Medicine

To elicit the explanatory models (EM) of hypertension among patients in a hospital-based primary care practice in Nigeria. Design. Semi-structured in-depth individual interviews and focus groups were conducted with 62 hypertensive patients. Interviews and focus groups were audiotaped and transcribed verbatim. Data analysis was guided by phenomenology and content analysis using qualitative research software ATLAS.ti 5.0. Patients expressed four categories of EM of hypertension: (1) perceptions of hypertension, (2) consequences, (3) effect on daily life, and (4) perception of treatment. Focus group discussions and individual interviews yielded a wide range of insights into the social and cultural factors influencing patients' beliefs and health behavior. Participants were aware of the risks of hypertension. There was disagreement between participants' own understanding of the serious nature of hypertension, the need for long-term treatment, and the desire to take long-term med...

Renal tuberculosis is an uncommon manifestation of extrapulmonary tuberculosis, due to its insidious onset and non-specific constitutional symptoms, which makes it difficult to make proper diagnosis[1]. If renal tuberculosis is not treated early, it can disseminate into the genitourinary system resulting into ureteric obstruction, hydronephrosis or pyonephrosis[2]. This is the case of a 31 year old lady with obstructive uropathy from extrapulmonary tuberculosis.

Kidney transplant is now generally accepted as the treatment of choice for patients with end-stage renal disease. This is because of its association with improved survival and quality of life when compared with other forms of renal replacement therapy. Immunosuppression including induction has played a strong role over the years in improving the outcomes of renal transplant. The main aim of transplant immunosuppression is renal allograft survival in the long term and the patient survival while at the same time reducing the risk of known attendant complications of immunosuppression such as malignancies and infection. The use of induction immunosuppression in low risk kidney transplant recipients varies with different transplant programmes. Different studies in different environments have varying conclusions. While some argue for the use of antibodies as part of induction immunosuppression protocol, the prohibitive cost of these agents preclude their regular use in resource poor envir...

Paraneoplastic syndromes (PNS) are defined as a collection of symptoms and clinical signs occurring in cancer patients and involving systemic effects taking place remotely from the tumor; they are not related either to its local repercussion or distant spread and are not caused by infection, nutritional deficiency or treatment. A paraneoplastic phenomenon usually arises from (a) biologically active substances (hormones, hormone precursors, or hormone-like substances) aberrantly produced by the underlying neoplasm, (b) modulation of the immune system via autoimmunity, immune complexes production and immune suppression, (c) unknown causes(1). The prevalence of low grade papillary carcinoma of the bladder in Nigeria is 5.4%(2), while the commonest histologic pattern seen is squamous cell carcinoma(2,3). This is the case of a 65year old woman with features of peripheral neuropathy; however had an underlying bladder cell carcinoma with low grade papillary carcinoma.

Chronic kidney disease (CKD) is a growing public health problem worldwide. Awareness about the disease has been documented to lead to early recognition, prompt treatment and halt progression to end-stage renal disease (ESRD). This study was carried out to determine the knowledge of CKD among inhabitants of Ado Ekiti, South Western Nigeria. Using a semi-structured questionnaire, the participants were interviewed during a public medical screening and scored on 13 items to determine their knowledge of anatomy, physiology, clinical features and treatment of CKD. The mean age of the participants was 36.04 ± 12.75years. A large proportion of the respondents 76.3% were able to identify correctly some functions of the kidney. The majority (78.4%) of the respondents have no idea about common symptoms associated with CKD. Few respondents knew that habitual use of NSAID and herbal concoction among others are potential causes of CKD. Overall, only 14.5% of the respondents had good knowledge abo...

Introduction:The perception of death differs by region, culture, religion, and ethnic group in Nigeria.These differences can affect the consent rate for cadaveric transplantation. Understanding theYoruba concept of death and approaching
families for consent in a culturally sensitive manner may increase family consent to deceased donor organ harvesting. This literature review explores the Yoruba concept of death and organ transplantation.

Methods: Three research questions were formulated and a search strategy was drafted by creating a SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, and Research type) logic search grid. Relevant databases were then examined using the search terms, concepts and keywords so generated.The findings of publications retrieved onYoruba beliefs regarding death were entered into a summary table based on the themes identified in them. These themes served as the basis for the interpretation synthesis.

Results: Fifteen of the eighty-five studies identified initially were deemed contextually relevant to the research questions and used in the analysis. These sources revealed that death in the Yoruba belief system signifies the dematerialization of the soul and its transformation from earthly existence into a spiritual one. Consequently, the physical body of the deceased is perceived as becoming dust and of little relevance to the afterlife.

Conclusion: In the Yoruba worldview, the state of the physical body after death has no relevance to afterlife and
reincarnation. However, transplant teams must consider the circumstances of death when asking for consent.When death is viewed positively, success is more likely.

