Health Facility In Nigeria Research Articles

“BORN TOO SMALL” AND IT’S ASSOCIATED FACTORS IN A TERTIARY HEALTH FACILITY IN NIGERIA.

Background: Low Birth Weight (LBW) is a major adverse outcome of pregnancy. Methods: A prospective cohort study conducted at a tertiary health facility in Nigeria. Data was retrieved from the ante-natal and delivery card of women that delivered within the time of data collection. Data was analyzed using SPSS version 25 and variables were presented as frequencies, percentages, means, and standard deviation. Bivariate analysis was done using chi-square test with the level of signicance set at p ≤ 0.05. Binary logistic regression was used to determine factors that predicted low birth weight. Results:The prevalence of LBW was 11.1%. About 48% of the mothers delivered through caesarean section while 53.9% booked within 14-28weeks gestation. On logistic regression agricultural workers had 4 times odds of having LBW babies when compared to the unemployed while the un-booked mothers had 11 times odds of having LBW babies when compared to those that booked at >28weeks gestational age. Conclusion: The prevalence of LBW was high. Booking status of the mother and having complications during pregnancy were strongly associated with preterm delivery.

Comparative study and sensitivity analysis of a standalone hybrid energy system for electrification of rural healthcare facility in Nigeria

This paper investigated the techno-economic viability assessment of solar PV/wind/diesel generator (DG)/battery hybrid energy systems (HES) for powering an isolated rural health clinic in northern Nigeria. HOMER–software tool developed by the US National Renewable Energy Laboratory (NREL) has been utilized for the techno-economic assessment of the proposed HES. The results of the simulation reveal that PV/DG/battery HES with 5.43 kW PV, 2 kW DG, 3.06 kW power converter, and 10 units of batteries emerged as the optimum system and most preferable with the minimum Net Present Cost (NPC) of $16,457 and Cost of Energy (COE) of $0.259/kWh compared to other system cases. The outcome also shows that the optimized solution is environmentally friendly as it presented an acceptable carbon dioxide emission of 1304 kg/year, which was about 80% and 82.5% less than that of system case 3 (DG/battery) and system case 5 (DG-Only). To have a good understanding of the operation of various system configurations considered, details of the system’s battery storage status and power flow are discussed via the energy balance of the various system configurations. This analysis shows operating cost, fuel cost, COE, fuel consumption, and renewable fraction are sensitive to the variation in all the considered sensitivity parameters.

Cost associated with hospitalization of non-adherent type 2 diabetes patients in a tertiary healthcare facility in Ibadan, Nigeria

Purpose: To estimate the cost of hospitalization associated with medication non-adherence among type 2 diabetes mellitus (T2DM) patients in a tertiary healthcare facility in Nigeria.
 Methods: Three hundred and fifty-four (354) medical records of T2DM patients admitted into the medical wards from 2013 to 2015 were used for the study. Medical records with history of medication non-adherence (MNA) prior to hospitalization as indicated by physicians were included in the study. Direct medical costs associated with the management of the patients during hospitalization were measured using out-of-pocket payer perspective. Pearson product moment correlation coefficient was used to determine the relationship between the variables, with p < 0.05 considered statistically significant.
 Results: Among the 354 admitted patients, 226 (63.8 %) had a record of MNA. The mean age was 57.5years ± 14.6. The majority of the patients (61.5 %) were either petty traders or artisans/selfemployed. Duration of hospitalization increased with increase in number of comorbid disease (Pearson product moment correlation r = 0.13 p = 0.05). Total cost incurred during hospitalization was US$146,669.3 (average, $ 650.1), of which more than one quarter was cost of medications. Cost of management and cost of laboratory investigations increased with increase in the number of co-morbid diseases (r = 0.24, p = 0.00; r = 0.2, p = 0.02, respectively). Cost of management also increased with increase in days of hospitalization (r = 0.2, p = 0.00).
 Conclusion: Cost of hospitalization related to non-adherence to medication is high among the studied population. There is need to work out strategies to enhance adherence among diabetes patients.

