Direct Medical Cost of Treating Substance Use Disorders in Two Tertiary Hospitals in South-West, Nigeria: A Cross-Sectional Study

Introduction. Successful interventions for substance use disorders (SUDs), though obtainable, are not effectively utilized due to the high cost of treatment. The adoption of any given therapy is often impeded by insufficient evidence of the effectiveness of such treatment. Objective. This study aimed to assess the direct medical cost of treating SUD in two tertiary hospitals in South-West, Nigeria. Methods. A descriptive, cross-sectional survey of patients managed for SUD at the two psychiatric hospitals was carried out between January and June 2020. The inclusion criteria were patients with SUD above 18 years of age, registered and managed at the two hospitals. Data were collected from selected patients' case notes using a standardized data collection tool and analyzed using descriptive and inferential statistics. Results. The average costs of treatment for alcohol use disorder, drug use disorder, and drug and alcohol use disorder were ₦146,425.38 ± 57,388.84, ₦135,282.09 ± 53,190.39, and ₦143,877.33 ± 68,662.04, respectively. This translates to $384.82, $355.53, and $378.12, respectively. The highest contributors to SUD treatment cost are inpatient admissions and the cost of medicines; inpatient admissions include accommodation, feeding, and laundry. Conclusion. Considering that over 60% of the Nigerian population lives below the poverty line, the direct cost of SUD treatment is unaffordable to the patients and the health care system, which is grossly underfunded.

Modelling Outpatients Cost of Wound Dressing in Nigeria: A Prospective Study

Background: Estimating the direct cost of wound dressing poses a challenge to patients, nurse managers, hospital administrators, health maintenance organisations and other policy makers. This study therefore model the weekly cost of wound dressing in South West NigeriaMethods: A descriptive cross sectional research design was utilized to assess the cost of wound dressing among outpatients’ clinics attendees. An inventory of direct cost of wound dressing per week consisting of cost of materials, lotion and consumables were recorded. The data collection was for period of three months in three selected Teaching Hospitals South West Nigeria. Then modelling weekly cost of wound types was done by regression analysis. The effect of various independent variables such as age, occupation, family size, monthly income, aetiology, diagnosis, wound type, comorbidities, frequency of wound dressing and health insurance coverage on cost of wound dressing per week was considered. Ethical approval was obtained from each of the hospital and Covid-19 precautions were observed.1 USD equalled ₦570Results: The estimated cost of wound dressing per week with no contribution from other variables was found to be ₦36,922- Open wound, ₦6011-Leg ulcer, ₦3768- Cancer wound, ₦2785- Diabetic Foot Ulcer, ₦610-Surgical wound. Only frequency of wound dressing was found to contribute to weekly cost of leg ulcers (P value= 0.003)Conclusions: The estimated cost of various type of wound provides yardstick for determining the weekly cost of wound dressing in Nigeria. Also, frequency of wound dressing is a major determinant of the outpatient cost of dressing. Therefore, it is imperative for nurses to render high quality wound care to match up with the huge financial commitment from patients and families

Livestock Feed Processing and Storage Mechanizims in Bench Maji, Sheka Ad Kaffa Zones, South West Ethiopia

This study was conducted in Kaffa, Bench Maji and Sheka zones with the objective of assessing livestock feed processing and storage mechanisms in South West Ethiopia. Purposive sampling technique was used to select study districts based on livestock population, accessibility and availability of feed resources. A total of 384 households having a minimum one hectare of land and livestock were randomly selected for interview. The mean total number of cattle in the study area was 8.48+6.79 per households. Majority of the respondents could not practice livestock feed processing and storage mechanisms in dry and wet season in the study area. The bases for feed provision for livestock in the study area were production level, work load and availability of feed ingredients. Different plants parts were used for livestock to increase milk yield, to improve growth rate and to treat diseases. Livestock production was lowest in dry season due to lack of feed shortage in the dry season. Due to this conclusion, government office should give training how to process and store feeds for dry season.

Caregiver burden among family members of patients diagnosed with cancer in Jimma medical center oncology unit, south west Ethiopia.

Background Cancer is a type of disease defined by uncontrolled growth and spread of abnormal cells, which can result in death. Globally, around 25 million people are surviving with it. The burden of cancer is growing in developing countries and it frequently comprises patient’s vitality. In addition, it has emotional, economical, physical and psychological burden on family, friends, significant others, community and other social resource. Objective To assess caregiver burden of cancer patients in Jimma medical center oncology unit, South west Ethiopia. Method An institutional based cross-sectional study design was employed. The study was done on 141 respondents using simple random sampling. A pretested semi structured interviewer administered questionnaire was used to collect the data. The collected data was entered in to EPI data version 3.1 then transferred to SPSS version 23 for data analysis. Multivariable logistic regression model was fitted, Adjusted Odds Ratio (AOR) at 95% confidence interval and p-value <0.05 were estimated to determine statistically association between predictors and outcome variables. Results The data were collected from the total of 141 respondents with 100% response rate. The mean ±SD age of cancer patients and care givers were 46.4 ±12.406 and 32 ± 11.23 years, respectively. The general level of caregiver burden in this study was mild to moderate (71.6%) with ZBI total score of 30 and by using CBI114 (80.9%) had some burden. Caregivers whose their age is greater than 40 years were 4.01 times more likely have high burden than those age between 20-40 old age [AOR=4.01, 95%CI (1.58, 10.17)]. Conclusion The study disclosed a moderate level of caregiver burden among family caregivers.

