Tertiary Hospital In South West Nigeria Research Articles

Prevalence and correlates of sexual dysfunction among patients with mental disorders in a tertiary hospital in Southwest Nigeria.

BackgroundSexual dysfunction is more common among patients with mental disorders compared to the general population. Despite this high occurrence, information regarding sexual dysfunction as well as their correlates in patients receiving care for mental disorders in developing countries is still sparse.AimTo determine the prevalence and correlates of sexual dysfunction among patients with mental disorders receiving care in a tertiary hospital in Southwest Nigeria.SettingThis study was performed at the psychiatric outpatient clinic at the University College Hospital, Ibadan, Southwest Nigeria.MethodsA cross-sectional study was conducted on a convenience sample of 238 adults aged 18–60 years. Socio-demographic and clinical information was obtained from all recruited patients. Sexual dysfunction was assessed using the International Index of Erectile Function questionnaire for men and the Female Sexual Function Index questionnaire for women. Questionnaires for measuring depression, medication adherence and autonomic medication side effects were also administered. Associations between sexual dysfunction and socio-demographic and clinical factors were explored.ResultsThe prevalence rates of sexual dysfunction among male and female participants were 84.7% and 95.7%, respectively. In the multivariate analysis, employment status and autonomic side effects of psychotropic medications significantly predicted male sexual dysfunction, while religion and employment status were predictors of female sexual dysfunction.ConclusionSexual dysfunction is very common among patients with mental disorders, with higher rates in female participants. There is a need for clinicians to consider routine screening for sexual dysfunction in psychiatric outpatients with a view of providing psychosocial interventions to improve patient’s quality of life.

The determinants of knowledge of cervical cancer, attitude towards screening and practice of cervical cancer prevention amongst antenatal attendees in Ibadan, Southwest Nigeria.

Cervical cancer (CC) is an extremely preventable and curable disease with early detection and treatment. Unfortunately, the practice of cervical cancer prevention (CCP) remains poor in resource constrained countries. This study aimed to identify determinants of knowledge of CC, attitude towards cervical cancer screening (CCS) and practice of CCP among antenatal attendees in a tertiary hospital in Southwest Nigeria as they are sexually active women. This was a cross-sectional survey of a cohort of 287 antenatal attendees using a self-administered structured questionnaire to assess their knowledge of CC, attitude towards screening and uptake of screening and human papillomaviruses (HPVs) vaccination as methods of practice of CCP. Data was analysed using the Statistical Package for Social Sciences version 20.0. Descriptive statistics were conducted for all relevant data. Categorical variables were explored using chi-square test and the independent variables with significant associations (p-value < 0.05) entered into logistic regression analysis. The mean age was 30.62 ± 4.5 years. Three-fifths (60.6%) of the women had good knowledge of CC while 47.4% had heard about CCS. Majority (75.6%) were willing to undergo CCS thereby exhibiting positive attitude towards screening. The practice of CCP was poor as only 27 (9.4%) had ever been screened for CC while 10 (3.5%) had received the HPV vaccine. Interestingly, none of the women who had received the HPV vaccine had been screened for CC. Those with tertiary education were more likely (OR = 2.140, 95% CI = 1.166–4.979) to exhibit positive attitude to CCS, while those with poor knowledge were about two times less likely to have a positive attitude (OR = 0.532, 95% CI = 0.291–0.972). Poor knowledge of CC was associated with lesser odds (OR = 0.061, 95% CI = 0.008–0.471) of practice of CCP. In Nigeria, the burden of CC can be reduced if women are educated and health care providers challenged to recommend CCS and HPV vaccination.

Pregnancy-related anxiety symptoms and associated factors amongst pregnant women attending a tertiary hospital in south-west Nigeria.