Examining the influence of illness perception and financial toxicity on the quality of life of prostate cancer patients

BackgroundCancer of the prostate (CaP) is a public health problem that affects the male genitourinary system causing a significant threat to men’s quality of life (QoL). Experiencing financial constraints and poor illness perception may further compromise the QoL of men with CaP.MethodsAim: To examine the relationship between financial toxicity and illness perception with quality of life in men with CaP. The descriptive cross-sectional study used simple random sampling technique to recruit 173 men with CaP from four tertiary health facilities in Nigeria. Data were collected with the comprehensive score for financial toxicity (COST-FACIT), the brief illness perception questionnaire (Brief IPQ) and the functional assessment of cancer therapy-prostate (FACT-P). Analysis of data was carried out using analysis of variance, correlation and hierarchical regression analyses.ResultsThe 173 participants had an average age of 71.57 ± 11.18, and 53.18% had one comorbid disease. Significant difference was found in overall QoL based on treatment site and number of comorbid diseases (P < 0.01). QoL had a significant inverse relationship with all the illness perception variables and a significant linear relationship with lower financial toxicity (P < 0.01). Furthermore, financial toxicity (P < 0.05) and four illness perception variables: consequences, identity, concern and illness understanding (P < 0.01), had significant individual influences on QoL of men with CaP.ConclusionsQuality of life in men with CaP may be improved through mitigating the financial toxicity associated with accessing care and providing appropriate counseling about the illness and what to expect following prostate cancer diagnosis and during treatment.

Assessing the Current States of Logistics Management and Training on Family Planning Services in Nigerian Healthcare Facilities

Background: Management of Family planning (FP) commodities is a significant problem that is not limited to compromising the quality of FP services but also results in economic burden especially in developing countries. Some facilities may have ample FP commodities while others have a shortage if FP logistics are managed poorly. Hence, assessing the FP commodities logistic management is relevant to inform decision-makers.&#x0D; Methods: This survey was a cross-section study of 763 public primary and secondary healthcare facilities in Nigeria. The study involved facility assessment and quantitative interview of key personnel in each facility, using a structured questionnaire. The study was conducted from May to July 2019. The data collected were analysed with IBM-SPSS version 25.0. Descriptive statistics were performed, Chi-Square and linear logistics regression were used to establish significant associations; p&lt;0.05 was considered significant.&#x0D; Results: About half (51.4%) of primary and 33.5% of secondary healthcare facilities were not using forms for reporting FP supplies. Also, 23.8% of primary and 18.8% of secondary facilities waited for more than two months before receiving orders. The facilities have an average of 2-3 trained personnel on FP services. FP staff who were trained had their last training over a year ago (primary-31.9%); secondary-37.4%). Secondary facilities were 2.102(95% CI:1.567–2.820) times more likely to use log forms, 1.845(95% CI: 1.076–3.165) times more likely to have cold chains, and 4.785(95% CI: 3.207–7.139) more likely to have trained staff on insertion and removal of implants than primary facilities (p&lt;0.05).&#x0D; Conclusion: We advocate that the government and donor agencies carry out urgent interventions such as regular supply of contraceptives, regular training of FP service providers, provide sufficient manpower, carry out regular monitoring and evaluation of FP services and create awareness on the need to use FP services among grassroots citizens.

Antibiogram of Pseudomonas species: an important tool to combat antibiotic resistance for patient safety in Gombe, Nigeria

