Prevalence, Awareness and Risk Factors for Hypertension in Adults Attending a Tertiary Hospital in South-East Nigeria

Hypertension, a non-communicable disease, is considered a major public health challenge because of its widespread prevalence globally coupled with its huge morbidity and mortality burden, which is largely preventable if early detection and prompt initiation of management are done. Hypertension prevalence is increasing especially in the developing world, despite this, its awareness among the general population is low. This study aimed at determining the prevalence of hypertension among adult attendees of the General Outpatient Clinic of the Federal University Teaching Hospital (FUTH), Owerri, with an assessment of the proportion of hypertensives who were aware of their hypertensive status, and identifying risk factors of hypertension in the study participants. A cross-sectional analytical study was conducted between October and November 2022 at the General Outpatient Clinic of the FUTH, Owerri. A total of 257 consenting and eligible adult patients made up of 135 males and 122 females, aged 18 years and above, were selected by systematic random sampling method. The overall prevalence of hypertension was 34.6%. The prevalence was higher in females than in males (37.7% vs 31.9%, P = 0.325). Among the hypertensive subjects 56.2% had awareness of their hypertensive status. Following a multiple regression analysis, hypertension was independently associated with age, family history of hypertension, occupation (retirees, traders, farmers and the unemployed), and marital status (being widowed). Hypertension is prevalent in our environment;the prevalence rate from this study is higher than in most studies in our environment, suggesting possibly, a rising burden. The results from the study underscore the need for increased and sustained advocacy for implementation of policies and programs directed at increased detection and management of hypertension in the different population groups such as annual wellness check for employees in the formal sector, largescale dietary and lifestyle adjustments, and know your numbers (an approach to population driven blood pressure check for all adults). Also, health workers should use any opportunity of contact with a patient to screen for hypertension.

Retro-Viral Disease Status of Patients on DOTS Tuberculosis Treatment Strategy in a South-East Nigeria Teaching Hospital

Introduction: Tuberculosis is associated with HIV/AIDS and it has been recognized as one of the most frequent opportunistic infections in persons with HIV. Tuberculosis is the leading cause of death in people with HIV having an adverse effect on HIV progression. Objectives: The objective is to determine the retroviral disease status of patients on the DOTS strategy. Materials and Methods: A retrospective study of patients was seen at the University of Nigeria Teaching Hospital from January 2013 to April 2015. Relevant information was collected from patients’ folders. Statistical analysis was done with the SPSS and results were represented in tables. Results: 171 patients (77%) were HIV negative while 51 (23%) were positive giving an HIV negative/HIV positive ratio of 3.35:1. 97 patients (43.7%) had 6 months duration of treatment. The least was 2 patients (0.9%) that complied with their medication for 7 months. The 61 - 70 years age group accounted for the least number of HIV-positive patients. Conclusion/Recommendations: There is strong tuberculosis/HIV co-infectivity among the studied population. Strategies to reduce the burden of TB/HIV co-infection should be strengthened.

The Stigma of Epilepsy among Outpatients in a Tertiary Hospital in South-East Nigeria

Background: The stigma of epilepsy is pervasive in developing country contexts and negatively affects the psychological and social wellbeing of its sufferers. The experience of stigma varies across settings and probably relate to disease severity and social characteristics. This study sought to describe the extent and correlates of perceived and enacted stigma among outpatients with epilepsy. Methods: The participants were consecutively presenting epilepsy outpatients in a tertiary facility that attended clinic regularly and had no overt medical or psychiatric co-morbidities. The patients were interviewed with a semi-structured questionnaire. Results: There were 93 participants with a mean age of 30.2 ± 10.3 years and 57.0% were males. The experience of stigma was reported by 46.2% and 67.7% of the participants for perceived and enacted stigma, respectively. Over one-third of the patients had suffered burns or a similar injury in the past. The correlates of perceived stigma were rural residence, lower levels of education, and longer duration of illness. Gender, age and frequency of seizures were not statistically significant determinants. The correlates of enacted stigma were being single, older age, rural residence, and longer duration of epilepsy. A past history of burns and disclosure of epilepsy to individuals outside the family added to the likelihood of experiencing stigma. Conclusion: The burden of epilepsy related social stigma is high in Nigeria. Cultural stereotypes and misconception add to this. There is need for appropriate culture-congruent educational interventions to provide the right information about epilepsy and debunk the misconceptions and myths associated with the condition. This will need to be coupled with astute clinical management of cases and active case finding. Both qualitative and longitudinal quantitative studies would be required to deepen our understanding of the lived reality of grappling with stigma in our setting.