BackgroundPregnancy can be associated with anxiety symptoms because of anticipated uncertainty.AimThis study investigated pregnancy-related anxiety symptoms (PRASs) and their associated factors amongst pregnant women.SettingObafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.MethodsThis cross-sectional survey involved 230 pregnant women attending antenatal clinic at a tertiary teaching hospital in Nigeria. Pregnancy-related anxiety symptoms, maternal worries, personality traits and social support were measured by using Perinatal Anxiety Screening Scale (PASS), Cambridge Worry Scale (CWS), Big Five Personality Inventory (BFI-10) and Maternal Social Support Scale (MSSS) respectively. Socio-demographic and obstetric details were also obtained. The Chi-square, t-test and logistic regression were used.ResultsRespondents’ mean age was 28.2 ± 5.4 years, whilst 192 (83.5%) were of Yoruba ethnicity. Twenty-four respondents (10.4%) were in the first trimester, 85 (37.0%) in the second and 121 (52.6%) in the third trimester. Some 154 (67.0%) were parous. The prevalence of PRAS and major maternal worries were 43.5% and 55.7% respectively. The socio-demographic factors significantly associated with PRAS were age (p = 0.004), ethnicity (p = 0.001), educational level (p = 0.011) and living arrangement (p = 0.029). Associated obstetric factors include trimester (p = 0.01), hypertension (p = 0.006), past miscarriage(s) (p = 0.013) and past pregnancy complication (p = 0.030). Significant psychosocial factors were partner social support (p = 0.038), maternal worries (p < 0.001) and extraversion (p = 0.016). Factors that contributed significantly to regression models were older maternal age and socio-medical worries.ConclusionHigh level of PRAS and major maternal worries were common amongst antenatal clinic attendees of a tertiary teaching hospital in Nigeria. Older maternal age and socio-medical maternal worries are important predictors of PRAS.

Ocular Morbidities In a Tertiary Hospital In Southwest Nigeria: Pattern and Visual Impact

Ocular Morbidities In a Tertiary Hospital In Southwest Nigeria: Pattern and Visual Impact

Removal of an Impacted Foreign Body from The Upper Airway with a Gastroscope in a Tertiary Hospital in South-West Nigeria – A Case Report

Removal of an Impacted Foreign Body from The Upper Airway with a Gastroscope in a Tertiary Hospital in South-West Nigeria – A Case Report

Cardiac diseases in pregnancy: A 10-year review in a tertiary hospital in South-west Nigeria

Background: The superimposition of the morbidity of cardiac diseases on the physiological demands of pregnancy could impact adversely on pregnancy outcomes. Therefore, contemporary information is for appropriate clinical management. Objective: To determine the management outcomes of cardiac diseases in pregnancy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife. Methods: A retrospective review of the hospital records of patients with cardiac diseases in pregnancy between January 2006 and December 2015 was conducted. The age, parity, gestational age at admission, NYHA class, clinical diagnosis, the results of investigations, complications of cardiac diseases, and maternal and foetal outcomes were recorded. Results: There were 33 women with cardiac diseases in pregnancy and 11,352 deliveries within the period, giving an incidence of 2.9 per 1000. Further analysis was based on 24 women with complete records. The mean age of the patients was 29.2±5.5 years. Twenty (83%) of the women were Para 2 or less, while 13 (54%) presented postpartum. The majority of the women (15; 62.5%) had peripartum cardiomyopathy, while 17 (71%) had NYHA Class III or IV disease. Thirteen (54%) women had vaginal delivery. There were four perinatal and two maternal deaths, with a perinatal mortality rate of 166/1,000 total births and maternal mortality ratio of 8,333/100,000 live births. Conclusion: Cardiac diseases in pregnancy are associated with high perinatal and maternal mortality rates at the OAUTHC, Ile-Ife. However, with early diagnosis and appropriate care, the majority of the patients had a satisfactory clinical outcome. Early presentation and advocacy to improve health-seeking behaviour are recommended.

