Tertiary Hospital In South-east Nigeria Research Articles

Determinants of willingness to participate in health insurance amongst people living with HIV in a tertiary hospital in South-East Nigeria

Waning donor funding and poor country ownership of HIV care programmes are challenges for the sustainability of care for people living with HIV (PLHIV) in Nigeria. Health insurance presents a viable alternative for funding of HIV care services. This study assessed the determinants of willingness to participate in health insurance amongst PLHIV in a tertiary hospital in South-East Nigeria. Across-sectional survey was conducted amongst 371 PLHIV on treatment at Federal Teaching Hospital, Abakaliki, Nigeria, using a semi-structured, interviewer-administered questionnaire. Chi-square test and logistic regression were conducted with SPSS version 20 at 5% level of significance. Respondents were mostly males (51.8%) with a mean age and monthly income of 45.4 ± 10.3 years and $74.1 ± 42, respectively. Majority were willing to participate (82.5%) and to finance health insurance (65.2%). The major reasons cited by those unwilling to participate were poor understanding of how the system works and lack of regular source of income. The predictors of willingness to participate were female gender (adjusted odds ratio [AOR] = 2.9; 95% confidence interval [CI]: 1.6-5.7), being currently unmarried (AOR = 4.3; 95% CI: 2.3-7.8), being self-employed (AOR = 2.2; 95% CI: 1.2-3.9), having family size >5 (AOR = 3.1; 95% CI: 1.7-5.9) and having less than secondary school education (AOR = 4.3; 95% CI: 2.3-7.8). Majority of the respondents surveyed were willing to participate in, and finance health insurance. Willingness to participate was more amongst vulnerable subgroups (females, unmarried, self-employed, poorly educated and those with large family size). We recommend the inclusion of health insurance in the care package of PLHIV.

Prevalence of hypoxaemia and its associated factors in children with pneumonia seen at a tertiary hospital in Southeast Nigeria

Background: Hypoxaemia is a common complication and a significant predictor of death from pneumonia in children under five years of age. Knowledge of the prevalence of hypoxaemia and clinical signs associated with it may guide use of oxygen in the management of childhood pneumonia in resource-poor settings. This study was carried out to determine the prevalence of hypoxaemia in children with pneumonia and assess the relation between hypoxaemia and age, duration of illness and clinical signs.Methods: This was a descriptive cross-sectional study undertaken between 1st July 2016 and 27th April 2017. Children with pneumonia, aged 2-59 months, who attended Federal Medical Centre, Owerri and met the inclusion criteria, were recruited into the study. Subject evaluation included history and physical examination. Their blood oxygen saturation was determined by pulse oximetry and value less than 90% indicated hypoxaemia.Results: Out of the 144 children with pneumonia, 93(64.6%) were males and 51(35.4%) females giving a male to female ratio of 1.8:1. Median age was 8 months and mean weight (SD) was 8.6 kg (3.6). The overall prevalence of hypoxaemia was 17.4%. Hypoxaemia prevalence was significantly higher in infants (p=0.026) and severe pneumonia (p<0.0001). There was statistically significant association between hypoxaemia and lower chest in-drawing, nasal flaring, suprasternal recession, grunting, lethargy, tachypnoea and tachycardia. With adjustment for confounding variables, only lower chest in-drawing (OR: 9.672; p=0.004), lethargy (OR: 8.103; p=0.020) and grunting (OR: 4.960; p=0.050) predicted hypoxaemia in pneumonia. Each of these signs had a poor combination of sensitivity and specificity.Conclusions: Hypoxaemia is common in childhood pneumonia. Though some clinical signs are significantly associated with hypoxaemia in childhood pneumonia, they may be unreliable in predicting hypoxaemia. Therefore, pulse oximeters should be provided in every health facility for accurate detection of hypoxaemia.

