Nigerian Journal of Family Practice

The potential role of AI improving health care delivery in low- and middle-income countries (LMICs).

AB. Bello — 2024-11-15

This paper explores the transformative potential of artificial intelligence (AI) in enhancing healthcare delivery in low- and middle-income countries (LMICs), focusing on its applicability, challenges, and pathways for integration. The study is structured around three core objectives: examining current AI applications in Low- and Middle-Income Countries and their potential adaptations; investigating how AI can address pressing health challenges such as resource allocation and disease management; and identifying barriers to AI adoption, including technological infrastructure, data privacy concerns, and workforce training deficits. AI technologies have demonstrated significant efficacy in diagnostics, disease surveillance, and resource optimization, exemplified by mobile health (mHealth) solutions that extend healthcare access to underserved populations. However, the successful implementation of AI in LMICs is impeded by insufficient data quality, lack of robust infrastructure, and ethical considerations. By drawing on lessons from developed nations and emphasizing public-private partnerships, this study proposes strategies to overcome these obstacles, ensuring that AI can be harnessed effectively to improve health outcomes. The findings highlight the need for context-specific AI solutions and collaborative efforts among stakeholders to realize the full potential of AI in achieving equitable and efficient healthcare systems in LMICs.

Does the Nigerian health sector need family medicine?

P.O Dienye — 2024-11-15

Family medicine plays a vital role in enhancing healthcare delivery, yet its importance remains underrecognized in Nigeria. This article evaluates the relevance of family medicine in Nigerian health care industry where the healthcare system faces significant challenges, including limited access to care, an overburdened tertiary system, and a shortage of healthcare professionals. This article assesses the value of family medicine in the Nigerian healthcare sector, which is beset by a number of problems such as a lack of healthcare experts, a tertiary system that is overworked, and restricted access to care. Family medicine, with its focus on holistic, patient-centered, and continuous care, has the potential to address these gaps, particularly at the primary care level. Family physicians provide comprehensive care that addresses not only physical health but also the psychological and social factors affecting patients. They are crucial in managing common conditions and the rising burden of non-communicable diseases such as hypertension, diabetes, and respiratory illnesses. Additionally, family physicians are integral to maternal and child health, infectious disease control, and mental health services, which are critical public health areas in Nigeria. However, family medicine in Nigeria faces significant challenges, including a shortage of trained family physicians, limited government support, and poor integration into the healthcare system. The preference for specialist care, combined with underinvestment in primary care, undermines the role of family medicine in health system strengthening. To address these challenges, policy reforms are necessary to prioritize the training of family physicians, improve funding for primary care services, and raise public awareness about the importance of family medicine. By enhancing the role of family medicine, Nigeria can improve access to care, reduce pressure on tertiary care facilities, and create a more equitable healthcare system. In conclusion, Family medicine is essential for ensuring sustainable and effective healthcare delivery in Nigeria.

Prevalence and pattern of neurological disorders in adult patients seen at an outpatient rural tertiary hospital setting

NF Fuh — 2024-11-15

Introduction: Neurological Diseases (NDs) are common and most disabling leading to significant morbidity and mortality globally particularly in resource constrained settings. This study was aimed at determining the prevalence, distribution and pattern of NDs seen at the outpatient family medicine clinics of Irrua Specialist Teaching hospital (ISTH), Irrua, Edo State, Nigeria. Methods: A descriptive, retrospective review of hospital record was conducted for 1086 adult patients presenting to the general outpatient clinics of ISTH from January to December 2021 using hospital records. The diagnosis as made based on clinical findings and laboratory and radiological investigations using the 10th revision of the International Statistical Classification of Diseases and related Health Problems (ICD 10). Results were analysed using epi info version 3.5.4. level of significance was set at 0.05. Results: The prevalence of neurologic disorders was found to be 2.06%. The age of respondents ranged from 18 to 93 years with a mean age of 46±18 years. They were mostly females 678 (62.4%), married 678 (62.4%) with majority of them being traders 315 (29.0%). The most common disorder among respondents was neuropathy 372 (34.3%) followed by Headache 368 (33.9%), Seizure Disorder 144 (13.3%), Stroke 98 (9.0%) and Migraine 20 (1.8%). There was association between age (p <0.001), marital status (p <0.001) and occupation (p <0.001) with the above neurological disorders. Conclusion: Neurologic disorders were common among the respondents with neuropathy, headache, seizure disorders, stroke and migraine being the most common. The study also found an association between these conditions with age, marital status and occupation.