Level of implementation of WHO COVID-19 document on rights, roles and responsibilities of health workers in a tertiary hospital in Southwest Nigeria

Introductionin order to curb the increasing spread of COVID-19 amongst health care workers (HCWs), the World Health Organization (WHO) released the COVID-19 Rights, Roles and Responsibilities of Health workers (COVID-19 RRRHW) policy document aimed at protecting HCWs amidst the on-going pandemic. This study determined the level of implementation of the document in a tertiary hospital in Southwest Nigeria.Methodsthis was a cross-sectional descriptive study among HCWs in a tertiary hospital in South-western Nigeria that assessed the level of implementation of the WHO COVID-19 RRRHW document using a closed ended structured questionnaire.Resultsfive hundred and thirty-five HCWs participated in the study comprising 165(30.8%) males and 370(69.2%) females. Majority (87.3%) of the HCWs were 40 years and below. One hundred and sixty-three (30.5%) of the HCWs had been involved in the care of COVID-19 patients; less than 60% of the respondents were aware of the presence of an official platform for dissemination of information on suspected or confirmed cases of COVID-19 and 435(81.3%) were aware of hospital training on Infection Prevention and Control (IPC); 191(35.7%) have had uninterrupted supplies of personal protective equipment(PPE) and IPC materials; 211(39.4%) were aware of mental and counselling services in the hospital while only 106(19.8%) knew how to access these services; 289(54%) have attended IPC training and 307(57.4%) are able to don and doff PPE.Conclusionthis study showed inadequate implementation of the WHO COVID-19 RRRHW document. There is urgent need for all stakeholders to familiarize with the document in order to ensure adequate protection of HCWs and minimize their risk of contracting COVID-19.

Prevalence of Rhesus C and D Alloantibodies among Rhesus-Negative Women of Child Bearing Age at a Tertiary Hospital in South-West Nigeria.

A major cause of hemolytic disease of the fetus and newborn (HDFN) is an incompatibility of the Rhesus (Rh) blood group between the mother and fetus. To determine the prevalence of Rh c and D alloantibodies among Rh-negative women of childbearing age (18-49 years). We conducted a cross-sectional study among women who attended the antenatal, gynecology and blood donor clinics at a Tertiary Hospital in South-West Nigeria from January to August 2019. Serological typing of Rh c and D was done manually with the tube test using anti-c and anti-D antisera, while indirect antiglobulin test was then performed to screen for Rh antibodies. Data was analyzed using Stata 16.1 software; Categorical data was summarized using frequency and percentages while continuous variables were described using the mean and standard deviation or median and interquartile range. Pearson's Chi-square (or Fisher's exact) test was used to test for association between categorical variables and Rh status. P values of ≤0.05 were assumed to be statistically significant. A total of 700 consenting women, comprising 505 pregnant (72.1%) and 195 non-pregnant (27.9%) women were recruited into this study. The mean age was 30.7 ± 4.9 years. All (100%) participants were Rhc positive while 641 (91.6%) were RhD positive and 59 (8.4%) were RhD negative. All 59 RhD negative subjects tested negative for anti-D. There was no statistically significant difference between proportion of RhD-negative women who had a jaundiced baby and the proportion of RhD-positive women who had a jaundiced baby (15.6% vs. 18.6%, P = 0.540). This study did not identify any Rhc and D alloantibodies in the study population suggesting there is a low risk of alloimmunization and HDFN due to anti-Rhc and D in this population.

Patients’ Treatment Satisfaction: Experiences of HIV Patients in a Tertiary Hospital in Southwest Nigeria