Trend and determinants of tuberculosis treatment outcome in a tertiary hospital in Southeast Nigeria

IntroductionNigeria ranked 7th among the high TB burden nations globally and second most endemic in Africa. There are several highly effective interventions available for tuberculosis control. Operational challenges have been reported to interfere with the success of these interventions. This review was conducted to ascertain the treatment outcome using the Directly Observed Short Course Strategy implemented in the hospital. MethodsA retrospective review of the Tuberculosis treatment was conducted in former Ebonyi State Teaching Hospital and Federal Teaching Hospital from 2008 to 2014 as part of the departmental critique of patients’ clinical care and tuberculosis control activities. Using the facility’s TB treatment register, information on the patient’s demography, clinical characteristics and treatment outcome was extracted. The data were analyzed using Epi Info version 7.2. Frequencies and proportions were calculated. ResultsA total of 1070 cases were reviewed with majority 491 (45.9%) belonging to 25–44 years age group. There were 585 (54.7%) males and 68 (11.6%) paediatrics. Pulmonary tuberculosis (667, 62.3%) was the most common presentation. Among those that did sputum smear AFB, 53.2% were smear negative. In all, 91.2% of the cases were treatment naïve, 59.1% were HIV negative at beginning of their treatment while 8% had unknown HIV status. Of the treatment outcome, 40.5% were classified as treatment completed, 16.0% cured, 17.4% of the cases defaulted while 14.1% of the cases died on treatment. These patients were often referred from primary and secondary level hospitals. ConclusionsThe cure rate was very poor and treatment default rate high. The high default rate could be due to the referral nature of the hospital. The treatment success rate of 56.5% is still far below the national target of 85% treatment success rate for effective tuberculosis control. An operational research is recommended to elicit the root causes of low treatment success rate and high patient default rate.

The experience of women following caesarean section in a tertiary hospital in SouthEast Nigeria

To explore maternal experience following caesarean section. The study was a cross-sectional prospective study involving 250 women. The mean age of the study population was 27.2 ± 5.5 years with fifty-three per cent (53.1%) of the women between the ages of 20-9 years. Majority of the participants (67.1%) were multiparous and 37.4% of the parturient had secondary school education. The majority (67.1%) were in social class 3-5. Emergency caesarean section accounted for 74.5% of the caesarean section and the commonest indication was foetal distress. One hundred and forty-four participants (59.3%) were satisfied with their caesarean section experience which was significantly associated with health care attention and foetal outcome. More than half of the study population would not accept caesarean section when indicated in a future pregnancy. The health care attention [AOR 0.53, 95% CI (0.32, 0.88)] and maternal age [AOR 3.05, 95%CI (1.43, 6.49)] were significant predictors. Majority of the women were satisfied with their caesarean section experience which is influenced by the hospital care and foetal outcome. Improvement in maternal caesarean section experience through quality health care is important in increasing uptake when indicated.

Evaluation of Female Sexual Function in Persons With Type 2 Diabetes Mellitus Seen in a Tertiary Hospital in Southeast Nigeria With Emphasis on its Frequency and Predictors

Women with diabetes are at increased risk of sexual problems. However, this problem is underreported; hence, the need for this study. This was a cross sectional case-controlled study. Seventy-five consenting females with type 2 diabetes mellitus (T2DM) were enrolled from the Diabetes Clinic of the Federal Medical Center, Umuahia, while 75 persons, which included hospital workers and female companions of subjects, were recruited as a control group. Sexual dysfunction in both groups was diagnosed and characterized using the female sexual function index (FSFI). Data obtained from this study was presented as Mean ± SD and analyzed using SPSS 17 software. The mean age of the T2DM group and control were 44.5 years and 38.9 years, respectively. The mean total female sexual score was 22.10 ± 6.66 in the T2DM subjects, while in the control subjects it was 22.43 ± 5.29. This was not statistically significant. The FSFI scores in the desire, lubrication, and orgasm domains were all lower in the diabetic women and this was statistically significant (p < 0.05). The domains of pain and arousal were also lower in the diabetic women, although this was not statistically significant (p > 0.05). The proportion of diabetic females who reported problems in the arousal, lubrication, orgasm, and pain domains was higher (40.0, 36.4, 32.7, 29.1) than the controls (27.9, 16.2, 14.7, 19.1; p < 0.05). The prevalence of female sexual dysfunction in our study was high. Similarly, the FSFI score was low in women with diabetes when compared with controls. The domains of arousal, pain, orgasm, and satisfaction were the most affected in subjects with DM. Age, marital status, body mass index, fasting blood sugar, and hypertension were predictive of sexual dysfunction in the diabetic women.

