Research Articles in Medicine & Surgery

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Phaeochromocytoma in a 4-year old girl
(Nigerian Journal of Surgical Research, 2004-02-02) Gali Bata Mtaku; Madziga A G; Nggada H A; Hamid A U
This is a report of a 4-year old female Nigerian patient with phaeochromocytoma, a rare surgically correctable cause of hypertension, highlighting the problems in diagnosis and management in our sub region with review of the literature.
Pyomyositis in north - eastern Nigeria
(Nigerian Journal of Surgical Research, 2004-02-02) Madziga A G; Na’aya U H; Gali Bata Mtaku
Background: Pyomyositis is a suppurative disease of skeletal Muscle and a well-known disease with frequent occurrence in the tropics and subtropics, which continues to cause significant morbidity. Despite several studies of the disease in various regions of the tropics, there has been none from the northeast region of Nigeria, consisting of a largely rural population where the climate is hot and dry with little annual rainfall.Methods: A retrospective study of all patients seen and treated for pyomyositis in the University of Maiduguri Teaching Hospital from April 1990 to April 2000 was undertaken.Results: Fifty four patients with pyomyositis were seen and managed comprising 36 Males and 18 Females (M: F ratio 2:1). Two peak age incidences of 6-10 years and 31-40 years were noted. Most were from a labouring population and presented with a fully evolved disease affecting the large and powerful muscles of the thigh and calf in 59.7% of cases, the glutei in 12.9% and the trunk in 9.7%. The smaller muscles of the arm and forearm and head and neck were rarely affected. 8 patients had multiple lesions. Staphylococcus aureus was cultured in 91.8% of cases sensitive to cloxacillin, augmentin, chloramphenicol and erythromycin in that order.Conclusion: Prompt diagnosis, appropriate supportive therapy, effective antibiotic therapy and early drainage of abscesses have resulted in minimal mortality despite late presentation although hospital stay was prolonged.
Incidence of Renal Insufficiency in Cancer Patients
(Health Communications Inc, 2005-02-02) Dogan Ekrem; Izmirli Mustafa; Ceylan Kadir; Erkoc Reha; Sayarlioglu Hayriye; Begenik Huseyin; Alici Suleyman; Yil Yuzuncu
The frequency of chronic renal insufficiency among cancer patients is unclear. The aim of this study was to determine the frequency of impaired renal function within a population of cancer patients. One thousand two hundred seventeen patients (563 women, 654 men) with cancer underwent serum creatinine concentration and glomerular filtration rate (GFR) evaluations. The Cockcroft-Gault formula was used to estimate the GFR from the creatinine clearance (Clcr). Renal insufficiency was defined as a GFR ≤90 mL/min. Among this population, 72 (5.9%) demonstrated an abnormal serum creatinine concentration (>1.2 mg/dL). According to the Cockcroft-Gault formula evaluations, however, 330 (27.1%) of the patients had an estimated GFR <90 mL/min. Among these, the Clcrwas between 60 and 89 mL/min in 241 patients (19.8%); 30 and 59 mL/min in 75 patients (6.2%); and 15 and 29 mL/min in 7 patients (0.6%); 7 patients (6%) had a Clcr <15 mL/min. As a result, 21.2% of patients demonstrating a normal serum creatinine level had abnormal renal function. Renal function should be evaluated in all cancer patients, regardless of their serum creatinine level, before any drug regimen is administered. The Cockcroft-Gault formula appears to be more accurate than serum creatinine concentration for diagnosing renal insufficiency in patients with cancer, but more prospective studies in this population will be necessary to confirm this finding.
