Comparative Costs of Antibacterial Usage in Sexually Transmitted Infections in a Nigerian Teaching Hospital (original) (raw)
Related papers
2010
Purpose: To evaluate the cost of antibacterial usage to patients in a tertiary health facility in Nigeria. Methods: Drug utilization evaluation was carried out retrospectively among patients with sexually transmitted infections (STIs) over a one-year period between 2005 and 2006 in Lagos University Teaching Hospital (LUTH), Nigeria. Case notes numbering 230 and containing 317 prescriptions were sampled consecutively with the aid of diagnostic coding cards. Relevant data including case demographics, diagnosis, prescribed drugs, and dosages were extracted and the associated costs analysed. Results: A majority of the patients (82.3 %) were youths aged 21- 40 years. Higher prevalence was observed among male patients (70.2 %). The proportion of drugs prescribed in generic and branded names were 82.1 and 17.9 %, respectively. Total number of antibacterial doses was 7284 at a total cost of NGN239,420.00 (US$1,841.69). Average antibacterial cost per patient was NGN1,040.96 (US$8.00). Quinol...
Background: Sexually Transmitted Infections (STIs) are of public health importance in Nigeria. Timely interventions could alleviate STI-associated symptoms, and delay transmission. This study investigated how Community Pharmacists responded to complaints of STI-associated symptoms and explored factors that hinder these efforts. Methods: A cross-sectional, descriptive study was carried out among 48 Community Pharmacists in Surulere Local Government Area of Lagos. Data were collected using a pretested self-administered, semi-structured questionnaire that comprised demographic characteristics of the pharmacists and the patients, STI symptoms, and services provided by the community pharmacists. Descriptive and inferential statistics were used to summarize the data using SPSS version 20.0. A P-value of <0.05 was considered significant. Results: More than half of the Community Pharmacists (58.3%) were females, with 56.3 % having < 5 years of practice experience. An average of 10 patients presented to the pharmacies daily with STIassociated symptoms. Most patients (97.9%) were aged 18 to 49 years, and are mainly females (70.8%). The most common STI-associated complaints in females were vaginal discharge (93.8%) and urethral discharge (70%) in men. On any STI-related visit, the pharmacist elicited information on the history of present symptoms (92%), medications taken before the pharmacies' visit (88%), onset and duration of symptoms (85%). They suggested medications (94%), counseled patients on medication use (89%), offered preventive care (Condom use (83.3%); abstinence (31.3%), and referred patients to hospital (79%). Un-resolving symptoms (86.8%) were the main reason for referrals. The Pharmacists failed to confirm patients' identities and did not follow up with the patients in 45.8% of the visits. They suggested metronidazole (89.6%) most, followed by Azithromycin (85% and Ciprofloxacin (79%). Patients' reluctance to open up was the main obstacle to the provision of STI management services in the community. Conclusion: Community pharmacists provided a wide range of STI management services of which treatment, medication counseling, and preventive care are the most common. There is a need for pharmacists to improve on referrals and follow-ups to ensure continuity in care.
Evaluating antimicrobial prescribing in a Tertiary Healthcare Institution in Nigeria
Journal of Pharmaceutical Policy and Practice, 2021
Background Regular evaluation of antimicrobials prescriptions is important for optimal use. Objective This study determined the prescription patterns, class and costs of antimicrobials in the adult out-patient pharmacy of a Teaching Hospital in Nigeria. Methods A 1-year retrospective study from 1st January to 31st December 2018. The data, which included identification code, age, sex, antibiotics prescribed, number of antibiotics per prescription, number of medicines per prescription, dosage form, generic prescribing, drug on the essential drug list, and cost, were used in the analysis. The Chi-square test and Analysis of Variance were used to compare our data with the WHO–developed antimicrobial prescription Guidelines for Anatomical Therapeutic Chemical and Defined Daily Dose assignment of 2019. Results From 450 patient records, significantly more females (70%) were prescribed with antimicrobials ( P = 0.0038). The prescription pattern showed that antimicrobials selection by class...
South African Family Practice, 2011
Background: Sexually transmitted infections (STIs) are among the most common infectious diseases in the world today. There are few reliable statistics on the true prevalence of STIs in developing countries, especially in the general practice setting, hence the need to determine the prevalence in each locality. With the scourge and pandemicity of human immunodeficiency virus (HIV) and the fact that STIs are recognised as independent risk factors for its transmission, determining the risk profiles for STIs has become paramount. The aim of this study was to describe the pattern of STIs among patients attending a Nigerian general practice (GP) clinic. Methods: This was a descriptive, cross-sectional, hospital-based study. Consenting patients were recruited serially between February and April 2006 until the sample size of 415 was reached. Subjects' genital symptoms were considered according to the four common STI syndromes according to National AIDS/STD Control Programme guidelines. Results: The age range of the subjects was 15 to 95 years (mean 45.16 years, standard deviation 18.83 years, median 44 years). The median age at coitarche was 21 years while the median age at marriage was 25 years. The prevalence rates of current, past and lifetime STI were 18.8%, 22.4% and 32% respectively. Only 28 (6.8%) study subjects had laboratory evidence of STIs at the time of study. Previous sex with a commercial sex worker, previous history of STIs, premarital sex, first intercourse before or at 21 years of age and multiple sexual partners were significantly associated with STIs. Previous history of STIs was a strong predictor of current STI in this study while premarital sex and previous sex with a commercial sex worker were strong predictors of past STI. The frequency of HIV infection among subjects with STIs was more than double that of the control and a co-infection rate of 17.9% was found. Conclusions: The findings of this study indicate a high prevalence of STIs in the study community in association with prevailing high sexual risk behaviours, hence the need for reliable control programmes targeting the latter.
