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The persistent power dynamics between men and women in most countries of Africa has continued to deny women necessary access to contraceptive. The study examines the impact of men’s involvement in contraceptive use and wellbeing among married women in Nigeria using DHS data. Two sets of data, NDHS 2008 & 2018 were used in this study. The selection of the samples was based on two-stage sampling techniques and the data for the study were analyzed using three levels of statistical method. The study reveals higher significant effect of men’s involvement on reproductive rights was affirmed while an inverse significant relationship was confirmed between male involvement in contraceptive use and years of schooling of women in the study The study concludes that changing behavioral attitudes of men toward family planning is therefore essential and urgent.

This study examined occupational hazards in small-scale sawmills in three Local Government Areas (Makurdi, Gwer west and Gwer east) in Benue state, Nigeria. A total of ten sawmills were sampled and visited. Ten copies of well-structured questionnaire were distributed in each sawmills to elicit information on the hazards supported by workers due to sawmill activities. Results on hazards in sawmills revealed that Destiny, Ire Akari, and Segun sawmills had 100% accident victims, followed by Igbor (87.5%) Hafilla (83.3%) Adekola (77.8%) Apir and Mase (71.4%), and 60% in Ogo Oluwa and El-matandi respectively. High rate of accident was recorded in Gwer East (93.7%) followed by Gwer West (78.9%) and Makurdi (71.4%). The most injuries registered were Laceration, sprain and strain, 41.65% in Gwer East, 30.13% in Gwer West and 28.6% in Makurdi. Fracture was more frequent in Gwer East (22.9%) and Gwer West (9.53%). Bruises were common in Makurdi (42.9%), Gwer West (40.21%) and Gwer East (29.15%) respectively. Most of workers are male and they are performed a lot of manual activities without any protection means which led to injuries in different parts of the body. Generally back and hand pains dominated in all studied sawmills. It was therefore concluded that efforts should be made by owners of sawmills towards drastically practical measures (training, protective materials and specific devices), that had to reduce hazards among their employees to the minimum level

The provision of written information is a low-cost and readily available intervention that has been found to reduce pain and anxiety in a variety of clinical settings. The current study was undertaken to determine if information provision may improve patients' experience during conventional electrodiagnostic studies.128 participants were recruited from a tertiary teaching hospital who were referred for electrodiagnostic studies. They were randomized into 2 groups where the intervention group was provided with written information about the electrodiagnostic testing. Patients were invited to complete a questionnaire that included pain and anxiety using a visual analogue scale (VAS) following the testing. All participants underwent nerve conduction studies (NCS) whilst a subset also underwent subsequent needle electromyography (EMG).Those who received information had a statistically significant lower perception of anxiety during NCS, whilst only females who received information had a statistically significant lower perception of pain to both NCS and EMG.The provision of written information can reduce the degree of pain and anxiety experienced during electrodiagnostic testing.Improving patient comfort and tolerability during electrodiagnostic testing may have practical implications towards more reliable and accurate results obtained from such investigations that may in turn improve patient diagnosis and management.

Background: Inhalational therapy is the cornerstone in the management of chronic obstructive pulmonary disease (COPD) patients. Patients' peak inspiratory flow impacts effective dry powder inhaler (DPI) delivery and management outcome., Objective: This study assessed peak inspiratory flow rates (PIFR) and determined the factors associated with suboptimal inspiratory flow rates among COPD patients., Methods: A descriptive cross-sectional study was conducted among 60 participants (30 stable COPD patients and 30 age-and-sex matched controls). Socio-demographic characteristics was obtained and spirometry was done for all participants. PIFR assessment was done using the In-Check Dial Meter and was categorized as suboptimal (< 60L/min) or optimal (≥ 60L/min). P values less than 0.05 were taken as statistically significant., Results: Mean age of the COPD patients and healthy controls were both 67.8 ± 10.3 years, with 53.3% being females. Post-bronchodilation FEV 1/FVC% for COPD patients was 54.15 ± 11.27%. The mean PIFR among COPD patients was significantly lower than that of healthy controls, in all DPIs simulated, especially for Clickhaler (46.2±13.4 vs 60.5±11.4L/min, p<0.001). A significant proportion of COPD patients had suboptimal PIFR, in the simulated resistances against Clickhaler and Turbuhaler (70% vs 80%; p<0.001). Older age, shorter height and low BMI were associated with suboptimal PIFR among COPD patients. However, independent predictors of suboptimal PIFR were BMI, PEFR, FEV1% and FVC%., Conclusion: Suboptimal PIFR was found in a significant number of COPD patients when compared with healthy respondents. Routine assessment using In-Check Dial meter should be done to determine the suitability of dry powder inhalers for patients with COPD., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2023 by West African Journal of Medicine.)

