Browsing by Author "Akpa O. M."

Now showing 1 - 17 of 17

Birth preparedness and complication readiness among Pokot nomadic pastoralists’ pregnant women in East Pokot district, Midwest- Kenya
(Science Publishing Group, 2018) Kasmai K. E.; Akpa O. M.; Olayemi O.
Birth Preparedness and Complication Readiness (BPCR) is a strategy to promote the timely use of skilled maternal and neonatal care, especially during childbirth, based on the theory that preparing for childbirth and being ready for complications reduces delays in seeking health care and averts serious complications that women face during child birth. However, information on BPCR among Pokot nomadic pastoralists have not been well documented in literatures. The purpose of this research was to determine factors affecting BPCR among Pokot nomadic pastoralists’ pregnant women living in East Pokot District of Kenya. A cross-sectional facility based study was conducted among 275 Pokot pregnant women, above 18 years of age who were on their second and third trimesters and attending various Antenatal Clinics (ANCs) in East Pokot district. This was response rate of 90.1%. A multi-stage sampling technique was used and data was collected from those who met the inclusion criteria between August-October, 2017, using a pretested researcher administered questionnaire. The data collected was analyzed using (SPSS) version 21. Chi-square was used to test the hypothesis. A p-value of <0.05 was considered significant. The results showed that practice of BPCR was low (28%) among the respondents. Being educated (OR=18, CI=3.83-85.16) and having high household income (OR=2.53, CI=1.37-4.66) increased practice of BPC R. Ethnic affiliation to Pokot (OR=4.85, CI=1.38-17.07), practicing African Traditional Religion (OR=2.48, CI=1.44-4.26), practicing pastoralism (OR=2, CI=1.17-3.42) were found to significantly reduce the level of BPCR. In conclusion, birth preparedness and complication readiness was low among Pokot nomadic pastoralist’s pregnant women. There is a need for more BPCR awareness programmes targeting pastoralists’ women and other vulnerable groups in the region.
Data resource profile: Cardiovascular H3Africa Innovation Resource (CHAIR)
(Oxford University Press, 2018) Owolabi M. O.; Akpa O. M.; Made F.; Adebamowo S. N.; Ojo A.; Adu D.; Motala A. A.; Mayosi B. M.; Ovbiagele B.; Adebamowo C.; Tayo B.; Rotimi C.; Akinyemi R.; Gebregziabher M.; Sarfo F.; Wahab K. W.
Environmental and socioeconomic determinants of child mortality: Evidence from the 2013 Nigerian demographic health survey
(Science and Education Publishing, 2016) Adeolu M. O.; Akpa O. M.; Adeolu, A.T.; Aladeniyi I. O.
Despite the global decline in under-five mortality rate from 91 deaths per 1000 live births in 1990 to 43 deaths per 1000 live births in 2015 and Nigeria’s under-five mortality reduction from 201 per 1,000 live births in 2009 to 128 per 1,000 live births in 2013 as against the Sustainable Development Goal target of 25 per 1,000 live births, child mortality rate still remain unacceptably high in Nigeria and thereby has a long way to go in achieving this target. This study explores the household’s environmental, socio-economic characteristics, maternal demographic and their effect on child mortality. Data from the Nigeria Demographic and Health Survey (NDHS) 2013 was used to investigate the predictors of child (aged 0-4 years) mortality in Nigeria. Data for the currently married women who had experienced child mortality and those who have not, totaling 20,192. Cross-tabulation and binary logistic regression techniques were employed in the statistical analysis. The result indicated that child mortality rate was highest (46.0%) among mothers with no educational and lowest (13.6%) among mothers with tertiary education and was statistically significant in reducing the child mortality rate. Children born in households with unimproved toilet experienced highest mortality rate (41.0%) compared to those who were born in households with improved toilet (30.4%) and have substantial impact on child mortality. Maternal education and provision of sanitation facilities should be advocated as a strategy to reduce child mortality.
Factors Associated with Vulnerability to HIV and Sexually Transmitted Infections among Street Children in Selected Towns of Ethiopia, 2016
(Scientific Research Publishing, 2017) Chimdessa A.; Olayemi O.; Akpa O. M.