Universal Health Coverage and Healthy Living in South-East Nigeria: How Far with Mental Health?

Background: Universal health coverage implies access to key promoting, preventive, curative, and rehabilitative health interventions for all at an affordable cost, thereby achieving equity in access and service. The mentally-ill belongs to a vulnerable group that has not been given adequate attention especially in the south-eastern part of Nigeria. In September 2015, a health summit was organized in Enugu, South-East Nigeria with the sole aim of strategizing towards achieving universal health coverage in the zone. From all indications, much of the efforts being made towards achieving universal health coverage in the zone are geared towards physical conditions with mental disorders being grossly neglected. Purpose: This position paper briefly highlights the burden of mental disorders in South-East Nigeria;brings to fore the numerous challenges/barriers to effective mental health service delivery in the area;and calls for a positive change before a meaningful health coverage can be achieved in the zone (and by extension in the country). Findings: The burden of mental disorders in south-east Nigeria is heavy. Enormous barriers to mental health services in the area range from ignorance and stigmatization to self-marginalization by the unwillingness of many concerned leaders or hospital chief executives in the area to appreciate mental health and employ or increase the number of mental health professionals. Recommendations: All the stakeholders, from policy makers to consumers should wake up, recognize mental health as an indispensable part of health and take urgent and necessary measures that would ensure the promotion of mental health, prevention and treatment of mental disorders, and appropriate rehabilitation of those with mental illnesses in the zone.

The Bacteriological Profile of Surgical Site Infections in Orthopaedic Implant Surgeries in South-East Nigeria

Background: Knowledge of the common bacteria that cause surgical site infection (SSI) and their antibiotic sensitivity is mandatory if treatment of surgical infection is to be successful. The threat of the emergence of resistant strains of bacteria is ever-present. Hence, a sensitivity directed therapy is paramount for the successful eradication of organisms with minimal risk of development of antibiotic resistance. Aim: The aim is to identify the common bacteria that cause SSI in orthopaedic implant surgeries in our hospital. Method: This is a prospective longitudinal study that includes all orthopaedic surgeries involving the use of implants within one year. Patients that had major orthopaedic surgeries involving implant were followed up and their wounds inspected for signs of SSI on postoperative days 3, 7, 14, 42 and 90. Wound swab was taken for microscopy, culture and sensitivity analysis from those who had wound infection, based on the CDC guidelines. Results: One-hundred and sixteen patients met our inclusion criteria and were included in the analysis. There were 62 males and 54 females. The mean age of the participant was 39.62 years (SD = 15.02 years). Fracture fixation with plates and screws was the most common implant surgery done. The incidence of SSI was 2.6%, and Escherichia coli was the most common isolated pathogen. All the SSIs were superficial incisional type, and the infection was monomicrobial in 67% of cases and polymicrobial in 33%. All of the isolated pathogens were sensitive to Imipenem and Gentamycin. Conclusion: Superficial incisional SSI is the most common type of SSI in this study. Escherichia coli is the most frequent pathogen in SSI affecting implant surgeries in our hospital. Gentamycin and Imipenem should be used for the prophylaxis of SSI in our environment.

Fear of HIV Susceptibility Influencing Burden of Care among Nurses in South-East Nigeria

HIV/AIDS currently is a major cause of disability and mortality especially in sub-Saharan Africa. As the population affected by HIV/AIDS increases, so does the burden of this chronic disease and the challenges associated with caring. HIV scourge in Nigeria has been overwhelming since 1992 with debilitating impacts and this study presents the extent of fear of susceptibility and the level of caregivers burden among Nigerian nurses. To direct the study, three special objectives and one hypothesis were raised, which were to determine the extent of fear of susceptibility and perceived seriousness of HIV, to ascertain the percentage of nurses who tested to know their HIV status and the associated level of caregivers burden among nurses. The study also determined the relationship between fear of susceptibility and caregiver’s burden. A purposive sampling technique was used to select 210 nurses caring for people living with HIV/AIDS in the University of Calabar Teaching Hospital, Nigeria. Structured questionnaires and relevant validated scales such as Zarit Burden Interview [1] and abridged Champion Health Belief Model Scale [2] were used to elicit data. Results revealed that the majority of 41.0% respondents nursed fear of susceptibility despite the practice of universal precaution and perceived HIV as a serious and life threatening infection, 36.0% were not sure of their experience and 23% had no fear of HIV. 33.8% respondents experienced mild to moderate level of burden, 27.2% respondents experienced moderate to severe level of burden while 15.7% experienced severe burden. A Chi Square value of 68.2 at P < 0.05 was obtained showing a significant relationship between fear of susceptibility and caregivers burden. This paper discusses the implications of these findings for nursing and health care and recommends the implementation of educational opportunities to allay fears and minimize caregiver burden among nurses and other health care professionals.