According to the World Health Organization, about 40 Million people are living with HIV/ AIDS, where two- third resides in the African region and about 2 Million of them are from Nigeria. Hence, this study assessed the satisfaction of patients with services provided in a tertiary hospital in southwest Nigeria. This is due to the fact that the satisfaction of patients is a measure used to evaluate the quality of health care delivery of a hospital and from health care services providers. It is a cross sectional study that employed purposive and convenience sampling methods using well-structured questionnaires to retrieve information from HIV/ AIDS patients. A total of 143 respondents participated fully and whose data were analyzed using Statistical Package for Social Science (SPSS version 20), where the level of patient’s satisfaction was measured. The patients’ satisfaction was based on Service Quality (SERVQUAL) framework. Result from the study revealed that the patients were currently satisfied with the services being offered them, at a grand mean of 4.46 and standard deviation of 0.52. Also, the respondents ranked responsiveness dimension of SERVQUAL framework first with an average mean of 4.53 and standard deviation of 0.47. They ranked Empathy dimension as the lowest dimension, with an average mean of 4.36 and standard deviation of 0.58. Thus, the study recommends that health workers should be trained by the government on how to convey affection while providing services to HIV/ AIDS patients.

Cost implication of inpatient care of chronic kidney disease patients in a tertiary hospital in Southwest Nigeria.

The financial cost of inpatient care of chronic kidney disease (CKD) patients has not been well described in Nigeria; even though, the majority of these patients require inpatient care at the time of diagnosis due to late presentation. This study determined the cost implication of inpatient care among CKD patients in a Kidney Care Center in South-west Nigeria. This was an 18-month descriptive retrospective study. The financial records of the ward, laboratory, dialysis, pharmacy, and dietary services were obtained for each patient during their hospital stay and the sum of these costs was taken as the total direct cost of care. One hundred and twenty- three CKD patients with a male:female ratio of 2.3:1 and mean age of 50 ± 17 years were studied. One hundred and six (86.2%) patients had Stage 5 CKD, 105 (85.4%) had emergency hemodialysis (HD) at presentation and all patients paid out of pocket. The median number of HD sessions and days spent on admission was 4 and 14 days, respectively. The major contributors to the cost of care were total dialysis, ward, and pharmacy expenses with a median total cost of ₦70,000 (US $200), ₦28,000 ($80), and ₦22,230 ($66), respectively. The median total direct cost of inpatient care of CKD was ₦150,770 ($431). The cost of care was higher in those with Stage 5 CKD and diabetic nephropathy. The cost of inpatient care of CKD is beyond the reach of most Nigerians. There is a definite need for the government to include CKD care under the national insurance scheme.

Level of implementation of WHO COVID-19 document on rights, roles and responsibilities of health care workers in a tertiary hospital in Southwest Nigeria.

in order to curb the increasing spread of COVID-19 amongst health care workers (HCWs), the World Health Organization (WHO) released the COVID-19 Rights, Roles and Responsibilities of Health workers (COVID-19 RRRHW) policy document aimed at protecting HCWs amidst the on-going pandemic. This study determined the level of implementation of the document in a tertiary hospital in Southwest Nigeria. this was a cross-sectional descriptive study among HCWs in a tertiary hospital in South-western Nigeria that assessed the level of implementation of the WHO COVID-19 RRRHW document using a closed ended structured questionnaire. five hundred and thirty-five HCWs participated in the study comprising 165(30.8%) males and 370(69.2%) females. Majority (87.3%) of the HCWs were 40 years and below. One hundred and sixty-three (30.5%) of the HCWs had been involved in the care of COVID-19 patients; less than 60% of the respondents were aware of the presence of an official platform for dissemination of information on suspected or confirmed cases of COVID-19 and 435(81.3%) were aware of hospital training on Infection Prevention and Control (IPC); 191(35.7%) have had uninterrupted supplies of personal protective equipment(PPE) and IPC materials; 211(39.4%) were aware of mental and counselling services in the hospital while only 106(19.8%) knew how to access these services; 289(54%) have attended IPC training and 307(57.4%) are able to don and doff PPE. this study showed inadequate implementation of the WHO COVID-19 RRRHW document. There is urgent need for all stakeholders to familiarize with the document in order to ensure adequate protection of HCWs and minimize their risk of contracting COVID-19.