Background: The problem of street children is becoming a world crosscut ting issue since these children exist in every part of the world and become a worldwide problem. Objective: To assess factors associated with vulnerability to STIs and HIV/AIDS among street children in selected towns of Ethiopia. Methodology: Community-based cross-sectional descriptive study de sign was used on the three selected towns of Ethiopia from June-September, 2016. A total of 360 street children were selected, using snow ball sampling technique. Data were collected using pre-tested interviewer-administered questionnaire. Logistic regression was used to analyze the data. Results: A total of 360 (97.8%) respondents were included in this study. Among them, 167 (46.4%) of them had practiced sexual intercourse and out of these, 137 (82%) had started having sex at the age of 16 years old. Out of these, 61 (36.53%) of them started to get daily basic needs whereas 54 (32.3%) of them were forcefully raped on the street. Only 53 (59.6%) had used condom consistently and 83 (49.7%) had conducted survival sex within the last 12 months. Children on the street or chewing khat or consumption of alcohol had more vulnerability to STIs and HIV about 2.532 (1.57 - 4.08), 2.32 (1.11 - 4.80), 4.18 (2.31 - 7.55) times respectively. But those enrolled in school were about 0.40 (0.25, 0.64) less likely vulnerable than their counterparts. Conclusion: Street children are at a higher likelihood of vulnerability to STIs and HIV. Intervention targeted multilevel approach such as re-integration with their family, life skills training, sexuality education, creating income-generating activities and information education about STIs.
Lepage-type change-pointcontrol chartsapplied to monitoring acute mal-nutrition in under-5 children in Nigeria
(Science and Education Publishing, 2017) Afolabi R. F.; Akpa O. M.; Osanaiye P. A.
Introduction: Identification of the most affected age is an important statistical contribution to monitoring nutritional problems among children. Previous studies have demonstrated that monitoring processes’ parameters (mean and variability) individually or simultaneously could provide some insights but no application has been related to monitoring proportion of wasting in under-5 children. The present study applied a nonparametric-based Lepage-type change-point (LCP) control chart to monitor the proportion of acute malnutrition in under-5 children in Nigeria. Methods: Data were extracted for 24,530 under-5 children with valid and complete information on date of birth, height and weight in the 2013 Nigeria Demographic and Health Survey dataset. Data were analysed using descriptive statistics including mean, standard deviation and proportion. The Shapiro-Wilk lamda was used to assess the normality of the distribution of wasting among under-5 while the LCP control chart was used for monitoring the distribution. Affter-signal diagnosis was conducted to ascertain what distributional data parameters have changed, at 5% level of significance. Results: Children were 23.8(±16.8) months old and mostly female (50.3%). Prevalence of wasting among under-5 was 18.4% and higher among children aged 0-55 months (24.9%). Normality test (Shapiro-Wilk: W= 0.9268; p=0.001463) suggested that the distribution of wasted children was non-normal. The LCP chart signalled a shift (abnormal rate) in the proportion of wasting at aged 24 month; while its estimated change-point was at age 21 month. After-signal diagnosis indicated the change may have occurred in both a location shift (p=0.002949) and a variability shift (p=0.03978) of the proportion of wasted children. Conclusion: Prevalence of wasting in the present analysis is not uniform across age groups and the LCP chart demonstrated prompt detection of shift (both in mean and variability) in the proportion of wasted under-5 children. The LCP chart could be used to monitor proportion of wasting among children to identify groups needing intervention
Mitigating environmental sustainability challenges and enhancing health in urban communities: The multi-functionality of green infrastructure
(Alanya University, Faculty of Engineering and Natural Sciences, 2020) Dipeolu A. A.; Akpa O. M.; Fadamiro J. A.
