Clinical Pharmacy and Biopharmacy- Scholarly Publications

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Browsing Clinical Pharmacy and Biopharmacy- Scholarly Publications by Author "Aina, B.A"

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    Open Access
    Associated factors and treatment outcomes of tuberculosis patients with diabetes mellitus in a secondary health facility in Lagos Nigeria.
    (West African Journal of Pharmacy, 2016) Ayeni, F.A; Aina, B.A; Oyetunde, O.O; Adejumo, O.A
    Background: The presence of diabetes mellitus (DM) has been shown by a growing body of evidence to be a risk factor for tuberculosis (TB) and co-infected patients may show poor response to TB treatment as both diseases interact negatively. Objectives: This study is aimed at determining associated factors and comparing the treatment outcomes of TB patients living with and without DM in a secondary care TB treatment facility in Lagos state, Nigeria. Methods: A retrospective review of patients records above 18 years' enrolled between 1st January 2011 and 31st December 2012 in a secondary care TB treatment facility in Lagos state was carried out. Results: A total of 424 records of TB patients were reviewed, out of which 36 (8.5%) had DM. Mean age of TBDM patients (50.0±12.8) was higher than for TB-only patients (34.1±13.8). Male: Female ratio of TBDM and TB only patients was comparable. All TBDM patients had pulmonary TB. Of these, proportion of smear negativity (72.2%) was significantly higher than TB only patients (34.9%, p <0.001). More TBDM patients (38.9%) compared to TB only patients (20.6%) had poor treatment outcomes (p = 0.012). Conclusion: The prevalence of TBDM was substantial and it was associated with advanced age, smear negative sputum result and poor treatment outcomes. Concurrent management of both diseases should be considered to improve treatment outcomes.
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    Open Access
    Care Seeking Pattern, Knowledge and Response of Caregivers to Childhood Diarrhoea in a Sub-urban Community in Lagos, Nigeria.
    (Journal of Basic and Social Pharmacy Research, 2019) Ogbo, P.U; Soremekun, R.O; Aina, B.A
    Background Diarrhoea remains one of the leading causes of morbidity and mortality among children under 5 years old in spite of availability of effective treatment. Families and communities have been identified as key stakeholders to the improvement of child survival in diarrhoea. Objective This study was set to determine caregivers’ knowledge and response to diarrhoea within the first 24 hours, evaluate their care-seeking pattern and identify determinants of response. Method A descriptive cross-sectional survey of 1,236 caregivers of children under five years was carried out in a sub-urban community in Lagos. Pretested, structured questionnaire was administered to caregivers whose children had experienced diarrhoea within one month of survey. Data were analyzed using descriptive and inferential statistics with Statistical Package for the Social Sciences (SPSS) Version 23.0. Results The mean age of caregivers was 30.2 years ±5.305 with 1,201 (97.2%) being biological mothers of the children. Majority, 848 (68.6%) correctly recognized diarrhoea as passage of three or more watery stools within a 24-hour period. Knowledge of correct cause of diarrhoea was poor (332; 26.8%) and 797 (64.5%) perceived diarrhoea as a serious condition. While 48.9% opted for home treatment, 35.3% offered no care to the child. Only 119 (9.9%) respondents sort care in government health facilities. Conclusion Majority of caregivers kept the child at home either treating them or not rendering care. Care seeking at government health facilities was low. Age category of child, educational status of caregiver, number of children being cared for by caregiver and overall knowledge of diarrhoea were significantly associated with response within the first 24 hours.
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    Open Access
    Economic Burden of Tuberculosis Diabetes Co-Morbidity in Tuberculosis Patients Attending Two Chest Clinics in Lagos State
    (Nigerian Journal of Pharmaceutical Research, 2020) Ayeni, F.A; Oyetunde, O.O; Aina, B.A; Yarah, H.O
    Background: Diabetes mellitus (DM) increases the risk of developing tuberculosis (TB) three-fold. The cost of accessing care for TB-DM co-morbidity poses a significant burden on patients, as they bear both direct and indirect costs of treatment, mostly of out-of-pocket. Objective: To estimate the direct medical cost of illness in patients with TB-DM co-morbidity in two chest clinics in Lagos State. Materials and Methods: An observational study, carried out in two chest clinics in Lagos State to evaluate direct medical costs associated with TBDM co-morbidity during TB treatment. A semi structured questionnaire, pharmacy price list of drugs and an online transportation service lara.ng was employed to document and quantify prescribed medications, laboratory investigations, number of clinic attendance and attendant transportation costs. Results: Among the participants, 53.8% were females. The mean age was 50.7±9.7 years. The total direct medical and non-medical costs for TBDM management was NGN8,604,819 (USD24,585.20) for the duration of TB treatment. Average cost per patient (CPP) was NGN179,384.85 (USD512.53). This was equivalent to 49.8% of the current national minimum wage. Male patients incurred more mean direct medical cost than female patients (NGN26, 647.90 vs NGN24, 020.40), while female patients incurred more mean direct non-medical costs than the males (NGN22, 314.30 versus NGN13, 041.70). Patients aged 60 years and above incurred the highest mean direct costs compared to other age groups. Conclusion: Direct medical costs are substantial in TBDM co-morbidity and increase with age.