MON-160 VIABILITY OF PALLIATIVE CARE AS A TREATMENT OPTION FOR ELDERLY PATIENTS WITH END-STAGE RENAL DISEASE IN TWO TERTIARY HOSPITALS IN SOUTHEAST NIGERIA; A PRELIMINARY REPORT

The number of elderly patients developing end-stage renal disease (ESRD) is on the increase in Nigeria. With multiple co-morbid conditions, evidence is needed to inform decision making for or against dialysis among these patients. A cross-sectional analysis of patients from 60 years and above with ESRD who were treated with either haemodialysis or palliative care over a period of two years in two tertiary hospitals in SouthEast Nigeria. The symptom burden, quality of life and functional status were assessed by standard validated methods. Survival was defined as time from diagnosis of ESRD to either death or been censored. Kaplan-Meier survival analysis and Log rank test was used to estimate and compare survival. Cox proportional hazard regression models were used to investigate the impact of independent variables on survival. Haemodialysis was offered to 114 (75%) while 38 (25%) choose palliative (non-aggressive) renal care for various reasons. Patients who opted for palliative care had a significantly higher mean symptom burden score and lower quality of life scores than their counterparts on dialysis treatment (p=0.760). There was no significant difference in mean functional status scores between the two groups (p=0.837). The mean survival time for those on dialysis treatment (7.1 months) was slightly higher than mean survival time for those on palliative care (5.8 months) but there is no significant evidence of difference in survival times for both groups (Log rank = 1.2, p=0.27). Palliative care may be a viable option for management of ESRD as it has comparable survival advantage with haemodialysis; howbeit with a higher symptom burden and lower quality of life.

Evaluation of The Utilization of Parenteral Preparations for Fluid, Electrolyte and Nutrition Management in Two Tertiary Hospitals in Southeast Nigeria

Parenteral nutrition is the intravenous administration of a nutritionally balanced and physicochemical stable sterile emulsion or solution.

Frequency of hemophilia and hemostatic evaluation in persons with bleeding symptoms in Southeast, Nigeria

Background: A significant number of people living with hemophilia and other bleeding disorders are reported to be either underdiagnosed or untreated in most developing countries. Objectives: To evaluate the frequency of hemophilia and some hemostatic parameters in persons with bleeding symptoms in Southeast Nigeria. Materials and Methods: This was a cross-sectional, hospital-based pilot study of 50 persons consecutively recruited with bleeding symptoms from four tertiary hospitals in Southeast Nigeria. Full blood count was carried out using Mythic 22 semiautomated analyzer, (Orphee, Geneva, Switzerland). Prothrombin time (PT) and activated partial thromboplastin time (APTT) mixing studies and one-stage factor assays were carried out using tube tilt technique. Bleeding score was assessed using the International Society on Thrombosis and Haemostasis bleeding assessment tool. Data were analyzed using the Graphpad Prisim, version 6.0, San Diego. Results: Only 2% of the subjects had hemophilia A, whereas 68% of the subjects had thrombocytopenic bleeding. Most (32.4%) had bleeding score of four. Analysis of variance of these variables showed a significant relationship with P < 0.0001. Post hoc analysis showed significant P values for platelet count versus bleeding score (P = 0.000, 95% confidence interval [CI]: 95.74–126.4) and APTT versus bleeding score (P = 0.000, 95% CI: 44.34–74.98). Conclusion: Bleeding assessment tools are important in evaluating persons with bleeding symptoms and it may be necessary to screen for hemophilia in these cases. Larger multicenter epidemiological studies are needed to determine the prevalence of hemophilia and other bleeding disorders in our environment.

