Hospitals In Southeast Nigeria Research Articles

Palliative Social Work Services for Cancer Patients in Southeast Nigeria: An Exploration

Palliative social work services are essential for addressing the complex psychosocial needs of cancer patients, particularly in resource-constrained areas like Southeast Nigeria. Despite the recognition of social work in palliative care for cancer patients, effective delivery faces significant challenges impacting both social service delivery and patient outcomes. This study investigates the provision of palliative social work services for cancer patients using in-depth interviews with 18 participants (six social workers and twelve cancer patients) from two hospitals in Southeast Nigeria. Participants were purposefully sampled based on their roles in providing or receiving palliative care support. Thematic analysis of the data revealed that social work palliative services encompass psychosocial support, spiritual guidance, and educational resources. However, social workers encounter barriers such as emotional stress, burnout, communication gaps, financial constraints, and socio-cultural factors. The study suggests that regular debriefing sessions and educational programs could improve palliative care delivery. Policy advocacy is recommended to recognize and support the pivotal role of palliative social workers in cancer care. Future research should explore innovative strategies using quantitative methods to overcome barriers and enhance palliative social work effectiveness across diverse cultural and healthcare contexts, ultimately improving social service delivery to cancer patients and advancing social service research.

Ocular disorders in a tertiary Hospital in South East Nigeria

The object of this study was to determine the pattern of ocular disease patients that presented to the Enugu State University of Science and Technology Teaching Hospital, Park Lane, Enugu, Nigeria. A retrospective study was conducted, where the medical case notes of patients who had ocular examinations, other clinical examinations, and investigations from April 2022 through December 2022 were retrieved. There were a total of 1145 patients, with a male population of 476 (41.6%), while females were 669 (58.4%). The mean age of the study population was 40.8 years, with a Standard Deviation (SD) of 22.4. A total of 924 (80.7%) participants were adults while children (aged 16 years and below) were 221 in number and constituted 19.3% of the study population. The most common eye disease was refractive error, which occurred in 266 (23.2%) of the participants; it was followed by allergic eye diseases, 201 (17.6%), cataract, 170 (14.9%), glaucoma, 111 (9.7%), and trauma to the eye, 94 (8.2%). Among the children, the most common eye disease seen were allergic eye diseases, 78 (35.3%), followed by refractive error, 70 (31.7%), trauma, 21 (9.5%), cataract, 11 (5.0%), while infections of the eye were 10 (4.5%). The most common eye disease among the adult participants was refractive error, 196 (21.1%), and then cataract, 159 (17.2%), allergic eye diseases, 123 (13.3%), glaucoma, 105 (11.4%), and retinal pathologies, 82 (8.9%). The most common causes of eye diseases in this study were refractive error, allergic eye diseases, cataracts, glaucoma, and trauma. Health education at community and primary health care level could help to reduce the number of people with avoidable causes of visual impairment.

Effect of dolutegravir-based regimen on the body mass index of adolescents living with HIV in an African population: a pre-post design

ABSTRACT Dolutegravir, an integrase strand inhibitor, has been linked to an increase in body mass index among adults. However, little is known about its effect on adolescents. The study assessed the effect of a dolutegravir-based regimen on adolescents’ body weight and emphasized the gender-specific differences in weight gain, if any. This prospective cohort study was conducted among 182 treatment-experienced adolescents living with HIV at a tertiary hospital in Southeast Nigeria. The body mass index measurements were calculated before transitioning to dolutegravir and after six months of being on the dolutegravir regimen. A comparison of the difference in mean body mass index before and after dolutegravir-based therapy was determined using a paired t-test. At the end of the six-month follow-up, there was a significant increase in the respondents’ overall body mass index z-score (t = −10.00, p < 0.001). There was a significant increase in the body mass index z-score of both genders (male; t = −7.49, p < 0.001, female; t = −6.91, p < 0.001). The dolutegravir-based therapy (β-coefficient = −0.17, t = − 2.09, p < 0.001) and baseline body mass index z-score (β-coefficient = 0.76, t = 15.86, p < 0.001) were significant predictors of body mass index z-score at six months. In adolescents living with HIV, the transition to dolutegravir is associated with increased body weight. Female adolescents tend to gain more weight compared to males. Therefore, there is a need for regular monitoring of body weight for early detection of obesity and prompt intervention.

