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Welcome to UISpace, The University of Ibadan Institutional Repository. A collection of theses, articles, books, videos, images, lectures, papers, data sets and all types of digital content originating from the University of Ibadan Nigeria. This repository is managed by the Kenneth Dike Library University of Ibadan, Nigeria.
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The current status of kidney transplantation in Nigerian children: still awaiting light at the end of the tunnel
(Pediatric Nephrology, 2020) Eke, F. U.; Ladapo, T. A.; Okpere, A. N.; Olatise, O.; Anochie, I.; Uchenwa, T.; Okafor, H.; Ibitoye, P.; Ononiwu, U.; Adebowale, A.; Akuse, R.; Oniyangi, S.
Background Kidney transplantation (KT) is the gold standard treatment for childrenwith chronic kidney disease stage 5 (CKD5). It is easily accessible in well-resourced countries, but not in low/middle-income countries (LMICs). We present, a multicenter experience of paediatric KT of children domiciled in Nigeria. We aim to highlight the challenges and ethical dilemmas that children, their parents or guardians and health care staff face on a daily basis.
Methods A multicentre survey of Nigerian children who received KTs within or outside Nigeria from 1986 to 2019 was undertaken using a questionnaire emailed to all paediatric and adult consultants who are responsible for the care of children with kidney diseases in Nigeria. Demographic data, causes of CKD5, sources of funding, donor organs and graft and patient outcome were analysed. Using Kaplan-Meier survival analysis, we compared graft and patient survival.
Results Twenty-two children, aged 4–18 years, received 23 KTs, of which 12 were performed in Nigeria. The male-to-female ratio was 3.4:1. Duration of pre-transplant haemodialysis was 4–48 months (median 7 months). Sixteen KTs were self-funded. State governments funded 3 philanthropists 4 KTs. Overall differences in graft and patient survival between the two groups, log rank test P = 0.68 and 0.40, respectively were not statistically significant.
Conclusions The transplant access rate for Nigerian children is dismal at < 0.2%. Poor funding is a major challenge. There is an urgent need for the federal government to fund health care and particularly KTs
Trends in the epidemiology of childhood nephrotic syndrome in Africa: A systematic review
(Pediatric Nephrology, 2021) Wine, R.; Vasilevska-Ristovska, J.; Banh, T.; Knott, J.; Noone, D.; Gbadegesin, R.; Ilori, T. O.; Okafor, H. U.; Adetunjil, A. E.; Boima, V.; Amira, O.; Osafo, C.; Guemkam, G.; Ajayiq,, S.; Makusidi, M. A.; Anigilaje, E. A.; Ruggajo, P.; Asinobi, A. O.; Ademola, A. D.; Parekh, R. S.
Background: Childhood nephrotic syndrome, if left untreated, leads to progressive kidney disease or death. We quantified the prevalence of steroid-sensitive nephrotic syndrome, steroid-resistant nephrotic syndrome, and histological types as the epidemiology of nephrotic syndrome in Africa remains unknown, yet impacts outcomes.
Methods: We searched MEDLINE, Embase, African Journals Online, and WHO Global Health Library for articles in any language reporting on childhood nephrotic syndrome in Africa from January 1, 1946 to July 1, 2020. Primary outcomes included steroid response, biopsy defined minimal change disease, and focal segmental glomerulosclerosis (FSGS) by both pooled and individual proportions across regions and overall.
Findings: There were 81 papers from 17 countries included. Majority of 8131 children were steroid-sensitive (64% [95% CI: 63–66%]) and the remaining were steroid-resistant (34% [95% CI: 33–35%]). Of children biopsied, pathological findings were 38% [95% CI: 36–40%] minimal change, 24% [95% CI: 22–25%] FSGS, and 38% [95% CI: 36–40%] secondary causes of nephrotic syndrome.
Interpretation: Few African countries reported on the prevalence of childhood nephrotic syndrome. Steroid-sensitive disease is more common than steroid-resistant disease although prevalence of steroid-resistant nephrotic syndrome is higher than reported globally. Pathology findings suggest minimal change and secondary causes are common. Scarcity of data in Africa prevents appropriate healthcare resource allocation to diagnose and treat this treatable childhood kidney disease to prevent poor health outcomes.
Funding: Funding was provided by the Canadian Institute for Health Research (CIHR) and the National Institute of Health (NIH) for the H3 Africa Kidney Disease Research Network. This research was undertaken, in part, from the Canada Research Chairs program.
Risk coping behaviour of small scale poultry farmers in Ogun State, Nigeria
(Academic Journals Inc., 2013) Adepoju, A. O.; Timothy, O. A.; Oyekale, A. S.
