Tertiary Hospital In Nigeria Research Articles

Quality of life and spiritual needs of patients diagnosed with cancer in a tertiary hospital in southwestern Nigeria

ObjectiveIn Africa, cancer is considered a death sentence. Its impact can be debilitating for the patient and those who care for them. This study therefore assessed the spiritual needs and Quality of life of Cancer patients in a tertiary hospital in Nigeria. MethodsThis study utilized a cross-sectional descriptive design. We systematically recruited 302 cancer patients who visited the cancer registry and outpatient departments. A standardized and validated Spiritual needs questionnaire (SpNQ) and WHO Quality of Life (WHOQL) were used to collect data. Data was analyzed with SPSS version 23 with a significance level set at p < 0.05. ResultsThe preponderance cancer among respondents was breast cancer 146 (48.4%) followed by prostate cancer 41 (13.6%). Most of the respondents admitted having “strong” spiritual needs. Categorization of the spiritual need score was below average in 20% of the respondents which indicated those with low spiritual needs and the majority 241 (79.8%) of the patients had high spiritual needs. Most respondents had poor quality of life in all four domains. The spiritual care needs of respondents were significantly associated with the quality of life of the respondents particularly in the psychological domain (p = 0.040) and social domain (p = 0.005). ConclusionThis study revealed high spiritual needs and poor quality of life among cancer patients. Healthcare practitioners should provide for the spiritual needs of cancer patients to enhance their quality of life.

First-Genome Sequence Data of an Alcaligenes nematophilus Strain EBU-23 Encoding bla Gene Implicated in Acute Childhood Gastroenteritis.

Although an environmental contaminant, Alcaligenes sp. are now increasingly reported in clinical infections. Here, we present a whole-genome sequence of an extended spectrum beta-lactamase (ESBL) Alcaligenes nematophilus strain EBU-23 encoding beta-lactamase, bla gene, isolated from the stool of a hospitalized infant with acute gastroenteritis in a tertiary hospital in Nigeria. Antibiotics susceptibility test revealed that the isolate was resistant to the β-lactams, cephalosporins, and penicillin, β-lactam combination, and the fluoroquinolones. Genomic analysis exposed the presence of a class A beta-lactam hydrolase gene and multiple multidrug efflux permease which may be responsible for the beta-lactamase and multidrug resistance observed with the isolate. To the best our knowledge, we describe the first whole-genome sequence of a multidrug-resistant A. nematophilus implicated in acute childhood gastroenteritis in Nigeria.

The Distribution of Acme Gene and MRSA Related Virulence Genes in Staphylococcus Aureus Strains from Nigeria