Incidence of retro-aortic left renal vein and its relationship with varicocele
(Urogenital European Radiology, 2005-02-23) Arslan Halil; Etlik Ömer; Ceylan Kadir; Temizoz Osman; Kavan Mustafa; Ceylan, K
The retro-aortic left renal vein (RLRV) is a malformation characterized by the presence of a vessel that drains the left renal blood up to the inferior vena cava crossing behind the aortic artery. Varicocele is defined as venous dilation of the pampiniform plexus, and the left side is the most commonly affected. Several theories concerning the possible aetiology of varicocele are reviewed in the literature, but RLRV was not mentioned as an aetiologic factor of varicocele. in this study we investigated the percentage of RLRVs and their relation with varicocele. A total of 1,125 contrast-enhanced abdominal CT scans was examined to identify RLRVs. RLRVs were found in nine women (1.6%) and ten men (1.7%). We performed scrotal Doppler ultrasonography (US) for all affected men except one. Varicocele of varying degrees was found in seven of the nine male patients with RLRV (77%). RLRV could be one of the aetiological factors in the development of varicocele, and the cases with RLRV should be examined by scrotal Doppler US for the presence of varicocele.
Sero-prevalence of hepatitis B surface antigen among primary school pupils in rural Hawal valley, Borno State, Nigeria
(Journal of Community Medicine and Primary Health Care, 2005-06-09) DN Bukbuk; Bassi Amos Paul; ZM Mangoro
Background and objective: Hepatitis B virus infection is a major public health problem worldwide and in Africa. In the northeastern part of Nigeria. Information on the prevalence of HBV infection in rural communities is scarce. This study was carried out to determine the sero-prevalence of hepatitis B surface antigen amongst primary school pupils in a rural setting in northeastern Nigeria. Methods: Hepatitis B surface antigen was tested for in 150 apparently healthy children in two primary schools in two rural communities situated in the Hawal valley area in Borno State, North East zone of Nigeria using an Enzyme Linked Immunosorbent Assay technique. Results: The overall sero-positivity of Hepatitis B surface antigen (HBsAg) in the pupils was 44.7% (95% C.I: 36.6 53.0). The prevalence of HBsAg was found to increase with age, rising from 40.6% in children aged 10-11 years to 75% in children aged above 13 years. The sero-prevalence is (47.2%, (95% C.I: 37.5 57.1) among males while among the females it was slightly lower 38.1 % (95 C.I: 23.6 54.4%). The differences in the HbsAg sero-prevalence by age, sex and location were not statistically significant. Conclusion: The high prevalence of HBsAg in the two primary school children provides evidence for an urgent mass immunization for children on entry to the schools.Keywords: HBs Antigenaemia, primary school pupils, rural hawal river valley, northeastern NigeriaJournal of Community Medicine and Primary Health Care 2005, 17(1): 20-23
A Clinicopathological Pattern Of Tumoral Calcinosis In Maiduguri, North Eastern Nigeria
(The Internet Journal of Third World Medicine, 2005-06-28) Gali Bata Mtaku; Nggada H; Mshelia D
Background: Tumoral calcinosis is a rare disease reported mainly among blacks of African descent with paucity literature in Africa. Aims and Objective: This study aims at reviewing the clinicopathological pattern of Tumoral calcinosis in Maiduguri Northeastern Nigeria. Methods: All histologically diagnosed cases of Tumoral calcinosis were retrieved and reviewed at the University of Maiduguri Teaching Hospital between January 1994 and December 2003. Results: There were twelve diagnosed cases of Tumoral calcinosis. All age groups were affected except the pediatrics age group. The age ranges between 15 and 70 years with a mean age of 38.5 years. There was no sex predilection. Multiple sites occurred in three patients with two recurrences. The commonest site is the hip joint and one unusual site, which is the scrotum. Surgical excision was performed on all patients with recurrences. Conclusions: Tumoral calcinosis is a rare benign lesion and most of the lesions are asymptomatic. However, morbidity may be related to the size, location and secondary infection. Early and adequate wide surgical excision is essential to avoid the morbidity and recurrence.