Cost-minimization analysis of antimicrobial therapy in a tertiary healthcare institution in Nigeria
Journal of Pharmacy & Bioresources, 2010
Cost Minimization Analysis of antimicrobial therapy in a tertiary health care institution in a developing economy country was carried out. The most applicable tool for generic equivalent drugs was used in Ahmadu Bello University Teaching Hospital, a tertiary healthcare Institution in Nigeria, between 2005 and 2007. Relevant information such as diagnosis, cost of drugs (in Naira-N), dosage, duration of therapy among others were obtained retrospectively from patient case-notes for which antibacterial are the mainstay of therapy and dispensed prescriptions. The mean cost per defined daily dosage (DDD) of generic and branded for each antibacterial was computed. These were compared using Student's t-test. The outcome measure was potential eradication of bacterial in question by the respective antibacterial drug. The analyses showed that the use of expensive branded drugs were very rampant even when the much cheaper generic equivalent is available. The differences in the mean cost/DDD were very significant for all the antimicrobial agents at p<0.05. For example the mean cost/DDD of ciprofloxacin was N267 for branded product and N80.00 for generic (t = 421.2 at p<0.05).Sensitivity analysis also Confirm this decision. Prescriptions of expensive branded drugs were rampant even when the much cheaper generic equivalents are available. The mean cost per Defined Daily Dose of Branded and Generic equivalent were significantly different for all antibiotics applicable for cost minimization analysis, with Generic Products much cheaper than Branded equivalent.
African Journal of Pharmacy and Pharmacology, 2009
The overall goal of this study is to reduce morbidity and mortality ascribable to bacterial infections by encouraging rational use of antibiotics. Antibiotics use prior to and prescriptions of antibiotics by the attending physicians were evaluated in a group of patients attending a secondary health facility. A quasi-exit interview was conducted using a structured questionnaire. The major presenting symptoms were sought from patients and/or parents and/or guardians; drug history was taken and doctors’ prescriptions were copied onto an already prepared format. All data were entered into EPI-INFO version 6 for analyses. The mean age of patients who were enrolled was 14 ± 16.96 [range: 0.08-78 years] but males patients were statistically younger than females: respectively 9.94 ± 15.48 years (0.08-78 years) and 18.43 ±17.10 years (range: 0.08 ‐ 70 years); F: 122 P< 0.00. Pre-hospital use of antibiotics was documented in about a third of all the patients and cotrimoxazole was the most ...
Journal of Pharmacy & Bioresources, 2010
Comparative pharmacoeconomic analysis of benzathine and procaine penicillin in the treatment of early syphilis in Ahmadu Bello University Teaching Hospital, Zaria, northern Nigeria was carried out retrospectively for prescribed/dispensed antibacterial drugs to outpatients with early syphilis among other infectious diseases, by examining outpatients case notes between 2005 and 2007. Results show that benzathine penicillin cost N 4.31/unit of effectiveness while procaine penicillin injection cost N 18.19/unit of effectiveness in the treatment of early syphilis. Benzathine penicillin injection therefore appears to be more cost effective than procaine penicllin injection. Subjecting the cost and effectiveness to sensitivity analysis did not change this conclusion. Statistical analysis shows that there is a statistically significant difference in the effectiveness (outcome) of benzathine penicillin and procaine penicillin injection, (56.2%) (χ 2 = 48.58, P<0.5), Therefore there is association between effectiveness and therapeutic option chosen with benzathine penicillin being a more cost effective option. The result of this study is significant because benzathine penicillin is usually traded off for less cost-effective procaine penicillin in many cases even when there is no contraindication to the use of benzathine penicillin. Benzathine penicillin injection is more cost effective than procaine penicillin injection at their usual therapeutic dose in the treatment of early syphilis.
World Journal of Medical …, 2011
This study aimed at detecting and determining the prevalence of genital pathogens among attendees of sexually transmitted infections (STIs) clinic of a tertiary care hospital in Ibadan, Southwestern Nigeria. One hundred consecutive patients (43 males and 57 females) who attended the STI clinic of a tertiary care hospital at Ibadan, with one or more of the complaints as enunciated by WHO in its syndromic approach for the diagnosis of STIs, were included as subjects. Detailed history, demographical data and clinical features were recorded and screened for common STIs by standard microbiological methods. Samples of urethral swab (for the males), endocervical and high vaginal swab (for the females) were collected per patients and processed using standard laboratory procedures for the isolation of genital isolates. The results obtained were analysed using SPSS 17.0 statistical methods. Majority came with the complaint of genital discharge (18 males; 20 females), followed by candidiasis (7 females), gonococcal urethtitis (5 males), haematuria and infertility (3 males, 3 females), PID (2 females) and dysuria (1 female) while 22.0% did not state their clinical presentations and 19.0% came for check ups. Though no Trichomonas vaginalis was detected in the samples examined; Neisseria gonorrhoeae, Gardnerella vaginalis, Klebsiella species and Escherichia coli was found in the same proportion (25.0% respectively). In conclusion, this study showed a high prevalence of genital bacterial infection. The genital colonization by these isolates (Neisseria gonorrhoeae and Gardnerella vaginalis) among the patients was high (25.0%), thus, emphasizing the importance of routine screening of patients thereby assisting in prevention of bacterial STIs.