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Background : Inappropriate prescribing negatively impacts on health and economy of individual and the society. Objectives : To evaluate the prescribing patterns and patients’ opinions on healthcare practices in selected primary healthcare centres (PHC) in Ibadan, South-Western Nigeria. Methods : A prospective cross-sectional study was carried out among patients and healthcare workers in selected PHCs using semi-structured questionnaires. Also, patients’ prescription records were reviewed using the WHO-prescribing indicators. Results : About one-half (210; 52.5%) were very satisfied with convenience of obtaining prescribed medicines in the PHCs, accessibility of PHC to abode (158;39.5%) and affordable medications (136;34.0%). Patients were dissatisfied with follow-up of care (191; 47.8%), courtesy of workers (184; 46.3%) and non-availability of medicines (138;34.5%). Number of drugs per encounter was 5.8±2.3 and % encounter with an antibiotic was >26.8% in each facility. Hematinics accounted for (814; 35.0%), analgesics (544; 23.4%), antimicrobials (303;13.0%) and antihypertensives (5; 0.2%). Conclusion : Primary healthcare attendees were satisfied with medication costs affordability and accessibility of PHC to abode but expressed dissatisfaction with follow-up of care and courtesy of workers. Also, inappropriate prescriptions characterized by polypharmacy and overuse of antibiotics were common underscoring the need for regular training of PHC workers on rational drug use and instituting appropriate measures for improvement. Keywords : Primary healthcare, healthcare workers, prescribing patterns

Background: Irrational antibiotic prescriptions for children is a global concern requiring periodic evaluation and monitoring. Objectives: To assess appropriateness of antibiotic prescribing for under-five children, as well as evaluating mothers’ usage of antibiotics for their under-five and reason(s) for use. Method: Cross-sectional review of out-patient case-notes of under-five using principles of antibiotic prescribing and a questionnaire-guided interaction with under-five mothers. Results: Nearly all (445;98.9%) antibiotic prescriptions were based on signs and symptoms indicative of bacterial infection. Only 3(0.7%) had the initial antibiotic regimen modified. Nine (2.0%) had documented evidence of sensitivity test requested before antibiotic prescribing. Presence of infection or need for antibiotic therapy was established in 190(42.2%). Majority (324;72.0%) of mothers had administered antibiotics to their under-five. Of these, 157(48.5%) were prescribed by physicians and 79(24.4%) were self-recommended. Educational status of mothers significantly influenced antibiotic usage. Conclusion: Antibiotic prescriptions for under-fives was largely based on symptoms indicative of bacterial infections, thereby corroborating the widespread empirical antibiotic prescribing. Considerable number of mothers engaged in self-recommendation of antibiotics for their under-fives. Thus, there is a need for continuous enlightenment of prescribers and mothers on rational use of antibiotics, while microbiological confirmation of clinical diagnosis is encouraged for evidence-based antibiotic prescribing. Keywords: Antibiotic prescription, under-five children, mothers/caregivers.

Background: Poor adherence to prescribed therapy among patients with chronic diseases is a growing concern which undermines the benefits of current medical care. Objectives: To evaluate the pattern of treatment non-adherence among ambulatory patients with poorly controlled type 2 diabetes in southwestern Nigeria, and to determine the possible factor(s) that accounted for such non-adherence with a view to identifying areas of future intervention to improve outcome. Methods: A prospective cross-sectional interview using the concept of RIM (Recognize, Identify and Manage) model was used to evaluate adherence to treatment recommendations among 176 consented patients recruited from the endocrinology out-patient clinics of two teaching hospitals in southwestern Nigeria between November, 2010 and January, 2011. Results: Overlaps of non-adherence behavior were obtained. More than three-quarter (153; 88.4%) were not aware of indication for each of the prescribed medications, 26 (15.3%) correctly described regimen as prescribed. The factor(s) identified as possible barriers to medication adherence include practical (145; 40.1%), knowledge (103; 28.5%), and attitudinal (114; 31.5%) barriers. Dietary non-adherence was mostly due to inappropriate guidance (62; 33.7%). Conclusions. The arrays of non-adherence behavior among the cohort further emphasize the need for patient-centered questioning approach as a reasonable strategy in resolving non-adherence problems in routine clinical practice.Keywords: Type 2 diabetes, Non-adherence, Ambulatory careAfrican Health sciences Vol 14 No. 1 March 2014

Background: Antibiotic misuse is a major contributory factor to treatment failure, antibiotic resistance and high healthcare costs.Objectives: To evaluate level of self-reported antibiotic misuse among non-medical undergraduate students of a Nigerian university.Methods: Respondents’ knowledge of antibiotics and disposal system for left-over antibiotics were explored using a structured questionnaire. Data were summarized with descriptive statistics. Chi square was used to evaluate relationship between specific categorical variables and respondents’ opinions with p0.05).Conclusion: Misuse of antibiotics among non-medical undergraduate students in a Nigerian university setting is pervasive suggesting an urgent need for enlightenment on rational use and disposal of antibiotics.Keywords: Antibiotic misuse, University Students, NigeriaAfrican Health Sciences 2013; 13(4): 1149 - 1155

Background: Giant fibroadenoma of the breast is a rare benign breast tumour which seldom grows to a giant size, it is even rarer for this benign tumour to grow rapidly, ulcerate spontaneously and present like a fungating breast tumour in a way mimicking breast cancer. Case presentation: This is a presentation of a 14 year old premenarchal girl with a massive ulcerating and fungating left breast mass that was initially thought to be a fungating locally advanced breast carcinoma on clinical examination. Further examination of the morphology of the resected surgical specimen and histological examination confirmed it to be giant fibroadenoma of the breast. It was successfully managed by partial mastectomy and breast reconstruction with an excellent result and a high degree of patient satisfaction was achieved. Conclusion: Though a rare clinical entity benign breast tumour can present like a fungating breast cancer and this must be bore in mind especially in young adolescent patients presenting with ulcerating breast tumour. Key word: Giant fibroadenoma, fungating tumour, Nigeria teenager.

Testicular schistosomiasis caused by Schistosoma mansoni is very rare and more so when associated with primary infertility. A 40 years old man from the Jos Plateau, North Central Nigeria presented with primary infertility after ten years of marriage. Sperm count revealed oligospermia and he also complained of inability to sustain erection. Testicular biopsy revealed several ova of Schistosoma mansoni in the connective tissue of the testes. Cases of infertility in endemic areas especially when there is no supply of potable water should raise suspicion of schistosomiasis among other pathologies and possible hormonal disturbances when the testes are involved. Key words: Schistosomiasis, testes, infertility

It is a pleasure to welcome you to this first issue of African Health Sciences for 2014. We bring you papers on non-communicable diseases, infections, herbal medicine, reproductive health and medical education. The paper by Adisa and Fakeye1, introduces us to an interesting component of patient management in type 2 diabetes, that is, adherence to the medication. More than 75% of the patients were not aware of the indication for the prescribed medicine. Possible barriers to non-adherence included lack of knowledge, poor attitude, high cost, confusing doze of medicine, and premature discontinuation due to side effects. Saudi authors have studied the ‘impact of mild versus moderate intensity aerobic walking exercise training on markers of bone metabolism and hand grip strength in moderate hemophilia patients’.2 On the other hand, Ugandan authors3 describe histopathological types of cancer of the esophagus , while Chinese authors4 report on the anti-human gastric cancer effect of astragalosides.