Annals of African Medicine
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   2016| January-March  | Volume 15 | Issue 1  
    Online since February 8, 2016

 
 
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ORIGINAL ARTICLES
Knowledge and practices of infection control among healthcare workers in a Tertiary Referral Center in North-Western Nigeria
Garba Iliyasu, Farouq Muhammad Dayyab, Zaiyad Garba Habib, Abdulwasiu Bolaji Tiamiyu, Salisu Abubakar, Mohammad Sani Mijinyawa, Abdulrazaq Garba Habib
January-March 2016, 15(1):34-40
DOI:10.4103/1596-3519.161724  PMID:26857935
Background: Healthcare acquired infections (HCAIs) otherwise call nosocomial infection is associated with increased morbidity and mortality among hospitalized patients and predisposes healthcare workers (HCWs) to an increased risk of infections. The study explores the knowledge and practices of infection control among HCW in a tertiary referral center in North-Western Nigeria. Materials and Methods: This is a cross-sectional study. A self-administered structured questionnaire was distributed to the study group (of doctors and nurses). Data on knowledge and practice of infection control were obtained and analyzed. Study population were selected by convenience sampling. Results: A total of 200 responses were analyzed, 152 were nurses while 48 were doctors. The median age and years of working experience of the respondents were 35 years (interquartile range [IQR] 31–39) and 7 years (IQR 4–12), respectively. Most of the respondents 174/198 (87.9%) correctly identified hand washing as the most effective method to prevent HCAI, with nurses having better knowledge 139/152 (91%) (P = 0.001). Majority agreed that avoiding injury with sharps 172/200 (86%), use of barrier precaution 180/200 (90%) and hand hygiene 184/200 (92%) effectively prevent HCAI. Only 88/198 (44.4%), 122/198 (61.6%), and 84/198 (42.4%) of the respondents were aware of the risks of infection following exposure to human immunodeficiency virus, hepatitis B virus and hepatitis C virus-infected blood, respectively. About 52% of doctors and 76% of nurses (P = 0.002) always practice hand hygiene in between patient care. Conclusion: Gaps have been identified in knowledge and practice of infection control among doctors' and nurses' in the study; hence, it will be beneficial for all HCW to receive formal and periodic refresher trainings.
  19,207 35 -
Seroprevalence of hepatitis B virus serological markers among pregnant Nigerian women
Henrietta Oneh Aba, Maryam Aminu
January-March 2016, 15(1):20-27
DOI:10.4103/1596-3519.172555  PMID:26857933
Background: Chronic hepatitis B infection is a global problem; however, Asia and sub-Saharan Africa are most affected by it. Hepatitis B status of pregnant women is essential for the effective management of the disease and prevention of mother to child transmission. Materials and Methods: The study was conducted at the antenatal care unit of four hospitals within Kaduna Metropolis, Nigeria, between August and December 2011. After obtaining ethical clearance, blood samples were collected from 800 consenting pregnant women, the plasma were screened for hepatitis B surface antigen (HBsAg) using first response HBsAg card and the reactive sera were confirmed with enzyme-linked immunosorbent assay. Other serological markers of hepatitis B virus (HBV) were detected using the one-step HBV multi-5 test kit. Results: Of the 800 pregnant women screened, 31 (3.9%) tested positive for HBsAg. Only one of the 31 HBsAg positive women had developed the hepatitis B surface antibody, 16 (51.6%) had the envelop antibody, 18 (58.1%) had the hepatitis B core antibody (anti-HBc), and two (6.5%) had hepatitis B envelop antigen (HBeAg). The highest prevalence of HBsAg was recorded among women in age group 21–25 years old (P = 0.968). Similarly, married women (P = 0.772), women in their second trimester of pregnancy (P = 0.938), women with tertiary education (P = 0.972), women from the South-East geopolitical zone (P = 0.250) and those whose husbands were in polygamous relationships (P = 0.944) had the highest seroprevalence of HBsAg. Conclusion: HBV was detected with a prevalence of 3.9% among pregnant women in Kaduna Metropolis, Nigeria. About 96.8% (29) of the reactive women had HBeAg negative chronic hepatitis while 6.5% (2) had HBeAg positive chronic hepatitis B infection. About 58.1% of the women had anti-HBc, hence, did not have immunity and probably had chronic infection with reduced risk of vertical transmission. Pregnant women should be screened for HBsAg at the first antenatal clinic visit for appropriate clinical management and effective prevention of vertical transmission.
