Publications by authors named "Samuel Olowookere"

40 Publications

Caesarean delivery rate and indications at a secondary healthcare Facility in Ibadan, South Western Nigeria: a five-year review.

Afr Health Sci 2021 Mar;21(1):320-326

Centre for Family Medicine, Jericho Specialist Hospital, Jericho, Ibadan.

Background: Caesarean delivery is an essential surgical skill within the primary care setting aimed at reducing maternal morbidity and mortality.

Objectives: To determine the rate and indications for caesarean deliveries with a view to improving on the service delivery in the study area.

Methods: A retrospective review of all caesarean deliveries over a five-year period, January 1, 2012 to December 31, 2016.

Results: A total of 2321 deliveries were recorded during the study duration and 481 of them were through caesarean section (CS) giving a caesarean section rate of 20.4%. The rate was higher in the multigravida 255 (53.1%). The commonest indication for caesarean section was previous caesarean section 131 (27.2%). Emergency caesarean delivery accounted for 278 (57.8%). Only 16 (3.3%) stayed more than five days postoperatively while the rest, 465 (96.7%), stayed less than five days. There was a gradual yearly increase in rate from 12.1% in 2012 to 19.5% in 2016.

Conclusion: The rate of CS in this study has shown a gradual yearly increase with emergency CS having a higher percentage. Early diagnosis and referral of high-risk pregnancies from peripheral hospitals could reduce emergency CS among the study population.
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http://dx.doi.org/10.4314/ahs.v21i1.41DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8356609PMC
March 2021

A Novel Afrocentric Stroke Risk Assessment Score: Models from the Siren Study.

J Stroke Cerebrovasc Dis 2021 Jul 28;30(10):106003. Epub 2021 Jul 28.

Medical University of South Carolina, SC, USA.

Background: Stroke risk can be quantified using risk factors whose effect sizes vary by geography and race. No stroke risk assessment tool exists to estimate aggregate stroke risk for indigenous African.

Objectives: To develop Afrocentric risk-scoring models for stroke occurrence.

Materials And Methods: We evaluated 3533 radiologically confirmed West African stroke cases paired 1:1 with age-, and sex-matched stroke-free controls in the SIREN study. The 7,066 subjects were randomly split into a training and testing set at the ratio of 85:15. Conditional logistic regression models were constructed by including 17 putative factors linked to stroke occurrence using the training set. Significant risk factors were assigned constant and standardized statistical weights based on regression coefficients (β) to develop an additive risk scoring system on a scale of 0-100%. Using the testing set, Receiver Operating Characteristics (ROC) curves were constructed to obtain a total score to serve as cut-off to discriminate between cases and controls. We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) at this cut-off.

Results: For stroke occurrence, we identified 15 traditional vascular factors. Cohen's kappa for validity was maximal at a total risk score of 56% using both statistical weighting approaches to risk quantification and in both datasets. The risk score had a predictive accuracy of 76% (95%CI: 74-79%), sensitivity of 80.3%, specificity of 63.0%, PPV of 68.5% and NPV of 76.2% in the test dataset. For ischemic strokes, 12 risk factors had predictive accuracy of 78% (95%CI: 74-81%). For hemorrhagic strokes, 7 factors had a predictive accuracy of 79% (95%CI: 73-84%).

Conclusions: The SIREN models quantify aggregate stroke risk in indigenous West Africans with good accuracy. Prospective studies are needed to validate this instrument for stroke prevention.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2021.106003DOI Listing
July 2021

The Burden and Perceived Stress on Family Caregivers of Patients With Orofacial Cleft Deformities in The Perioperative Period of Cleft Repair.

J Patient Exp 2020 Dec 14;7(6):1602-1609. Epub 2020 Aug 14.

Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.

Different stages along the trajectory of cleft care may present with different and peculiar challenges that may negatively impact family caregivers, leading to considerable stress and burden. This study aims to evaluate the family caregiver burden and perceived stress of caring for patients with cleft deformities. Contributing factors to family caregivers' burden in the perioperative period of cleft repair was also identified. A cross-sectional design that included 90 adult caregiver-patient pairs was employed. Semi-structured questionnaire was used to collect necessary information. The level of caregiver's burden was assessed using the Zarit burden interview score. The results demonstrated the levels of caregiver burden as severe (4.4%), moderate to severe (21.1%), mild to moderate (40%), and little or none (34.5%). The only significant and independent predictor of caregiver burden was earning less than US$50/month (odds ratio = 2.30, 95% CI = 0.95-5.61, = .066). Coping strategy was mainly family support (98.9%), while the greatest need expressed was financial assistance (66.7%). Our findings suggests that efforts geared at reducing direct and indirect cost of cleft care may help in reducing caregivers' burden.
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http://dx.doi.org/10.1177/2374373520948650DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7786686PMC
December 2020

Effect of malaria preventive education on the use of long-lasting insecticidal nets among pregnant females in a Teaching Hospital in Osun state, south-west Nigeria.

Parasite Epidemiol Control 2020 Nov 19;11:e00182. Epub 2020 Sep 19.

Department of Obstetrics and Gynaecology, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.

Background: Malaria in pregnancy is a major public health problem in Nigeria. Long-Lasting Insecticidal Nets (LLINs) have been advocated as an effective tool against malaria transmission. However, success of this intervention largely depends on the knowledge and practices regarding malaria and its prevention. Unfortunately, few studies have been done on effect of malaria preventive education on use of LLIN in pregnancy.

Objective: To assess the knowledge of malaria and determine the effect of malaria preventive education on the use of LLINs among pregnant females in a Teaching Hospital in Osun state.

Method: It was a one group pre-test post-test quasi - experimental hospital based study involving pregnant females attending Ante-Natal Clinic (ANC) of the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC). A total of 200 respondents were recruited for this study by 2-stage sampling technique. Data was collected using a pretested questionnaire to elicit information on socio-demographic characteristics, use of LLIN in pregnancy, knowledge of malaria and its preventive measures. The data collected was analysed using descriptive and inferential statistics. The descriptive statistics comprised frequency, percentage, means and standard deviations. Bivariate analysis comprised Chi-square test on knowledge of malaria before and after intervention while correlation test assessed strength of relationship between knowledge of malaria preventive education and use of LLINs before and after intervention. Multivariate analysis determined the predictors of LLINs use. Analytical statistics of cross tabulation was conducted considering a  < 0.05 to be statistically significant.