Surgical management of uterine fibroids in a tertiary hospital in south-west Nigeria

Context: Symptomatic uterine fibroids are frequently encountered in gynecological practice in black populations. An evaluation of the surgical management is in order to audit practice, highlight complications, and facilitate care. Aims: This study aimed to evaluate morbidity following abdominal myomectomy and hysterectomy for symptomatic uterine fibroids. Settings and Design: A cross-sectional study retrospectively reviewing cases of symptomatic uterine fibroids that were managed surgically at a tertiary hospital in south-west Nigeria. Methods and Material: Surgeries performed over a five-year period were retrieved from the gynecological theatre of the hospital. The case notes were retrieved and information on socio-demographic, perioperative and postoperative characteristics was obtained. Statistical analysis used: Chi-square tests and Student's-t tests were performed to evaluate categorical and continuous variables, respectively. Significant P was set at Results: Of 214 eligible cases, 79 (36.9%) had hysterectomy and 135 (63.1%) had myomectomy. No other surgical treatment methods were employed. Age was the only significant socio-demographic feature; younger women were more likely to have myomectomy (P Conclusions: Apart from hemorrhage, morbidities were few in this series. Gynecologists should ensure adequate preparations to control blood loss before and during fibroid surgery.

Neonatal Jaundice: Perception of Pregnant Women Attending Antenatal Clinic at a Tertiary Hospital in Southwest, Nigeria.

Background: Severe neonatal jaundice (NNJ) remains a leading cause of preventable brain damage, mental handicap, physical disabilities, and early death among infants. Methods: Using a descriptive cross-sectional study design, information was gathered using a structured, pretested questionnaire from 518 pregnant women who attended the antenatal clinic at a tertiary Hospital in Southwest Nigeria. Results: Most (77%) of the respondents have heard about NNJ prior the survey. Most respondents (69.5%) demonstrated poor knowledge of the causes of NNJ. The majority, 98.4% had good attitude toward treatment of NNJ. Most respondents (72.1%) demonstrated poor knowledge of the correct treatment of NNJ. A quarter of the respondents knew no danger sign of NNJ. Conclusion: There is serious knowledge gap among the respondents about the causes, treatment, dangers signs and complications of NNJ. There is need for increased awareness campaign using every available means of reaching women of reproductive age group to reduce the consequences of this common neonatal problem.

Quality of emergency nursing care in two tertiary healthcare settings in a developing Sub-Saharan African Country

IntroductionThe quality of care received by patients during the first few hours following an accident and/or acute life-threatening conditions can significantly affect the overall outcome of treatment. This study, therefore, assessed the quality of emergency nursing care in two tertiary healthcare settings in a developing Sub-Saharan African Country.MethodsThe study was conducted in two renowned tertiary hospitals in Southwest Nigeria. Four hundred and twenty-eight patients selected by purposive sampling technique from the two hospitals formed the sample. The Donabedian three-pronged approach of structure, process and outcome domains was employed for data collection. Two instruments; an adapted validated structured questionnaire and an observation checklist were used for data collection and data collected were analysed with the aid of Statistical Package for Social Sciences (SPSS 24) using mainly descriptive statistics such as frequency counts and percentages.ResultsResults showed that a majority (62.6%) rated the quality of emergency nursing care as high though observation revealed glaring differences in the structure, process and outcome domains of quality in selected hospitals.Discussion/ConclusionThe study, therefore, concluded that while the quality of emergency nursing care in the selected hospitals can be described in general as average, a lot still needs to be done to address the identified deficiencies in emergency nursing care.

Factors associated with clinical outcomes among neonates admitted with acute bilirubin and hypoxic-ischaemic encephalopathies at a tertiary hospital in south-west Nigeria