Background: Pseudomonas species are responsible for different healthcare-associated infections and are inherently resistant to many commonly used antibiotics. Hospital antibiograms are either absent or not regularly available in most healthcare facilities in Nigeria. The objective of this study is to present the antibiogram of Pseudomonas isolates in Federal Teaching Hospital Gombe (FTHG) in order to guide antibiotic prescription for better patient safety in the hospital.Methodology: The is a hospital-based cross-sectional study. A total of 4309 bacterial isolates were recovered from aerobic cultures of routine clinical specimens including urine, sputum, blood, swabs, aspirates, biopsies, seminal fluids and cerebrospinal fluids at the Medical Microbiology laboratory of the hospital between January and December 2019. Pseudomonas species were identified by colony morphology, Gram-reaction and conventional biochemical tests. Antibiotic susceptibility testing was performed on each Pseudomonas isolate using the modified Kirby-Bauer disk diffusion method on Mueller-Hinton agar and results interpreted according to the guideline of the Clinical and Laboratory Standards Institute (CLSI). Data were analysed using the Statistical Package for Social Sciences (SPSSTM) software version 23.0.Results: Of the total 4309 bacterial isolates, 436 (10.1%) Pseudomonas species were identified, with majority (49.8%) from urine specimens. Antibiotic susceptibility test results revealed average susceptibility rates of 73.8%, 70.1%, 66.2%, 59.5%, and 34.3% to ciprofloxacin, gentamicin, levofloxacin ceftazidime, and carbenicillin respectively. These rates fluctuate only slightly for each of the antibiotic during the 12 months period of survey.Conclusion: Pseudomonas species were most sensitive to ciprofloxacin and gentamicin among the first line antibiotics in FTHG in 2019. Regular updates and presentation of hospital antibiogram especially for intrinsically resistant bacteria such as Pseudomonas involved in healthcare associated infections, is an important tool in combating antimicrobial resistance and ensuring patient safety.&#x0D; Keywords: antibiogram, Pseudomonas, antimicrobial resistance, antimicrobial stewardship, patient safety

Direct and Indirect Costs of Non-surgical Treatment for Acute Tonsillitis in Children in Southeast Nigeria.

BackgroundAcute tonsillitis has become one of the main reasons why children visit healthcare facilities in Nigeria. Presently, there is no information on the costs of its treatment, and this study aimed at determining these costs.MethodsThe study was conducted in two hospitals located in southeast Nigeria. The information was obtained in two ways: (1) retrospectively from the medical records of children treated for acute tonsillitis over a period of 5 years and (2) cross-sectionally from children who presented with complaints of acute tonsillitis over a period of 7 months. The information obtained was the costs of self-medication and hospital treatment, and the payment mechanisms used to settle these costs. The human capital method approach was used to estimate the indirect cost (loss in productivity) from the caregivers’ absenteeism from work.ResultsThe mean costs of self-medication and hospital treatment for acute tonsillitis in children were €3.85 and €13.48, respectively. The indirect cost was €11.31. The mean total cost of treatment of acute tonsillitis was €23.80. The proportion of households that suffered catastrophic health expenditure (CHE) from the treatment of acute tonsillitis was 55 (55%). CHE was highest [22 (91.7%)] in the lowest socio-economic quartile compared to households in the highest quartile [4 (16.7%)], and the difference was statistically significant (p = 0.02). Of the 72 participants whose payment mechanisms were documented, the proportion who paid out of pocket was 53 (73.6%), and 19 (26.4%) used the National Health Insurance Scheme.ConclusionThe costs of treatment for children with acute tonsillitis were high, and most of these costs were settled out-of-pocket. The costs for laboratory investigations, drugs, and productivity loss contributed to these high costs. There is a need to cover the costs of non-surgical treatment of acute tonsillitis in social health insurance and improve efforts to increase the coverage of the health insurance scheme.

Knowledge, attitude, and practice towards diabetes mellitus among outpatient diabetic elderly persons: a descriptive study

To investigate the knowledge, attitude, and practice (KAP) towards diabetes mellitus (DM) among outpatient diabetic elderly persons attending tertiary healthcare facilities in Nigeria and also to verify the null hypotheses of no significant differences within demographic variables. The study was based on descriptive research design and was carried out in 36 public tertiary healthcare facilities in Nigeria, from August to December 2019. Using the purposive sampling technique, a total of 360 diabetic elderly persons aged 60 years and above were studied. An adapted KAP questionnaire with 0.86 reliability indexes was used for data collection. Frequency, percentage, and chi square were used for data analysis. All analysis was completed using IBM SPSS version 22. There were 348 (97%) valid copies of the questionnaire used for analysis. The study revealed that the outpatient diabetic elderly persons had high knowledge 303 (87%), positive attitude 265 (76%), and good practice 286 (82%) towards DM. Statistically, there was a significant difference within variables of age (p value=0.001 0.05). The participants had high KAP relating to DM. However, the finding of this study is not a complete reflection of the real situation regarding DM among elderly persons in Nigeria. There are overwhelming evidences of high prevalence of DM and thus the need for KAP sustainability and subsequent improvement in the healthcare sector to successfully combat the disease and proffer reliable ways of prevention among the population.