Introduction: the relationship between asthma control and health-related quality of life (HRQoL) in adult asthmatics is fairly established, but the unique contribution of atopy to this relationship has received less attention. The aim of this study was to quantify the contribution of atopy to this relationship., Methods: in a cross-sectional study, we assessed HRQoL using mini-Asthma Quality of Life Questionnaire (AQLQ). Asthma control, atopy and lung function were assessed using the Asthma Control Test (ACT), skin prick test and spirometry respectively. Hierarchical multiple regression was used to examine the association between of HRQol and asthma control, atopy and other clinical and demographical factors., Results: eighty-two adult asthmatics (59 females), with median age of 44 years and median duration of asthma of 15 years were recruited from a tertiary hospital. Fifty-two (63%) were classified as atopic based on sensitization to at least one aeroallergen. The atopic individuals were younger and had better quality of life in activity domain; however, there was no significant difference between the atopic and non-atopic asthmatics in ACT score (19.0 vs 18.0) p=0.91, total AQLQ score (4.9 vs 4.6) p=0.22. The ACT scores correlated positively with total AQLQ scores [rho= 0.53, 95% Confidence Interval (CI) 0.35, 0.67; p< 0.001]. However, atopy contributed significantly to the emotional domain of HRQoL score, p=0.028., Conclusion: we concluded that better asthma control is associated with better quality of life and atopy contributed uniquely to emotional domain in health-related quality of life., Competing Interests: The authors declare no competing interests., (Copyright: Olayemi Fehintola Awopeju et al.)

Background: Co-morbid depression poses a challenge to the successful management of pulmonary tuberculosis (TB). This study assessed the prevalence of depression and its associated factors among patients receiving treatment for TB in a tertiary health care facility in southwestern Nigeria., Materials and Methods: A descriptive cross-sectional study was conducted among all the pulmonary TB patients presenting in the initiating or continuous phase of treatment and they were consecutively recruited between January and December, 2017. The Mini International Neuropsychiatric Interview (MINI) tool was used for the diagnosis of depression. The severity of depression was assessed using Hamilton Rating Scale for Depression (HAMD)., Results: Of the 152 patients, 85 (55.9%) were males with a mean age of 41.7 ±15.5 years and 71 (46.7%) had depression of which 64(90.1%) had mild depression and 2 (2.8%) had severe depression. Among female 38(56.7%) were depressed compared to 33 (38.8%) male (p=0.028). Fifty-nine (55.1%) of those on continuous phase of treatment were depressed compared to 12 (27.3%) initiating treatment (p=0.002). In those with HIV co-morbidity 36 (66.7%) were depressed while 35 (35.7%) were depressed among those without HIV co-morbidity (p <0.001). Among those who had poor perception of treatment outcome, 7 (87.5%) were depressed compared to 64 (44.4%) with good perception, p=0.018. Overall, predictors of depression were having poor perception about outcome of treatment (AOR: 12.9; CI 95%: 1.4-118.4), having HIV co-morbidity (AOR: 2.9; CI 95%: 1.4-6.3) and being on continuous phase of TB treatment (AOR: 2.5; CI 95%: 1.1- 5.9)., Conclusion: The care of patients with TB should be more comprehensive. Health care workers should actively seek for evidence of depression among patients diagnosed with Tuberculosis and appropriate help offered to them.

