BackgroundMalaria in pregnancy (MIP) is a major disease burden in Nigeria and has adverse consequences on the health of the mother, the foetus and the newborn. Information is required on how to improve its prevention and treatment from both the providers’ and consumers’ perspectives.MethodsThe study sites were two public and two private hospitals in Enugu, southeast Nigeria. Data was collected using a pre-tested structured questionnaire. The respondents were healthcare providers (doctors, pharmacists and nurses) providing ante-natal care (ANC) services. They consisted of 32 respondents from the public facilities and 20 from the private facilities. The questionnaire elicited information on their: knowledge about malaria, attitude, chemotherapy and chemoprophylaxis using pyrimethamine, chloroquine proguanil as well as IPTp with sulphadoxine-pyrimethamine (SP). The data was collected from May to June 2010.ResultsNot many providers recognized maternal and neonatal deaths as potential consequences of MIP. The public sector providers provided more appropriate treatment for the pregnant women, but the private sector providers found IPTp more acceptable and provided it more rationally than public sector providers (p < 0.05). It was found that 50 % of private sector providers and 25 % of public sector providers prescribed chemoprophylaxis using pyrimethamine, chloroquine and proguanil to pregnant women.ConclusionsThere is sub-optimal level of knowledge about current best practices for treatment and chemoprophylaxis for MIP especially in the private sector. Also, IPTp was hardly used in the public sector. Interventions are required to improve providers’ knowledge and practices with regards to management of MIP.

Background: Drug abuse, an excessive and persistent self-administration of a drug without regard to the medically or culturally accepted patterns, has been reported amongst teenagers and adolescents in various regions of the world.Aim: This study aimed to measure the prevalence of drug use amongst students of junior and senior secondary schools (aged 10–15 years).Setting: This study was conducted at two local government areas in Lagos State.Methods: The cross-sectional study was carried out in Ikotun or Igando local council development area (LCDA) and Ikoyi LCDA of Lagos State. Students were sampled using stratified random sampling with classes as strata and sampling performed by balloting. The modified WHO Model Drug Use Survey Questionnaire was distributed to the students for self-reporting. Ethical approval was received from district school boards.Results: A total of 1048 students participated in the survey. In this study, alcohol had the highest lifetime drug prevalence rate (29.1%), followed by pharmaceutical opioids (9%). Gender, educational level, type of school management, and geographical economic distribution were found to be predictors of prevalence of drug use. This study demonstrated significant differences in the prevalence of tobacco and opioids use among students in private and public schools; and documented statistically significant differences in the prevalence of cocaine use between low income and high-income areas in two LCDAs in Lagos, Nigeria.Conclusion: Prevalence of lifetime, recent use, and current use of drugs among secondary school students in two LCDAs located in Lagos State, Nigeria were documented with alcohol as the drug with the highest prevalence.

Background: Diabetes mellitus is a chronic, degenerative disease, requiring a multi-dimensional, multi-professional care by healthcare providers and substantial self-care by the patients, to achieve treatment goals. Objective: To evaluate the impact of pharmacist-led care on glycaemic control in patients with uncontrolled Type 2 Diabetes Methods: In a parallel group, single-blind randomised controlled study; type 2 diabetic patients, with greater than 7% glycated haemoglobin (A1C) were randomised into intervention and usual care groups and followed for six months. Glycated haemoglobin analyzer, lipid analyzer and blood pressure monitor/apparatus were used to measure patients’ laboratory parameters at baseline and six months. Intervention group patients received pharmacist-structured care, made up of patient education and phone calls, in addition to usual care. In an intention to treat analysis, Mann-Whitney U test was used to compare median change at six months in the primary (A1C) and secondary outcome measures. Effect size was computed and proportion of patients that reached target laboratory parameters were compared in both arms. Results: All enrolled participants (108) completed the study, 54 in each arm. Mean age was 51 (SD 11.75) and majority were females (68.5%). Participants in the intervention group had significant reduction in A1C of -0.75%, compared with an increase of 0.15% in the usual care group (p<0.001; eta-square= 0.144). The proportion of those that achieved target A1C of <7% at 6 months in the intervention and usual care group was 42.6% vs 20.8% (p=0.02). Furthermore, intervention patients were about 3 times more likely to have better glucose control; A1C<7% (aOR 2.72, 95%CI: 1.14-6.46) compared to usual care group, adjusted for sex, age, and duration of diabetes. Conclusions: Pharmacist-led care significantly improved glycaemic control in patients with uncontrolled T2DM.

