Browsing by Author "Uchendu, O. C."

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A review of the health problems of the Internally Displaced Persons in Africa
(The National Postgraduate Medical College of Nigeria, 2016) Owoaje, E. T.; Uchendu, O. C.; Ajayi, T. O.; Cadmus, E. O.
Globally, over 40 million people were displaced as a result of wars and violence due to religious and ethnic conflicts in 2015 while 19.2 million were displaced by natural disasters such as famine and floods. In Africa, 12 million people were displaced by armed conflict and violence and there were hundreds of thousands of people displaced by natural disasters. Despite these large numbers of internally displaced persons (IDPs) in Sub‑Saharan African countries and the potentially negative impact of displacement on the health of these populations, there is limited information on the health problems of IDPs in the region. The previous studies have mainly focused on the health problems of refugees and single disease entities among IDPs. However, a more comprehensive picture is required to inform the provision of adequate healthcare services for this vulnerable population. The objective of this review was to fill this knowledge gap. Bibliographic databases were searched and screened, and nine studies were selected and reviewed. The major physical health problems and symptoms were fever/malaria (85% in children and 48% in adults), malnutrition in children (stunting 52% and wasting 6%), malnutrition in adult males (24%), diarrhoea (62% in children and 22% in adults) and acute respiratory infections (45%). The prevalent mental health problems were post‑traumatic stress disorder (range: 42%–54%) and depression (31%–67%). Most of the studies reviewed focused on mental health problems. Limited evidence suggests that IDPs experience various health problems but more research is required to inform the provision of adequate and comprehensive healthcare services for this group of individuals.
A review of the health problems of the internally displaced persons in Africa.
(Wolters Kluwer - Medknow, 2016) Owoaje, E. T.; Uchendu, O. C.; Ajayi, T. O.; Cadmus, E. O.
Globally, over 40 million people were displaced as a result of wars and violence due to religious and ethnic conflicts in 2015 while 19.2 million were displaced by natural disasters such as famine and floods. In Africa, 12 million people were displaced by armed conflict and violence and there were hundreds of thousands of people displaced by natural disasters. Despite these large numbers of internally displaced persons (IDPs) in Sub‑Saharan African countries and the potentially negative impact of displacement on the health of these populations, there is limited information on the health problems of IDPs in the region. The previous studies have mainly focused on the health problems of refugees and single disease entities among IDPs. However, a more comprehensive picture is required to inform the provision of adequate healthcare services for this vulnerable population. The objective of this review was to fill this knowledge gap. Bibliographic databases were searched and screened, and nine studies were selected and reviewed. The major physical health problems and symptoms were fever/malaria (85% in children and 48% in adults), malnutrition in children (stunting 52% and wasting 6%), malnutrition in adult males (24%), diarrhoea (62% in children and 22% in adults) and acute respiratory infections (45%). The prevalent mental health problems were post‑traumatic stress disorder (range: 42%–54%) and depression (31%–67%). Most of the studies reviewed focused on mental health problems. Limited evidence suggests that IDPs experience various health problems but more research is required to inform the provision of adequate and comprehensive healthcare services for this group of individuals
A Rural-Urban comparison of the prevalence and factors associated with unintentional home fall injuries in South Western Nigeria
(College of Medicine, University of Ibadan, 2018) Uchendu, O. C.; Owoaje, E. T.; Iken, O. F.
Background: Unintentional home fall injuries contribute to the morbidity and mortality burden in developing countries. Rural-Urban variation on the burden of unintentional home fall injuries in Africa is poorly documented. We compared the prevalence and factors associated with unintentional home fall injuries among household members in rural and urban areas of South Western Nigeria. Methods: We conducted a community-based cross sectional survey using a three-stage cluster sampling technique to select 4433 individuals from 1015 households from selected settlements in a rural and urban Local Government Areas (LGAs). A structured questionnaire was used to obtain information on household members’ characteristics, individual injury experience and nature of injury experienced. Chi square test and logistic regression were used to determine factors associated with unintentional home fall injuries. Results: Overall, the incidence of unintentional home falls injury was 171/1000 per year with a significantly higher incidence in the urban (195/1000 per year) compared to rural (150/1000 per year) areas. The odds of experiencing unintentional home fall injuries was 1.47 times higher in household members living in urban areas compared to their rural counterparts (OR=1.47; 95%CI: 1.13-1.92). Conclusion: The burden of unintentional home fall injuries is high with a significantly higher urban preponderance. Enforcement of building codes to ensure safety of the home environment especially in urban areas is also recommended for resource poor countries like Nigeria.
