Browsing by Author "Salako, B. L."

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Acute kidney injury among paediatric emergency room admissions in a tertiary hospital in South West Nigeria: a cohort study
(Oxford University Press, 2019) Ademola, A. D.; Asinobi, A. O.; Ekpe-Adewuyi, E.; Ayede, A. I.; Ajayi, S. O.; Raji, Y. R.; Salako, B. L.; James, M.; Zappitelli, M.; Samuel, S. M.
Background. Epidemiological data on paediatric acute kidney injury (AKI) in sub-Saharan Africa are limited and largely retrospective. We performed a prospective study of AKI among patients admitted through the emergency room. Methods. Children admitted to the post-neonatal emergency room of the University College Hospital, Ibadan, Nigeria between February 2016 and January 2017 were studied. AKI was defined by Kidney Disease: Improving Global Outcomes serum creatinine criteria. AKI ascertainment relied on serum creatinine measurements carried out in routine care by post admission Day 1. We compared in-hospital mortality by post-admission Day 7 for patients with and without AKI (no-AKI). Results. Of the 1344 children admitted to the emergency room, 331 were included in the study. AKI occurred in 112 patients (33.8%) with a median age of 3.1 years [interquartile range (IQR) 0.9–9.4] and was Stage 3 in 50.5% of the cases. The no-AKI group had a median age of 1.8 (IQR 0.7–5.8) years. The underlying diagnoses in patients with AKI were sepsis (33.0%), malaria (12.5%) and primary renal disorders (13.4%). Twenty-four of the patients with AKI underwent dialysis: haemodialysis in 20 and peritoneal dialysis in 4. By Day 7 of admission, 7 of 98 (7.1%) patients in the AKI group had died compared with 5 of 175 (2.9%) patients in the no-AKI group [odds ratio 2.6 (95% confidence interval 0.8–8.5)]. Outcome data were not available for 58 (17.5%) patients. Conclusions. AKI is common among paediatric emergency room admissions in a tertiary care hospital in sub-Saharan Africa. It is associated with high mortality risk that may be worse in settings without dialysis.
Effect of hemodialysis on the hearing function of patients with chronic renal failure
(2006-12) Lasisi, A. O.; Salako, B. L.; Osowole, O.; Osisanya, W. P.; Amusaf, M. A.
Sensorineural hearing impairment (SHI) has been reported in chronic renal failure (CRF) patients with a prevalence of 20-40%. The aetiopathogenetic mechanisms reported included osmotic alteration resulting in loss of hair cells and in some, complications of haemodialysis have been hypothesized' We have in the past reported 2 cases of CRF patients who developed acute SHL following hemodialysis. This is a report of investigation of the effect of hemodialysis on the hearing function of CRF patients using pure tone audiometry findings. Thirty-three CRF patients were recruited for Pure Tone Audiometry (PTA) at admission and after three sessions of hemodialysis. The pure tone audiometry was done with a computer audiometer BA 20 Kamplex in the sound - proof (acoustic) booth in the ENT clinic. The duration of illness, dosage of diuretics and blood pressure were also noted. Similar age and sex-matched control were selected among volunteers who were otherwise clinically healthy. The data was processed using the Statistical Package for the Social Sciences (SPSS Inc, Chicago, Illinois, USA). Thirty-three CRF patients treated with haemodialysis and 28 healthy controls completed the study, 34 males and 27 females, age range was 16 - 72 years, mean of 45.30 (SDI6.20) for subjects and 49.7 for controls. Hearing loss was found in 22/34 (67%) at recruitment and 27/34 (79%) after 3 sessions of hemodialysis. There was a significant difference between the mean pre- and post-hemodialysis PT A values, P =0.0008. There was also a signiticant correlation between post-hemodialysis hearing threshold and (i) duration of illness (P = 0.00340) and (ii) creatinine levels of the patients (P=0.035). In conclusion, there was a significant depression in the hearing threshold of patients with CRF following three sessions of hemodialysis. This could be caused by changes induced by hemodialysis or effects of the duration and severity of disease.
