West African journal of medicine最新文献

{"title":"IMPERATIVE OF SPIRITUALITY HISTORY IN CLINICAL PRACTICE, A PRIMARY CARE PERSPECTIVE; IN THE DEPARTMENT OF FAMILY MEDICINE, RIVERS STATE UNIVERSITY TEACHING HOSPITAL, PORT HARCOURT.","authors":"P K Biralo, N O Nnadi, O Ogunfowokan, A O Obodoegbulam, N Okocha, O Titi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cultural practices and spirituality militate against effective utilization of healthcare facilities in Sub-Saharan Africa, especially in primary care settings. Spirituality history in clinical practice will help the health professional understand patients' values, religious beliefs, cultural practices, and preferences. It gives insight into proper counseling, and appropriate treatment and serves as an adjuvant to necessary therapeutic approaches. Family and social history have been a recognized feature of clerking patients over the years but effort is hardly been made in exploring their cultural practices and spirituality. This study aimed to Identify attitudes, socio-demographic, and professional predictors towards spirituality history in the management of patients at the Family Medicine department in Rivers State University Teaching Hospital. It was a cross-sectional study conducted over a period of six months, from January to June 2024. Out of 62 participants, 60 fully responded. The data from the questionnaire were entered into an Excel spreadsheet and analyzed using SPSS version 16. The respondents consisted of physicians (n, 55%), nurses (n, 8.3%), and Industrial Training (IT) Students (n, 36.7%). Health professionals within the age bracket of 45 -54 years and above were well willing to take spiritual history as against those within 18 - 24 years age group. Consultant physicians, senior registrars, and nurses with higher years of practice, exposure, and experience in service had a more positive attitude towards spirituality history than the younger ones. Spirituality history in clinical practice will make healthcare culturally acceptable with an increase in the utilization of available healthcare facilities. Training of health professionals in this regard is hereby advocated.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"41 11 Suppl 1","pages":"S14-S15"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DECENTRALIZED IMMUNIZATION MONITORING: LESSONS LEARNED FROM FOUR STATES - NIGERIA.","authors":"Mohammed Yahaya, Adam Attahiru, Tukur Mustapha, Nurudeen Aliyu, Musa Melton, Ismaial Habila, Fiyidi Mikailu, Talatu Buba Bello, Hyelshilni Waziri, Bernsah Damian Lawong, Ndadilnasiya Endie Waziri, Moreen Kamateeka, Adewole Adefisoye, Ijeoma Joy Nwajiaku, Bilkisu Abdullahi, Garba Mustafa, Ismail Auwalu, Margaret Wisdom, Oladimeji Amal, Nememma Makachi Agu, Success Ocholangba Abah, Aminu Garba Magashi, Muhammad Usman, Nancy Voller, Teemar Fisseha, Nassor Mohamed, Joseph Valadez, Willam Vargas, Gustavo Caetano Correa, Heidi W Reynolds, Patrick Nguku","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Low immunization coverage in Nigeria accounts for 2.3 million children with zero doses, increasing morbidity and mortality. The government prioritizes 100 local government areas for strategic interventions aiming for a 15% reduction in zero-dose (ZD) children by 2024.</p><p><strong>Objective: </strong>We set out to track immunization performance, identify priority indicators, estimate coverage, and generate evidence for informed decision-making.</p><p><strong>Methods: </strong>A cross-sectional study using the validated behavioral and social drivers of immunization (BeSD) and lot quality assurance sampling (LQAs) frameworks was used in Kano, Sokoto, Borno, and Bauchi states that included 4, 028 children across 106 wards.</p><p><strong>Findings: </strong>The mean age of caregivers was 28 years (SD+ 6 years) - slightly lower in Bauchi 26 years and higher in Borno 30 years. Over 97% had Islam as their religion and married. The prevalence of Zero Dose was 30.7%. About 66% of caregivers had no formal education with 84% of ZD had no education. About 51% of ZD caregivers are not engaged nor have they any source of income. Average Monthly income was found to be 3 times higher in NZD Caregivers than ZD caregivers. Home Delivery was 54% with Sokoto and Kano having 72.5 and 66.4% respectively. However, 71% of ZD Caregivers delivered at Home. Overall, 79% Uptake. ANC uptake was higher amongst NZD Caregivers than ZD caregivers. Sokoto and Kano (Sumaila) had the lowest uptake. About 73% of Sample children received at least one immunization antigen. Sokoto had the least 46%. Penta 1 coverage was at 66% with Bauchi having 77%. About 68.5% of Zero dose caregivers reported little or no intention to be vaccinated with all the childhood vaccines. About 69% of caregivers trust healthcare workers who vaccinate children. 