An observational study of seatbelt use among vehicle occupants in Nigeria
(BMJ Publishing Group Ltd, 2009) Sangosawa, A. O.; Alagh, B. T.; Ekanem, S. E. U.; Ebong, I. P.; Faseru, A.; Adekunle, B. J.; Uchendu, O. C.
Objective: The use of seatbelts reduces the likelihood of death and severe injuries to crash-involved vehicle occupants by 45e60%. Several countries, including Nigeria, have laws mandating the use of seatbelts but compliance is not universal. This study was conducted to determine rates of use of seatbelts among vehicle occupants in Ibadan municipality. Design: An observational study was conducted. A selected petrol station in each of the five local government areas in Ibadan municipality was used as an observation site. Observations were documented by trained research staff between 08:30 and 18:00 hours over a 6-day period. Results: 5757 occupants in 2870 vehicles were observed. Approximately 90% of drivers were men. Driver seatbelts were installed in approximately 90% of vehicles. Overall seatbelt use was 18.7; 31.7% among drivers and 10.3% and 0.4% among front and rear-seated adults, respectively. Only one child (0.7%) was restrained. Significantly more female drivers 47.3% used their seatbelts compared with men, 30.3% (p<0.001). An adult passenger was more likely to be restrained when riding with a female driver (p=0.007) and when the driver was restrained (p=0.000). Conclusions: The study showed that seatbelt use among vehicle occupants was low. Further research into reasons for the non-use of restraints needs to be conducted so that these can be incorporated into programmes aimed at improving seatbelt use.
Awareness and knowledge of birth defects among antenatal clinic attendees at thè University College Hospital, Ibadan, South-West, Nigeria
(West African College of Physicians and the West African College of Surgeons, 2021) Akinmoladun, J. A.; Uchendu, O. C.; Lawal, T. A.; Oluwasola, T. A. O.
BACKGROUND: The burden of birth defects is disproportionately higher in developing countries. OBJECTIVES: This study assessed the knowledge of risk factors and prevention of birth defects among ante-natal clinic attendees at the University College Hospital, Ibadan, Oyo State, Nigeria. METHODS: This was a cross-sectional study among 415 mothers who presented at the antenatal clinic. A semi-structured questionnaire was used to obtain information on respondents' socio-demographic profile, pregnancy, birth history, knowledge on prevention and risk factors for birth defects. Descriptive statistics was used to present results, independent t-test and ANOVA were used to determine the factors associated with mean of overall knowledge of birth defects. Test statistics was done at a 5% level of statistical significance. RESULTS: The mean age of the women was 31.7 ± 4.8 years. Overall, 93 (22.4%) of the women were above 35 years, 118 (29.9%) were skilled workers and 343 (84,9%) had tertiary education. More than half (219, 52.8%) of the respondents had good knowledge of birth defects (56.4% bad good knowledge of prevention and 66.0% had good knowledge of risk factors). Antenatal clinic attendees in their first trimester had higher. mean overall knowledge score (8.3 4.9) compared to those in second (7.9 4.5) and third (7.9 4.9) trimesters but this was not statistically significant (p=0.873). However, respondents in skilled semi-skilled occupation (8.62) had a significantly higher mean knowledge score compared with those in unskilled occupation/ unemployed (7.33) (p=0,005), CONCLUSION: Knowledge of birth defects is relatively low among women. To reduce the occurrence and severity of birth defects, there is a need to educate mothers on the knowledge, prevention and importance of screening for birth defects.
Awareness and utilization of female condoms among street youths in Ibadan, an urban setting in South-West Nigeria
(African Field Epidemiology Network, 2019) Uchendu, O. C.; Adeyera, O.; Owoaje, E. T.
