Impact of short-term Educational Interventions on Asthma Knowledge and metered-dose Inhaler Techniques among post basic nursing students in Ilorin, Nigeria- Result of a pilot study

Background: Nurses’ knowledge of asthma and inhaler device technique could positively or negatively affect the outcome of asthma treatment. There exists paucity of data on asthma knowledge and inhaler techniques in Nigeria.Objective: Our study aimed at evaluating the level of knowledge of asthma and inhaler techniques among post basic nursing students in Ilorin, Nigeria.Methods: This was a pre-post intervention design study carried out among 40 post basic nursing students from September to October 2011. A pretest was conducted which involved self- administration of asthma knowledge questionnaire and demonstration of inhaler device techniques using the pressurized metered dose inhaler (pMDI). The pre-test was followed immediately by educational interventions (lecture, physical and video demonstrations), and after one month by a post test.Results: Forty out of 44 nurses completed the study giving a response rate of 91%. The median years after basic nursing training was 4 (range 1-21 years). Majority (70.0%) have not had a recent training on how to use inhalers. The total mean percentage score of asthma knowledge increased significantly from 75.9 %( pre intervention) to 86.5% (post intervention). For the demonstration of pMDI, none (0%) of the respondents had percent demonstration score of 100% pre intervention and post intervention 25.0% had a demonstration score of 100%.Conclusion: The knowledge of asthma was satisfactory while the demonstration of inhaler techniques was very poor pre intervention, both of which significantly improved after educational intervention. Additional studies need to be performed in larger, mixed populations of healthcare professional to confirm these findings.Keywords: Asthma, inhaler techniques, nursing students, Nigeria

The reported preparedness and disposition by students in a Nigerian university towards the use of information technology for medical education

Background: The computer and information technology (IT) revolution have transformed modern health care systems in the areas of communication, storage, retrieval of medical information and teaching, but little is known about IT skill and use in most developing nations.Objectives: The aim of this study has been to evaluate the reported preparedness and disposition by medical students in a Nigerian university toward the use of IT for medical education.Methods: A self-administered structured questionnaire containing 24 items was used to obtain information from medical students in the University of Ilorin, Nigeria on their level of computer usage, knowledge of computer software and hardware, availability and access to computer, possession of personal computer and e-mail address, preferred method of medical education and the use of computer as a supplement to medical education.Results: Out of 479 medical students, 179 (37.4%) had basic computer skills, 209 (43.6%) had intermediate skills and 58(12.1%) had advanced computer skills. Three hundred and thirty (68.9%) have access to computer and 451(94.2%) have e-mail addresses. For medical teaching, majority (83.09%), preferred live lecture, 56.78% lecture videos, 35.1%lecture handout on web site and 410 (85.6%) wants computer as a supplement to live lectures. Less than half (39.5%) wants laptop acquisition to be mandatory. Students with advanced computer skills were well prepared and disposed to IT than those with basic computer skill.Conclusion: The findings revealed that the medical students with advanced computer skills were well prepared and disposed to IT based medical education. Therefore, high level of computer skill is required for them to be prepared and favorably disposed to IT based medical education

Prevalence and antibiotic susceptibility pattern of ESBL producing Klebsiellae isolated from clinical specimens in a Nigerian tertiary hospital

Background: Infection by Extended Spectrum Beta Lactamases (ESBLs) producing bacteria is a threat to man as a consequence of treatment challenges. This study evaluated the prevalence and antimicrobial susceptibility pattern of ESBL producing Klebsiellae (EPK) in clinical specimens at the University of Ilorin Teaching hospital, Ilorin (UITH), Nigeria.Methods: ESBL production was assayed using Double Discs Synergy Test (DDST). Antimicrobial susceptibility was performed by Modified Kirby- Baeur method with the organism tested against ceftazidime (30μg), cefotaxime (30μg), amoxicillin-clavulinic acid (20/10μg), cefepime (30μg), ciprofloxacin (5μg), gentamicin (10μg), trimethoprim-sulphamethoxazole (23.75/1.25μg), imipenem (10μg) and doripenem (10μg) (Oxoid, UK).Results: Fifty (26.7%) of the 187 Klebsiellae studied were EPK comprising of 37(26.8%) Klebsiella pneumoniae and 13(26.5%) Klebsiella oxytoca. EPK were mostly from wound specimens (24.0%) although Klebsiellae were mostly occurring in sputum (26.2%). The EPK were resistant to ceftazidime (100%), cefotaxime (94.0%), trimethoprim-sulphamethoxazole (92.0%), gentamicin (70.0%) and ciprofloxacin (70.0%) but 100% susceptible to both doripenem and imipenem.Conclusion: The prevalence of EPK in this study is high and they are multi-drug resistant. Carbapenems are the best antibiotic treatment option for infections arising from these organisms although a coordinated rational usage is desired along with functional antibiotic prescription policy to avoid treatment failures. Continuous surveillance for ESBL producing Klebsiellae and resistance monitoring are necessary routine to strengthen infection control policies.Keywords; ESBL, cephalosporins, Klebsiella, antibiotics susceptibility, drug resistance