Background: Arginine Catabolic Mobile Element (acme) is a Staphylococcal genomic island that enhances fitness and ability of bacteria cells to colonize on mucous membrane and skin. It is stongly associated with the epidemic and virulent S. aureus USA 300. This study determined the distribution of acme and Methicillin Resistant Staphyllococus Aureus (MRSA)-related genes in S. aureus isolated from patients in five tertiary hospitals in Nigeria. Methods: A total of 51 S. aureus isolates from the clinical specimens submitted to laboratories in five tertiary hospitals in Nigeria were used in this study. Phenotypic and genotypic identifications of the S. aureus were performed. Antibiotic Susceptibility Test (AST) was carried out to determine the susceptibility pattern of the isolates using various antibiotics discs. Minimum Inhibitory Concentration (MIC) was used to determine the degree of resistance of the isolates to methicillin and vancomycin. Polymerase Chain Reaction (PCR) was used to screen for the presence of mecA, acme sae, sarA, PVL, α-psm and norB genes using specific primers. The SCCmec type was determined for all the MRSA isolates using polymerase chain reaction. Results: The MIC for mecA negative strains was ≤4 µg/ml, while the MIC for mecA positive was 8 µg/ml. mecA gene was detected in 35 (68.6%) of 51 strains of S. aureus. The prevalence of sae, sarA, mecA, acme, PVL, α-psm and norB gene were estimated to be 70.6%, 68.6%, 68.6%, 29.4%, 5.1%, 39.2% and 33.3% respectively. There was an association between the distribution of mecA+ and norB+ strains (P = 0.034) and the hospitals (P =0.008) where the isolates were obtained from, whereas there was no association between acme positive strains and the hospitals (P = 0.669) from which the isolates were obtained from. Also, there was no association between mecA, norB, acme with the sex, age and hospital admission status (P&gt;0.05). Furthermore, there was an association between PVL gene and the two geographical regions (South-Western and North-Western, Nigeria) (χ2 = 7.77; p &lt; 0.05). The SCCmec typing showed that 21 (60.0%) out of the 35 MRSA used in this study carried the SCCmec type elements such as type I, II, III and VIII which were all the characteristic of HA-MRSA while the remaining 14 (40%) carried the SCCmec type elements such as type IV, V, VI and VII which were all characteristic of CA-MRSA. Thus the overall prevalence of HA-MRSA and CA-MRSA in this study was 60.0% and 40.0%, respectively. Conclusion: The prevalence of acme and α-psm genes in S. aureus are high and this is a novel discovery in Nigeria which has opened a new era in the transmission and fitness of circulating MRSA in causing infection in the community at large. The study concluded that there is high prevalence of HA-MRSA in South-Western, Nigeria and high prevalence of CA-MRSA in the North-Western, Nigeria.

Correlation between parental willingness to pay, health-related quality of life, and satisfaction with physiotherapy services in Nigeria: a cross-sectional study

Abstract Background Being a parent of a child with a disability requiring many clinic visits is burdensome. Therefore, understanding the willingness-to-pay (WTP) for physiotherapy for children with disability is important to facilitating access to care and for policy-making. This study aimed to investigate patterns and correlates of parental WTP for physiotherapy. Methods A total of 65 parents of children with disability receiving physiotherapy as outpatients were recruited from selected tertiary hospitals in Nigeria. A WTP questionnaire, SF-12 health survey, and Physiotherapy Satisfaction Questionnaire were used to assess the WTP, health-related quality of life (HRQoL), and satisfaction with physiotherapy respectively. Descriptive statistics of mean, standard deviation, frequency, and percentages were used to summarize the data. Chi-square and regression analysis were also used to test the association and determinants of WTP from each of the socio-demographic factors, satisfaction with physiotherapy, and health-related quality of life, respectively. Results A majority (49.2%) of the respondents were in the 21–35 years age category. There was 30.8% “no WTP” for physiotherapy among parents of children with disability. A significant association was observed between socio-economic status and WTP for all treatment modalities (p &lt; 0.05). The majority of the respondents had above-average levels of physical and mental health domain of SF-12. No significant association was observed between WTP and each satisfaction with physiotherapy and HRQoL (p &gt; 0.05). Conclusion There was a high rate of ‘no WTP’ for physiotherapy among parents of children with disability. Level of satisfaction with physiotherapy and health-related quality of life was not significantly associated with parental WTP for physiotherapy.

Impact of pharmacist-led intervention in medication adherence and inhaler usage on asthma and chronic obstructive pulmonary disease control: a quasi-experimental study.