Knowledge and Attitude of Eye Care Workers towards Electronic Medical Records in a Tertiary Eye Facility in South-East Nigeria

Electronic Medical Records (EMR) has been an integral part of patient management in the developed world but still gradually gaining popularity in the developing world. It was met with resistance by health workers in Nigeria though this is changing in the post COVID era. However, there still appears to be some resistance to its acceptance for different and sometimes justifiable reasons. The aim is to determine the knowledge and attitude towards EMR among eye health workers in a teaching hospital in South East Nigeria. This cross-sectional quantitative study was conducted among consenting consecutive eye care workers at Guinness Eye Centre, Onitsha aged≥ 18years from July to September, 2023. A pretested semi structured self-administered questionnaire was used. Information of interest were biodata, knowledge and attitude towards EMR. They were summarized into simple frequencies and percentages. Knowledge scores were grouped into good and poor using the blooms cut off for knowledge attitude and practice. Univariate and bivariate analysis were done and results represented in tables and charts with levels of significance placed at p&lt;0.05. There was a total of 135 respondents; the mean age was 32.6 years ± 10 SD, male to female ratio of 1:1.1. The result showed good knowledge and positive attitude towards EMR (85.2% and 73.2% respectively) with younger age group, professional cadre and computer literacy found to be associated with good knowledge and positive attitude towards EMR in the population. The hospital/ clinic were the most common sources of EMR information. This study showed good knowledge and positive attitude toward EMR in the study population. It also suggested an association with younger age group, professional cadre and computer literacy.

Investigation into quality of life of patient receiving chemotherapeutic regimen in selected hospital in South East Nigeria: A pilot study

In 2008 approximately 12.7million cancers were diagnosed and 7.6million people died due to cancer worldwide. People living with cancer experience a variety of reactions as such quality of life and chemotherapy for cancer patients and its associated side effects are topical issues in oncology practice. A survey was conducted among 264 breast cancer patients selected by Purposive sampling technique, the instrument for the study was (EORTC QLQ - C30 &amp; BR 23). This instrument was used to determine the quality of life of cancer patients and breast cancer in particular. It has a total of 53 items. The first 30 items (i.e. EORTC QLQ - C30), bothers on patients perception of health, the last 23 items which are numbered 31 – 53 (i.e. BR 23). QOL of breast cancer patients using EORTC QLQE30-BR23, revealed that they have trouble taking a long walk, they have you had pains, they need to rest with a mean of 1.9, 2.7 and 2.8 respectively. Also, 15.9% of the respondents had an excellent quality of life in the past week, 78.0% have good quality of life in the past week, it also further revealed that 14.8% had an overall excellent quality of life during the past week. Also, findings revealed that most of the respondents 57.95% had a very bad/poor QOL. Furthermore, findings further revealed that the patients’ perception of overall health past weeks was good, 206(78.03%). Cancer patients experienced many adverse reactions that affected their QOL. There is a need to develop strategies for managing their adverse event resulting from interventions for cancer, thus improving the patient quality of life.

Prevalence, Awareness and Risk Factors for Hypertension in Adults Attending a Tertiary Hospital in South-East Nigeria

Prevalence, Awareness and Risk Factors for Hypertension in Adults Attending a Tertiary Hospital in South-East Nigeria

Medical ethics and compliance amongst physician groups: a self-assessed survey in a hospital in Southeast Nigeria.

Being a doctor remains a moral enterprise as he is expected to make some medical decisions based on ethical principles during encounter with patients. The objective of this study was to investigate the knowledge and application of medical ethical principles amongst physician groups in a Hospital in Enugu, Nigeria. This was a cross-sectional self-assessed study conducted amongst medical doctors in five specialty groups in a teaching hospital in Enugu, Nigeria.Descriptive and inferential statistics were used to summarize the items and determine whether significant differences on knowledge and application of medical ethics existed amongst the physician groups in the treatment of patients. Observance and compliance with medical ethical conduct was highest among doctors that were aged 55 years and above. In sex, male doctors had higher ethical conduct compliance than female doctors. Comparing the doctors by rank, medical officers, consultants and senior registrars respectively had the highest ethical conduct. Knowledge and practice of medical ethics were mostly deficient among younger Nigerian and female doctors. Remedying the situation will require better curricula both at the undergraduate and post-graduate medical school programmes for doctor trainees. Requiring certification in bioethics for license renewal will also help in resolving and improving the knowledge gap.

