Objective We determined the prevalence of poor glycemic control and associations with sociodemographics, comorbid conditions, and medication adherence among patients with type 2 diabetes mellitus (T2DM) at a tertiary hospital in southwestern Nigeria. Methods We conducted a retrospective observational study among 300 patients with T2DM using systematic random sampling. We used a semi-structured questionnaire to collect information on respondents’ sociodemographic profile, lifestyle, comorbid conditions, and antidiabetic medications. Adherence was determined using the Morisky Medication Adherence Scale. Fasting blood samples were tested using a glycated hemoglobin marker. Multivariate logistic regression was used to identify factors associated with poor glycemic control. Results Respondents’ mean age was 61.9 ± 11.8 years. The prevalence of poor glycemic control was 40.0% (95% confidence interval [CI]: 34.4%–45.8%). The adjusted odds ratio (95% CI) for factors associated with poor glycemic control was 2.522 (1.402–4.647) for older age, 1.882 (1.021–3.467) for low income, 1.734 (1.013–3.401) for obesity, 2.014 (1.269–5.336) for non-initiation of insulin therapy, and 1.830 (1.045–3.206) for poor medication adherence. Conclusion Older age, lower income, obesity, non-initiation of insulin, and poor medication adherence were associated with poor glycemic control. These variables may help clinicians identify patients at high risk of poor glycemic control.
Background: The use of drugs with anticholinergic effects among elderly patients is associated with adverse clinical outcomes. There is paucity of information about anticholinergic drug burden among Nigerian elderly population.Objectives: To determine the anticholinergic drug burden among elderly Nigerian patients.Methods: This was a retrospective cross-sectional study conducted among elderly patients (aged 65 and above) who visited the Family Medicine outpatients’ clinics of the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria between July 1 and October 31, 2018. Information extracted from the case files included patient’s age, sex, diagnoses, and list of prescribed medications. Medicines with anticholinergic effects were identified and scored using the anticholinergic drug burden calculator (http://www.acbcalc.com).Results: The medical records of 400 patients were analyzed with females accounting for 60.5% of the study population. The mean age of participants was 73 ± 7.4 years with only 28 (7%) of patients having more than two co-morbid conditions. Polypharmacy was identified in 152 (38%) of the patients while 147 (36.7%) had drugs with anticholinergic effects prescribed. The anticholinergic burden was high in 60 (15%) patients. Polypharmacy was significantly associated with having more than two diagnosed conditions and high anticholinergic burden (p value of < 0 .001 and 0.013 respectively). There was significant correlation between total number of prescribed drugs and count of diagnoses (r = 0.598; p < 0 .000) and between total number of prescribed drugs and number of drugs with anticholinergic effects (r = 0 .196; p < 0 .000).Conclusion: The anticholinergic burden in this group of elderly Nigerian patients was low; majority (67%) had no exposure to drugs with anticholinergic effects with only 15% having high anticholinergic burden. Polypharmacy and multiple diagnosed conditions were positively associated with high anticholinergic burden. Based on the positive and significant correlations found in this study, a reduction in the number of prescribed medicines especially those with significant anticholinergic effects used for secondary indications may lessen the anticholinergic burden among the elderly.
Many developing countries like Nigeria lack policy for the care of the older adults and this creates major challenges for the elderly population. The traditional family institution and community support that used to be safety nest are being adversely affected by westernization. This development might have adverse effect on life satisfaction among the older adults. This hospital based cross-sectional study was designed to determine the association between support and life satisfaction among older adults. A total of 128 subjects participated in the study out of which 28.9% were satisfied with life. Expectation of support was mainly from the family, less from the community and very low from the government. The level of support received from all sources generally fell short of expectations. Marital status and source of livelihood were significantly associated with life satisfaction. There is inadequate social support from the government and support from family and community fell below expectations. Expectations of support were the most strongly correlated with life satisfaction. Support for older adults must be addressed in order to meet their expectations and improve their level of satisfaction with life.
Background: National surveys indicate that among countries in Africa where malaria is endemic, Nigeria alone accounts for 21% of pregnancies that are unprotected from malaria. This study aimed to ascertain the extent of utilization and effectiveness of malaria prevention methods, found out the existing relationship between maternal parasitaemia and the effectiveness of these methods at (p<0.05) level of signicance.Methods: The study was a cross sectional survey involving 264 consenting pregnant women who were recruited at booking clinic at Federal Teaching Hospital, Ido -Ekiti, Ekiti State, Nigeria. Interviewer administered questionnaire was used to elicit information on their socio-demographic characteristics, mode and extent of utilization of malaria prevention methods and their effectiveness. Venous blood samples were collected and analyzed for malaria parasitaemia using the microscopy. Data was analyzed using SPSS version 20.0 Results:The malaria prevention methods most commonly reported as being effective were the Insecticide Treated Nets (ITNs), Indoor Residual Spray (IRS) or both, which were utilized by 97(36.5%), 79 (30.0%) and 88 (33.4%) participants respectively. Eight (8.3%), 9 (10.8%), and 7 (7.9%) of the participants that used ITNs, IRS or both combination respectively tested positive for malaria parasitaemia. There was a statistically signicant association between maternal parasitaemia and malaria prevention methods using ITNs (p=0.001), IRS (p = 0.001) or both (p = 0.001).Conclusion: The most commonly adopted malaria prevention methods were ITNs, Indoor Residual Spray or both. Despite their protective effectiveness, their utilizations are still poor. Information and communication strategies by the stakeholders are suggested to improve the utilization of these methods as adopted by other countries.
Background: Caesarean delivery is an essential surgical skill within the primary care setting aimed at reducing maternal morbidity and mortality. Objectives: To determine the rate and indications for caesarean deliveries with a view to improving on the service delivery in the study area. Methods: A retrospective review of all caesarean deliveries over a five-year period, January 1st, 2012 to December 31st, 2016. Results: A total of 2321 deliveries were recorded during the study duration and 481 of them were through caesarean sec- tion (CS) giving a caesarean section rate of 20.4%. The rate was higher in the multigravida 255 (53.1%). The commonest indication for caesarean section was previous caesarean section 131 (27.2%). Emergency caesarean delivery accounted for 278 (57.8%). Only 16 (3.3%) stayed more than five days postoperatively while the rest, 465 (96.7%), stayed less than five days. There was a gradual yearly increase in rate from 12.1% in 2012 to 19.5% in 2016. Conclusion: The rate of CS in this study has shown a gradual yearly increase with emergency CS having a higher percentage. Early diagnosis and referral of high-risk pregnancies from peripheral hospitals could reduce emergency CS among the study population. Keywords: Caesarean section; rate; secondary healthcare; Nigeria.
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