Results: There was an increase in the scores of knowledge on malaria transmission after the intervention and this was statistically significant (χ = 8.862,  < 0.01). Similarly, the scores of knowledge on malaria prevention increased after the intervention and this was statistically significant (χ = 10.023,  < 0.01). Respondents' age, marital status and gravidity were predictors of LLINs use. Biserial correlation showed a statistically positive relationship between knowledge of malaria preventive education and use of LLINs after intervention ( = 0.036,  < 0.01).

Conclusion: The use of malaria preventive education was found to be effective in increasing the use of LLIN in this study. These findings highlight a need for educational intervention in implementation of LLINs. There is therefore a need to strengthen the policy of malaria prevention education as an integral component with distribution of free LLIN in health care setting to enhance its utilization.
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http://dx.doi.org/10.1016/j.parepi.2020.e00182DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7519353PMC
November 2020

Willingness of Family Caregivers to Consent to Relative's Postmortem Examination that Die Suddenly in a Nigerian Tertiary Hospital.

Ethiop J Health Sci 2020 May;30(3):377-386

Department of Community Health, Obafemi Awolowo University, Ile-Ife, Nigeria.

Background: Postmortem examination is necessary to diagnose the cause of sudden death, and family caregivers are expected to consent to this examination. This study assessed knowledge, attitude, practices and willingness of family caregivers to consent to postmortem examination of their relative if they die suddenly in a Nigerian tertiary hospital.

Methods: Descriptive cross-sectional study of family caregivers of our patients that completed an interviewer administered semistructured questionnaire assessing their knowledge, attitude, practices and willingness to consent to postmortem examination of their relative if they die suddenly. Data were analyzed using descriptive and inferential statistics.

Results: A total of 224 caregivers were interviewed. The mean age (SD) was 34.95 (11.74), ranging 22-75 years. They were parents (32.6%), siblings (37.9%), spouses (11.2%) and other relatives (18.3%). Only 17% had adequate knowledge, 44.6% positive attitude and 11.2% good practices to postmortem examination of sudden death. The majority (75.9%) would consent to postmortem examination of their relatives if they die suddenly. Sociodemographic variables associated with willingness to consent to postmortem examination after relative's sudden death include being male (AOR 3.61; 95%CI 3.09-8.92; p=0.001), having tertiary education (AOR 4.83; 95%CI 1.01-8.29; p=0.034), Christianity (AOR 2.59; 95%CI 1.25-5.35; p=0.010) and skilled worker (AOR 1.43; 95%CI 1.33-3.80; p=0.020).

Conclusion: Some family caregivers would not consent to postmortem examination of their relatives when they die suddenly. Sensitization programs targeting family caregivers are necessary to increase knowledge and enhance prevention of sudden death as well as improve willingness to consent to postmortem examination when their relatives die suddenly.
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http://dx.doi.org/10.4314/ejhs.v30i3.9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445937PMC
May 2020

Hepatitis B Infection: A Mixed Methods of Disclosure Pattern and Social Problems in the Nigerian Family.

J Patient Exp 2020 Apr 7;7(2):208-216. Epub 2019 Mar 7.

Department of Medicine, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.

Background: Hepatitis B virus (HBV) infection has a high prevalence rate in Nigeria. Disclosure of infection status to close partner and the public attracts support for infected people. This study looks at disclosure and social challenges of infected persons.

Methods: Mixed methods of patients' administered questionnaire and an in-depth interview conducted on HBV-infected respondents in a hospital in Nigeria were used. The study recruited all participants who satisfied the inclusion criteria. Data were entered into SPSS version 20 and analyzed using simple and inferential statistics and content analysis for the in-depth interview.

Results: A total of 205 participants completed the questionnaire study. Mean (standard deviation) age was 35.3 (±11.0) years. There were 121 married, 37 singles with noncohabiting partners and 47 singles without partners with disclosure rates being 96.7% versus 97.9% versus 89.2%, respectively. Singles disclosed infection more to their parents while married respondents disclosed infection more to their spouses. Singles had high rate of denial of sexual relationship (22.6%), emotional trauma (34.5%), broken relationships (11.4%), and surreptitious use of contraception for protection (67.6%). Married respondents had the highest rate of HBV vaccination of their family members (40.1%). Infection prevention and allaying fears of family members were their counseling needs. In-depth interview revealed that infected respondents usually expressed shock and depression at a positive test leading to fear and deception that put close associates at risk.

Conclusion: Hepatitis B virus-infected respondents have high rate of disclosure. Family problems of these people can therefore be solved through public enlightenment and individual counseling.
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http://dx.doi.org/10.1177/2374373519827965DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7427354PMC
April 2020

Unraveling the risk factors for spontaneous intracerebral hemorrhage among West Africans.

Neurology 2020 03 19;94(10):e998-e1012. Epub 2020 Feb 19.

From Kwame Nkrumah University of Science and Technology (F.S.S., L.A., A. Singh, D.O.), Kumasi, Ghana; University of California (B.O.), San Francisco; Medical University of South Carolina (M.G., D.L., C.J., F.M.), Charleston; College of Medicine (O. Akpa, G. Ogbole, M.O., J.A., A.O., A. Adeoye, L. Ogunjimi, O. Arulogun, F.A., O. Ogah, A. Makanjuola, O. Adebayo, A. Agunloye, S.L., S.D., M.F., C.E.), University of Ibadan, Nigeria; University of Ghana Medical School (A. Akpalu, R.L., B.C.-T.), Accra; University of Ilorin Teaching Hospital (K.W., L. Oyinloye, P.K., E.S.); Federal Medical Centre (R.A., O. Adeleye), Abeokuta; Ahmadu Bello University (R.O., O.B., V.S., H.I.), Zaria; Obafemi Awolowo University Teaching Hospital (M.K., B.F., O. Ajose, S.O.), Ile-Ife; Aminu Kano Teaching Hospital (L. Owolabi, A. Mande), Kano, Nigeria; University of Kentucky (D.A.), Lexington; University of Alabama at Birmingham (H.T.); University of Cambridge (H.S.M.), UK; Delta State University Teaching Hospital (O. Olugbo); Jos Teaching Hospital (G. Osaigbovo, A. Salaam, G.A., C.I.), Plateau State; Federal Medical Centre (I.C.), Umuahia, Abia State; Federal Medical Centre (T.S.), Owo, Ondo State; and Ladoke Akintola University of Technology Teaching Hospital (A. Akintunde), Ogbomosho, Oyo State, Nigeria.