Background: Poor sleep quality is reportedly common among asthmatic patients, however, there is little or no data among Nigerian asthmatics. The purpose of this study was to determine the contribution of sleep quality to Asthma control OBJECTIVE-To determine the impact of sleep quality on asthma control amongst asthma patients at Federal Medical Centre, Owo, Ondo State. METHODS-This was a cross sectional study evaluating 100 clinically stable asthmatic patients at the outpatient department at Federal Medical Center, Owo. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and Daytime sleepiness was assessed using the Epworth sleepiness scale (ESS). Asthma control was assessed by Asthma Control Test (ACT) score. Peak Expiratory Flow variability (PEF) was used to determine average daily variability in lung expiratory flow and this was used to monitor asthma control and severity over a period of two weeks. Additionally, lung function was assessed by spirometry., Results: The mean age of the study population was 45.2 ± 17. 5years. Sixty patients (60%) had poor quality of sleep (PSQI > 5), while fifty-three patients (53%) had excessive daytime sleepiness (ESS>9). Increasing global PSQI score (poor sleep quality) was associated with decreasing ACT score (poor asthma control) with (r=-0.63; p <0.001). Multiple regression analysis showed that quality of sleep was the independent predictor of asthma control in our patients (p= <0.001)., Conclusion: Results from this study suggest that quality of sleep is a significant determinant of asthma control in asthmatic patients. Therefore, efforts should be made to screen patients with asthma for sleep impairment.

Background: Tuberculosis is the world's deadliest infectious disease and a leading cause of death in Nigeria. The availability of a functional healthcare system is critical for effective TB service delivery and attainment of national and global targets. This study was designed to assess readiness for TB service delivery in Oyo and Anambra states of Nigeria., Methods: This was a facility-based study with a mixed-methods convergent parallel design. A multi-stage sampling technique was used to select 42 primary, secondary, and tertiary healthcare facilities in two TB high burden states. Data were collected using key informant interviews, a semi-structured instrument adapted from the WHO Service Availability and Readiness Assessment tool and facility observation using a checklist. Quantitative data were analysed using descriptive and inferential statistics while qualitative data were transcribed and analysed thematically. Data from both sources were integrated to generate conclusions., Results: The domain score for basic amenities in both states was 48.8%; 47.0% in Anambra and 50.8% in Oyo state with 95% confidence interval [- 15.29, 7.56]. In Oyo, only half of the facilities (50%) had access to constant power supply compared to 72.7% in Anambra state. The overall general service readiness index for both states was 69.2% with Oyo state having a higher value (73.3%) compared to Anambra with 65.4% (p = 0.56). The domain score for availability of staff and TB guidelines was 57.1% for both states with 95% confidence interval [- 13.8, 14.4]. Indicators of this domain with very low values were staff training for the management of HIV and TB co-infection and training on MDR -TB. Almost half (47.6%) of the facilities experienced a stock out of TB drugs in the 3 months preceding the study. The overall tuberculosis-specific service readiness index for both states was 75%; this was higher in Oyo (76.5%) than Anambra state (73.6%) (p = 0.14). Qualitative data revealed areas of deficiencies for TB service delivery such as inadequate infrastructure, poor staffing, and gaps with continuing education on TB management., Conclusions: The weak health system remains a challenge and there must be concerted actions and funding by the government and donors to improve the TB healthcare systems.

Background: Asthma is known to constitute a huge economic burden to its sufferers and their carers. There is a dearth of studies documenting this burden among asthmatics in Nigeria., Objective: This study assessed the relationship between economic cost and psychiatric morbidity among stable Nigerian patients with asthma., Methods: 85 patients with asthma completed a socio-demographic and illness-related questionnaire, the modified Economic Cost Questionnaire and General Health Questionnaire 12 (GHQ 12). Associations between socio-demographic characteristics, illness related variables, psychiatric morbidity and the direct, indirect and total costs in relation to asthma were assessed., Results: The average annual total, direct and indirect cost were $309, $190.65 and $118.34 respectively per patient for subjects with asthma. Direct cost constituted 62.7% while the indirect cost was 38.3% of the total cost for asthma. Drugs and hospitalisation were leading contributors to direct costs for asthma. Psychiatric morbidity was found to be present in 35% of subjects with asthma, those with psychiatric morbidity had a higher economic burden., Conclusion: The economic cost of asthma is high, psychiatric morbidity increases this cost. The cost is largely due to drugs and hospitalisations for exacerbation. There is an urgent need to optimize means of helping to minimize this cost and increase measures for detecting and treating psychiatric morbidity.