Despite recent advances in the management of asthma and chronic obstructive pulmonary disease (COPD), patients still experience suboptimal disease control largely due to medication non-adherence and inappropriate use of inhaler. This study evaluates the impact of pharmacist-led intervention in medication adherence and inhaler usage on asthma and COPD control among out-patients attending the premier tertiary hospital in Nigeria. A quasi-experimental study carried-out among eligible out-patients attending pulmonology clinic of University College Hospital, Ibadan. Baseline questionnaire explored medication adherence using a comprehensive-medication-adherence-assessment-scale (CMAAS-12) developed by the study co-investigators, use of pressurized-metered-dose (pMDI) and Diskus inhalers, as well as asthma/COPD control using validated asthma control test (ACT) and COPD assessment test (CAT). Subsequently, patients were allocated into control (n = 65) or intervention group (n = 65) using odd or even number. Intervention group received 2-month follow-up educational and/or cognitive-behavioural interventions to resolve identified adherence barriers, while control group continued with traditional care. Descriptive statistics, Chi-square and Wilcoxon-signed-ranked tests were used for analysis at p < 0.05. Overall, patients with optimal adherence were 11(18.6%) and 16(27.1%), p = 0.132 (control), but 20(33.3%) and 38(63.3%), p < 0.001 (intervention) at baseline and post-baseline, respectively. Specifically, in the intervention group, the identified adherence barriers at baseline were summarized into knowledge (120;40.4%), practical (115;38.7%) and attitudinal (62;20.9%). Patients with correct use of pMDI were 11(21.6%) baseline and 19(36.5%) post-baseline, p = 0.011 (control), but 13(22.8%) and 46(80.7%) respectively, p < 0.001 (intervention). Correct use of Diskus inhaler were 5(50.0%) and 4(40.0%), p = 0.157 (control), but 7(35.0%) and 14(70.0%), p = 0.025 (intervention) at baseline and post-baseline, respectively. Patients with 'well-controlled asthma' were 25(44.6%) and 26 (47.3%), p = 0.025 (control), but 18(35.3%) and 32(60.4%), p < 0.001 (intervention) at baseline and post-baseline, respectively. The COPD-specific health status indicated that 0(0.0%) and 1(14.3%), p = 0.059 (control), but 0(0.0%) and 7(50.0%), p < 0.001 (intervention) at baseline and post-baseline, respectively, belonged to 'low COPD impact'. Pharmacist-led intervention significantly enhanced medication adherence and appropriate use of inhaler among the intervention cohort, with subsequent significant improvement in asthma control and reduced COPD impact compared with the control group. This underscores the need for active involvement of pharmacists in collaborative management of patients with chronic respiratory diseases in clinical practice. ClinicalTrials.gov identifier: NCT06417931. Retrospectively-registered.

Design and Implementation of a Sickle Cell Disease Electronic Registry in Resource Limited Setting in Nigeria—A Pilot Study

Background: Sickle cell disease (SCD) is an autosomal recessive haemoglobin disorder, affecting about 7.74 million individuals worldwide, but it is more prevalent among Africans and Asians. SCD is characterised by many complications, and it is a major health issue in Nigeria, the country with the largest burden of the disease globally. This work aims to present the design and implementation of electronic registries (ER) for SCD in a tertiary hospital in Nigeria. Methods: Registry design was initiated during a staff exchange programme within the ARISE initiative (EU grant agreement no. 824021). Ethical approval was obtained, and paper records were retrieved and transferred into one adult and one paediatric database, developed with Microsoft Access. Results: Data from 2659 SCD patients were entered in the ERs, including 698 (26.3%) adults and 1961 (73.7%) children. There were 287 (41%) male adults, 404 (58%) female and 7 (1%) patients whose gender was missing. There were 1041 (53.1%) male children, 906 (46.2%) female and 14 (0.7%) whose gender was missing. Information on phenotype was available for 2385 subjects, and most of them (2082, 87.3%) were SS. The most prevalent SCD-related complication was painful events (26.6% in adults and 68.7% in children, considering valid cases). Conclusions: About 60% of SCD patients in the centre were included in the ERs providing useful, hands-on recommendations for future ER design in SCD. These ERs might be an appropriate tool for collecting and analysing SCD patients’ data.

Molecular detection and genotyping of HBV from HBsAg positive patients in a tertiary hospital in Nigeria.