Green Infrastructure (GI) facilities have capacity to enhance health and mitigate Environmental Sustainability Challenges (ESC). However, the extent of the mitigation and health benefits is unclear in developing countries. This study examined the impact of GI on ESC and Perceived Health (PH) of urban residents in Lagos Metropolis, Nigeria. Multi-stage sampling technique was used to select 1858 residents of Lagos Metropolis who completed semi-structured questionnaires. Descriptive statistics and chi-square test were used to explore data distributions and assess association of the availability of GI with resident’s PH and ESC. Odds ratio with 95% confidence interval (OR;95%CI) were estimated for good health and ESC mitigation. Participants were mostly men (58.9%) and younger than 50 years old (86.3%). Good health (20.5%) and high mitigation of ESC (collection and disposal of waste-52.7% and official development assistance 63.9%) were reported where GI is mostly available. Participants were more likely to report good health (OR:1.40; 95%CI:1.02-1.92) and high mitigation of ESC [water quality (OR:1.42; 95%CI:1.12-1.81) passenger transport mode (OR:1.41; 95%CI:1.06-1.89)] where GI are mostly available. Availability of Green infrastructure is supporting health and mitigating environmental sustainability challenges in the study area. Green infrastructure should be provided in urban areas where environmental sustainability is under threat
Modelling the factor structure of the Child Depression Inventory in a population of apparently healthy adolescents in Nigeria
(Public Library of Science (PLOS), 2018) Olorunju S. B.; Akpa O. M.; Afolabi R. F.
Background: Childhood and adolescent depression is common and often persists into adulthood with negative implications for school performances, peer relationship and behavioural functioning. The Child Depression Inventory (CDI) has been used to assess depression among adolescents in many countries including Nigeria but it is uncertain if the theoretical structure of CDI appropriately fits the experiences of adolescents in Nigeria. This study assessed varying theoretical modelling structure of the CDI in a population of apparently healthy adolescents in Benue state, Nigeria Methods: Data was extracted on CDI scale and demographic information from a total of 1, 963 adolescents (aged 10–19 years), who participated in a state wide study assessing adolescent psychosocial functioning. In addition to descriptive statistics and reliability tests, Exploratory Factor Analysis (EFA) and Confirmatory Factor analysis (CFA) were used to model the underlying factor structure and its adequacy. The suggested new model was compared with existing CDI models as well as the CDI’s original theoretical model. A model is considered better, if it has minimum Root Mean Square Error of Approximation (RMSEA <0.05), Minimum value of Discrepancy (CMNI/DF<3.0) and Alkalike information criteria. All analyses were performed at 95% confidence level , using the version 21 of AMOS and the R software. Results :Participants were 14.7±2.1 years and mostly male (54.3%), from Monogamous homes (67.9%) and lived in urban areas (52.2%). The measure of the overall internal consistency of the 2-factor CDI was α = 0.84. The 2-factor model had the minimum RMSEA (0.044), CMIN/DF (2.87) and least AIC (1037.996) compared to the other five CDI models. Conclusion: The child depression inventory has a 2-factor structure in a non-clinical general population of adolescents in Nigeria. Future use of the CDI in related setting may consider the 2-factor model.
Practice and efficiency of breast self-examination among female health workers in a premier tertiary hospital in Nigeria
(Marsland Press, 2017) Olanloye E. E.; Ajayi I. O.; Akpa O. M.
Background: Recommendation by physicians has been shown to motivate women to obtain one of the breast cancer screening (BCS), however information about the contribution of female health workers (FHWs) is generally lacking in the literature. The aim of this study was to ascertain BSE practice and its efficiency among female health workers. Methods: A descriptive cross-sectional study was conducted among 336 consenting FHWs at the University College Hospital (UCH), Ibadan, Nigeria, using an interviewer-administered questionnaire for data collection. Descriptive statistical tests, Chi-square test and logistic regression were used for univariate, bivariate and multivariate analyses respectively. All analysis was performed using SPSS version 21 at 5% significant level. Results: Nearly all the respondents (99.4%) were aware of breast cancer, and of BSE, CBE and mammography as breast cancer screening methods (99.1%, 97.5% and 94.6% respectively). One hundred and ninety-four (57.7%) respondents had good overall knowledge score of the disease. Health programmes appeared to be the major source of our respondents’ information on BSE. Although a larger proportion 318/336 (94.6%) practiced BSE, only 46.3% practiced it on a monthly basis. Those who resides in urban areas were 0.049 times more likely to have practiced BSE when compared with those who resides in semi-urban locations (OR = 0.049, 95% CI = 0.037 – 0.992). Conclusion: The level of awareness, knowledge and practise of BSE among the FHWs in UCH was high but the efficiency of its practice was poor among them. Continuous education of health workers by primary care providers and hospital managements on BSE screening intervention with emphasizes on competence in its practice is of utmost importance. This enables them serve as positive role models through their own participation in the behaviours being promoted.