Human Myiasis in Neonates and Children of the Niger Delta Wetlands and South-East Nigeria

Background: Myiasis is characterized by larval infestation of body tissues or cavities of living hosts. Although most frequently observed in underdeveloped and tropical countries, reports of human myiasis have been encountered throughout the world including temperate zones. Cases of human myiasis in Nigeria and most African countries are most probably underreported because many remain undiagnosed, unidentified or unpublished. We had conducted studies on myiasis earlier in 2006. Here we conducted preliminary studies in 2009 and went in the main studies between January and December 2010. Objectives: We assessed the infection rates of neonates and children of two ecological zones in Nigeria [Niger Delta and South-east]. Patients and Methods: We studied a cohort of 400 patients presenting different cases of myiasis in children within the age bracket 0-12 years. We extracted maggots from different parts of neonates, toddlers and children and our therapeutic approach was the application of cholesterol-free oil for extraction and the use of antibiotics to seal up the openings of wounds. Results: Dermatological data showed in neonates an overall infection rate of 16% in Enugu state [CI 95%, 15.2 - 16.2];4% in Anambra [CI 95%, 3.4 - 4.7];7% in Abia State [CI 95%, 6.1 - 7.4];11% in Imo [CI 95%, 10.3-11.7];20% in Ebonyi [CI 95%, 18.4 -2 1.6];7% infection in Rivers [CI 95%, 6.8 - 7.8];17% in Bayelsa [16.1 - 17.5] and 18% in Akwa Ibom [CI 95%, 17.7 - 18.8]. Based on their sites of infection, five different types of myiases were diagnosed. in neonates and children of the Niger Delta and South-east zones of Nigeria.

Incidence, Presentation and Management of Bartholin’s Gland Cysts/Abscesses: A Four-Year Review in Federal Teaching Hospital, Abakaliki, South-East Nigeria

Background: The Bartholin’s gland cysts and abscesses are one of the most common vulva cyst or abscesses in gynaecological practice. Symptomatic cases give significant discomfort to sufferers and have a negative impact on their quality of life. Objective: To investigate the incidence, pattern of presentation and management of Barthholin’s gland cysts and abscesses in the Federal Teaching Hospital Abakaliki (FETHA) Ebonyi State, Nigeria. Methodology: This was a four-year retrospective study of cases of Bartholin’s gland cysts and abscesses in FETHA. We studied all cases of Bartholin’s gland cysts and abscesses that were managed at the Federal Teaching Hospital Abakaliki from 1st January 2012 to 31st December 2015. Results: During the study period, there were 1015 gynaecological surgical cases of which 18 were for Bartholin’s gland cysts or abscess giving an incidence of 1.78%. The mean age of the patients was 28.8 ± 5.6 years with 61% of the patients within the age range of 21 to 30 years. The commonest risk factor that was found for the occurrence of Bartholin’s gland cyst or abscess was previous history of the disease in 14 (77.8%) followed by previous history of sexually transmitted diseases 8 (44.4%). Pain was the commonest presenting symptom in 14 (77.8%) of cases. The left vulva was the commonest site of disease as noted in 15 (83.3%) of patients. Escherichia coli and Staphylococcus aureus were the commonest isolates on swabs with 16 (88.9%) and 14 (77.8%) prevalence respectively. The disease presented commonly in form of abscess as observed in 10 (55.6%) of patients. All the patients had Marsupialization as the modality of treatment. Conclusion: Symptomatic Bartholin’s gland cyst and abscess cause significant morbidity for the sufferers and decreased quality of life. Accurate diagnosis and treatment is advocated to prevent chronicity and complications. Although options of treatment abound, Marsupialization remains the mainstay of treatment in low resource setting like ours.

