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Item Antimicrobial stewardship: Assessment of knowledge, awareness of antimicrobial resistance and appropriate antibiotic use among healthcare students in a Nigerian University(Springer Nature, 2021) Akande-Sholabi, W.; Ajamu, A. T.Background: Inappropriate use of antibiotics is a major cause of antimicrobial resistance (AMR). Inadequate knowledge about AMR among healthcare students could affect their practice of antimicrobial stewardship as future healthcare professionals. This study aims to assess the use of antibiotics and knowledge of AMR among future healthcare professionals of a Nigerian University. Methods: Respondents’ knowledge of antimicrobial resistance, use of antibiotics, and source of antibiotics in the past 12 months was explored using a self-administered questionnaire. Multivariate analyses were used to evaluate the relationship between specific variables and respondents’ knowledge. Results: Of the 939 questionnaires administered to the students, 866 were filled given a response rate of 92.2 %. A total of (765; 88.3 %) of the respondents were aware that antimicrobial resistance makes it harder to eliminate the infection from the body as existing drugs become less effective. In all 824, (95.2 %) of the respondents had use antibiotics in the past 12 months. The use of antibiotics to treat malaria was self-reported by (175; 21.2 %). About half (432; 52.4 %) purchased the antibiotics from community pharmacies, while others obtained their antibiotics from the hospitals (192; 23.3 %), patent medicine stores (150; 18.2 %), and friends and family (50; 6.1 %) in the last 12 months. In all 506, (58.4 %) had good knowledge of antimicrobial resistance. Logistic regression shows that students in 3rd to 6th year 9.29 [AOR = 9.29, 95 % CI: (3.7–22.96)], had greater knowledge of antimicrobial resistance. Conclusions: The healthcare students demonstrated a moderate knowledge of AMR. This underscores the need to adopt several educational tactics to introduce the concepts of AMR to the students and ensure there are strict policies to regulate the flow of antibiotics.Item COVID-19 in Nigeria: Is the pharmaceutical sector spared?(Elsevier Ltd, 2020) Akande-Sholabi, W.; Adebisi, Y. A.; Bello, A.; Ilesanmi, O. S.The coronavirus disease 2019 (COVID-19) is an infectious disease caused by the newly discovered Severe Acute Respiratory Syndrome Coronavirus 2. The World Health Organization declared the novel coronavirus outbreak as pandemic after it was previously referred to as a public health emergency of international concern [1]. The first case of the disease in Nigeria was reported by the Federal Ministry of Health on the February 27, 2020 in Lagos. Since this period, there has been a steady geometric rise in the number of daily reported cases in the country with over 58,000 confirmed cases and 1100 deaths as of September 25, 2020. Many sectors have been impacted by the pandemic and the pharmaceutical sector is not an exception. This letter emphasizes how COVID-19 pandemic has impacted industrial, community and hospital pharmacy practice in Nigeria. The emergence of this pandemic brought with it, unprecedented challenges, and changes to all the nations of the world, Nigeria inclusive [1]. In a bid to contain the spread of this virus and to decrease the associated mortality and morbidity, a consensus of restricted movement, total lockdown in some places, have been reached in various countries. As a result of this, a country such as Nigeria which is heavily dependent on importation to meet its demands, will suffer a huge blow to several sectors including the pharmaceutical industry. Even though the local industry in Nigeria fairs better when compared to its counterparts in other developing countries in Sub-Saharan Africa [2], Nigeria is only able to meet 25% of its local demand. Nigeria’s pharmaceutical market predominantly runs on imports of active pharmaceutical ingredients machinery and quality control analytical equipment from abroad [2] . In Nigeria, over 70% of the prescribed medications are produced from active ingredients primarily sourced from firms in China and India [2]. Taking these into consideration alongside the travel restrictions in most countries, and the recently imposed travel ban on Nigerians, the current and future drug security in Nigeria is threatened. The added COVID-19 burden on the feeble healthcare system of Nigeria provides cause for grave concern. In an effort to manage the situation, the Central Bank of Nigeria has provided credit support as a palliative measure to reduce the impact of the pandemic on the health sector [3] . However, the availability of this fund to pharmaceutical industries is unknown. Lack of adequate infrastructures such as constant power supply, good water supply, functional transportation system and under-utilized manufacturing capacity have been some of the major challenges facing pharmaceutical industry in Nigeria [2]. Efforts should be made to address these challenges in order to reduce the total manufacturing and distribution costs. Adopting and enforcing production and distribution friendly policies amid and post-COVID-19 pandemic is essential. Community and hospital pharmacies have also been impacted as a result of the COVID-19 pandemic in Nigeria [4]. For instance, mode of operations has also evolved from face-to-face counselling into window-dispensing/counselling in hospital and community pharmacies. Low pharmacy workforce in the pre-COVID-19 era has also been previously reported. In a study carried out by Aniekan et al., in 2018 [5], there were 21,892 registered pharmacists in the country, of which only 59% are in active professional practice. It