Nigerian Journal of Clinical Practice最新文献

{"title":"Assessing Determinants of Enrollees' Satisfaction with Quality of Health Services within the State Social Health Insurance Scheme: An Application of Modified SERVQUAL Model.","authors":"S Onyemaechi, U Ezenwaka, C Okeke, T Ibeziakor, C Okuakaji, O Osifala","doi":"10.4103/njcp.njcp_562_23","DOIUrl":"https://doi.org/10.4103/njcp.njcp_562_23","url":null,"abstract":"<p><strong>Background: </strong>Patient satisfaction is an important indicator to measure the quality of healthcare and provider performance. Understanding enrollees' satisfaction with the quality of health services provided by Anambra State Health Insurance Scheme is crucial for its effectiveness.</p><p><strong>Aim: </strong>This study assessed health insurance enrollees' satisfaction with the quality of care and its determinants in Anambra State, Nigeria.</p><p><strong>Methods: </strong>This was a cross-sectional study that involved 447 enrollees selected from health facilities using a multistage sampling technique. Data was collected using a 25-item structured close-ended patients' satisfaction questionnaire adapted from the SERVQUAL model. Data analysis was done using SPSS version 25. Logistics regression analysis was done to identify determinants of overall satisfaction. The level of significance was set at a P value <0.05.</p><p><strong>Results: </strong>The overall level of satisfaction with services rendered was 80.6%. Enrollees were satisfied with tangibility (87.2%), reliability (89.3%), responsiveness (80.3%), assurance (90.2%), empathy (87.5%), and affordability (81.4%). Significant factors associated with the enrollees' satisfaction across the six dimensions of care assessed were facility ownership (AOR = 1.42; CI 0.24-0.74; P < 0.00) and geographical location (AOR = 1.33; CI 0.14-0.78; P < 0.01). Age (AOR = 2.86; CI 1.55-5.29; P < 0.00) was the only demographic characteristic associated with satisfaction with care.</p><p><strong>Conclusion: </strong>The quality of care was satisfactory across dimensions of care assessed. However, enrollees' satisfaction was positively influenced by facility-related factors. Managers and healthcare providers should focus on continuous quality improvement efforts in public and rural facilities to improve the quality of services and enrollees' retention within the health insurance scheme.</p>","PeriodicalId":19431,"journal":{"name":"Nigerian Journal of Clinical Practice","volume":"28 4","pages":"513-524"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Simple but Often Neglected Technique for Managing Prolonged Urinary Leakage from Urethrovesical Anastomosis: The Side-Fenestrated Catheter Approach.","authors":"F Bicaklioglu","doi":"10.4103/njcp.njcp_795_24","DOIUrl":"https://doi.org/10.4103/njcp.njcp_795_24","url":null,"abstract":"<p><p>Urethrovesical anastomotic leakage (UVAL) is a well-documented early complication following radical prostatectomy. While low-volume leaks are often self-limiting, persistent high-volume leaks (>300 mL/day), where most urine bypasses the catheter, may require invasive interventions. We report the case of a 58-year-old male with prostate adenocarcinoma who developed high-volume UVAL after undergoing laparoscopic radical prostatectomy, which was unresponsive to conservative measures. A side-fenestrated catheter was placed under local anesthesia via cystoscopy on postoperative day 2, leading to rapid resolution of the leak. The patient was subsequently discharged on postoperative day 4 following drain removal. This case highlights the effectiveness of a simple, minimally invasive side-fenestrated catheter approach for managing UVAL, offering an alternative to more invasive interventions such as bilateral percutaneous nephrostomy, suprapubic catheter placement, or even surgical revision of the urethrovesical anastomosis.