IntroductionDevelopments in rapid diagnostic tests (RDTs) have opened new possibilities for improved remote malaria diagnosis that is independent of microscopic diagnosis. Studies in some settings have tried to assess the influence of RDTs on the prescribing behaviour of health workers, but such information is generally lacking in Nigeria and many parts of sub-Saharan Africa. This study analysed health workers' perceptions of RDTs and their potential influence on their prescribing and treatment practices after their introduction.MethodsThe study was conducted in four health centers in the Enugu East local government of Enugu State, Nigeria. All 32 health workers in the health centers where RDTs were deployed were interviewed by field workers. Information was sought on their perception of symptoms-based, RDT-based, and microscopy-based malaria diagnoses. In addition, prescription analysis was carried out on 400 prescriptions before and 12 months after RDT deployment.ResultsThe majority of the health workers perceived RDTs to be more effective for malaria diagnosis than microscopy and clinical diagnosis. They also felt that the benefits of RDTs included increased use of RDTs in the facilities and the tendency to prescribe more Artemisinin-based combination therapies (ACTs) and less chloroquine and SP. Some of the health workers experienced some difficulties in the process of using RDT kits. ACTs were prescribed in 74% of RDT-negative results.Conclusions/SignificanceRDT-supported malaria diagnosis may have led to the overprescription of ACTs, with the drug being prescribed to people with RDT-negative results. However, the prescription of other antimalarial drugs that are not first-line drugs has been reduced. Efforts should be made to encourage health workers to trust RDT results and prescribe ACTs only to those with positive RDT results. In-depth studies are needed to determine why health workers continue to prescribe ACTs in RDT-negative results.

Background: The doctor-patient relationship has been linked to patient satisfaction, treatment adherence and outcome. It remains the cornerstone of medical practice though may be affected in this era of COVID-19 pandemic. The objective of the study was to determine the effect of COVID-19 pandemic on the doctor-patient relationship.Methods: The study was a cross-sectional study conducted in a tertiary health facility in Enugu State South-East Nigeria. It involved all the doctors working in the hospital as at the time of data collection. Patients that attended the general out-patient clinic of the hospital were selected using convenience sampling. One hundred and eighty six (186) doctors and 155 patients participated in the study. A similarly structured self-administered questionnaire was used to collect data from both the doctors and the patients.Results: There was disparity in some of the studied aspect of the doctor-patient relationship as reported by the doctors and the patients. The prominent being the social distancing practice which almost all the patients (91.6%) said that it has affected their relationship with their doctors while only about half of the doctors (52.7%) agreed to this assertion. However both parties agreed that the level of physical examination have reduced to the barest minimum.Conclusions: The present COVID-19 pandemic have affected the doctor-patient relationship adversely.

IntroductionOnchocerciasis or river blindness constitutes a major burden to households especially in resource-poor settings, causing a significant reduction in household productivity. There has been renewed interest from policy makers to reduce the burden of Neglected Tropical Diseases (NTDs) such as onchocerciasis on individuals and households. This paper provides new information on the patient’s perceptions of onchocerciasis and its economic burden on households in South-eastern Nigeria. The information will be useful to health providers and policy makers for evidence-informed resource allocation decisions.MethodsInformation was generated from a cross-sectional household survey conducted in Achi community, Oji River Local Government Area (LGA) of Enugu State, Southeast Nigeria. A pre-tested interviewer-administered questionnaire was used to collect data. A total of 747 households were visited randomly and data were collected using pre-tested interviewer administered questionnaire from 370 respondents. The respondents’ knowledge of the cause of symptoms of the disease, costs incurred for seeking treatment and productivity losses were elicited. Data were analyzed using tabulations and inferential statistics. A socio-economic status (SES) index was used to disaggregate some key variables by SES quintiles for equity analysis.ResultsMany people had more than one type of manifestation of onchocerciasis. However, more than half of the respondents (57%) had no knowledge of the cause of their symptoms. Male respondents had significantly more knowledge of the cause of symptoms than females (P = 0.04) but knowledge did not differ across SES (P = 0.82). The average monthly treatment cost per respondent was US$ 14.0. Drug cost (US$10) made up about 72% of total treatment cost. The per capita productivity loss among patients was US$16 and it was higher in the poorest (Q1) (US$20) and the third SES quintiles (Q3) (US$21). The average monthly productivity loss among caregivers was US$3.5.ConclusionOnchocerciasis still constitutes considerable economic burden on patients due to the high cost of treatment and productivity loss. Prioritizing domestic resource allocation for the treatment of onchocerciasis is important for significant and sustained reduction in the burden of the disease. In addition, focused health promotion interventions such as health education campaigns should be scaled up in onchocerciasis-endemic communities.

Background: The risk of acquiring blood borne infections by healthcare workers (HCWs) in developing countries is accentuated by the high prevalence of blood borne infections, poor provision of personal protective equipment (PPEs), negative socio-cultural factors and poorly maintained healthcare systems. The objective was to determine the prevalence of occupational accidents among HCWs in a tertiary health facility in Enugu state, South-East Nigeria.Methods: A descriptive cross-sectional study that used mixed method technique. The quantitative data was collected using a self-administered questionnaire while an in-depth interview (IDI) guide was used for the qualitative data. Manual content analysis was done for the qualitative data while the quantitative data was analysed using SPSS version 22. The significance level placed at p<0.05.Results: The prevalence of mucous membranes exposure to blood/body fluids were the same in the past 6 and 12 months (22.0%) while the mean number of exposures were 3.93±3.002 and 4.47±4.008 respectively. The prevalence of needle stick or sharps injury in the past 6 and 12 months were 17.0% and 23.0% while the mean numbers of injuries were 2.24±2.001 and 2.48±2.858 respectively. The injuries occurred majorly while recapping needles and breaking injection ampoules. Emergent themes from the IDI were also recapping of needles and breaking of injection ampoules.Conclusions: There is still high prevalence of occupational accidents among the studied HCWs training and re-training of HCWs on the dangers associated with these occupational accidents.