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Background: Cognitive assessment is a key component of clinical evaluations for patients with dementia and Alzheimer's disease in primary health care (PHC) settings. The need for well-validated, culturally appropriate, and easy-to-use assessments is especially urgent in low- and middle-income countries (LMICs) that are experiencing rapid growth in their older adult populations. Objective: To examine the feasibility and demographic determinants of performance for a tablet-based cognitive assessment tool (TabCAT) battery, which includes subtests for four cognitive domains, among older PHC patients in southeastNigeria. Methods: A cross-sectional mixed-method descriptive study evaluating the useability and performance of TabCAT. Results: We enrolled 207 participants (mean age of 64.7±13.5 years; 52% with only primary, 41% secondary, and 7% tertiary education). Most (91%) who initiated the assessment were able to complete it, requiring 10-15 minutes to complete. More years of education was associated with better test scores across all tests (p < 0.001). Living in a rural location was also associated with better performance (p < 0.05). Male compared to female sex did not associate with performance on any of the tests (all ps > 0.05). Conclusions: Tablet-based cognitive assessment was feasible in rural and urban settings of Nigeria. Better performance on cognitive subtests linked to more education and residing in a rural area; however, sex did not predict performance. Digital cognitive assessment tools hold potential for widespread use in healthcare and educational contexts, particularly in regions with varying levels of urbanization and educational access.

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Objective: The aging population in developing countries demands parallel improvements in brain health assessment services to mitigate stigma, promote healthy aging, and diagnose cognitive impairments including dementia in primary health care (PHC) facilities. The lack of culturally appropriate cognitive assessment tools in PHC facilities delays early detection. This study aims to culturally adapt a brief digital cognitive assessment tool for PHC professionals in Southeast Nigeria. Method: A total of 30 participants (15 healthcare workers HCW and 15 community members) were selected to be culturally representative of the community. We completed focus groups and pilot testing to evaluate and refine the Brain Health Assessment (BHA) a subset of tools from the Tablet-based Cognitive Assessment Tool (TabCAT) known to be sensitive to cognitive impairment in other settings. We examined BHA subtests across local languages (Pidgin and Igbo) spoken at two geriatric clinics in Anambra State Southeast Nigeria. Results: Following structured approaches in focus groups, adaptations were made to the Favorites (memory) and Line Length (visuospatial) subtests based on their input. Participants found the new adaptations to have good construct validity for the region. Conclusions: The BHA subtests showed content validity for future work needed to validate the tool for detecting early cognitive changes associated with dementia and Alzheimer's disease in PHC settings. The use of culturally adapted and concise digital cognitive assessment tools relevant to healthcare professionals in Southeast Nigeria's PHCs is advocated.

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Objectives: Primary health care remains the widely available first point of medical care in Nigeria and in other low- and middle-income countries. Recognizing the rising prevalence of dementia in these settings, primary healthcare providers should be trained on cognitive assessment. However, little is known about the current Nigerian primary healthcare providers' knowledge of dementia, cognitive assessment tools, and use in elderly populations. The aim of this study was to evaluate primary healthcare providers' knowledge of dementia and cognitive assessment tools in Southeast Nigeria in preparation for the introduction of digital tablet-based assessment tool. Methods: This is a cross-sectional mixed method descriptive pilot survey carried out in a comprehensive healthcare center affiliated with Nnamdi Azikiwe University Teaching Hospital. Fifty healthcare workers participated. Convenience sampling was employed involving all consenting primary healthcare providers in comprehensive healthcare center-Nnamdi Azikiwe University Teaching Hospital. A structured questionnaire was distributed for generation of both qualitative and quantitative data. Result: The mean age of the 50 primary healthcare providers was 36.6 years, with females constituting 80%. Mean practice duration was 10.8 years. Their response on the mean age at which patients may need a cognitive assessment was reported as 52.8 years. Primary healthcare providers reported that dementia is associated with memory loss and can be genetically inherited. None of the respondents were familiar with Montreal cognitive assessment, or any form of tablet-based cognitive assessment tool. Most (86%) knew about the mini mental state examination. Conclusion: Primary healthcare providers are deficient in knowledge of dementia Alzheimer's or cognitive assessment tools, and so they do not routinely carryout cognitive screening in elderly patients during clinic visits. It is important to train all cadres of primary healthcare staff on the use and benefit of cognitive assessment using culturally validated user-friendly tool to improve quality of care for the elderly population.

