Bolajoko A. Aina

Management of acute diarrhea in children by community pharmacists in Lagos, Nigeria

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.

Knowledge and use of dietary supplements by students of College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria

Rationale: Nutritional supplements are preparations intended to supplement the diet and provide nutrients. They include vitamins, minerals, fiber, fatty acids, or amino acids, that may be missing or may not be consumed in sufficient quantities in a persons diet. Many health professionals including dietitians, physicians and pharmacists are supplement users. Objectives: The objectives of the present study were to determine knowledge and use of dietary supplements among students of College of Medicine, University of Lagos who are potential health professionals. Methodology: A self-administered questionnaire with a mix of open and close ended questions was employed to collect data in this study. It was distributed to 300 students that were in their final year in various departments of the college. Findings: Response rate was 89%. About 86% of the students have used dietary supplement before while half of them (50%) have used it in the past 12 months. The common types of dietary supplements used in the past 12 months are the vitamins. The reasons for use by the students were good health, poor diet, to boost immunity, weight gain and doctors prescription. Most of the students were occasional and once in a while users. Conclusions: Majority of the students were aware of dietary supplement use and most of them were occasional users.

In Vitro Equivalence Studies of Generic Metformin Hydrochloride Tablets and Propranolol Hydrochloride Tablets Under Biowaiver Conditions in Lagos State, Nigeria

This study used biowaiver conditions to assess bioequivalence of some generic products used in Nigeria. None of the generic samples tested met biowaiver conditions; therefore, in vivo bioequivalence studies are required to ascertain therapeutic equivalence. To take advantage of the cost savings of using in vitro dissolution as a surrogate for bioequivalence studies, manufacturers of generic products need to consider factors that affect solubility and permeability of their products when formulating them.

Pharmacists' participation in the documentation of medication history in a developing setting: An exploratory assessment with new criteria

Objective To assess the impact of pharmacists’ participation on the frequency and depth of medication history information documented in a developing setting like Nigeria Method The study consisted of two phases. The first phase was a baseline cross-sectional assessment of the frequency and depth of medication history information documented by physicians in case notes of systematic samples of 900 patients that were stratified over 9 Medical outpatients Units at a premier teaching hospital in south western Nigeria. The second phase was an exploratory study involving 10 pharmacists who conducted cross-sectional medication history interview for 324 randomly selected patients. Results 49.2% of patients, whose medication history were documented at the baseline, by physicians, were males; while 50.3% of patient interviewed by pharmacists were male. Mean age (SD) of males and females whose medication histories were documented by physicians and pharmacists were 43.2 (SD=18.6), 43.1 (SD=17.9) years and 51.5 (SD=17.6), 52.1 (SD=17.4) years respectively. The frequency of medication history information documented by pharmacists was significantly higher for twelve of the thirteen medication history components (P < 0.0001). These include prescription medicines; over the counter medicines; source of medicines; adverse drug reactions; allergy to drugs, allergy to foods, allergy to chemicals; patient adherence; alcohol use; cigarette smoking; dietary restrictions and herbal medicine use. The depth of medication history information acquired and documented by pharmacist was significantly better for all the thirteen medication history components (P<0.0001). Conclusion Pharmacists’ participation resulted in significant increase in frequency and depth of medication history information documented in a developing setting like Nigeria. The new medication history evaluation criteria proved useful in assessing the impact of pharmacists’ participation.

Assessment of communication skills among pharmacy students of the university of Lagos, Lagos, Nigeria

BACKGROUND: Communication skill is the bridge between the pharmacists and the patient. Communication in health can contribute to all aspects of disease prevention and health promotion. In order to become successful pharmacists, one needs to possess excellent communication skills to serve clients. This study was conducted at the University of Lagos to assess communication skills of Pharmacy students. METHOD: The study was descriptive and cross sectional. It was carried out between May and July 2009. Questionnaires were used for data collection. The questionnaire had two sections - the bio data section and pre-formulated questions on communication skills which has three options and one of these is the best option. RESULTS: A total number of 125 respondents were involved in the study which included 25 students from 200level, 50 from 300level and 50 from 500 level. Majority of them were between 18-25 years old (89.6%). There were more females (71.2%) than males (28.8%). Also most of them were Christians (71.2%). Among the respondents, about 62% picked the best options as their answer while the rest picked other options. There was no statistical difference in the choice of best options between the different levels of study. CONCLUSIONS: It can be concluded from the results of this study that majority of Pharmacy Students at the University of Lagos had good communication skills and they will be able to discharge their duties as pharmacists when they eventually graduate.

Stakeholders views on why child overweight and obesity is rising in Lagos, Nigeria: A qualitative study

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.