Objective: To characterize risk factors for spontaneous intracerebral hemorrhage (sICH) occurrence and severity among West Africans.

Methods: The Stroke Investigative Research and Educational Network (SIREN) study is a multicenter case-control study involving 15 sites in Ghana and Nigeria. Patients were adults ≥18 years old with CT-confirmed sICH with age-, sex-, and ethnicity-matched stroke-free community controls. Standard instruments were used to assess vascular, lifestyle, and psychosocial factors. Factors associated with sICH and its severity were assessed using conditional logistic regression to estimate odds ratios (ORs) and population-attributable risks (PARs) with 95% confidence intervals (CIs) for factors.

Results: Of 2,944 adjudicated stroke cases, 854 were intracerebral hemorrhage (ICH). Mean age of patients with ICH was 54.7 ± 13.9 years, with a male preponderance (63.1%), and 77.3% were nonlobar. Etiologic subtypes of sICH included hypertension (80.9%), structural vascular anomalies (4.0%), cerebral amyloid angiopathy (0.7%), systemic illnesses (0.5%), medication-related (0.4%), and undetermined (13.7%). Eight factors independently associated with sICH occurrence by decreasing order of PAR with their adjusted OR (95% CI) were hypertension, 66.63 (20.78-213.72); dyslipidemia, 2.95 (1.84-4.74); meat consumption, 1.55 (1.01-2.38); family history of CVD, 2.22 (1.41-3.50); nonconsumption of green vegetables, 3.61 (2.07-6.31); diabetes mellitus, 2.11 (1.29-3.46); stress, 1.68 (1.03-2.77); and current tobacco use, 14.27 (2.09-97.47). Factors associated with severe sICH using an NIH Stroke Scale score >15 with adjusted OR (95% CI) were nonconsumption of leafy green vegetables, 2.03 (1.43-2.88); systolic blood pressure for each mm Hg rise, 1.01 (1.00-1.01); presence of midline shift, 1.54 (1.11-2.13); lobar ICH, 1.72 (1.16-2.55); and supratentorial bleeds, 2.17 (1.06-4.46).

Conclusions: Population-level control of the dominant factors will substantially mitigate the burden of sICH in West Africa.
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http://dx.doi.org/10.1212/WNL.0000000000009056DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238923PMC
March 2020

Knowledge about and preventive practices against neonatal tetanus among young Nigerian women.

Ci Ji Yi Xue Za Zhi 2019 Jul-Sep;31(3):154-157

Department of Community Health, College of Health Sciences, Obafemi Awolowo University, IIe-Ife, Osun State, Nigeria.

Objective: The objective of this study was carried out to determine the knowledge about and preventive practices against neonatal tetanus (NNT) in young women of reproductive age.

Materials And Methods: Descriptive cross-sectional study design of 380 randomly selected consenting young women of child-bearing age at a Nigerian tertiary educational institution. They completed a semi-structured questionnaire on knowledge about and risk factors for NNT, willingness to receive the vaccine, and uptake of tetanus toxoid vaccine.

Results: The mean age (standard deviation) of the women was 22.4 (4.6) years ranging from 15 to 30 years. The majority (64.5%) had poor knowledge of the causes of and risk factors for NNT with only 31% knowing that immunizing women against tetanus prevents NNT. Most of the women (58%) were unwilling to receive tetanus immunization. A total of 15.5% had received tetanus toxoid, but only 0.5% had completed the required dosage. A higher proportion of respondents with good knowledge about tetanus had tetanus toxoid immunization (28.1% vs. 8.6%; < 0.0001).

Conclusion: Knowledge about NNT, willingness to receive the vaccine, and uptake of tetanus toxoid were unacceptably poor among respondents. There is a need for continuous education targeting young women on the link between the tetanus immunization status of women and the occurrence of NNT.
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http://dx.doi.org/10.4103/tcmj.tcmj_55_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6559023PMC
July 2019

Burden of family caregivers of ophthalmic patients in a university teaching hospital in south-west Nigeria.

Malawi Med J 2019 03;31(1):39-44

Department of Ophthalmology, Osun State University, Osogbo, Nigeria.

Background: The family provides support in the care of their ill members and suffers some burden during caregiving. This study assessed the burden of family caregivers and associated factors in an ophthalmic clinic situated in a university teaching hospital in southwest Nigeria.

Methods: This was a descriptive cross-sectional study where consenting family caregivers of ophthalmic patients completed a semi-structured questionnaire containing information on their socio-demographic characteristics and caregiving burden using the Zarit burden interview. Descriptive and inferential statistics analyses were done.

Results: A total of 273 caregivers completed the study. The caregivers were parents (23.5%), spouses (20.1%), siblings (3.3%), children (35.9%) and other relatives (14.2%) with mean age (SD) of 38.9 (14.9) years (range 8-79 years). Majority (81.2%) experienced caregiver burden with prayer (89%) as a coping strategy. Financial support (56%) was a major caregiver need with majority (59.3%) satisfied with their relatives' hospital care. Neither the patients nor their caregivers were on health insurance scheme. Statistical significant factors associated with caregivers' burden included young age (AOR=4.63, 95%CI=1.55-13.90; p=0.01), higher education (AOR=5.51, 95%CI=2.30-13.2, p=0.01), being employed (AOR=1.72, 95CI=1.30-4.76, p=0.04), longer caregiving (AOR=3.37, 95%CI=1.27-7.02, p=0.02), and having patient on hospital admission (AOR=1.90, 95%CI=1.26-3.09, p=0.02).

Conclusion: Family caregivers of ophthalmic patients experienced significant burden. Hence, they need more assistance from the health care institutions and community, including policy makers, so that they can cope with their caregiving activities. Enrollment in the social health insurance scheme will reduce out of pocket payment of hospital bills.
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http://dx.doi.org/10.4314/mmj.v31i1.7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6526346PMC
March 2019

Nutritional status of under-five children born to teenage mothers in an urban setting, south-western Nigeria.

BMC Res Notes 2019 Mar 4;12(1):116. Epub 2019 Mar 4.

Community Health Department, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.

Objective: There have been many studies on the nutritional status of under-fives and factors responsible but very few looks at this special group of women. This study assessed the breastfeeding practices of teenage mothers and determined its association with the nutritional indices of their under-five children. The study was a descriptive cross-sectional survey. A total of 300 mother-child pair was selected using a multi-stage sampling technique from Primary Health Care centres in Ondo West Local Government Area, Ondo State, Nigeria. Bivariate and multivariate logistic regression were done to identify predictors' of poor nutritional status at p < 0.05.