Prevalence of hypertension and associated factors among residents of Ibadan North Local Government Area of Nigeria
(Wolters Kluwer, 2017) Ajayi I. O.; Sowemimo I. O.; Akpa O. M.; Ossai N. E.
Background: Hypertension is a major public health challenge worldwide. It is the most important risk factor for cardiovascular disease. Objectives: This study aimed to investigate the prevalence of hypertension and associated factors among the residents of Yemetu community in Ibadan-North Local Government Area of Oyo State, Nigeria. Methods: A descriptive cross-sectional design was used. The study involved 806 respondents aged from 18-90 years from 171 households, selected by cluster sampling technique. It was a house-to-house survey. Behavioural risk factors were measured using World Health Organisation (WHO) STEPwise approach to chronic disease risk factor surveillance (STEPS 1 & 2). Hypertension was defined as Systolic blood pressure (SBP) ≥ 140 and/or Diastolic blood pressure (DBP) ≥ 90mm Hg or currently on anti-hypertensive medication. Data were analysed using descriptive statistics, Chi-square and binary logistic regression tests at P <0.05. Results: The overall prevalence of hypertension was 33.1% (male 36.8% and female 31.1%). The proportion of self reported hypertension was 11.1%, while 5.1% were currently on anti-hypertensive medication. The mean age of the respondents was 38.8 ±15.6 years. The body mass index of the respondents was 5.2%, 52.0%, 29.5% and 13.3% for underweight, normal, overweight and obese, respectively. Alcohol and tobacco use were found in 11.5% and 3.2%, respectively. The result of binary logistic regression analysis revealed that hypertension was significantly associated with being in age groups 30-49 years (OR 2.258, 95% CI: 1.311 - 3.884), ≥50 years (OR 7.145, 95% CI: 3.644 - 14.011), being overweight or obese (OR 2.281, 95% CI: 1.022 – 5.088). Hypertension was inversely associated with being underweight (OR 0.537, 95% CI: 0.395 – 0.832). Conclusion: This study revealed a high prevalence of hypertension. These data underscores the need for urgent steps to create awareness and implement interventions for prevention and early detection of hypertension, especially among those aged ≥30 years and the overweight or obese. "
Prevalence of psychosocial dysfunctional behaviours among in-school adolescents in Ikere-Ekiti, Ekiti state, Nigeria
(African Journal Online, 2018) Ogunboyo O. F.; Akpa O. M.
Psychosocial disorders affect people across all ages in both high and low income countries. Unfortunately, information on psychosocial functioning among children and adolescents are practically scarce in Nigeria. However, local studies can provide remote strategies to identify the risk factors, increase awareness, remove stigma and improve access to mental health services. In this work, prevalence of psychosocial disorders across participants’ demographic and background characteristics were examined.A self-administered Rosenberg Self-esteem Scale (RSS) and Strengths and Difficulties Questionnaire (SDQ) were used to screen for psychosocial symptoms among in-school adolescents. Participants were selected from six (6) secondary schools within Ikere Ekiti. The reliability of the scales were using Cronbach’s alpha. Preliminary data analyses were performed using descriptive statistics while independent t-test and ANOVA were used to compare psychosocial scores across selected background and demographic characteristics of the participants. The participants comprised 480 students, aged 11 to 19. Cronbach’s alpha showed a moderate reliability estimate of 0.60 for the SDQ and 0.43 for the RSS. It was observed that higher mean scores on self-esteem and prosocial behavior correlate with lower mean scores on psychosocial disorder symptoms. Moreover, male participants significantly (t=2.810, P=0.01) exhibited conduct problems more than their female counterparts while those from polygamous families also have higher inattention problems compared to their counterparts from monogamous homes (t= -2.980, p=0.003). The study revealed that boys are more exposed to externalizing behavioural problems while girls possess more pro-social features. Also, it was found that self-esteem and family type have an important role to play in adolescent psychosocial dysfunction.
