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REVIEW ARTICLE
Principles and methods of validity and reliability testing of questionnaires used in social and health science researches
Oladimeji Akeem Bolarinwa
October-December 2015, 22(4):195-201
DOI
:10.4103/1117-1936.173959
PMID
:26776330
The importance of measuring the accuracy and consistency of research instruments (especially questionnaires) known as validity and reliability, respectively, have been documented in several studies, but their measure is not commonly carried out among health and social science researchers in developing countries. This has been linked to the dearth of knowledge of these tests. This is a review article which comprehensively explores and describes the validity and reliability of a research instrument (with special reference to questionnaire). It further discusses various forms of validity and reliability tests with concise examples and finally explains various methods of analysing these tests with scientific principles guiding such analysis.
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573,593
40,164
A review of the health problems of the internally displaced persons in Africa
Eme T Owoaje, Obioma C Uchendu, Tumininu O Ajayi, Eniola O Cadmus
October-December 2016, 23(4):161-171
DOI
:10.4103/1117-1936.196242
PMID
:28000636
Globally, over 40 million people were displaced as a result of wars and violence due to religious and ethnic conflicts in 2015 while 19.2 million were displaced by natural disasters such as famine and floods. In Africa, 12 million people were displaced by armed conflict and violence and there were hundreds of thousands of people displaced by natural disasters. Despite these large numbers of internally displaced persons (IDPs) in Sub-Saharan African countries and the potentially negative impact of displacement on the health of these populations, there is limited information on the health problems of IDPs in the region. The previous studies have mainly focused on the health problems of refugees and single disease entities among IDPs. However, a more comprehensive picture is required to inform the provision of adequate healthcare services for this vulnerable population. The objective of this review was to fill this knowledge gap. Bibliographic databases were searched and screened, and nine studies were selected and reviewed. The major physical health problems and symptoms were fever/malaria (85% in children and 48% in adults), malnutrition in children (stunting 52% and wasting 6%), malnutrition in adult males (24%), diarrhoea (62% in children and 22% in adults) and acute respiratory infections (45%). The prevalent mental health problems were post-traumatic stress disorder (range: 42%-54%) and depression (31%-67%). Most of the studies reviewed focused on mental health problems. Limited evidence suggests that IDPs experience various health problems but more research is required to inform the provision of adequate and comprehensive healthcare services for this group of individuals.
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38,485
3,557
ORIGINAL ARTICLES
Knowledge regarding Zika virus infection among dental practitioners of tricity area (Chandigarh, Panchkula and Mohali), India
Nidhi Gupta, Ravneet Kaur Randhawa, Sahil Thakar, Mohit Bansal, Preety Gupta, Vikram Arora
January-March 2016, 23(1):33-37
DOI
:10.4103/1117-1936.180179
PMID
:27098947
Background:
Zika virus (ZIKV), a vector-borne virus affecting a large number of people, has today become a major public health concern in the developed and developing countries worldwide.
Aim:
The purpose of this study was to assess the knowledge of ZIKV among dental practitioners residing in Tricity area (Chandigarh, Panchkula and Mohali), India.
Subjects and Methods:
A total of 412 private dental practitioners were randomly sampled of whom 254 (61.6%) responded to participate in this cross-sectional survey. A self-structured, closed-ended questionnaire was administered to each participant to record demographic and professional characteristics followed by their knowledge regarding ZIKV. Statistical analysis was performed using SPSS Version 20 (IBM Corp, Armonk, NY). The results were expressed in percentages. Multivariable linear regression analysis was carried out to assess the association of participant's demographics and professional characteristics with knowledge.
Results:
The sample consisted of 152 (59.9%) male and 102 (40.1%) female practitioners. Majority of the practitioners belonged to the age group of 25-34 years (66.1%). High knowledge was reported by only 38.2% of the practitioners. A statistically significant difference was seen when mean knowledge scores were compared with the qualification of the participants (
P
= 0.04), with postgraduates having more knowledge than graduates regarding ZIKV. Most of the knowledge of the practitioners came from television (37.8%) while journals only represented 4.7% of the total information gained.
Conclusion
: ZIKV infection, a new public health emergency, needs to be addressed urgently. All health care professionals should have adequate knowledge of the virus and be conversant with necessary precautionary measures to be taken making it imperative that dental practitioners strive to continually update their knowledge from time to time.
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6,009
881
REVIEW ARTICLES
COVID-19 pandemic: A global health burden
Oluwatosin Wuraola Akande, Tanimola Makanjuola Akande
July-September 2020, 27(3):147-155
DOI
:10.4103/npmj.npmj_157_20
PMID
:32687112
Coronavirus disease 2019 (COVID-19) pandemic began in China with a group of severe pneumonia cases, later identified to be caused by the severe acute respiratory syndrome coronavirus 2 in December 2019. Thailand reported the first COVID-19 case outside of China on 13
th
January 2020, Africa reported its first case in Egypt on 14
th
February 2020 and Nigeria reported its index case of COVID-19 on 27
th
February 2020. Virtually, all countries in the world are affected, with over 5 million cases reported globally. A literature search was conducted using publications from academic databases and websites of relevant organisations. The disease is associated with typical and atypical signs and symptoms, mimicking other common illnesses. Nigeria is now in the phase of widespread community transmission as almost all the states have reported confirmed cases. The pandemic has shown a wide range of case-fatality rate (CFR) globally; this is postulated to be related to the demographics, existing health systems and probably other unidentified factors. There has been a steady increase in the burden caused by the disease in Nigeria with a relatively stable CFR, which is lower than the global CFR. Health systems have responded with the guidelines for prevention, management, and surveillance of the disease, while effort is being put in place to find a vaccine and a specific therapy for the cure of the disease. The pandemic has had a severe effect on health systems globally, including an unintended disruption in the service delivery of other diseases. It has the potential to disrupt the weak health system in Nigeria significantly. As such, a combination of non-pharmaceutical preventive measures that are cost-effective needs to be scaled up to prevent it from further weakening the existing health system.