Results: About 87% initiated breastfeeding less than 1 h after birth while 31.9% breastfed their children exclusively for 6 months. Prevalence of stunting, wasting and underweight among the under-fives were 18.6%, 25.3%, and 29.5% respectively. Initiation of breastfeeding more than 1 h after birth increased the odds of stunting (OR = 9.551, CI = 1.279-16.310) and underweight (OR = 6.674, CI = 3.159-14.097) by about 10 and 7 times respectively. Whereas odds of wasting (OR = 2.346, CI = 1.228-4.480) was 2 times higher with breastfeeding duration less than 6 months. Therefore, education of teenage mothers on breastfeeding initiation and duration is vital in reducing malnutrition among under-fives.
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http://dx.doi.org/10.1186/s13104-019-4147-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398233PMC
March 2019

Knowledge, attitudes and practices related to stroke in Ghana and Nigeria: A SIREN call to action.

PLoS One 2018 16;13(11):e0206548. Epub 2018 Nov 16.

University of Ghana Medical School, Accra, Ghana.

Introduction: Stroke is a prominent cause of death, disability, and dementia in sub-Saharan Africa (SSA). The Stroke Investigative Research and Education Network works collaboratively with stroke survivors and individuals serving as community controls to comprehensively characterize the genomic, sociocultural, economic and behavioral risk factors for stroke in SSA.

Purpose: In this paper, we aim to: i) explore the attitudes, beliefs, and practices related to stroke in Ghana and Nigeria using the process of qualitative description; and ii) propose actions for future research and community-based participation and education.

Methods: Stroke survivors, their caregivers, health care professionals, and community representatives and faith-based leaders participated in one of twenty-six focus groups, which qualitatively explored community beliefs, attitudes and practices related to stroke in Ghana and Nigeria. Arthur Kleinman's Explanatory Model of Illness and the Social Ecological Model guided the questions and/or thematic analysis of the qualitative data. We hereby describe our focus group methods and analyses of qualitative data, as well as the findings and suggestions for improving stroke outcomes.

Results And Discussion: The major findings illustrate the fears, causes, chief problems, treatment, and recommendations related to stroke through the views of the participants, as well as recommendations for working effectively with the SIREN communities. Findings are compared to SIREN quantitative data and other qualitative studies in Africa. As far as we are aware, this is the first paper to qualitatively explore and contrast community beliefs, attitudes, and practices among stroke survivors and their caregivers, community and faith-based leaders, and health professionals in multiple communities within Nigeria and Ghana.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0206548PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6239297PMC
April 2019

Determinants of Quality of Life of Elderly Patients Attending a General Practice Clinic in Southwest Nigeria.

Int Q Community Health Educ 2018 Oct 12;39(1):3-7. Epub 2018 Jun 12.

1 Department of Family Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.

Background: Aging is associated with change in health status and decreasing functional capacity affecting the general well-being of individuals with increase in the prevalence of chronic noncommunicable diseases.

Objective: This study aimed to assess the quality of life (QoL) and its determinants in elderly patients attending a general practice clinic in Southwest Nigeria.

Method: Descriptive cross-sectional study of consenting elderly patients completed an interviewer-administered questionnaire on QoL and its determinants. Data were analyzed using descriptive and inferential analysis. Logistic regression was done to identify predictors of QoL.

Results: A total of 216 older adults were interviewed. Only 25% had good QoL with majority having multiple morbidities which was associated with poorer QoL. Predictors of QoL were family support (odds ratio = 0.249, 95% confidence interval [0.079, 0.850], p = .026) and socioeconomic class (odds ratio = 3.66, 95% confidence interval [1.47, 7.87], p = .004) of the respondents.

Conclusion: QoL was found to be poor among the study population and worst in those with multiple morbidities. There is a need for policy direction to advocate for preventive strategies for risk of chronic diseases as well as provide better access to primary care through National Health Insurance Scheme (NHIS).
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http://dx.doi.org/10.1177/0272684X18781781DOI Listing
October 2018

Restless legs syndrome: a rarity in the Nigerian pregnant population?

Sleep Med 2018 03 31;43:47-53. Epub 2018 Jan 31.

Department of Chemical Pathology, Obafemi Awolowo University, Ile-Ife, Nigeria.

Objectives: The prevalence of RLS in pregnancy is higher when compared with the general population however it remains unknown among indigenous black Africans. Available data indicate that RLS is uncommon in sub-Saharan Africa. We embarked on this study to determine the prevalence and characteristics of RLS in an antenatal clinic sample of Nigerian pregnant women compared with a primary care sample of non-pregnant women.

Methods: A total of 310 pregnant women and non-pregnant women filled out a questionnaire which incorporated the 2014 minimal criteria of the International Restless Legs Syndrome Study Group. Demographic and clinical data, including sleep duration and samples for blood hemoglobin concentration and urinalysis were obtained.

Results: The mean ages of the pregnant and non-pregnant women were 24.9 ± 5.6 years and 23.6 + 5.4 years, respectively (p = 0.003). There was no case of RLS found among pregnant women while five (1.6%) of the non-pregnant women fulfilled the criteria for RLS. Overall, the prevalence report of RLS symptoms was associated with lower mean habitual nocturnal sleep duration (p < 0.05) coffee (p = 0.013) and kola nut (0.023) consumption, report of leg cramps (p < 0.001) and proteinuria (p = 0.047), Report of leg cramps and proteinuria were independently associated with RLS.

Conclusion: The prevalence of restless legs syndrome is low among women of child-bearing age in the Nigerian population and may be lower in pregnancy. Report of leg cramps and proteinuria are independently associated with RLS.
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http://dx.doi.org/10.1016/j.sleep.2018.01.002DOI Listing
March 2018

In-school adolescents' weight status and blood pressure profile in South-western Nigeria: urban-rural comparison.

BMC Obes 2018 26;5. Epub 2018 Jan 26.

3Department of Community Health, Obafemi Awolowo University Ile-Ife, Ile-Ife, Nigeria.

Background: Obesity is a risk factor for hypertension. The study observed the relationship between adolescent weight status and blood pressure (BP) and the determinants of the BP pattern in urban and rural areas.

Methods: This was a cross-sectional study of 1000 randomly selected respondents (500 from urban and 500 from rural areas) who had anthropometry and BP measurements done. The pattern of BP measurements based on the weight status by location was observed. Statistical inferences were drawn via Chi-square and logistic regression.