Causes of Dental Trauma: Results of Findings Among Patients in a Secondary Oral Healthcare Center, Jos, Nigeria.

Background:Dental trauma is a major type of traumatic dental injury (TDI) and a common presentation in many oral health facilities in Nigeria. Despite the high prevalence of TDIs, causes of dental trauma are yet to be fully investigated among Nigerians.Aim:The aim of this study is to determine the types of dental trauma, aetiology, and the causes of dental trauma as it relates with sociodemographic characteristics among dental patients.Materials and Methods:This was a cross-sectional study among patients attending a secondary oral healthcare facility in the North Central city of Jos between January 2019 and December 2020. The sociodemographic features of the patients include patients’ complaints, clinical and social history, result of simple clinical oral examinations, and diagnoses of dental trauma. The classification of Ellis and Davey (1970) was used to classify dental trauma for this study.Results:One hundred and seventy-six (6.7%) patients presented with dental trauma involving 281 teeth. The mean age was 37.54 ± 2.16 years. The most common cause of dental trauma in 48 (27.3%) patients was bone cracking, followed by falls in 33 (18.8%), road traffic accidents (RTAs) in 26 (14.8%), and bottle opening with teeth in 26 (14.8%). Bone cracking was the major cause of dental trauma in 18 (31.0%) educated and 2 (28.6%) non-educated patients. Among the patients, 118 (67.1%) presented with single traumatized tooth. Permanent anterior teeth 151 (53.74%) were more involved, and class 2 trauma involving enamel and dentinal structure was the most common presentation.Conclusion:Oral health awareness campaign on the damaging effect of bone cracking and use of tooth for opening metal caps of bottled drinks among adult population will reduce the prevalence of dental trauma among many adult Nigerians.

Point of Care (POC) for Early Infant Diagnosis (EID) in Nigeria? Healthcare Workers Opinion

Without access to life-saving drugs, including antiretroviral, about one-third of HIV exposed infants (HEI) will die by age 1 year and 50% by age 2 years. A 75% reduction in disease progression and 76% reduction in HIV mortality in infants has been attributed to early diagnosis of HIV and early commencement on ART. Early Infant Diagnosis (EID) of HIV aids timely commencement on antiretroviral therapy (ART). Several challenges have been identified with the current process. Point of care (POC) technologies are recommended as a veritable means of addressing these challenges and improving EID uptake. With the aim of assessing the standard of care and the acceptability of POC for the provision of EID. A descriptive cross-sectional survey was conducted across eight healthcare facilities in Nigeria. The survey was conducted among 72 healthcare workers using self-administered questionnaire; with a recovery rate of 61(84.7%). Analysis of participants’ responses indicate that 100% of the respondents believes there is a need for EID. Most respondent reported an average turnaround time (TAT) of 3-4 weeks (35.8%) and &gt;6 weeks (34.0%). Most respondents identified distance to the PCR laboratories (45.7%) and long TAT (34.8%) as key issues affecting the conduct of EID. On the benefit of POC for EID; 90.2% of respondent believe it is beneficial; while 81.5% of respondent believe that with the introduction and use of POC for EID there will be an increase in EID uptake. The POC is a viable and acceptable alternative for EID to increase uptake.

Cleft Care in a Developing Country: An Assessment of Knowledge and Attitudes of Patients/Parents of Children With an Orofacial Cleft to Orthodontic Treatment

