Hospital In Southern Nigeria Research Articles

Childhood dead-before-arrival, our experience at a tertiary hospital in Southern Nigeria: a clarion call to stakeholders in the health sector

Dead-Before-Arrival (DBA) is a term used to describe patients who have no sign of life at the time of presentation to the hospital. There is a dearth of information about this cohort of children at most healthcare service delivery points. In fact, these children are also never captured in most of our national and local healthcare data. This research is aimed at sharing our experience on DBA at the Children’s Emergency Room of a tertiary hospital in the South-South geopolitical region of Nigeria, by determining the prevalence, probable disease cause, and pattern of DBA among children presenting at our facility. This is a cross-sectional study that used a standardized verbal autopsy instrument to ascertain the details of all the children aged 1 month to 17 years who were cases of DBA at the Children’s Emergency Room of the University of Benin Teaching Hospital, Benin City, Edo State, Nigeria, over 24 months (January 2018 to December 2019). Socio-demographic characteristics, symptoms before demise, treatment received, and suspected cause(s) of death were documented. The prevalence of DBA was compared to the in-hospital mortality during the period. A total of 96 (3.2%) compared to 144 (4.9%) in-hospital of the 2,914 emergency admissions were cases of DBA, with a 2:1 male-to-female ratio. The age group of 1-6 months had the highest proportion (41.7%). Children under two were 62.5% and 81.3% were under-fives. Infections such as diarrhea, bronchopneumonia, and sepsis were the most common suspected causes of death, followed by non-infectious causes such as perinatal asphyxia, Chronic Kidney Disease (CKD), cyanotic congenital heart disease, drowning, and electrocution. Cases of DBA were significantly lower than in-hospital mortality (144 cases) during the study period (3.2% vs 4.9%) The DBA prevalence as recorded in this hospital-based study may be the tip of the iceberg compared to what happens in the community. Making our primary and secondary health care services more accessible, affordable, and optimally functional may help reduce the burden of DBA.

Admission Patterns and Patient Outcomes in Intensive Care Delivery at a Rural Tertiary Hospital in Southern Nigeria: A Five-Year Retrospective Review

Admission Patterns and Patient Outcomes in Intensive Care Delivery at a Rural Tertiary Hospital in Southern Nigeria: A Five-Year Retrospective Review

Using motivational interviewing to improve sleep quality among patients with hypertension attending a tertiary hospital in southern Nigeria: a randomized controlled trial

IntroductionRestorative sleep is essential for the maintenance of overall health and for the prevention of chronic diseases, including hypertension. The aim of this study was to determine the effect of motivational interviewing (MI) on sleep quality in patients with hypertension.MethodsThe study was a randomised controlled trial (PACTR202301917477205) of 250 adult patients aged 18 to 65 years (125 in each group) with hypertension presenting to the Family Medicine Clinics of Irrua Specialist Teaching Hospital, Irrua, Nigeria from April to December 2023. Patients were selected through systematic random sampling and randomised into intervention and control group with the intervention group having monthly sessions of motivational interviewing in addition to standard care for hypertension and the control group having standard care only. Data were analysed with Stata with level of significance set at p < 0.05.ResultsThe participants had a mean age of 51.5 ± 10.0 years, were mostly females 156 (62.4%), married 135 (54.0%), and Christians 134 (53.6%). There was no significant difference in the sleep pattern of both the intervention and control groups (χ2 = 1.111 and p = 0.292) at baseline. Post-intervention with MI, there was a significant improvement in sleep quality (p = 0.002) and a corresponding improvement in blood pressure control (p < 0.001) of patients in the intervention group compared to controls.ConclusionThe use of motivational interviewing led to a significant improvement in sleep quality and a corresponding improvement in blood pressure control. Motivational interviewing should be employed by physicians and other health workers during sleep prescription counselling.

Paediatric Emergency Admissions, Mortalities, and Unmet Intensive Care Needs at a Tertiary Hospital in Southern Nigeria

Paediatric Emergency Admissions, Mortalities, and Unmet Intensive Care Needs at a Tertiary Hospital in Southern Nigeria

Building a Laparoscopic Urology Cancer Program in an Academic Tertiary Hospital in Southern Nigeria

Building a Laparoscopic Urology Cancer Program in an Academic Tertiary Hospital in Southern Nigeria

Association between family functioning and depression in adult patients with hypertension attending the family medicine clinic of a tertiary hospital in Southern Nigeria

Association between family functioning and depression in adult patients with hypertension attending the family medicine clinic of a tertiary hospital in Southern Nigeria

