Impact of Seasonal Changes on Asthma Control in North-Western Nigeria

BACKGROUND

Asthma control is poor worldwide and is often affected by changes in environmental conditions. Effort to determine the cause of this heavy burden on patients and the healthcare system is crucial.

AIM

To determine the role of seasonal changes on asthma control in Sokoto, North-Western Nigeria.

METHODS

One hundred and one (101) patients with physician diagnosed asthma were consecutively recruited after obtaining informed consent. A structured researcher administered questionnaire was used as instrument of data collection and asthma control test questionnaire was also used to assess level of asthma control in each participant. Five items with a 4-week recall were assessed. Data for temperature, humidity, wind and rain was obtained from the Nigerian Meteorological Agency (NIMET), Sokoto. We computed frequency and level of asthma control with seasons of the year and weather variables.

RESULTS

One hundred and one patients comprising 71 females and 30 males with a mean age of 32.14 ± 10.68 years participated in the study. Level of asthma control was found to be poor among the participants with 41(40.6%) having very poorly controlled asthma, 30(29.7%) with not well controlled and 30(24.8%) well controlled asthma respectively. Among patients with very poorly controlled asthma, 22(48.9%) occurred during harmattan season and 14(31.1%) during rainy season. Weather parameters such as humidity shows significant relationship with asthma control (B= -0.504, P= 0.031, 95% CI [-0.012, -0.0253]).

CONCLUSION

The study shows that asthma control is poor among the participants and presentation with poor asthma control is more during harmattan season.

Should oxygen saturation be included in the vital signs sheet of all medical admissions?

Hypoxaemia is not uncommon in hospitalised patients and may be overlooked because cyanosis is a late sign. To estimate the incidence of undetected hypoxaemia we measured oxygen saturation (SpO2) by pulse oximetry randomly in medical patients who were not receiving supplemental oxygen in a teaching hospital and a community hospital. Of 580 patients studied, nine patients (1.55%) had SpO2 <92%. All nine patients had multiple morbidities, but all had cardiopulmonary disease in common. There was no significant difference between the teaching and the community hospitals. We conclude that undetected hypoxaemia is not common in patients on the medical wards, and that routine pulse oximetry is not necessary except for patients with known cardiopulmonary disease.

Pattern and antibiotic susceptibility of bacteria in pyogenic meningitis in a children's emergency room population in Maiduguri, Nigeria, 1988-1992

From January 1988 to November 1992, 107 (3.5%) of 3074 postneonatal children admitted to the Children's Emergency Room, University of Maiduguri Teaching Hospital, Nigeria, had sporadic pyogenic meningitis; 66 (61.7%) were aged < or = 12 months. Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae together were responsible for 77.3% (58) of 75 culture-proven cases, 13.4% (10) had Enterobacteriaceae, 5.3% (4) had Staphylococcus aureus and 4% (3) untyped alpha-haemolytic streptococci. Fifty percent of 62 bacteria were resistant to ampicillin, 47.2% of 36 to penicillin and 10.7% of 56 to chloramphenicol; none of 21 bacteria was simultaneously resistant to all three antibiotics. Up until 1992, we have encountered treatment failure with a regimen containing chloramphenicol in only 2 of 53 patients; the 2 patients had coliform meningitis. Non-meningococcal bacteria are an important cause of sporadic pyogenic meningitis in sub-Saharan Nigeria and chloramphenicol is the most appropriate initial drug of choice at the present time for the management of sporadic meningitis.

Congenital hepatic fibrosis: A study of a Saudi family and review

A Saudi family with three members afflicted with congenital hepatic fibrosis (CHF) is described. CHF was associated with cystic dilatation of the intrahepatic bile ducts and autosomal dominant polycystic kidney disease (ADPKD) in all of the three siblings. The proband's case report is presented and the detection of the other two children by family screening is described. This is the first report of CHF in a Saudi family. Review of the disease is outlined.