Results: The mean age for all the respondents was 13.73 years ±2.04 (13.63 ± 2.05 for urban and 13.82 ± 2.03 for rural). Systolic and diastolic BP generally increased with increasing respondents' age, with mean pressures higher in urban areas. About 3% were obese, while 7.7% were overweight. The overall prevalence of high BP was 4.1%, with two-thirds coming from urban areas. On logistic regression analysis, the significant variables associated with high BP include being female (AOR 2.067, 95%CI1.007-4.243,  = 0.048), overweight (AOR 5.574, 95%CI 2.501-12.421,  = 0.0001) and obese (AOR 12.437, 95%CI 4.636-33.364, p = 0.0001).

Conclusion: High BP was associated with being female, overweight and obesity in both urban and rural areas. Urgent measures are needed to address increasing prevalence of overweight and obesity among adolescents and consequent high blood pressure.
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http://dx.doi.org/10.1186/s40608-018-0179-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787246PMC
January 2018

Determinants of Skilled Care Utilization among Pregnant Women Residents in an Urban Community in Kwara State, Northcentral Nigeria.

Ethiop J Health Sci 2017 May;27(3):291-298

Department of Community Health, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria.

Background: Skilled attendant at delivery (SBA) is one of the key indicators used in assessing progress towards improved maternal health. This study aimed at identifying factors influencing SBA utilization in Ilorin, Nigeria.

Methods: This cross-sectional study was carried out using multi-stage sampling technique among 400 participants in Ilorin, Northcentral Nigeria. A pre-tested questionnaire was used for data collection, and data analysis was done using descriptive and inferential statistics.

Results: SBA supervised 73.8% births. Determinants of skilled birth attendance at delivery include higher education (AOR; 10.94, 95% CI; 3.60-33.26), having only one child (AOR; 4.33, 95% CI; 1.18-15.82), having at least 4 ANC attendance (AOR; 18.84, 95% CI; 8.95-55.82) and residing near delivery sites (AOR; 11.49, 95% CI; 2.43-55.56).

Conclusion: The proportion of births supervised by SBA needs improvement in Northcentral Nigeria. Full implementation of reproductive health policies will enhance skilled births in Nigeria.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5615000PMC
http://dx.doi.org/10.4314/ejhs.v27i3.11DOI Listing
May 2017

Prevalence and Prognostic Features of ECG Abnormalities in Acute Stroke: Findings From the SIREN Study Among Africans.

Glob Heart 2017 06 14;12(2):99-105. Epub 2017 Mar 14.

University of Ghana Medical School, Accra, Ghana.

Background: Africa has a growing burden of stroke with associated high morbidity and a 3-year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke outcomes have not been previously characterized in Africans.

Objectives: The study assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study.

Methods: We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 h of admission and stroke classified based on brain computed tomography scan or magnetic resonance imaging. Stroke severity at baseline was assessed using the Stroke Levity Scale (SLS), whereas 1-month outcome was assessed using the modified Rankin Scale (mRS).

Results: Patients' mean age was 58.4 ± 13.4 years, 490 were men (55%) and 400 were women (45%), 65.5% had ischemic stroke, and 85.4% had at least 1 ECG abnormality. Women were significantly more likely to have atrial fibrillation, or left ventricular hypertrophy with or without strain pattern. Compared to ischemic stroke patients, hemorrhagic stroke patients were less likely to have atrial fibrillation (1.0% vs. 6.7%; p = 0.002), but more likely to have left ventricular hypertrophy (64.4% vs. 51.4%; p = 0.004). Odds of severe disability or death at 1 month were higher with severe stroke (AOR: 2.25; 95% confidence interval: 1.44 to 3.50), or atrial enlargement (AOR: 1.45; 95% confidence interval: 1.04 to 2.02).

Conclusions: About 4 in 5 acute stroke patients in this African cohort had evidence of a baseline ECG abnormality, but presence of any atrial enlargement was the only independent ECG predictor of death or disability.
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http://dx.doi.org/10.1016/j.gheart.2017.01.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5582979PMC
June 2017

Targeting women with free cervical cancer screening: challenges and lessons learnt from Osun state, southwest Nigeria.

Pan Afr Med J 2016 19;24:319. Epub 2016 Aug 19.

Department of Community Medicine, Faculty of Clinical Sciences, Bowen University Teaching Hospital, Ogbomoso, Oyo State, Nigeria.

Introduction: The study was conducted to determine the challenges and suggest solutions to conducting free cervical cancer screening among Nigerian women.

Methods: Awareness was created among women groups and mass media in Osun State for women to undergo free cervical cancer screening programme. Consenting women had their socio-demographic characteristics, awareness and uptake of HPV vaccine documented and papanicolaou smear procedure done with adequate referral for treatment given where necessary.

Results: A total of 287 women had cervical cancer screening. Mean (SD) age was 51.6 (14.3) years. Most participants were urban based (87.1%), married (63.1%), had secondary education (39%) and were traders (79.1%). None of the women were aware of the preventive HPV vaccine or had been vaccinated against HPV. About 6% were pre-invasive while 0.7% had invasive cervical cancer. The highest proportions of respondents affected were young, married and had lower education. Challenges identified included poor attendance, low risk perception and logistic issues.

Conclusion: Most participants were urban based. There is need to decentralize cancer of cervix screening through mobile clinics and establishment of screening centres in the rural areas. Neighbour to neighbour sensitization is essential. Also, HPV vaccine should be available and affordable to all girls before sexual maturity.
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http://dx.doi.org/10.11604/pamj.2016.24.319.9300DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5267846PMC
February 2017

Willingness to participate in Ebola viral disease vaccine trials and receive vaccination by health workers in a tertiary hospital in Ile-Ife, Southwest Nigeria.

Vaccine 2016 11 14;34(47):5758-5761. Epub 2016 Oct 14.

Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria. Electronic address:

Background: Ebola viral disease (EVD) epidemic need to be contained through means which include vaccination of susceptible population. Vaccination has eradicated major killer diseases.

Objective: The study determined the health workers willingness to participate in EVD vaccine clinical trials and receive EVD vaccine.

Materials And Methods: A descriptive cross-sectional study design involving 370 consenting health workers of Obafemi Awolowo University, Ile-Ife that completed a self administered semi-structured questionnaire. Data analysed using descriptive and inferential statistics.