Objective: Previous reports has shown that asthmatic patients with poor asthma control exhibited cognitive dysfunction. However, there is paucity of information on the cognitive functions of patients with clinically stable asthma particularly in sub-Saharan Africa. Subjects, study setting, materials and methods: This was a cross-sectional study conducted at the Federal Medical Centre, Owo, South West Nigeria from 2014-2016. Forty patients with mild to moderate asthma and forty matched (age, sex and educational status) non-asthmatic control subjects were included. Spirometry was done for all participants. Cognitive performance on domains of psychomotor speed, attention/concentration, memory and vigilance were assessed in all the participants using the Fepsy neuropsychological test battery Results: The mean age of the patients with asthma in years was 38.65±16.67 while that of the control subjects was 39.18±11.64 years. The patients with asthma had prolonged visual and binary choice reaction time relative to controls. Older asthmatic patients had prolonged visual and binary choice reaction time when compared to controls (p<0.05) while other socio-demographic clinical characteristics of the patients did not have impact on their cognitive performance (p>0.05)., Conclusion: Cognitive performance was similar between the patients with mild to moderate asthma and non-asthmatic controls. Older asthmatic patients have impaired psychomotor speed relative to younger asthmatic patients.

Background: Metered dose inhalers are cornerstone in effective management of bronchial asthma when correctly used. Most studies hitherto have focused on assessing patient's knowledge of inhaler technique. We sought to assess the knowledge of inhaler technique, spacer device and peak flow meter among doctors and nurses in a tertiary healthcare institution in Nigeria., Method: A cross sectional survey of nurses and doctors from emergency department, family and internal medicine; who were attending a continuous professional development lecture, was carried out. From a total of 100 questionnaires administered, we retrieved 87 of which 75 were completed, giving a response rate of 75%. It was a self-administered questionnaire. Data was analysed with SPSS version 21.0. Descriptive statistics were done. Association was examined using chi-square test., Result: Mean age of respondent was 35.8 years ± 8.7, 47(62.7%) were < 40 years, 33(44%) were male, nurses were 30(40.0%). Only 28(37.3%) had ever used a peak flow meter. Only 4(14.3%) used peak flow meter frequently, while 12(26.7%) checked patient's inhaler technique often. Only 9 out of the 75 (12%) participants all of who are doctors knew at least 3 essential steps of the techniques in using the metered dose inhaler correctly. None of the participants got all the steps for the use of pMDI totally correct., Conclusion: Knowledge regarding the use of the metered dose inhaler and spacer device was poor. Health practitioners should have constant reminders in the form of continuous medical education to update their knowledge regarding correct inhaler technique., Funding: self-funded., Competing Interests: Conflict of interest: None declared

Background and Objectives: We examined the association of respiratory symptoms, health status, and lung function with the use of solid fuel (wood, charcoal, coal or crop residue) for cooking or heating in a predominantly non-smoking population., Methods: Using the protocol of the Burden of Obstructive Lung Diseases (BOLD) initiative, we collected representative population data using questionnaires and spirometry tests. We categorized solid fuel use into 'never user', 'ex user' and 'current user' based on responses to the survey. We developed regression models to evaluate the relation between use of solid fuel and the prevalence of respiratory symptoms, quality of life and lung function adjusting for confounding variables., Results: Out of 1147 respondents with complete information on domestic fuel type, 33% were 'never-users', 19% were 'ex-users' while 48% reported current use of solid fuel for domestic cooking and/or indoor heating. Compared with never-users, current solid fuel users were more likely to report cough (OR: 1.7, 95% CI: 1.0, 2.9), cough or phlegm (OR: 1.6, 95% CI: 1.0, 2.5) and the association was stronger among women (OR: 3.0, 95% CI: 1.3, 7.1 and OR: 2.3, 95% CI: 1.1, 5.2, respectively). Current solid fuel users also had lower mental health status (coefficient: ?1.5, 95% CI: ?2.8, - 0.2) compared with the group of never-users. Current or previous domestic use of solid fuels for cooking or heating was not associated with higher prevalence of chronic airflow obstruction (FEV 1 /FVC < LLN)., Conclusions: Using solid fuel for domestic cooking or heating was associated with a higher risk of cough or phlegm and a lower mental quality of life. However we found no significant effect in the prevalence of chronic airflow obstruction in Ife, Nigeria., (Copyright © 2017. Published by Elsevier Ltd.)