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ORIGINAL ARTICLES
Factors associated with antenatal care services utilisation patterns amongst reproductive age women in Benin Republic: An analysis of 2011/2012 benin republic's demographic and health survey data
Justin Dansou, Adeyemi O Adekunle, Ayodele O Arowojolu
April-June 2017, 24(2):67-74
DOI
:10.4103/npmj.npmj_16_17
PMID
:28762359
Background:
High maternal and neonatal mortality persist in Benin Republic despite recent improvements. Numerous women and newborns continue to suffer preventable deaths. Although factors associated with the attendance of at least one antenatal care (ANC) visit are well documented, there is little evidence on factors related to compliance with World Health Organization (WHO) recommended four ANC visits. The present study determined the extent to which reproductive age mothers received the ANC check-ups at a health facility focussing on the WHO-recommended regimen.
Methods:
We examined factors related to ANC services utilisation patterns amongst 8701 women recruited in the 2011/2012 Benin Demographic and Health Survey data using multinomial logistic regression.
Results:
The percentage of mothers with full ANC attendance was 59.56%, 27.61% received less than 4 visits and 12.84% had never attended ANC services. Results showed that out of 13 variables assessed, only the place of residence was not associated with ANC seeking. Amongst significant variables, household wealth index, female education and desire for pregnancy were the most important factors related to ANC services seeking, especially for the achievement of WHO recommended four ANC visits. The relative risk ratio of ANC attendance, for the achievement of WHO recommended four ANC regimens was high amongst mothers from economically well-off households (adjusted relative risk ratio [aRRR] for richest women = 10.6, 95% confidence interval [CI]: 6.16–18.33), educated women (aRRR for primary level = 4.34, 95% CI: 3.00–6.27) and those with desired pregnancies (aRRR = 3.4, 95% CI: 2.58–4.48).
Conclusion:
To achieve WHO-recommended minimum four ANC visits in Benin Republic, our findings suggest the need to financially support the most economically disadvantaged pregnant women and their families during pregnancy, advocate for reducing unmet needs for family planning, strengthen girls' education, especially by maintaining them in school till completion of at least the secondary school.
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923
Self-reported dental pain and dental caries among 8–12-year-old school children: An exploratory survey in Lagos, Nigeria
Abiola A Adeniyi, Olumuyiwa O Odusanya
January-March 2017, 24(1):37-43
DOI
:10.4103/npmj.npmj_7_17
PMID
:28492208
Background:
Dental pain is considered an important public health problem because it affects the daily life of children. This study was designed to assess the prevalence, associated factors, and impact of dental pain among 8–12-year-old school children in Lagos, Nigeria.
Subjects and Methods:
A cross-sectional survey to determine self-reported dental pain among 8–12-year-old school children using an interviewer-administered questionnaire was conducted. This was followed by a clinical examination to determine the child’s oral hygiene status and dental caries status. Chi-square and Fisher’s exact tests were used for comparing proportions. Binary logistic regression analysis was also conducted. Statistical significance was set at
P
< 0.05.
Results:
Of the 414 children included in the survey, 254 (61.4%) children and 103 (24.9%) children reported experiencing dental pain 3 months and 4 weeks before the survey, respectively. Caries prevalence was 21.0%, whereas mean decayed, missing, and filled tooth index score was 0.4420 (±1.078). A report of pain up to 3 months before the survey was significantly associated with the child’s age [odds ratio (OR) = 1.254; confidence interval (CI) = 1.037–1.516;
P
= 0.019], whereas the type of school attended (OR = 1.786; CI = 1.124–2.840;
P
= 0.014) and the presence of dental caries (OR = 1.738; CI = 1.023–2.953;
P
= 0.041) were significantly associated with reporting pain 4 weeks before the survey.
Conclusion:
The prevalence of self-reported dental pain was high among the children surveyed. Report of dental pain was associated with the presence of dental caries. The provision of school oral health services could be useful in reducing the level of untreated caries and possibly dental pain among school children.
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Neonatal Jaundice: Knowledge, Attitude and practices of mothers in Mosan-Okunola community, Lagos, Nigeria
Olayinka O Goodman, Omolara A Kehinde, Babatunde A Odugbemi, Toriola T Femi-Adebayo, Olumuyiwa O Odusanya
July-September 2015, 22(3):158-163
DOI
:10.4103/1117-1936.170741
PMID
:26739202
Background:
A community-based survey was conducted amongst mothers aged 15–49 years living in Mosan-Okunola, Lagos, Nigeria to determine the knowledge of, attitudes to, preventive and treatment practices towards neonatal jaundice (NNJ).
Materials and Methods:
The mothers were selected using a multi-stage sampling technique. A pre-tested interviewer-administered structured questionnaire was used to obtain data. The knowledge of the mothers was scored and scores lower than 50% were graded as poor, 50–74% as fair and ≥75% as good. The practice was also categorised as appropriate if one correct option was identified and was categorised as inappropriate where an incorrect option(s) was identified singly or in combination with a correct option.
Results:
Three hundred and fifty-eight mothers were recruited. The mean age was 34.8 ± 9.05 years. Two hundred and seventy (75.4%) mothers had ever heard about the condition. Two hundred and forty-seven (91.4%) mothers correctly identified the condition and infection was the only most common known cause (47%). Only 34% of the mothers knew that NNJ could cause brain damage, and 40% identified refusal of feeds as a danger sign. Up to 64% of the mothers believed attending antenatal care could prevent the condition, and 58% were of the opinion that exposing babies to sunlight could prevent the condition. Sixty-eight percent (68.9%) of the mothers had a poor level of knowledge. Age and educational qualification did not show any statistically significant relationship with knowledge about NNJ (
P
< 0.05) but increasing maternal age had a significant association with an appropriate treatment practice (
P
< 0.05), the association was negative (
r
= −0.32).