Nigeria remains one of the countries with a high hepatitis B virus (HBV) burden in Africa. Reports have indicated the presence of mixed HBV genotypes in Nigeria; however, there is still paucity of data regarding mixed genotype infections particularly in the Southern part of the country. Our aim is to determine the HBV genotype distribution among HBsAg-positive gastroenterology patients at the University College Hospital Ibadan, Nigeria. Serum samples were screened for HBsAg by ELISA, and positive samples were genotyped by semi-nested multiplex PCR for HBV genotypes A, B, C, D, E and F. Data generated were analyzed in R-studio. A total of 81/90 (90%) of HBsAg-positive samples were successfully genotyped, and genotype A was most prevalent with 15.7%, while genotypes B and E were the least with 1.2% each. Genotypes A/C infection was the highest among mixed infections with 40% prevalence, while genotypes A/D were the least prevalent mixed infection with 4.8%. We advocate for a comprehensive genotype analysis in larger cohorts across Nigeria, to give a more comprehensive understanding of the distribution and prevalence of different HBV genotypes population wide.

Obstructed Labor at a Tertiary Hospital in Nigeria: A Six-Year Review

Introduction: Unlike most developed countries, obstructed labor with a dead fetus is still a reality in many developing countries, and it is a well-known cause of maternal and perinatal morbidity and mortality. Objective: To highlight the characteristics of patients presenting with obstructed labor at a tertiary hospital and determine fetomaternal outcomes. Methodology: A retrospective descriptive study of 45 cases of obstructed labor that were managed in a tertiary hospital from January 2009 to December 2014. Relevant information was extracted from patients’ case files, and the data obtained were analyzed. Results: Obstructed labor constituted 0.75% of all deliveries. All patients were referred in, and thirty (2/3) of them were nulliparous, while 25 (55.6%) were between the ages of 16 and 25. Forty-one (91.1%) of the patients were delivered by emergency caesarean section, while four patients had exploratory laparotomy with uterine repair and bilateral tubal ligation. Thirty-eight (84.5%) of the babies weighed between 2.6-4kg and five (11.1%) weighed more than 4kg. Most of the patients, 91.1%, had prolonged hospital stay with 25% staying over 3 weeks postpartum before being discharged. Eight (17.8%) suffered severe birth asphyxia, and there were five perinatal and two maternal mortalities. The commonest complication was puerperal sepsis. Conclusion: The study showed obstructed labor remains a cause of perinatal and maternal morbidity and mortality. Effective use of partographs in the peripheral centers, where all the women came from, would ensure early referral before labor became obstructed.

Ectopic Pregnancy at a Tertiary Hospital in Nigeria: A Six-Year Review

Introduction: Ectopic pregnancies, though a disease of vagaries, its diagnosis remains essentially clinical; hence, a review of sociodemographic characteristics, risk factors, and clinical features will help determine the pattern of presentation. Objective: To highlight the characteristics that best predict ectopic pregnancy. Methodology: A retrospective descriptive analysis of 128 cases of ectopic pregnancy that were managed in a tertiary hospital from January 2009 to December 2014. Relevant information was extracted from patients’ case files, and the data obtained were analyzed. Results: Ectopic pregnancies constituted 4% of all gynecological admissions and 2.1% of all pregnancies occurring commonly in the age group 25–29 years. The commonest clinical presentations were lower abdominal pain (94.5%), amenorrhea (64%), and vaginal bleeding (53.9%). The majority (44.5%) of the women had a history of previous induced abortions. Sixty-nine patients had their diagnosis made clinically, and there was no maternal mortality. Conclusion: Lower abdominal pain in the presence of amenorrhea is a good predictor of ectopic pregnancy. Other symptoms that might be helpful in diagnosing ectopic pregnancy are a previous history of induced abortion and vaginal bleeding. This, however, needs further research.

Relationship Between Hematologic Inflammatory Markers and Glycemic Control in Type 2 Diabetes Mellitus Patients in a Tertiary Hospital in Nigeria.