Background: Babies who are delivered outside hospital are most at risk of serious illnesses such as perinatal asphyxia and severe hyperbilirubinaemia. These conditions are major contributors to neonatal mortalities in resource-poor settings.Objective: To explore the relationship between pre-admission and intra-facility care and immediate outcomes among neonates with acute bilirubin and hypoxic-ischaemic encephalopathies.Methods: Using a retrospective design, the outcome of outborn babies with acute bilirubin encephalopathy (ABE) and hypoxic-ischaemic encephalopathy (HIE) were studied in a Nigerian hospital between 2012 and 2016.Results: A total of 40 and 80 babies with ABE and HIE were studied. Among babies with ABE, 67.5% arrived at the hospital on self-referral and of the babies with official referral, only 61.5% had had a serum bilirubin check prior to referral. Among the babies with ABE, 25.0% had both social and facility-related challenges, 45.0% had only facility-related challenges and 20.0% had only social challenges. All the babies with ABE who died had either social or facility-related challenges. For the babies with HIE, 56.2% came on self-referral while 70% received no care prior to presentation at the hospital. Some 40% of babies with HIE had both social and facility-related challenges while 12.5% had only facility-related challenges. None of the babies who died presented early. Comparable proportions of babies who died or survived had social challenges and facility-related challenges.Conclusion: Most of the outborn babies with HIE and ABE who arrived at the hospital on self-referral and facility-based care were hindered by social issues and facility-related challenges.

Factors Associated with the Survival Outcome of Hepatocellular Carcinoma Patients on Supportive Care in a Tertiary Hospital in South-West Nigeria

Background: Hepatocellular carcinoma (HCC) is a primary liver cancer. This study assessed the factors associated with the survival outcome of HCC on supportive care. Methods: This was a prospective cohort study carried out from January 2010 to June 2016 on cases of HCC recruited into a cancer data registry. Clinical, laboratory and survival outcomes were obtained. Data obtained were analyzed using descriptive and inferential statistics. Results: A total of 149 cases were analyzed: 120 (80.5%) males and 29 (19.5%) females. Age range was 18-87years, with mean (SD) being 45.0 (14.3) years. Identifiable aetiological factors were hepatitis B and C viruses, alcohol and herbal preparations in 94% while no risk factor was identified in 6%. Some risks co-occurred in multiples in 71.2% of cases. The overall median survival was 20 days, and general survival was 59.1% at two weeks, 33.6 % at one month, and only 7.3% surviving beyond thirty one days to two years. The survival of cases, according to the Child-Pugh (CTP) class, was CTP A: 36 days (ranged 4 to 730 days), CTP class B: 22 days (ranged 1 to 210 days) and CTP class C: 14 days (ranged 2 to 660 days). Higher proportion of young cases was HBsAg positive. Factors significantly associated with survival outcome included older age, female sex, abdominal pain, jaundice, elevated creatinine, bilirubin, AST, ALT, white cell count and hyponatreamia. Conclusion: Overall survival outcome among cases of HCC was poor. It is necessary to prevent HBV, reduce alcohol use, detect and treat HCC early.

Factors associated with clinical outcomes among neonates admitted with acute bilirubin and hypoxic-ischaemic encephalopathies at a tertiary hospital in south-west Nigeria

Background: Babies who are delivered outside hospital are most at risk of serious illnesses such as perinatal asphyxia and severe hyperbilirubinaemia. These conditions are major contributors to neo...

Collaborative Molecular Epidemiology Study of Metabolic Dysregulation, DNA Methylation, and Breast Cancer Risk Among Nigerian Women: MEND Study Objectives and Design.