Factors associated with medication nonadherence among hypertensives in Ghana and Nigeria
(Hindawi Publishing Corporation, 2015) Boima, V.; Ademola, A. D.; Odusola, A. O.; Agyekum, F.; Nwafor, C. E.; Cole, H.; Salako, B. L.; Ogedegbe, G.; Tayo, B. O.
Background. Blood pressure (BP) control is poor among hypertensives in many parts of sub-Saharan Africa. A potentially modifiable factor for control of BP is medication non-adherence (MNA); our study therefore aimed to determine factors associated withMNA among hypertensives in Ghana and Nigeria. Methodology. We conducted a multicenter cross-sectional study. Patients were recruited from Korle-Bu Hospital (𝑛 = 120), Ghana; and University of Port Harcourt Teaching Hospital, (𝑛 = 73) Apapa General Hospital Lagos (𝑛 = 79) and University College Hospital Ibadan (𝑛 = 85), Nigeria. Results. 357 hypertensive patients (42.6% males) participated. MNA was found in 66.7%. Adherence showed correlation with depression (𝑟 = −0.208, 𝑃 < 0.001), concern about medications (𝑟 = −0.0347, 𝑃 = 0.002), and knowledge of hypertension (𝑟 = 0.14, 𝑃 = 0.006). MNA was associated with formal education (𝑃 = 0.001) and use of herbal preparation (𝑃 = 0.014). MNA was found in 61.7% of uninsured participants versus 73.1% of insured participants (𝑃 = 0.032). Poor BP control was observed in 69.7% and there was significant association between MNA and poor BP control (𝑃 = 0.006). Conclusion. MNA is high among hypertensives in Ghana and Nigeria and is associated with depression, concern about hypertensive medications, formal education, and use of herbal preparations. The negative association between health insurance and MNA suggests interplay of other factors and needs further investigation.
Prevalence and determinants of depression among patients with hypertension: A cross‑sectional comparison study in Ghana and Nigeria
(Wolters Kluwer ‑ Medknow, 2020) Ademola, A. D.; Boima, V.; Odusola, A. O.; Agyekum, F.; Nwafor, C. E.; Salako, B. L.
Background: Despite evidence linking depression to poor blood pressure (BP) control and increased hypertension‑related morbidity and mortality, there is paucity of data about depression among patients with hypertension in sub‑Saharan Africa. We assessed factors associated with depression among patients with hypertension in Ghana and Nigeria. Subjects and Methods: Patients with hypertension were recruited from four hospitals: In Ghana, Korle Bu Teaching Hospital (n = 120), and in Nigeria, the University of Port Harcourt Teaching Hospital, the Lagos State General Hospital, and the University College Hospital Ibadan (n = 237). Demographic, socioeconomic, psychosocial, and clinical factors which predicted depression among the study cohort were assessed by logistic regression. Depression and beliefs about medications were assessed with the Patient Health Questionnaire (PHQ‑9) and the Beliefs about Medication Questionnaire, respectively. Depression was regarded as PHQ‑9 score >4. Results: The mean ages of the Ghanaian and Nigerian cohort were 57.0 ± 13.7 years (58.3% female) and 56.4 ± 12.9 years (57.0% female), respectively. Prevalence of depression was 41.7% and 26.6% among the Ghanaian and Nigerian cohorts, respectively. Significant predictors of depression in the Nigerian cohort were age in years [OR 0.97 (0.95–0.99)], concern about medications [OR 1.15 (1.03–1.30)], and poor BP control [OR 2.06 (1.09–3.88)]. Young age was the only independent predictor of depression in the Nigerian cohort. In the Ghanaian cohort, none of the factors significantly predicted depression. Conclusion: Prevalence of depression is high among patients with hypertension in Ghana and Nigeria. Screening and treatment of depression among patients with hypertension in Ghana and Nigeria may have important implications for improving outcomes.