Risk perception and hesitancy towards malaria vaccines among hospital pharmacists in southeast Nigeria: a cross-sectional study

ABSTRACT This study evaluated the willingness and perceived concerns of hospital pharmacists in allowing and recommending malaria vaccines. This was a cross-sectional-based study. Participants were recruited from two teaching hospitals in southeast Nigeria – the University of Nigeria Nsukka (UNTH) and the Enugu State University Teaching Hospital (ESUTH). Outcomes were acceptability of the malaria vaccine and concerns about the use of malaria vaccine measured using a validated 21-item questionnaire adapted from a similar study. Descriptive statistics were used to characterise and compare data, with chi-test to test the association between variables. A sub-group analysis within the acceptability was done to determine the predictors of ‘probably’ by also dichotomizing the responses. Data were analysed using STATA v17. Out of 250 participants recruited for this study, 187 completed and returned the questionnaire, with UNTH having the highest response rate (n = 137, 73.3%). Ninety-two (54.1%) out of 170 participants agreed that they would allow their children to take the malaria vaccine. Sixty-six (50.4%) out of 131 and 30 (62.5%) out of 48 participants from UNTH and ESUTH, respectively, will likely recommend the vaccine to family members, while 64 (49.6%) out of 129 and 31 (64.6%) out of 48 participants from UNTH and ESUTH, respectively, were likely to recommend the vaccine to their patients. Eighty-three (61.9%) out of 134 and 33 (67.3%) out of 49 participants from UNTH and ESUTH, respectively, had concerns about the adverse effects of taking this vaccine. Education level (p = 0.017) and age (p = 0.014) were significantly associated with the likelihood of recommending this vaccine to patients. Our findings showed that pharmacists are not likely to accept and recommend malaria vaccines to their children and patients. Hospital pharmacists’ demographic characteristics did not predict their acceptability or probability of allowing the malaria vaccine to be administered to their children. Similar findings were also observed for hesitancy towards malaria vaccines. There were concerns about the failure of the vaccine and its adverse effects.

Comparative Assessment Of Job Satisfaction Among Frontline Health Care Workers In A Tertiary Hospital In South East Nigeria

Background: Job satisfaction cuts across facets of mental perception and responses individuals make towards their jobs. They include cognitive, affective, and behavioral components. In light of reducing workforce in the Nigerian healthcare, this study was aimed at comparing the outlook of job satisfaction among healthcare workers in Nnamdi Azikiwe University teaching Hospital, Nnewi, Nigeria. Methods: It was a cross-sectional study design with a sample size of 281 healthcare personnel consisting of doctors, nurses, medical laboratory scientists, pharmacists, physiotherapists, and radiographers using a structured, self-administered questionnaire. The data was analyzed using SPSS version 20. Statistical significance was set at p≤0.05. Results: The study showed that Radiographers and Physiotherapists averagely had the best job satisfaction scores in comparison to other healthcare personnel. Doctors and Nurses were noted to have the worst average scores in relation to other personnel. Conclusion: The disparity in job satisfaction among different professional cadres may be a reflection of disproportionate work expectations, outlooks, and rewards experienced by different professionals in the course of their duties. Favorable and unfavorable work environments and policies may be weighted differently in the work experience of different professionals.

Perception, precausions and acceptance of vaccination against SARS COV-2 viral infection among health workers in two tertiary hospitals in southeast Nigeria, four years after the onset of the pandemic