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    Open Access
    The Effect of Collaborative Care on Treatment Outcomes of Newly Diagnosed Tuberculosis Patients with Type‑2 Diabetes Mellitus and Adverse Drug Reaction Presentations: A Prospective Study
    (International journal of Mycobacteriology, 2021) Ayeni, F.A; Aina, B.A; Oyetunde, O.O
    The burdens of tuberculosis (TB) and diabetes mellitus (DM) in Nigeria are high. DM often goes unrecognized in TB patients, resulting in poorer treatment outcomes compared with TB patients only. This study set out to compare TB treatment outcomes and associated factors in TB only and TBDM patients when a collaborative care (CC) model is in place. Methods: A prospective quasi‑experimental study, modeled after the World Health Organization and The Union’s Collaborative Framework for Care and Control of TB and DM was carried out among TB patients in two chest clinics in Lagos state. Patients were grouped into TB only, who received the usual TB care, directly observed treatment, short course (DOTS), and TBDM, who received DOTS and CC. Data were analyzed with IBM Statistical Package for the Social Sciences, version 23.0. Chi‑square and multivariate analysis determined the association between treatment success and CC. Statistical tests were calculated at 95% confidence intervals and considered significant when P value is < 0.05. Results: Of 671 participants in the study, 52 (7.7%) had DM. At TB treatment completion, there was no statistically significant difference in outcomes between TBDM and TB‑only patients (P = 0.40). Patients who received CC were about 32 (OR: 31.60, 95% CI: 3.38‑293), and 5 times (OR: 5.08, 95% CI: 1.35‑19.17) more likely to achieve success and cure, respectively, compared to those who did not. Conclusion: Provision of CC with DOTS ensured improved TB treatment outcomes in TBDM patients. Recommendations of WHO/The Union are feasible in our setting.
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    Open Access
    Knowledge and Attitude towards Diabetes Mellitus among Residents of Igbo-Ora, a Rural Community in South-Western Nigeria
    (The Nigeria Journal of Pharmacy, 2019) Adetona, I.O; Ogbo, P.U; Aina, B.A
    Background: Diabetes mellitus is a chronic disorder that has permeated every nation of the world with about 451 million people living with it. There is poor awareness among the public about the extent to which diabetes is dilapidating to health and the available intervention for prevention. Knowledge is a critical component of behavioural change and being knowledgeable of various aspects of a disease is the first step for primary prevention and a better attitude towards disease. This study aimed to assess the knowledge and attitude towards diabetes mellitus among residents of Igbo-Ora, a rural community in Oyo State, Southwestern Nigeria. Methods: The study was a descriptive cross-sectional survey, conducted in Igbo-Ora among adults, 18 years and above using an interviewer-administered questionnaire. The questionnaire was distributed to344 respondents. Data were analyzed using Epi info statistical software version 7:1. Results: Overall, about 57% of the respondents had good knowledge about the symptoms, risk factors and complications associated with diabetes mellitus. The majority (83.7%) of the respondents knew that excessive urination is one of the symptoms. However, less than half of the respondents were aware that obesity (41.3%) and lack of physical activity (39.24%) are major risk factors. The majority (73.3%) of the respondents had a positive attitude toward diabetes mellitus prevention and control. Conclusion: This study showed that more than half of the respondents had good knowledge about diabetes and a greater population had positive attitude towards prevention of the disease.
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    Open Access
    Knowledge and use of insecticide treated nets as a malaria preventive tool among pregnant women in a local government area of Lagos state, Nigeria
    (Journal of Applied Pharmaceutical Science, 2011) Ayeni, F.A; Aina, B.A
    Malaria has been described as the foremost public health concern in tropical and subtropical regions of the world, Nigeria inclusive. This survey set out to assess the knowledge, attitude and practice on the use of ITNs as a malaria preventive tool among pregnant women and to determine its level of recommendation and proper instructions given by pharmacists. Structured questionnaires were administered to pregnant women attending antenatal clinics at two selected hospitals in Alimosho Local Government Area (ALGA) of Lagos State and also to community pharmacists practicing in the same ALGA. Data was analyzed using Epi Info 2002 and Microsoft Excel. Forty eight community pharmacists and 163 pregnant women participated in the study. About 77 and 91% of pregnant women were aware of ITNs at Igando GH and the private hospital respectively. Only 11.2% and 37.5% actually used it. Majority of the pharmacists (95.8%) recommended the use of ITNs and 95% of them also gave counsel on ITN use while 5% did not. There is a wide difference between the level of awareness and the rate of use of ITNs by pregnant women. More emphasis should be placed on ownership and use of ITNs so that the benefit of its protection can be derived.