Conclusion:
Knowledge about NNJ was low in this community and ineffective preventive practices were utilised. Efforts should be made to increase it, and health workers should play a leading role.
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1,908
Dysphagia following acute stroke and its effect on short-term outcome
Sani Atta Abubakar, Bello Yusuf Jamoh
July-September 2017, 24(3):182-186
DOI
:10.4103/npmj.npmj_96_17
PMID
:29082909
Background:
Dysphagia is assciated with numerous medical conditions including stroke, and there are wide variations in reported frequency of dysphagia in stroke survivors in the literature. Dysphagia has been shown to be an important risk factor for aspiration pneumonia and has profound impact on survivors.
Aims:
This study aims to determine the frequency of dysphagia in stroke survivors and its effects on short-term outcome.
Methods:
Consecutive patients hospitalised for first-ever acute stroke at Ahmadu Bello University Teaching Hospital Zaria, Nigeria, were prospectively enrolled from April 2015 to January 2017. Stroke severity was assessed using the National Institute of Health Stroke Scale (NIHSS). Water swallowing test was used to screen patients for the presence of dysphagia. This was followed by swallowing provocative test which was aimed at evaluating swallowing reflexes. All the patients were then followed up till day 30. Outcome measures applied were 30-day mortality and functional impairment on the Modified Rankin Scale.
Results:
Ninety-four patients (53 males and 41 females) with acute stroke were studied. Mean age of patients was 55.51 ± 15.7 years and 32 (34.4%) patients had dysphagia at presentation. Mean NIHSS score of patients with dysphagia was significantly higher than those without dysphagia. Aspiration pneumonia occurred more significantly in those with dysphagia. In multivariate logistic regression, only aspiration pneumonia was independently associated with 30-day mortality.
Conclusion:
The prevalence of dysphagia in this cohort of stroke patients was 34.4%, and the major independent determinant of 30-day mortality was development of aspiration pneumonia.
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Phenotypic determination of carbapenemase producing
enterobacteriaceae
isolates from clinical specimens at a tertiary hospital in Lagos, Nigeria
OO Oduyebo, OM Falayi, P Oshun, AO Ettu
October-December 2015, 22(4):223-227
DOI
:10.4103/1117-1936.173973
PMID
:26776335
Aims and
Objectives:
Carbapenemase production among clinical isolates of
Enterobacteriaceae
has been widely reported with prevalence rates ranging from between 2.8% and 53.6%. The aim of this study was to assess the prevalence of carbapenemase production among clinical isolates of
Enterobacteriaceae
from a Tertiary Hospital in Lagos, Nigeria, and to characterize the type of carbapenemase produced.
Materials and Methods:
Carbapenemase production was detected phenotypically using a commercially available combination disc test (Rosco Diagnostica carbapenemase detection Neo-Sensitab) containing inhibitors to the various carbapenemase classes. The Neo-Sensitabs were used for
Enterobacteriaceae
isolates that were resistant after the initial antibiotic susceptibility testing with meropenem (10 μg).
Results:
A total of 177
Enterobacteriaceae
isolates were investigated and 27 (15.2%) were carbapenem-resistant. From the 27 carbapenem non-susceptible isolates, 22 (12.4%) were carbapenemase producers while 5 (2.8%) exhibited carbapenem resistance due to extended spectrum beta-lactamase production. Of the 22 isolates that were positive for carbapenemase production, 15 (8.5%) were metallo beta-lactamase (MBL) producers, 6 (3.4%) produced oxacillinase-48 while 1 (0.5%) produced both MBL and
Klebsiella pneumoniae
carbapenemase. Hence, the overall prevalence of carbapenemase-producing
Enterobacteriaceae
in this study was 12.4%.
Conclusion:
Carbapenemase-producing
Enterobacteriaceae
was indeed prevalent in our institution. The combination disc test was a cost effective and suitable method for the initial detection of carbapenemase-producing
Enterobacteriaceae
within the clinical setting especially when molecular detection methods are not available.
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Predictors of quality of life in patients with diabetes mellitus in two tertiary health institutions in Ghana and Nigeria
Grace K Ababio, Samuel Bosomprah, Adesola Olumide, Nicholas Aperkor, Chris Aimakhu, Audrey Oteng-Yeboah, Joan Agama, William F Chaplin, Kola S Okuyemi, Albert G.B. Amoah, Gbenga Ogedegbe
January-March 2017, 24(1):48-55
DOI
:10.4103/npmj.npmj_3_17
PMID
:28492210
Background:
Patients with chronic diseases such as Type 2 diabetes mellitus (DM) usually have a relatively poor quality of life (QoL), because the cost of care (living expenses and health) or diet restrictions are heavily felt by these patients, and this is of a public health concern. However, limited data on DM QoL exist in Ghana and Nigeria. This makes it imperative for data to be collated in that regard.
Materials and Methods:
We adopted the Strengthening The reporting of observational studies in epidemiology (STROBE) consensus checklist to survey the patients with DM seen at the diabetic clinic at the Department of Medicine of the Korle-Bu Teaching Hospital and University College Hospital, Ibadan, Nigeria. Patients with Type 2 DM aged 40 years and older were recruited by using systematic random sampling method. The World Health Organization Quality of Life-BREF, diabetes empowerment scale, and DM knowledge scale were used to assess QoL, patient empowerment, and knowledge of DM, respectively. The predictors of QoL were determined using multiple linear regression analyses.
Results:
A total of 198 patients in Ghana and 203 patients in Nigeria completed the survey, with female-to-male ratio being 3:1 and 2:1, respectively. The overall QoL in both countries was relatively low: 56.19 ± 8.23 in Ghana and 64.34 ± 7.34 in Nigeria. In Ghana, significant correlates of higher scores on the QoL scale were medication adherence (
P
= 0.02) and employment status (
P
= 0.02). Among patients in Nigeria, employment status (
P
= 0.02) and DM empowerment (0.03) were significant predictors of QoL in patients with DM.