Poultry farmers in Nigeria are faced with diverse forms of risks. In the absence of any form of insurance and the almost inexistent credit markets, households have devised strategies to at least mitigate the effect of these risks on their livelihoods. This study analyzed the risk-coping strategies and potential of 116 small scale poultry farmers in Ogun State. The analytical techniques used included descriptive statistics, Mean Absolute Deviation (MAD) and the Ordinary Least Square (OLS) regression model. Results revealed that the major idiosyncratic risks faced by the farmers were death of birds, high costs of inputs and low poultry production. On the other hand, the major types of covariate risks faced by the poultry farmers include outbreak of diseases, rainfall shocks and hard economic times. Coping methods that were mostly used included drawing from personal savings, rearing of resistant breeds and restocking of birds. Econometric analysis revealed that factors such as number of years of formal education of the household head, initial capital outlay and proportion of non-farm to the total monthly income had positive impacts on the risk-coping potentials of the poultry farmers. The negative impacts of factors such as household size on the potential of the poultry farmers to cope with risks were also noted. Thus, the risk behavior of farmers and the factors influencing such behavior should be considered in the design and development of effective programs for the farmers.
HIV Viremia Is associated With APOL1 Variants and Reduced JC-Viruria
(Frontiers Media SA, 2021) Kruzel-Davila, E.; Sankofi, B. M.; Amos-Abanyie, E. K.; Ghansah, A.; Nyarko, A.; Agyemang, S.; Awandare, G. A.; Szwarcwort-Cohen, M.; Reiner-Benaim, A.; Hijazi, B.; Ulasi, I.; Raji, Y. R.; Boima, V.; Osafo, C.; Adabayeri, V. M.; Matekole, M.; Olanrewaju, T. O.; Ajayi, S.; Mamven, M.; Antwi, S. |; Ademola, A. D.; Plange-Rhule, J.; Arogundade, F. A.; Akyaw, P. A.; Winkler, C. A.; Salako, B. L.; Ojo, A.; Skorecki, K.; Adu, D.
Variants in the Apolipoprotein L1 (APOL1) gene (G1-rs60910145, rs73885319, G2-rs71785313) are common in Africans and in individuals of recent African ancestry and are associated with an increased risk of non-diabetic chronic kidney disease (CKD) and in particular of HIV associated nephropathy (HIVAN). In light of the significantly increased risk of HIVAN in carriers of two APOL1 risk alleles, a role in HIV infectivity has been postulated in the mechanism of APOL1 associated kidney disease. Herein, we aim to explore the association between HIV viremia and APOL1 genotype. In addition, we investigated interaction between BK and JC viruria, CKD and HIV viremia. A total of 199 persons living with HIV/AIDS (comprising 82 CKD cases and 117 controls) from among the participants in the ongoing Human Heredity and Health in Africa (H3Africa) Kidney Disease Research Network case control study have been recruited. The two APOL1 renal risk alleles (RRA) genotypes were associated with a higher risk of CKD (OR 12.6, 95% CI 3.89–40.8, p < 0.0001). Even a single APOL1 RRA was associated with CKD risk (OR 4.42, 95% CI 1.49–13.15, p = 0.007). The 2 APOL1 RRA genotypes were associated with an increased probability of having HIV viremia (OR 2.37 95% CI 1.0–5.63, p = 0.05). HIV viremia was associated with increased CKD risk (OR 7.45, 95% CI 1.66–33.35, P = 0.009) and with a significant reduction of JC virus urine shedding (OR 0.35, 95% CI 0.12–0.98, p = 0.046). In contrast to prior studies, JC viruria was not associated with CKD but was restricted in patients with HIV viremia, regardless of CKD status. These findings suggest a role of APOL1 variants in HIV infectivity and emphasize that JC viruria can serve as biomarker for innate immune system activation.
Food insecurity status of rural households during the post-planting season in Nigeria
(Academic Journals Inc., 2013) Adepoju, A. O.; Adejare, K. A.
About two-thirds of rural households in Nigeria are engaged in crop and livestock production as their main source of livelihood. These households are especially vulnerable to chronic food shortages owing to adverse weather and the unavailability of enough food from home production, especially during the post-planting season. This study attempts a proper empirical identification of the food insecure and the reasons for their insecurity, through a profile of food insecurity indices and an investigation of the factors influencing their status during the post-planting season in rural Nigeria. We construct food insecurity indices and specify a probabilistic model, employing the post-planting visit data of the first wave of the General Household Survey-Panel (2010). Results showed that almost half (49.4 percent) of rural households in the country were food insecure during the post-planting period. Identified key rural food insecurity determinants include: gender of household head, tertiary education of household head, access to both formal and informal credit and remittances, household size, dependency ratio and living in the North-Central, North-East, South-East and South-West Geopolitical zones of the country. Since food availability remained below the required levels for large parts of the rural populace during this season, identified food insecure households should be targeted for safety nets.