  5,540 31 -
Nurses' knowledge of care of chest drain: A survey in a Nigerian semiurban university hospital
Emeka Blessius Kesieme, Ifeanyichukwu Stanley Essu, Bruno Jeneru Arekhandia, Katrin Welcker, Georgi Prisadov
January-March 2016, 15(1):28-33
DOI:10.4103/1596-3519.172556  PMID:26857934
Background/Objective: Inefficient nursing care of chest drains may associated with unacceptable and sometimes life-threatening complications. This report aims to ascertain the level of knowledge of care of chest drains among nurses working in wards in a teaching hospital in Nigeria. Methods: A cross-sectional study among nurses at teaching hospital using pretested self-administered questionnaires. Results: The majority were respondents aged between 31 and 40 years (45.4%) and those who have nursing experience between 6 and 10 years. Only 37 respondents (26.2%) had a good knowledge of nursing care of chest drains. Knowledge was relatively higher among nurses who cared for chest drains daily, nurses who have a work experience of <10 years, low-rank nurses and those working in the female medical ward; however, the relationship cant (P > 0.05). Performance was poor on the questions on position of drainage system were not statistically significant with relationship to waist level while mobilizing the patient, application of suction to chest drains, daily changing of dressing over chest drain insertion site, milking of tubes and drainage system with dependent loop. Conclusion: The knowledge of care of chest drains among nurses is poor, especially in the key post procedural care. There is an urgent need to train them so as to improve the nursing care of patients managed with chest drains.
  4,755 38 1
Relationship between serum leptin and insulin resistance among obese Nigerian women
Ifeyinwa Osegbe, Henry Okpara, Elaine Azinge
January-March 2016, 15(1):14-19
PMID:26857932
Background: Leptin is a hormone produced directly from adipocytes and has been associated with type 2 diabetes mellitus (T2DM) which is characterized by insulin resistance (IR). Due to the increasing prevalence of obesity in sub-Saharan Africa, serum leptin can be explored as a predictive risk factor for T2DM. Therefore, the aim of this study was to determine the relationship between serum leptin and IR among obese women. Methods: This was a cross-sectional study of obese, adult Nigerian females. Participants with body mass index (BMI) ≥30 kg/m2 and nondiabetic were recruited as subjects. Fasting serum leptin, insulin, and plasma glucose were determined. IR was calculated using the formula: Homeostatic model assessment-IR (HOMA-IR) = (glucose × insulin)/22.5. Statistical analyses were performed using SPSS and P < 0.05 was considered to be significant. Results: Eighty obese females with mean ± standard deviation BMI 39.1 ± 7.2 kg/m2 and serum leptin level 48.4 ± 24.4 ng/ml participated in study. Prevalence of hyperleptinemia was 92.5% (confidence interval: 87.3–97.7%). The relationship between leptin and HOMA-IR among the subjects was: BMI 30–34.9 kg/m2: n = 27, r = 0.18, P = 0.42; BMI 35–39.9 kg/m2: n = 24, r = 0.36, P = 0.11; BMI ≥ 40 kg/m2: n = 29, r = 0.52, P = 0.004*; and after controlling for BMI (n = 29, r = 0.46, P = 0.014*). Multiple linear regression showed that leptin did not predict for IR (P = 0.837). Conclusion: Serum leptin levels were positively correlated with IR, which was significant among the Class III (morbid) obesity class. However, leptin was not a predictive factor for IR in obese Nigerian women.
