Research Journal of Health Sciences

Postnatal home visit: An effective strategy to a successful postnatal care

2023-08-03T17:09:58+00:00

Home visiting is a crucial aspect of postnatal care services as recommended by the WHO, but it appears to be the most neglected service. This is due to various challenges like a shortage of manpower, inadequately skilled or trained health care workers, the non-availability of assessment tools and resources, and a lack of community awareness of the importance of postnatal care. However, it's the responsibility of health care workers, especially the midwives, to carry out postnatal home care visits to ensure the well-being of both the mother and the neonates, as well as the assessment of the environment where the newborn will be nurtured. Therefore, to ensure effective postnatal home care visits, there should be availability of adequate tools and resources for the services, training of health care personnel, allocation of experienced health care workers, and community awareness of the importance of postnatal home care visits. This review thus explained the concept of postnatal home care visits, the timing of visits, who should conduct postnatal home visits, what to look out for in mothers, babies, and environments.

Comparison of CKD-EPI, C-G and MDRD equations for estimating glomerular filtration rate in chronic kidney disease population in South-Western Nigeria

2023-08-03T12:14:48+00:00

Background: Ethnic variabilities make reliability of formula equations for assessing glomerular filtration rate (GFR) doubtful in many populations. We compared Cockroft-Gault (CG), modification of diet in renal disease (MDRD), and chronic kidney diseases epidemiology collaboration (CKD-EPI) equations in adult Nigerian CKD subjects.

Methodology: We measured 24-hour-urinary creatinine clearance of 311 adult CKD patients and compared with the three estimated equations. Bland-Altman plots were used to assess agreement between estimated equations and measured creatinine clearance (mGFR). Receiver-operating curve (ROC) analysis was used to assess the diagnostic power of the equations. Equation with accuracy within 30% of mGFR of ≥90% was considered acceptable for use.

Results: Mean age was 41.9±12.7 years with 182(58.5%) females. The mean GFR using CKD-EPI, 2 MDRD and CG equations were 69.5±33.9, 65.9±33.0 and 66.2±30.9 mls/min/1.73m respectively 2 (mGFR 68.3±31.1mls/min /1.73m ). The 3 equations showed positive correlation to mGFR (r=0.95) but CKD-EPI had the least bias.

Conclusion: All three equations can be used but CKD-EPI equation is preferable in Nigerian CKD patients, especially with GFR> 60mls/min.

First laparoscopically-assisted vaginal hysterectomy in a tertiary health facility in Abeokuta, Nigeria: A case report

2023-08-03T14:54:34+00:00

Background: Laparoscopic surgery as a form of minimal access operation has been performed for decades in the developed world, but is now gaining popularity in the developing countries including Nigeria. The recent rise in minimal access surgery in low-resource settings may be attributed to increasing expertise, growing awareness among patients and relatively reducing cost.

Case report: Although laparoscopically-assisted vaginal hysterectomy (LAVH) has been documented from some centres in Nigeria, we are reporting the first case of this highly-technical surgery in our centre. Mrs. GJ was admitted with second degree uterine prolapse and had LAVH with a smooth post-operative recovery. She had reduced hospital stay as she was discharged on the first post-operative day and was satisfied with her choice of surgery as well as the outcome. There were no immediate or late post-operative complications.

Conclusion: The success of this procedure further emphasize the feasibility of minimal access surgery in resource-poor settings.

Kidney dysfunction and mortality risk in hospitalized Covid-19 patients: A large Covid-19 centre experience

2023-08-03T12:51:07+00:00

Objective: Kidney dysfunction is common in patients infected with the coronavirus (COVID-19). The study's objective was to determine the relationship between glomerular filtration rate and mortality in COVID-19 patients.

Methods: This is a retrospective cohort study of patients admitted into the COVID-19 isolation center from March 2020 through December 2021. The serum creatinine at admission was used to estimate the glomerular filtration rate (eGFR) using the CKD equation method. The patients were categorized into 2 groups based on the eGFR (≥ or < 60ml/minute). The outcome was in-hospital mortality. Kaplan Meier survival plots and cox proportional modelling were employed in the data analysis.

Results: Atotal of 623 patients were analysed. The mean age was 53.4±15.3 years, and 58.6% were male. An eGFR of < 60 ml/min was observed in 196 (31%) patients. A significantly higher number of deaths occurred among patients with eGFR <60ml/min (32% vs 10.5% (P<0.001). After adjusting for age, sex, disease severity, haemoglobin, ICU admission, and dialysis, the patients with reduced eGFR of (<60ml/min) were twice more likely to die than patients with eGFR ≥60mls/min(AHR 1.95, 95% CI 1.26- 3.04, P= 0.003).

