Background:The burden of obstructive sleep apnea among commercial drivers in Nigeria is not known.Aim:To assess the prevalence of high risk of obstructive sleep apnea (OSA) and excessive daytime sleepiness (EDS) among intra-city commercial drivers.Setting and Design:A descriptive cross-sectional study in three major motor parks in Lagos metropolis.Materials and Methods:Demographic, anthropometric and historical data was obtained. The risk of OSA and EDS was assessed using the STOP BANG questionnaire and the Epworth Sleepiness Scale, respectively.Statistical Analysis:The relationship between the OSA risk, EDS risk and past road traffic accident (RTA) was explored using the Pearson's chi square. Independent determinants of OSA risk, EDS risk and past RTA, respectively, were assessed by multiple logistic regression models.Result:Five hundred male commercial drivers (mean age (years) ±SD = 42.36 ± 11.17 and mean BMI (kg/m2) ±SD = 25.68 ± 3.79) were recruited. OSA risk was high in 244 (48.8%) drivers and 72 (14.4%) had EDS. There was a positive relationship between OSA risk and the risk of EDS (Pearson's X2 = 28.2, P < 0.001). Sixty-one (12.2%) drivers had a past history of RTA but there was no significant relationship between a past RTA and either OSA risk (X2 = 2.05, P = 0.15) or EDS risk (X2 = 2.7, P = 0.1), respectively. Abdominal adiposity, regular alcohol use and EDS were independent determinants of OSA risk while the use of cannabis and OSA risk were independent determinants of EDS. No independent risk factor for past RTA was identified.Conclusion:A significant proportion of commercial drivers in Lagos metropolis are at high risk of OSA and EDS.

The validity of self-reported smoking is questionable because smokers are inclined to deny smoking. We aimed to determine the prevalence of self-reported smoking among intra-city commercial drivers in Lagos, and assess its validity based on urinary cotinine assessment. This study was conducted at three major motor parks in Lagos, Nigeria. Information on smoking status and habits was obtained from 500 consecutive male drivers using a structured questionnaire during a face-to-face interview. Eighty-one self-reported smokers and non-smokers were selected by systematic random sampling for urinary cotinine assessment using cotinine strips. The prevalence of self-reported smoking was compared to the prevalence of smoking based on urinary cotinine and the specificity and positive predictive values of self-reported smoking was determined. Prevalence of self-reported current smoking was 32% and 17.9% of non-smokers were passive smokers. Among 81 drivers in whom urinary cotinine assessment was performed, the prevalence of smoking based on self-report was 34 (42%) compared to 41 (50.6%) when based on urinary cotinine, (X2=38.56, P<0.001). The rate of misclassification among self-reported non-smokers as smokers was 21.3% and misclassification rate for self-reported smokers as non-smokers was 8.8%. The sensitivity of self-reported smoking in accurately classifying smoking status was 91.2% and the specificity was 78.7%. The prevalence of self-reported cigarette smoking among commercial drivers in Lagos is high and a significant proportion of self-reported non-smokers are passive smokers. Self-reported smoking status obtained during face-to-face interview appears unreliable in obtaining accurate smoking data in our locality.

Background. Post-tuberculosis (TB) lung disease is a recognised cause of chronic respiratory disease, and its impact on health-related quality of life (HRQoL) has not been extensively described. Objective. To describe the clinical profile, spirometry impairment and impact of post-TB lung disease on HRQoL among patients attending two tertiary hospitals in Lagos, Nigeria. Methods. We conducted a cross-sectional study and obtained data through interviews, chart reviews and physical examination. We measured dyspnoea severity using the Medical Research Council (MRC) scale, HRQoL with the St George's respiratory questionnaire (SGRQ) and performed spirometry. Univariate regression was used to explore the associations between selected variables and HRQoL. Results. A total of 59 participants were recruited and their median (interquartile range (IQR)) age was 45 (36 -60) years. The most frequent symptom was cough (93.2%; n=55) and sputum production (91.5%; n=54). Less than two-thirds of the participants (62.4%; n=38) had received treatment for TB on more than one occasion, 50.8% (n=30) had moderate to very severe dyspnoea on the MRC scale and 88.7% (n=47/53) had abnormal spirometry with the mixed pattern predominating in 56.6% (n=30) of the participants. The mean (standard deviation (SD)) SGRQ component score for symptoms was 43.89 (18.66), followed by activity (42.50 (22.68)), impact (29.41 (17.82)) and total components (35.78 (17.25)). Dyspnoea, cough, sputum production and weight loss were associated with worsened HRQoL. Conclusion.Post-TB lung disease was characterised by a high symptom burden, severe spirometry impairment and poor HRQoL. There is a need for increased recognition and development of guidelines for diagnosis and treatment of post-TB lung disease and for further studies to explore preventive strategies. Keywords. tuberculosis; post-TB; TB sequelae; health-related quality of life; chronic respiratory diseases.

Background: This study aimed to assess the prevalence of cigarette smoking among medical students, and to determine their level of knowledge regarding risk associated with cigarette smoking and their attitude and behavior towards tobacco control strategies and policies. Materials and Methods: A stratified random sampling approach was used to select participants. A modified version of the the Global Health Professional Students Survey questionnaire was self-administered. Descriptive statistics were applied and comparisons were done using chi-square test. Multivariate logistic regression was used to obtain the significant determinants of smoking. A P < 0.05 was considered significant. Results: A total of 250 students participated in the study with a response rate of 89.2%. The mean age (years) was 21.4 ± 3. Rate of ever smoking and current smoking was 9.6 and 1.2%, respectively. Age > 21, having a smoking father, and use of alcohol were significantly associated with ever smoking. Knowledge of smoking as a risk for emphysema was 72.8%, coronary artery disease 82.8%, stroke 68.8%, and low birth weight 76.4%. There were 103 (41.2%) students aware of antidepressant usage in smoking cessation. One hundred and ninety-five (78%) offered smoking cessation advice if a smoker had no smoking-related disease and did not seek their opinion about smoking, 68.8% affirmed to having adequate knowledge on smoking cessation, and 56.8% had received formal training on smoking cessation techniques. The ban on cigarette smoking in enclosed public places was supported by 92.4%. Conclusions: The prevalence of current cigarette smoking among medical students in Lagos is relatively low. Gaps exist in the level of knowledge of the students regarding risks of cigarette smoking, tobacco cessation strategies, and in their attitude and behavior towards offering tobacco cessation advice. There is need therefore to include formal training on tobacco control strategies at an early stage in the medical curriculum. RésuméFond: Cette étude visait à évaluer la prévalence du tabagisme chez les étudiants en médecine et de déterminer leur niveau de connaissance au sujet du risque lié à l'usage de la cigarette et leur attitude et de comportement à l'égard des politiques et des stratégies de lutte antitabac. Matériel et Méthodes: Approche d'échantillonnage aléatoire un stratifié a été utilisé pour sélectionner les participants. Une version modifiée de la questionnaire Global Health Professional étudiants sondage était autogéré. Statistiques descriptives ont été appliqués et comparaisons ont été effectuées à l'aide de test Khi-deux. Régression logistique multivariée a été utilisée pour obtenir les déterminants significatifs du tabagisme. Une P < 0,05 était considérée comme significative. Résultats: Un total de 250 étudiants ont participé à l'étude avec un taux de réponse de 89,2%. L'âge moyen (années) était de 21,4 ± 3. Taux de jamais fumer et tabagisme actuel était de 9,6 et 1,2%, respectivement. Âge > 21, d'un père fumeur et la consommation d'alcool étaient...

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