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    Open Access
    Management of acute diarrhea in children by community pharmacists in Lagos, Nigeria.
    (Pharmacy Practice (Granada), 2014) Ogbo, P.U; Aina, B.A; Aderemi-Williams, R.I.
    Background: Acute diarrhea in children leads to dehydration and death if not appropriately managed. World Health Organization (WHO) recommends treating diarrhea with oral rehydration therapy (ORT), fluids and foods. Proper management is hinged on accurate assessment of patients to identify the acute watery diarrhea. Objective: To compare the knowledge and attitude of community pharmacists in the management of acute diarrhea in children with their observed practice. Methods: This study was carried out using two instruments: structured self-administered questionnaire to assess knowledge and attitude of community pharmacists in the management of acute diarrhea in children and simulated patient visits to evaluate assessment of patients, recommendation of products and instructions on feeding and fluid intake. The simulated patient visits were done in 186 pharmacies in the city of Lagos, Nigeria. Results: The study reveals that the knowledge and attitude of community pharmacists in the management of acute diarrhea in children was different from their observed practice. The difference was statistically significant (p<0.05). During the simulations, 23% carried out appropriate assessment before recommending any products, and 15% recommended ORT alone. Although information to the pharmacists indicated non-dysentery, non-cholera, acute watery diarrhea, antibiotics and antidiarrheals were irrationally recommended and these were the mainstay of symptoms’ management in practice. Questionnaire data revealed that 24% of pharmacists knew the correct instructions to give on food and fluid intake during diarrhea, whereas 8% followed WHO guideline on food and fluid intake during the visits. Conclusions: Assessment of patients to determine acute diarrhea was inadequate. Observed practice in managing acute diarrhea in children was inappropriate and significantly different from their claims in the questionnaire. The recommendation of ORT was scanty and advice on food and fluid intake was inadequate and sometimes inappropriate. This study shows that only 15% of community pharmacists managed acute diarrhea in children according to the WHO guidelines.
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    Open Access
    Prescribing Practices in the Management of Childhood Diarrhoea in Primary Health Care Centres in a Sub-Urban Community in Nigeria.
    (Journal of Community Medicine and Primary Health Care, 2019) Ogbo, P.U; Soremekun, R.O; Oyetunde, O.O; Aina, B.A
    Background: Childhood diarrhoea remains the second leading cause of morbidity and mortality among children under the age of five. Oral rehydration therapy and zinc tablets are the cornerstone for its management both at home and in the health facilities. Primary health care is the first level of contact of individuals and communities with the health care system and appropriate prescription is crucial for sustainable health benefits. This study assessed the prescribing pattern for childhood diarrhoea management and determined the appropriateness of treatment for acute watery diarrhoea without comorbidities in Primary Health Care (PHC) facilities in a sub-urban community in Nigeria. Methods: This descriptive study was done in 19 PHC facilities in Ikorodu Local Government Area of Lagos State, Nigeria. A retrospective review of 1271 prescriptions for diarrhoeal cases of children between 6 to59 months was done using the records from the Outpatient Department register for a period of one year. Descriptive analysis was done. Results: From the cases reviewed, 1239 (97.5%) had acute watery diarrhoea (AWD), either alone 819 (64.4%), or with malaria/fever 347 (27.3%), cough/URTI 59 (4.6%), and other conditions 14 (1.1%). For cases of AWD alone, there were 499 (60.9%) prescriptions for ORS/Zinc, 249 (30.4%) for antibiotics and 203 (28.4%) for antimalarials. Antibiotic and antimalarial injections were also included in the prescriptions. Conclusion: This study found the prescription pattern for childhood diarrhoea to be inadequate with suboptimal prescriptions of ORS/Zinc. The prescriptions of antibiotics and antimalarials for acute watery diarrhoea was high and unnecessary.