Conclusion:
Our study revealed an association between a number of psychosocial factors and QoL among patients with DM in Ghana and Nigeria.
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6,403
945
REVIEW ARTICLE
The West African ebola virus disease epidemic 2014–2015: A commissioned review
SA Omilabu, OB Salu, BO Oke, AB James
April-June 2016, 23(2):49-56
DOI
:10.4103/1117-1936.186299
PMID
:27424613
The first epidemic of Ebola haemorrhagic disease in West Africa is the largest and longest Ebola epidemic till date, where the outbreak notably involved three countries with distant spread to other countries. It has caused significant mortality, with reported case fatality rates of up to 70%. Data and relevant information were extracted from the review of majorly relevant publications/papers about the Ebola epidemic in West Africa and other previous outbreaks of Ebola virus (EBOV). As of 2016, with the epidemic under control, the World Health Organization has warned that flare-ups of the disease are likely to continue for some time as recently occurred in Sierra Leone and the on-going in Guinea. As this may not be the last outbreak of Ebola virus disease (EVD) in West Africa, there is a need to focus on diagnostic and research capacity required to curtail EVD with adequate measures for emergency preparedness and policies for innovative treatment strategies.
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6,232
736
ORIGINAL ARTICLES
Neonatal septicaemia, bacterial isolates and antibiogram sensitivity in Maiduguri North-Eastern Nigeria
Simon Pius, Mustapha Bello, Gadzama Balla Galadima, Halima A Ibrahim, Samuel Timothy Yerima, Jose Pwavimbo Ambe
July-September 2016, 23(3):146-151
DOI
:10.4103/1117-1936.190340
PMID
:27623727
Aims and Objectives:
The aim and objective of the study was to determine the incidence, bacterial isolates and the antibiogram sensitivity of the isolates in neonates with septicaemia.
Patients and Methods:
The neonates with clinical diagnosis of neonatal septicaemia (NNS) were consecutively enrolled into our special care baby unit. The patients were investigated including blood cultures, cerebrospinal fluid cultures and urine among others. Data were analysed with Statistical Package for Social Sciences software version 16.0 (SPSS Inc., Chicago, IL, USA).
Results:
Forty-six neonates (42.0%) had a positive blood culture, while 64 (58.0%) were blood culture-negative. Eighteen (39.1%) of those septicaemic neonates with positive blood culture were inborn, while 28 (60.9%) were outborn. The incidence of NNS was 5.9/1000 live births. The male-to-female ratio among septicaemic neonates was 1.9:1. The common risk factors for NNS were prolonged rupture of membrane, prematurity and low socioeconomic status of parents among others. Common clinical features were fever, poor feeding, excessive crying, tachypnoea and hepatomegaly.
Staphylococcus aureus
16 (69.6%) and
Streptococcus pyogenes
5 (21.8%) were the predominant Gram-positive organisms isolated whereas
Escherichia coli
9 (39.1%) and
Klebsiella pneumoniae
7 (30.4%) were the predominant Gram-negative organisms isolated.
S. aureus
was sensitive to cephalosporins and quinolones, but resistant to penicillins.
E. coli
and
K. pneumoniae
showed a high resistance (16.7% and 25.6%, respectively) to commonly used aminoglycoside such as gentamycin.
Conclusion:
The burden of NNS was high with high mortality in the study centre. The sensitivity pattern had remarkably changed; however, a combination of cephalosporins such as cefuroxime and gentamycin is still a good option.
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Antibiotic susceptibility profiles of non-fermenting gram-negative Bacilli at a Tertiary Care Hospital in Patiala, India
Udhayvir Singh Grewal, Rupinder Bakshi, Geeta Walia, Parth Rajeshbhai Shah
April-June 2017, 24(2):121-125
DOI
:10.4103/npmj.npmj_76_17
PMID
:28762368
Background:
Non-fermenting Gram-negative bacilli (NFGNB) have emerged as a major cause of healthcare-associated infections and are innately resistant to many antibiotics.
Aim:
The aim of this study was to determine the prevalence of NFGNB isolated from various clinical specimens and evaluate their antimicrobial susceptibility profiles.
Materials and Methods:
This retrospective study was done at our Department of Microbiology from December 2015 to December 2016. NFGNB were isolated from a variety of clinical specimens, plated on blood agar and MacConkey agar and incubated at 37°C for 18–24 h under aerobic conditions. Appropriate biochemical tests were done to identify the organisms isolated. Antibiotic susceptibility test was performed using the modified Kirby–Bauer disc diffusion method using commercially available discs on Mueller–Hinton agar.
Data was analyzed using SPSS IBM version 20
.
Results:
Out of 19065 clinical samples, cultures were positive in 1854 samples. Out of 1854 culture-positive samples, 216 (11.6%) yielded NFGNB.
Pseudomonas aeruginosa
was the most common NFGNB, isolated in 190/216 (87.96%) samples, followed by
Acinetobacter baumannii
(17/216, 7.87%). Overall, most of the NFGNB isolates were susceptible to polymyxin B (88.4%), imipenem (82.9%) and cefoperazone + sulbactam (50.9%), and a total of 11 (64.71%) multidrug-resistant
A. baumannii
(MDRAB) strains were isolated in the study.
Conclusion:
Our study showed a significantly high prevalence of NFGNB. Isolation of multidrug-resistant
P. aeruginosa
and MDRAB in the present study raises the concern of rapidly emerging antibiotic resistance in this group of bacteria in our region.