Results: Mean age was 34.4±8.6years (range, 19-60years). Most were females (60.3%), and had worked <10years (74.3%). The health workers were mostly medical doctors (22.7%) and nurses (52.4%). EVD awareness (84.9%) was high among respondents with radio (37.2%) as major source of information. A higher proportion of respondents willing to participate in clinical trials were willing to receive vaccine (93% vs. 68%, p=0.0001). The significant variables associated with willingness to participate in EVD vaccine trials include being male [AOR 1.58, 95%CI 1.04-2.40, p=0.033], medical doctor [AOR 2.28, 95%CI 1.31-3.96, p=0.003] and having safe vaccine [AOR 2.10, 95% 1.58-3.98, p=0.0001] while the significant variable associated with willingness to receive EVD vaccine was vaccine safety [AOR 3.19, 95%CI 2.13-6.03, p=0.029].

Conclusion: Male gender, medical doctor and vaccine safety determine willingness to participate in Ebola vaccine trials while vaccine safety determines willingness to receive vaccine when ready. Researchers should ensure gender equality and vaccine safety in vaccine trials.
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http://dx.doi.org/10.1016/j.vaccine.2016.10.004DOI Listing
November 2016

PENTAZOCINE VERSUS PENTAZOCINE WITH RECTAL DICLOFENAC FOR POSTOPERATIVE PAIN RELIEF AFTER CESAREAN SECTION- A DOUBLE BLIND RANDOMIZED PLACEBO CONTROLLED TRIAL IN A LOW RESOURCE AREA.

Middle East J Anaesthesiol 2016 Feb;23(4):443-8

Background: The unimodal approach of using pentazocine as post-cesarean section pain relief is inadequate, hence the need for a safer, easily available and more effective multimodal approach.

Aim: To evaluate the effectiveness of rectal diclofenac combined with intramuscular pentazocine for postoperative pain following cesarean section.

Methods: In this double blind clinical trial, 130 pregnant women scheduled for cesarean section under spinal anesthesia were randomly assigned to two groups. Group A received 100mg diclofenac suppository and group B received placebo suppository immediately following surgery, 12 and 24h later. Both groups also received intramuscular pentazocine 30mg immediately following surgery and 6 hourly postoperatively in the first 24 h. Postoperative pain was assessed by visual analogue scale at end of surgery and 2, 12 and 24 h after surgery. Patient satisfaction scores were also assessed.

Results: One hundred and sixteen patients completed the study. Combining diclofenac and pentazocine had statistically significant reduction in pain intensity at 2, 12, and 24 hours postoperatively compared to pentazocine alone (p <0.05). No significant side effects were noted in both groups. The combined group also had significantly better patient satisfaction scores.

Conclusion: The addition of diclofenac suppository to intramuscular pentazocine provides better pain relief after cesarean section and increased patient satisfaction.
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February 2016

Determinants of Cervical Cancer Screening Uptake among Women in Ilorin, North Central Nigeria: A Community-Based Study.

J Cancer Epidemiol 2016 6;2016:6469240. Epub 2016 Jan 6.

Department of Obstetrics and Gynaecology, Bowen University Teaching Hospital, P.O. BOX 15, Ogbomoso 210251, Nigeria.

Introduction. Cancer of the cervix is the leading cause of cancer deaths among women in developing countries. Screening is one of the most cost effective control strategies for the disease. This study assessed the determinants of cervical cancer screening uptake among Nigerian women. Methodology. This cross-sectional study was conducted using multistage sampling technique among 338 participants in Ilorin, North Central Nigeria. A pretested questionnaire was used for data collection and data analysis was done using SPSS version 21. Chi-square test was used for bivariate analysis while binary logistic regression was used for multivariate analysis. Statistical significance was set at p < 0.05. Results. Only 8.0% of the respondents had ever been screened for cancer of the cervix. The proportion of women who had ever been screened was significantly higher among those who demonstrated positive attitude to screening (81.5%, p = 0.001), respondents who were aware of the disease (100.0%, p = 0.001), and those who were aware of cervical cancer screening (88.9%, p = 0.001). Respondents who had negative attitude had 63% lesser odds of being screened compared to those who had positive attitudes towards screening (AOR; 0.37, 95% CI; 0.01-0.28). Conclusion. There is urgent need to improve the knowledge base and attitude of Nigerian women to enhance cervical cancer screening uptake among them.
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http://dx.doi.org/10.1155/2016/6469240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4736774PMC
February 2016

Knowledge, Attitude, and Practice of Health Workers in a Tertiary Hospital in Ile-Ife, Nigeria, towards Ebola Viral Disease.

J Trop Med 2015 20;2015:431317. Epub 2015 Oct 20.

Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.

Background. Health workers are more prone to Ebola viral disease (EVD) than the general population. This study assessed the preparedness of health workers in the control and management of EVD. Methods. A descriptive cross-sectional study. Consenting 400 health workers completed a semistructured questionnaire that assessed participants' general knowledge, emergency preparedness, and control and management of EVD. Data were analysed using descriptive and inferential statistics. Results. The mean age (SD) was 34.5 ± 8.62 years ranging from 20 to 59 years. Most participants were medical doctors (24.6%) and nurses (52.2%). The majority had practised <10 years (73.8%) and were aware of the EVD outbreak in the West African subregion (85.5%). Colleagues (40%) and radio (37.2%) were their major sources of information. Only 42% had good knowledge while 27% knew that there was no vaccine presently to prevent EVD. About one-quarter (24.2%) had low risk perception. The majority (89%) felt the hospital infection control policy was inadequate to protect against EVD. The only predictor of good knowledge was participants' occupation. Conclusion. There is knowledge gap and poor infection control preparedness among respondents. Thus, knowledge and practices of health workers towards EVD need improvement.
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http://dx.doi.org/10.1155/2015/431317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4630404PMC
November 2015

Patterns and Correlates of Intimate Partner Violence to Women Living With HIV/AIDS in Osogbo, Southwest Nigeria.

Violence Against Women 2015 Nov 14;21(11):1330-40. Epub 2015 Jul 14.

Obafemi Awolowo University, Ile-Ife, Nigeria.

We assessed the prevalence and correlates of intimate partner violence (IPV) to women living with HIV/AIDS in an antiretroviral clinic in Nigeria. Three hundred sixty respondents were interviewed using a structured questionnaire. Sixty percent were married, of which 24% had disclosed HIV status to their partner. About a quarter (23.6%) had experienced IPV since HIV diagnosis. Types of violence experienced were physical violence (17%), emotional violence (21%), and sexual violence (2%). Predictors of IPV included having a younger aged partner, disclosing status, and partner's alcohol use (p = .001). Suggestions to prevent IPV include increasing public awareness and family counseling.
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http://dx.doi.org/10.1177/1077801215594889DOI Listing
November 2015

Clinicopathological review of 156 appendicectomies for acute appendicitis in children in Ile-Ife, Nigeria: a retrospective analysis.

