Browsing by Author "Oladokun, A."

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Acceptability of child adoption as management option for infertility in Nigeria: evidence from focus group discussions
(2009) Oladokun, A.; Arulogun, O.; Oladokun, R.; Morhason-Bello, I. O; Bamgboye, E. A.; Adewole, I. F.; Ojengbede, O. A.
Infertility remains a global health challenge with devastating psycho-social consequences in many African communities. Adoption that may serve as an alternative strategy for the affected couples is not widely practiced. This study was conceptualized to assess the acceptability of child adoption as a management option by Nigerians. Twelve focus group discussions were held involving three communities stratified into inner core, transitory and peripheral, within Ibadan metropolis, South-Western Nigeria from May to July 2008. The participants were purposively selected based on gender and age group. The barriers mentioned were cultural practices, stigmatization, financial implications, and procedural bottle-necks. Measures suggested to curb these negative attitudes were advocacy, community mobilization and enactment of supportive law that will protect all parties involved
Anaesthesia considerations for the HIV positive parturient
(Association of Resident Doctors, University College Hospital, Ibadan, Nigeria, 2009-06) Adesina, O.; Oladokun, A.
The HIV epidemic in children parallels that among women on account of perinatal transmission. A combination of antiretroviral therapy and elective caesarean section reduces the rate of vertical transmission to <2%. Elective caesarean section independent of antiretroviral therapy decreases the risk of HIV vertical transmission from mother to baby. However, a caesarean section is a major surgical intervention that has well-reported complications. Women infected with HIV have been reported to be more susceptible to such complications. The multi-organ nature of HIV poses challenges at the time of surgery and anesthesia. Preoperative evaluation will allow a good prediction for the perioperative risk of the HIV-patient. The anesthesiologist should be aware of the possible toxic side effects or the possible interaction of antiretroviral drugs with the anesthetics. Some of these adverse effects may mimic signs and symptoms of the HIV disease itself. Regional anesthesia has been shown to be associated with reduced morbidity and mortality in a wide range of patients, including HIV positive parturients. Finally, the possibility of transmission in the health care setting highlights the need for anesthetists to enforce rigorous infection control policies to protect themselves, other health workers and their patients.
Anemia in pregnancy at two levels of health care in Ibadan, south west Nigeria
(Annals of African Medicine Society, 2011-12) Adesina, O.; Akinyemi, O.; Oladokun, A.
Background: In Africa, anemia in pregnancy contributes to non-attainment of the MDG goals 4 and 5. This study examined the prevalence and some risk factors for anemia at two levels of health care in the Ibadan metropolis. Methods: This was a retrospective study of the booking records of pregnant women at the University College Hospital (UCH, a profit-making tertiary institution) and Adeoyo Maternity Hospital (AMH, a secondary level institution offering free services) in Ibadan, September 1, 2008 to December 31, 2008. Eligible women had singleton pregnancies and no known chronic illnesses. Anemia was defined as packed cell volume (PCV) <30%, and degrees of anemia as mild (PCV 27–29%), moderate (PCV 19–26%), and severe (PCV below 19%). Statistical analysis was done by the Chi-square test, Fisher exact test, and t-test. A P value of <0.05 was considered significant. Results: Data from 2702 women (384 and 2318 from UCH and AMH, respectively) were available for analysis. About 30% of the women were anemic. The patients in UCH had higher mean PCV (33.03± 4.32 vs. 31. 04 ± 4.09, P = 0.00). A higher proportion of anemia was seen in patients presenting in Adeoyo (32.4% vs. 16.7%, P = 0.00). Factors associated with anemia included young age (P = 0.00), low parity (P = 0.00), and hospital type (P = 0.00). Parity and hospital type remained significant on logistic regression. Conclusion: Lower prevalence of anemia at the tertiary hospital maybe attributed to the higher socioeconomic status of the clientele. Short-term early antenatal management of anemia and long-term economic/educational empowerment is advocated.
Asymptomatic bacteriuria among HIV positive pregnant women
(Taylor and Francis, 2010-06) Awolude, O. A.; Adesina, O. A.; Oladokun, A.; Mutiu, W. B.; Adewole, I. F.