560 (45%) of zero-dose caregivers do not. About 69% of caregiver's vaccinators said payment is \"moderately\" or \"very\" easy for the vaccination of their child. 47% of ZD caregivers reported challenges in affording vaccines for their children. Bauchi & Sokoto had the highest number of access challenges. Over 57% of zero dose caregivers live within a short distance (trekkable distance) to an RI service delivery point.</p><p><strong>Conclusion/recommendation: </strong>Targeted outreach with financial aid, education, community leader engagement, and social support promotion can increase vaccinations. Improving service delivery, accessibility, and clear centre location information is crucial. Keywords: Immunization, Zero-dose children, Vaccine hesitancy, Nigeria.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"41 11 Suppl 1","pages":"S54"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HEALTH-RELATED QUALITY OF LIFE AND ITS ASSOCIATED FACTORS IN PERSONS WITH TYPE 2 DIABETES MELLITUS ATTENDING THE UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN CITY, EDO-STATE, NIGERIA.","authors":"O Nnaecheta, O A Ohenhen, A Eregie","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Health-related quality of life (HRQoL) is an important Patient-Reported Outcome Measure (PROM) for evaluating outcomes in patients with chronic diseases such as diabetes mellitus (DM). With the rising prevalence of Type 2 diabetes worldwide, especially in developing countries such as Nigeria, there is a need to study the impact of the disease and its treatment on the quality of life of the patients.</p><p><strong>Objectives: </strong>The objectives of this study were to assess the HRQoL of persons with type 2 diabetes and determine the medical factors and socio-demographic variables associated with it.</p><p><strong>Methods: </strong>150 patients with Type 2 diabetes were recruited for this Institution-based cross-sectional study. Seventy-five (75) age and sex-matched controls were also recruited for the study. A structured questionnaire was used to collect data on socio-demographic and clinical variables. The World Health Organization quality of life-abbreviated tool (WHOQoLBREF) was used to assess the quality of life of the respondents. Physical examination and anthropometric measurements were done according to standard protocols. Samples were collected for fasting blood glucose and HbA1c. Multivariate logistic regression was employed to identify the predictors of HRQoL among persons with type 2 diabetes.</p><p><strong>Results: </strong>The study population was predominantly females (68.7%) with a female: male ratio of 2:1. The mean (SD) overall HRQoL scores in subjects with type 2 diabetes and control sub-groups were 59.5(11.9) and 66.7(10.9) respectively, (p= <0.001). The mean HRQoL scores across all four domains were also lower in the type 2 diabetic arm compared with the controls. The factors significantly associated with HRQoL were: Age, educational level, level of income, duration of illness, presence of chronic complications, glycaemic control and co-morbidities (p <0.05). Older age and poor glycaemic control were identified as significant predictors of poor quality of life.</p><p><strong>Conclusion: </strong>The findings from this study indicate that all dimensions of the HRQoL of persons with type 2 diabetes were reduced compared to their age and sex-matched controls. This entails the need for interventions that will address the associated factors, beyond the provision of standard treatments so as to improve the quality of life of these patients.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"41 11 Suppl 1","pages":"S35-S36"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DEVELOPMENTAL DELAY AND ASSOCIATED FACTORS AMONG UNDER-FIVE CHILDREN: A COMPARATIVE STUDY OF RURAL AND URBAN AREAS IN OYO STATE.","authors":"O O Olabumuyi, O C Uchendu, E A Oyewole","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Developmental delay, characterized by a child's failure to achieve expected milestones in one or more developmental domains, is prevalent in Sub-Saharan Africa, where two-thirds of children under five are at risk, exacerbated by limited early screening.</p><p><strong>Objectives: </strong>This study assessed the prevalence and factors associated with developmental delay among under-five children in rural and urban areas of Oyo State, Nigeria.</p><p><strong>Methods: </strong>This comparative cross-sectional study utilizing cluster sampling was used to select 1,839 children aged 3 to 4 years. A semi-structured questionnaire adapted from the Nigeria Demographic Health Survey, the Multiple Indicator Cluster Survey Early Childhood Development Index (MICS ECDI), and a literature review were used to collect data on child demographics, nutritional characteristics, and developmental delay across four domains (physical, social-emotional, learning approach, and literacy-numeracy). Analysis was done using STATA which included descriptive and inferential statistics.