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    Open Access
    The Prescription of Medicines for Childhood Acute Diarrhoea: A Retrospective Study at Four Secondary Healthcare Facilities in Lagos State, Nigeria
    (Nigerian Journal of Pharmaceutical Research, 2021) Ogbo, P.U; Aina, B.A; Owoborode, O.E
    Background: Diarrhoea remains the second leading cause of mortality in children, with an estimated 205 children under the age of 5 dying daily in Nigeria. Combination therapy of ORS with zinc tablets is the cornerstone for its management. Secondary healthcare facilities (SHFs) represent the second level of contact for patients requiring professional care; hence an appropriate prescription for diarrhoea is crucial for the survival of under-fives. Objectives To evaluate the prescription of medicines in the management of acute watery diarrhoea (AWD) in under-fives at SHFs, and determine the appropriateness of the prescriptions. Method A descriptive cross-sectional study was done at four randomly selected SHFs in Lagos State. A retrospective review of prescriptions for diarrhoea cases totalling 480, was done using records from the General Out-Patient Department from September 2018 to August 2019. A descriptive analysis was performed. Results: All cases reviewed were diagnosed as AWD occurring either alone (352; 73.3%) or in combination with malaria/fever (55; 11.5%), cough/URTI (23; 4.8%), and other conditions (50; 10.4%). Of the 352 AWD only cases, there were 121 (34.4%) prescriptions for ORS/Zinc as combined therapy without the addition of antibiotics, 120 (34.1%) for antibiotics, and 134 (38.1%) for probiotics. Other prescriptions include analgesics (18.2%), injectables (9.7%) and antimalarials (8.8%). Conclusion: The study revealed suboptimal prescriptions of ORS/Zinc with the appropriateness of prescription at 34.4%. The prescription of antibiotics and other medicines which have no rehydration benefits was high.
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    Open Access
    Stakeholders views on why child overweight and obesity is rising in Lagos, Nigeria: A qualitative study
    (Journal of Clinical Sciences, 2016) Adedini, A.A; Aina, B.A; Ogbo, P.U
    Background and Objective: According to the World Health Organization, the number of obese children would increase to 70 million by 2025 if no intervention is made. An increase in the prevalence of overweight and obesity among school children in Lagos State, Nigeria has been established, but specific factors promoting its prevalence are unknown. The aim of this study was to elicit the views of stakeholders on the perceived causes for the rise in child overweight and obesity. Methods: Five focus group discussions were conducted with different groups of stakeholders involved in child care, namely: Parents, teachers, and healthcare givers. Participants were recruited using a purposive sampling method; a structured question guide was employed for the discussion sessions. The discussions were recorded, collated, and analyzed using grounded theory to extract themes. Results: Six themes emerged as factors responsible for the rise, of which civilization and lifestyle imbalance of the populace emerged as the prominent cause. Of the fifty respondents, 76% of respondents identified parents (particularly young mothers) as major contributors to the prevalence of overweight and obesity in children of Lagos State; and 52.3% of the participants reported that a direct relationship exists between income class of parent and weight of a child resident in Lagos. Conclusion: Civilization and lifestyle imbalance, insecurity and congestion, low level of public awareness, inadequate educative and enlightenment programs, myths and societal perception were factors identified to responsible for the rise in the prevalence of child obesity in Lagos, Nigeria. Preventive strategies to control the prevalence of overweight and obesity in children residing in Lagos State should be considered for further studies.
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    Open Access
    Tuberculosis and Diabetes Mellitus Co-Morbidity: Lessons to Learn From HIV/AIDS
    (Journal of Basic and Social Pharmacy Research, 2019) Ayeni, F.A; Oyetunde, O.O; Aina, B.A
    Tuberculosis (TB) and Diabetes mellitus (DM) are among the top ten causes of morbidity and mortality globally, with the Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome.(AIDS) also causing significant mortality as well. The HIV-TB link has been well recognized since the beginning of the HIV epidemic, but link between TB and DM has only returned to the fore-front recently after effective treatments for each condition reduced the association that was reported earlier in the twentieth century. Recently also, urbanization, increasing age and sedentary lifestyle has led to an increase in diabetes prevalence. Diabetes mellitus is associated with a 3-fold incident risk of tuberculosis and, to a lesser extent, tuberculosis may also increase the risk of developing diabetes. Both diseases interact negatively at multiple levels, exacerbating and worsening the outcomes of the other. The impact of these co-morbidities particularly in developing countries of Sub Saharan Africa, of which Nigeria is one, is likely to be large. An increasing prevalence of diabetes mellitus may hinder efforts aimed at tuberculosis control, making successful TB treatment and control more difficult. Improved management of tuberculosis and diabetes could build on the successes of the TB-HIV/AIDS collaborative activities, and DOTS strategy, which emphasizes support to patients, as well as a reliable.supply of quality-assured medicines. This review aims to examine the association between these twoimportant diseases, and explore ways to manage and reduce mortality caused by the duo.