The prognostic significance of asymptomatic bacteriuria resides in the observation that the prevalence is, relatively, high in persons with certain medical conditions, such as diabetes mellitus and pregnancy. This prevalence might, even, be higher in patients with human immunodeficiency virus infection. Hence, this study set out to determine the prevalence of asymptomatic bacteriuria among symptom free and newly enrolled HIV infected pregnant women attending PMTCT unit of Antiretroviral Clinic of University College Hospital, Ibadan, Nigeria between 1st May and 30th September 2007. Information was obtained on the socio-demographic characteristics of the subjects, CD4 count and viral load. Microbial culture was carried out on aseptically collected urines from the patients. Statistical analysis was done with SPSS 12 package. There were 161 analyzable samples from the participants. The mean age and gestational age at presentation of participants was 30.49 ± 4.3 years and 27.3 ± 3.2 weeks, respectively with modal parity of 2. Twenty-five (15.5%) of the urine samples significantly grew bacteria. The CD4 cells were significantly lower and the viral loads significantly higher (250.52 vs. 355.57 cells/mm3; 88,731 vs. 55,384 copies/ml; p = <0.0000) for the urine culture positive patients. Eshcherichia coli were isolated in 48%, Proteus in 16.0%, Klebsiella in 8.0% and Staphylococcus aureus in 28.0% of the urine positive cultures. The study showed that the prevalence of asymptomatic bacteriuria among PLWHAs is high. The microbial isolate from the urine samples were not different from those of HIV-negative patients.
Asymptomatic bacteriuria among HIV positive pregnant women
(2010) Awolude, O. A.; Adesina, O. A.; Oladokun, A.; Mutiu, W. B.; Adewole, I. F.
The prognostic significance of asymptomatic bacteriuria resides in the observation that the prevalence is, relatively, high in persons with certain medical conditions, such as diabetes mellitus and pregnancy. This prevalence might, even, be higher in patients with human immunodeficiency virus infection. Hence, this study set out to determine the prevalence of asymptomatic bacteriuria among symptom free and newly enrolled HIV infected pregnant women attending PMTCT unit of Antiretroviral Clinic of University College Hospital, Ibadan, Nigeria between 1st May and 30th September 2007. Information was obtained on the socio-demographic characteristics of the subjects, CD4 count and viral load. Microbial culture was carried out on aseptically collected urines from the patients. Statistical analysis was done with SPSS 12 package. There were 161 analyzable samples from the participants. The mean age and gestational age at presentation of participants was 30.49 ± 4.3 years and 27.3 ± 3.2 weeks, respectively with modal parity of 2. Twenty-five (15.5%) of the urine samples significantly grew bacteria. The CD4 cells were significantly lower and the viral loads significantly higher (250.52 vs. 355.57 cells/mm3; 88,731 vs. 55,384 copies/ml; p = <0.0000) for the urine culture positive patients. Eshcherichia coli were isolated in 48%, Proteus in 16.0%, Klebsiella in 8.0% and Staphylococcus aureus in 28.0% of the urine positive cultures. The study showed that the prevalence of asymptomatic bacteriuria among PLWHAs is high. The microbial isolate from the urine samples were not different from those of HIV-negative patients.
Attitudes of women and men living with HIV and their healthcare providers towards pregnancy and abortion by HIV-positive women in Nigeria and Zambia
(Routledge, 2015) Moore, A. M.; Bankole, A.; Awolude, O.; Audam, S.; Oladokun, A.; Adewole, I.