Comparative in-vitro activity of Imipenem and Doripenem against ESBL producing Klebsiella isolates from a tertiary hospital in Ilorin, Nigeria

Background: Doripenem is a recent carbapenem not commercially available in Nigeria with broad spectrum antibacterial activity against various clinical infections. Carbapenems have been shown to be the last line of agents against ESBL producing organisms.Objective: To determine the in-vitro activity of Imipenem and Doripenem against ESBL producing Klebsiella spp.Design: A cross-sectional laboratory based study.Setting: The University of Ilorin Teaching Hospital, a major tertiary hospital in Ilorin, the capital of Kwara state in Nigeria.Subjects: All strains of Klebsiella spp isolated from all clinical specimens collected at the hospital laboratory non– repetitively.Result: Doripenem had a superior in-vitro activity compared to imipenem with MIC 50/90 value of 0.0125/0.023 while imipenem was found to be 0.19/0.38 which was statistically different.Conclusion: The result obtained in this study is similar to those from other studies and therefore re-affirms the superior activity of doripenem compared to imipenem and should therefore be introduced as a better alternative to imipenem against ESBL producing organisms

Smokeless tobacco use in adult Nigerian population

The study aim was to establish the prevalence and determinants of smokeless tobacco use in Nigerian adults' population.Across-sectional survey of 1776 adults inYola, North-East Nigeria was carried out in June 2007.A modified World Health Organization (WHO) tobacco survey questionnaire was used for interview and datacollection. Out of 1776 interviewed respondents, 133 (7.49%) were user of smokeless tobacco. Snuffing of tobacco powder was the most common method of using smokeless tobacco (6.8%). Fifteen (0.9%) chewedtobacco while only 2(0.1%) both chewed and snuffed tobacco. Social acceptance (21.8%) was the major reason for using smokeless tobacco. Males, 5th and 6th decades of life, poor education, lower socioeconomic class, Margi, Hausa and Fulani tribes were the determinants of smokeless tobacco use.About 89.5% of the smokeless tobacco users believed that smokeless tobacco was not harmful to their health. : Although the prevalence of smokeless tobacco use was low among Nigerian adult population in this study. Ignorance of the potential health dangers of smokeless tobacco was rampant therefore; concerted efforts should be made to discourage the use of all forms of tobacco rather than concentrating on cigarette smoking

Diabetic foot care: Self reported knowledge and practice among patients attending three tertiary hospital in Nigeria

Background: Diabetes Mellitus (DM) foot complications are a leading cause of mortality in developing countries and the prevalence of diabetes is expected to increase in the next decades in these countries. Theaim of this study was to determine the knowledge and practice of foot care among diabetes patients attending three tertiary hospitals in Nigeria.Methods: This is a cross-sectional study carried out from November 2009 to April 2010. Pre-tested structured questionnaires were administered by medical officers to diabetes patients. The outcome variables were knowledge and practice regarding foot care. The knowledge and practice scores were classified as good if score .70%, satisfactory if score was 50-69% and poor if score was < 50%.Results: Of 352 diabetes patients, 30.1% had good knowledge and 10.2 % had good practice of DM foot care. Majority (78.4%) of patients with poor practice had poor knowledge of foot care. With regard toknowledge, 68.8% were unaware of the first thing to do when they found redness/bleeding between their toes and 61.4% were unaware of the importance of inspecting the inside of the footwear for objects. Poor footpractices include; 89.2% not receiving advice when they bought footwear and 88.6% failing to get appropriate size footwear. Illiteracy and low socioeconomic status were significantly associated with poor knowledge and practice of foot care.Conclusion: This study has highlighted the gaps in the knowledge and practice of foot care in DM patients and underscores the need for an educational programme to reduce of diabetic foot complication