Introduction: female condom awareness and use have been poorly documented in sub-Saharan region especially among street youths. This study assessed its awareness and use among street youths. Methods: a cross-sectional study was conducted among 964 youths between ages 15 to 24 years old using questionnaires to elicit information. Univariate and multivariate analysis were conducted at 5% level of significance. Results: more than half (69.9%) were males and between 20-25 years of age (61.2%). More than three-quarter (81.0%) had initiated sexual activity. Almost half (47.9%) of the respondents have heard about female condoms however only 16.8% have ever seen while 4.3% have actually ever used a female condom. Age, education, current sexual activity and experience of rape attempt were predictors of female condom awareness. Conclusion: awareness of female condom was a significant predictor of utilization of female condoms. There is therefore a need for proper awareness and education on the effectiveness of female condoms.
Clinical audit of antenatal service provision in Nigeria
(Taylor & Francis, 2011) Osungbade, K. O.; Shaahu, V. N.; Uchendu, O. C.
We audited records of 365 pregnant women whose mean age was 25.6 ± 5.6 years. Their mean gestational age at booking was 29.3 ± 2.7 weeks; their mean number of antenatal visits was 4.2 ± 2.3. Weight, blood pressure, and urine were checked on 97.3%, 95.1%, and 86.3% of the women respectively. Hemoglobin estimation was done on 19.2% of women; 34.8% received two doses of tetanus toxoid. Malaria prophylaxis and iron and folate supplements were provided to 263 (72.1%) and 293 (80.3%), respectively. Late booking was common, and antenatal service was inadequately equipped. Early booking and full implementation of preventive treatments are recommended. Support for detection of anaemia and immunization service is desirable.
Differences in the malariometric indices of asymptomatic carriers in three communities in Ibadan, Nigeria
(Hindawi Publishing Corporation, 2014) Amodu, O. K.; Olumide, A. O.; Uchendu, O. C.; Amodu, F. A.; Omotade, O. O.
This study was conducted to determine the malariometric indices of children in three different settings in Ibadan,Nigeria. Children were recruited from an urban slum (Oloomi) and a periurban (Sasa) and a rural community (Igbanda) in Ibadan. Children aged between 2 and 10 years were randomly selected from primary schools in the urban and periurban areas. In the rural community, children were recruited fromthe centre of the village. A total of 670 (55.0%) out of 1218 children recruited were positive formalaria parasitaemia.The urban population had the highest proportion of children with malaria parasitaemia. Splenomegaly was present in 31.5%, hepatomegaly in 41.5%, hepatosplenomegaly in 27.5%, and anaemia in 25.2% of the children.The parasite density was not significantly different among children in the three communities. Children in the rural community had the highest mean PCV of 34.2% and the lowest rates of splenomegaly (6.1%), hepatomegaly (7.6%), and hepatosplenomegaly (4.6%).The spleen rates, liver rates, and presence of hepatosplenomegaly and anaemia were similar in the urban and periurban communities.The malariometric indices among the asymptomatic carriers were high, especially in the urban slum. This stresses the need for intensified efforts at controlling the disease in the study area.
Differences in the malariometric indices of asymptomatic carriers in three communities in Ibadan, Nigeria
(Hindawi Publishing Corporation, 2014) Amodu, O. K.; Olumide, A. O.; Uchendu, O. C.; Amodu, F. A.; Omotade, O. O.
This study was conducted to determine the malariometric indices of children in three different settings in Ibadan,Nigeria. Children were recruited from an urban slum (Oloomi) and a periurban (Sasa) and a rural community (Igbanda) in Ibadan. Children aged between 2 and 10 years were randomly selected from primary schools in the urban and periurban areas. In the rural community, children were recruited fromthe centre of the village. A total of 670 (55.0%) out of 1218 children recruited were positive formalaria parasitaemia.The urban population had the highest proportion of children with malaria parasitaemia. Splenomegaly was present in 31.5%, hepatomegaly in 41.5%, hepatosplenomegaly in 27.5%, and anaemia in 25.2% of the children.The parasite density was not significantly different among children in the three communities. Children in the rural community had the highest mean PCV of 34.2% and the lowest rates of splenomegaly (6.1%), hepatomegaly (7.6%), and hepatosplenomegaly (4.6%).The spleen rates, liver rates, and presence of hepatosplenomegaly and anaemia were similar in the urban and periurban communities.The malariometric indices among the asymptomatic carriers were high, especially in the urban slum. This stresses the need for intensified efforts at controlling the disease in the study area.