Background: The study was conducted in two tertiary hospitals located in ababkaliki the capital city of Ebonyi State.&#x0D; Aim: To ascertain the perception, awareness and vaccination of COVID-19 among the health workers.&#x0D; Methods: A questionnaire/data sheet was developed for the study. Information on sociodemographic characteristics, perception and awareness and COVID 19 vaccination were obtained. The data were fed into the computer using SPSS version 25, Illinoi USA and analysis done.&#x0D; Results: We had 420 respondents with the mean age of 39.1±9.8 and ranged from 20 to 70years made up of doctors, nurses/midwives, laboratory scientists, pharmacists and others. There was high awareness of COVID 19 in the group but with poor knowledge of spread 47.4% and preventive measures 43.1%. awareness of vaccine was high 96.9% but the uptake was low 33.8% with major reason being fear of side effect and some also believe vaccine is a scam. Some of the respondents were survivors of COVID 19.&#x0D; Conclusion: There is high awareness of COVID 19 disease in the hospitals but poor knowledge of mode of spread and preventive measures including very low uptake of anti-COVID 19 vaccines and inadequate provision of PPEs 4 years after the onset of the pandemic.

Strangles in a stallion in southeast Nigeria: clinical and pathological report

ABSTRACT. Streptococcus equi subspecies equi is the causative agent of strangles, a highly contagious mucopurulent upper respiratory tract infection of horses. This report describes the clinicopathologic findings of a fatal case of pulmonary form of strangles in a two-and-half-year-old stallion presented at a Veterinary Teaching Hospital in Southeast Nigeria. Treatment was attempted in quarantine using high doses of procaine penicillin; but it was unsuccessful. The clinical signs observed in the affected horse include a left unilateral supra-orbital swelling containing purulent matter, which progressed to a chronic intractable exudative pus. Anaemia with leukocytosis (due to neutrophilia) were observed in the haematologic parameters. Gross and histologic lesions were multifocally extensive abscessing necrotic lymphadenitis and bronchopneumonia with inflammatory oedema and infiltrate of polymorphonuclear leukocytes.

The Spectrum of Intradialysis Complications in Renal Patients Accessing Care in A Tertiary Hospital in South East Nigeria

Background: Haemodialysis (HD) is currently the most common mode of renal replacement therapy (RRT) in the Sub-Saharan Africa. It is however, fraught with many complications which sometimes cause morbidity and mortality outside the primary kidney problems. Hence, there must be concerted effort to identify them early. This would enable the clinician institute preventive measures or treat them efficiently when these adverse effects occur. Materials and Method: A prospective study was carried out among chronic kidney disease (CKD) and acute kidney injury (AKI) patients in failure assessing HD care at the Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi dialysis center. Subjects were one hundred and twenty six in number: 84 CKD and 42 AKI. Sixty five (65) were males while sixty one (61) were females.  A total of three hundred and sixty nine (369) HD sessions were done. Sociodemographic data and medical history were obtained from each subject and relevant physical examinations and laboratory investigations were carried out prior to and intra dialysis for each subject. Results were analyzed using Statistical Package for Social Sciences (SPSS) software version 17. Results: Intradialytic complications occurred in 86 out of 126 subjects. The commonest intradialytic complication was hypotension (20.6% for patient-based analysis and 21.1% for session-based analysis). This was followed by hypertension (19.8% for patient-based analysis and 16.5% for session-based analysis). Other complications noted were fever (9.95%), chest pain (9.95%), cramps (1.0%) and seizure (1.0%). Conclusion: In this study population, intradialysis hypotension was the most common complication followed by intradialysis hypertension. Patients on HD should be assessed and monitored actively to identify and possibly prevent or treat these complications when they occur.

Evaluation of Medication Safety Practices Among Pharmacists in A Teaching Hospital in South-East Nigeria

The study evaluated the practice of Medication Safety and assesses the knowledge of medication safety practices among hospital pharmacists in a teaching hospital in southeast Nigeria. It was a quantitative study divided broadly into two phases. Phase one involved the collection of the medication error forms filled by pharmacists in the hospital over 3 months; January – March 2021. The second phase was the administration of self-completed questionnaires. The data was collected and analyzed. The medication errors encountered were assessed, classified, and the prevalence determined. Descriptive statistics were used to summarise the data. Overall, 68 medication error forms were collected over the 3-month data collection period. The top category of prescribing error was dose/frequency omitted (24.65%), followed by duration/stop date omitted and dose inappropriate (over), both were 17.81%. The medication safety domain to which pharmacists demonstrated the highest positive response rate (PRR) was Personal Influence Over Safety with 63.33% (SD±20.09), and the domain with the lowest positive response rate was Facilitators and Barriers at the Workplace with 46.25% (SD±25.67). Most of the pharmacists answered yes to having filled out the hospital’s medication error form at least once. 3 of the 4 medication safety domains had above-average positive response rates (PRR). The medication safety domain with the lowest PRR was the facilitators and barriers at the workplace domain with 46.25%. There were no significant differences in associations between pharmacists of different ages, years of experience, and different genders in their attitudes toward medication safety; after applying Pearson’s correlation test.  