Virtual computed tomography cystoscopy in bladder pathologies
(International Braz J Urol, 2006-04-02) Arslan Halil; Ceylan Kadir; Harman Mustafa; Yilmaz Yuksel; Temizoz Osman; Can Saban
Assessed the usefulness of virtual cystoscopy performed with multidetector computed tomography (CT) in patients with different urinary bladder pathologies compared to the conventional cystoscopy.Eighteen patients with different bladder pathologies, which consisted of 11 tumors, 3 diverticula, 2 trabecular changes and 2 stones, were assessed with conventional cystoscopy and virtual CT cystoscopy. The results of virtual CT cystoscopy were compared with the findings of conventional cystoscopy. We determined the detection rate and positive predictive value of CT imaging based virtual cystoscopy in the diagnosis of urinary bladder lesions.CT scanning was well tolerated by all patients, and no complications occurred. Images in 16 (88%) of the 18 virtual cystoscopic examinations were either of excellent or good quality. All tumors except one, 2 trabecular changes and 2 stones were characterized with similar findings in the both of methods. The masses ranged from 0.4 to 7.0 cm in diameter. While conventional cystoscopy could not evaluate interior part of the diverticulum, virtual CT cystoscopy could demonstrate clearly within it. There were no false-positive findings in our series.Virtual CT cystoscopy is a promising technique to be used in the detection of bladder lesions. It should be considered especially at the evaluation of bladder diverticula. In the future, it may be possible or even advantageous to incorporate into the imaging algorithm for evaluation of bladder lesion.
Communities’ Awareness, Perception and Participation in the Community-Based Medical Education of the University of Maiduguri
(Taylor and Francis, 2006-07-02) Omotara, B. A.; Yahya, S. J.; Shehu, U.; Bello, H. S.; Bassi Amos Paul
Background: Community-based medical education (CBME) is no longer a new innovation in medical education since the establishment of The Network: Towards Unity for Health (The Network: TUFH) 25 years ago. The CBME of the University of Maiduguri medical college is 14 years old and has never been assessed in terms of the population it serves. The study was conducted to determine the level of awareness, perception, and participation of the communities in CBME. Methods: A cross-sectional survey was carried out in 11 village units of three Local Government Areas (LGAs) using a 14-item structured questionnaire administered to adults in randomly selected households. The questionnaire was based on guide questions used for focus group discussions held earlier with community leaders. Results: Awareness of students’ visits among respondents was 73.7%. Knowledge of the frequency of presence of the students in the communities was 72.2%. ‘‘To examine and treat’’ (33.6%) and ‘‘to ask questions’’ (16.6%) were the most prominent reasons given for the visits. The majority of respondents perceived the visits as beneficial (72.2%). More frequent visits were requested by 54.4% of the respondents. The communities were willing to be more accessible and felt that the LGAs should provide more logistic support to the program. Discussion: This study revealed that communities were aware of students’ visits and knew reasons for the visits, thought visits were beneficial, and were willing to provide more support for these visits.
Impact of Health Education on Home Treatment and Prevention of Malaria in Jengre, North Central Nigeria
(Annals of African Medicine, 2008-02-02) Chirdan, O.O.; Zoakah, A.I.; Ejembi, C.L.
Background: Malaria accounts for 1 million deaths among children under five annually. It has been shown that improving home treatment and preventing delays in seeking treatment, by teaching women to respond promptly when their children have fever, can decrease malaria related complications and mortality. This study looks at the impact of health education on knowledge of malaria: its recognition, treatment and prevention among caregivers of children under five in Jengre, North Central Nigeria. Methods: The study was a community based intervention study conducted in three stages: A pre-intervention stage, where 150 caregivers, were selected through a multistage sampling technique from the households containing children under five. Information for the baseline was collected through an interviewer administered semi-structured questionnaire. The intervention consisted of a series of health education sessions designed based on findings from the pre-intervention stage. The post-intervention impact assessment was conducted using a modified version of the questionnaire used in the pre intervention stage. Results: Malaria was recognized as one of the diseases that cause fever in community by all the respondents. Sixty-one (40.6%) had adequate knowledge concerning malaria causation, transmission, prevention and treatment. Twenty eight (56%) of respondents reported Self-treatment. There was a statistically significant relationship between years of formal education and first line treatment option (P = .012). Thirty-four (68%) mothers acted within eight hours of onset of fever. The intervention had an effect on perception (P < .001), knowledge (P < .001), malaria prevention practice (P = .001), first line treatment option (P = .031) and the type of treatment given to the children with fever (P = .048). Conclusion: Health education impacted positively caregivers’ knowledge of malaria and their willingness to access antimalarial treatment when their children have fever. Malaria information should be made available to caregivers visiting child welfare clinics. Caregivers should also be integrated into malaria control activities at community level.