Effect of training on knowledge and attitude to standard precaution among workers exposed to body fluids in a tertiary institution in south-west Nigeria
(Association of Resident Doctors (ARD), University College Hospital (UCH), Ibadan, Nigeria., 2020) Uchendu, O. C.; Desmenu, A. P.; Owoaje, E. T.
Introduction: Standard precaution in the workplace reduces the risk of occupational hazards among workers exposed to body fluids of humans and animals. Training on standard precaution has been recommended as a strategy to improve knowledge, attitude and compliance to these guidelines. This study therefore determine the effect of training on knowledge and attitude to standard precaution among workers exposed to body fluids of humans and animals in the University of Ibadan, South-west, Nigeria. Methods: This was an interventional study among workers exposed to body fluids of humans and animals. A total survey of all faculties where staff and student come in contact with human and animal body fluid was done. Selected staff were trained for two days on standard precaution. A self-administered questionnaire was used to obtain infor mation on socio-demographic information, knowledge and perception of staff on standard precaution. The maximum obtainable knowledge and attitude scores were 27 and 6 points respectively. The mean knowledge and attitude score were determined at pre- test and post-test. Frequency, proportion, mean and standard deviation were used for summary statistics and an independent t-test was performed to test for association. Statistical significance was set at 5%. Results: A total of 136 and 123 responses were obtained at pre-test and post- test respectively. A little over half of the respondents were females (51.5%) and below 40 years (54.4%). The mean knowledge score among the workers increased from 22.59 ± 3.4 at pre-test to 22.83 ± 3.2 at post-test, but it was not statistically significant. However, the mean post-test attitude score (5.10 ± 1.4) was significantly different from the pre-test attitude score (4.49 ± 1.5). Conclusion: Training improved the knowledge and attitude of workers exposed to body fluids of humans and animals working in the University of Ibadan on standard precaution. Periodic training on standard precaution is therefore recommended to sustain a proper attitude to standard precaution guidelines.
Evaluation of the Haemodynamic and Metabolic Effects of Local Anaesthetic Agent in Routine Dental Extractions
(Springer, 2013) Akinmoladun, V. I.; Okoje, V. N.; Akinosun, O. M.; Adisa, A. O.; Uchendu, O. C.
Introduction: The systemic effects of adrenaline adminisitered during dental local anesthesia have been the subject of many studies. The purpose of this study was to investigate the haemodynamic and metabolic effects attributable to adrenaline injected during local anesthesia in dental extraction patients. Methods Apparently medically fit patients were included and randomized into two groups. Participants had breakfast before coming in for tooth extraction. The weight, height, blood pressure and pulse rate were measured and blood sample taken before administration of local anaesthetic injections. Blood pressure, pulse and blood sample were again taken at 15 and 30 min. Results: While the adrenaline group showed a modest increase between pre- and post-drug administration states, the control group showed no difference in median systolic blood pressures. Both groups showed a slight increase in diastolic blood pressure observed between pre- and post drug administration states. Also both groups showed no significant difference in median pulse rate throughout. Although blood glucose values were widely dispersed in the pre-drug administration state in both groups, the control group showed no difference in median values throughout. However, a modest increase was observed in the adrenaline group between pre- and post-drug administration states, which persisted beyond 30 min. Conclusion: The patients treated with local anesthesia with adrenaline showed a response similar to that observed in the control group.
Experience of burden of care among adult caregivers of elderly persons in Oyo State, Nigeria: a cross-sectional study
(African Field Epidemiology Network, 2022) Ojifinni, O. O. M.; Uchendu, O. C.