Histopathologic Spectrum and Clinicopathologic Concordance of Pediatric Skin Biopsies: 18-Year Experience in a Tertiary Hospital in Southeast Nigeria

ABSTRACT Background: Many studies have evaluated the spectrum of pediatric skin disorders in outpatient, inpatient, and emergency settings in different regions of Nigeria. However, literature analyzing histopathological data of dermatologic diseases in children undergoing biopsy or excision of skin lesions in Nigeria is lacking. The present study was aimed at determining the spectrum, frequency, and clinicopathologic diagnostic concordance of pediatric dermatopathological lesions at a tertiary care hospital in southeast Nigeria. Materials and Methods: This is a retrospective cross-sectional study undertaken at the department of Histopathology, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi. All pediatric (up to 18 years old) skin biopsies received at the department of Histopathology, NAUTH, Nnewi over an 18-year period from January 2004 to December 2021 were included in the study. Relevant clinical and demographic data had been collected from the request forms. For ease of analysis and comparison with other skin studies, the skin lesions were classified according to the International Classification of Diseases, Tenth revision (ICD-10) (2019), for disorders of the skin and subcutaneous tissue. Results: Pediatric skin biopsies constituted 20.2% of all the skin biopsies received at our laboratory during the study period, with a male to female ratio of 1:1. The initial clinical diagnosis was concordant with histopathologic diagnosis in 88 out of 189 cases (46.6%). Forty-nine percent of biopsies/excisions were performed in the head and neck area. The most common diagnostic categories, in decreasing order of size, were neoplasms, disorders of skin appendages, papulosquamous disorders, and infections. Only about a quarter of neoplasms were malignant. Conclusion: Our study has documented the importance of histopathology as a gold standard in the diagnosis and management of skin lesions. Improved training of primary care physicians and closer cooperation between pediatricians, dermatologists, and pediatric surgeons will increase the chances of accurate diagnosis.

Abdominal Injuries from Civilian Conflicts: An Emerging Global Health Challenge in Rural Southeast Nigeria.

In recent time, incidence of abdominal injuries continues to increase steadily in most major regions of West Africa due to emergence of various religious, social and political conflicts. Indeed, violence and social conflicts constitute major global public health challenges that commonly lead to injuries and long-term physical and mental health problems. In our setting, increasing cases of abdominal trauma resulting from civilian violence led to additional workload in the general surgery unit and the audit of our experiences is presented in this paper. To analyze the etiological spectrum, trend and management outcome of abdominal injuries from civilian violence in our setting. This was a multicenter prospective study of adult patients with abdominal injuries from civilian conflicts managed at three selected district hospitals in Southeast Nigeria between January 2013 to December 2020. Of 398 patients evaluated, 359 (90.2%) sustained penetrating while 39 (9.8%) had blunt abdominal injuries. Gunshot was the most common mechanism, accounting for 248 (62.3%) cases, followed by stab wound (95, 23.9%). Armed robbery attack (68, 27.4%) was the main source of gunshot wounds. Overall, annual rates showed a four-fold rise over an eight-year period from 24 cases (6.0%) in 2013 to 96 (24.1%) in 2020. Majority (365, 91.7%) had operative management (OM); the rest (33, 8.3%) were treated non-operatively. Morbidity and mortality rates for operative cases were 29.6% and 12.1% respectively. The main factors associated with increased mortality rates were delayed presentation (p = 0.002), bowel resection (p = 0.006), gunshot wounds (p = 0.013), advanced age (p = 0.033), multiple visceral injury (p = 0.034) and ASA score ≥ III (p = 0.001). Abdominal trauma from civilian violence is on the steady rise in our setting. The main etiologic factors are armed-robbery, communal clashes, political thuggery and cultism perpetrated predominantly through gunshots and stab wounds. Advancing age, gunshot wounds, delayed presentation, bowel resection and multiple injuries were associated with increased mortality.

