OBJECTIVEKnowing tuberculosis (TB) patients’ satisfaction enables TB program managers to identify gaps in service delivery and institute measures to address them. This study is aimed at evaluating patients’ satisfaction with TB services in southern Nigeria.MATERIALS AND METHODSA total of 378 patients accessing TB care were studied using a validated Patient Satisfaction (PS-38) questionnaire on various aspects of TB services. Factor analysis was used to identify eight factors related to TB patient satisfaction. Test of association was used to study the relation between patient satisfaction scores and patient and health facility characteristics, while multilinear regression analysis was used to identify predictors of patient satisfaction.RESULTSHighest satisfaction was reported for adherence counseling and access to care. Patient characteristics were associated with overall satisfaction, registration, adherence counseling, access to care, amenities, and staff attitude, while health system factors were associated with staff attitude, amenities, and health education. Predictors of satisfaction with TB services included gender, educational status, if tested for HIV, distance, payment for TB services, and level and type of health-care facility.CONCLUSIONPatient- and health system–related factors were found to influence patient satisfaction and, hence, should be taken into consideration in TB service programing.

Most reports of Multisystem Inflammatory Syndrome (MIS-C) have come from Europe and North America. The paucity of reports in Africa is in contrast with the demographics of the series in New York, Paris and UK with children of African ancestry accounting for over 40%, of all cases of MIS-C. With the global trend of higher prevalence of MIS-C in children of African ancestry, enhanced surveillance and awareness for this syndrome in children with COVID-19 in Africa are therefore important. A case report of a 12-year old Nigerian girl with MIS-C is presented in line with the WHO global surveillance especially in areas were MIS-C is considered a rarity. This case report stimulates a call for vigilance and expanded effort at surveillance to promote early recognition and diagnosis of MIS-C in Nigeria and Africa. The favourable outcome and experience from this case will create awareness, expand knowledge, and support clinicians in Nigeria and the African continent in their approach to other potential cases.

Toxic Epidermal Necrolysis (TEN) is classified as severe cutaneous adverse reaction. It can be induced by drugs, infection, and malignancy or can be idiopathic. We present a 62‐year‐old male of Indian origin with a widespread, tender, erythematous maculo‐papular eruption and targetoid lesions on the palms and soles. He had a history of multiple myeloma and a stem cell transplant in 2008. He was recently started on amoxicillin for a suspected lower respiratory tract infection and lenalidomide, septrin and allopurinol 6 weeks prior to presentation due to a relapse of the myeloma. The rash evolved into large areas of flaccid blistering (over 30% of the body surface area) with severe mucosal involvement (Fig.1a) and a diagnosis of TEN was made.

Identifying AKI associated with DEG is difficult. Detailed drug history, increasing metabolic acidosis, and multiorgan deterioration despite peritoneal dialysis should arouse suspicion. Simple diagnostic tests need to be developed and facilities for hemodialysis of infants and financial support provided. Recurrences can be prevented by creating awareness, improving manufacturing practices, field-testing of drugs, and international monitoring of pharmaceuticals imported for manufacture.