Prevalence of stroke in three semi-urban communities in middle-belt region of Nigeria: A door to door survey

Introduction: the burden of stroke has been projected to increase for developing countries, but data are limited, especially in sub-Saharan Africa.This necessitated this study to determine the stroke prevalence in a semi urban community in middle-belt region of Nigeria. Methods: a twophasedoor-to-door study was performed in three semi-urban communities of  Kwara state; in the first phase 12,992 residents were screened andprobable stroke cases were identified by trained health care workers. In the second phase individuals adjudged to be positive for stroke were screened with a stroke-specific questionnaire and made to undergo a complete  neurological examination by a neurologist. Stroke diagnosis was based on clinical evaluation using WHO criteria. Results: out of the numbers that were screened, 18 probable stroke cases were identified in the first stage, and of these, 17 fulfilled WHO criteria for stroke, giving a crude prevalence rate of 1.31/1000 population. The prevalence of stroke was higher among the males than the females (1.54/1000 vs. 1.08/1000) with a ratio 1.4: 1. Sixteen subjects (94.1%) had one or more risk factors for stroke.  Uncontrolled systemic hypertension (82.4%) was the commonest risk  factors for stroke followed by transient ischaemic attack (TIA) (41.2%). Conclusion: stroke is a condition that is prevalent in our environment; especially in older adults and men. Uncontrolled systemic hypertension and previous transient ischaemic attacks were the commonest risk factors for stroke in our community

General practitioner reported follow–up visits among asthma patients in North Central Nigeria

Background: Despite the benefits of regular follow–up in the long–term care of asthma, no previous study has reported on it among asthma patients in Nigeria. Objective: This survey was designed to evaluate GP–reported follow–up visits among asthma patients in North Central Nigeria. Methods: It was a cross–sectional survey conducted among GPs in three North Central states of Nigeria. Results: Overall, 48.3% of the GPs reported that their patients usually come for follow-up visits. About 63.6%, 40.0%, and 55.3% of the GPs in Kwara, Kogi, and Niger states, respectively, reported that their patients came for follow–up visits in the month prior to this study. Less than two–third of GPs in both private (55.1%) and public (56.8%) hospitals reportedly attended to patients on follow–up visits. About 46.5%, 37.5%, and 52.0% of the GPs who attended to patients 2 weeks prior to the study reported that their patients came for follow–up visits. There was signifi cant difference (P = 0.04) in the reported follow–up visits by GPs who attended to ≥ 10 asthma patients compared to others. None of the nine GPs who reportedly treated ≥ 10 patients in the preceding month of the study attended to any patient on follow–up visits. Conclusion: The GP–reported rates of follow–up visits in patients that are accessing asthma care from GPs practicing in the North Central part of Nigeria are low. Further studies to identify barriers to follow–up visits and how to correct them are therefore recommended.Keywords: Asthma care, follow—up visits general practitioners, NigeriaArrière-plan: Malgré les avantages de suivi régulier–jusqu’à long - term care de l’asthme, aucune étude antérieure n’a signalé sur elle chez les patients asthmatiques au Nigeria. Objectif: Ce sondage a été conçu pour évaluer les GP–signalés suivi–visites chez les patients asthmatiques au Centre Nord du Nigéria. Méthodes: C’est une croix–sectionnelle enquête menée parmi les GPs dans trois États centrale du Nord du Nigéria. Résultats: Dans l’ensemble, 48,3% des GPs a signalé que les patients sont en général pour des visites de suivi. 63,6% Environ, 40,0% 55,3% des GPs dans les États Kwara, Kogi et au Niger, respectivement, rapporte et que leurs patients sont venus pour suivi–visites dans le mois précédant cette étude. Moins de deux - tiers des GPs dans les hôpitaux publics (56,8%) et le privé (55,1%) auraient été assisté aux patients sur suivi–visites. Environ 46,5%, 37,5% et 52,0% le GPS qui ont participé aux patients 2 semaines avant l’étude rapporte que leurs patients sont venus pour suivi–visites. Il y avait une différence signifi cative (P = 0,04) dans le suivi déclaré–up visites par GPs qui ont participé à ≥ 10 patients asthmatiques par rapport aux autres. Aucun des neuf GPs qui auraient été traités ≥ 10 patients dans le mois précédent de l’étude ont assisté à tout patient sur suivi–visites. Conclusion: Le GP–taux signalés de suivi–visites chez les patients qui sont à accéder aux soins de l’asthme de GPs pratiquant dans la partie centrale du Nord du Nigéria sont faibles. D’autres études pour identifi er les obstacles à suivre–visites et comment à correct eux sont donc recommandés.Mots clés: L’asthme care, suivre — up généralistes, des visites, Nigeri