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5,828
646
Predictive factors of management outcome in adult patients with mechanical intestinal obstruction
Adebambo Olalekan Bankole, Adedapo Olumide Osinowo, Adedoyin Adekunle Adesanya
October-December 2017, 24(4):217-223
DOI
:10.4103/npmj.npmj_143_17
PMID
:29355160
Background:
Mechanical intestinal obstruction (MIO) is a common and potentially fatal surgical emergency, which constitutes about 20% of all admissions to the surgical emergency departments.
Objective:
To determine the predictive factors of morbidity and mortality in patients undergoing treatment for MIO at our tertiary hospital.
Patients and Methods:
This was a prospective study of consecutive patients, 18 years and above, that presented with features of MIO during a 1-year period (May 2014 to April 2015). Each patient had resuscitation, comprehensive clinical evaluation, appropriate investigations and definitive treatment. The data were analysed using SPSS version 22.
Results:
One hundred and five patients were studied. The age range was 18–86 years with a mean (standard deviation) of 45.6 (14.8) years. There were 54 males with a male to female ratio of 1.1–1. The common causes of MIO were post-operative adhesion (48.6%), tumour (25.7%), external hernia (15.2%) and volvulus (5.7%). Eighty-four patients (80%) had operative intervention while 21 patients (20%) had conservative management. Univariate analysis showed that dehydration, tachycardia (>90 bpm), pyrexia, abnormal levels of potassium, urea and creatinine, leucocytosis, American Society of Anesthesiologists (ASA) status >IIIE, bowel resection, intraoperative blood loss >500 ml and duration of surgery >2 h were significant predictors of mortality (
P
< 0.05). Multivariate analysis showed that elevated serum urea at hospital presentation and ASA status greater than IIIE were the independent predictors of mortality, but none of the factors could independently predict morbidity. The most common post-operative complication and cause of death were wound infection (29.6%) and sepsis (66.7%). The mortality rate was 14.3%.
Conclusion:
The most common cause of MIO was post-operative adhesion. Elevated serum urea and ASA status greater than IIIE were the independent predictors of mortality.
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5,723
677
Uterine and umbilical artery doppler in women with pre-eclampsia and their pregnancy outcomes
Ademola Joseph Adekanmi, Adebola Roberts, Janet Adetinuke Akinmoladun, Abiodun Oludotun Adeyinka
April-June 2019, 26(2):106-112
DOI
:10.4103/npmj.npmj_161_18
PMID
:31187750
Background:
Pre-eclampsia (PE) is an important public health menace in both developed and developing countries with high maternal and perinatal morbidity and mortality globally. A major goal towards improving antenatal management of PE is to develop accurate prediction models that identify women at high risk of this disease for appropriate interventions.
Methodology:
In a longitudinal cohort study, high-risk singleton pregnant women enroled between April 2015 and February 2016 had uterine and umbilical artery Doppler sonography at 22–24 weeks and 32–34 weeks gestation and had their delivery outcomes documented by the obstetrician and gynaecologist. The peak systolic velocity (PSV), end-diastolic velocity (EDV), Resistivity Index (RI), Pulsatility Index (PI) and the systolic-diastolic ratio (S/D) were recorded.
Results:
Among the ninety-eight high-risk pregnant women, 61 (62.2%) developed PE and 32 (32.8%) did not have PE. In the PE cases, 15 (24.5%) were mild and 46 (74.5%) were severe PE. The uterine artery PI was significantly associated with PE. A unit increase in uterine PI in high-risk pregnancies, increases the odd of PE by 37.37 times (95% confidence interval; odds ratio = 6.09, 241.9;
P
< 0.001). The combination of the uterine and umbilical PSV predicted 80.3% of severe PE. All three spontaneous abortions were in women who developed PE, more caesarean section (48.4%) and 69.2% of 45 pre-term deliveries occurred in women with severe PE.
Conclusion:
The findings from this study show significantly lower uterine and umbilical arteries PSV and EDV but higher RI, PI and S/D in cases that developed PE. The uterine artery PI is the best predictor of PE, whereas the combinations of uterine and umbilical arteries PSV best predict severity of PE among high-risk pregnant Nigeria women.
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CASE REPORTS
Condyloma acuminata of the bladder in benign prostatic obstruction: Case report and review of literature
Emmanuel Ajibola Jeje, Moses Adebisi Ogunjimi, Taiwo Opeyemi Alabi, Nicholas Awodele Awolola, Rufus Wale Ojewola
July-September 2015, 22(3):189-193
DOI
:10.4103/1117-1936.170737
PMID
:26739208
Condyloma acuminata (CA) is a warty lesion caused by the sexually transmitted human papillomavirus that most commonly affects external genitalia and mucocutaneous junctions. Involvement of the urinary tract (UT) is rare. Anogenital CA is considered a predisposition for urethral and subsequently bladder involvement. Isolated urinary bladder involvement is thought to be due to immunosuppression. A 60-year-old man presented with progressively worsening lower UT symptoms, which culminated in acute urinary retention due to histologically proven benign prostatic obstruction (BPO). He had neither cutaneous nor anogenital CA, and viral markers were unremarkable. He had failed a trial of voiding without catheter and had simple prostatectomy 2 years later. Findings at surgery included an enlarged prostate with prominent median lobe and a sessile, warty lesion of 1.2 cm in the widest diameter found incidentally at the dome of the bladder, which turned out to be CA after histopathological analysis of excisional biopsy specimen. CA of the urethra is uncommon while that of the bladder is rare. CA of the bladder without preceding anorectal CA or immunosuppression is uncommon. There is no report of CA of the bladder in BPO till date. Complete surgical excision is the preferred option of management except when not practicable.
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ORIGINAL ARTICLES
Prevalence and pattern of amblyopia among primary school pupils in Kosofe town, Lagos state, Nigeria
Segun Joseph Ikuomenisan, Kareem Olatunbosun Musa, Olufisayo Tade Aribaba, Adeola Olukorede Onakoya
October-December 2016, 23(4):196-201
DOI
:10.4103/1117-1936.196261
PMID
:28000640
Objective:
The objective of this study was to determine the prevalence and pattern of amblyopia in primary school pupils in Kosofe town of Lagos State with a view to providing baseline data that may facilitate the establishment of routine school eye screening programs in primary schools in Lagos State.