Hematologic inflammatory biomarkers derived from a full blood count (FBC) are elevated in Type 2 diabetes mellitus (DM). In low- and middle-income countries like Nigeria, a FBC is an affordable and easily available test, even in rural areas. Glycated hemoglobin (HbA1c), a measure of glycemic control, has been found to correlate with hematologic inflammatory markers. In Nigeria, where health care is expensive and patients essentially pay out of pocket, a more affordable and accessible alternative to HbA1c in determining glycemic control is needed. Therefore, this study aimed to determine the relationship between Hb A1c and hematologic inflammatory biomarkers, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and mean platelet volume (MPV), in predicting glycemic control. This was a six-month study of 109 patients with Type 2 DM in a tertiary hospital in Lagos. The patients' HbA1c and FBC were measured. NLR, PLR, and MPV were derived from the FBC values. We categorized the patients based on glycemic control. Spearman correlation analysis was used to determine the relationship between HbA1c and the inflammatory biomarkers. There was no significant difference in NLR, PLR, and MPV between optimal and suboptimal controlled diabetic patients. Spearman's correlation analysis showed no significant association between NLR, PLR, MPV, and HbA1c in the patients (NLR: r=0.027, P=0.680; PLR: r=-0.091, P=0.356; MPV: r=-0.032, P=0.744). The inflammatory markers studied had no significant relationship with HbA1c and might not help monitor glycemic control in Type 2 DM patients.

Prevalence and associated risk factors for Helicobacter pylori infection using stool antigen test among children presenting to the outpatient clinic of a tertiary hospital in Nigeria

Prevalence and associated risk factors for <i>Helicobacter pylori</i> infection using stool antigen test among children presenting to the outpatient clinic of a tertiary hospital in Nigeria

High drug-pathogen mismatch in the management of invasive carbapenem-resistant Enterobacteriaceae infections at a tertiary hospital in Nigeria

ObjectivesThis study aims to provide lacking data on antibiotics and treatment strategies used in the management of carbapenem-resistant Enterobacteriaceae (CRE) infections in Nigeria. MethodsA cross-sectional study was carried out at the University College Hospital in Ibadan. CRE isolated from routine culture of specimens from hospitalized patients from December 2021 to September 2022 was identified. Treatment information and other data were collected from the patients’ medical records. ResultsThe hospital laboratory isolated CRE from 55 patients during the study period and 27 (49.1%) of them had data available for the study. The most frequently isolated CRE was Klebsiella spp. (13 of 27, 48.1%). Of the 24 patients who received empiric antibiotics, only two (8.3%) of their CRE isolates were susceptible. After receiving culture results, 18 (66.7%) patients were treated with at least one antibiotic, to which resistance was documented. Only three (11.1%) patients overall commenced or remained on an antibiotic, to which their CRE isolate was susceptible. ConclusionsDespite culture data, we found a high prevalence of drug-pathogen mismatch in CRE treatment, including new or persistent use of antibiotics, to which resistance was documented. Antimicrobial stewardship efforts need to be strengthened to specifically address CRE treatment and effective antibiotics need to be made accessible.

A National survey describing the quality of care in Paediatric Emergency Departments of Tertiary Hospitals in Nigeria

A National survey describing the quality of care in Paediatric Emergency Departments of Tertiary Hospitals in Nigeria

Leadership style, change management and job performance of health information management practitioners in tertiary hospitals in South-East, Nigeria