Profile of women with Gynaecological cancers at a Tertiary Hospital in Southern Nigeria

Background: Gynaecological cancers remain a major public health concern in Low-and Middle-Income Countries. In sub-Saharan Africa, gynaecological cancers account for approximately one-third of all female cancers. Objectives: To determine the socio-demographic, reproductive, and clinical characteristics of gynaecological cancer patients at the University of Port Harcourt Teaching Hospital. Materials and Methods: This was a prospective cross-sectional study of 75 women with histologically confirmed gynaecological cancer managed at the University of Port Harcourt Teaching Hospital, from January 1, 2022, to December 31, 2022. A structured interviewer-administered questionnaire was used to obtain socio-demographic characteristics and clinical profile from the patients and their clinical records after informed consent was obtained. Data was entered into a MS Excel spreadsheet and analyzed with SPSS version 25. Results: Most 27 (36%) of the women were between 40-49 years of age, with a mean age of 50.4 ± 12.3 years. Majority 46 (61.3%) were married, 27 (36%) had tertiary education, and two-thirds earned N30,000 or less (≤ $20) per month. Many 23 (30.7%) were Para ≥ 5, almost all 63 (84%) of the women were referred to UPTH, with one-third 21 (33.3%) of the referrals coming from other tertiary health facilities. Most 63 (84%) of the women had never had a Pap smear screening, and 48 (64%) were menopausal. The most common presenting symptom was vaginal bleeding 37 (49.3%). Cervical cancer accounted for about half 40 (53.3%) of the cases, followed by ovarian cancer 27 (36%), with the majority 28 (43%) presenting with stage III disease. Chemotherapy was administered to all the patients. However, treatment was delayed in 57 (76%) of the women due to financial constraints, with most of the funding and support coming from family members in 43 (57.3%) of the women. Conclusion: There is an urgent need to increase advocacy for gynaecological cancers to increase awareness, prevent late presentation and progression of early disease. Furthermore, the government needs to subsidize the cost of cancer care to encourage early presentation and treatment.

Instituting coronavirus disease 2019 testing: opportunities and challenges of molecular laboratory diagnosis in a Southern Nigerian teaching hospital.

The coronavirus disease 2019 pandemic emphasised the importance of laboratory preparedness, including molecular diagnostic capacity, in the control of infectious disease outbreaks. This article reflects on diagnostic capacity-building opportunities presented by the pandemic, the challenges experienced along the way and the lessons learned from the perspective of a university teaching hospital in Southern Nigeria. We advocate for these lessons to inform strategic planning for laboratory preparedness at subnational, national and continental levels.

Association between sleep quality and blood pressure control among hypertensive patients at a rural tertiary hospital in Southern Nigeria: a cross-sectional study

ObjectivesRestorative sleep is critical in preventing hypertension and other chronic diseases. Limited research has explored the relationship between sleep quality and hypertension in Africa. This study investigated the association between...

Association between Lifestyle and Biosocial Conditions with Erectile Dysfunction among Adult Patients in a Tertiary Hospital in Southern Nigeria

Erectile dysfunction is one of the most distressing often not discussed disorder affecting the male gender globally responsible for a lot of psychosocial distress. The objective of this study was to explore the association between lifestyle, biosocial conditions with erectile dysfunction among the adult males presenting at general outpatient clinic of our hospital. This was a study carried out at Federal Medical Center, Umuahia, Southern Nigeria. A well structured questionnaire was administered to 421 respondents. Results showed 219(52%) had erectile dysfunction while 202 (48%) didnot have erectile dysfunction. Factors associated with erectile dysfunction were age, tobacco use, alcohol intake, diabetes mellitus, hypertension, use of anti hypertensive and oral hypoglycaemic medications which were statistically significant. Body mass index, family functionality, use of illicit drugs and polypharmacy were not associated with erectile dysfunction. However, the independent risk factors were age, tobacco use and alcohol intake.Emphasis on health education and life style modificaation are highly recommended to reduce the burden of erectile dysfunction among our patients.