</p>","PeriodicalId":19431,"journal":{"name":"Nigerian Journal of Clinical Practice","volume":"28 4","pages":"561-563"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the CHA2DS2-VASc Score to Predict Concurrent Critical Coronary Artery Stenosis in Patients with Severe Carotid Artery Disease.","authors":"O Baran, Y Yilmaz, S Inci, Z Cetinkaya, S Kelesoglu","doi":"10.4103/njcp.njcp_759_24","DOIUrl":"https://doi.org/10.4103/njcp.njcp_759_24","url":null,"abstract":"<p><strong>Background: </strong>There is a significant correlation between the severity of atherosclerosis in one arterial region and the occurrence of atherosclerotic disease in other regions. Identifying and managing vascular disease in patients with multifocal arterial disease is often complex. The CHA2DS2-VASc score encompasses several cardiovascular risk factors and was initially used to assess the risk of thromboembolism, stroke, and death in patients with atrial fibrillation. In recent years, this score has been proposed to predict the prognosis of various cardiovascular diseases.</p><p><strong>Aim: </strong>The study aimed to investigate the prevalence of concomitant coronary artery disease (CAD) and the correlation between the CHA2DS2-VASc score and CAD in patients who were scheduled for carotid stenting due to carotid artery stenosis (CAS) but had no history of CAD.</p><p><strong>Methods: </strong>A total of 452 patients were included in the study, 213 with symptomatic CAS and 239 with asymptomatic CAS. The patients were separated into two groups: those with and without.</p><p><strong>Results: </strong>One hundred forty-eight (32.7%) of 452 patients had critical CAD. Multivariate logistic regression analysis showed that a high CHA2DS2-VASc score (OR: 4.283, 95% CI: 2.903-6.321, P < 0.001) was an independent predictor of the development of CAD. Receiver operating characteristic curve (ROC) analysis showed 64.9% sensitivity and 82% specificity in detecting CAD of the CHA2DS2-VASc score at >4 cutoff [Area under ROC curve = 0.781 (95% CI: 0.724-0.838), P < 0.001].</p><p><strong>Conclusion: </strong>When our results were analyzed, a CHA2DS2-VASc score of >4 was highly significant in predicting severe CAD.</p>","PeriodicalId":19431,"journal":{"name":"Nigerian Journal of Clinical Practice","volume":"28 4","pages":"487-495"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Assessment of the Relationship Between Fetal Growth Restriction and Maternal Serum Markers of Systemic Inflammation (NLR, SIRI, SII, and PIV).","authors":"A Akay, Y Akdaş-Reis, S Yilmaz-Ergani, K Hajiyeva, Y Engin-Üstün","doi":"10.4103/njcp.njcp_530_24","DOIUrl":"https://doi.org/10.4103/njcp.njcp_530_24","url":null,"abstract":"<p><strong>Background: </strong>The processes involved in inflammatory regulation are crucial during pregnancy.</p><p><strong>Aim: </strong>This study aims to identify the association between fetal growth restriction (FGR) and neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory response index (SIRI), Systemic immune-inflammatory index (SII), and pan-immune inflammatory value (PIV).</p><p><strong>Methods: </strong>This retrospective case-control study was conducted between 2015 and 2021. The study group comprised cases diagnosed with FGR, while the control group was randomly selected from a healthy cohort of pregnancies. The levels of inflammatory markers were calculated from the blood count results of the cases. A comparison was conducted between the two groups' obstetric and neonatal outcomes and serum inflammatory markers.</p><p><strong>Results: </strong>A total of 1052 cases were included in the study, with 526 (50%) belonging to the FGR group. The mean age was found to be similar in both groups (P = .311). A significant increase in neutrophils, NLR, SIRI, SII, and PIV was observed in the FGR group (P < .05). The multivariate logistic regression analysis results demonstrated that elevated neutrophil, NLR, and SII values were independent risk factors for FGR (P < .001). No notable discrepancy was observed in these markers between the early and late FGR (P > .05). A significant inverse relationship was observed between neutrophils, NLR, and SII, and gestational age and fetal weight at birth (P < .05).</p><p><strong>Conclusion: </strong>The findings indicated that elevations in neutrophils, NLR, and SII are independent risk factors for FGR. These markers reflecting maternal systemic inflammation, have been linked to FGR and associated poor neonatal outcomes.