PurposeManaging patients’ health information is one of the building blocks of the health system and the adoption of health information technologies like electronic health records (EHRs) is expected to reduce the various challenges in keeping and accessing quality health-care data that aid decision-making among medical practitioners. This study aims to investigate how leadership styles and change management affected the job performance of health information management practitioners on their adoption of EHRs in tertiary hospitals in Nigeria.Design/methodology/approachThe study used primary data collected using a Likert scale questionnaire from 117 health information management officers and health information technicians in selected tertiary hospitals in South-Eastern Nigeria. The data were analysed using bivariate correlation and multiple regression techniques of inferential statistics.FindingsThe analyses revealed that transformational leadership style, transactional leadership style and change management had significant positive influence on the job performance of health information management practitioners. However, laissez-faire leadership style did not show any significant positive influence. A further analysis showed that the combined effects of leadership styles and change management were also affirmed to significantly influence the adoption of EHRs for quality health-care delivery in Nigerian tertiary hospitals.Originality/valueThe study contributes to health information management and the need to understand how leadership styles and change management can influence the adoption of EHRs. However, there is no adequate research that examined the role of leadership style and change management in influencing the job performance of Nigerian HIM practitioners regarding their usage of EHRs in tertiary hospitals in Nigeria.

Health Promotion Practices among Pregnant Women Attending Antenatal Clinics at a Tertiary Hospital in Nigeria.

A cross-sectional study conducted in a semi-urban tertiary healthcare hospital in South western Nigeria to assess health promotion practices and associated sociodemographic factors among pregnant women attending antenatal clinics. A total of 220 pregnant women were studied. Results showed that 95.0% of the participants had good health promotion practices with physical activities having the lowest while spiritual values had the highest score. Moreover, age, religion, education, and occupation were significantly associated with health promotion practices among the pregnant women.

PCR17 Evaluation of Quality of Life and Its Predictors Among Breast Cancer Patients Accessing Care at a Tertiary Hospital in Nigeria

PCR17 Evaluation of Quality of Life and Its Predictors Among Breast Cancer Patients Accessing Care at a Tertiary Hospital in Nigeria

Predictors of time to diagnosis and treatment: A retrospective cohort study of patients with clinically localized prostate cancer in Nigeria.

e23123 Background: Equitable access to the management of early-stage prostate cancer is important for optimal outcome in the diagnostic and curative treatment pathway of patients. This study aimed to identify the predictors of time to treatment and time to diagnosis in these patients. Methods: This was a cohort study of 110 patients with clinically localized prostate cancer (T1-T3a, N0, M0) in three government-funded tertiary hospitals in Nigeria. Retrospective data on sociodemographic status, co-morbid conditions, clinical, pathological and radiological quality metrics, date of first presentation for cancer-related complaint in the tertiary hospital, date of diagnosis of prostate cancer, and the date of commencement of first cancer-directed treatment were collected. Primary endpoint was the time from diagnosis to treatment and the secondary endpoint was the time from presentation to diagnosis. Predictors were determined by Cox proportional hazards using Stata software, version 18.0 with a p-value of less than 0.05 considered significant. Results: Twelve percent (n = 13) of the patients had a family history of prostate cancer. Fifty-four percent (n = 59) had other co-morbid conditions. Nearly one-third, 29% (n = 32) had retired from their primary occupation and 10% (n = 11) were covered by health insurance. The overall median time to diagnosis was 30 (interquartile range (IQR) 10 - 48) days. The median time to treatment commencement was 32 (IQR 19 - 82) days for ADT; 57 (IQR 50 - 63) days for active surveillance; 45 (IQR 21 - 78) days for radical radiotherapy; and 100 (IQR 0 - 127) days for radical prostatectomy. Diagnostic PSA documentation independently predicted delayed time to diagnosis (adjusted HR = 0.22 with 95% CI [0.05,0.97]) while those with guideline concordant imaging investigations independently predicted longer time to treatment (adjusted HR = 0.63 with 95% CI [0.40,0.99]). Conclusions: The documentation of PSA level and use of guideline concordant imaging investigations were significantly associated with delayed time to care. Studies on interventions to reduce barriers associated with these factors is warranted to strengthen equitable access to care in this setting.

Effects of speculum lubrication on cervical smears for cervical cancer screening: A double blind randomized clinical trial.

