Operations and roles of patent and proprietary medicine vendors in selected rural communities in Edu Local Government Area, Kwara State, north-central Nigeria

Background: Patent and Proprietary Medicine Vendors (PPMVs) are a ubiquitous feature of the informal health sector in many African countries including Nigeria. Little has been reported about the services they render. This study assessed the operations and role of PPMVs in selected rural communities of Edu LGA, Kwara State, NigeriaMethods: This explorative study used a mixed method approach of data collection. In-depth interviews were conducted among 25 purposively selected PPMVs in three out of the five operational zones in the LGA. Enumeration and mapping of PPMVs shops was done to determine the number and location of the PPMVs in all the five operational zones in the LGA.Results: PPMVs sell drugs with or without prescription and offer services like weight, blood pressure measurements. Products stocked align with the approved list of drugs, though some stock drugs outside the list. Their collaboration with the pharmacists is limited to drug purchasing. Collaboration with the formal health sector consists of training and patients’ referrals. Membership of National Association of Patent and Proprietary Medicine Dealers (NAPPMED) is a ‘sine qua non’ for business. Enumeration of PPMVs shops in the five zones revealed 136 shops with Lafiagi having the highest and the GPS coordinates mapped on Google Earth Map showed the location and spread of the PPMVsConclusion: PPMVs can potentially bridge the gap in healthcare delivery in the study area and by extension to the State. Organizing capacity building workshops for the PPMVs can help strengthen their quality of health service and collaboration with other stakeholders.Keywords: Patent medicine, Pharmacies, Proprietary medicine vendors, Rura

Eye care practices among commercial drivers in a developing country

Objective: Vision is regarded as the most important source of information during driving. The need for good eye care practices among the commercial drivers therefore cannot be overemphasized. This study aimed to determine the eye care practices of commercial drivers in a developing country and their association with involvement in road traffic crash (RTC).Methods: A cross-sectional descriptive study was carried out among 328 registered commercial drivers in Ilorin metropolis, Kwara State, Nigeria. Multistage random sampling method was used to select the participants while semi-structured, interviewer administered questionnaire was used to obtain information on the socio-demography, eye care practices and involvement in RTC.Results: Data was analysed using SPSS version 18. The level of significance was set at p-value of less or equal to 0.05. Most (75.8%) of the commercial drivers had clear knowledge on good eye care practices. Majority, 79.6% of them had poor eye care practice. Only one-fifth of the drivers who practice good eye care had been involved in RTC in the last five years (p = 0.548). There was no statistically significant association between good eye care practices and involvement in RTC.Conclusion: Good eye care practice especially regular eye check at the hospital can help in early detection of poor visual function to enable prompt intervention. The consequences of RTC could be very fatal, it is therefore imperative for commercial drivers to always exhibit good eye care practices bearing in mind the major role of vision in driving.Keywords: Eye care practice, Commercial drivers, Road traffic crash, Developing countr

Self-reported symptoms of uninvestigated dypepsia among University staff in Ilorin, Nigeria

Objectives: Dyspepsia is a common gastrointestinal (GI) symptom which impacts negatively on quality of life, workplace efficiency and overall productivity. Many studies on dyspepsia in our environment are hospital based, but being a complaint frequently treated first by self-medication before presentation to the hospital, such studies may underestimate its prevalence. The objective of the study was to determine the prevalence of the dyspepsia and its associated factors among administrative staff of the College of Health Sciences, University of Ilorin, Nigeria.Methods: This was a cross-sectional study. Pretested structured, close-ended, interviewer-administered questionnaires were administered to 53 administrative staff selected across the different units by stratified random sampling. The questionnaire obtained information about subject's experiences of dyspeptic symptoms and presence of associated factors such as family history, non-steroidal anti-inflammatory drugs (NSAIDS), tobacco and alcohol use, and presence of diabetes mellitus (DM).Results: The prevalence of uninvestigated dyspepsia among the respondents was 37.5%. Age was significantly predictive of the occurrence of dyspepsia among the subjects Odds Ratio- 1.46, 95% Confidence Interval (1.042-2.045) P=0.03. Use of NSAIDS, presence of DM, family history and tobacco use were not predictive of occurrence of dyspepsia.Conclusion: The prevalence of dyspepsia is high among respondents in the study.Keywords: Dyspepsia, prevalence, university, Nigeri