Unmet needs in asthma treatment in a resource-limited setting: Findings from the survey of adult asthma patients and their physicians in Nigeria

Introduction: The prevalence of asthma in our society is rising and there is need for better understanding of the asthma patients’ perception andtreatment practice of physicians. The study was aimed at determining asthma attitudes and treatment practices among adult physicians andpatients in Nigeria, with the goal of identifying barriers to optimal management.Methods: To assess asthma attitudes, treatment practices and limitations among adult physicians and patients in Nigeria, a questionnaire survey was conducted among 150 patients and 70 physicians.Results: Majority (66.7%) of the patients reported their asthma as  moderate to severe, 42.7% had emergency room visit and 32% had admission due to asthma in the previous 12 months. Physicians and patients perceptions significantly differed in the time devoted to  educational issues (31.4% vs.18.7%) and its contents: individual  management plan (64.3% vs.33.3%), correct inhaler technique (84.0% vs.71.0%), medication side effects (80.0% vs.60.0 %) and compliance 100% of time (5.7% vs. 18.7%). Patients reported that non-compliance with medication causes increased symptoms (67.0%), exacerbations (60.0%), bronchodilator use (56.0%), urgent physician visit (52.0%) and hospitalizations /ER visits (38.7%). Asthma medication in patients caused short term (10.7%) and long term side effects (20.0%). Due to side  effects, 28.0% skipped and stopped their medications. Most physicians (85.7%) and patients (56.0%) agreed on the need for new medication options. The need for new medication in patients was strongly related to asthma severity, limitation of activities, side effects, cost and lack of satisfaction with current medication. With the exception of pulmonologists, physicians did not readily prescribe ICS and their prescriptions were not in line with treatment guidelines.Conclusion: This study has highlighted the gaps and barriers to asthma treatment which need to be addressed to improve the quality of care in Nigeria

Self-reported sleep parameters among secondary school teenagers in middle-belt Nigeria

Background: Available evidences seem to suggest increasing trend in sleep deficit among teenagers worldwide, and there is limited information on this among Nigerian teenagers. This study was carried out to determine the basic sleep schedule and sleep duration among schooling teenagers in Ilorin, Nigeria.Methods: This is a descriptive cross‑sectional study conducted among 20 selected public secondary schools in Ilorin, Nigeria. A multistage sampling technique was used to randomly select participating schools.Result: A total of 1033 students participated in the study; of these 47.3% were males and 51.7% females. Students mean age (standard deviation) was 15.3 ± 1.6 years with a range of 12–19 years. Majority (76.2%) of participants co‑share bed with at least one person and some (23.8%) slept alone in bed. The three leading reasons given for going to bed were: Tiredness ‑ 31.1%, completion of house assignment ‑ 20.5%, and parental directive ‑ 12.4%. 10% of teenagers do make regular phone calls at night and 5.5% surf internet and use computers at night. Regular habits of daytime sleepiness were reported by 8.2% of study participants. Students’ mean sleep duration during school days was 9.33 ± 2.29 h compared to 10.09 ± 1.32 h at weekend (P &lt; 0.05). The duration of night time sleep was adequate (&gt;9 h) in 41% of students; borderline (8–9 h) in 44.3% while 13.3% of the students had insufficient nighttime sleep duration (&lt;8 h) P &lt; 0.05.Conclusion: A substantial number of students had borderline nighttime sleep duration and so had potentials to transit into the problematic insufficient range. To prevent this, there is a need to educate schooling teenagers on the dangers associated with prolonged sleep insufficiency.Key words: Bedtime, schooling, sleep duration, teenagers, wake‑up‑tim