PURPOSETo elucidate the role of metabolic dysregulation and associated DNA methylation changes on breast cancer risk and aggressive subtypes among Nigerian women. We describe the design and methods of a collaborative molecular epidemiology study of breast cancer in Nigerian hospitals.METHODSThe Mechanisms for Novel and Established Risk Factors for Breast Cancer in Women of Nigerian Descent (MEND) study was designed as a matched case-control study of 350 patients, age 18 to 75 years, with newly diagnosed, treatment-naïve breast cancer and 350 age-matched healthy controls from surrounding geographic areas. Patients with breast cancer seen for initial diagnosis at four large tertiary hospitals in southwest Nigeria and one affiliated private hospital were recruited. Healthy female controls were selected from a cohort of 4,000 healthy women recruited as part of the Human Heredity and Health (H3) in Africa Chronic Kidney Disease Case-Control Study in Nigeria. Tumor and adjacent normal tissue, and blood and saliva samples were collected for molecular and epigenetic assays.RESULTSAlthough recruitment is ongoing, a total of 416 patients have been recruited to date, with tumor and blood samples obtained from at least 310 patients. Data on age-matched (± 6 months) controls have also been obtained and harmonized. Lipid assays for 350 pathologically verified cases and 350 age-matched controls is underway, and pathologic characterization of tumors (including immunohistochemistry for subtyping) is ongoing. Data on DNA methylation for tumors and adjacent normal tissue are expected by the end of the study period.CONCLUSIONThe MEND study will provide a unique, high-quality source of data to evaluate the contribution of metabolic dysregulation such as obesity, diabetes, hypertension, and metabolic syndrome to the biology of breast cancer among Nigerian women and foster collaborative studies relevant for women of African descent globally.

Delays in uptake of surgery for childhood cataract at a child eye health tertiary facility in sub-Saharan Africa.

Timely uptake of surgery is vital in the control of childhood blindness due to cataract. The aim of this study is to determine the uptake of surgery as well as the frequency and reasons for rescheduling of surgery for childhood cataract in a tertiary hospital in southwest Nigeria. A retrospective study of children with childhood cataract seen at the Paediatric Ophthalmology unit of the University College Hospital, Ibadan between 2011 and 2015. Demographic and clinical information was retrieved from case records. Caregivers of children who did not have surgery were contacted by telephone to elicit reasons why surgery was not done. A total of 164 children were included in the study; 90 (54.9%) were male. The median age at presentation was 4 years with a range of 2-180 months. A total of 64 (39.0%) children had unilateral cataract. All patients were scheduled for surgery, but 123 (75%) underwent surgery. Surgery was rescheduled in 42 (34.1%) of those who had surgery. Reasons for rescheduling included financial constraints, illness, delay in paediatrician evaluation to ascertain fitness for anaesthesia and strike actions by health workers in the hospital. Three quarters of the children had surgery, though it had been rescheduled, at least once, in about one-third of them. Delayed uptake of surgery was mainly due to inability to afford treatment and strike actions. The need for improved coverage of health insurance especially for the paediatric age group in developing countries cannot be overemphasized. This is because good vision is an integral part of child development.

Medication adherence and influencing factors in patients with type 2 diabetes attending a tertiary hospital in South-West Nigeria

Background and Objectives: Adherence to antidiabetic medications represents a huge hurdle that needs to be overcome for patients to gain maximum clinical benefits from their therapies. Several factors have been associated with patient adherence. This study assessed adherence to antidiabetic medications and evaluated the influence of pill burden on adherence. Materials and Methods: This is a cross-sectional study of 418 consenting patients with established type 2 diabetes attending the endocrinology Outpatient Clinic of a Tertiary Hospital. Patients were approached consecutively and surveyed using a questionnaire comprising information on demographics, medication adherence, and factors affecting adherence. Data on medication regimen and comorbidities were extracted from participants' case records. The study lasted for 15 months. Data were analyzed and summarized using descriptive and inferential statistics. Results: Nearly 27.5% of the participants were adjudged nonadherent to antidiabetic medications. The average number of antidiabetics was 1.56 ± 0.617. Of the number of participants that are adherent, nearly 33% and 35% of them were on one and two antidiabetic medications, respectively. However, been on three or more medications is associated with poorer adherence. Participants on metformin had better adherence compared to those on insulin alone or insulin plus oral antidiabetics. Short duration of diabetes (P = 0.048), older age (P = 0.024), and high educational level (P = 0.002) are associated with better adherence. Conclusion: A substantial number of patients were non-adherent to their antidiabetic medications. Been prescribed 3 or more antidiabetic medications was associated with poor adherence. The association between adherence to medication and glycemic control is not significant. High Pill-burden, young age, low educational level are potential targets for interventions.