Integrated control of Aedes albopictus in Southwest Germany supported by the Sterile Insect Technique

Background The invasive species Aedes albopictus, commonly known as the Asian tiger mosquito, has undergone extreme range expansion by means of steady introductions as blind passengers in vehicles traveling from the Mediterranean to south-west Germany. The more than 25 established populations in the State of Baden-Württemberg, Palatine and Hesse (south-west Germany) have become a major nuisance and public health threat. Aedes albopictus deserves special attention as a vector of arboviruses, including dengue, chikungunya and Zika viruses. In Germany, Ae. albopictus control programs are implemented by local communities under the auspices of health departments and regulatory offices. Methods The control strategy comprised three pillars: (i) community participation (CP) based on the elimination of breeding sites or improved environmental sanitation, using fizzy tablets based on Bacillus thuringiensis israelensis (fizzy Bti tablets; Culinex® Tab plus); (ii) door-to-door (DtD) control by trained staff through the application of high doses of a water-dispersible Bti granular formulation (Vectobac® WG) aimed at achieving a long-lasting killing effect; and (iii) implementation of the sterile insect technique (SIT) to eliminate remaining Ae. albopictus populations. Prior to initiating large-scale city-wide treatments on a routine basis, the efficacy of the three elements was evaluated in laboratory and semi-field trials. Special emphasis was given to the mass release of sterile Ae. albopictus males. Results More than 60% of the local residents actively participated in the first pillar (CP) of the large-scale control program. The most effective element of the program was found to be the DtD intervention, including the application of Vectobac® WG (3000 ITU/mg) to potential breeding sites (10 g per rainwater container, maximum of 200 l = maximum of approx. 150,000 ITU/l, and 2.5 g per container < 50 l) with a persistence of at least 3 weeks. In Ludwigshafen, larval source management resulted in a Container Index for Ae. albopictus of < 1% in 2020 compared to 10.9% in 2019. The mean number of Aedes eggs per ovitrap per 2 weeks was 4.4 in Ludwigshafen, 18.2 in Metzgergrün (Freiburg) (SIT area) and 22.4 in the control area in Gartenstadt (Freiburg). The strong reduction of the Ae. albopictus population by Bti application was followed by weekly releases of 1013 (Ludwigshafen) and 2320 (Freiburg) sterile Ae. albopictus males per hectare from May until October, resulting in a high percentage of sterile eggs. In the trial areas of Ludwigshafen and Frieburg, egg sterility reached 84.7 ± 12.5% and 62.7 ± 25.8%, respectively; in comparison, the natural sterility in the control area was 14.6 ± 7.3%. The field results were in line with data obtained in cage tests under laboratory conditions where sterility rates were 87.5 ± 9.2% after wild females mated with sterile males; in comparison, the sterility of eggs laid by females mated with unirradiated males was only 3.3 ± 2.8%. The overall egg sterility of about 84% in Ludwigshafen indicates that our goal to almost eradicate the Ae. albopictus population could be achieved. The time for inspection and treatment of a single property ranged from 19 to 26 min depending on the experience of the team and costs 6–8 euros per property. Conclusions It is shown that an integrated control program based on a strict monitoring scheme can be most effective when it comprises three components, namely CP, DtD intervention that includes long-lasting Bti-larviciding to strongly reduce Ae. albopictus populations and SIT to reduce the remaining Ae. albopictus population to a minimum or even to eradicate it. The combined use of Bti and SIT is the most effective and selective tool against Ae. albopictus, one of the most dangerous mosquito vector species. Graphical Abstract

Sensitivity studies on the air flow characteristics In Kharagpur using a meso-scale model

A three-dimensional hydrostatic model has been employed for the study of sea breeze circulations over south West Bengal with special reference to an inland station Kharagpur (22°.21' N, 87° 19'E). A series of sensitivity experiments have been performed to stress the Importance of differential heating on circulation over south West Bengal during pre-monsoon period. It is found that due to differential heating rate between land and sea surfaces, sea breezes can penetrate to the inland station Kharagpur and beyond even in case of moderate gradient wind. Surface observations at Kharagpur and pilot balloon observation at nearby station Kalaikunda are used to compare the model results. The onset of sea breezes, variation of the air temperature and humidity are In fairly good agreement whereas It over estimates the depth of the circulation and cannot predict the variation of the late morning hours surface wind.