Conclusion: eGFR of < 60mls/min is associated with an increased risk of mortality in COVID-19 patients. This stresses the need for better recognition of renal dysfunction as a high-risk for mortality in COVID-19 infections.

Leadership competencies of primary healthcare managers: a cross-sectional quantitative study of high, medium and low performing district councils in Tanzania

2023-08-03T12:58:33+00:00

Objectives: This research article examined the leadership competency of primary healthcare facility managers in the selected high, medium and low performing District Councils in Tanzania.

Methods: The study was conducted in the selected high, medium and low performing District Councils in Tanzania. This research used cross sectional quantitative research design. A complete enumeration sampling strategy was employed to inquire data from 102 primary healthcare facility managers. Similarly, the Statistical Package for Social Sciences (SPSS version 25) was used to analyse the data. Ethically, the permission was granted by the University of Dodoma.

Findings: Results revealed that, (72.55%), (66.45%) and (80.39%) of primary healthcare manager were competent and (27.45%), (33.55%), and (19.61%) were less than competent in leading people and teams, leading organisation, and leader quality respectively.

Conclusions: The study concludes that primary healthcare managers exhibited competent and less than competent levels of leadership competency in all investigated constructs.

Common facts and fictions about HIV transmission, prevention and treatment among PLWHA attending a tertiary healthcare centre in North-Western Nigeria

2023-08-03T13:06:07+00:00

Objectives:The transmission, prevention, and treatment of the human immunodeficiency virus (HIV) are greatly influenced by human behavioral practices. This makes knowledge of some truths (facts) and lies (fictions) about the disease extremely important in its prevention and control. Several studies on the assessment of knowledge about HIV infection have been undertaken among the general population, but only a few have involved people living with HIV/AIDS (PLWHA). This study was conducted to assess the level of knowledge and understanding on transmission, prevention, and treatment of HIV infection among PLWHA attending an adult anti- retroviral therapy (ART) clinic at Federal Medical Centre, Birnin Kebbi, North-western Nigeria.

Method: The study was conducted as a hospital-based descriptive cross-sectional study using interviewer-administered questionnaires among 62 patients, selected by convenience sampling technique, attending adult ART-clinic over a period of 8 weeks. The data was analyzed using SPSS-16.

Result: More than 70% of the respondents scored above 75% in the questions on modes of transmission of HIV infection. However, 73.4% of the respondents believed HIV infection was curable, and 40.6% believed there is commercially available vaccination against HIV infection. There were statistically significant associations between high mean scores (75% and above) in questions on modes of transmission and prevention of HIV, and being of Hausa ethnicity (p-value=0.013), having a senior secondary or higher level of education (p-value=0.014) and being a resident in an urban setting (pvalue=0.003)

Conclusion: There is a fairly good basic knowledge about HIV transmission, prevention and treatment among the respondents; however, there is need for improvement in knowledge on certain lies/fictions regarding the disease.

Congenital heart diseases: Pattern of clinical presentations in children less than 2-years of age in a pediatric practice in southsouth Nigeria

2023-08-03T13:13:15+00:00

The increase in the prevalence of congenital heart disease remains a major contributing factor to
childhood morbidity and mortality in Africa. The study describes the clinical features of children with
CHD that presented to a general pediatric hospital, to improve on early recognition and management of
the diseases. The prevalence of CHD from the study was 2 per 100 (30 per 1577 or 1 in 52) i.e. (2/100 or
20/1000). A higher incidence in females (53.3%) with M: F = 1:1.14, the majority presented with
difficulty / fast breathing (70%), cough(40%), other presenting symptoms are poor weight gain (26.7%),
delayed milestones(13.3%). On examination, 60% had dyspnea, 56.7% had murmur. Packed cell volume
for acyanotic heart disease ranged 28-30%, and 50-61% for cyanotic heart disease. The majority had
comorbid bronchopneumonia (46.6%), and heart failure (23.3%). Echocardiographic findings revealed
VSD in 26.7%, 20.0% had PDA and tetralogy of Fallot in 6.7%, Transposition of Great Arteries in 3.3%,
and Dextrocardia in 3.3%. The outcome showed that 30% had no symptoms on follow-up, 23.3% were
referred for surgery, 10% dropped from follow-up and 3.3% died. These findings which are comparable to
the findings of other researchers showed that congenital heart disease has a place in childhood morbidity
and mortality, therefore appropriate attention should be directed to improve on early recognition and
management of the diseases.