Depression among elderly individuals attending primary care clinic in Northwestern Nigeria: Prevalence, pattern, and associated factors

HS Akogwu — 2024-11-15

Background: Depression represents a major international public health problem for both developed and developing countries. It is associated with increased risk of morbidity, suicide, decreased physical, cognitive and social function, and greater self-neglect which in turn is associated with increased mortality. The aim was to investigate the prevalence, pattern and associated factors of depression among the elderly individuals in a primary care clinic in Northwestern Nigeria Methodology: The study was a cross-sectional hospital-based study and 391 elderly participants in a primary care clinic of Usmanu Danfodiyo University Teaching Hospital were recruited through systematic sampling technique. Data was collected using pre-tested, structured interviewer-administered questionnaire, Oslo – 3 social support scale and the GDS- 30 was used to screen for depression.Data was analyzed using SPSS version 20. Test of associations was done using Chi- square test and P< 0.05 was considered statistically significant. Results: The prevalence of depression among the elderly was found to be (41.2%) and of these respondents who were depressed, (99.4%) of them had mild depression while (0.6%) had severe depression. Marital status, level of education, occupational status, average monthly income, location of residents, social support,(P-value <0.05) were found to be significantly associated with depression in the elderly. Conclusion: The prevalence of elderly depression was high in primary care with preponderance of mild depression, the study recommends early screening, detection and treatments of depressive disorder in the elderly by primary care physician.

Medication adherence and blood pressure control among hypertensive patients in a Nigerian tertiary hospital: A cross-sectional study

MA. Ibrahim — 2024-11-15

Background: Despite the availability of potent antihypertensive medications blood pressure control remains low worldwide. Poor blood pressure control is known to contribute significantly to the morbidity and mortality among hypertensive patients with developing countries disproportionately affected. There are limited studies locally on relationship between medication adherence and blood pressure control. Aim: To investigate the relationship between medication adherence and blood pressure control among hypertensive patients attending Family Medicine clinic of UNIOSUN Teaching Hospital, Osogbo, Osun State, Nigeria. Methods: A cross-sectional hospital-based study was conducted. Systematic sampling method was used to recruit 300 known adult hypertensive patients from August to November, 2021. Data was collected using a pre-tested interviewer-administered questionnaire and medication adherence was measured using Morisky 8-Item Medication Adherence Questionnaire. Data was analyzed using descriptive and inferential statistics with p-value < 0.05 taken to be statistically significant. Results: This study recorded poor medication adherence among the study participants with 51.3% and 48.7% medium and low medication adherence respectively. Blood pressure control rate (46.7%) was also low. There is a directly proportional relationship between medication adherence and blood pressure control among the participants which was statistically (p= 0.001). Conclusions: Hypertensive patients adhered poorly to antihypertensive medication and the blood pressure control among them was poor.

Exclusive breastfeeding: Update on the knowledge and practices of care providers and mothers in the Maluku I and Lemba Health Zones.

UT Dimandja — 2024-11-15

Background Exclusive breastfeeding (EBF) is the practice of feeding newborns and infants only breast milk over six months of age. A child who is not exclusively breastfed for the first 6 months of life is exposed to infectious diseases such as diarrhea and is at high risk of developing malnutrition. According to WHO and UNICEF recommendations, EBF should be practised by every woman with an infant under six months of age. The percentage of EBF practice in the Lemba health zone is low in contrast to Maluku I. This study aim to assess the current knowledge and practices regarding EBF among care providers and mothers in Maluku I and Lemba Health Zones. Methods : Aqualitative case study approach was used to highlight the knowledge and practice of cares providers and in-depth interviews were used to collect data, which were analyzed using Atlas-ti V7 software. Results : The majority of our respondents had a superficial knowledge of EBF and knew the importance of this, but healthcare providers hadn't received appropriate training on EBF. A significant proportion of healthcare providers don't discuss EBF with women during medical appointments and visits. Culture, surroundings, spouse are all factors influencing the non-adherence of these women to the practice of EBF Conclusion : Providers aren't well trained and don't talk enough to women about EBF; work, culture, advertising of artificial milk on the media and the entourage slow down women in Lemba from practicing EBF. This study will help to improve the health of breast-feeding children.