To assess the knowledge, awareness and attitude to orthodontic treatment of patients and parents of children with orofacial clefts, receiving comprehensive cleft care treatment. Cross-sectional survey. A major tertiary health care facility in Nigeria, the Lagos University Teaching Hospital, Idi-araba, Lagos. Patients and parents of children with orofacial clefts receiving comprehnsive cleft care. Patients and parents of children with orofacial clefts were asked to complete the survey. Interviewer-administered questionnaires were used. A total of 123 patients participated in the study, 55.3% (68) were females and 44.7% (55) were males. The majority (85.3%, 114) of patients were children aged between 0 and 5 years, while only 7.3% (9) were adults, aged 18 years and above. About one-third (41) of the respondents indicated that they felt "their teeth was not straight." Although 43.9% (54) reported that they knew that braces could be used to straighten teeth, only 13.8% of the respondents knew who an orthodontist was. Eighty percent (99) indicated that they would be willing to undergo treatment to straighten their teeth or their children/wards' teeth. The majority of parents of children with clefts and adult patients attending the institution's cleft clinic had limited knowledge of orthodontics and the orthodontic care required for patients with clefts, although they had a positive attitude toward orthodontic treatment. These findings will guide the center in planning patient-centered orthodontic care for patients with clefts while also highlighting areas of importance for patient counseling and education in the orthodontic care for these patients.

Effect of Vaccine Direct Delivery (VDD) on vaccine stockouts and number of vaccinations: Case study from Bauchi State, Nigeria

ObjectiveVaccine stockouts are prevalent in Africa. Despite the importance of this as a barrier to universal vaccination coverage, rigorous studies looking at ways to reduce vaccine stockouts have been limited. We causally evaluated the effect of Vaccine Direct Delivery (VDD), an intervention to ensure the vaccine stock availability at health facilities, on the reduction of stockouts in Bauchi state, Nigeria. MethodsEmploying the interrupted time-series method, we evaluated the change in the occurrence of vaccine stockouts before and after the introduction of VDD in July 2015. We used health facility level data from January 2013 to December 2018 among 175 facilities in Bauchi state, collected through the District Health Information Software 2 (DHIS2) for monthly information on stockouts and stock balances in all the health facilities in Nigeria. Data were analyzed using Stata 15 SE. To validate the causal relationship between VDD and vaccine stockouts, we conducted two sets of robustness checks. First, we evaluated the effect of VDD on the stockouts of other commodities. Second, we compared the trend of the prevalence of vaccine stockouts among health facilities between Bauchi state where VDD was introduced and another state (Adamawa state) where VDD was never introduced. ResultsAfter the introduction of VDD, vaccine stockouts in Bauchi state decreased by 9 percentage points on average, and they have been decreasing monthly by 0.4 percentage points more than pre-VDD. In Adamawa state, where VDD was never introduced, the prevalence of vaccine stockouts did not change over time. In Bauchi state after VDD introduction, the stock balances of target vaccines all increased, and the number of vaccinations carried out increased in neighboring health facilities. ConclusionsVDD intervention resulted in a significant reduction of vaccine stockouts as well as in an increase in the number of vaccinations performed. However, we should consider how to improve the system to provide vaccination service to the population in a sustainable way.

Comparative analysis of family planning services in urban and rural health facilities in Nigeria

Aim: This study aimed to compare family planning (FP) services in urban and rural health facilities in Nigeria. Materials and Methods: The study is a cross-sectional study conducted in 204 rural and 198 urban health facilities comprising 182 primary and 216 secondary facilities in Nigeria. A FP client was randomly selected from each of the facilities, and structure questionnaires were used to collect information from them. Data collected include the various types of contraception available, waiting time, and satisfaction with services. Data were analyzed with IBM-SPSS Statistics Version 25.0. Results: The most requested contraceptives methods were injectables (48.2%) and oral contraceptives (22.6%). Most clients in both the rural (76.0%) and urban (76.3%) waited 0.05). Conclusion: There is a need for an improvement in waiting time and quality of services offered in health facilities. Policymakers should to carry out regular supervision of health facilities and ensure availability of contraceptives in the health facilities at affordable prices in order to improve FP uptake in Nigeria.