School absenteeism among orphans and vulnerable children in Lagos State, Nigeria: a situational analysis
(Informa UK Limited, trading as Taylor & Francis Group, 2017) Bamgboye E. A.; Odusote T.; Olusanmi I.; Nwosu J.; Phillips–Ononye T.; Akpa O. M.; Yusuf O. B.; Adebowale A. S.; Todowede O.; Ladipo O. A.
Knowledge of factors associated with school absenteeism among orphans and vulnerable children (OVC) who are at greater risk could facilitate effective policies to mitigate school dropouts. This study assessed the level of school absenteeism and its associated factors among OVC in five local government areas (LGAs) in Lagos State, Nigeria. A cross-sectional study of OVC households in purposively selected five LGAs in Lagos State was conducted. Enrolled vulnerable households were based on the National Household Vulnerability Assessment criteria. School absenteeism was measured by whether the OVC missed any school day, for any reason in the last school week. Data were collected by personal interview using a semi-structured questionnaire. IBM SPSS Statistics, version 20, was used for all analysis of data collected on schooling of OVC aged 10–17 years. Chi-square test and logistic regression model were used to determine significance of associations at 5% level. The 757 OVC participants were aged 13.1±2.2 years and their caregivers were aged 43.1 ±13.9 years from 1300 households. There was high proportion of school enrolment (85.7%) as well as absenteeism (20%). The rate of absenteeism among OVC was significantly higher among those who involved in household chores (31.2%) and who often sleep at night without food (40.0%). The odds of absenteeism were almost twice higher among OVC who involved in household chores (odds ratio [OR]: 1.93, 95% confidence interval [CI]: 1.14– 3.27), whose guardian could not pay unexpected expenses (OR: 1.78, 95% CI: 1.05–3.02) and those from households where there was often no food (OR: 1.84, 95% CI: 1.04–3.27). A high rate of OVC school enrolment might not translate to regular school attendance. Also, a high proportion of school absenteeism can be attributed to OVC engagement in house chores, poor economy and food insecurity. Economic empowerment of OVC care givers may improve school attendance.
Substance use and psychosocial functioning of adolescents in Benue state, Nigeria: Assessing the role of age
(African Journal Online, 2019) Akpa O. M.; Okekunle A. P.
Aim: To assess whether Substance Use (SU) is associated with Psychosocial Function (PF) among adolescent. Methods: Using a self-administered validated instrument, we obtained information on demographic, SU (defined as self reported affirmative use of one or more of any form of alcoholic drinks, cigarettes, hemps etc) and PF [using the adolescent psychosocial functioning inventory comprising of three subscales; optimism and coping strategies (OCS), behaviour and relationship problems (BRP) and general psychosocial dysfunction designed (GPD)] among 2272 apparently healthy adolescents. PF was categorized as ‘elevated’ if the psychosocial functioning index (PFI) score were >75th percentile, otherwise, ‘not elevated’ and multivariable-adjusted logistic regression was used to compute odds ratio (OR) and 95% confidence interval (CI) of SU for elevated PF risk. In addition, we applied Johnson Neyman (JN) technique to identifying the JN significance regions at which age moderated the SU-PF relationship at a statistical significance of two-sided P<0.05. Results: Prevalence of SU and elevated PF was 50.7% and 79.8% respectively. Prevalence of elevated PF differed insignificantly by sex, but the proportion of adolescent with elevated PFI on SU (82.6%) was significantly higher (P<0.001) compared to those with elevated PFI but not on SU (76.9%). Multivariable-adjusted odds of decreased OCS risk given SU exposure was; OR (95%CI): 1.3791 (1.1458-1.6698), P=0.0007. Similarly, multivariable-adjusted odds of elevated PF risk in the light of SU exposure was; OR (95%CI): 1.4286 (1.1617-1.7567), P=0.0007. Furthermore, the JN significance regions for moderated regression analyses of odds of decreased OCS risk was between 10.4years [OR (95%CI): 0.5820 (0.1411-1.0228), P=0.0097] and 16.7years [OR (95%CI): 0.3025 (0.0001-0.6050), P=0.0500]. Conclusion: Adolescents on SU are about one and half times at risk of psychosocial dysfunction and age significantly attenuated the SU-decreased OCS risk link particularly in early adolescence.