BMC Emerg Med 2015 May 9;15. Epub 2015 May 9.

Department of Surgery, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria.

Background: Acute appendicitis is one of the most common causes of acute abdomen in children. Late surgical intervention is often associated with increase morbidity and sometimes fatal outcome. We sought to determine the pattern of presentation of acute appendicitis, and the effect of late presentation on surgical outcome in children.

Methods: This is a retrospective descriptive study done at the paediatric surgical unit of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. The hospital records of all 180 patients (15 years and below) treated for acute appendicitis, between January 1995 and December 2012, were reviewed; only 156 patients had adequate records out of which 139 cases confirmed histologically as having appendicitis were analyzed.

Results: There were 80 (57.6%) females and 59 (42.4%) males. The age range was 5-15 years with mean (SD) age of 11.2 (±2.9) years. Most patients (64.7%) were more than 10 years old. Sixty-four (46%) patients had simple appendicitis while 75 (54%) patients had complicated appendicitis. More children with complicated appendicitis (63, 84.0%) presented after 24 hours of abdominal pain; and they had more vomiting (59, 78.7%), spent longer days on admission (57, 76.0%) and had more post- operative complications (34, 45.3%) compared with uncomplicated appendicitis (25, 39.1%; 29, 45.3%; 7, 10.9%; 1, 1.6% respectively), and this was statistically significant (p < 0.05). No mortality was recorded among these children.

Conclusion: Late presentation was common and was associated with longer duration of hospital stay and high morbidity. No mortality was recorded from the disease.
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http://dx.doi.org/10.1186/s12873-015-0030-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445528PMC
May 2015

Sexual experiences of married HIV positive women in Osogbo, southwest Nigeria: role of inappropriate status disclosure.

BMC Womens Health 2015 7;15. Epub 2015 Feb 7.

Department of Obstetrics and Gynaecology, Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria,

Background: Worldwide heterosexual sex is the most common mode of HIV transmission, with the marital heterosexual route becoming a major contributor in sub-Sahara Africa. This study examined the role of inappropriate HIV status disclosure, after diagnosis, on marital sexual experiences of HIV positive women.

Methods: The study employed a descriptive cross-sectional design. An interviewer administered questionnaire that elicited information about HIV status disclosure to partners, sexual experiences, condom use and parity was administered to 122 married women living with HIV/AIDS. Participants were referred from peripheral health centres to receive comprehensive HIV care at the State Specialist Hospital, Osogbo, Nigeria.

Results: Mean age (SD) of respondents was 33.8 (8.9) years. Only 23.8% of partners had HIV screening, with 3.3% being HIV positive. A majority (62%) of respondents reported experiencing marital sex deprivation since their partners became aware of their HIV status. There was a reported rejection (74.3%) of condom use by partners during sexual intercourse. Fear of becoming infected (85.7%) and blaming the women for their positive status (85.7%) were the main reasons the respondents gave for being sexually deprived by their partners.

Conclusion: Inappropriate status disclosure due to poor HIV counseling and testing (HCT) practices resulted in sexual deprivation of married HIV positive women. Adequate training and retraining of health care workers on HCT and HIV status disclosure will reduce experience of sexual deprivation among married HIV positive women.
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http://dx.doi.org/10.1186/s12905-015-0164-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364566PMC
December 2015

Knowledge of Hepatitis B Virus Infection, Immunization with Hepatitis B Vaccine, Risk Perception, and Challenges to Control Hepatitis among Hospital Workers in a Nigerian Tertiary Hospital.

Hepat Res Treat 2015 22;2015:439867. Epub 2015 Jan 22.

Department of Community Health, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife 220005, Osun State, Nigeria.

Background. Studies had reported high rate of hepatitis B infection among hospital workers with low participation in vaccination programmes, especially those whose work exposes them to the risk of HBV infection. The study assessed knowledge of hepatitis B virus infection, risk perception, vaccination history, and challenges to control hepatitis among health workers. Methods. A descriptive cross-sectional study. Consenting health care workers completed a self-administered questionnaire that assessed respondents' general knowledge of HBV, vaccination history and HBsAg status, risk perception, and challenges to control hepatitis. Data was analysed using descriptive and inferential statistics. Results. Three hundred and eighty-two health care workers participated in the study. There were 182 males and 200 females. The respondents comprised 94 (25%) medical doctors, 168 (44%) nurses, 68 (18%) medical laboratory technologists, and 52 (14%) pharmacists. Over 33% had poor knowledge with 35% not immunized against HBV. Predictors of good knowledge include age less than 35 years, male sex, being a medical doctor, previous HBsAg test, and complete HBV immunisation. Identified challenges to control hepatitis include lack of hospital policy (91.6%), poor orientation of newly employed health workers (75.9%), and low risk perception (74.6%). Conclusion. Hospital policy issues and low risk perception of HBV transmission have grave implications for the control of HBV infection.
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http://dx.doi.org/10.1155/2015/439867DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4320901PMC
February 2015

Predictors of mortality in children with typhoid ileal perforation in a Nigerian tertiary hospital.

Pediatr Surg Int 2014 Nov 4;30(11):1121-7. Epub 2014 Oct 4.

Obafemi Awolowo University, Teaching Hospitals Complex, Ile-Ife, Osun, Nigeria,

Purpose: Childhood typhoid ileal perforation is associated with high morbidity and mortality. Our aim was to ascertain the predictors of survival in children.

Materials And Methods: This is a tertiary hospital-based retrospective review of patients aged ≤15 years managed for typhoid ileal perforations between January 2005 and December 2013. The details of their biodata, potential risk factors and outcome were evaluated.

Results: Forty-five children out of a total of 97 with typhoid fever had typhoid ileal perforation. The age range was 2-15 years, mean (±SD) = 9.3 (±3.31) years, median = 10 years. There were more males than females (26:19). Thirty-nine (86.7%) patients were >5 years old. There were nine deaths (20% mortality). The mean (±SD) age of survivors was 9.8 (±2.9) years and 7.1 (±4.2) for non-survivors (p = 0.026). The duration of illness at presentation, gender, admission temperature, nutritional status and packed cell volume, perforation-operation interval, number of perforations, surgical procedure, and the duration of surgery did not statistically influence survival (p > 0.05). The age of the patients and burst abdomen attained statistical significance (p < 0.05).