</p><p><strong>Results: </strong>The mean age was 3.5 ± 0.5 years with slight male predominance in both rural (51.1%) and urban (51.4%) areas. Overall developmental delay was comparable in rural (39.8%) and urban (36.6%) areas. Physical delay was the most common (rural: 55.7%, urban: 52.5%), while learning approach delay was the least prevalent (rural: 15.9%, urban: 18.3%). Child's age, wealth quintile and exclusive breastfeeding predicted overall developmental delay in both rural and urban LGAs.</p><p><strong>Conclusions: </strong>There is little variance in the overall prevalence of developmental delay across rural and urban areas, though it remains prevalent in both settings. While risk factors are similar, tailored interventions are necessary to address them effectively.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"41 11 Suppl 1","pages":"S37"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COMPARATIVE ASSESSMENT OF PERCEIVED QUALITY OF ANTENATAL SERVICES AMONG INSURED AND UNINSURED PREGNANT WOMEN ATTENDING ANTENATAL CLINIC IN A TERTIARY HEALTH INSTITUTION, IN SOKOTO, NIGERIA.","authors":"Habibullah Adamu, Khadija Mohammed Ojoagefu, Mubarak Ibrahim Umar, Fatima Ibrahim Saulawa","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Access to quality antenatal care (ANC) is essential in reducing high maternal morbidity and mortality, especially in resource-poor countries. One way of ensuring financial accessibility to high-quality ANC services is through health insurance. This study assessed the perceived quality of services among insured and uninsured pregnant women attending the ANC at a tertiary health institution in Sokoto, Nigeria.</p><p><strong>Methodology: </strong>A comparative cross-sectional study was carried out among 118 pregnant women selected via systematic sampling technique. Data were sought using a validated structured questionnaire and IBM SPSS version 25 was used for data analysis. Statistical significance was set at p < 0.05.</p><p><strong>Result: </strong>Key socio-demographic variables (age, marital status, educational status) of the respondents were comparable concerning their health insurance status (p>0.05). Duration of registration time was significantly longer among the insured than the uninsured clients (p<0.001), however, time spent in waiting was comparable in both groups (p=0.936). Similarly, the ease of getting prescribed drugs and investigations was higher among uninsured compared to their insured counterparts (p<0.001). Clients in both groups were generally satisfied with the services received at the clinic, and there was no statistically significant difference between the two groups (p>0.05). No factor was found to be significantly associated with clients' satisfaction in both groups (p>0.05).</p><p><strong>Conclusion: </strong>Insured clients spent considerably longer time in registration, laboratory, and in waiting to get their drugs after prescription. To reduce delay in obtaining investigation and prescribed drugs, a dedicated laboratory and pharmacy need to be provided within the antenatal clinic complex.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"41 11 Suppl 1","pages":"S4-S5"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EVALUATING A HEALTH INSURANCE SCHEME IN A HOSPITAL SETTING: PROPOSING AN ALTERNATIVE TO OUT-OF-POCKET PAYMENTS IN NIGERIA.","authors":"N Hayatudeen, A O Umar, T Abiola, Z T Sulaiman, J Jatau","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Mental health care in Nigeria relies heavily on out-of-pocket payments, creating financial barriers that hinder access. A pilot scheme linked to the National Health Insurance Authority (NHIA) Group, the Individual and Family Social Health Insurance Program (GIFSHIP) was initiated to alleviate these challenges.</p><p><strong>Objective: </strong>The study sought to assess the NHIA scheme's effectiveness in reducing costs, enhancing clinical outcomes, and improving patient satisfaction relative to traditional payment methods in mental health care, while also evaluating the feasibility of a pilot individual GIFSHIP.</p><p><strong>Methodology: </strong>The study examined the NHIA scheme over nine months at a tertiary mental health facility in Nigeria, involving patients with various mental health diagnoses eligible for insurance. Data on care costs, in-patient admission rates, and patient satisfaction were gathered through structured questionnaires and hospital records. A comparative analysis was performed between insured and non-insured patients.