Fertility decisions among people living with HIV/AIDS (PLWHA) are complicated by disease progression, the health of their existing children and possible antiretroviral therapy (ART) use, among other factors. Using a sample of HIV-positive women (n = 353) and men (n = 299) from Nigeria and Zambia and their healthcare providers (n = 179), we examined attitudes towards childbearing and abortion by HIV-positive women. To measure childbearing and abortion attitudes, we used individual indicators and a composite measure (an index). Support for an HIV-positive woman to have a child was greatest if she was nulliparous or if her desire to have a child was not conditioned on parity and lowest if she already had an HIV-positive child. Such support was found to be lower among HIV-positive women than among HIV-positive men, both of which were lower than reported support from their healthcare providers. There was wider variation in support for abortion depending on the measure than there was for support for childbearing. Half of all respondents indicated no or low support for abortion on the index measure while between 2 and 4 in 10 respondents were supportive of HIV-positive women being able to terminate a pregnancy. The overall low levels of support for abortion indicate that most respondents did not see HIV as a medical condition which justifies abortion. Respondents in Nigeria and those who live in urban areas were more likely to support HIV-positive women’s childbearing. About a fifth of HIV-positive respondents reported being counselled to end childbearing after their diagnosis. In summary, respondents from both Nigeria and Zambia demonstrate tempered support of (continued) childbearing among HIV-positive women while anti-abortion attitudes remain strong. Access to ART did not impart a strong effect on these attitudes. Therefore, pronatalist attitudes remain in place in the face of HIV infection.
Awareness and desirability of the Nigerian antenatal women about analgesia use during childbirth
(2007-12) Oladokun, A.; Morhason-Bello, I.O.; Eyelade, O. R.; Adedokun, B. O.; Akinycmi, J O.; Adewole, I. F.
Care providers’ knowledge and practice of malaria control measures in pregnancy in Ibadan, South west Nigeria
(College of Medicine, University of Ibadan, Ibadan, 2012) Oladokun, A.; Adesina, O. A.; Oladokun, R. E.
Background: Effective prevention and control of malaria during pregnancy include prompt and effective case management of malaria combined with prevention of infection by the use of insecticide-treated nets and intermittent preventive treatment in pregnancy (IPTp). Care givers knowledge and practice of malaria control is pivotal to effective implementation of these guidelines. The objective of this study was to determine the awareness of care providers in facilities offering maternity services in Ibadan of the National Malaria Treatment Guideline and Policy in Nigeria. The study also aimed to describe the prescription practice, for malaria chemoprophylaxis and case management in pregnancy, by these care providers. Materials and method: The study was a cross-sectional survey of the; lead care givers in all registered hospitals and maternity centres in Ibadan over one year (April 2008 to April 2009), using structured questionnaires. The list of the one hundred and thirty-two (132) registered centres was obtained from the State Ministry of Health. The lead care givers provided information, on their awareness of the new government policy and antimalarials believed to be effective and prescribed for malaria prevention and case management in pregnancy. Results: Over two thirds (84.2%) of the facilities were operated by either Medical Officers with only basic medical training or by Nurses/Mid wives. The modes of prevention most commonly reported as being effective were the use of insecticide spray, window nets and ITN. The drugs most commonly prescribed for chemoprophylaxis were sulphadoxine-pyrimethamine (SP) (65.2%), Proguanil (45.5%) and pyrimethamine (42.4%). The drugs most commonly prescribed for case management were ACIfe (66.7%), amodiaquine (59.8%) and artemether (47.7%). Quite a number of respondents were unsure of the frequency (81.8%) and timing (56.5%) of administration of sulphadoxine- pyrimethamine for prophylaxis. Conclusion: This study demonstrates awareness but lack of in-depth knowledge of control measures. Also, there is poor use of the recommended agent for IPT. The factors militating against the use of these preventive measures need to be urgently explored and addressed.
Cervical cytology service in Nigeria: providers’ perspective
(Taylor and Francis, 2003-07) Adesina, O. A.; Babarinsa, I. A.; Fawole, A. O.; Oladokun, A.; Adeniji, R. A.; Adewole, I. F.
It has been noted that efforts to organise an effective screening programme in developing countries will have to find adequate financial resources, develop the infrastructure, train the necessary manpower and elaborate surveillance mechanisms. In our study, we set out to determine (a) just how frequent is cervical cancer, to warrant the investment of funds in screening programmes; (b) what proportion of surveyed health facilities offer a cervical cytology screening programme; and (c) what basic facilities are currently available where such programmes exist? A pretested, self-completed questionnaire was sent to heads of department of obstetrics and gynaecology in public tertiary and secondary care hospitals in Nigeria as well as major mission hospitals. The response rate was 63%, monthly consultations included a mean of 114 (±11.7) new gynaecological patients and an average of 5 (4.7±0.8) cervical cancer cases. One-half of the institutions had a hospital-based cervical screening programme with an average of 27 patients being screened monthly. Finance was the main difficulty encountered in maintaining a screening service. Only four had a certified gynaecological oncologist. In conclusion, there is dismal utilization of available services and a dearth of trained specialists should any cervical cancer screening programme be considered.