Magnitude of limb loss attributable to diabetes mellitus in a tertiary institution in Nigeria

2023-08-03T13:18:24+00:00

Background: Diabetes mellitus (DM) and its complications, continues to pose enormous challenge to health and financial stability. Diabetes has remained a source of national and global economic burden. It has been observed lately that incidence of diabetic foot ulcer (DFU); one of the complications of DM, is on the increase and it is contributing hugely to financial loss, morbidity and mortality among diabetic patients. This is taking a great toll on affected individuals in terms of cost of treatment, deformities sustained, number of working/productive days lost while on admission and its attendant economic implications, and ultimately mortalities recorded. The aim was to determine the magnitude of limb loss or lower extremity amputation attributable to DM over a period of 12 months in tertiary institution and to assess the clinical profile of the patients.

Method: This is a retrospective study of the records of all patients that were consecutively booked for lower limb amputation and operated upon in the last 12 months at UNIOSUN Teaching Hospital, Osogbo, South-Western Nigeria. Out of these total, cases of DFU were extracted to form another study group and then studied in detail.

Results: Atotal of 38 patients had lower limb amputation from July 2021 to May 2022. Twenty three of the total number of amputations had DFU with a huge proportion of 60.5%, followed by road traffic accident with 28.9% (n=11) Of the 23 diabetic cases , females were 15 with M:F ratio of 1:1.9. Mean age was 63±11.18 years. Mean duration of DM was 8.06±5.64 years. 78.3% had no foot care education and Doppler USS confirmed atherosclerosis in 100% of the patients. The commonest bacteria isolated was Proteus 34.8%. Length of hospital stay ranged between 6 weeks to 16 weeks. Outcome of admission was largely successful with 95.7% discharged and 4.3% mortality.

Conclusion: DFU contributes markedly to morbidity and mortality. Long duration of DM, presence of PAD and DPN as well as advancement in age and wound infection with proteus bacterial are observed to be risk factors associated with gangrenous DFU. However, larger studies are needed to establish these factors as predictors of amputation in patient with DFU. Outcome was majorly good as majority of the patients were discharged.

COVID-19 vaccination acceptability among type 2 diabetes mellitus patients in a tertiary hospital in Southwest Nigeria: a cross-sectional study

2023-08-03T13:26:06+00:00

Background: The mortality from COVID-19 is higher in diabetes mellitus (DM) patients compared to the general population, hence it is highly desirable that DM patients are vaccinated against COVID-19 infection. The aim was to determine the willingness of type 2 DM patients to accept COVID-19 vaccine and associated factors.

Methods: This was a cross-sectional descriptive study that involved DM patients. Multivariable logistic regression was used to assess factors ssociated with willingness to be vaccinated.

Results: A total of 302 DM patients participated in the study. About 90% of the respondents perceived COVID-19 to be a serious disease; however, 33.5% of the patients considered themselves to be at risk of contracting COVID-19 despite having DM. About 70.0% of the DM patients were willing to receive the vaccine. Factors associated with willingness to be vaccinated were perception of COVID-19 as a severe disease (Adjusted odds ratio (AOR), 6.09; 95% CI, 4.96- 12.27), previous vaccination (AOR, 1.58; 95% CI, 1.04- 2.98), and higher education (AOR, 2.36; 95% CI, 1.04- 6.86).

Conclusion: About a third of the study participants were not willing to receive COVID-19 vaccination. There is need to educate the at-risk population about the importance of COVID-19 vaccination.

Biologic quality of households' drinking-water in an urban local government area of Oyo State, Southwest, Nigeria

2023-08-03T13:35:35+00:00

Background: Inadequate access to Water, Sanitation, and Hygiene (WASH) facilities is a global public health issue with several associated illnesses, particularly in developing countries like Nigeria. It is imperative to understand the availabilities of these facilities, to provide baseline data for policy design and implementation. This study assessed access to WASH facilities. It also examined the factors associated with drinking-water contamination by coliform organisms in households within Ogbomoso North Local Government Area, Oyo-State, Nigeria.

Methods: Cross-sectional design was employed and a two-stage cluster-sampling method was used to recruit eligible respondents from 100 households. Interviewer-administer, semi-structured questionnaire was used to collect data. Chi-square test and binary logistic regression were used for inferential statistics.

