Monday Health Burst

Blindness and Visual Impairment, Health, Monday Health Burst, WHO / cfhinitiative

MONDAY HEALTH BURST – BLINDNESS AND VISUAL IMPAIRMENT

Blindness is a complete or partial loss of vision. It is presenting visual acuity of 3/60 or less. Visual impairment on the other hand is often defined as a best corrected visual acuity of worse than 20/40 or 20/60. These could be cataracts, the infectious river blindness, trachoma, glaucoma, diabetic retinopathy, uncorrected refractive errors, and some cases of childhood blindness.

There are variations in the causes of visual impairment across countries. For example, the proportion of visual impairment attributable to cataract is higher in low- and middle-income countries than high-income countries. In high income countries, diabetic retinopathy, glaucoma and age-related macular degeneration are more common. Also, the leading cause of vision impairment among children in low-income countries is congenital cataract, whereas in middle-income countries it is more likely to be retinopathy of prematurity.

The categories of people at risk for blindness include people with eye diseases, such as macular degeneration and glaucoma, people with diabetes, stroke, people undergoing eye surgery, people who work with or near sharp objects or toxic chemicals, and premature babies. However, according to World Health Organization (WHO), more than 1 billion people worldwide are living with vision impairment because they do not get the care they need for conditions like short and far sightedness, glaucoma, cataract in time. This World report on vision by WHO estimates that 80% of visual impairment is either preventable or curable with treatment.

Many people with significant visual impairment benefit from vision rehabilitation, changes in their environment, and assistive devices. In some cases of vision impairment, use of eyeglasses, contact lenses, surgery, and medication may help restore vision, but in the case of irreversible partial or complete blindness, rehabilitation is recommended. Children using glasses are advised to go for medical checkups annually, glaucoma patients for monthly checkups, and people without any confirmed eye problem to go for eye check-up atleast once in 6months.

Monday Health Burst is an initiative of Centre for Family Health Initiative (CFHI) to tackle issues of basic health concerns. Join us every Monday for more health-related articles on all our social media platforms.

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Hygiene, Monday Health Burst, WHO, World Rabies Day / cfhinitiative

RABIES: SYMPTOMS, CAUSES, PREVENTION AND TREATMENT

Rabies is a viral disease that causes inflammation of the brain in humans and other mammals. It is caused by lyssaviruses, which includes the rabies virus and Australian bat lyssavirus. Some of the known ways of spreading rabies are scratches or bites from an infected animal on human or other animals, and infected saliva’s contact with the eyes, mouth, or nose.

According to World Health Organization (WHO), dogs are the most common animals infected with rabies globally. In countries where dogs commonly have the disease, majority (99%) of rabies cases are the direct result of dog bites. However in America, bat bite is the most common source of rabies infection in humans, and less than 5% of cases from dogs.

After a bite or other rabies exposure, the rabies virus has to travel through the body to the brain before symptoms can surface. This time between the exposure and the appearance of symptoms is called the incubation period. The incubation period may last for weeks to months depending on the distance between the bite wound and the brain, the type of rabies virus, and existing immunity.

The first symptoms of rabies may be very similar to those of the flu like general weakness, fever, or headache. Symptoms may also be discomfort or a prickling or itching sensation at the site of the bite, progressing within days to acute symptoms of cerebral dysfunction, anxiety, confusion, and agitation. As the disease progresses, the person may experience delirium, abnormal behavior, hallucinations, hydrophobia (fear of water), and insomnia. The acute period of disease typically ends after 2 to 10 days. Generally, by the time the symptoms appear, it is usually too late to save the patient.

Rabies is a serious disease, but individuals and governments can take actions to control and prevent the spread. These preventive strategies include: Regular ant rabies vaccinations for all pets and domestic animals; bans or restrictions on the importation of animals from infected countries; widespread vaccination of humans in high risk areas, and awareness creation.

Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive. After exposure and before symptoms begin, a fast-acting dose of rabies immune globulin should be delivered as soon as possible, close to the bite wound to prevent the virus from infecting the individual. Also, rabies vaccine should be given to train the body to fight the virus whenever it is exposed.

Monday Health Burst is an initiative of Centre for Family Health Initiative (CFHI) to tackle issues of basic health concerns. Join us every Monday for more health related articles on all our social media platforms.

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Health, Monday Health Burst, Patient Safety / cfhinitiative

PATIENT SAFETY

The simplest definition of patient safety according to World Health Organization, is the prevention of errors and adverse effects to patients associated with health care.

Unhealthy conditions of the body or mind displace people from the normal state of health thereby deterring their physical or mental wellbeing. It is expected for such individuals to seek out solutions to their health challenges through different means available and accessible to them. Nowadays, people utilize the health services of trained medical practitioners to recuperate and expect that they will be cared for in a safe manner. Unfortunately, there are so many recorded cases of medical negligence resulting in injury or death of patients.