Histopathological analysis of gynaecological hysterectomy specimens at a tertiary care hospital in southern Nigeria

Histopathological analysis of gynaecological hysterectomy specimens at a tertiary care hospital in southern Nigeria

Pattern of Referral of Obstetric Patients at a Tertiary Care Hospital in Southern Nigeria

Pattern of Referral of Obstetric Patients at a Tertiary Care Hospital in Southern Nigeria

Eclampsia: A Continuous Scourge in a Tertiary Hospital in Southern Nigeria

Eclampsia: A Continuous Scourge in a Tertiary Hospital in Southern Nigeria

Practice of Cervical Cerclage at a University Teaching Hospital in Southern Nigeria

Background: Although the aetiology of preterm deliveries is largely unknown, it is said to be multifactorial and cervical insufficiency has been implicated. Hence, cervical cerclage is a necessary and common prophylactic obstetric procedure for preventing prematurity and associated recurrent second trimester miscarriages. Objectives: To evaluate the pattern, indications, and fetal outcome of cervical cerclage. Methodology: This was a retrospective study of 50 women who had cervical cerclage insertion at the University of Port Harcourt Teaching Hospital between January 1, 2021, and December 31, 2022. Data was obtained from the ward registers, theatre records, and case notes of the women, and entered into a structured proforma. Data analysis was done with SPSS version 25, and results are presented as frequency tables and charts. Results: The mean age of the patients was 35 ± 2.07 years. The mean of number of previous miscarriages was 2.46 ± 2.07, 56.8% were multiparous and 50% had a previous manual vacuum aspiration. Majority 35 (70%) of the women had prophylactic cerclage, 10 (20%) had cerclage following in-vitro fertilization and embryo transfer pregnancy, while 5(10%) had rescue cerclage. Most 29 (58%) of the prophylactic cervical cerclage insertion were done between 11-15 weeks, with MacDonald technique being the most common technique practiced. Of these, only 18 (36%) carried the pregnancy up to 36 weeks of gestation. Conclusion: Many of cervical cerclage procedures were performed for prophylaxis and resulted in improved fetal outcomes in women who had previously experienced mid-trimester losses or preterm delivery.

Awareness of risk factors associated with tubal infertility among female youth corps members in Benin City, Nigeria

Infertility is the inability to achieve pregnancy within one year of regular unprotected coital exposures. It is a common gynecological problem in our environment. The cause of infertility could be of female origin, male origin, a combination of both, or idiopathic. It can be primary when there is no previous pregnancy, or secondary infertility when there is an inability to conceive after a previous conception. In secondary infertility, a tubal factor is the most typical cause globally. In a review of factors associated with tubal factor infertility in a tertiary hospital in southern Nigeria, the tubal aspect constituted 13.5%. It was due to previous post-abortion sepsis, puerperal sepsis, and Pelvic Inflammatory Disease (PID). Awareness of infertility risk factors is an essential first step to safeguard future fertility; however, several studies demonstrated poor knowledge of tubal infertility and its risk factors, especially among infertile couples and couples attending gynecology clinics. This study assesses the knowledge of female youth corps members in Benin City, Edo State, on tubal factor infertility, its risk factors, and management. A cross-sectional analytical study was conducted among female youth corps members in Benin City using a multi-stage sampling technique. A self-administered questionnaire was used for data collection. The data was entered and analyzed using Statistical Package for Social Sciences (SPSS) Version 25.0 (IBM SPSS V 25.0, Chicago, IL, USA) and presented using tables. From this study, there is good knowledge of the burden of tubal infertility and treatment implications (50.4%). However, the knowledge of tubal infertility (34.3%) and its risk factors (27.0%) was poor. Age, marriage, and the medical profession are associated with sound knowledge of the burden of tubal infertility (p=0.02). However, only the medical profession is independently associated with good knowledge of tubal infertility (AOR=2.963, p=0.006, CI=1.370-6.411). There is generally poor knowledge of tubal infertility among females of reproductive age, who are at higher risk of pelvic inflammatory disease being the most typical risk factor for tubal infertility. This calls for more health awareness programs for the youth to help safeguard their future fertility.

Pre-Operative Anaemia in Newly Diagnosed Patients with Gynaecological Malignancy at a University Teaching Hospital in Southern Nigeria

Pre-Operative Anaemia in Newly Diagnosed Patients with Gynaecological Malignancy at a University Teaching Hospital in Southern Nigeria

The practice of using repurposed medications as chemoprophylaxis for COVID-19 by healthcare workers in a tertiary hospital in Southern Nigeria.