A comparative study of two surgical management methods for cervical incompetence at the University College Hospital, Ibadan
(Nigerian Medical Association, Akwa Ibom State Branch, 2007-02) Oladokun, A.; Adesina, O. A.; Odukogbe, A. A.; Morhason-Bello, I. O.; Adewole, I. F.
Incompetence of the internal uterine cervical os is associated with recurrent pregnancy loss. Different surgical techniques are in practice to correct the defect. The objective of this study therefore was to review the outcome of pregnancies following cervical using either of the two procedure among patients diagnosed as having incompetence of the cervix. A comparative study of 2 standard methods of cerclage used in our hospital, McDonald & Shirodkar, in a group of 80 patients was done. All the patients had cervical cerclage insertion done between the 14 & 16 weeks of gestation using either of the two methods. There was no significant morbidity with either of the 2 methods. The overall success rates, as measured by continuation of the pregnancy to term, were similar. Both methods of cervical cerclage are equally effective in producing the desired outcome, but since the McDonald method is technically simpler to perform, it may be desirable to adopt this approach more frequently.
Correlates of HIV sero-disclosure and partner status at a PMTCT centre, UCH
(Corporate Office, One Media Studies, Ibadan, 2011) Adesina, O. A.; Awolude, O.; Akinyemi, A.; Oladokun, A.; Adewole, I. F.; Kanki, P.
Correlates of HIV sero-disclosure and partner status at a PMTCT centre, UCH, Ibadan
(2010) Adesina, O. A.; Awolude, O. A.; Akinyemi A.; Oladokun, A.; Adewole, I. F.; Kanki, P.
Emergency obstetric patients in a developing country and prevalence of HIV infection
(2009) Awolude, O. A.; Oladokun, A.; Adesina, O. A.; Mutiu, W. B.; Adewole, I. F.
The availability of VCT for HIV for booked antenatal patients offers a unique opportunity for best obstetrics practice but not for patients presenting with emergencies and unknown HIV status. Health workers who attend to such patients are at higher risk of acquiring HIV infections. Between 1st March 2005 and 30th September 2007, unbooked emergency obstetric patients in the labour ward of a teaching hospital who consented were tested using double rapid immunodiagnostic technique and confirmed by Western Blot. HTV positive patients were post-test counselled and offered single dose nevirapine tablet (200mg) in labour with syrup given to the baby at birth at 2mg/kg followed by syrup zidovudine for 6 weeks: The results showed that 275 (89.0%) of the 309 women pre-test counselled agreed to testing. The mean age of clients was 27.7 years (± 4.4 SD). The mean gestational age at presentation was 36.4 weeks (± 4.2 weeks). Primigravidae constituted 37.5% of the patients. Twenty-one (7.6%) of these consenting patients were H3V positive. In conclusion, the HIV prevalence of 7.6% among these unbooked obstetric patients is higher than the 4,7% among our booked antenatal patients and National prevalence of 4.4%. This poses substantial risk of transmission of HIV to attending health workers considering the readiness with which needle prick accident can occur in emergency situations.
Emergency obstetric patients in developing countries and prevalence of HIV infection
(College of Medicine, University of Ibadan, Ibadan, 2009) Awolude, O. A.; Adesina, O. A.; Oladokun, A.; Adewole, I. F.