The factor structure of the adapted who quality of life bref questionnaire in a sample of adolescents in Nigeria
(Faculty of Basic and Applied Medical Sciences, 2018) Akpa O. M.; Fowobaje K. R.
The World Health Organization’s Quality of Life Instrument (WHOQOL-BREF) is widely validated and popularly used in assessing perceived quality of life (QOL) of adolescents and the general population. Though the WHOQOL-BREF has been used in some studies in Nigeria, its theoretical structure has not been comprehensively investigated. This study examined the factor structure of the Adopted WHOQOL-BREF questionnaire and it theoretical structure in a large sample of adolescents in Nigeria. Data on demographic characteristics and QOL were extracted from 1,963 adolescents who participated in a state-wide study on psychosocial functioning and quality of life of adolescents in Benue State, Nigeria. Descriptive statistics were used to present the distribution of the data while Cronbach’s alpha and Polychoric ordinal alpha were used to describe the internal consistency (reliability) of the adapted WHOQOL-BREF and alpha value of 0.700 was considered reliable. Structural analysis was performed to extract the underlying factors while confirmatory factor analyses were used to assess some hypothesized structure of the adapted WHO-QOL BREF. Relative Chi-square test value ≤3.0 was regarded a good fit while multiple fit indexes with values ≥0.90 (for acceptable fit) were used for assessing diverse aspects of the models. All analyses were performed at 5% significance level using IBM SPSS statistics version 20, R package and AMOS version 21. Participants were mostly male (54.8%) and 14.7±1.4 years old with 51.0% residing in rural areas. The overall internal consistency of the 4-factor model was 0.862 (for Cronbach’s Alpha) and 0.989 (for Polychoric Alpha) while the 2-factor model had 0.870 (for Cronbach’s Alpha) and 0.990 (for Polychoric Alpha). The Cattelle’s Scree plot, Horn’s parallel analysis and the confirmatory factor analysis revealed a 2-factor model as the best model for the WHO-QOL BREF. The 23-item 2-factor structure had a relative Chi-square test value with all fit indices within the acceptable range. The adapted WHO QOL BREF can be safely used to assess quality of life among Adolescents in Nigeria and related settings. Using the two factors extracted in the present study may yield better results in settings similar to the present study location.
The factor structure of the environmental attitude scale in a community-based study in Lagos, Nigeria
(Adventist University of Africa, 2019) Dipeolu A. A.; Akpa O. M.; Fadamiro A. J.
Environmental Attitude (EA) has been understood to be a complex multidimensional construct with minimal empirical evidence in developing countries. In the present study, psychometric properties of an EA scale was empirically assessed using data from a community based study conducted in Nigeria. Different measures of EA were aggregated into a single EA scale and administered to 1,858 individuals. Mean (Standard deviation) and proportions were used to describe the distribution of continuous and discrete data respectively. Reliability of the scale was assessed using Cronbach's alpha. Varying hypothetical models of the EA were assessed using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Data were analyzed using IBM SPSS version 20 and AMOS version 21 at 5% significant level. Overall mean score and alpha coefficient for the combined EA measure was 381.7 (49.0) and 0.928 respectively. A 3-factor structure accounting for 36% cumulative variance in the scale item was extracted in an EFA. A nonorthogonal 3-factor model was a significant improvement over the original none-correlated 5-factor model [÷2 (1344) =29216.33, P<0.001; CAIC=9816.870]. The conceptualization of the EA as a non-orthogonal 3-factor structure provides a better fit to the present data. The 3-factor structure is advised in Nigeria and similar settings.