Introduction: caring for elderly persons is challenging for caregivers due to elderly persons´ increased dependence and reduced physical strength. This study assessed the burden of care experienced by caregivers of elderly persons in family settings. Methods: this cross-sectional study used a multistage cluster sampling technique to select 1,119 caregivers of elderly persons aged 18-59 years from one rural and one urban local government area in Oyo State, Nigeria. Interviewer-administered questionnaires collected information on caregiving arrangements and burden of care experienced (determined using the modified short version of the Zarit Burden Interview). Results: caregivers´ mean age was 38.6 ± 8.7 years with 50.2% aged ≥40 years. There were more females (59.8%) than males (40.2%) and 78.4% were married. Only 47.8% were primary caregivers, 54% cared for their parents and 2% cared for non-relatives. Prior to their caregiving, 81% reported good relationships with the elderly. Although 80.3% of the elderly were reported to be fully independent for activities of daily living, 74.0% of the caregivers experienced burden of care with 28.2% reporting severe burden. The odds of burden of care were 10 times higher among rural than urban caregivers (OR=10.09, 95%CI=5.99-17.01); eight times higher among those with poor than those with good mental health status (OR=7.90, 95%CI=4.60-13.57) three times higher among those with dependent than independent elders (OR=2.74, 95%CI=1.68-4.47). Conclusion: experience of burden of care was high among caregivers in the rural area and those with poor mental health. Community-oriented support including daycare centres and old people´s homes will provide relief to caregivers.
Experiences of mistreatment among medical students in a University in South West Nigeria
(Nigerian Medical and Dental Consultants Association, 2012) Owoaje, E.T.; Uchendu, O. C.; Ige, O. K.
Objective: This study was conducted to assess the experiences of mistreatment and harassment among final-year clinical students in a Nigerian medical school. Materials and Methods: A self-administered questionnaire was used to obtain information on the various forms of mistreatment experienced by 269 students in the 2007 and 2008 graduating classes of a medical school in Nigeria. Results: Almost all the respondents (98.5%) had experienced one or more forms of mistreatment during their training. The commonest forms experienced by the students were being shouted at (92.6%), public humiliation or belittlement (87.4%), negative or disparaging remarks about their academic performance (71.4%), being assigned tasks as punishment (67.7%), and someone else taking credit for work done by the student (49.4%). Religious or age discrimination was reported by 34.2%, sexual harassment and other forms of gender-based mistreatment by 33.8%, and threats of harm by 26.4%. These incidents were mainly perpetrated by physicians and occurred mostly during surgical rotations. The effects included strained relationships with the perpetrators, reduced self-confidence and depression. Conclusion: Most medical students experienced verbal forms of mistreatment and abuse during their training. Appropriate strategies for the prevention and reduction of medical student mistreatment should be developed.
Factors influencing the choice of health care providing facility among workers in a local government secretariat in south western Nigeria
(Association of Resident Doctors (ARD), University College Hospital (UCH), Ibadan, Nigeria., 2013) Uchendu, O. C.; Ilesanmi, O. S.; Olumide, A. E.
Background: There is increasing interest in the choice of health care providing facility in Nigeria. Objectives: This study aimed to assess the factors influencing choice and satisfaction with health service providers among local government staff. Methods: A cross sectional survey of all 312 workers in a Local Government Secretariat in South West Nigeria was done. Chi Square and logistic regression analysis was done. Results: The mean age was 38.6 ± 7.5 years, 55% were females and 71.7% had tertiary education. The median monthly family income of the respondents was N 28, 000 (N3,000 – N500,000), with 24.4% earning a monthly income of N21, 000 to N30, 000. Many (72.3%) utilized public health facilities attributing the choice to the low cost of services. Respondents who are satisfied with their usual care providing facilities are 12.2 times more likely to have used public facilities than private facilities (95%, CI 3.431 – 43.114). Respondents who described the quality with ease of getting care/short waiting times as being good are 3.9 times more likely to have private facilities as their chosen health care providing facility (95%, CI 1.755 – 8.742). Cost/payment for service is 2.9 times more likely to predict the use of public health facility as the usual health care provider. Conclusion: Private facilities though costlier do not appear to be providing better services than public facilities. To increase access to health care the cost of services and the waiting time are important factors to address.
Falls and outcomes amongst old people in rural dwellings
(Association of Resident Doctors (ARD), University College Hospital (UCH), Ibadan, Nigeria., 2009) Adebiyi, A. O.; Uchendu, O. C.; Ikotun, O. T.; Oluleye, O. W.; Olukotun, O. P.