Materials
and Methods:
A descriptive, cross-sectional study was conducted among pupils from public and private primary schools in Kosofe town. The pupils underwent visual acuity assessment with the HOTV charts, detailed ocular examinations and cycloplegic refractions. Data obtained were analysed using the Statistical Package for Social Sciences version 20.0.
Results:
A total of 1702 pupils participated in the study, out of which 899 (52.8%) were males. The age range was 4-16 years with 1630 (95.8%) pupils within the ages of 4 and 10. Amblyopia was detected in 24 (1.4%) of the screened pupils (95% confidence interval = 0.610-0.914). There was no significant sex predilection (
P
= 0.367) or age trend (
P
= 0.158) in this study although amblyopia occurred more in boys (54.2%). Refractive amblyopia (58.4%) was the most common type of amblyopia out of which anisometropic amblyopia accounted for 78.6%. Unilateral amblyopia was observed in 87.5% of the amblyopic pupils, and the left eye was more commonly affected than the right eye. All the types of amblyopia were more common within the age group of 4-10 years and in public school children (
P
= 0.039 and
P
= 0.015, respectively).
Conclusion:
The prevalence of amblyopia in this study was low and it falls within the general prevalence range for amblyopia in Nigeria.
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Prevalence of chronic kidney disease and its risk factors among adults in a semi-urban community of South-East Nigeria
Chimezie Godswill Okwuonu, Innocent Ijezie Chukwuonye, Oluseyi Ademola Adejumo, Emmanuel Idoko Agaba, Louis Ikechukwu Ojogwu
April-June 2017, 24(2):81-87
DOI
:10.4103/npmj.npmj_34_17
PMID
:28762361
Background:
Chronic kidney disease (CKD) is an increasingly prevalent problem worldwide. Treatment of end-stage kidney disease is beyond the reach of an average Nigerian. The prevention and early detection are imperative to reducing its burden.
Aim:
The aim of this study was to determine the prevalence of CKD and some of its risk factors among adults in a representative semi-urban Nigerian population.
Subjects and Methods:
A cross-sectional study involving 400 randomly selected adults. Participants were assessed using the WHO stepwise approach. Urinary protein-creatinine ratio (PCR) and estimated glomerular filtration rate (GFR) from serum creatinine, among other parameters, were analysed. A PCR ≥200 mg/g was regarded as significant proteinuria while GFR <60 ml/min/1.73 m
2
was regarded as reduced GFR. Participants with abnormal PCR and/or reduced GFR were re-evaluated after 3 months to document persistence of these abnormalities. CKD was defined as persistent significant proteinuria and/or reduced GFR for more than 3 months.
Results:
Data were complete for 328 participants. Persistent significant proteinuria was found in 5.8% while persistently reduced GFR was obtained in 4.6% of participants. Overall, the prevalence of CKD was 7.8%. The prevalence of some established CKD risk factors was old age, 36.3%; hypertension, 36.9%; diabetes mellitus, 7.9%; and family history of kidney disease, 6.4%. The predictors of CKD included old age (adjusted odds ratio = 3.2; confidence interval: 1.10–8.92;
P
= 0.02), hypertension: 3.5 (1.93–11.90;
P
= 0.001), family history of kidney disease; 4.5 (3.91–10.23;
P
= 0.01), generalised obesity 1.3 (1.20–6.21;
P
= 0.001) and central obesity 3.8 (1.13–12.68;
P
= 0.003).
Conclusion:
The prevalence of CKD and some of its risk factors were high. Effective control of the modifiable risk factors identified will assist in reducing the burden of CKD.
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Prevalence and pattern of potential drug-drug interactions among chronic kidney disease patients in south-western Nigeria
J Fasipe Olumuyiwa, A Akinbodewa Akinwumi, O Adejumo Ademola, B Akawa Oluwole, E Okaka Ibiene
April-June 2017, 24(2):88-92
DOI
:10.4103/npmj.npmj_64_17
PMID
:28762362
Background:
Management of chronic kidney disease (CKD) patients often requires the use of multiple drugs due to a high number of cardiovascular risk factors and complications associated with the disease. Multiple drugs predispose to potential drug-drug interactions (DDIs) which may be associated with increased morbidity, mortality, length of hospital stay and health-care cost.
Objectives:
This study determined the prevalence and pattern of potential DDIs among CKD patients attending Kidney Care Centre, in Ondo City, Nigeria.
Methodology:
It was an 18-month retrospective study that involved the reviewed CKD patients' records. The Lexi-Interact database was used to evaluate patients' medications for potential DDIs.
Results:
One hundred and twenty-three (123) CKD patients, made up of 82 (66.67%) males and 41 (33.33%) females were studied. The mean age of the CKD patients was 53.81 ± 16.03 years. The most common comorbid conditions were hypertension in 103 (83.74%) and diabetes mellitus in 39 (31.71%). A total of 1237 prescriptions were made and the mean number of prescribed medications per patient was 10.06 ± 3.97. A total number of 1851 potential DDIs were observed among 118 patients. The prevalence of potential DDIs was 95.9% while the mean DDIs per prescription was 1.27. Among the potential DDIs observed, the severity was mild in 639 (34.5%), moderate in 1160 (62.7%), major in 51 (2.8%) and only 1 (0.1%) was of avoid drug combination. The most frequent DDI was between calcium carbonate and oral ferrous sulphate.
Conclusion:
The prevalence of potential DDIs is high among CKD patients. About 63% of these interactions have moderate severity. Clinicians and pharmacists should utilise available DDI software to avoid harmful DDIs in CKD patients.