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Objectives: Routine dipstick urinalysis is a useful and inexpensive method for the early detection of asymptomatic diseases. Our study was carried out to detect the prevalence of urinary abnormalities among an apparently asymptomatic healthy female group and emphasize the value of routine dipstick urinalysis. Methods: A cross-sectional study was carried out among second to sixth (final)-year female medical students of Nnamdi Azikiwe University, Nnewi campus between 8 and 30 September 2019. A total of 100 subjects were enrolled. First-morning midstream urine samples were collected and promptly tested with dipstick strips. Subjects with abnormal findings were informed and treated appropriately. Results: In all, 54 (54%) of the subjects had urine abnormalities. Trace proteinuria was the commonest abnormality seen with a prevalence of 33%, followed by abnormal urine appearance (17%), leucocytes (14%), nitrites (8%) and urobilinogen (2%). Urine abnormalities were commoner in students who resided in the school hostel. Abnormal urine appearance was significantly associated with nitrites (0.003) and leucocytes (0.001). Conclusion: Routine dipstick urinalysis should be performed among students and apparently healthy individuals for early detection and diagnosis of renal diseases to facilitate quick interventions and prevent further progression.

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INTRODUCTION: The coronavirus disease (COVID-19) infection rate and mortality among Nigerian health care workers appear to be on the increase. This study determined the level of knowledge, attitude, practices, and impact of COVID-19 infection on healthcare workers (HCWs) working in a South-Eastern Nigerian state. METHODOLOGY: This was a web-based, cross-sectional study conducted among healthcare workers in South-eastern, Nigeria during the lockdown period. Socio-demographic profile, knowledge of COVID-19, fears and impact concerning COVID-19, attitude of health workers to work, preventive practices during this pandemic period were obtained. Data were analysed using STATA 16.0. Chi-square and Fisher's exact tests of association were used to determine the association between variables, with the significance level set at p < 0.05. RESULTS: A total of 403 health care workers participated in the study. Majority of participants (n = 357, 88.59%) had good knowledge and good preventive practices (n = 328, 81.39%) of COVID-19. A significant proportion of respondents had a poor attitude to work (n = 101, 25.06%) and an attitude of indifference (n = 233, 57.82%). Almost half (48.64%) of participants had been negatively affected by COVID-19. Knowledge significantly influenced practice (p = 0.029). Lack of Personal protective equipment, fear of dying and going to common places, had a significant impact on the attitude of workers. CONCLUSION: Good knowledge which influenced practice, high use of preventive practices, with associated poor and indifferent attitude was noted among healthcare workers. Fear of death and lack of personal protective equipment had a strong impact on attitude. Female HCWs had poorer attitude to work than males.

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Introduction: The coronavirus disease (COVID-19) infection rate and mortality among Nigerian health care workers appear to be on the increase. This study determined the level of knowledge, attitude, practices, and impact of COVID-19 infection on healthcare workers (HCWs) working in a South-Eastern Nigerian state.Methodology: This was a web-based, cross-sectional study conducted among healthcare workers in South-eastern, Nigeria during the lockdown period. Socio-demographic profile, knowledge of COVID-19, fears and impact concerning COVID-19, attitude of health workers to work, preventive practices during this pandemic period were obtained. Data were analysed using STATA 16.0. Chi-square and Fisher's exact tests of association were used to determine the association between variables, with the significance level set at p < 0.05. Results: A total of 403 health care workers participated in the study. Majority of participants (n = 357, 88.59%) had good knowledge and good preventive practices (n = 328, 81.39%) of COVID-19. A significant proportion of respondents had a poor attitude to work (n = 101, 25.06%) and an attitude of indifference (n = 233, 57.82%). Almost half (48.64%) of participants had been negatively affected by COVID-19. Knowledge significantly influenced practice (p = 0.029). Lack of Personal protective equipment, fear of dying and going to common places, had a significant impact on the attitude of workers. Conclusion: Good knowledge which influenced practice, high use of preventive practices, with associated poor and indifferent attitude was noted among healthcare workers. Fear of death and lack of personal protective equipment had a strong impact on attitude. Female HCWs had poorer attitude to work than males

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