</p>","PeriodicalId":19431,"journal":{"name":"Nigerian Journal of Clinical Practice","volume":"28 4","pages":"545-551"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathologic Profile and Pelvic Magnetic Resonance Imaging Pattern of Prostate Cancer in Southeast Nigeria.","authors":"S K Anyimba, E C Ajare, O M Mbadiwe, E F Nnakenyi, O C Amu, A C Onuh, A C Ilo, E K Mgbe","doi":"10.4103/njcp.njcp_766_24","DOIUrl":"https://doi.org/10.4103/njcp.njcp_766_24","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa) is the most frequently diagnosed malignancy in men. It is the commonest cancer in Nigerian men. Multiparametric magnetic resonance imaging (mpMRI) is essential in the evaluation of patients with PCa.</p><p><strong>Aim: </strong>To evaluate the clinicopathologic profile and pelvic MRI pattern of prostate cancer patients.</p><p><strong>Methods: </strong>This was a retrospective study performed between July 2020 and June 2024. The study population was derived from men with histologically diagnosed PCa who subsequently had mpMRI for cancer staging. From the medical records, age, prebiopsy PSA, Gleason score (GS) and other relevant information were obtained.</p><p><strong>Results: </strong>The records of 458 subjects were retrieved. A total number of 229 subjects had their prebiopsy PSA recorded while 158 subjects had their GS recorded. The mean age of the subjects was 66.38 ± 8.46 years, while the mean and median prebiopsy PSA were 49.37 ± 59.81 ng/ml and 33ng/ml, respectively. The mean GS of the subjects was 7.72 ± 1.29. The prostate capsule was the most commonly invaded structure (65.4%). The prevalence of bone metastasis was 22.8%, and the spine was the most commonly affected bone. Stage 3 and stage 4 disease were the most predominantly observed (58.4% and 32%, respectively). There was a statistically significant but weak correlation between tumor stage and GS.</p><p><strong>Conclusion: </strong>The subjects' clinicopathologic profile and pelvic MRI findings show that patients commonly present with advanced prostate cancer in our environment.</p>","PeriodicalId":19431,"journal":{"name":"Nigerian Journal of Clinical Practice","volume":"28 4","pages":"508-512"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Efficacy of Hypochlorous Acid as a Cost Effective Environmental Decontaminant in Dentistry: A Scoping Review.","authors":"R Ahmed, S Ahmed","doi":"10.4103/njcp.njcp_674_24","DOIUrl":"10.4103/njcp.njcp_674_24","url":null,"abstract":"<p><p>Dental procedures result in the production of bioaerosols that contaminate various environmental surfaces in the dental clinic. In order to maintain a safe environment in the dental clinic and prevent cross contamination, it is important to find alternative disinfection methods and agents to ensure effective decontamination. Hypochlorous acid (HOCl) is a cost-effective antimicrobial agent that can be used for infection control. The purpose of this scoping review is to provide evidence from the literature supporting the routine use of HOCl as a biodecontamination and disinfection agent in dental clinics. An electronic search was completed on the following databases: PubMed, Web of Science, Scopus, Wiley, and Science Direct. The studies were included based on their titles, abstract, and relevance to HOCl and the ability to render pathogens deactivated after exposure to HOCl vapor. The search focused on studies in the past 5 years. The search resulted in a total of 15 articles being selected after exclusions based on duplications, title, and abstract assessment. The articles included studies that used various HOCl concentrations and expanded on the inactivation of several pathogens. The reviewed studies highlight HOCl's broad-spectrum antimicrobial efficacy, with significant reductions in severe acute respiratory syndrome coronavirus 2, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Clostridioides difficile, reinforcing its role in optimizing disinfection protocols across healthcare and occupational settings. The articles selected provided clear evidence that under correct and established parameters, HOCl can provide a cheaper safer alternative to most disinfectants. Further studies are recommended on applications methods in clinical settings.