Drug pooling: A cost-saving strategy to enhance antibiotics availability for pediatric in-patient in Nigeria.

Antibiotic use is common but has a lot of challenges. Implementation of an efficient and cost-effective policy, which can improve the availability and sustainability of pediatric antibiotic use, is required. In this study, we explore the concept of antibiotic drug pooling (DP) as a means to overcome challenges often associated with antibiotic use. The study was undertaken in three public tertiary hospitals in Southeast Nigeria using a mixed-methods approach. Three focus group discussions with caregivers of in-patient children and 16 in-depth interviews with physicians, nurses, and pharmacists provided the data for the study. In addition, the medical records of patients on admission were examined. Information collected centered mainly on antibiotic use and challenges, participants' perception of antibiotics pooling, as well as possible ways to improve on antibiotic availability and sustainability. Out of 53 children on admission, antibiotics were prescribed for 45 (84.2%) of them children. Seventeen (37.8%) of the 45 on antibiotics had their initial antibiotics changed. The major challenges encountered by all the caregivers interviewed were the cost of the antibiotics (85%). None of the caregivers was willing to submit their purchased drugs for pooled use by other in-patients. Health-care providers, however, lauded the concept of DP and made the following suggestions on ways the proposed concept could be improved: harmonized prescription, billing, and unit-dose dispensing for the first 72 h antibiotic treatment. The adoption of a harmonized prescription pattern and billing as well as unit-dose dispensing for the first 72 h antibiotic treatment will provide a cost-effective means of ensuring antibiotic availability and sustainability. The drug-pooling concept will not only enhance prompt commencement and discontinuation of antibiotic treatment but will also reduce waste and improve time-out policy.

Patient satisfaction with services at a tertiary hospital in south-east Nigeria.

Patients' views of the services they receive in a healthcare service help identify critical areas that may need improvement. This survey set out to determine patients' satisfaction with quality of general services and specifically with staff attitude and the hospital environment, while on admission at a teaching hospital in Enugu, south-east Nigeria. This was a descriptive cross-sectional study using a structured self-administered questionnaire on 170 patients (54% females and 46% males, aged between 20 and 65 years), post admission, selected by multistage sampling. Less than half (47.3%) of the patients were satisfied with care received on admission. More than half of them (51.8%) were satisfied with the cleanliness of the hospital environment and how power supply was maintained in the hospital (62.4%). Doctors (90%), nurses (64.1%) and records staff (60.6%) were considered courteous and professional. Most patients were satisfied with the level of privacy given to them in their course of hospital stay (67.6%) and with the cost of laboratory investigations (51.8%). Despite more than half of the surveyed patients being satisfied with some specific aspects of services given while on admission, those satisfied with the overall experience were less than half. Therefore, periodic patient satisfaction surveys should be institutionalized in this facility to provide feedback for continuous quality improvement.

Paediatric hydrocephalus: pre-treatment Computed Tomography findings in 80 consecutive patients.

Background: Hydrocephalus, a common indication for paediatric neuro-imaging, results from any disorder in the formation, circulation and absorption of cerebrospinal fluid. Serious neurological sequelae often result if neglected.Computed Tomography (CT) plays a vital role in revealing the various aetiologies of hydrocephalus in order to guide intervention. Objectives: To retrospectively assess the spectrum of CT findings in children with clinical features of hydrocephalus referred to the CT suite of a tertiary hospital in South-East Nigeria for radiodiagnosis and compare with findings in existing literature Materials and Methods: We evaluated 80children- 32 females and 48 males- over a period of one year. Included also in this study were children with clinical features of hydrocephalus who presented with other findings such as delayed developmental milestones and congenital neural tube defects. Results: The age range was 0.01 to 14 years, a mean of 2.23 years. 56.3% of the cases had CT features consistent with obstructive hydrocephalus- ventriculomegaly proximal to the site of obstruction with normal-sized ventricles distal to the obstruction). The communicating subtype, hydranencephaly and Benign External Hydrocephalus were seen in 36.25%, 6.2% and 1.25% respectively. The level of predilection for ventricular obstruction was the Aqueduct of Sylvius in 75.6%. Secondary causes were demonstrable in 10 of the children with aqueductal stenosis (AS) while 24 had no evident secondary cause. Congenital AS occurred more in males- 17, as against 7 females; however, there was no significant correlation between gender and predisposition for AS (P= 0.546). Conclusion: This study demonstrates the positive yield of computed tomography in the diagnosis of hydrocephalus in children albeit the downside of exposure to ionizing radiation