Results: Mean age of respondents was 40.5±16.7years, 81.0% of the households practiced open defecation, and 78.9% of those with toilet facilities used pit latrines. The most common water source was borehole (71.6%); available within 5 minutes walking distance to residence of 68.0% of study participants. Sixty-three percent of the households had high drinking water coliform counts. High drinking-water coliform counts were influenced by the presence or absence of toilets facilities (OR=4.61, CI=1.22-1.68), types of toilets (OR=2.63, CI=3.22-5.34), and water sources (OR=0.12, CI=0.47-0.68).

Conclusion: Access to good quality water and basic sanitation facilities is sub-optimal in the study setting despite being an urban community. Authors advocate for more vibrant and intentional government efforts at ensuring equitable access to WASH facilities in the Nigerian communities. This is to fast-track the nation's journey towards the actualization of the sustainable development goal (SDG)-6.

Rate of perceived exertion and cardiovascular response of community dwelling older adults to six-minute walk test

2023-08-03T14:30:10+00:00

Objectives: This study was designed to determine the rate of perceived exertion, cardiovascular responses of community dwelling older adults to six minutes' walk (6MWT) and possible gender difference.

Methods: One hundred and three apparently healthy community dwelling older adults, aged 60 years and above participated in the study. Rate of perceived exertion (RPE) and cardiovascular responses (blood pressure, peripheral capillary oxygen saturation (SPO₂ ) and pulse rate) were measured pre and post 6MWT.

Results: There was a significant increase (p = 0.01) in RPE among all participants after the 6MWT. There was no significant difference (p>0.05) in all the cardiovascular parameters pre and post 6MWT but with a significant difference in SPO₂ between male and female participants.

Conclusion: Among older adults, rate of perceived exertion after a 6MWT was sort of hard with possible influence on the Systolic Blood Pressure following 6MWT. Female participants showed higher oxygen saturation than males.

Prevalence of, disposition towards and factors associated with cohabitation among undergraduates in Ladoke Akintola University of Technology, Ogbomoso, Nigeria

2023-08-03T17:36:06+00:00

Background: Cohabitation is increasingly common in tertiary institutions and is associated with reproductive health and other related challenges. This study is designed to determine the prevalence, pattern, disposition and reasons for premarital cohabitation among students of a tertiary institution in South West Nigeria

Methods: A descriptive cross-sectional study of 350 undergraduates selected from a university in Oyo State using a multistage sampling technique. Data was collected via a semi-structured self-administered questionnaire and analyzed using SPSS version 22.0

Results: Majority (90.0%) of the respondents were below 25 years and 70.0% were females. Twenty seven (7.7%) were currently cohabiting while 70 (20.0%) had ever cohabitated. A third (32.0%) were favorably disposed towards cohabitation. More males, older respondents and those whose parents were not their source of income reported ever having cohabited.

Conclusion: Cohabiting is practiced among university students and is socially acceptable to many. Concerted efforts geared towards sensitization and awareness programs to educate students on the adverse consequences of cohabitation should be embarked upon by concerned stakeholders.

Determinants of cervical cancer screening uptake among female staff in a multicampus university in South-Western Nigeria

2023-08-03T18:20:27+00:00

Background- Cervical cancer remains a leading cause of morbidity and mortality among women in developing countries despite the availability of screening tests that could detect pre-cancerous conditions. The aim was to assess the respondents' level of knowledge and attitude towards cervical cancer screening as well as to identify factors predictive of screening uptake.

Methodology- A cross-sectional survey of 150 female staff of Osun State University, South Western Nigeria selected across campuses by multi-stage sampling. Data was collected with the aid of semistructured questionnaire and analysed using descriptive and inferential statistics.

Results- The mean age for the respondents was 34.7 (±8.32) years. Majority (80%) of the respondents were aware of cancer of the cervix but only 40% had good knowledge of the disease. About 77.5% of the respondents had a good attitude towards its screening. Only 21 (%) had ever done cervical cancer screening. Factors associated with cervical cancer screening uptake include age, income, level of education, staff category, respondents' belief on general availability of cervical screening, attitude, having known a person with cervical cancer, having had information through counseling on cervical cancer as well as respondents' knowledge of cervical cancer. The latter two are predictive of screening uptake. Respondents with good knowledge were about four times likely to have had cervical cancer screening compared with respondents with poor knowledge.

Conclusion- Majority of the respondents had poor knowledge of cervical cancer but good attitude towards its screening. Identifiable determinants of cervical cancer screening uptake were knowledgebased, thus continuous enlightenment of women of all age-groups becomes imperative.