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Introduction: Reduction in salt intake improves blood pressure control and reduces the risk of hypertension and other noncommunicable diseases (NCDs). However, salt intake remains high among Nigerians. This study aimed to identify barriers and facilitators to salt reduction among hypertensive patients attending a family medicine clinic in southern Nigeria. Methodology: A focussed group discussion (FGD) exploring patients' perceptions of the barriers and facilitators to salt reduction was conducted with 8 groups of purposefully selected 74 hypertensives who consumed excess dietary salt, stratified by age and sex, using an FGD guide. Thematic analysis was then performed using Nvivo® version 12 pro. Ethical approval was obtained from Irrua Specialist Teaching Hospital (ISTH), and written informed consent was obtained from the patients before the FGD. Results: Respondents had a mean age of 51.96 ± 8.98 years. The majority were females (47, 63.5%) and had uncontrolled blood pressure (66, 89.2%). Five major themes were identified, from which several minor themes emerged. Respondents rated their overall health as good but expressed concerns about their poor blood pressure control. Identified barriers to salt reduction included family pressure, ignorance, ready availability and affordability of salt and lack of affordable alternatives. Facilitators of salt reduction were measuring the amount of cooking salt, removing salt from the dining table and providing substitutes. Respondents, however, expressed willingness to reduce their salt consumption. Conclusion: The study identified barriers and facilitators to salt reduction. There is a need to create awareness of the safe amount of salt to be consumed and provide safe and readily available alternatives.

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OBJECTIVES: Restorative sleep is critical in preventing hypertension and other chronic diseases. Limited research has explored the relationship between sleep quality and hypertension in Africa. This study investigated the association between sleep quality and blood pressure control among hypertensive patients in Southern Nigeria. DESIGN: Cross-sectional study. SETTING: A rural tertiary hospital in Southern Nigeria, April to June 2023. PARTICIPANTS: 250 systematically selected hypertensive adults. Participants completed a validated semistructured interviewer-administered questionnaire to assess their sleep patterns, including sleep duration, self-reported trouble sleeping and a history of clinical diagnosis of sleep disorders. Sleep patterns were categorised as restorative (healthy) or non-restorative (unhealthy). The blood pressure of respondents was checked and categorised as controlled (<140/90 mm Hg) or uncontrolled (≥140/90 mm Hg). Data were analysed descriptively using SPSS V.24.0 OUTCOME MEASURES: Quality of sleep and blood pressure control. RESULTS: Respondents had a mean age of 51.5±10.0 years, with the majority being female (156, 62.4%), married (135, 54.0%) and belonging to the Esan tribe (125, 50.0%). The prevalence of restorative sleep was 36%, while the blood pressure control rate was 23.6%. An association was found between restorative sleep and blood pressure control (adjusted OR =4.38; 95% CI=2.37-8.10; p<0.0001). Respondents aged ≥60 years had 3.5 times higher odds of experiencing non-restorative sleep than those aged ≤40 years (aOR=3.46; 95% CI=1.37-8.74; p=0.009). CONCLUSION: The study found an association between poor quality sleep and poor blood pressure control. Incorporating sleep assessments and interventions into comprehensive hypertension management strategies could be explored as a possible approach to improve sleep quality and enhance blood pressure control. TRIAL REGISTRATION NUMBER: PACTR202301917477205.

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Antenatal care is an important entry point to the health system and provides access to essential obstetric care. Satisfaction with different aspects of antenatal care, has the potential to improve health. This study aimed to determine the prevalence of satisfaction with Antenatal care services and identify factors influencing client satisfaction among antenatal clinic attendees in University of Calabar Teaching Hospital Calabar (UCTH), Cross River State. A descriptive cross-sectional study was conducted among 200 pregnant women attending the ANC in UCTH. Systematic random sampling technique was used to recruit participants and the Client Satisfaction questionnaire (CSQ8) measured satisfaction. Data was analysed using bivariate (Chi-square test) and multivariate (binary logistic regression) analysis. The overall level of satisfaction recorded in this study was 92%. Reasons for dissatisfaction were long waiting time 57%, cost of services 40.3%, clinic environment 31%, doctors assigned to ANC attendees 19% and attitude of doctors 13%. Being satisfied with their previous experience in the health facility was the only significant predictor of satisfaction in this study(p<0.05). Although a high level of satisfaction with ANC services was noted among pregnant women in UCTH, it is pertinent that waiting time, cost of services, toilet facilities and infrastructure be addressed.

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Introduction: improved access to antiretroviral therapy (ART) has significantly increased the survival and quality of life of HIV-infected persons. Strict adherence to antiretroviral therapy (ART) is crucial if viral suppression must remain optimal. We assessed predictors of adherence to ART among adult patients in Cross River State (CRS), Nigeria. Methods: a cross-sectional survey was conducted among 999 adult patients on ART in selected secondary and tertiary health facilities in CRS from January to June 2017. Respondents were recruited using multistage technique. Data were collected using a pre-tested interviewer-administered questionnaire. Adherence was defined as clients taking at least 95% of their pills in the last seven days. Multivariate analysis was performed to determine predictors of adherence at 5% level of significance. Results: majority (70.5%) of the respondents were females with a mean age of 43.7 ± 11.1 years. The self-reported adherence rate was 60.1%. The commonest reasons for non-adherence was client travelling out of home, being busy, forgetting and lack of food. The significant predictor identified in this study was being on first-line drugs (OR=3.677, 95% C.I=2.523-5.358), were 3 times more likely to have good adherence. Predictors of poor-adherence were alcohol intake (OR=0.382, 95% C.I=0.262-0.559), dosing medications (OR=0.502, 95% C.I=0.381-0.661), CD4 cell count ≥ 500 (OR=0.723, 95% C.I=0.543-0.964), poor attitude to HIV status and medication (OR=0.713, 95% C.I=0.512-0.994) and family support (OR=0.736, 95% C.I=0.544-0.995). Conclusion: adherence to ART among clients in this study was fair. Majority of the reasons for poor-adherence were client-related. There is need for targeted counselling to improve adherence.

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