Impact of Gene Xpert on the diagnosis of pulmonary tuberculosis at a tertiary health care facility in Nigeria

Background: Gene Xpert mycobacterium tuberculosis (MTB)/Rifampicin (RIF) was introduced for the detection of pulmonary tuberculosis (PTB) at the Federal Medical Centre, Owo, Ondo State, Nigeria in 2015. The study aimed to determine the effect of Gene Xpert MTB/RIF on diagnosis of PTB. Methods: We reviewed Gene Xpert register from January 2015 to January 2017. The agreement of Gene Xpert with acid-fast bacilli was determined using the sensitivity and positive predictive value of the Gene Xpert test. Association was assessed using chi-square test. Binary logistic regression was used to determine the predictors of positive Gene Xpert result. Results: A total of 1246 records were reviewed; the average age was 41 ± 19 years, and nearly half of the patients (48.6%) were female. While 264 (21.2%) were human immuno-deficiency virus (HIV) positive. Smear microscopy was positive in 118 (16.9%); 90 (13.6%) had tuberculosis (TB) detected on Gene Xpert. Those positive for smear microscopy and Gene Xpert were 21 (10.0%). The Gene Xpert detected 90 (8.3%) of the 653 with presumptive TB. The turnaround time for Gene Xpert was 24 hours. When compared to smear microscopy, Gene Xpert showed sensitivity of 45.7% (95% confidence interval [CI]: 31.7–60.1) and specificity of 98.2% (95% CI: 95.1–99.5) in all the cases and sensitivity of 50% (95% CI: 29.8–70.2) and specificity of 100% among HIV positives. Conclusion: Gene Xpert should be preferred to smear microscopy in evaluating HIV positive patients for TB. Nevertheless, clinicians can still rely on results from smear microscopy for clinical decision when Gene Xpert is not available.

Implementing electronic health care record in a public health facility in Nigeria: awareness, acceptance and concerns among critical stakeholders

This descriptive cross-sectional study investigated staff and patient awareness, preferences and concerns for EHR using a structured questionnaire. More of the staff were females (52.5%), nurses (4...

Adherence to Guidelines in Postpartum Management of Hypertensive Disorders in Pregnancy in Tertiary Health Facilities in Nigeria: A Multi-centre Study

ABSTRACT Hypertensive disorders in pregnancy (HDPs) are a leading cause of maternal morbidity and mortality. Available guidelines for their postpartum management are expected to be optimally utilized. This study aimed to determine adherence to guidelines in selected Nigerian tertiary hospitals. It was nested in a cohort of women with HDPs who delivered in eight facilities between October 2017 and June 2018. Nine weeks after delivery, their cases were evaluated on prespecified indicators and supplemented with interviews. The level of adherence to the guidelines was determined using descriptive analyses, including frequencies, percentages, means, and standard deviations, as well as charts. Of the 366 participants, 33 (9%), 75 (20%), 200 (55%), and 58 (16%) had chronic hypertension, gestational hypertension, preeclampsia, and eclampsia, respectively. Only about a third had their blood pressure measured between postpartum days three and five. Similarly, a third of those with persistent hypertension (≥140/90 mmHg) were not on antihypertensive medications within the first week postpartum. In addition, 37% and 42% of participants were not counseled on contraceptives and early subsequent antenatal visits, respectively. Among those with preeclampsia/eclampsia, 93% were not offered postpartum screening for thromboprophylaxis. Although all women with preeclampsia/eclampsia remained hypertensive two weeks after discharge, only 24% had medical reviews. Overall, only 58% and 44% of indicators were adhered to among all HDPs and preeclampsia/eclampsia-specific indicators, respectively. Level of adherence to guidelines on postpartum management of HDPs in Nigerian tertiary hospitals is poor. It is recommended that institutionalization of guidelines be prioritized and linked to the entire continuum from preconception through longer term postpartum care.

Co-infection and Risk Factors Associated with STIs among Pregnant Women in Rural Health Facilities in Nigeria: A Retrospective Study.