Gastrointestinal Injuries Following Blunt Abdominal Trauma in Children.
(Nigerian Journal of Clinical Practice, 2008-02-02) Chirdan, L.B.; Uba, A.F.; Chirdan, O.O.
Gastrointestinal (GI) injuries in children following blunt abdominal trauma is rare; early diagnosis and treatment is important for good outcome. The purpose of this report is to describe the management problems encountered in children with GI injuries following blunt abdominal trauma. From January 1996 June 2006, 168 children were treated at our centre for abdominal trauma. Twenty three had GI injuries, 19 were due to blunt trauma while four were due to penetrating trauma. We retrospectively reviewed the clinical data of the 19 children that had GI injuries as a result of blunt abdominal trauma to document the presentation, clinical features, diagnosis and outcome. There were 19 patients, 14 were boys, and five were girls. The median age at presentation was nine years (range 1.5 15 years). Road traffic accident was responsible for injuries in 10, fall from heights in six and assault in two children. In one child the cause of injury was not recorded. Most children presented late and at presentation over 80% had abdominal signs. Diagnosis was mainly by physical examination supported by plain abdominal x-ray in 15 children. All 19 children had laparotomy. There were a total of 23 injuries. Gastric and duodenal injuries accounted for one each. Most of the injuries were in the jejunum and ileum (10 perforations, two contusions with one mesenteric haematoma and one mesenteric tear). There was one caecal perforation and six colonic injuries, one of which was associated with intraperitoneal rectal injury. Five children had other associated injuries (three splenic injuries, one renal injury, one bladder contusion associated with long bone fractures and one severe closed head injury). Treatment included segmental resection with end to end anastomosis, wedge resection with anastomosis, exteriorizations stomas, simple excision of the perforation and closure in two layers (gastric perforation). The total mortality was four (21.1%), two of them due to associated injuries. Gastrointestinal injuries due to blunt abdominal trauma pose a management challenge. Management based on decisions from serial clinical examinations and simple tests without recourse to advance imaging techniques may suffice.
Tuberculous ileal perforation in a HIV positive patient: a case report and review of literature.
(Nigerian Journal of Clinical Practice, 2008-12-02) Dogo D; Bakari AA; Gali Bata Mtaku; Ibrahim AG
Tuberculosis is prevalent worldwide. Even in developed countries there is a resurgence of tuberculosis mainly due to increasing HIV infection. Tuberculous ileal perforation is uncommon. It is, however, a potentially fatal complication of intestinal tuberculosis especially in HIV/AIDS patient.To highlight tuberculous ileal perforation as an underestimated complication of intestinal tuberculosis in an HIV patient presenting with acute abdomen.A 42-year-old HIV positive long distance truck driver with tuberculous ileal perforation is presented and related literatures reviewed.Intestinal perforation due to abdominal tuberculosis is an aetiological factor in acute HIV abdomen. High index of suspicion remains the key to diagnosis.
Perceptions of working conditions amongst health workers in state-owned facilities in northeastern Nigeria
(Annals of African Medicine, 2009-01-01) Chirdan, Oluwabunmi O; Akosu, Joeseph T.; Ejembi, Clara L.; Bassi Amos Paul; Zoakah, Ayuba I.
The health care sector depends to a large extent on human labor. Poor worker motivation can greatly affect health outcomes and patient safety. There is little information on the health workers' perceptions of working conditions in resource-poor settings.Three state-owned facilities in each state were selected by simple random sampling technique. The selected facilities were visited on weekdays between 9 and 10 a.m. A self-administered structured questionnaire was given to all health care workers on duty in the facility at the time of visit.A total of 299 questionnaires were returned. The response rate was 85.43%. Two hundred four (68.2%) workers experienced general satisfaction with their current jobs. The relationships between general job satisfaction and presence of conflict at work (P = 0.001), freedom of expression (P > 0.001), managerial support for staff welfare (P > 0.001), managerial support for staff career development (P > 0.001), availability of tools and consumables in the workplace (P > 0.001) and progress towards personal professional goals (P = 0.001) were statistically significant.The level of general job satisfaction was high. Though salaries were important, presence of conflict at work, freedom of expression, managerial support for staff welfare, managerial support for staff career development, availability of tools and consumables in the workplace and progress towards personal professional goals appear to play a role in worker motivation.