</p><p><strong>Results: </strong>Insured patients experienced a significant reduction in financial burden, with monthly out-of-pocket expenses approximately 40% lower than their non-insured counterparts. In-patient admission rates and patient satisfaction were similar across both groups. The hospital's indigent patient fund supported a pilot individual GIFSHIP program for individuals with mental illness. Anticipated cost benefits may enhance service uptake and revenue for the hospital.</p><p><strong>Conclusion: </strong>The pilot mental health GIFSHIP scheme may alleviate financial pressures on patients and enhance access to quality care. Policymakers and healthcare providers can advocate for similar insurance schemes, particularly in integrated care environments, to foster sustainable and equitable mental health care for all. Keywords: Mental health insurance, GIFSHIP, Nigeria, out-of-pocket payment.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"41 11 Suppl 1","pages":"S25-S26"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EXAMINING THE PREVALENCE AND DETERMINANTS OF PERSISTENTLY HIGH PRIMARY CARE USE AMONG NATIONAL HEALTH INSURANCE ENROLLEES OF A HEALTHCARE FACILITY IN KANO, NORTHWEST NIGERIA.","authors":"G C Michael, Z A Umar, B A Grema","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Among frequent healthcare users is a small group called \"high-care users\", with ≥ 10 hospital visits annually. They consume a disproportionate share of the healthcare budget, and their care is often inappropriate and unnecessary.</p><p><strong>Objectives: </strong>To assess the prevalence and determinants of persistent high-care (PHC) use (≥ 10 visits in two consecutive years) among National Health Insurance Authority (NHIA) enrollees.</p><p><strong>Methods: </strong>This cross-sectional study analyzed the data of 380 randomly selected patients attending the NHIS Clinic of Aminu Kano Teaching Hospital between January and June 2022. Using a data sheet, we collected their 2018 and 2019 data on biodata, clinic visit characteristics, diagnoses, and cost of care (medicines and investigations) from their medical records.</p><p><strong>Results: </strong>There were more females (62.6%); their mean age was 37.5±16.0years. Three-quarters (285/380) of patients visited the clinic with an infectious disease in 2018/2019, while 37.6%(143/380) visited with a cardiovascular disease (CVD). Only 2.6%(10/380) were PHC users in the two years. The median cost of care for PHC users in 2018 was 30,549.0((IQR), 23,454 - 35,280) naira compared to the 10,290.0(5,856-18,079) naira consumed by non-PHC users. The median cost of care in 2019 was 41,238.5(25522-54020) naira (PHC users) versus 9,523.5(4709-19070) naira (nonPHC users). Older age, tribe and having CVD were significantly associated with PHC use; however, having CVD (OR=11.38, 95%CI [1.15 - 112.26], P=0.037) predicted PHC use.</p><p><strong>Conclusion: </strong>The prevalence of PHC users was low. However, they consumed 3 to 4 times more resources than the other enrollees. More robust studies will be required to ascertain the complete picture in order to provide appropriate interventions needed to reduce inappropriate/unnecessary visits and cost of care.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"41 11 Suppl 1","pages":"S24"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VIRAL HEPATITIS C IN ADULT DIABETICS IN COTONOU IN 2023: PREVALENCE AND ASSOCIATED FACTORS.","authors":"A R Kpossou, C N M Sokpon, E O H Alade, R K Vignon, S E Gbedo, A Kerekou Hode, J Séhonou","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes and chronic liver diseases such as viral hepatitis C (HVC) are global public health problems. The combination of the 2 increases the risk of cirrhosis and hepatocellular carcinoma.</p><p><strong>Objective: </strong>The aim of this study was to investigate viral hepatitis C in adult diabetics in referral health centers in Cotonou.</p><p><strong>Methods: </strong>This was a descriptive and analytical cross-sectional study with prospective data collection from July to October 2023 at the Clinique Universitaire d'Endocrinologie Métabolisme Nutrition of the CNHU-HKM, and at the Banque d'insuline d'Akpakpa. A rapid test was used to diagnose hepatitis C and the C viral load determined by PCR. Hepatic fibrosis was assessed by the APRI (ASAT to platelet ratio Index) score.</p><p><strong>Results: </strong>A total of 281 patients were included, with a mean age of 60.4±11.2 years, ranging from 22 to 88 years, and a sex ratio of 0.6. Anti-HCV antibodies were positive in 5 patients, for a prevalence of 1.7%, including 2 with detectable HCV RNA PCR (0.7% of the study population). Factors associated with HCV were, in bivariate analysis, hepatic cytolysis (p=0.005), prothrombin level (p=0.015), APRI score (p=0.003) and insulin therapy (p=0.030). In multivariate analysis, surgical history (p=0.045) and insulin therapy (p=0.030) were statistically associated with the presence of anti-HCV antibodies in diabetics.