Rationale: Black Africans have reduced FVC compared with white persons, but the prevalence and determinants of reduced values are not well understood., Objectives: To evaluate the prevalence and factors leading to reduced FVC in a Nigerian population and to examine current theories regarding the determinants of this difference., Methods: We studied the ventilatory function of 883 adults aged 40 years or older participating in the Burden of Obstructive Lung Disease Study in Ile-Ife, Nigeria. Respondents completed pre- and post-bronchodilator spirometry test and provided information on their smoking history, respiratory symptoms, risk factors, and diagnoses, including anthropometric details. We used standard categories to define body mass index as either underweight, normal, overweight, or obese. We defined reduced FVC as a post-bronchodilator FVC below the lower limit of normal using National Health and Nutrition Examination Survey (NHANES) equations, Global Lung Function Initiative 2012 equations, and local reference equations based on nonsmoking study participants without a respiratory diagnosis. We fit multivariate linear regression models to FVC as a continuous measure, adjusting for age, sex, height, and other confounders., Results: The prevalence of reduced FVC was 70.4% for men and 72.8% for women when using NHANES values for white Americans, 17.8% for men and 14.4% for women using NHANES equations for African Americans, and 15.5% for men and 20.5% for women using the Global Lung Function Initiative 2012 equations. Using the equations derived from nonsmoking respondents in the survey without a respiratory diagnosis, the prevalence of reduced FVC was less than 4% for both men and women. FVC was lower in participants who had less than 7 years of education (FVC, -96 ml; 95% confidence interval [CI], -172 to -19), were underweight (FVC, -269 ml; 95% CI, -464 to -73), were overweight (FVC, -132 ml; 95% CI, -219 to -46), and were obese (FVC, -222 ml; 95% CI, -332 to -112)., Conclusions: There is a wide variation in the prevalence of reduced FVC based on the reference standard used. This variation is not satisfactorily explained by factors thought to affect FVC within individual populations. However, the prevalence strongly associates with both education level and body mass index in this population, regardless of the specific standard used.

Competing Interests: There are no conflicts of interest.

Objective: Lung function measurements performed several times daily are useful for the diagnosis of occupational asthma. Patient fabrication of hand-recorded charts can limit confidence in the results; this is overcome using electronic meters that log time and measurement. We have compared individual and meter differences in FEV1 and PEF recorded by hand and from meter logs using expert subjects on four data-logging spirometers with different methods of measurement and different quality control software., Methods: Eight workers in a respiratory physiology department were asked to record FEV1 and PEF 2-hourly from waking for 7 days using four electronic meters (Easyone, Micro DL, Vitalograph Diary card 2110 and Piko-1) in random order. Subjects hand-recorded the best FEV1 and PEF from each session, this was compared with the logged data., Results: Discordant measurements from individuals were lower for FEV1 than PEF and differed from 4.4-19.1% for FEV1 (mean 9.4%, p < 0.0001) and 6-23.3% for PEF (mean 12.6, p < 0.0001). There were also significant differences between meters for both variables (p < 0.0001). The magnitude of the differences in PEF was highest for the Easyone (34l/min) and lowest for the Vitalograph Diary card 2110 (14l/min) and varied significantly between meters (mean 22l/min, p = 0.002)., Conclusions: Differences between hand-recorded and logged measurements are unlikely to be due solely to patient fabrication and can be due to quality criteria or other unclear software requirements applied after the results are shown on the meter screen; they differ between meters. Whether the differences shown affect clinical outcome will require further investigation.