The availability of VCT for HIV for booked antenatal patients offers a unique opportunity for best obstetrics practice but not for patients presenting with emergencies and unknown HIV status. Health workers who attend to such patients are at higher risk of acquiring HIV infections. Between 1st March 2005 and 30th September 2007, unbooked emergency obstetric patients in the labour ward of a teaching hospital who consented were tested using double rapid immunodiagnostic technique and confirmed by Western Blot. HIV positive patients were post-test counselled and offered single dose nevirapine tablet (200 mg) in labour with syrup given to the baby at birth at 2 mg/kg followed by syrup zidovudine for 6 weeks. The results showed that 275 (89.0%) of the 309 women pre-test counselled agreed to testing. The mean age of clients was 27.7 years (± 4.4 SD). The mean gestational age at presentation was 36.4 weeks (± 4.2 weeks). Primigravidae constituted 37.5% of the patients. Twenty-one (7.6%) of these consenting patients were HIV positive. In conclusion, the HIV prevalence of 7.6% among these unbooked obstetric patients is higher than the 4.7% among our booked antenatal patients and National prevalence of 4.4%. This poses substantial risk of transmission of HIV to attending health workers considering the readiness with which needle prick accident can occur in emergency situations.
Human Immuno-deficiency Virus and Hepatitis B virus coinfection in pregnancy at the University College Hospital, Ibadan
(2010) Adesina, O.; Oladokun, A.; Akinyemi, O.; Adedokun, B.; Awolude, O.; Odaibo, G. O.; Olaleye, D.; Adewole, J.
Human Immuno-deficiency virus (HIV) and Hepatitis B Virus (HBV) share common modes of transmission which include blood borne and the vertical routes. Although, the natural course of HIV does not appear altered by HBV, the rate of liver-related deaths is several times higher among HIV/HBV co-infected persons. Clinicians providing care for HIV positive individuals, including pregnant women, need to be aware of this problem. This is a 2-year cross-sectional study that commenced in January 2006, among HIV positive pregnant women seen at the University College Hospital, Ibadan. During the study period, 721 HIV positive pregnant women were screened for hepatitis B virus infection. Sixty-four women (8.9%) were positive for HBsAg, 14(1.9%) were HCV positive and 642 (89.2%) were negative for both HBV and HCV. One patient was positive forboth HBV and HCV. There were no remarkable differences between HIV infected and HIV-HBV coinfected patients in terms of the hematological, albumin and bilirubin measurements. Alanine transaminase was however higher in the HIV-HBV co-infected patients than HIV patients and this was statistically significant (17.5 iu/ ml vs. 15.0 iu/ml, p value--0.009). In addition, the CD4 cell count was lower and the viral load marginally higher in the hepatitis B virus positive patients. The differences were however not statistically significant (p value--0.114 and 0.644 respectively). HIV-HBV co-infection in HIV positive pregnant women is not of negligible proportions as demonstrated in this study. Thus, HIV positive pregnant women should be screened for HBV and assisted to access care targeted at preventing morbidity and vertical transmission.
Human immuno-deficiency virus and hepatitis B virus coinfection in pregnancy at the University College Hospital, Ibadan
(2010) Adesina, O.; Oladokun, A.; Akinyemi, O.; Adedokun, B.; Awolude, O.; Odaibo, G.; Olaleye, D.; Adewole, I. F.
Human Immuno-deficiency virus (HIV) and Hepatitis B Virus (HBV) share common modes of transmission which include blood borne and the vertical routes. Although, the natural course of HTV does not appear altered by HBV, the rate of liver-related deaths is several times higher among HIV/HBV co-infected persons. Clinicians providing care for HIV positive individuals, including pregnant women, need to be aware of this problem. This is a 2-year cross-sectional study that commenced in January 2006, among HIV positive pregnant women seen at the University College Hospital, Ibadan. During the study period, 721 HIV positive pregnant women were screened for hepatitis B virus infection. Sixty-four women (8.9%) were positive for HBsAg, 14(1.9%) were HCV positive and 642 (89.2%) were negative for both HBV and HCV. One patient was positive for both HBV and HCV. There were no remarkable differences between HIV infected and IIIV-HBV coinfected patients in terms of the hematological, albumin and bilirubin measurements. Alanine transaminase was however higher in the HIV-HB V co-infected patients than HIV patients and this was statistically significant (17.5 iu/ ml vs. 15.0 iu/ml, p value- 0.009). In addition, the CD4 cell count was lower and the viral load marginally higher in the hepatitis B virus positive patients. The differences were however not statistically significant (p value- 0.114 and 0.644 respectively). HIV- HBV co-infection in HTV positive pregnant women is not of negligible proportions as demonstrated in this study. Thus, HIV positive pregnant women should be screened for HBV and assisted to access care targeted at preventing morbidity and vertical transmission.