Globally, sexually transmitted infections are recognized as a public and reproductive health challenge. The study determined the prevalence, co-infection, and risk factors associated with HBV, HCV, HIV, and Syphilis infections among pregnant women receiving antenatal care in rural health facilities in Ebonyi State, Nigeria. A retrospective study was conducted from January to December 2018 in 8 primary healthcare facilities using antenatal records of all the 4657 pregnant women who attended ANC within the period. Data were analyzed using descriptive and inferential statistics with IBM SPSS statistics version 20 and hypotheses tested at P < .05. The findings indicated a medium prevalence of HBV (4.1%), a high prevalence of HCV (4.1%) and syphilis (1.8%), and a low prevalence of HIV (0.9%). An overall co-infection rate of 0.623% that was not significant (P > .05) was observed. Also, prevalence was more among the younger mothers (<20 years), those with secondary education. And the history of blood transfusion was significantly associated with HBV and HCV prevalence (χ2 = 7.865; P = .05*), 11.8%. conclusively, due to medium HBV prevalence and a high prevalence of HCV and syphilis observed, attention should be paid to blood screening before transfusion by health workers. Relevant stakeholders should provide intensive health education and appropriate free treatment services particularly for younger mothers and the less educated.

Paracervical Block for Oocyte Retrieval: Experience at a Public Health Facility in Nigeria

Background: Transvaginal Ultrasound Guided Oocyte Retrieval(TUGOR) for in vitro fertilization is one of the most common minorsurgical procedures. Despite this, it is stressful and painful for thepatient and thus requires some form of analgesia with or without sedation. The effects of various anesthetic techniques used for TUGORon reproductive outcomes remain controversial.Aims: This study assessed patients’ perception of pain using paracervical block and its effect on IVF outcomes.Methods: A cross sectional study of 66 eligible patients that underwent assisted reproduction program in our facility. All clients weretreated with antagonist protocol for Controlled Ovarian Hyperstimulation. Self- administered questionnaires was used as the research instrument. Pain was assessed using a 10cm Visual Analogue Scale whileclients’ overall satisfaction was rated using Likert scoring system.Results: Client’s aged 32.8 ±3.4. More than half had primary infertility with mean duration of 4.6 ± 2.4. Female factor infertility wasthe commonest cause of infertility. The pregnancy rate per embryotransfer was 36.4%, miscarriage rate was 9.1%, while the live ratewas 27.3%. The mean VAS scores at 1hour, 6 hours, 24 hours andat embryo transfer were 7.1 ± 2.8, 4.6 ±1.4, 2.8 ±1.2 and 1.0 ± 0.9respectively. The mean Likert score was 2.4 ± 0.9.Conclusion:Paracervical block is a safe and effective anaesthesia/analgesia option for TUGOR.However a multimodal approach of analgesia/anaesthesia for TUGOR is recommended to further improve on clients’ satisfaction andacceptance.

Implementing electronic healthcare record in a public health facility in Nigeria: awareness, acceptance and concerns among critical stakeholders

Implementing electronic healthcare record in a public health facility in Nigeria: awareness, acceptance and concerns among critical stakeholders

Congenital heart defects in orofacial cleft: A prospective cohort study

Background:Congenital heart defects (CHDs) are one of the most common associated anomalies in patients with an orofacial cleft (OFC). However, few studies have shown the association between cleft type and CHDs in our population. This study aimed to assess the prevalence of CHDs in a cohort of OFC patients at a tertiary health facility in Nigeria, as well as assess the risk of CHD by OFC type.Materials and Methods:This was a prospective study design. Patients with an OFC were consecutively enrolled at a single OFC treatment facility. All subjects were assessed by a paediatric cardiologist and had echocardiography done. They were categorised based on the presence of CHDs, as well as the OFC phenotypic type (cleft lip and/or alveolus, cleft lip and palate and cleft palate only). Statistical analysis was done using STATA version 14 (College Station, Texas), and significance was set at P < 0.05.Results:A total of 150 subjects enrolled in the study over a period of 2 years (2018–2020). The median age of subjects was 6 months (interquartile range: 2–24), and 54.7% were female. The prevalence of CHDs in the subjects reviewed was 30.7%. Based on the severity of CHDs, the majority presented with simple defects (95.6%). Overall, the most common presentation was patent foramen ovale (12.7%), followed by septal defects (8.0%). There was no significant association between cleft type and the odds of a CHD.Conclusion:The study reports a relatively high prevalence of CHDs in patients with OFC; however, there was no association between the risk of CHD by cleft type. Although a majority of CHDs may pose a low operative risk, cardiac evaluation is recommended for all cases of OFC to aid the identification of potentially high-risk cases.