Conclusion: The patients' age and postoperative burst abdomen were significant determinants of survival in children with typhoid ileal perforation.
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http://dx.doi.org/10.1007/s00383-014-3592-9DOI Listing
November 2014

Diagnostic proficiency and reporting of Lassa fever by physicians in Osun State of Nigeria.

BMC Infect Dis 2014 Jun 20;14:344. Epub 2014 Jun 20.

Department of Community Health, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun state, Nigeria.

Background: Lassa fever is highly contagious and commonly results in death. It is therefore necessary to diagnose and report any suspected case of Lassa fever to facilitate preventive strategies. This study assessed the preparedness of physicians in the diagnosis and reporting of Lassa fever.

Methods: The study design was descriptive cross-sectional. The consenting medical doctors completed a self-administered questionnaire on the diagnosis and reporting of Lassa fever. Descriptive and inferential statistics were used in data analyses.

Results: One hundred seventy-five physicians participated in the study. The mean age was 41.5 ± 10.9 years (range, 24-75 years). Most of the physicians were male (78.9%) and had practiced medicine ≥ 20 years (51.5%). Most of the physicians had a good knowledge regarding the diagnosis and reporting of Lassa fever; however, none of the physicians had ever diagnosed or reported a suspected case. Predictors of good knowledge include male sex, not practicing at a secondary health care level and post graduation year more than 20 years.

Conclusion: There is disparity in knowledge and practices of physicians regarding the diagnosis and reporting of Lassa fever. Thus, it is necessary to improve the knowledge and practices of physicians regarding the diagnosis and reporting of Lassa fever.
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http://dx.doi.org/10.1186/1471-2334-14-344DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230318PMC
June 2014

Quality of life in patients with visual impairment in Ibadan: a clinical study in primary care.

J Multidiscip Healthc 2014 17;7:173-8. Epub 2014 Apr 17.

Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.

Background: Visual function is important for optimal orientation in functional and social life, and has an effect on physical and emotional well-being. Visual impairment, therefore, leads to restrictions in all aspects of daily living and is related to quality of life. The aim of this study was to provide information on the causes of visual impairment in patients presenting to their family physician, the spectrum of impairment, and its impact on quality of life for these patients.

Methods: This descriptive cross-sectional study of 375 adult patients with ocular symptoms was performed in the general outpatient department of the University College Hospital, Ibadan, from July to September, 2009. After checking their presenting visual acuity, the patients were interviewed using the Vision-Related Quality of Life questionnaire to determine the impact of visual impairment on their quality of life. Ophthalmic examinations were performed to determine the causes of visual impairment. The results were analyzed using proportions and percentages.

Results: The main causes of visual impairment were cataracts (58.7%), refractive error (19.4%), and glaucoma (2.9%). Visual impairment was found to be associated with advancing age, low education, and unemployment (P<0.001). Most patients (85.1%) were found to have good quality of life overall. Quality of life was found to be poor in the domains of visual function (64.2%) and social interaction (50.9%). Quality of life was found to be related to the degree of visual impairment, ie, blind patients reported poor quality of life (41.4%) when compared with those having low vision (8.6%) or near normal vision (2.4%, P<0.001).

Conclusion: This study identified poor quality of life in patients with a higher degree of visual impairment. Family physicians need to identify these visually impaired patients early and make timely referrals.
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http://dx.doi.org/10.2147/JMDH.S51359DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4000176PMC
May 2014

Awareness and attitude to the law banning smoking in public places in Osun State, Nigeria.

Tob Induc Dis 2014 Mar 27;12(1). Epub 2014 Mar 27.

Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.

Objective: This study determined the awareness and attitude towards the Osun state prohibition of smoking in public places law.

Method: Descriptive cross-sectional study design. 520 consenting respondents recruited using a convenience sampling method were interviewed using a semi-structured questionnaire covering their smoking pattern, awareness and attitude towards the law of prohibition of smoking in public places in Osun State. Data analyzed using descriptive and chi-square statistics.

Results: Only 38% were aware of the law while none had seen the document. Fifty six percent felt cigarette smoking is a problem that required the law to be implemented, while only 20% agreed that the law will stop tobacco use. The radio (58%), bill boards (45%) and newspapers (44%) were the major sources of awareness of the law. The perception of risk posed to the public and family health by cigarette smoking was poor among the participants.

Conclusion: There is poor awareness and attitude to the law of prohibition of smoking in public places in Osun State. It is necessary to increase sensitization of the general public and enforcement of the law.
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http://dx.doi.org/10.1186/1617-9625-12-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3973749PMC
March 2014

Living well with HIV in Nigeria? Stigma and survival challenges preventing optimum benefit from an ART clinic.

Glob Health Promot 2014 Mar 25;21(1):13-22. Epub 2014 Feb 25.

1.Sociology and Anthropology, Faculty of Social Sciences, Obafemi Awolowo University, Nigeria.

Thirty years into the HIV pandemic, the interactions of stigma, social and economic survival, and clinical interventions continue to be key to understanding and managing HIV at both personal and societal levels. With antiretroviral therapy, HIV is increasingly a chronic condition requiring lifelong treatment, near-perfect adherence, and support from both social networks and formal services. This study asked: is stigma still a significant problem for people living with HIV (PLHIV) who have secured access to antiretrovirals (ARVs)? How do PLHIV accessing ARVs in Nigeria experience the social, economic and health service supports intended to address their needs? What are the concerns and challenges of PLHIV and health workers regarding these supports? What are the implications for approaches to stigma and discrimination? This qualitative study at the Antiretroviral (ART) Clinic of the Osogbo State Hospital, Osun State, Nigeria involved in-depth interviews with 15 PLHIV who have been attending the clinic for at least one year, and three health workers. The results reveal both the diversity among even a small number of patients, and persistent cross-cutting themes of stigma, discrimination, poverty, and the psychological impacts of insecure livelihoods and well-intentioned but ultimately stigmatizing supports such as selective food parcels. Both population-based interventions against stigma and poverty, as well as micro-level, contextualized attention to patients', families' and health workers' fear of social exclusion and infection at a clinic and community level are needed if patients - and society - are to live well with HIV in Nigeria.
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http://dx.doi.org/10.1177/1757975913507297DOI Listing
March 2014
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