Analysis of the Digital Skill Gap of Agricultural Extension Personnel in South-East, Nigeria

The study analysed the digital skill gap of agricultural extension personnel on the use of digital technologies for extension services delivery in South-East, Nigeria. The specific objectives were to describe the socioeconomic characteristics of agricultural extension personnel in South-East Nigeria and identify the digital skill gaps among agricultural extension personnel in the area of study. Purposive sampling technique was used to select 364 Agricultural Extension personnel for the study. Data were collected through the use of structured questionnaire and were analysed using simple descriptive statistical tools such as percentages, mean score, and standard deviation. Findings indicated that most of the personnel were male (57.8%), within the age bracket of 38 - 47 years (62.9%), had B.Sc./HND as their highest educational qualification (74.7%), married (86.3%), and had a household size of 6 - 10 Persons (57.7%). It was further revealed that the majority (70.1%) were members of professional organization, earned a monthly income of N50,001.00 - N100,000.00 (65.7%), had a work experience of 11 - 15 years (51.1%), and owned a smartphone/ iPad/laptop (91.5%). Findings further indicated that they had moderate skill gap in Basic Computer skills (Mean = 4.32), and digital communication and collaboration skills (Mean = 4.26). Findings also showed that they had a high skill gap in digital technical skills (Mean = 2.46), digital data analysis skills (Mean = 2.09), digital content creation skills (Mean = 2.43), digital ethical skills (Mean = 2.79), multimedia production skills (Mean = 2.81), and video library management skills (Mean = 2.39). The study concluded that though there exists a high digital skill gap among agricultural extension personnel in South-East, Nigeria, their socioeconomic characteristics are capable of supporting the implementation of digital extension services in the area. The study recommended that the management of Agricultural Development Programs in South-East, Nigeria, should provide digital training for extension personnel to close the digital skill gap that currently exists among the personnel.

Factors Confronting the Present-Day Construction Practices in South-East, Nigeria: The Professionals’ View

The study evaluates the factors confronting the present-day construction practices in South-East Nigeria. Being a survey research, questionnaires containing information relating to factors/challenges affecting construction practices were randomly administered to selected construction practitioners in South-Eastern States of Nigeria. Accordingly, a total of 240 questionnaires were administered to the selected respondents while 160 copies were completed, returned and found useful. Thus, giving a response rate of 66.67%. Data collected were analysed and presented using percentages, mean scores, principal and factor analysis, z-test and tables. The study found that the core factors that constrain present-day construction in the study area are issues related to inadequate/dearth of technical and managerial expertise, corruption and poor project planning and control;which significantly affect operational effectiveness of the construction industry in the study area. Therefore, the study concluded by recommending that thorough capacity building through training or retraining programme which should centre on areas of the issues identified should be religiously pursued in the study area.

The Prevalence of Cigarette Smoking and Knowledge of Its Health Implications among Adolescents in Owerri, South-Eastern Nigeria

Despite the growing problem of global cigarette use, accurate information on the prevalence and pattern in Nigerian adolescents’ remains sparse. The aim of this study was to determine the prevalence of cigarette smoking among in-school male adolescents in Nigerian population and to assess their level of knowledge on the health effects of cigarette smoking. A descriptive cross-sectional study was carried out among 944 randomly selected in-school male adolescents in Owerri, south-east Nigeria, between September and November 2013. Information was obtained using a self-administered questionnaire. The findings indicated a prevalence of 15.3% for ever smoked adolescents and 11.2% for current smokers. The mean age at cigarette smoking initiation was 14 years. Sixty-three percent had good knowledge of health problems associated with cigarette smoking. Lung cancer was the most reported associated health problem. Fifty-two (36.1%) indicated that they were initiated by their friends who offered them their first stick of cigarette. The major reason for smoking cigarette the first time was to be like their friends/role model and out of curiosity. Poor knowledge of health effects of smoking was statistically associated with cigarette smoking (X2 = 26.82, p-value < 0.001). Knowledge of health problems associated with smoking proved to be the major reason for not smoking by never smoked adolescents, which means that awareness creation on health problems associated with cigarette smoking through health education in schools coupled with stiff legislative ban on sale of cigarette to adolescents will, to a reasonable extent, reduce the high prevalence of adolescent cigarette smoking in our society.