Knowledge and utilization of malaria control measures by pregnant and newly delivered mothers in Ibadan, Nigeria
(Makerere University, 2011-12) Oladokun, A.; Oladokun, R. E.; Adesina, O. A.
Background: The World Health Organisation (WHO) guidelines for the control of malaria during pregnancy include prompt and effective case management of malaria combined with prevention of infection by insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (IPTp). Despite this the uptake is poor. Objective: To describe the malaria prevention measures utilized by these women in this environment. Methods: Information was obtained from consented pregnant and newly delivered women on their socio-demographic characteristics, knowledge and use of malaria chemoprophylaxis Results: One Thousand three hundred thirty (1330) pregnant and newly delivered women in 132 facilities within the Ibadan metropolis were surveyed. The mean age of the respondents was 29. 67 years (±5.21). The modes of prevention most commonly reported as being effective were the use of insecticide spray, window nets and ITN. Only 28.2% were using ITNs in the index pregnancy, and 67.2% of the women had had a drug administered for prophylactic purposes in the index pregnancy. Conclusion: This study demonstrates awareness but poor use of control measures. Additionally, there is poor use of the recommended agent for IPT. The factors militating against the use of these preventive measures need to be urgently explored and addressed.
Knowledge of the human papilloma virus vaccines, and opinions of gynaecologists on its implementation in Nigeria
(Women’s Health and Action Research Centre, 2013) Morhason-Bello, I. O.; Adesina, O. A.; Adedokun, B. O.; Awolude, O.; Okolo, C. A.; Aimakhu, C. O.; Akinwunmi, B. O.; Oladokun, A.; Adewole, I. F.
The objective of this study was to determine the knowledge and perception of Nigerian Obstetricians and Gynaecologists towards human papilloma virus vaccine use in Nigeria. A cross sectional study was conducted amongst participants that attended the 42nd Society of Gynaecology and Obstetrics of Nigeria. The findings revealed that 44.5% knew the correct HPV vaccine schedule. Regarding implementation in Nigeria, 87.4% suggested its incorporation into the national immunization program and about a third agreed that it should be a precondition for school enrollment. Regression analysis showed that senior residents were more likely to have adequate knowledge of the vaccine compared to junior residents (AOR 7.181 95% CI OR=1.792 – 28.782). We conclude that the knowledge of eligibility and schedule is poor. It is recommended that adequate information should be provided to this group of health workers because of their strategic position in its implementation in Nigeria.
Knowledge of the human papilloma virus vaccines, and opinions of gynaecologists on its implementation in Nigeria
(2013-06) Morhason-Bello, I. O.; Adesina, O. A.; Adedokun, B. O.; Awolude, O.; Okolo, C. A.; Aimakhu, C. O.; Akinwunmi, B. O.; Oladokun, A.; Adewole, I. F.
The objective of this study was to determine the knowledge and perception of Nigerian Obstetricians and Gynaecologists towards human papilloma virus vaccine use in Nigeria. A cross sectional study was conducted amongst participants that attended the 42nd Society of Gynaecology and Obstetrics of Nigeria. The findings revealed that 44.5% knew the correct HPV vaccine schedule. Regarding implementation in Nigeria, 87.4% suggested its incorporation into the national immunization program and about a third agreed that it should be a precondition for school enrolment. Regression analysis showed that senior residents were more likely to have adequate knowledge of the vaccine compared to junior residents (AOR 7.181 95% CI OR=1.792 – 28.782). We conclude that the knowledge of eligibility and schedule is poor. It is recommended that adequate information should be provided to this group of health workers because of their strategic position in its implementation in Nigeria
Postpartum contraceptive choices made by HIV-infected women at the University College Hospital, Ibadan
(Corporate Office, One Media Studies, Ibadan, 2013) Adesina, O. A.; Awolude, O.; Oladokun, A.; Roberts, A.; Adewole, I. F.