Perceptions of working conditions amongst health workers in state-owned facilities in northeastern Nigeria
(Annals of African Medicine, 2009-02-02) Chirdan, O.O.; Akosu, J.T.; Ejembi, C.L.; Bassi, A.P.; Zoakah, A.I.
Background: The health care sector depends to a large extent on human labor. Poor worker motivation can greatly affect health outcomes and patient safety. There is little information on the health workers’ perceptions of working conditions in resource-poor settings. Method: Three state-owned facilities in each state were selected by simple random sampling technique. The selected facilities were visited on weekdays between 9 and 10 a.m. A self-administered structured questionnaire was given to all health care workers on duty in the facility at the time of visit. Results: A total of 299 questionnaires were returned. The response rate was 85.43%. Two hundred four (68.2%) workers experienced general satisfaction with their current jobs. The relationships between general job satisfaction and presence of conflict at work (P 0.001), freedom of expression (P 0.001), managerial support for staff welfare (P0.001), managerial support for staff career development (P 0.001), availability of tools and consumables in the workplace (P 0.001) and progress towards personal professional goals (P 0.001) were statistically significant. Conclusion: The level of general job satisfaction was high. Though salaries were important, presence of conflict at work, freedom of expression, managerial support for staff welfare, managerial support for staff career development, availability of tools and consumables in the workplace and progress towards personal professional goals appear to play a role in worker motivation.
Sacrococcygeal teratoma: Clinical characteristics and long-term outcome in Nigerian children
(Annals of African Medicine, 2009-02-02) Chirdan, L.B.; Uba, A. F.; Pam, S.D.; Edino S.T.; Mandong B.M.; Chirdan O.O.
Background/Purpose: The excision of sacrococcygeal teratoma (SCT) may be associated with significant long-termmorbidity for the child. We reviewed our experience with SCT in a tertiary health care facility in a developing country with particular interest on the long-term sequelae. Methods: Between January 1990 and May 2008 inclusive, 38 consecutive children with the diagnosis of SCT were identified from the operation register and the Cancer Registry of the Jos University Teaching Hospital. Their clinical presentation, investigation, operative fi ndings, histology report, and outcome were recorded and analyzed. The long-term follow-up of some of the patients were also recorded and analyzed. Results: There were 31 females and 7 males. Twenty-three patients presented during the neonatal period with a median age at presentation of 7 days (range 1-18 days) and a median weight at presentation of 2.8 kg (range 2.0-3.6kg), 10 presented between 1 month and 12 months, while 5 were older than 1 year at presentation. Most of the patients had signifi cantly external tumors. Excision of the tumor was mainly by the sacral route, four had abdominal-sacral excision. Histology was mainly benign; four were malignant at presentation. Four children with malignant disease had chemotherapy in addition to excision of the tumor. Eight had immediate post-operative wound-related complications while three children died, two of the deaths were related to anesthesia, while one died of colostomy complications. Twenty-one (60%) were followed up for a median duration of 6 years (range 1 month–8 years). Two (9.5%) had recurrent disease after primary excision; fi ve (23.8%) had some degree of functional impairment at the follow-up. Conclusion: While SCT is usually benign, recurrence, malignant transformations in patients who present late and long- term functional sequelae are problems that must be tackled by the care givers. A multi-center study may be necessary to characterize this disease in developing countries and assess the long-term functional sequelae in survivors.
Childhood cancers: Challenges and strategies for management in developing countries
(African Journal of Paediatric Surgery, 2009-07-07) Chirdan, L.B.; Bode-Thomas, F.; Chirdan, O.O.