further stated that 42% of this licensed workforce are in community practice and 11% are hospital-based. A steady rise in number of migrating pharmacists have been observed thus bringing the pharmacists-patients ratio to about 1:14, 000 in 2018 which is way below the WHO recommendation of 1:2000. This remains worrisome in this COVID-19 era where the essential roles of pharmacists are much-needed. A large proportion of patients have stayed away from hospitals with the notion that health facilities increase their risk of contracting the virus. This has therefore resulted to a decline in the frequency of hospital visits which will negatively affect the provision of pharmaceutical care services including provision of point-of-care testing to patients. In lieu of hospitals treating COVID-19 patients, healthcare workers including pharmacists are constantly exposed to this highly infectious disease. This is a further concern since the lack of adequate personal protective equipment has been reported in Nigeria. Of great concern is that most community and hospital pharmacies are also not structured for effective physical distancing. In Nigeria, there is no guideline or standard operating procedure specific to the community and hospital pharmacies on COVID-19. Guidelines from international bodies or countries may not be applicable to Nigeria due to significant differences in pharmacy practice, demographics, and different COVID-19 transmission dynamics. There is a need for relevant tailor-made guidelines on how to handle COVID-19 in community and hospital pharmacies. Decline in patients’ hospital visits implies a higher flux of patients to community pharmacies for refills and as first points of contact for minor ailments. A large proportion of COVID-19 patients present with mild symptoms similar to a cold or flu and do not require hospitalization. Consultation with such patients put the community pharmacist at risk of contracting the virus. More than 30 frontline pharmacists across the country have tested positive for COVID-19 [6]. This situation suggests a possible increase in pressure on the available community pharmacy outlets in the country. Coupled with the reduced importation capacity which signifies impending drug scarcity, the surge to community pharmacies intensifies the pressure on the available stock of medicines which may result into price hikes and scarcity. COVID-19 presents an opportunity for increased production of drugs locally, while also relieving stock-out burden on available retail outlets. It is time to rethink pharmaceutical sector in Nigeria and ensure that health emergencies do not disrupt their much-needed roles in the health system.Item COVID-19 and Older Adults: A Call to Accelerate Geriatrics Differentiated Healthcare Services in Africa(ResearchGate, 2020-08) Akande-Sholabi, W.Introduction: COVID-19 pandemic is having a global impact on healthcare system around the world. Everyone is susceptible to COVID-19, but older adults aged 60 years due to physiological changes that come with ageing and possible underlying medical disorders are more susceptible [1]. The need to ensure access to healthcare services by the elderly during this pandemic is paramount. Nonetheless, it is essential that stakeholders continue to prioritize access to healthcare services and medicines among the older adults amid the fight against this global public health, especially in Africa where little attention is paid to geriatric care. Methods: This is a descriptive recommendation abstract for countries in Africa based on tailored strategies to improve access to healthcare among the geriatric population during this pandemic and in the post-pandemic era. Discussion and key conclusion: When implementing interventions to reduce the spread of disease, such as partial or total lockdown, exceptional attention must be offered to older people. Remote consultations such as telemedicine have the potential to protect healthcare workers and older adults from unnecessary exposure to disease, while ensuring continuity in the delivery of care, and in addition, decreases resource utilization across the already stressed health-care infrastructure[2]. COVID-19 is a call to accelerate improved geriatrics differentiated healthcare services in Africa by leveraging on telemedicine and technology without necessarily exposing older adults to the risk of contracting diseases by visiting healthcare settings. During COVID-19 pandemic and post-pandemic telemedicine would have unlimited potential to provide effective, appropriate, and secure care in the context of highly transmissible disease epidemics, both for management, and for regular follow-up of chronic disease among older adults. The implementation of this technology should ensure that the future policy on telemedicine includes the end-users in the planning and implementation.Item Assessment of Attitude, Practice and Barriers to Pharmaceutical Care Among Community Pharmacists in Ibadan(2022) Akande-Sholabi, W.; AKINBITAN, A.A.Background: Pharmaceutical care (PC) is a professional responsibility of a pharmacist that involves medication management with the overall goal of improving the quality of life of patient. Objectives: To evaluate the attitude, practice, and barriers to PC among community pharmacists in Ibadan. Method: A cross-sectional survey was conducted among community pharmacists between May and July 2021, with the aid of a self-administered questionnaires, information on socio-demographic characteristics, practice, attitudes, and barriers to PC was obtained. A consecutive sampling technique was used for participants’ enrolment. Participating pharmacists must have had a minimum of one-year practice experience in a community