Predictors of post-COVID syndrome among adult patients with COVID -19 infection in Ibadan, Nigeria

Temitope Ilori — 2024-11-15

Background: While most individuals recover from acute Coronavirus disease (COVID-19), a subset experiences persistent symptoms, referred to as post-COVID-19 Syndrome (PCS). Understanding the clinical spectrum and determinants of PCS is essential to provide evidence-based long-term care for COVID-19 survivors. This study aimed to describe the clinical spectrum and predictors of PCS among hospitalized and non-hospitalized COVID-19 patients in Ibadan, Nigeria. Methods: A retrospective cross-sectional study involved 536 adult individuals who tested positive for SARS-CoV-2 via polymerase chain reaction (PCR) in Ibadan, Nigeria. Data, including demographics, symptoms, comorbidities, and quality of life, were collected using a semistructured questionnaire and analyzed with descriptive statistics. Pearson's Chi-square and logistic regression were used to assess associations and predictors of PCS. Results: Among the 536 participants, 98 (18.3%) had PCS. Of these, 67 (68.4%) reported mild symptoms, while 31 (31.6%) experienced severe symptoms. Common symptoms included fatigue/malaise (36.7%), headache (19.4%), cough (17.3%), and sore throat (13.3%). Comorbidities, initial COVID-19 severity, vaccination status pre-infection, treatment location, oxygen supplementation, and ICU care were associated with PCS. Logistic regression revealed that having received a pre-COVID-19 vaccination decreased the odds of PCS by 62.4% (aOR=0.376; 95% CI [0.205, 0.692]). Individuals that experienced PCS had lower quality of life scores (Mean EQ VAS score: 85.8) compared to those without PCS (89.7), with impacts across mobility, self-care, daily activities, pain/discomfort, and anxiety/depression domains in EQ5D analysis. Conclusion: PCS affects a significant proportion of COVID-19 survivors in Ibadan, Nigeria. Pre-COVID-19 vaccination was associated with a reduced risk of PCS. Understanding the clinical and demographic factors predicting PCS can aid in providing long-term care and support for affected individuals.

Relationship between marital satisfaction and psychological health among married couple in South-South region of Nigeria.

OG Orhe — 2024-11-15

Background: Marital satisfaction is the largest contributor to overall happiness for married individuals and is strongly associated with physical and psychological wellbeing. Marital satisfaction is so critical to health and happiness that it generally declines over time when problems weigh down on a couple. Couples are expected to assist each other in various aspect of life and if these are not met, it can lead to marital dissatisfaction and invariably divorce or separation. Family stability is crucial and important to every society and nation as a whole. Ahealthy family atmosphere markedly influences the psychological health of each member of the family. This study is aimed at eliciting a relationship between marital satisfaction and psychological health among patients attending Family Medicine Out-patient Clinic in Delta State University Teaching Hospital, Oghara. Methods: This was a cross-sectional study that adopted a General Health Questionnaire(GHQ 28) as well as Index of Marital Satisfaction (IMS 25) to assess the relationship between psychological health and marital satisfaction respectively among patients recruited using a systematic sampling technique from Family Medicine Out-patient Clinic in Delta State University Teaching Hospital. The information required for the study was collected with the use of researcher-administered questionnaires. The questionnaire was translated into Pidgin and Urhobo languages and reinterpreted back by an external source in order to validate it. Collected data were entered into a spreadsheet and analysed using Statistical Package for Social Sciences (SPSS) Version 22. Results were presented in proportions, mean ± standard deviation and displayed in tables and charts. The relationship between marital satisfaction and psychological health was expressed using Pearson's chisquare. Ap-value was considered significant if less than 0.05. Result: The association between duration of marriage and psychological stability was highly significant; p = 0.001. Over three-fifths 115 (62.5%) of the patients had marital satisfaction whereas 69 (37.5%) of them were not satisfied in their marriage. The majority of the study participants were psychologically stable in their marriage, while 29.4% were unstable. Conclusion: The level of marital satisfaction was moderately high. The relationship between marital satisfaction and psychological health was statistically significant. This shows that marital satisfaction has a positive impact on the psychological health of the couple and vice versa.