The developing countries bear the greatest burden of childhood cancers as over 90% of the world’s children live in these countries. Childhood cancer in most instances is curable, but many children die from cancer because most children live in developing countries without access to adequate treatment due to high cost of treatment and poor organization in these countries. Initiatives to increase cancer care in developing countries would therefore include establishment of standard cancer care centres, manpower training, establishment of standardized management protocols, procurements of standard drugs and collaboration with international organizations.
Congenital aganglionic megacolon in Nigerian adults
(Nigerian Journal of Clinical Practice, 2011-06-02) Bakari AA; Gali Bata Mtaku; Ibrahim AG; Nggada HA; Ali N; Dogo D; Abubakar AM
Congenital aganglionic mega colon (Hirschsprung’s disease) is a motor disorder in the gut, due to a defect in the craniocaudal migration of the neuroblast originating from the neural crest that occurs during the first twelve weeks of gestation, causing a functional intestinal obstruction, with its attendant complications, in infants. Despite modern pediatric practice, with emphasis on early diagnosis, Hirschsprung’s disease is seen in adults in regions where perinatal care is limited. We report two cases of Nigerian adults with longstanding, recurrent constipation, getting relieved by laxatives and herbal enemata, and then presented to our Emergency Department with a history of progressive abdominal distention, colicky pain, occasional vomiting, and weight loss. Per rectal examination revealed a gripping sensation in the rectum, 10cm from the anal verge, with rectal fecal load. Barium enema showed a grossly distended proximal large colon, with high fecal retention, with the transition zone at the middle one-third of the rectum. Due to difficulty in bowel preparation of these patients, emergency laparotomy was done. The first case had a diverting sigmoid colostomy and later had a low anterior resection. The second case had a one-stage procedure. Histology of both the cases showed aganglionosis of the stenotic segment and a normal distal rectum. Both patients had complete resolution of the symptoms, without complications, in a three-year follow-up. The related literatures were reviewed. Hirschsprung’s disease should be considered in adults patient presenting with chronic constipation. Low anterior resection of the rectum would be a surgical option for the treatment of short and zonal segment of adult Hirschsprung’s disease.
Knowledge, treatment seeking and preventive practices in respect of malaria among patients with HIV attending Lagos University Teaching Hospital, Nigeria
(Tanzania Journal of Health Research, 2011-10-02) Akinwumi, A.; Akinyede A.; Charles O.; Olufunsho, A.; Sunday, O.O.; Duro, C.D.; Adebimpe, A.; Ademola, Y.
Abstract: The synergistic interaction between Human Immunodeficiency virus (HIV) disease and Malaria makes it mandatory for patients with HIV to respond appropriately in preventing and treating malaria. Such response will help to control the two diseases. This study assessed the knowledge of 495 patients attending the HIV clinic, in Lagos University Teaching Hospital, Nigeria. Their treatment seeking, preventive practices with regards to malaria, as well as the impact of socio – demographic / socio - economic status were assessed. Out of these patients, 245 (49.5 %) used insecticide treated bed nets; this practice was not influenced by socio – demographic or socio – economic factors. However, knowledge of the cause, knowledge of prevention of malaria, appropriate use of antimalarial drugs and seeking treatment from the right source increased with increasing level of education (p < 0.05). A greater proportion of the patients, 321 (64.9 %) utilized hospitals, pharmacy outlets or health centres when they perceived an attack of malaria. Educational intervention may result in these patients seeking treatment from the right place when an attack of malaria fever is perceived.