pharmacy. Pharmacy students, interns, non-pharmacist attendants, and community pharmacists who were absent from their pharmacies during the study were excluded. Data were summarized with descriptive statistics. Results: Over 12 weeks, 120 survey were collected (90.9% response rate). About (115; 95.8%) of respondents had good practice of PC and reported that pharmaceutical care is a timely innovation to pharmacy practice. However, only (62; 52.0%) had positive attitude and (117; 97.5%) believed more pharmaceutical care could be provided. Regarding their practice, most respondents (118; 98.3%) stated pharmaceutical care involves monitoring improvement in patient response to treatment and adherence to treatment regime and counselling patients with drug therapy problems. The top detected barriers for PC provision included insufficient time (71; 59.2%), and inadequate collaboration with other healthcare professionals (56; 46.7%). Conclusion: Community pharmacists in Ibadan demonstrated good practice and positive attitudes towards PC provision. However, further work should emphasise on improving PC understanding, better collaboration among other healthcare professionals and overcoming system-related barriers.Item Extent of misuse and dependence of codeine-containing products among medical and pharmacy students in a Nigerian University(Springer Open, 2019) Akande-Sholabi, W.; Adisa, R.; Ilesanmi, O.S.; Bello, A. E.Background: Misuse and dependency of opioids especially codeine-containing products is of increasing global concern. Inappropriate use of opioids among healthcare students could affect quality of service and ethical conducts of these future professionals, thereby putting the society at risk. This study aimed to evaluate knowledge and perception of medical and pharmacy students in a Nigerian tertiary University on use of opioids with focus on codeine-containing products. Methods: A cross-sectional survey among 335-medical and 185-pharmacy students from University of Ibadan, Nigeria, between September and December 2018, using a self-administered semi-structured questionnaire. Results: A total of 178 (34.2%) in multiple responses had used opioid-containing products among the respondents, of this, 171 (96.1%) used codeine-containing formulation. Precisely, 146 (28.1%) of the students had used codeine-containing products before, of this, 16 (11.0%) used the products for non-medical or recreational purpose regarded as a misuse/ abuse. In all, 201 (38.7%) had good knowledge of opioid use, with 51 (34.9%) among those who had used opioids and 150 (40.1%) among those who had not used opioids (X2 = 1.186; p = 0.276). Majority (469; 90.2%) had good perception of risks associated with opioid use; comprising (130; 89.0%) among those who had taken opioids and (339; 90.6%) among those who had not taken opioids before (X2 = 0.304; p = 0.508). Logistic-regression shows that students who experienced some side effects to be experienced again 22.1 [AOR = 22.1, 95% CI: (5.98–81.72)] as well as those pressured into using codeine-containing products 10.6 [AOR = 10.6, 95% CI: (1.36–82.39)] had more tendency of misuse. Conclusion: There is a potential for misuse of codeine-containing products among medical and pharmacy students. Peer-influence and experience of some side effects are possible predictors of misuse among the students. Thus, healthcare students’ curriculum should incorporate preventive programme, while public education and policy that favours peer-support programme on medication misuse is advocated for healthcare students.Item When it is available, will we take it? Social media users’ perception of hypothetical COVID-19 vaccine in Nigeria(PanAfrican Medical journal, 2021) Adebisi, Y. A.; Alaran, A. J.; Bolarinwa, O. A.; Akande-Sholabi, W.; Lucero-Prisno, D. E .Introduction: COVID-19 pandemic is a global public health threat facing mankind. There is no specific antiviral treatment for COVID-19, and many vaccine candidates are currently under clinical trials. This study aimed to understand the perception of social media users regarding a hypothetical COVID-19 vaccine in Nigeria. Methods: we conducted a crosssectional survey among social media users in Nigeria in August 2020 using an online questionnaire. The questionnaire includes sections on the demographic characteristics of the respondents and their perception regarding a hypothetical COVID-19 vaccine. A total of 517 respondents completed and returned the informed consent along with the questionnaire electronically. Data were coded and abstracted into Microsoft Excel spreadsheet and loaded into the STATA 14 software for final analysis. Results: the results showed that more than half of the respondents were male 294 (56.9%). Most of the respondents 385 (74.5%) intend to take the COVID-19 vaccine when it becomes available. Among the 132 respondents that would not take the COVID-19 vaccine, the major reason for non-acceptance was unreliability of the clinical trials 49 (37.1%), followed by the belief that their immune system is sufficient to combat the virus 36 (27.3%). We found a significant association between the age of the respondents and the COVID-19 vaccine acceptance (P-value=0.00) as well as geographical location and COVID-19 vaccine acceptance (P-value=0.02). Conclusion: it was observed that most of the respondents were willing to take the COVID-19 vaccine. Our findings also reiterate the need to reassure the public the benefits an effective and safe COVID-19 vaccine can reap for public health. There is a need for national health authorities in Nigeria to ensure public trust is earned and all communities, including the marginalized populations, are properly engaged to ensure an optimal COVID-19 vaccine acceptance.