Traditional eye medication: A rural-urban comparison of use and association with glaucoma among adults in Ilorin-west Local Government Area, North-Central Nigeria

Background: Globally, the last two decades witnessed increase in the use of  Traditional Eye Medication (TEM); and its use worsens the prognosis of visual outcome. This study assessed and compared the use of TEM and its association with glaucoma among adults in selected rural and urban communities of Ilorin-west Local Government Area, North-Central Nigeria.Methodology: This was a comparative cross-sectional study. Respondents were selected using multi-stage sampling technique. Interviewer-administered structured questionnaire, and clinical report form were used to collect data. Data were analyzed using SPSS version 15. Level of statistical significance was set at p<0.05.Results: A higher proportion of the rural, 174 (38.7%) than the urban, 111 (24.7%) respondents knew about TEM (p<0.001). More of the rural, 83 (18.4%) than the urban, 78 (17.3%) respondents had ever used TEM (p=0.664). TEM known to the respondents in rural versus urban areas included camphor (47.1% vs 28.8%), personal urine (3.5% vs 2.7%) and salt-sugar solution (1.7% vs 14.4%) among others. There exists an association between the use of traditional eye medication and presence of glaucoma within rural (p=0.011) and urban (p<0.001) areas.Conclusion: The use of TEM among the respondents was associated with glaucoma. While the association between glaucoma and uptake of TEM may not be causal, it provides a window of thought for further researches. There is need to strengthen awareness on the dangers of using TEM in the communities. Regular  community-based eye screening involving measurement of intraocular pressure will be useful in early detection of glaucoma.Keywords: Traditional eye medication; Glaucoma; Rural-Urban; Nigeri

Step-by-step Guideline for disease-specific costing studies in low and middle income countries: a mixed methodology.

__Abstract__ BACKGROUND: Disease-specific costing studies can be used as input into cost-effectiveness analyses and provide important information for efficient resource allocation. However, limited data availability and limited expertise constrain such studies in low- and middle-income countries (LMICs). OBJECTIVE: To describe a step-by-step guideline for conducting disease-specific costing studies in LMICs where data availability is limited and to illustrate how the guideline was applied in a costing study of cardiovascular disease prevention care in rural Nigeria. DESIGN: The step-by-step guideline provides practical recommendations on methods and data requirements for six sequential steps: 1) definition of the study perspective, 2) characterization of the unit of analysis, 3) identification of cost items, 4) measurement of cost items, 5) valuation of cost items, and 6) uncertainty analyses.Please provide the significance of asterisk given in table body. RESULTS: We discuss the necessary tradeoffs between the accuracy of estimates and data availability constraints at each step and illustrate how a mixed methodology of accurate bottom-up micro-costing and more feasible approaches can be used to make optimal use of all available data. An illustrative example from Nigeria is provided. CONCLUSIONS: An innovative, user-friendly guideline for disease-specific costing in LMICs is presented, using a mixed methodology to account for limited data availability. The illustrative example showed that the step-by-step guideline can be used by healthcare professionals in LMICs to conduct feasible and accurate disease-specific cost analyses

PATTERN AND EXPLANATORY FACTORS FOR MEDICATION ADHERENCE AMONG PATIENTS WITH HYPERTENSION, DIABETES MELLITUS AND THEIR COMORBIDITY IN A NORTH CENTRAL STATE OF NIGERIA

Introduction: Hypertension and diabetes are the two most common non-communicable diseases seen in outpatient clinics in Sub-Saharan Africa. Promoting medication adherence is a major clinical hurdle to be crossed in reducing the premature morbidity and mortality associated with these diseases. This study explored factors that predict medication adherence among hypertensive and diabetic patients in Ilorin, Nigeria. Methods: This cross-sectional study was carried out among hypertensive and diabetic patients in outpatient clinics of a teaching hospital in Ilorin, Nigeria. Data was collected from 1,203 patients using a validated Morisky 8-item medication adherence questionnaire. Multivariate ordinal logistic regression was used to model the medication adherence explanatory factors with SPSS version 22. Result: Less than half (43.3%) of the patients were highly adherent to their medication. The relative proportion for high adherence was 42.7%, 35.6% and 49.2% for hypertension, diabetes and both diseases respectively. The odds of medication adherence improving from either low to medium level or from medium to high level was explained by; age, symptoms count, absence of disease complication and absence of drug side effect among the patients. Blood pressure, gender and disease duration did not explain medication adherence among hypertensive and diabetic patients. Conclusion: It is concluded that the discomfort experienced due to the disease condition and the medication regimen are important explanatory factors for patient’s medication adherence in the study setting. This study recommends strategies to reduce multiple drug combinations and promote medication adherence counselling and education among patients