Determinants of delay in presentation and clinico-laboratory features of newborns admitted for neonatal jaundice in a tertiary hospital in south-east Nigeria

Background: Neonatal jaundice (NNJ) is one of the most common causes of hospital visit in the first 30 days of life. It is one of nine danger signs of neonatal illness recognized by the World Health Organization. Understanding its clinical and laboratory features will enhance early diagnosis and management to forestall associated morbidities. This study explored the clinical and laboratory features of newborns admitted for NNJ in a tertiary hospital in the south-eastern Nigeria. Methods: It is a descriptive study carried out prospectively over a 18-month period on all newborns admitted for jaundice at the Enugu State University Teaching Hospital. Patients were enrolled consecutively at presentation and relevant clinical and laboratory features in these newborns were documented in a structured admission register designed for this study. These data were subsequently transferred to Microsoft Excel and analyzed with SPSS version 20. Results: A total of 83 (17.0%) out of 487 newborns were admitted for NNJ during the study period. More female newborns (P = 0.321), newborns delivered outside Enugu State University Teaching Hospital (P = 0.09), mothers ≤ 30 years (P = 0.648), and mothers with lower educational attainment (P = 0.502) had delayed presentation to hospital. Poor suckling (42%), fever (38%), and depressed primitive reflexes (38%) were the most common clinical features seen in admitted newborns. Yellowish discoloration of newborns was noticed within the first 24 h of life in only 13%, between 2 and 7 days in 81%, and after the seventh day of life in 6% of newborns. The median (interquartile range, IQR) of the age jaundice was first noticed and when infant was brought to the hospital for evaluation was 3.0 days (IQR 2–5) and 5.0 days (IQR 4–7), respectively. This resulted to a mean onset–presentation delay time of 2.8 ± 2.3 days (∼67.2 h). The mean total serum bilirubin and unconjugated hyperbilirubinemia was 307 ± 145.2 and 257.5 ± 127.6 μmol/L, respectively. Malaria parasite (17%), glucose-6-phosphate deficiency (5%), and ABO incompatibility was seen in 8% of newborns surveyed. Conclusions: NNJ remains a common health problem in our setting. This underscores the need to upscale education of the mothers and caregivers especially those that prefer to deliver outside a tertiary health institution on the need for early presentation in newborns with jaundice associated with poor suckling and reduced activities.

Determinants of Felt Stigma among Patients Living with Epilepsy Attending a Tertiary Neurology Clinic in South East Nigeria

Background: Felt stigma is a major social and psychological problem in epilepsy and manifests the fear or expectations of such “reactions” from people. Understanding of the pattern and prevalence of felt stigma gives an insight into the burden of this “second illness” of epilepsy in southeast Nigeria. Methods: Consecutive consenting adult epilepsy patients attending a neurology outpatient in Enugu southeast Nigeria were interviewed. Data on felt stigma was also collected using a scale for collection of stigma data on stigma designed by Jacoby et al. Results: A total of 295 patients were interviewed during the study (165 (55.9%) males and 130 (44.1%) females). About 29.4% (88/295) felt stigmatized and 82.1% of them highly so. Correlates of felt stigma were age of onset (negatively), seizure frequency, duration of epilepsy, use of non-orthodox treatment, seizures occurring in public and the presence of physical injuries. Predictors of felt stigma were having seizures in public (R2 = 0.232, p < 0.001) and seizure related injuries (R2 = 0.277, p < 0.001). Conclusions: Felt epilepsy stigma is common among patients attending urban tertiary hospital in southeast Nigeria. Several preventable factors are associated with this phenomenon hence efforts aimed at preventing epilepsy should also target felt stigma prevention.

