Chijioke C P, Okolo T O, Nwadike K I, Ejim E C, Ekochin F C, Aronu G N, Ghasi S I, Chijioke O U
Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu; Department of Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria.
Niger J Clin Pract. 2015 Jul-Aug;18(4):544-7. doi: 10.4103/1119-3077.156899.
Our aim was to investigate the availability of functional blood pressure monitors at health care institutions in Enugu, Nigeria.
During repeated surveys of 15 (primary, secondary and tertiary) health care institutions in Enugu between 2007 and 2012, records were made of the availability and functional status of sphygmomanometers in the clinics and wards. We also assessed the degree of agreement between measurements by institutional staff and measurements by trained observers using the same or the standard sphygmomanometer.
Apart from three institutions, there was inadequate availability of fully functional sphygmomanometers: 61 staff attending to outpatients were sharing 35 sphygmomanometers, 6 of which were faulty i.e. needing repairs. Wards invariably had only one or two functional sphygmomanometers, regardless of bed occupancy. Institutional staff ignored recommended guidelines for blood pressure measurement. The overall mean difference in blood pressure measurements between institutional staff and a trained observer (1.6 mmHg; 95% confidence interval, CI: -0.3 to 3.4; P=0.1) was greater and more significant than the mean difference between the two observers (0.1 mmHg; CI: -1.5 to 1.7; P=0.9) and the mean difference between institutional and standard sphygmomanometers (-0.2 mmHg; CI: -1.7 to 1.3; P=0.8).
There has been a notable lack of reporting on the availability of blood pressure measuring devices in third world health care institutions. Our surveys have shown inadequate availability of functional sphygmomanometers in the institutions, but satisfactory agreement between measurements by institutional staff and trained observers. In view of recent guidelines and recommendations, there is need to supplement office readings with mercury devices with oscillometric home or automated office blood pressure recording.
我们的目标是调查尼日利亚埃努古市医疗机构中功能性血压监测仪的可用性。
在2007年至2012年期间对埃努古市15家（初级、二级和三级）医疗机构进行的重复调查中，记录了诊所和病房中血压计的可用性和功能状态。我们还评估了机构工作人员测量结果与经过培训的观察员使用相同或标准血压计测量结果之间的一致性程度。
除了三家机构外，功能齐全的血压计供应不足：61名门诊工作人员共用35台血压计，其中6台有故障，即需要维修。无论床位占用情况如何，病房通常只有一两台功能性血压计。机构工作人员忽视了推荐的血压测量指南。机构工作人员与经过培训的观察员之间血压测量的总体平均差异（1.6 mmHg；95%置信区间，CI：-0.3至3.4；P = 0.1）大于且比两名观察员之间的平均差异（0.1 mmHg；CI：-1.5至1.7；P = 0.9）以及机构血压计与标准血压计之间的平均差异（-0.2 mmHg；CI：-1.7至1.3；P = 0.8）更显著。
第三世界医疗机构中血压测量设备可用性的报告明显不足。我们的调查表明，这些机构中功能齐全的血压计供应不足，但机构工作人员与经过培训的观察员之间的测量结果一致性令人满意。鉴于最近的指南和建议，需要用示波法家用或自动办公血压记录设备补充汞柱式设备的诊室测量结果。