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Factors influencing the use of malaria prevention methods among women of reproductive age in peri-urban communities of Port harcourt city, Nigeria
Charles Ibiene Tobin-West, Esther Njideka Kanu
January-March 2016, 23(1):6-11
DOI
:10.4103/1117-1936.180114
PMID
:27098942
Background:
Malaria remains a huge national concern in Nigeria with severe implications for maternal and child health.
Aims:
This study was aimed at investigating factors that influence malaria prevention among women of reproductive age in line with the National Malaria Control objectives.
Subjects and Methods:
A descriptive, cross-sectional study design and cluster sampling technique was used to recruit study participants. Respondents had 'correct' knowledge of malaria if they knew the cause and symptoms of malaria. Otherwise is classified as 'incorrect'. Data were analysed in Epi Info version 7 with the level of statistical significance set at
P 0≤ 0.05. Results: Most respondents, 709 (89%) had good knowledge of malaria. Their educational level was significantly associated with this knowledge (χ
2
= 3.6993, P =
0.0544). There were, however, some myths and misconceptions about malaria. Of 390 (49.3%) that owned insecticide treated bed nets (ITNs), only 59 (18.2%) used them consistently, while only 31 (50%) of the pregnant women received intermittent preventive treatment (IPTp). Malaria knowledge, ITNs ownership and female education were not significantly associated with ITN and IPTp usage. Married women had 3 times higher odds of ITN usage than the unmarried, (odds ratio [OR] = 2.69, 95% confidence interval [95% CI] = 1.56-4.62), and women with children had 2 times higher odds of usage than those without (OR = 2.42, 95% CI = 1.42-4.12).
Conclusions:
The use of malaria prevention measures among women of reproductive age is still sub-optimal. We advocate for intensified education of women on malaria in local languages, using role plays and community dialogues. Efforts must also be directed at dispelling myths and misconceptions about malaria for maximum impact.
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Rota virus genotypes and the clinical severity of Diarrhoea among children under 5 years of age
Ezeonwu Bertilla Uzoma, Chinedu Chukwubuikem, Efe Omoyibo, Oguonu Tagbo
January-March 2016, 23(1):1-5
DOI
:10.4103/1117-1936.180108
PMID
:27098941
Background:
Diarrhoeal disease still remains one of the common causes of morbidity and mortality in children under 5 years of age. It is caused notably by the different serotypes of rotavirus.
Objectives:
To ascertain the prevalence and risk factors for rotavirus diarrhoea in children under 5 years of age seen at Federal Medical Centre, Asaba, and to determine the different serotypes and their relationship with diarrhoea severity.
Subjects and Methods:
A hospital-based cross-sectional study in which all children under 5 years of age, with diarrhoea had their stool samples tested for rotavirus antigen with enzyme immunoassay. Significant values of variables were determined using
t
-tests and Chi-square tests as appropriate.
Results:
One hundred and thirty-two children were studied: 52.3% were males and 46.7% were females. Children 1-11 months of age constitute 49.2%, whereas those 12-59 months were 50.8%. Only 49 (37.1%) children were ELISA positive for rotavirus and of this number, 31 (63.3%) were within 1-11 months of age,
P
= 0.013. The three most common rotavirus genotypes were G3P[6] in 24.5%, G1P[6] in 12.2% and G12P[8] in 10.2% of the samples, respectively. Duration of vomiting was more prolonged with G3P[6] infection,
P
= 0.029, whereas dehydration and the overall severity of the diarrhoea were more with G12P[8] infection,
P
= 0.026 and 0.010, respectively.
Conclusion:
The emerging G12 rotavirus genotype was isolated in Asaba.
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Foetal congenital anomalies: An experience from a tertiary health institution in north-west nigeria (2011-2013)
Swati Singh, Daniel Nnadi Chukwunyere, Joel Omembelede, Ben Onankpa
July-September 2015, 22(3):174-178
DOI
:10.4103/1117-1936.170743
PMID
:26739205
Background:
Structural or functional defects present at birth may lead to physical or mental disabilities. They contribute significantly to perinatal morbidity and mortality.
Aims and Objectives:
The study aimed to determine the prevalence of congenital anomalies among women delivering in the labour room suites of a tertiary health institution in North-Western Nigeria. Various maternal risk factors were also correlated and analysed.
Subjects and Methods:
This was a 3-year hospital-based prospective study carried out in the Department of Obstetrics and Gynaecology in association with the Department of Paediatrics in a tertiary health care centre in North-Western Nigeria. All neonates delivered in the labour rooms were examined for congenital abnormalities (CAs) soon after birth. The study group included all live births along with stillbirths delivered after the 28
th
week of gestation. Those diagnosed with congenital anomaly were admitted to the special care baby unit for observation and documentation.
Results:
A total of 72 congenital anomalies were documented among 10,163 deliveries. Central nervous system (CNS) anomalies had the highest prevalence 34.7% (25/72) and were followed by those of the musculoskeletal system 22.2% (16/72). Spina bifida/meningocoele were the most common anomalies of the CNS 44% (11/25) followed by hydrocephaly 28% (7/25). Most of the anomalies involved single organs 59/72 (81.9%). Majority of the CA 84.7% (61/72) were prevalent within the maternal age range of 16–35 years, while 12.5% were seen in teenage pregnancy. Diagnosis of most of the anomalies was made after delivery 69.4% (50/72). History of maternal febrile illness during pregnancy was present in 75% (54/72) and in 50% (27/54) of cases with CNS anomaly.
Conclusion:
Central nervous system anomalies were the most prevalent congenital anomalies observed. Improved maternal health, pre-conception care, folic acid supplementation and routine foetal anomaly scan may help to reduce these anomalies.