Prevalence of Anticonvulsants Utilization at a Tertiary Hospital in Southeast Nigeria; Bridging the Gaps Between Facilities Outcomes and Policies Through Evidence-Based Reports

The World Health Organization (WHO) recommended regular drug utilization studies in health facilities as a tool in generating information on disease pattern, and as a guide for policy in healthcare systems. These information help in assessing disease patterns, population health status, quality of care, quality of prescribers, and treatment practices. The choice of anticonvulsants depends on individual tolerance, affordability, and efficacy. This study assessed the proportions of anticonvulsants used and determined the most commonly used anticonvulsants. The study was a retrospective cross sectional analysis of prescription records. Study lasted between June to December 2016. Data were analyzed based on frequency of prescribed drugs, number of drugs, defined daily dose (DDD), number and frequency of anticonvulsants used. The number of prescriptions analyzed was 1393.0. Of these prescriptions, 7700.0 drugs were prescribed with each prescription containing an average of 5.5±0.9 drugs per prescription. The mean age of patients was 46±4.3 years. Anticonvulsant drugs accounted for 19.0 (0.25%) of the entire drugs prescribed. Carbamazepine was the most prescribed anticonvulsant 12.0 (63.2%) at a dose of 200mg daily, followed by diazepam 6.0 (31.6%), while the least was pregabalin 1.0 (5.2%). Generic prescription of carbamazepine was 84.0% while that of diazepam was 100.0%. Prescription of anticonvulsants monotherapy was 100.0%. Study suggested low anticonvulsants use an indication of low prevalence of seizure related disorders in the population. Patients were controlled on monotherapy. Carbamazepine was the most used anticonvulsant and suggested good tolerance, efficacy, affordability, and acceptability. The study provided baseline information for further studies to provide timely information for promoting anticonvulsant drugs utilization in healthcare facilities in Nigeria. Policy issues on the use of newer agents should be dependent on facility-based studies. Newer agents can be introduced when they match and exceed already existing ones based on key indicators.

PRM3 - Investigation Of Drug Therapy Problems In Type 2 Diabetes Outpatients With Comorbid Hypertension In A Tertiary Hospital In Southeast Nigeria

PRM3 - Investigation Of Drug Therapy Problems In Type 2 Diabetes Outpatients With Comorbid Hypertension In A Tertiary Hospital In Southeast Nigeria

Patients\u2019 willingness to pay for the treatment of tuberculosis in Nigeria: exploring own use and altruism

BackgroundAlthough, current treatment services for Tuberculosis (TB) in Nigeria are provided free of charge in public facilities, the benefits (value) that patients attach to such service is not known. In addition, the prices that could be charged for treatment in case government and its partners withdraw from the provision of free services or inclusion of the services in health insurance plans are not known. Hence, there is a need to elicit the maximum amounts that patients are willing to pay for TB treatment services, both for themselves and for the very poor patients that may not be able to pay if some user fees are introduced (altruistic willingness to pay).MethodsA pretested interviewer-administered questionnaire was used to elicit the maximum willingness to pay (WTP) for TB treatment services from TB patients in a tertiary hospital in southeast Nigeria. WTP was elicited using the bidding game question format after a scenario was presented to the respondents. Data was analysed using tabulations. Tobit regression models were used to examine the validity of the elicited WTP for own use and altruistic WTP.ResultsThe results show that those aged 30 years and below constituted more than two-fifth (43.2%) of the respondents. More than half of the respondents (52.8%) were not employed. 100 (80.0%) of the respondents were willing to pay for their own use of TB treatment services while 78(62.4%) of the respondents were willing to make altruistic contributions so that the very poor could benefit from the TB services. A Tobit regression analysis of maximum WTP for TB for own use shows that respondents were willing to pay maximum amounts at different statistically significant levels. The results equally show that altruistic WTP was positively and statistically significantly related to the employment status, distance from UNTH and global seriousness of TB.ConclusionsMost patients positively valued the provision of free TB services and were willing to pay for TB treatment for own use. The better-off ones were also willing to make altruistic contributions. Free provision of TB treatment services is potentially worthwhile, but there is potential scope for continuation of universal provision of TB treatment services, even if the government and donors scale down their financing of the services.

