FACULTY OF THE SOCIAL SCIENCES

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Author: search.filters.author.Ajayi, I. O.

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    Knowledge of and attitude to foot care amongst type 2 diabetes patients attending a university-based primary care clinic in Nigeria
    (2010-10-29) Ekore, R. I; Ajayi, I. O.; Arije, A.; Ekore, J. O.
    Background: Individuals living with diabetes mellitus are at an increased risk of developing foot ulcers and cardiovascular complications or a neuropathy that may result in amputations. These complications have been shown to be already present in about 10% of diabetic patients at the time of diagnosis. Objectives: This study was carried out to determine the level of awareness and attitude to foot care among adult diabetic patients attending a university health centre (i.e. a primary care centre) and to emphasise the ever-present need for health education and promotion and early complication detection (especially of foot problems) among diabetic patients. Method: A descriptive cross-sectional, clinic-based study was carried out at the University of Ibadan Health Centre (Jaja Clinic). The study population consisted of consenting adult diabetic patients. Data were collected by the self-administration of structured questionnaires to eligible subjects and were analysed using the SPSS v.15software. Appropriate statistics were employed to analyse the collected data. Results: A total of 137 patients participated in the study and ranged in age from 37 to 75 years, with the mean ± SD age being 58.2 ± 9.2 years. Of the participants, 98 (71.5%) were men and 39 (28.5%) were women; all of the participants were married. The duration of illness ranged from 1 year to 20 years, with the median duration of illness being 3 ± 1.7 years. One hundred and twenty-six (92%) patients had never received any education on foot care from their healthcare providers, while 11 (8%) had received some form of foot care education. Among those who had never received any foot care education, 92 (73%) had been diabetic for 1–5 years, while the remaining 34 (27%) had been diabetic for 6 – 20 years. Of the foot care measures that were known, 35 (25.5%) patients knew to wash their feet daily and dry in between the toes thoroughly, 31 (22.6%) knew not to go outdoors barefooted, 27 (19.7%) checked their feet daily, 27 (19.7%) checked inside their shoes daily, 8 (5.8%) consciously made an effort to avoid injuries to their feet and 4 (2.9%) clipped their toenails with care. Conclusion: The results of this study showed that awareness of foot care measures is very poor among known diabetic patients and this is largely due to a lack of education of the patients by their health care providers.
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    A qualitative study of the feasibility and community perception on the effectiveness of artemether-lumefantrine use in the context of home management of malaria in south-west Nigeria
    (Elsevier Ltd., 2008) Ajayi, I. O.; Falade, C. O.; Olley, B. O; Yusuf, B.; Gbotosho, S.; Iyiola, T.; Olaniyan, O.; Happi, C.; Munguti, K
    Background: In Nigeria ACT use at the community level has not been evaluated and the use of antimalarial drugs (commonly chloroquine (CQ)) at home has been shown to be largely incorrect. The treatment regimen of ACT is however more complicated than that of CQ. There is thus a need to determine the feasibility of using ACT at the home level and determine community perception on its use. Methods: A before and after qualitative study using key informant interviews (KII) and focus group discussions (FGDs) was conducted in selected villages in Ona-Ara local government area. At baseline, 14 FGDs and 14 KIIs were conducted. Thereafter, community medicine distributors (CMDs) were trained in each village to dispense artemeter-lumenfantrine (AL) to febrile children aged 6–59 months presumed to have uncomplicated malaria. After one year of drug distribution, nine KIIs and 10 FGDs were conducted. Participants and key informants were mothers and fathers with children under five years, traditional heads of communities, opinion leaders and health workers. Results: None of the participants have heard of AL prior to study. Participants were favourably disposed to introduction of AL into the community. Mothers/caregivers were said to have used AL in place of the orthodox drugs and herbs reported commonly used prior to study after commencement of AL distribution. The use of CMDs for drug distribution was acceptable to the participants and they were judged to be efficient as they were readily available, distributed correct dose of AL and mobilised the community effectively. AL was perceived to be very effective and no significant adverse event was reported. Major concerns to the sustainability of the program were the negative attitudes of health workers towards discharge of their duties, support to the CMDs and the need to provide CMDs incentives. In addition regular supply of drugs and adequate supervision of CMDs were advised. Conclusion: Our findings showed that the use of AL at home and community level is feasible with adequate training of community medicine distributors and caregivers. Community members perceived AL to be effective thus fostering acceptability. The negative attitudes of the health workers and issue of incentives to CMDs need to be addressed for successful scaling-up of ACT use at community level.