Trends in emergency room visits of oral and maxillofacial surgery patients in a tertiary hospital in South-East Nigeria

Trends in emergency room visits of oral and maxillofacial surgery patients in a tertiary hospital in South-East Nigeria

Effect of open book management and teamwork on productivity among staff of teaching hospitals in Southeast Nigeria

Effect of open book management and teamwork on productivity among staff of teaching hospitals in Southeast Nigeria

Mosquito Species Breeding Within a Tertiary Hospital in South-East Nigeria: Are There Public Health Implications?

Mosquito Species Breeding Within a Tertiary Hospital in South-East Nigeria: Are There Public Health Implications?

Investigating physician self-referral in public hospitals in South East Nigeria: Insights from stakeholders.

Physician self-referral occurs where a full-time paid doctor diverts patients from one hospital to another in which he or she has financial interest. This study is aimed at investigating the views of service users, physicians and policymakers on physician self-referral practice in public hospitals in Nigeria. The study was carried out in Enugu urban area of South East Nigeria. A mix of qualitative and quantitative methods was used to collect information from different categories of stakeholders. Service user views were explored through analysis of four focus group discussions involving 26 participants and 407 questionnaires completed with household members who had recently visited a public hospital and then gone to private hospitals. In-depth interviews were completed with 15 public sector doctors not involved in dual practice and eight key policymakers. Thirty-four of 407 respondents (8.4%) visiting a public hospital were diverted to a private facility associated with the attending public hospital doctor. The research examined age, gender and socio-economic status (SES) as factors that might influence the likelihood of patient diversion. Advice to transfer to a private clinic usually came directly from the doctor involved but might also come from nurses. Physician self-referral in Nigeria could take different forms. It was found that both direct and indirect forms of diversion exist, suggesting that this is an organised practice in which dual-practice doctors and supporting hospital staff members cooperate. The study recommends, among other things, that service users should be adequately protected from any form of diversion to private practice by the public system employee doctors.Contribution: This study contributes to understanding the extent and pattern of patient diversion in public hospitals in Nigeria. The findings reveal coordinated tactics for diverting public hospital patients and provide a direction for future research in negative behaviour among healthcare professionals in Nigeria.

Assessment of Drug Use in a Tertiary Hospital in Southeast Nigeria Based on Who Core Drug Use Indicators

Background: Irrational use of medicines is a global phenomenon and an issue of concern with so many undesirable consequences. The complex nature of the pharmaceutical care process is an indication for an essential tool that investigates drug use pattern in health facilities. The WHO released the core drug use indicators to address these issues. The study assessed drug use in a tertiary hospital in southeast Nigeria based on WHO core drug use indicators. Methods: A cross-sectional descriptive study design was used and the study was conducted from October 2021 to June 2022. Retrospectively, 300 prescriptions were selected and reviewed using systematic random sampling for a year from 2020 -2021 to investigate prescribing indicators. A total of 120 randomly selected patients and pharmacy personnel were observed and interviewed to investigate the patient-care and facility-specific indicators. The WHO/INRUD core drug use indicators were used to assess the patterns of drug use in comparison to the result gotten. Results: The average number of drugs per encounter was 2.76, the Percentage of drugs prescribed by generic names was 78.02%, the Percentage of antibiotics prescribed was 33.33%, and the Percentage of injections prescribed was 1.67%. Average consulting time in minutes was 17.5 minutes, the average dispensing time in seconds was 92.1 seconds, the Percentage of drugs actually dispensed was 76.97%, Percentage of adequately labeled was 100%, and the percentage of patients’ knowledge of correct dosage was 90%. The facility did not have an Essential Drug List but had all (100%) the key drugs listed by the WHO drug list. Conclusion: All of the prescribing indicators deviated from the WHO/INRUD recommended optimal values. Patient-care and facility-specific indicators deviated from the optimal values except that of the average consultation time, average dispensing time, percentage of drugs adequately labeled, and 100% availability of key drugs. Although a few of the WHO benchmark for rational drug use were met, the outcomes were not satisfactory and required interventions to improve rational drug use in the facility.