Caregiver–proxy reliability of the Igbo-culture adapted Maleka Stroke Community Reintegration Measure: a validation study

Objectives: This study was designed to determine the caregiver–proxy reliability of the Igbo-culture adapted urban version of the Maleka Stroke Community Reintegration Measure (I-MSCRIM).Methods: This was a validation study involving 74 consenting stroke survivors and their 74 primary informal caregivers consecutively recruited from selected tertiary hospitals in South-East Nigeria (Igboland). The I-MSCRIM was researcher-administered to the participants. Obtained data was analyzed using frequency counts, percentages, range, mean, standard deviation, Spearman rank order correlation, Mann–Whitney U test, Kruskal–Wallis test and Intra-class Correlation Coefficient. Alpha level was set at 0.05.Results: The mean ages of the stroke survivors (55.4% males) and their primary informal caregivers (41.9% males) were 50.14 ± 12.24 and 31.93 ± 10.9 years respectively. There was no significant difference in the community reintegration (CR) scores as rated by stroke survivors and their primary informal caregivers (p > 0.05). The correlations between stroke survivors’ and primary informal caregivers’ rated CR scores were all adequate and acceptable (ICC = 0.602–0.917). The discrepancy in the total CR scores between the two ratings was significantly influenced by primary informal caregivers’ educational attainment (k = 13.15; p < 0.01).Conclusion: The I-MSCRIM has acceptable caregiver–proxy reliability among Igbo stroke survivors in South-East Nigeria. This suggests that primary informal caregivers of stroke survivors can reliably estimate the CR of their care recipients when I-MSCRIM is administered to them. This will be useful when a stroke survivor cannot respond to I-MSCRIM.

Anaemia and its associated factors in patients attending a General Out-Patient Clinic in a tertiary hospital in Southeast Nigeria

Anaemia and its associated factors in patients attending a General Out-Patient Clinic in a tertiary hospital in Southeast Nigeria

Socio-demographic correlates of treatment response among patients with schizophrenia in a tertiary hospital in South-East Nigeria.

Many patients with schizophrenia respond poorly to antipsychotic medication. Few studies have systematically examined the relationship of social and demographic characteristics of these patients to treatment response in our environment. To identify the social and demographic variables associated with treatment response in patients with schizophrenia. A total of 172 participants with a diagnosis of schizophrenia receiving antipsychotics took part in the study. Participants were consecutively recruited involving patients presenting for the first time, or relapsed patients who had stopped antipsychotics in the previous six months. Both in-patients and out-patients who met the inclusion criteria were studied. Socio-demographic interview schedule and the Positive and Negative Syndrome Scale (PANSS) were administered at the initial encounter and between 4 and 6 weeks, subsequently. Defining good treatment response as ≥ 20% reduction in PANSS score, 68% had a good response while 32% had poor response. Good response to treatment was associated with late age of onset of illness, satisfactory family relationship, acquisition of skilled occupation and being married. However, there was no association between treatment response and gender. Knowledge about these variables in relation to treatment response would improve mental health services as regards articulation of prognosis and psycho education.

Knowledge of HIV/AIDS Transmission and Partner Notification Rate among Antenatal Care Attendees in a Tertiary Hospital in Southeast Nigeria

Knowledge of HIV/AIDS Transmission and Partner Notification Rate among Antenatal Care Attendees in a Tertiary Hospital in Southeast Nigeria