Background Congenital Heart Disease (CHD) places an enormous economic burden on families of affected children in Nigeria. This study sought to determine the healthcare costs of pre-surgical management of CHD and describe its effects on the family’s income.Methods Using a semi-structured interviewer-administered questionnaire, family income, type of CHD, co-morbidity, healthcare payment mechanism and healthcare cost were investigated among 121 families with CHD children. Indicators of Catastrophic Health Expenditure (CHE); healthcare spending in excess of 10% family income were calculated. Factors associated with increased healthcare spending in CHD management were explored using the Kruskal Wallis test of significance.Results Of the 121 parents interviewed, about 80% paid for healthcare using out-of-pocket payment mechanism. Mean annual total cost of healthcare was ₦87,951± ₦120,213 ($244.31± $333.92) with direct medical care accounting for 81.0% of this total annual cost. Mean annual consultation, medication, investigation and admission cost were ₦5,515 ($15.32), ₦57,882 ($160.78), ₦30,462 ($84.62) and ₦87,789 ($243.86) respectively. Mean estimated annual indirect cost was ₦19,233 ± ₦31,722 ($53.42 ± $88.12). Incidence of CHE was 35.5% while catastrophic overshoot and mean positive overshoot attributable to CHD healthcare cost were 6.5% and 32.9% of family income respectively. Healthcare cost was significantly higher in families of children with co-morbidities (p = 0.016) and those who suffered financial catastrophe (p = 0.001). Health insurance did not significantly reduce healthcare spending among the insured.Conclusion The economic burden of pre-surgical management of children with CHD is high in Nigeria. There is the need to scale up the inclusion of CHD under the National health insurance scheme.

Background: Understanding the safety culture of health care providers can help administrators improve patient safety. However, it is difficult to measure complex constructs such as safety culture without valid and reliable tools. This study determined the measurement properties of the ambulatory version of the safety attitude questionnaire (SAQ-AV) in the Nigerian clinical setting.Methods: A multiphase, iterative research involving clinical staff in primary and tertiary level of care in South-south Nigeria. The phases included face and content validity by subject experts, pretesting with clinical staff and a field validation involving 812 clinical staff. The acceptability, reliability (internal consistency), and validity (face, content, and construct) of the SAQ-AV were determined. All quantitative analysis was conducted using the SPSS Version 22 statistical package with statistical significance set at a P value of less than 0.05. Results:A response rate of 53.7% was obtained during the field validation study. The item nonresponse rates were less than 10%, whereas extremes of the response scale were frequently endorsed. The internal consistency of the scale was good (Cronbach's α of 0.91 for entire scale and ranged from 0.62 to 0.76 among the different domains of the tool). Patient safety culture scores from primary and tertiary health care facilities assessed were significantly different. Conclusions:The SAQ-AV is an acceptable, reliable, and valid tool for use in assessing patient safety culture in ambulatory settings in Nigeria. There is a need to determine its dimensionality and factor structure in future research.

The government of Nigeria ordered closure of schools to slow the spread of COVID-19 when the pandemic hit the country. About 5 months into the outbreak, secondary schools have been reopened to allow students to write their terminal examinations. Many state governments and school owners are fumigating their schools as a way of disinfecting the school environment and ensuring safe resumption of academic activities. We discuss the undue attention given to fumigation in this instance and stress the importance of addressing more beneficial and sustainable strategies to prevent COVID-19 in Nigerian schools.

Background: Suicidality is a broad term that encompasses suicidal ideation, suicide plans and suicide attempts. Suicide cuts across all age groups however the young adulthood phase is a critical time for the onset of suicidal behaviours. Often suicide is underreported because of the shame, as such it is a neglected public health problem in our environment. This study seeks to describe the pattern of suicidality and reported health seeking behaviour amongst young people in Bayelsa State.Methods: A descriptive cross-sectional study conducted in the national youth service corps orientation camp, Bayelsa amongst 387 corps members. With the aid of an electronic, self-administered questionnaire adapted from the WHO STEPwise manual on non-communicable diseases; information on socio demographic features, suicide ideation, plan and attempt were obtained. Data was analysed using IBM SPSS version 25.0.Results: The mean age was 25.37 (SD±2.38) years. Most participants were males (58.9%) and single (95.3%). Prevalence of suicidal ideation, plans and attempts was 7.5%, 4.4% and 3.1% respectively. Above one third (35.4%) of those who made suicidal plans in the past 12 months, actually attempted suicide, 4.4% and 2.6% of the respondents had a positive family history of suicide attempt and suicide death respectively.Conclusions: Young adults are a critical population for suicidality. Public health awareness on mental health promotion and uptake of mental health service should be encouraged. Decriminalisation of attempted suicide in Nigeria and better surveillance will enable more effective suicide prevention strategies.

Background: Foetal mitral annular plane systolic excursion (fMAPSE) helps in the evaluation of the left foetal cardiac function, which is key in the early diagnosis of congenital heart defects and abnormalities. Objectives: To assess foetal MAPSE in the second half of normal pregnancy, to establish reference ranges for this measurement in our environment, and to determine the relationship between foetal MAPSE and gestational age and estimated foetal weight. Materials and Methods: This descriptive cross-sectional study was conducted between March 2022 and August 2022 at the Obstetric Units and Radiology Departments of the two tertiary facilities, one secondary facility and one radiodiagnostic facility in Bayelsa State, Nigeria. Consenting pregnant women presenting to the antenatal clinics of the study centres during the second half of pregnancy were consecutively included. Obstetric ultrasound scans were was transabdominally. Data were analysed using SPSS version 25. Results: The correlation coefficient (ɼ) between fMAPSE and gestational age was 0.21 with a p-value of 0.001, reflecting a significant but weak relationship between fMAPSE and gestational age. There was a positively weak but significant relationship (ɼ = 0.29; p -0.001) between fMAPSE and estimated foetal weight. Conclusion: Our study revealed that there was a significant relationship between fMAPSE and gestational age, and between fMAPSE and estimated foetal weight, which correlates with published data around the globe.