Impact of Past Mining Activities on Water Resources Around Active and Abandoned Mines and Quarries in Ebonyi State,South-Eastern Nigeria-A Mini Review

This paper presents a review on previous activities of mining on water resources around active and abandoned mines/quarries across Ebonyi State,South-Eastern,Nigeria.As high demand for water increases due to population growth and rapid development across the state,it is of upmost importance to periodically review water quality and also monitor water resources.However,less information is available on evaluation of impact on mining activities on water resources.For the purpose of this research,related articles were downloaded from Google,published article on effect of mining on water resources was download and thoroughly studied to evaluate effect of mining on water resources of the study area.Findings revealed that past mining activities has lead to chains of complex chemical reactions that has altered the quality of water resources.

Safety evaluation in mice of the childhood immunization vaccines from two south-eastern states of Nigeria

Objective:To check the effects of the vaccines on the hematopoietic system and weight of mice after immunization.Methods:The study was done with the Expanded Programme on Immunization vaccines donated by the Ministries of Health of Abia and Imo States of Nigeria.The vaccines were collected from the cold-chain stores and transported in vaccine carriers to the cold-chain facility in Nnamdi Azikiwe University Teaching Hospital within 3 hours of collection.They were used to immunize a total of 160 mice.The Ethics Committee of Nnamdi Azikiwe University Teaching Hospital,Nnewi of Anambra State,Nigeria approved the protocol.Results:Mice body weight changes test showed that the mice all had increased body weight at Days 3 and 7 post-immunization and none died during the 7 d post-immunization observation.The percentage weight gains of the mice compared with the control were 69%.70%,64%.63%,65%and 68%for oral polio vaccine,diphtheria-pertussis-tetanus.bacillus CalmetteGuerin,measles,yellow fever and hepatitis B vaccines respectively collected from Imo State.The mice immunized with oral polio vaccine,pentavalent.bacillus Calmette-Guerin.measles,yellow fever and hepatitis B vaccines collected from Abia State had 123%.114%,121%.116%,142%and 119%weight gain respectively compared with the control.Leukocytosis promoting toxicity test showed that none of the vaccines was able to induce proliferation of leukocytes up to ten folds.Leukopenic toxicity test showed that all the vaccines had an leukopenic toxicity test value higher than 80%of the control(physiological saline).Conclusions:The vaccine samples tested were safe and did not affect the hematopoietic system adversely.The storage conditions of the vaccines in the States' cold-chain stores had not compromised the safety of the vaccines.

Micronutrient dynamics in some wetland soils of south-eastern Nigeria

The inventory of profile distribution of total iron (Fe), zinc(Zn), manganese(Mn) and copper(Cu) were determined in three different soil horizons each of the wetland soils selected form Mbiabet(MB), Nkari(NK) and Nkana(NA) in Ini Local Government Area of Akwa Ibom State. Total Fe ranged between 3 25 and 4 15 ppm. The average contents were 3 72, 3 91 and 3 62 ppm in Mbiabet(MB), Nkari(NK) and Nkana(NA) soils respectively. The total value of Zn also ranged between 2 4 and 4 9 ppm with the average content in each soil being 28.27, 17 73 and 36 53 ppm respectively. The amount of Fe and Zn in these soil profiles were strongly correlated with the clay content and high levels of organic matter of 3 70%, 2 47% and 2 5% respectively. The content clearly reflected a poor drainage conditions.In all the soil profiles Mn and Cu were detected in at least one of the soil horizons. However, Mn and Cu were not detected in the soil horizons at Nkari.Generally, the relative inventory of these micronutrients appeared to be influenced by pH, drainage pattern, organic matter and clay contents of these soils.The inventory of total values of the wetland soils considered are assessed in the light of establishing a baseline information.

Characterization of Tuberculosis Cases Presenting in a Tertiary Healthcare Facility in South-Eastern Nigeria

Background: Tuberculosis is second only to HIV/AIDS as the greatest killer worldwide, due to a single infectious agent. Directly Observed Treatment Short-Course (DOTS) is presently the WHO recommended programme to fight tuberculosis worldwide. There is need to understand the characteristics of patients who receive treatment for tuberculosis. This will help modify the strategies to fight the scourge of tuberculosis. Methods: This was a retrospective study conducted at the DOTS clinic at Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. The records of patients who received treatment from the clinic from 1st January 2012 to 31st December 2012 were reviewed. Three hundred and fifteen patients were included in the study. Important characteristics of the patients were retrieved. Associations between patients’ characteristics were determined using relevant tests of significance. Results: Three hundred and fifteen patients were included in the study. There were more male patients (59%). The reproductive age group (37.5%) was more than the other age groups. Mean age was 33.1 (±18.5) years. There were more rural patients (50.2%) than urban patients (49.8%). There were more pulmonary TB patients (87.3%) than extrapulmonary TB patients (12.7%). There were more sputum AFB negative patients (45.4%) than positive patients (41.3%). There were more HIV negative patients (59.4%) than positive patients (40.6%). Conclusion: This study demonstrated some important characteristics of tuberculosis patients. Such knowledge if taken into consideration in the tuberculosis control programme will definitely improve the outcome of the programme.