Background Youth friendly health services (YFHS) are services that attract, respond to the needs of and retain young people for continuing care. This study was conducted to determine the factors affecting utilization of government (GYFF) and non-governmental youth friendly facilities (NGYFF) in Lagos state, Nigeria. Methods A descriptive cross-sectional study was conducted. A total of 543 adolescents aged 15–24 years, between August 1, 2014 and October 31, 2014 were consecutively recruited from 10 (five government and five non-governmental) youth friendly health facilities that had been in operation for at least 6 months prior to the study. Logistic regression was used to determine predictors of utilization of youth friendly health facilities. Results Overall, the mean age of respondents was 17.9 ± 2.8. However, the mean age of respondents at GYFF (18.5 ± 3.0) was significantly higher than those at NGYFF (17.1 ± 2.5) (p < 0.001). Of the 567 youths enrolled, 196 (34.6%) had good u...

A community-based survey was conducted amongst mothers aged 15-49 years living in Mosan-Okunola, Lagos, Nigeria to determine the knowledge of, attitudes to, preventive and treatment practices towards neonatal jaundice (NNJ). The mothers were selected using a multi-stage sampling technique. A pre-tested interviewer-administered structured questionnaire was used to obtain data. The knowledge of the mothers was scored and scores lower than 50% were graded as poor, 50-74% as fair and ≥75% as good. The practice was also categorised as appropriate if one correct option was identified and was categorised as inappropriate where an incorrect option(s) was identified singly or in combination with a correct option. Three hundred and fifty-eight mothers were recruited. The mean age was 34.8 ± 9.05 years. Two hundred and seventy (75.4%) mothers had ever heard about the condition. Two hundred and forty-seven (91.4%) mothers correctly identified the condition and infection was the only most common...

Background: The World Health Organization prescribed that Youth-Friendly health services must be accessible, acceptable, equitable, efficient, effective, comprehensive and appropriate to meet the health needs of young people. Objective: To compare the clients’ and service providers’ assessment of services offered at the public and Non-Governmental Organization (NGO) Youth Friendly facilities (YFF) in Lagos Nigeria. Methods: A mixed method approach was used. Structured questionnaires were administered on youths (294 from public and 273 from NGO YFF) from ten (5 public and 5 NGO) YFF. Ten key informant interviews with service providers were also conducted between March 1st and December 31st 2014. SPSS version 22 was used to analyze quantitative data while thematic analysis of interviews with service providers was done. Results: Youths who utilized the public YFF had 60% chance (AOR 1.6, 95%CI 1.3 – 2.5, p= 0.005) of experiencing longer waiting times, 80% chance (AOR 1.8, 95%CI 1.2 – 2...

BackgroundThe overall goal of this study was to determine the causative factors for pregnancy status in adolescent girls in two communities in the Lagos Island local government area.MethodsA mixed methods (quantitative and qualitative) study reviewing routine health facility antenatal care (ANC) records and conducting focus group discussions among 46 pregnant adolescents, exploring their views about sex, contraception, pregnancy and sexual and reproductive health (SRH) services, was carried out. Key informant interviews were also carried out among healthcare workers and community members to assess their perceptions of adolescents’ SRH problems.ResultsFive percent of those accessing ANC services were adolescents. Pregnant adolescents were found to access health services at later stages of their pregnancies due to the shame and stigma associated with their condition. The presence of morbidity in the form of anaemia (33%) and HIV (2.4%) was also found in this population.Social factors ...

Background : The purpose of the laboratory services within the framework of the NTP is to provide bacteriologic evidence for the diagnosis, follow-up of TB patients and to document cure at the end of treatment. However to be fully functional, laboratory commodities should be available as needed. This study compared the laboratory hygiene practices and availability of laboratory equipment and other consumables for making diagnosis of TB in public and private DOTS laboratories in Lagos State. Methods: A descriptive comparative cross sectional study comparing availability of commodities in public and private laboratories involved in TB services in Lagos State. Results: Seventeen DOTS laboratories and 34 laboratory scientist/technician were recruited for this study. About three quarter and two thirds of the public and private DOTS laboratories respectively had reagents for smear microscopy. A significantly higher proportion of the public DOTS laboratories had separate area for TB work a...

This study assessed factors associated with TB/HIV co-infection among TB patients managed in a secondary health facility in Lagos Nigeria. A retrospective review of treatment cards of patients seen at a secondary referral hospital between January 1 2014 and December 31 2014 was conducted. Treatment outcomes and factors associated with TB/HIV co-infection were assessed. Of the 334 records of patients reviewed, the proportion of patients with TB/HIV co-infection was 21.6%. The odds of having TB/HIV co-infection was 2.7 times higher among patients above 40 years than patients less than 25 years (AOR 2.7 95% CI 1.1 - 6.5, p =0.030). In addition, the odds of having TB/HIV co-infection was 3.3 higher among extra-pulmonary TB cases (AOR 3.3; 95% CI 1.2 - 9.5; p = 0.026) and 2.1 times higher among retreated patients (AOR 2.1; 95% CI 1.1 - 3.9; p = 0.017) than pulmonary TB and new patients respectively. The chance of having TB/HIV co-infection was 2.7-fold more in patients with poor treatmen...