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Oral health knowledge, awareness and associated practices of pre-school children's mothers in Greater Noida, India
Priyanka Sehrawat, KK Shivlingesh, Bhuvandeep Gupta, Richa Anand, Abhinav Sharma, Monica Chaudhry
July-September 2016, 23(3):152-157
DOI
:10.4103/1117-1936.190344
PMID
:27623728
Aim:
To assess the oral health knowledge, awareness and associated exercised practices of pre-school children's mothers in Greater Noida, India. Subjects and Methods: The sampling frame for this study was chosen via convenient sampling. It comprised 598 mothers of children aged between 2 and 5 years, attending the paediatrics division of a government and four private hospitals in Greater Noida. A pre-tested questionnaire was distributed to the participants which comprised questions on the participant's sociodemographic characteristics and 23 statements regarding their knowledge, attitude and practices towards their child's oral health. Data were analysed using SPSS 21.0.
P
< 0.05 was considered statistically significant.
Results:
The study showed that merely 24.9% of the participating mothers had good knowledge and 29.1% and 12.5% exhibited poor attitude and practices, respectively, towards their child's oral health. Knowledge about the role of fluorides, causes and prevention of dental caries, gum disease, malocclusion, appropriate timing of commencing of toothbrushing and importance of frequent dental visit was found to be inadequate among the participants. The knowledge varied significantly with respect to age (
P
= 0.04), education (
P
= 0.00) and working status (
P
= 0.006) of the mothers.
Conclusion:
The study participants exhibited poor knowledge and attitude towards their child's oral heath which was leading to the adoption of poor oral health practices by these mothers. Thus, to improve the oral health of children, appropriate practices and measures should be promoted among their parents/guardians.
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Prevalence and factors associated with exercise-induced bronchospasm among rural school children in Ilesa, Nigeria
Bankole Peter Kuti, Demilade Kehinde Kuti, Kehinde Oluyori Omole, Lasisi Oluwafemi Mohammed, Busayo Gideon Ologun, Bolanle Idowu Oso
April-June 2017, 24(2):107-113
DOI
:10.4103/npmj.npmj_46_17
PMID
:28762366
Background:
Exercise-induced bronchospasm (EIB) assessed using changes in peak expiratory flow rates (PEFRs) to free range exercise is a relatively cheap way of screening for asthma in resource-poor centres where children with asthma are often undiagnosed and poorly managed. This study sets out to determine the prevalence and factors associated with EIB among rural schoolchildren in Ilesa, Nigeria.
Subjects and Methods:
Children aged 8–16 years from two middle schools in rural Ilesa were selected by multistage sampling. Their sociodemographic characteristics and personal/family history of asthma and allergies were obtained. The children had their PEFR measured before, 5, 10 and 15 min after 6–8 min of free running exercise to achieve 80% of their maximal pulse rate. EIB was defined as change in PEFR expressed as a percentage of the pre-exercise value ≥15%. The prevalence and factors associated with EIB were determined.
Results:
The mean (standard deviation) age of the 250 study participants was 12.5 (1.5) years (M: F 0.9:1) None of the children had previously been diagnosed with asthma. The prevalence of EIB was 9.2%, 6.4% and 4.0% at 5, 10 and 15 min post-exercise, respectively. Household poultry birds, personal history of allergies, wheeze in the past 12 months and family history of asthma were associated with EIB (
P
< 0.05); only wheezing in the past 12 months independently predicted EIB (odds ratio = 6.343; 95% confidence interval = 2.040–8.798;
P
= 0.020).
Conclusion:
The prevalence of EIB among rural schoolchildren in Ilesa was 9.2%. EIB was associated with the history of allergies and wheeze and presence of household poultry birds. We recommend routine screening of these children for early diagnosis and good asthma symptom control.
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Sleep quality among nurses in a tertiary hospital in North-West Nigeria
Ibrahim Aliyu, Zainab F Ibrahim, Lawal O Teslim, Helen Okhiwu, Igoche David Peter, Godpower Chinedu Michael
July-September 2017, 24(3):168-173
DOI
:10.4103/npmj.npmj_79_17
PMID
:29082906
Background:
Sleep is a necessity; it is nourishing, refreshing and healing. The nursing profession is associated with busy and difficult work schedules, especially the running of shifts which has been associated with cardiovascular and metabolic complications. There is a dearth of local data on sleep disorders, especially among nurses. In this study, we evaluated the quality of sleep and the tendency of daytime sleepiness among nurses.
Subjects and Methods:
This study was cross-sectional in nature involving 100 nurses working with Federal Medical Centre Birnin Kebbi, Kebbi State; the study was carried out between October 2016 and February 2017. The Pittsburg Sleep Quality Index was used to determine poor sleepers; while the Epworth Sleepiness Scale (ESS) was adopted to determine the presence of tendency of daytime sleepiness; 0–7 was considered normal, 8–9 represented average tendency of daytime sleepiness, 10–15 represented excessive daytime sleepiness, while 16–24 represented daytime sleepiness requiring medical intervention.
P
< 0.05 was set as statistically significant.
Results:
There were 23 (23%) males and 77 (77%) females, with a male-to-female ratio of 0.3:1. The age range was 18–50 years, with a mean age of 31.4 ± 8.6 years. The ESS score ranged from 0.0–17.0, with a mean score of 7.3 ± 3.5; while the Pittsburg score ranged between 1 and 15, with a mean score of 5.7 ± 2.7, and 61% of the nurses had a poor sleep quality. There was unlikely tendency of excessive sleepiness across all the age groups, though this was not statistically significant (χ
2
= 7.258,
P
= 0.283), and poor sleep quality was most prevalent among the 25–40-year-old group but this observation was also not statistically significant (χ
2
= 2.259, df = 2,
P
= 0.334).
Conclusion:
Poor sleep quality is a problem among nurses, though less tendency to daytime sleepiness was observed in this report.
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© Nigerian Postgraduate Medical Journal | Published by Wolters Kluwer -
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Online since 2
nd
July, 2015