PREDICTIVE FACTORS OF MEDICATION ADHERENCE AMONG HYPERTENSIVE AND DIABETICS PATIENTS IN A NORTH CENTRAL STATE OF NIGERIA

Introduction: Hypertension and diabetes are the two most common non-communicable diseases seen in outpatient clinics in Sub-Saharan Africa. Promoting medication adherence is a major clinical hurdle to be crossed in reducing the premature morbidity and mortality associated with these diseases. This study explored factors that predict medication adherence among hypertensive and diabetic patients in Ilorin, Nigeria. Methods: This cross-sectional study was carried out among hypertensive and diabetic patients in outpatient clinics of a teaching hospital in Ilorin, Nigeria. Data was collected from 1,203 patients using a validated Morisky 8-item medication adherence questionnaire. Multivariate ordinal logistic regression was used to model the medication adherence explanatory factors with SPSS version 22. Result: Less than half (43.3%) of the patients were highly adherent to their medication. The relative proportion for high adherence was 42.7%, 35.6% and 49.2% for hypertension, diabetes and both diseases respectively. The odds of medication adherence improving from either low to medium level or from medium to high level was explained by; age, symptoms count, absence of disease complication and absence of drug side effect among the patients. Blood pressure, gender and disease duration did not explain medication adherence among hypertensive and diabetic patients. Conclusion: It is concluded that the discomfort experienced due to the disease condition and the medication regimen are important explanatory factors for patient’s medication adherence in the study setting. This study recommends strategies to reduce multiple drug combinations and promote medication adherence counselling and education among patients

Photostress recovery time among commercial drivers in Nigeria

Photostress recovery time (PSRT) test is a simple technique used to assess the macular function. Prolonged recovery time is attributed to the delay in regeneration of visual pigments after being bleached with a bright light.  In car drivers with macular degeneration, photostress effects from opposing cars may bleach retinal pigments and cause a dramatic drop in visual acuity.The study aims todetermine the prevalence of abnormal PSRT and the association of PSRT with age, visual function and driving safety among commercial drivers in Nigeria.A cross-sectional descriptive study was carried out in Ilorin metropolis, a city in north central Nigeria.Of the estimated 4,729 registered commercial drivers, 327were selected using multistage sampling methods. Structured questionnaire was administered by trained research assistants. PSRT test and visual function tests were carried out by the principal researcher and an assistant.Subject with normal healthy macular function should be able to read the visual acuity line just above the pre-exposure visual acuity line in 50-60 seconds. Patients with a macular problem may have recovery times lasting 1.5 to 3 min or longer. The study revealed a statistically significant association between PSRT and visual acuity as well as colour vision (p<0.05). No association existed between PSRT and age, visual field and driving safety. Majority of the respondents with normal PSRT had fair driving safety.Regular visual screening especially during license renewals may be the most useful tool for the detection of impaired visual function and delayed photo stress recovery time among commercial drivers.Keywords:  Photostress, Macular degeneration, Commercial driver

Oral health seeking behaviour among patients attending outpatient clinic in University of Ilorin teaching hospital (UITH) Ilorin

Introduction: In sub – Saharan Africa, oral health services are greatly hampered by low availability and poor accessibility to health care and these are various interrelated factors responsible. This study determined the factors that influence oral health seeking behavior among patients attending outpatients' clinic.Methodology: A total of 460patients were selected into the study from the outpatients' clinic using systematic random sampling. Data was collected and was analyzed using SPSS 17. The significant level was set at 0.05Results: Of the 97.3% of the respondents with awareness of oral health facility, 90.9% of them had oral health facility within 5km distance. The commonest complaint was toothache. Majority of the respondents (88.2%) accessed orthodox oral health services mostly for teeth extraction (61.3%). There was statistically significant difference between the awareness of Oral health facility and closeness to residence.Conclusion:Age, awareness and attitude have positive effect on health seeking behavior of patients