Speculum lubrication may help to reduce the pain experienced during Pap-smear collection and hence increase uptake of cervical cancer screening and repeat testing, but there are fears of its interference with cytological results. To determine and compare the adequacy of cervical cytology smears and the mean pain scores of women undergoing cervical cancer screening with or without speculum lubrication. This was a randomised controlled study of 132 women having cervical cancer screening at a tertiary hospital in Nigeria. Sixty-six participants were randomly assigned to the 'Gel' and 'No Gel' groups, respectively. Pap smears were collected from each participant with a lubricated speculum ('Gel group') or a non-lubricated speculum ('No Gel group'). The primary outcome measures were the proportion of women with unsatisfactory cervical cytology smears and the mean numeric rating scale pain scores, while the secondary outcome measures were the proportion of women who were willing to come for repeat testing and the cytological diagnosis of Pap-smear results. The baseline socio-demographic variables were similar in both groups. There was no significant difference in the proportion of unsatisfactory cervical smear results between the two groups (13.6% vs. 21.2%, p = 0.359). However, the mean pain scores were significantly lower in the gel group than in the no gel group (45.04 vs. 87.96; p<0.001). An equal proportion of the participants in each group (90.9% vs. 90.9%; p > 0.999) were willing to come for repeat cervical smears in the future. Speculum lubrication did not affect the adequacy of cervical smears but significantly reduced the pain experienced during pap smear collection. Also, it did not significantly affect the willingness to come for repeat cervical smears in the future. The trial was registered with the Pan-African Clinical Trial Registry with a unique identification and registration number: PACTR2020077533364675.

Knowledge of Stroke, Its Symptoms or Signs, Risk Factor and Practice of Prevention among Healthcare Workers in a Tertiary Hospital in Nigeria

Purpose: Stroke is a leading cause of disability globally. Deaths from stroke and stroke-related disability occur more in low-income and middle-income countries. However, most studies narrated a lack of public knowledge and practice related to stroke. This study aims to investigate stroke-related knowledge, associated factors, and prevention practices among Healthcare workers. Materials and Methods: This was a cross-sectional study among 200 Healthcare workers from the Federal Medical Centre, Asaba Nigeria. They were selected by systematic sampling technique to participate in the study. A semi-structured questionnaire was used to collect data on the research variables. Data were analyzed using the IBM SPSS version 25 statistical package Findings: The mean age of respondents was 36.20 ± 10.60 years and they were predominantly females (56.5%). The respondents had good aggregate knowledge of stroke (84%), its warning signs or symptoms (72%), and risk factors (78%). However, the aggregate practice of stroke prevention among healthcare workers was poor (61%). There was a significant association (p &lt; 0.0001) between good knowledge of stroke and Clinical Healthcare when compared with Non-Clinical Health Care workers [Chi-squares =27.1, 95%CI= (0.029-0.256)] but this did not affect their practice [Chi-square =3.570, p-value = 0.02, 95%CI= (0.321-1.023)] Implications to Theory, Practice and Policy: There is a need for healthcare workers to encourage health educational programs on Knowledge and behavior-changing strategies toward stroke prevention practices.

Prevalence and pattern of sleep problems among older persons attending a tertiary hospital in Nigeria

Background: Sleep disturbances are common symptoms in adults and are related to various factors, but they are not an inherent part of the ageing process. Objective: To determine the prevalence and pattern of sleep problems among older persons attending the General Out-patient Clinics in a tertiary health-care facility in Uyo, Nigeria. Materials and Methods: This was a hospital-based cross-sectional descriptive study on older persons attending the GOP clinics of the University of Uyo Teaching Hospital. Using a semi-structured interviewer administered questionnaire, information on the sociodemographic characteristics and the sleep history of the respondents were obtained. Data entry and analysis were done using Epi info® version 3.5.1. Results: The prevalence of sleep problems was 64.5% with early awakening being the commonest sleep problem (50.5%) experienced by the respondents. Conclusion: The prevalence of sleep problems is high in this study, and there is need for counselling of older persons on how to improve their sleeping habits.