Background: Falls are the leading cause of injury deaths among people 65 years and older. This study gives an insight into the prevalence of falls among older people and how they occur in a rural setting in Nigeria. Methods: A community based survey of 210 consenting old people aged 65 years and above selected using a multi-stage sampling technique was done. Study instrument was a semi-structured interviewer administered questionnaire and visual acuity was tested using Snellens chart. Results: Incidence of falls was 21.4%. Of those who had falls, 86.7% were walking while 11.1% were either sitting or running when it occurred. The nature of the fall was tripping in 44.4%, slipping in 35.6% and hitting an object in 17.8% of cases. Consequences of falls included pain 48.9%, bruises 22.2%, lacerations 13.3% and fractures 11.1%. Females had more falls than males; 23.8% vs 19.0%, p = 0.40. Major injuries resulting from falls also occurred more frequently amongst females than males; 30.7% vs. 15.0%, p = 0.3. History of diabetes and alcohol use increased the odds of falling (OR 4.1, 95% CI 1.0 – 16.0; OR 2.2, 95% CI 1.0 – 4.6 respectively). Being in a monogamous marriage and having normal sight were protective of having falls (OR 0.4, 95% CI 0.2 – 0.9; OR 0.4, 95% CI 0.2 – 0.9 respectively). Conclusion: Falls often occur from tripping and slipping while females are more likely to have major injuries. Risk factors for falls were alcohol use and diabetes while having normal sight and being monogamous were protective. Prevention should aim at a life course approach to addressing these intrinsic and extrinsic factors.
Feeding practices and nutritional status of under-five children in a peri-urban setting in Ibadan, southwest Nigeria: a comparative cross-sectional study
(Association of Resident Doctors (ARD), University College Hospital (UCH), Ibadan, Nigeria., 2023-06) Bakare, A. A.; Uchendu, O. C.; Omotayo, O. E.; King, C.
Background: Existing literature suggests inequalities in nutritional and feeding practices for children in rural communities compared to their urban counterparts. However, with increasing urbanization and changing social norms, re-assessment of rural-urban differences in feeding practices for under-five children is essential. This study therefore aimed to assess the feeding practices and nutritional status of children in a peri-urban setting in Ibadan. Methods: We conducted a community-based cross-sectional comparative study in peri-urban LGA (Lagelu) in Ibadan. Participants were 617 caregivers of under five children identified, from wards typical of rural and urban settings, through a multistage sampling technique. Caregivers’ sociodemographic details, 24-hour dietary recall of the child’s feeding, and anthropometric measurements were obtained. Results: Nearly half of the children were 2 years or older (rural: n=142, 47.2%; urban: n=147, 46.2%). There was significant difference between settings in terms of maternal age and education, father’s education, caregiver’s occupation and socioeconomic status. In total, 611 children (99.0%) were breastfed. Of those breastfed, 45% and 39% in rural and urban settings respectively were initiated within an hour of delivery. Children in rural setting had longer duration of breast feeding. However, they are less likely to be exclusively breast fed for 6 – months compared with children whose caregivers are urban dwellers. Dietary diversity was similar in both settings but higher among males. (20.3% male, 11.7% female in rural; 17.3% male and 15.5% female in urban). Overall, 108 (22.3%), 107 (21.9%), 152 (30.6%) and 34 (7.0%) of children aged 6-59 months were cachetic, underweight, stunted, and overweight respectively but commoner among children in rural settings. Conclusion: Feeding and nutrition programmes need to apply a gender lens if sustained behavioural interventions on child nutrition are to reach equitable outcomes.
Indoor airborne microbial load of selected offices in a tertiary institution in South-Western Nigeria
(Science Publishing Group, 2018) Akindele, O. O.; Rowland, A. G.; Uchendu, O. C.; Fakunle, A. G.; Bello, T. B.