</p><p><strong>Conclusion: </strong>Viral hepatitis C is fairly common in adult diabetics, especially those with a history of surgery or on insulin therapy. Screening of diabetics for viral hepatitis C would be useful to reduce the morbidity and mortality associated with this association.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"41 11 Suppl 1","pages":"S4"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IMPACT OF BRIEF PSYCHO-EDUCATION ON CAREGIVER BURDEN AMONG CAREGIVERS OF CHILDREN AND ADOLESCENTS WITH INTELLECTUAL DISABILITY IN A NIGERIAN PSYCHIATRIC HOSPITAL: A RANDOMIZED CONTROL TRIAL.","authors":"A Archibong, I Agbonile, B Uteh, J Omoaregba, S Awhangansi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The effectiveness of Brief Psycho-education (BPE) is well-established among caregivers of adults with mental disorders, this is however not the case among caregivers of children and adolescents with Intellectual disability (ID) due to the dearth of data occasioned by relatively few studies in the area.</p><p><strong>Objective: </strong>This study assessed the impact of BPE on Caregiver burden (CB) among caregivers of children and adolescents with ID.</p><p><strong>Methodology: </strong>A single-blind RCT was conducted in the Child and Adolescent Clinic in the Psychiatric Hospital, Benin City. Randomization was done via a central computer system and group allocation via a third party. Family caregivers (n=58) were randomly assigned to intervention (n=29) and control (n=29) groups. Intervention and follow-up periods were 4 weeks each. Weekly BPE in addition to routine care (RC) was administered to the intervention group. The primary analysis was based on 58 participants (n=29; n=29) comparing CB in the two groups at the 4th week and 8th week post-intervention.</p><p><strong>Results: </strong>Mean follow-up post-intervention showed a significant reduction in overall CB in the intervention group between 0 and 4th week (mean deviation 6.76, p=0.03) as well as, 4th and 8th week (mean deviation 12.35, p<0.001). For the CB dimensions, mean follow-up scores post-intervention reached a significant reduction in the 8th week for financial/physical strain factor (mean deviation 1.8, p=0.02), time/dependence strain factor (mean deviation 2.4, p<0.001), emotional strain factor (mean deviation 1.3, p<0001), uncertainty factor (mean deviation 1.45, p=0.004) and self-criticism factor (mean deviation 1.19, p<0.001).</p><p><strong>Conclusion: </strong>BPE was superior to routine care in reducing CB among caregivers of Children and Adolescents with Intellectual disability.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"41 11 Suppl 1","pages":"S12"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HYPOTHALAMIC PITUITARY AXIS DYSFUNCTION IN A SEVERELY ASPHYXIATED NEONATE.","authors":"O Lukman, I Jalo, A G Iliya, V Ndubuisi, M P Raymond, A Rasaki","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Perinatal asphyxia is caused by a lack of oxygen to organ systems due to hypoxic or ischemic insult that occurs during labour and delivery. This may lead to multi-organ failure with brain involvement as the major organ of concern.</p><p><strong>Case report: </strong>We present a 19-day-old neonate referred to our centre with the complaint of inability to suck since birth and multiple seizures that started on the second day of life. He cried little, slept much, and had subnormal body temperature He was delivered via spontaneous vertex delivery at 41 weeks to a 19-year-old primigravida with a prolonged second stage of labour. He had a low APGAR score and was managed for severe perinatal asphyxia at the referral Centre. At presentation, He was conscious, not pale, anicteric, no edema with no dysmorphic features. Anthropometries were normal (weight was 2.8 kg, length 47 cm, OFC 37 cm). Had sutural diathesis, weak primitive reflexes, and hypotonia. No macroglossia or umbilical hernia. The stretched penile length was 2.7 cm. Magnetic Resonance Image showed cerebral and pituitary atrophy with hydrocephalus ex vacuo. Thyroid function test revealed central hypothyroidism and the serum cortisol was low (22.22 nmol/l). He was co-managed by a Paediatric neurologist with antiseizure medications, levothyroxine and hydrocortisone. There was some improvement in his activity and the seizure was controlled, however, hypothermia persisted.</p><p><strong>Conclusion: </strong>Neonatal hypoxic-ischemic encephalopathy does involve the hypothalamic-pituitary axis and there should be a high index of suspicion.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"41 11 Suppl 1","pages":"S31"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}