</p>","PeriodicalId":19431,"journal":{"name":"Nigerian Journal of Clinical Practice","volume":"28 4","pages":"425-445"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Relationship between Serum 25(OH) Vitamin D Levels and Cardiac Functions in Adolescent Athletes.","authors":"Ö Güneş, H Altın","doi":"10.4103/njcp.njcp_732_24","DOIUrl":"https://doi.org/10.4103/njcp.njcp_732_24","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D is a prohormone necessary for the optimal functioning of the locomotor and circulatory systems in humans. As a caveat, vitamin D metabolism is crucial for maintaining musculoskeletal and cardiovascular health for overexercising people, like athletes. Our study intended to explore the relationship between serum 25-hydroxy vitamin D (25(OH) D) levels and left ventricle/right ventricle (LV/RV) systolic and diastolic function in adolescent athletes using 2D Doppler studies.</p><p><strong>Methods: </strong>In our cross-sectional study, 100 adolescent athletes were divided into two groups: vitamin D insufficiency (25(OH)D<20 ng/mL) and vitamin D sufficiency (25(OH)D>20 ng/mL) with 30 males and 20 females in both groups. A detailed physical examination and basic biochemical tests were performed; serum 25(OH)D levels were determined, and an echocardiographic evaluation was performed.</p><p><strong>Results: </strong>We found that decreased serum 25(OH)D levels were associated with impairment in many indicators of cardiac function, such as left ventricular-right ventricular-interventricular septum peak systolic velocity (Sm) and Tei index, inflow peak early diastolic velocity and inflow peak late diastolic velocity ratio (E/A), annulus early diastolic myocardial peak velocity (E'), and E/E' ratio.</p><p><strong>Conclusions: </strong>To protect cardiac functions in adolescent athletes, we suggest screening serum 25(OH) D levels during certain periods, such as fall and winter, and vitamin D supplementation if necessary.</p>","PeriodicalId":19431,"journal":{"name":"Nigerian Journal of Clinical Practice","volume":"28 4","pages":"471-479"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histomorphometric Analysis of the Human Umbilical Cord and Its Vessels in Pregnant Women with Anemia: A Case-Control Study.","authors":"I Ahmed, A Elmugabil, M M Salih, L E Ali, A A Siniyeh, E H Khalifa, S M Hanafy, I Adam","doi":"10.4103/njcp.njcp_648_24","DOIUrl":"https://doi.org/10.4103/njcp.njcp_648_24","url":null,"abstract":"<p><strong>Background: </strong>Anemia during pregnancy is a significant public health concern as it is associated with adverse maternal and fetal consequences.</p><p><strong>Aim: </strong>To assess the histomorphometric changes in the umbilical cord as an indicator of maternal physiological dysfunction and to evaluate the impact of maternal anemia on fetal development.</p><p><strong>Methods: </strong>A case-control study was conducted to explore the histomorphometric changes in UC and its vessels in women with anemia in Central Sudan. The following parameters were studied using the ImageJ software: vessel area (VA), wall area (WA), lumen area (LA), mean wall thickness boundary (MWTB), mean wall thickness skeleton (MWTS), and external diameter skeleton (EDS).</p><p><strong>Results: </strong>UCs were studied in 73 women with anemia and 102 women without anemia. Only one woman had severe anemia (hemoglobin level, <7 g/dl). Maternal age, parity, and gestational age showed no significant differences between women with and without anemia. However, the median (interquartile range) birth weight was significantly lower in women with anemia than in those without anemia [3.29 (2.91‒3.58) g vs 3.42 (3.09‒3.77) g, P = 0.043]. None of the investigated variables (VVA, WA, LA), MWTB, MWTS, and EDS) did not differ between women with and without anemia. No significant correlations were found between maternal hemoglobin levels and UC parameters.</p><p><strong>Conclusion: </strong>The current study showed no difference in UC parameters between women with and without anemia. The nonsevere form of anemia may explain the results of this study. Therefore, further research is required in this regard.</p><p><strong>Data access statement: </strong>The data supporting the findings of this study are available from the corresponding author upon reasonable request. Due to ethical and privacy concerns, some data may be restricted in accordance with institutional and regulatory guidelines.