Indoor air quality (IAQ) has been identified by the Environmental Protection Agency (EPA) as one of the most urgent top five environmental risks to public health. Numerous studies have documented that sick building syndrome (SBS) is surprisingly common even in buildings without widespread complaints and its relationship with hypersensitivity disease are often associated with exposure to high concentration of airborne microbial organisms. To contribute to knowledge on IAQ, this study evaluates the levels and composition of bacterial and fungal contamination of different offices in a tertiary institution in South-western Nigeria. A cross sectional design was used to compare the indoor airborne microbial load of three categories of offices within the institution premises: the central administrative (CA), academic (AC) and work and maintenance (W&M) offices. Indoor temperature (ºC) and relative humidity (%) of the respective offices were measured using a 5-in-1 multi-tester N21FR made in China and categorized into comfort and high levels. Air samples were collected using a TE-10-890 Andersen single stage microbial air sampler and the total counts per cubic metre were compared with the American Industrial Hygiene Association guideline (AIHA). Data were analyzed using descriptive statistics, t-test, Spearman’s rank correlation and regression analysis. Offices in CA recorded the highest mean indoor Total Bacteria Count (TBC) of 22.6 ± 12.2cfu/m3 as compared to W&M (18.3 ± 10.4cfu/m3) and AC (15.6 ± 8.4cfu/m3) p<0.05. However, AC offices recorded the highest mean Total Fungi Count (TFC) of 3.6 ± 2.3cfu/m3 as compared to CA (3.5 ± 1.7cfu/m3) and W&M (3.3 ± 2.1cfu/m3) p>0.05. The indoor TBC and TFC of the categories of offices were found to be lower than the AIHA guideline limit. The number of persons at the point of sampling was found to significantly predict the level of indoor TBC, p<0.01. The most isolated bacteria were Staphylococcus spp., Streptococcus spp. and Micrococcus spp., whereas Cladosporium spp., Aspergillus spp. were the most abundant fungi isolates. The present study implicated population as a major source of microbial contamination in the office environment. Adequate knowledge about indoor air quality in terms of microbial contamination and its implication on health should be provided to staff of the institution in the hierarchy of control measures to mitigate the levels of indoor airborne microorganisms.
Integrated sustainable childhood Pneumonia and infectious disease reduction in Nigeria (INSPIRING) through whole system strengthening in Jigawa, Nigeria: study protocol for a cluster randomised controlled trial
(BioMed Central Ltd, 2022) King, C.; Burgess, R. A.; Bakare, A. A.; Shittu, F.; Salako, J.; Bakare, D.; Uchendu, O. C.; Iuliano, A.; Isah, A.; Adams, O.; Haruna, I.; Magama, A.; Ahmed, T.; Ahmar, S.; Cassar, C.; Valentine, P.; Olowookere, T. F.; MacCalla, M.; Graham, H. R.; McCollum, E. D.; Falade, A. G.; Colbourn, T.
Background: Child mortality remains unacceptably high, with Northern Nigeria reporting some of the highest rates globally (e.g. 192/1000 live births in Jigawa State). Coverage of key protect and prevent interventions, such as vaccination and clean cooking fuel use, is low. Additionally, knowledge, care-seeking and health system factors are poor. Therefore, a whole systems approach is needed for sustainable reductions in child mortality. Methods: This is a cluster randomised controlled trial, with integrated process and economic evaluations, conducted from January 2021 to September 2022. The trial will be conducted in Kiyawa Local Government Area, Jigawa State, Nigeria, with an estimated population of 230,000. Clusters are defined as primary government health facility catchment areas (n = 33). The 33 clusters will be randomly allocated (1:1) in a public ceremony, and 32 clusters included in the impact evaluation. The trial will evaluate a locally adapted ‘whole systems strengthening’ package of three evidence-based methods: community men’s and women’s groups, Partnership Defined Quality Scorecard and healthcare worker training, mentorship and provision of basic essential equipment and commodities. The primary outcome is mortality of children aged 7 days to 59 months. Mortality will be recorded prospectively using a cohort design, and secondary outcomes measured through baseline and endline cross-sectional surveys. Assuming the following, we will have a minimum detectable effect size of 30%: (a) baseline mortality of 100 per 1000 livebirths, (b) 4480 compounds with 3 eligible children per compound, (c) 80% power, (d) 5% significance, (e) intra-cluster correlation of 0.007 and (f) coefficient of variance of cluster size of 0.74. Analysis will be by intention-totreat, comparing intervention and control clusters, adjusting for compound and trial clustering. Discussion: This study will provide robust evidence of the effectiveness and cost-effectiveness of community-based participatory learning and action, with integrated health system strengthening and accountability mechanisms, to reduce child mortality. The ethnographic process evaluation will allow for a rich understanding of how the intervention works in this context. However, we encountered a key challenge in calculating the sample size, given the lack of timely and reliable mortality data and the uncertain impacts of the COVID-19 pandemic.