Knowledge and Practice of Breast Self-Examination among Female Undergraduates in South-Eastern Nigeria

Breast disease often presents as palpable masses (lumps), inflammatory lesions, nipple secretion, or mammography abnormalities;and this can be easily treated when discovered early. Breast Self-Examination (BSE) is the quickest and cheapest means of early breast cancer detection. The objective of this study was to determine the knowledge and practice of breast self-examination among female undergraduates in Owerri, south eastern Nigeria. A multi-stage sampling design was used to select participants. Interview using structured questionnaire was conducted on randomly selected respondents in six faculties from each tertiary institution. Questionnaire was prepared in English and was self-administered. Permission to conduct the survey was requested and obtained from the university ethical review board. Informed verbal and written consent was obtained from participants. Confidentiality of information was maintained throughout the study. Knowledge and practice of BSE was examined among 720 randomly selected female undergraduates aged 16 to 28 years. It was found that 98.9 percent have heard of BSE but only 32.5 percent of them performed this examination accurately and monthly as required. There is a statistically significant relationship between knowledge of risk factors for breast cancer and practice of BSE (χ2 = 31.17, P χ2 = 86.75, P χ2 = 75.94, P < 0.001). These female undergraduates had a poor knowledge of the right procedure and practice of BSE;therefore there is need for awareness creation on the risks of breast cancer and benefits of early detection among female undergraduates through breast self-examination.

Factors Affecting the Knowledge and Practice of Drug Management among Healthcare Workers in Primary Health Centers in South-East, Nigeria

The knowledge of health workers regarding their management of drugs is very important in ensuring good health. One of the major indices of the performance of primary health care (PHC) remains improved access to essential drugs as they are the link between patients and health services. Consequently, their availability or absence will contribute to a positive or negative impact on health. This was a quasi-experimental study, carried out in Anambra state, which compared the intervention and control groups following the training and provision of drug management tools to PHC workers in the intervention group. A multi-stage sampling technique was used to select 264 health workers from 132 health centers from two senatorial zones in the State, one acting as a control group and the other as an intervention group. Data was collected using a pre-tested in-depth interview guide and semi-structured interviewer administered questionnaire. Statistical analysis was conducted using SPSS at a statistical significance level of p value less than 0.05, while qualitative data was analyzed using N-Vivo. Several factors such as age, sex, educational qualification, cadre of staff, years of practice and PHC workers’ previous training were identified as affecting the knowledge and practice of drug management. The majority (72.0% and 71.2%) in intervention and control groups respectively said inadequate information or lack of knowledge was the main reason for poor practices while the proportion with low interest of health workers for drug management was (38.5%) for intervention and (59.8%) for the control group and the difference between the groups was statistically significant (p = 0.034). In conclusion, this study has shown that age, sex, educational qualification, cadre of staff, years of practice and PHC workers’ previous training were factors associated with health workers’ knowledge and practice of drug management. The study recommends the development of Aide Memoire and conduct of training and retraining on drug management to improve both knowledge and practice of drug management in PHCs in Nigeria.

Cardiovascular Risk Factors in South-Eastern Nigeria: A Community Based Survey

Background: Cardiovascular risk factors play a major role in cardiovascular disease burden worldwide. The prevalence is known to be in the increase especially in the developing countries. There is need for timely community based studies in order to keep tab with the current scope. It is against this background that we embarked on this cross-sectional community based study of the prevalence of selected cardiovascular risk factors in semi-urban community in Abakaliki Southeastern part of Nigeria in October 2016. Method: The consecutive consenting persons of 18 years and above were screened for selected cardiovascular risk factors in October 2016. Results: A total of 1074 adults were seen (males-567, females-507) with age range of 18 - 80 years and mean age of 35.63 ± 12.45 years. They were predominantly farmers, petty traders and artisans. The identified CVD risk factors were hypertension 285 (26.4%), alcohol abuse 131 (12.1%), obesity 122 (11.3%), diabetes 97 (9%), family history of stroke 87 (8.1%), smoking 74 (6.9%) and previous stroke 29 (2.7%). Conclusion: The cardiovascular risk factors were quite prevalent with male preponderance of alcohol abuse and smoking.