No abstract

No abstract

Background: The burden of infectious diseases among Nigerian children is high. These children are often prescribed antibiotics during periods of hospitalisation. Unfortunately antibiotic resistance (ABR) threatens the availability and efficacy of antibiotics for use by vulnerable children and the future generations. Monitoring prescribing trends in our hospital as a means of identifying targets for improving prescribing is inevitable. Objective: The aim of the study was to evaluate antibiotic prescribing practices for hospitalised children with suspected bacterial infections in a Paediatric hospital in Nigeria. Methods: A retrospective survey was carried out using case notes of previously hospitalised patients admitted between January and June 2016. Data from 150 case notes of patients admitted for suspected bacterial infections were collected using a predesigned data collection form. Patients' demographics, infection type, details of prescribed antibiotics, length of hospital stay and microbiological assessments were noted. Data were analysed using statistical package for social sciences (SPSS) version 22. Frequencies and percentages were calculated for categorical variables. Means and standard deviations were calculated for continuous (numerical) variables. Correlation was also employed in the analysis. Results: Of the 150 patients, 53.3% were males and 86% were children under 5 years of age. The mean duration of hospital stay was 7.59 (± 5.4) days. The most common infections were respiratory tract infection (32%) and sepsis (31.3%). The most common empirically prescribed antibiotics at the onset of admission were Gentamicin and a fixed dose combination of Ampicillin/Cloxacillin which were prescribed for 64.7% and 52.7% of the patients respectively. Cultures were ordered for only 7 (4.7%) of patients at the onset of hospitalisation. All antibiotics administered on admission were parenteral formulations and only 4% of the patients had their antibiotic switched to oral route on or before the third day of patients' admission. Another 71.3% were converted to oral formulations on the day of discharge from the hospital. A total of 87.3% were discharged on antibiotics and the most commonly prescribed antibiotic at discharge was Cefixime (37.2% of antibiotics prescribed as take home medication). Conclusions: Antibiotics were started empirically in all cases and cultures were ordered for few patients at the start of antibiotic therapy. Cultures should be more frequently ordered in the hospital to guide antibiotic prescribing for patients admitted for suspected bacterial infections. In addition, timely intravenous (IV) to oral (PO) antibiotic switch should be practised whenever appropriate. Educating physicians on the benefits of early switch from IV to PO formulations when appropriate is also recommended. Initiatives such as the "Antibiotic Time out" or Start Smart-then Focus approach will be appropriate in the hospital. Introduction of an empiric antibiotic policy in the hospital is highly recommended.

Objective Excipients are needed in the formulation of oral liquid medicines intended for children; they have however been reported to trigger safety issues. This study evaluated the concentrations and prevalence of ethanol and other potentially harmful excipients in pediatric formulations marketed in South Eastern Nigeria in line with international labeling guidelines and allowable daily limits (ADL). The study sampled oral pediatric formulations offered for sale in registered pharmacies. Those with accessible information leaflets were assessed for the presence and quantity of previously flagged excipients with potential to harm the pediatric population. Result Of the 380 oral pediatric medicines, 140 provided access to list/quantity of ingredients. 47.9% (67) of the formulations contain at least one of the flagged excipients while the remaining only listed the active ingredients. Ethanol had the highest occurrence (62.7%) and was more in cough/cold medicines. A homeopathic cough and cold remedy had concentration of 90% v/v. Ethanol and sucrose in some formulations exhibited concentrations with a potential of crossing their approved daily intake (ADI) (1–90% v/v and 1.7 g–3.7 g/5 ml respectively). Ethanol use in studied pediatric formulations was quite high, with ethanol-containing formulations being prescribed for children 0–6 years and older. Only 26 (38.8%) completely satisfied the labelling requirements for ethanol containing formulations.

BackgroundThrough several initiatives, there are increasingly more people who have access to anti-retroviral therapy. Adherence to therapy is, however, necessary for successful management of disease.ObjectivesThe objectives of this study were to describe adherence rates and determine what patient-related factors are related to adherence to anti-retroviral therapy among adult patients in an HIV clinic located in Lagos, Nigeria.MethodsAdherence was measured using the two-week self-recall method. Barriers, satisfaction with therapy, and socio-demographic and clinical variables served as independent variables. Data were collected via self-administered surveys.ResultsMost of the patients (79.5%) reported 100% adherence. The significant (p<0.05) barriers to adherence were forgetfulness, running out of medication, alcohol use, and medication side effects. For every unit increase in the number of barriers, patients were 60.8% less likely to be 100% adherent (p <0.05, odds ratio, OR = 0.392, 95% CI = 0.295–0.523).ConclusionInterventions should target helping patients cope with forgetfulness, specifically employing strategies to overcome busyness in schedules, being away from home, and tiredness.