Treatment satisfaction and medication adherence among hypertensive patients seeking care in selected hospitals in Ibadan, Nigeria
(Faculty of Basic and Applied Medical Sciences, 2018) Ajayi D. T.; Adedokun B. O.; Owoeye D. O.; Akpa O. M.
Poor adherence to hypertension treatment is a major health-related problem, and a significant risk factor for complications, disability and hypertension associated mortality. There is a paucity of evidence on the impact of treatment satisfaction on medication adherence among hypertensive patients in Nigeria. This study aimed to determine the association between treatment satisfaction and medication adherence among hypertensive patients in Ibadan, Nigeria. A descriptive cross-sectional study was conducted, wherein hypertensive patients were consecutively recruited from 5 hospitals in Ibadan, Nigeria. A pre-tested, interviewer-administered questionnaire was used to collect data. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8), and treatment satisfaction using the 9-item Treatment Satisfaction Questionnaire for Medication (TSQM). Descriptive statistics were computed for all variables. Bivariate analysis was carried out using chi-square test, and multivariate analysis using binary logistic regression. Sensitivity analysis was conducted to adjust for unmeasured binary confounders. Statistical significance was set at p < 0.05 for a 2-tailed. A total of 342 respondents with the mean age of 59.6 ± 12.6 years participated in the study. The overall prevalence of medication adherence was 35.1% (MMAS-8 scores = 8). Treatment satisfaction (AOR=2.03, 95% CI: 1.21-3.43) was independently associated with medication adherence. Sensitivity analysis revealed that the observed association between treatment satisfaction and medication adherence was unlikely to be due to unmeasured confounding variables. Medication adherence was low, and treatment satisfaction independently increases medication adherence. Treatment satisfaction strategies should be part of any treatment intervention packages in this population.
Using the zero inflated negative binomial model to assess factors associated with occurrence of childhood pneumonia
(Journal of the Indian Society for Probability and Statistics, 2018) Yusuf O. B.; Akpa O. M.; Akinpelu K. P.; Gbolahan A. O.
Zero inflated regression models with application to malaria surveillance data
(Scientific & Academic Publishing, 2016) Akinpelu K. P.; Yusuf O. B.; Akpa O. M.; Gbolahan A. O.
Monthly reports of malaria cases are usually presented as count data potentially with excess zeros. The standard Poisson and negative binomial regression used for modeling such data cannot account for excess zeros and over-dispersion. Hence, this study was designed to model the annual trends in the occurrence of malaria among under-5 children using the zero inflated negative binomial (ZINB) and zero inflated Poisson regression (ZIP). The study also determined the effects of month, year and geographical location on the occurrence of malaria. Malaria surveillance data were obtained from the Integrated Disease Surveillance and Response (IDSR) of Oyo State Ministry of Health, Nigeria from 2010 – 2014. Descriptive statistics were conducted to check for the presence of over-dispersion. Model comparisons were performed between ZINB and ZIP and the best model was selected using Vuong z-statistic criteria. Incidence rate ratios and 95% CI were determined. There were slight variations in the incidence of malaria cases; 35.81 per 1000 in 2011, 35.64 per 1000 in 2013 and 35.72 per 1000 in 2014. The highest risk of malaria was in the year 2014 (IRR = 3.59, 95% CI: 3.05, 4.23) and lowest in 2012 (IRR =2.56, 95% CI: 2.31, 2.83). The risk of malaria was highest in October (IRR = 1.47, 95% CI: 1.15, 1.88) and lowest in January (IRR = 0.80, 95% CI: 0.69, 0.94). The highest risk of malaria was reported in Saki West (IRR= 4.77, 95% CI: 3.58, 6.35) and lowest in Ogbomoso South (IRR = 0.73, 95% CI: 0.55, 0.97). The Vuong z-statistic for the ZINB and ZIP models was -17.079 (i.e. V < -1.96), indicating that ZINB fits the data better. The zero inflated negative binomial regression is the best model to determine the factors that predict the number of cases of malaria, when there is an indication of over dispersion and excess zeros. Zero inflated negative binomial model is suggested for researchers dealing with similar data