Outcome of surgery for toxic goitres in maiduguri
(Nigerian Journal of Clinical Practice, 2012-10-02) Ali N; Madziga AG; Dogo D; Gali Bata Mtaku; Gadzama AA
Background: Thyrotoxicosis a common endocrine disorder of the thyroid gland in Nigeria is commonly treated surgically. The outcome of thyroidectomy for toxic goiters in Maiduguri Nigeria is evaluated. Materials and Methods: Over the last 5 years (Jan 2005-July 2010), in a prospective review, the demographic, and clinical data of patients operated for toxic goiters in our department was entered, into a predesigned proforma and analyzed. The objective of the study is to review our experience with subtotal and near-total thyroidectomy as treatment for benign toxic goiters. Results: Seventy-eight patients, 11 males (14.1%) and 67 females (85.9%), with male: female ratio of 1:6.1 and the mean age of 30 ± 10.9 (range, 17-65 years), underwent thyroidectomy for toxic goiters. The mean duration of symptoms was 41.9 (range 3-126 months). There were 53 patients with toxic diffuse goiters (Grave’s disease) with their mean age of 27.6 ± 6.93 (range 17-38 years), 23 with toxic multinodular goiters, the mean age of 43.7 ± 15.68 (range 17-65 years) and two with toxic nodule. There was no case of permanent recurrent laryngeal nerve palsy or permanent hypocalcemia. Transient hypocalcemia occurred in 9 (11.5%) patients and hemorrhage with hematoma, requiring exploration in 4 (5.1%). There were two cases of wound infection and no postoperative mortality. The mean hospital stay was 7.6 ± 2.34 (range 5-15 days). There was no disease recurrence over a mean follow-up of 20.7 (range 2-48) months. Conclusion: Subtotal thyroidectomy is an effective procedure for the treatment of thyrotoxicosis with few postoperative complications and majority of patients being euthyroid after long follow-up.
Supportive supervision: An effective intervention in achieving high quality malaria case management at primary health care level in Jos, Nigeria
(Annals of African Medicine, 2013-02-02) Bello, A.B.; Hassan, Z.I.; Afolaranmi T.O.; Tagurum, Y.O.; Chirdan, O.O.; Zoakah, A.I
Background: Supportive supervision is a form of supervision that promotes quality at all levels of health system by strengthening relationships within the system through prompt identification and resolution of problems among others. It is an effective intervention in improving health worker performance in low resource settings. Malaria is responsible for majority of outpatient consultations in Nigeria at all levels of care. Materials and Methods: This was a facility-based interventional study with pre and post-intervention phases conducted among two groups.The study subjects were selected through a multistage sampling technique and data collection was done using both semistructured interviewer administered questionnaire and supervisory checklist. Results: The mean knowledge scores of malaria within the intervention group showed an increase from 10.3 ± 1.4 at preintervention to 11.3 ± 1.5 at post-intervention (P < 0.0015). The proportion of respondents who correctly followed malaria management guidelines increased from 32.73% at first supervisory visit to 70.91% by the third supervisory visit (P < 0.001). An analysis of the supervisory checklist showed improvement in performance of healthcare workers with each supportive supervisory visit in most of the variables examined. Conclusions: This study has demonstrated that supportive supervision is a feasible and practicable tool in improving knowledge and practice of malaria case management among PHC workers.
Knowledge of commercial bus drivers about road safety measures in Lagos, Nigeria
(Annals of African Medicine, 2013-02-02) Okafor, I.P.; Odeyemi, K.A.; Duro, C.D.
Background/Objective: Road traffic injuries have persisted as a serious public health problem and much of the health burden is in developing countries. Over speeding, poor enforcement of traffic regulations and commuter buses have been highly implicated in road traffic injuries in developing countries. The aim of this study was to determine drivers’ knowledge of selected road safety measures, i.e. the pre requisites for driver’s license, road signs and speed limits. Materials and Methods: This was a cross sectional study carried out in Lagos, Nigeria. Simple random sampling was used to select the two motor parks used for the study and all the consenting commercial minibus drivers operating within the parks (407) were included in the study. Data was collected with a pre tested, structured, interviewer administered questionnaire and analyzed with epi info statistical software. Results: Two hundred and sixty one (64.1%) of them knew that Visual Acuity test should be done before obtaining driver’s license and 53.8% knew the correct minimum age for obtaining driver’s license. Only 1% of the drivers had correct knowledge of the driver’s license authorities in Nigeria. The drivers had poor knowledge of road signs (59.0%) and poor knowledge of maximum speed limits (100%). The oldest, least educated and least experienced drivers had the poorest level of knowledge. Conclusion: The drivers demonstrated poor knowledge of road safety measures. There is need for driver education to improve their knowledge