal-Wallis and Mann-Whitney U tests were used to compare means. RESULTS : The overall Total Symptom Score (TSS) was 3.37±0.9, while male and female allergic patients and control TSS were 3.61±1.0; 3.16±0.8, and 0.98±0.2; 0.95±0.2, respectively. Effects of gender, marital status, senatorial districts, residential area and duration of symptoms had significant impact on the quality of life. The highest correlation with TSS and components of mini-RQOL questionnaire existed between nasal problems and other symptoms (r=0.866; 0.868). CONCLUSION : AR had appreciable impact on HRQoL of the participants. Gender, number of dependents, marital status, senatorial districts, residential area and duration of symptoms were major identifiable contributory factors to the patient's well-being.http://www.elsevier.com/locate/anl2017-04-30hb2016Agricultural Economics, Extension and Rural Developmen