Thomas Agan, the Chief Medical Director (CMD), University of Calabar Teaching Hospital (UCTH), once said during an interaction with journalists in 2017 that over 90 per cent of deaths recorded in Nigerian hospitals are due to poor attitude of health workers. He also mentioned that until healthcare providers are held accountable for every challenge they create, things will not go down well.

Trained medical professionals legally owe a duty of care to their patients. Universally, Medical practitioners are governed by the Hippocratic Oath pledged at serving humanity with optimum capacity. One of the several laws governing medical practice in Nigeria is Medical and Dental Practitioner Act (CAP M8), structured to regulate medical ethics and rules of professional conduct. Infringement of this duty through medical malpractices such as wrong diagnosis and treatment, polypharmacy, defective medical products, and other illegal practices resulting to some form of damage to the patient qualifies as medical negligence. It is pertinent to understand that medical negligence is not exclusive to medical doctors but includes nurses, technicians, pharmacists and other health care providers.

It is no news that a lot of progress needs to be made as a nation in providing an enabling environment with modern and innovative equipment to aid medical practitioners in carrying out their duties. Doctors in government hospitals constantly have to demand adequate remuneration, but some health care providers now use this as facades masking so many cases of medical negligence.

Maintaining patient safety and care requires cooperative effort from all health care providers responsible for patient care. Team work not only provides the safest care but improves medical management especially in diagnosis and treatment of patients. It may not be totally possible to eradicate crisis emanating from medical negligence but, with quality health care work force, the right hospital leadership and management, and the right health care facility and infrastructure, it can be controlled.

Developing active networks of patients and providers, sharing experiences, learning from failure and pro-active risk assessment, facilitating effective evidence-based care, monitoring improvement, empowering and educating patients and the public as partners in the process of care are some of the key factors to consider in achieving a quality agenda.

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Health, Monday Health Burst, Suicide Prevention, WHO / cfhinitiative

SUICIDE PREVENTION

Suicide is the act of intentionally causing one’s own death. According to World Health Organization (WHO), close to 800,000 people die by suicide every year and for each suicide, there are more than 20 suicide attempts. The WHO report also states that suicide is the third leading cause of death between the age of 15-19 globally. However, about 79% of suicides occur in low- and middle-income countries.

Nigeria is ranked “15th in the world” and “top in Africa” for its suicide rate, according to Global Health Equity (GHE). Due to the stigma associated with suicide in Nigeria, most cases are not reported. However, some of the widely reported suicide cases include that of a 100-level student of Kogi State University, Ayingba, who ended her life because her boyfriend left her, a student of Chemical Engineering at the University of Port Harcourt, Rivers State, who committed suicide by drinking two bottles of the deadly pesticide, the University of Ibadan lecturer, who took his life on April 6, 2019, after an unfulfilled dream of completing his PhD programme, a worker in Kogi State over alleged nonpayment of salary, among others.

The link of suicide and mental disorder (depression and alcohol abuse) is well established especially in high income countries but many suicides happen impulsively in moments of crisis with a breakdown in the ability to deal with life stresses, such as financial problems, relationship break-up or chronic pain and illness. Experiencing conflict, disaster, violence, abuse, or loss and a sense of isolation are strongly associated with suicidal behaviour. Suicide rates are also high amongst vulnerable groups who experience discrimination, such as refugees and migrants, lesbians, gays, bisexuals, transgenders, intersex (LGBTI) persons, and prisoners. The strongest risk factor for suicide according to WHO report is a previous suicide attempt.

It is estimated by WHO that around 20% of global suicides are due to pesticide self-poisoning, most of which occur in rural agricultural areas in low- and middle-income countries. Other common methods of suicide are hanging and firearms. Knowledge of the most used suicide methods is important to devise prevention strategies which have shown to be effective, such as restriction of access to means of suicide.

Suicides are preventable with timely, evidence-based, and often low-cost interventions. There are several measures that can be taken at population, sub-population, and individual levels to prevent suicide and suicide attempts. These include: Reducing access to the means of suicide (e.g. pesticides, firearms, certain medications), introducing alcohol policies to reduce the harmful use of alcohol, early identification, treatment and care of people with mental and substance use disorders, chronic pain and acute emotional distress, training of non-specialized health workers in the assessment and management of suicidal behaviour, follow-up care for people who attempted suicide and provision of community support, improving coping strategies of people who are at risk, reducing risk factors for suicide, such as poverty, and giving hope for a better life after current problems are resolved.

In conclusion, Suicide is a complex issue and therefore suicide prevention efforts require coordination and collaboration among multiple sectors of society, including the health sector and other sectors such as education, labour, agriculture, business, justice, law, defence, politics, and the media.

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