Coronavirus disease 2019 (COVID-19) is a viral infection that has been reported in virtually every country. Healthcare workers (HCW) are more at risk of COVID-19 than the general population making them a priority group for vaccination. Before the roll out of COVID-19 vaccines in Nigeria, some HCW were using some repurposed, unapproved drugs to possibly prevent the disease. This study evaluated the frequency and pattern of drug use for COVID-19 prevention. This was a prospective cross-sectional study of HCW conducted in Southern Nigeria. Data was obtained from the participants using a questionnaire and blood sample was obtained for SARS-CoV-2 antibody testing. Data was analysed using the statistical package for social sciences (SPSS) version 23. One hundred and sixty-six participants were enrolled in this study. Thirty-two (19.3%) of them had taken a repurposed medication as prophylaxis for COVID-19. The most used drugs were Vitamin C (9%), Azithromycin (8.4%) and Zinc (6.6%). History of contact with patient with confirmed COVID-19 and being a pharmacist were independent factors associated with the use of COVID-19 prophylaxis. Several HCW in Nigeria take drugs to possibly prevent COVID-19. These medications may not offer significant protection against COVID-19. There is an urgent need to increase uptake of COVID-19 vaccines in HCW in Nigeria.

Prevalence and predictors of hepatitis C infection among antenatal attendees in a tertiary hospital in Southern Nigeria.

Hepatitis C virus infection as it specifically relates to pregnancy has been a neglected condition, thus its recognition and treatment in pregnancy is relevant because of the risks of the long-term complications of the infection in the mother, potential effects of the infection on the pregnancy and risk of vertical transmission to the newborn. To determine the proportion of pregnant women with serologic markers of hepatitis C infection, identify risk factors as well as factors that predict the occurrence of the infection in them. Over a 3-week period, blood samples from 456 pregnant women were assessed for antibodies to hepatitis C virus, while a pre-tested questionnaire was used to obtain socio-demographic data and the presence of risk factors in the University of Uyo Teaching Hospital, Nigeria. The prevalence of HCV infection in pregnancy was 4.6%. No known risk factors for HCV infection in pregnancy were identified. Only increasing gestational age was a predictor of HCV infection in pregnancy in the study. The prevalence of hepatitis virus infection among the study population was high. Second trimester and increasing gravidity were protective of the infection in pregnancy. There is therefore need for introduction of general routine screening of all pregnant women presenting for antenatal care.

Influence of Perceived Family Functioning on Depression among Postmenopausal Women in Nigeria

This was a cross-sectional descriptive survey, designed to determine the influence of perceived family functioning on depression among of post-menopausal women attending the family medicine clinic of a tertiary hospital in Southern Nigeria. An interviewer-administered questionnaire was used to get the respondents’ socio-demographic and clinical parameters. Data were analysed to determine: the rate and severity of depression; how some socio-demographic factors related to depression in postmenopausal women, (PMW); whether there was an association between family function and depression among the women. Our survey revealed that 66.7% of PMW had some degree of depression and their sociodemographic factors were important markers for depression. One third of the women had no form of mood disturbance but 5.7% had severe depression necessitating referral to Neuropsychiatry clinic.The participants’ family function had statistically significant association with depression (χ2 =117, p-value = &lt;.001). Women in dysfunctional milieu were more likely to have depressive illnesses than those in functional families. There was also statistically significant strong negative correlation between respondents’ family function scores and their depression scores (Spearman’s rho = -0.622; sig. (2-tailed = &lt;.001). Using Independent-samples Kruskal-Wallis test, the relationship between family function scores and depression categories was such that women with depression had significantly lower functional scores, when compared with those without depression.

Pattern and Outcome of Paediatric Non-Communicable Diseases in a Teaching Hospital in Southern Nigeria

Non-communicable diseases (NCDs) are chronic non-transmissible diseases that are mainly attributable to lifestyle changes. There is a global increase in this category of diseases, which in developing countries constitute an added burden to the already existing burden of communicable diseases. This study aims at determining the prevalence, pattern, length of hospital stay and outcome of children admitted with non-communicable diseases.&#x0D; Methods: This is a retrospective cross-sectional study carried out in the paediatric wards of our hospital. Data was extracted from records of children admitted within the study period. The data was analyzed using the Statistical Package for Social Sciences (IBM SPSS) version 23. The student t-test was used to compare the means between two groups, while an ANOVA was used for more than two groups.&#x0D; Result: Out of 820 children studied, 32.2% had NCDs with sickle cell disease, neoplasms, and cardiovascular and neurological diseases, constituting the major non-communicable diseases recorded. There was a significantly longer duration of hospital stay and a higher mortality rate in patients admitted with an NCD. There was a significant association between mortality and the category of NCD, with a greater contribution from neoplastic diseases.&#x0D; Conclusion: There is a high prevalence of paediatric non-communicable diseases, although communicable diseases are still more prevalent among children in this study. This is associated with poor outcomes and a longer duration of hospital stay.