</p>","PeriodicalId":19431,"journal":{"name":"Nigerian Journal of Clinical Practice","volume":"28 3","pages":"367-372"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Anthropometric Measurement Results and the Relationship Between Individual Identity and Geographic Belonging Through Artificial Neural Networks from a Mental Health Perspective.","authors":"Ş Öztuna, C Işık, N A Altınöz","doi":"10.4103/njcp.njcp_290_24","DOIUrl":"https://doi.org/10.4103/njcp.njcp_290_24","url":null,"abstract":"<p><strong>Background: </strong>Identity verification and geographical belonging are significant issues with mental health implications, particularly in forensic contexts. Anthropometric measurements offer potential insights into these relationships.</p><p><strong>Aim: </strong>This study aims to evaluate the significance of anthropometric measurement results and the relationship between an individual's identity and their geographical belonging through artificial neural networks from a mental health perspective.</p><p><strong>Methods: </strong>Study Population: The study population consisted of female individuals who visited or were brought to the forensic medicine outpatient clinic of a public hospital located in the center of Balıkesir Province between June 2023 and October 2023. Sample: The sample consisted of 100 voluntary female participants who agreed to take part in the study. The participants' geographical origins were inquired, and anthropometric measurements were conducted. Measurement results were recorded in an artificial neural network program using participant code names and evaluated using the Matlab program.</p><p><strong>Results: </strong>It was found that lip prints, fingerprints, and the angle of the mandible contained varying amounts of usable data in both the training and testing phases. The system developed by the researchers achieved a high success rate with an R-value of 1 during the training process and 0.97 during the testing process.</p><p><strong>Conclusion: </strong>In future research addressing identity verification as a social issue from a mental health perspective, solutions may involve improving the performance of this system by utilizing different artificial neural network models, learning algorithms, and activation functions.</p>","PeriodicalId":19431,"journal":{"name":"Nigerian Journal of Clinical Practice","volume":"28 3","pages":"294-304"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Catastrophic Health Expenditure among Health-Insured and Noninsured Diabetic Patients in Kaduna State, North West Nigeria.","authors":"Z S Babandi, M A Darma, M B Jibril, A T Aliyu, S Shehu, A Lawal, A A Aliyu","doi":"10.4103/njcp.njcp_77_24","DOIUrl":"https://doi.org/10.4103/njcp.njcp_77_24","url":null,"abstract":"<p><strong>Background: </strong>Diabetes imposes significant economic burdens on individuals and households through higher out-of-pocket payment. Access to affordable care is critical to reducing mortality and associated suffering.</p><p><strong>Aim: </strong>To assess and compare catastrophic health expenditure (CHE) and factors associated with CHE among health-insured and noninsured diabetic patients in Kaduna State, Nigeria.</p><p><strong>Materials and methods: </strong>A comparative cross-sectional study was conducted using a multistage sampling technique to select 500 respondents. Using an interviewer-administered questionnaire, information was collected on sociodemographic characteristics, income, cost of care, and CHE.</p><p><strong>Results: </strong>The mean age of the respondents was 50.0 ± 1.3 years and 53.7 ± 14.6 years for the health-insured and non-insured groups, respectively. About 42% and 68% of the health-insured and insured patients incurred CHE, respectively (P = 0.001). The intensity of CHE was 18.3% and 26.2% for the health-insured and noninsured diabetic patients, respectively (P = 0.43). Religion (AOR: 1.98; CI: 4.21-6.6; P = 0.048), occupation (AOR: 0.13; CI: 0.042-0.421; P = 0.001), and duration of diabetes (AOR: 2.1; CI: 1.021-8.223; P = 0.045) were found to be associated with CHE.</p><p><strong>Conclusion: </strong>The study found a significant difference in the incidence of CHE between the two groups, although the difference in intensity of CHE was not significant. It is recommended that the Federal and State Governments ensure health insurance coverage and other social safety nets for nonformal sector diabetic patients to protect them from CHE.</p>","PeriodicalId":19431,"journal":{"name":"Nigerian Journal of Clinical Practice","volume":"28 3","pages":"417-424"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}