No abstract

IntroductionDyspepsia is prevalent in the community. Guidelines recommend early endoscopy in dyspeptic patients who are older than 55 years, or have alarm features. There is a lack of data on endoscopy in patients with alarm features in Nigeria.MethodsA retrospective study of the endoscopic findings in adults with dyspepsia and alarm features, between August 1st 2017 and July 31st 2018 in Lagos, Nigeria. Data were analysed using Statistical Package for Social Sciences, version 23.0. The sensitivity, specificity, positive predictive value, and negative predictive value of the alarm features were calculated.ResultsOne hundred and fifty-nine gastroscopies were performed during this period, mean age was 47.8 (±14.4) years, 49.1% were male. Dyspepsia was the commonest indication for endoscopy (80.5%), 60.2% of the dyspeptics had at least one alarm feature. The most frequent dyspeptic symptom was epigastric pain/burning sensation (75%), while the commonest alarm features were recent onset dyspepsia in a patient over 45 years (79%) and unexplained weight loss (28.6%). Endoscopy was normal in 26%. The most frequent significant endoscopic findings were gastritis (49%) and gastric ulcer (17%) and they were not associated with alarm features. Upper gastrointestinal bleeding, persistent vomiting and odynophagia were specific for significant endoscopic findings. The pooled sensitivity, specificity, positive predictive value, and negative predictive value of the alarm features were 65%, 49%, 71% and 41% respectively.ConclusionPatients with dyspepsia and upper gastrointestinal bleeding, persistent vomiting or odynophagia, should be referred for prompt upper GI endoscopy.

Background and study aims As with all other fields of medical practice, gastrointestinal endoscopy has been impacted by the COVID-19 pandemic. However, data on the impact of the pandemic in Africa, especially sub-Saharan Africa are lacking. Methods A web-based survey was conducted by the International Working Group of the European Society for Gastrointestinal Endoscopy and the World Endoscopy Organization to determine the impact and effects the COVID-19 pandemic has had on endoscopists in African countries. Results Thirty-one gastroenterologists from 14 countries in north, central, and sub-Saharan Africa responded to the survey. The majority of respondents reduced their endoscopy volume considerably. Personal protective equipment including FFP-2 masks were available in almost all participating centers. Pre-endoscopy screening was performed as well. Conclusion The COVID-19 pandemic has had a substantial impact on gastrointestinal endoscopy in most African countries; however, the impact may not have been as devastating as expected.

BackgroundDespite the creation of the National Health Insurance Scheme (NHIS) by the Nigerian government, most Nigerians are not covered by the scheme.AimThe aim of this study was to assess the knowledge and utilisation of NHIS among adult patients who attended a tertiary health facility in Lagos state, South-Western Nigeria.SettingOutpatient clinic, Lagos State University Teaching Hospital, Ikeja, Lagos.MethodsA descriptive cross-sectional study of 487 respondents recruited using a multi- stage sampling method. Data were collected using pretested semi-structured self-administered questionnaires, and analysis was done using Microsoft Excel 2007 and EPI Info 7 statistical software. Level of significance was set at p < 0.05. Ethical approval was obtained from the Health Research Ethics Committee Lagos State university teaching Hospital.ResultsA total of 487 of the 500 self-administered questionnaires were retrieved and analysed, giving a response rate of 97.4%. The study showed that 80.7% of the respondents had poor knowledge of NHIS, only12.3% of the respondents had registered with the NHIS, and 43.8% of respondents who had not registered with NHIS claimed they do not know where to register. There was a statistically significant association between age and utilisation (p = 0.0007), marital status and utilisation of NHIS (p = 0.016), employment status and utilisation of NHIS (p = 0.001).Most (96%) of those who have utilised NHIS were satisfied with NHIS services.ConclusionMajority of the respondents had poor knowledge of NHIS and also majority of those who had registered were satisfied with the scheme. There should be increased awareness campaigns so that all Nigerians can benefit from the scheme.

No abstract