Pattern of Referral of Obstetric Patients at a Tertiary Care Hospital in Southern Nigeria

Background: Health challenges that are difficult to manage at primary health centres should be referred to secondary health facilities, and if untreated, to the tertiary hospitals. A good referral should include the patient’s biography, such as age, gender, tribe, religion, occupation, medical history, the reason for the referral, treatments received, and clinical diagnosis. Objectives: To evaluate the referral patterns, indications for referrals, and feto-maternal outcomes for obstetric patients who were referred to the University of Port Harcourt Teaching Hospital. Materials and Methods: A prospective study of patients admitted to the Obstetric unit from January 1, 2021, to December 31, 2022. Data was collected from patients while on admission or clinic visits and recorded in an excel spread sheet. Data was analyzed with the Statistical Package for Social Sciences (SPSS) version 25. Results: Of the 3469 patients were admitted to the obstetric unit, 1476 and 1993 were admitted in 2021 and 2022, respectively. Most (70.35%) of the patients were in the 20-34 years age group, parity 1-4 was the most frequent (66.49%), while 85.39% of patients were booked. 10.46% of the booked patients were referred from other facilities, whereas 89.54% of patients were booked at our facility from the onset. Most common indications of referrals were previous caesarean section (CS) at term (40.09%) and hypertensive disorders of pregnancy (17.59%). The outcome for 2021 indicated 17 maternal deaths, 132 fetal deaths and 1010 live births, giving maternal mortality ratio (MMR) as 1810.44 per 100,000 live births and perinatal mortality ratio (PMR) of 130.7 per 1000 births respectively. In 2022, there were 17 maternal deaths, 130 fetal deaths and 1297 deliveries, giving a MMR of 1399 per 100,000 live births and a PMR of 100.2 per 1000 births. Conclusion: The pattern of referral among obstetric patients in this study shows that a lot of the patients do not get adequate care at the lower cadre of the referral system, hence adequate facilities should be made available in primary and secondary health centres to tackle obstetric emergencies.

Enhancing Private Healthcare Effectiveness in Lagos State, Nigeria: An Overview of the Effect of Quality Improvement Initiatives and Implications for Sustainable Healthcare Delivery

Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge of ensuring quality healthcare access. The overview of the effect of quality improvement initiatives in this paper focuses on private healthcare providers in Lagos State, Nigeria. The study assesses the impact of donor-funded quality improvement projects on these private healthcare facilities. It explores the level of participation, perceived support, and tangible effects of the initiatives on healthcare delivery within private healthcare facilities. It also examines how these initiatives influence patient inflow and facility ratings, and bring about additional benefits and improvements, provides insights into the challenges faced by private healthcare providers in implementing quality improvement projects and elicits recommendations for improving the effectiveness of such initiatives. Methods: Qualitative research design was employed for in-depth exploration, utilizing semi-structured interviews. Private healthcare providers in Lagos involved in the SP4FP Quality Improvement Project were purposively sampled for diversity. Face-to-face interviews elicited insights into participation, perceived support, and project effects. Questions covered participation levels, support perception, changes observed, challenges faced, and recommendations. Thematic analysis identified recurring themes from interview transcripts. Adherence to ethical guidelines ensured participant confidentiality and informed consent. Results: Respondents affirmed active involvement in the SP4FP Quality Improvement Project, echoing literature emphasizing private-sector collaboration with the public sector. While acknowledging positive influences on facility ratings, respondents highlighted challenges within the broader Nigerian healthcare landscape affecting patient numbers. Respondents cited tangible improvements, particularly in staff management and patient care processes, validating the positive influence of quality improvement projects. Financial constraints emerged as a significant challenge, aligning with existing literature emphasizing the pragmatic difficulties faced by private healthcare providers. Conclusions: This study illuminates the complex landscape of private healthcare provision in Lagos State, emphasizing the positive impact of donor-funded quality improvement projects. The findings provide nuanced insights, guiding policymakers, healthcare managers, and practitioners toward collaborative, sustainable improvements. As Nigeria progresses, these lessons will be crucial in shaping healthcare policies prioritizing population well-being.