  4,048 26 -
Gender dimensions to the Ebola outbreak in Nigeria
Olufunmilayo I Fawole, Olufunmi F Bamiselu, Peter A Adewuyi, Patrick M Nguku
January-March 2016, 15(1):7-13
DOI:10.4103/1596-3519.172554  PMID:26857931
Background: An outbreak of Ebola disease was declared in Lagos, South West Nigeria, on 23rd July 2014. Later, the outbreak spread to the south south and south eastern part of the country. The last cases occurred on August 31, 2014 and the country was certified to be Ebola free on 20th October, 2014. This paper describes the experiences and implications of the Ebola outbreak for Nigerian women. Subjects and Methods: Identification and listing of cases and contacts was done in Lagos, Port Harcourt and Enugu. Socio demographic information was collected. Results: Women made up 55% of Ebola cases and 56.6% of contacts traced. Of the 8 deaths reported 50.0% (4) were women, of which 75.0% (3) were health care providers. The sex specific case attack and fatality rates for males and females were 2.2% versus 2.3% and 45.5% versus 33.3% respectively. The women restricted their movement in order to avoid the infection. The outbreak affected their utilisation of health care services and livelihood. Conclusion: Women were exposed occupationally and domestically due to their care giving roles. In health facilities, they were directly involved in the care or encountered persons who had been in contact with persons with Ebola. In the homes, they were at the forefront of nursing the sick. There is the need to ensure women have access to information, services and personal protective equipment to enable them protect themselves from infection. Education and engagement of women is crucial to protect women from infection and for prompt outbreak containment.
  3,211 26 -
Effect of providing feedback and prescribing education on prescription writing: An intervention study
Adetutu A Ajemigbitse, Moses Kayode Omole, Wilson O Erhun
January-March 2016, 15(1):1-6
DOI:10.4103/1596-3519.161722  PMID:26857930
Background/Objective: Accurate medication prescribing important to avoid errors and ensure best possible outcomes. This is a report of assessment of the impact of providing feedback and educational intervention on prescribing error types and rates in routine practice. Methods: Doctors' prescriptions from selected wards in two tertiary hospitals in central Nigeria were prospectively reviewed for a 6-month period and assessed for errors; grouped into six categories. Intervention was by providing feedback and educational outreach on the specialty/departmental level at one hospital while the other acted as the control. Chi-squared statistics was used to compare prescribing characteristics pre- and post-intervention. Results: At baseline, error rate was higher at the control site. At the intervention site, statistically significant reductions were obtained for errors involving omission of route of administration (P < 0.001), under dose (P = 0.012), dose adjustment in renal impairment (P = 0.019), ambiguous orders (P < 0.001) and drug/drug interaction (P < 0.001) post intervention though there was no change in mean error rate post intervention (P = 0.984). Though House Officers and Registrars wrote most prescriptions, highest reduction in prescribing error rates post intervention was by the registrars (0.93% to 0.29%, P < 0.001). Conclusion: Writing prescriptions that lacked essential details was common. Intervention resulted in modest changes. Routinely providing feedback and continuing prescriber education will likely sustain error reduction.
  3,057 25 -
LETTERS TO THE EDITOR
Acute kidney injury following multiple bee stings
Bindu T Nair, Rama Krishna Sanjeev, Karmani Saurabh
January-March 2016, 15(1):41-42
DOI:10.4103/1596-3519.154241  PMID:26857936
  2,759 31 -
The 2015 measles outbreak in America: Identified shortcomings and recommendations to the health authorities
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
January-March 2016, 15(1):42-43
DOI:10.4103/1596-3519.153986  PMID:26857937
  2,583 25 -
Matching in hospital based case-control studies
Sunil Kumar Raina
January-March 2016, 15(1):43-44
DOI:10.4103/1596-3519.158523  PMID:26857938
  2,018 24 -
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