Measuring oxygen access: lessons from health facility assessments in Lagos, Nigeria
(BMJ Publishing Group Ltd, 2021) Graham, H. R.; Olojede, O. E.; Bakare, A. A.; Iuliano, A.; Olatunde, O.; Isah, A.; Osebi, A.; Ahmed, T.; Uchendu, O. C.; Burgess, R.; McCollum, E.; Colbourn, T.; King, C.; Falade, A. G.
The COVID-19 pandemic has highlighted global oxygen system deficiencies and revealed gaps in how we understand and measure ‘oxygen access’. We present a case study on oxygen access from 58 health facilities in Lagos state, Nigeria. We found large differences in oxygen access between facilities (primary vs secondary, government vs private) and describe three key domains to consider when measuring oxygen access: availability, cost, use. Of 58 facilities surveyed, 8 (14%) of facilities had a functional pulse oximeter. Oximeters (N=27) were typically located in outpatient clinics (12/27, 44%), paediatric ward (6/27, 22%) or operating theatre (4/27, 15%). 34/58 (59%) facilities had a functional source of oxygen available on the day of inspection, of which 31 (91%) facilities had it available in a single ward area, typically the operating theatre or maternity ward. Oxygen services were free to patients at primary health centres, when available, but expensive in hospitals and private facilities, with the median cost for 2 days oxygen 13 000 (US$36) and 27 500 (US$77) Naira, respectively. We obtained limited data on the cost of oxygen services to facilities. Pulse oximetry use was low in secondary care facilities (32%, 21/65 patients had SpO2 documented) and negligible in private facilities (2%, 3/177) and primary health centres (<1%, 2/608). We were unable to determine the proportion of hypoxaemic patients who received oxygen therapy with available data. However, triangulation of existing data suggested that no facilities were equipped to meet minimum oxygen demands. We highlight the importance of a multifaceted approach to measuring oxygen access that assesses access at the point-of- care and ideally at the patient-level. We propose standard metrics to report oxygen access and describe how these can be integrated into routine health information systems and existing health facility assessment tools.
Noise levels and hearing impairment in an urban community in Ibadan, Southwest Nigeria
(Oxford University Press, 2008) Omokhodion, F. O.; Ekanem, S. U.; Uchendu, O. C.
Aim The study sought to measure the noise levels in an urban community and assess the hearing levels of persons working within the community. Subjects and methods Noise levels were measured in selected locations in Ibadan, southwest Nigeria, using a sound level meter CEL 269 (CEL Instruments UK Ltd.). Measurements were done between the hours of 08:00 and 15:00. Audiometric screening was done on 51 persons working within the community to determine the occurrence of hearing impairment. Results The noisiest locations were workshops using machines such as saw mills, 95–102 dBA; carpentry tools, 87–101 dBA; printing presses, 85–88 dBA; and grain mills, 88–105 dBA. Music shops also constituted a nuisance with noise levels of 89–99 dBA. Roadside noise levels on major road junctions were 86–90 dBA and 61–65 dBA on side streets. Noise levels in designated markets ranged from 65– 69 dBA and 61–81 dBA in street markets. Within residential areas, noise levels ranged from 39–41 dBA in low-density areas to 55–59 dBA in high-density areas. Audiometric screening showed that 28 participants (55%) had normal hearing. Mild and moderate hearing impairment was recorded among 17(33%) and 6 (11.7%) participants, respectively. Of the 23 who were hearing impaired, 10 had bilateral impairment. The prevalence of hearing impairment increased with age from 14% in the 2nd decade to 75% in the 5th decade. Conclusion Noise levels in several areas of the city exceed WHO guideline values and constitute a public health hazard to residents and street workers. There is a need for regulation and control of the social and economic activities that generate noise. This may reduce the occurrence of hearing impairment and other adverse health outcomes in the general population.